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Severe fever with thrombocytopaenia syndrome virus (SFTSV) and Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause the hyperproduction of inflammatory cytokines, which have pathological effects in patient including severe or fatal cytokine storms. To characterize the effect of SFTSV and SARS-CoV-2 infection on the production of cytokines in SFTS and COVID-19 patients, we performed an analysis of cytokines in SFTS and COVID-19 patients and also investigated the role of IL-10 in vitro studies: LPS-induced THP-1-derived macrophages, SFTSV infection of THP-1 cells, and SARS-CoV-2 infection of THP-1 cells. In this study, we found that levels of both IL-10 and IL-6 were significantly elevated, the level of TGF-β was significantly decreased and IL-10 was elevated earlier than IL-6 in severe and critical COVID-19 and fatal SFTS patients, and inhibition of IL-10 signalling decreased the production of IL-6 and elevated that of TGF-β. Therefore, the hyperproduction of IL-10 and IL-6 and the low production of TGF-β have been linked to cytokine storm-induced mortality in fatal SFTS and severe and critically ill COVID-19 patients and that IL-10 can play an important role in the host immune response to severe and critical SARS-CoV-2 and fatal SFTSV infection.

Background Recently, bacterial extracellular vesicles (EVs) have been considered to play crucial roles in various biological processes and have great potential for developing cancer therapeutics and biomedicine. However, studies on bacterial EVs have mainly focused on outer membrane vesicles released from gram-negative bacteria since the outermost peptidoglycan layer in gram-positive bacteria is thought to preclude the release of EVs as a physical barrier. Results Here, we examined the ultrastructural organization of the EV produced by gram-positive bacteria using super-resolution stochastic optical reconstruction microscopy (STORM) at the nanoscale, which has not been resolved using conventional microscopy. Based on the super-resolution images of EVs, we propose three major mechanisms of EV biogenesis, i.e., membrane blebbing (mechanisms 1 and 2) or explosive cell lysis (mechanism 3), which are different from the mechanisms in gram-negative bacteria, despite some similarities. Conclusions These findings highlight the significant role of cell wall degradation in regulating various mechanisms of EV biogenesis and call for a reassessment of previously unresolved EV biogenesis in gram-positive bacteria.

Accumulating data have highlighted the role of monocytes/macrophages in immune escape by generating immunologically “cold” tumors that do not respond to immunotherapy. CD244 (SLAMF4, 2B4), a member of the signaling lymphocyte activation molecule family, is expressed on myeloid cells, but its precise role has not been elucidated. Using monocyte lineage-specific CD244-deficient (LysM-cre+/-CD244fl/fl;cKO) mice challenged with B16F10 melanoma, we report for the first time that CD244 negatively regulates tumor immunity by inhibiting the differentiation and functional maturation of CD11b+Ly6ChiF4/80lomonocytes into CD11b+Ly6CloF4/80himacrophages within the tumor microenvironment. CD244-deficient macrophages more effectively activated antigen-specific T cell responses compared to WT macrophages, thus delaying tumor growth in the B16F10 melanoma model. Moreover, combinatorial intervention of anti-PD-L1 antibodies with CD244-KO BMDM markedly improved tumor rejection compared to the anti-PD-L1 antibody alone or in combination with WT BMDM. Consistent with the murine data, transcriptome analysis of human melanoma tissue single-cell RNA-sequencing dataset (SCP398 from single-cell portal), revealed 221 differentially expressed genes of CD244-monocytes/macrophages were associated with phagocytosis, antigen presentation, and autophagy. Additionally, cell type deconvolution analysis within melanoma patients bulk RNA-seq datasets from TCGA database, revealed presence of CD244- monocytes/macrophages significantly increased patient survival in primary and metastatic tumors. Hence, we proposed that CD244 serve as a critical immune checkpoint receptor on macrophages, and CD244-deficient macrophages may represent a novel therapeutic modality to convert immunologically “cold” tumors to “hot” tumors, which can function synergistically with checkpoint blockade therapies.

With the rapid development of the nanofabrication of polymer materials, the local measurement of the chemical properties of polymer nanostructures has become crucial because they can be highly heterogeneous at the nanoscale. We developed a spectroscopic imaging approach to characterize the nanoscale local polarity of polymer films via spectrally resolved super-resolution microscopy. We demonstrate the capability of the recently developed single-molecule sensing and imaging method to probe the polarity of polymers either inside a polymer matrix or on the external surface of a polymer. The nanoscale polarity sensing capability of our method facilitates the differentiation of various polymer surfaces based on chemical polarities, and it can further differentiate the polarity of functional side chain groups. Moreover, we demonstrate that a two-component polymer mixture can be locally distinguished based on the contrasting polarities of the lateral phase separation, further allowing for the investigation of nanoscale phase separation depending on the composition of the polymer blend film. This approach is anticipated to open the door to further characterizations of various nanocomposite materials.

Nucleic acid aptamer-based research has focused on achieving the highest performance for bioassays. However, there are limitations in evaluating the affinity for the target analytes in these nucleic acid aptamer-based bioassays. In this study, we mainly propose graphene oxide (GO)-based electrical and optical analyses to efficiently evaluate the affinity between an aptamer and its target. We found that an aptamer-coupled GO-based chip with an electrical resistance induced by a field-effect transistor, with aptamers as low as 100 pM, can detect the target, thrombin, at yields as low as 250 pM within five minutes. In the optical approach, the fluorescent dye-linked aptamer, as low as 100 nM, was efficiently used with GO, enabling the sensitive detection of thrombin at yields as low as 5 nM. The cantilever type of mechanical analysis also demonstrated the intuitive aptamer–thrombin reaction in the signal using dBm units. Finally, a comparison of electrical and optical sensors’ characteristics was introduced in the attachment and detachment of aptamer to propose an efficient analysis that can be utilized for various aptamer-based research fields.

Applying an electric-field (

Researchers are interested in measuring mental stress because it is linked to a variety of diseases. Real-time stress monitoring via wearable sensor systems can aid in the prevention of stress-related diseases by allowing stressors to be controlled immediately. Physical tests, such as heart rate or skin conductance, have recently been used to assess stress; however, these methods are easily influenced by daily life activities. As a result, for more accurate stress monitoring, validations requiring two or more stress-related biomarkers are demanded. In this review, the combinations of various types of sensors (hereafter referred to as multiplexed sensor systems) that can be applied to monitor stress are discussed, referring to physical and chemical biomarkers. Multiplexed sensor systems are classified as multiplexed physical sensors, multiplexed physical–chemical sensors, and multiplexed chemical sensors, with the effect of measuring multiple biomarkers and the ability to measure stress being the most important. The working principles of multiplexed sensor systems are subdivided, with advantages in measuring multiple biomarkers. Furthermore, stress-related chemical biomarkers are still limited to cortisol; however, we believe that by developing multiplexed sensor systems, it will be possible to explore new stress-related chemical biomarkers by confirming their correlations to cortisol. As a result, the potential for further development of multiplexed sensor systems, such as the development of wearable electronics for mental health management, is highlighted in this review.

This study presents an automatic method for estimating antenatal amniotic fluid (AF) volume from two-dimensional ultrasound (US) images, which is an important indicator of fetal well-being. This automatic estimation of AF volume (AFV) requires automated segmentation of the AF pocket, which is a challenging task due to its amorphous features and US artifacts, such as reverberation, shadowing, particle noise, and signal dropout. Recently, AF-net, a deep-learning method, has been shown to successfully perform AF pocket segmentation. However, we observed that AF-net is prone to misjudging AF pockets containing severe reverberation artifacts. The proposed method addresses this problem by developing a dual path network, which consists of AF-net as the primary path and an auxiliary network as the secondary path. The auxiliary network is designed to focus on the local area that is likely to be contaminated with the reverberation artifacts. It infers this local region and generates a feature map of the artifacts, incorporating it as prior information into a deep neural network, denoted as RVB-net, for segmenting the reverberation-artifact-contaminated AF region. Finally, the segmentation output from the auxiliary network complements the AF-net. Experimental results show that the proposed dual path network effectively reduces misjudgment of the AF pocket caused by severe reverberation artifacts. The proposed dual path network achieved an average Dice similarity coefficient (DSC) of 0.8599 ± 0.1074 (mean ± standard deviation) for AF pocket segmentation on the entire evaluation set.

국내 수학교육 연구는 1960년대 이후 현재까지 주목할 만한 양적인 성장과 더불어 질적인 성장을 이루었다. 이러한 시점에서 우리나라에서 수학교육 저널이 처음 발간된 1963년부터 현재까지 50년 남짓 7개의 국내 전문 학술지에 게재된 논문을 분석하여 그간의 연구 성과를 종합적으로 검토하였다. 구체적으로 총 4559편의 논문을 연구시기, 연구주제, 연구방법, 연구대상 측면에서 면밀히 분석하였다. 그 결과, 국내 수학교육 연구는 1990년대부터 급격하게 증가하기 시작하였으며 현재까지 꾸준히 많은 연구가 진행되고 있다. 연구주제 측면에서 국내 수학교육 연구는 수업 및 지도 방안, 학습자의 인지적ㆍ정의적 특성 및 능력 등의 연구가 가장 많이 연구된 반면에 교육공학 및 교구, 평가에 대한 연구는 별반 연구되지 않았다. 연구방법의 측면에서 국내 수학교육 연구는 분석연구, 사례연구, 조사연구의 비중이 높은 편이었고, 연구대상의 측면에서는 초등학생, 중등학생을 대상으로 한 연구의 비중이 높은 편이었다. 이러한 결과를 토대로 국내 수학교육 연구의 향후 발전 방향과 후속 연구에 대해 시사점을 논의하였다.

With the rapid increase in automobiles, the importance of reducing low-frequency noise is being emphasized for a comfortable urban environment. Helmholtz resonators are widely used to attenuate low-frequency noise over a narrow range. In this study, a slit-type soundproof panel is designed to achieve low-frequency noise attenuation in the range of 500 Hz to 1000 Hz with the characteristics of a Helmholtz resonator and the ability to pass air through the slits on the panel surface for reducing wind load. The basic dimension of the soundproof panel is determined using the classical formula and numerical analysis using a commercial program, COMSOL Multiphysics, for transmission loss prediction. From the numerical study, it is identified that the transmission loss performance is improved compared to the basic design according to the shape change and configuration method of the Helmholtz resonator. Although the correlation according to the shape change and configuration method cannot be derived, it is confirmed that it can be used as an effective method for deriving a soundproof panel design that satisfies the basic performance.

To overcome the hurdles of immunotherapy, we investigated whether calcipotriol, a synthetic vitamin D analog, could overcome the immune evasion of glioblastoma multiforme (GBM) by modulating immune responses and the immunosuppressive tumor microenvironment. Administration of calcipotriol considerably reduced tumor growth. Both in vivo and in vitro studies revealed that CD8+T and natural killer (NK) cell gene signatures were enriched and activated, producing high levels of IFN-γ and granzyme B. In contrast, regulatory T cells (Treg) were significantly reduced in the calcipotriol-treated group. The expression of CD127, the receptor for thymic stromal lymphopoietin (TSLP), is elevated in CD4+T cells and potentially supports T-cell priming. Depleting CD4+T cells, but not NK or CD8+T cells, completely abrogated the antitumor efficacy of calcipotriol. These data highlight that the calcipotriol/TSLP/CD4+T axis can activate CD8+T and NK cells with a concomitant reduction in the number of Tregs in GBM. Therefore, calcipotriol can be a novel therapeutic modality to overcome the immune resistance of GBM by converting immunologically "cold" tumors into "hot" tumors. DATA AVAILABILITY: Data are available upon reasonable request. The RNA-seq dataset comparing the transcriptomes of control and calcipotriol-treated GL261 tumors is available from the corresponding author upon request.

Objectives Individuals delivered from preeclamptic pregnancies exhibit a long-term increased risk of developing cardiovascular and metabolic diseases, likely caused by aberrant fetal cell reprogramming incurred in utero. The present study investigated the functional impairment and epigenetic changes exhibited by endothelial progenitor cells derived from offspring born to preeclamptic pregnancies. Study design The capacity of CD133+/C-kit+/Lin− (CKL−) human umbilical cord blood endothelial progenitor cells (EPCs) derived from gestationally matched normal and preeclamptic (n = 10 each) pregnancies to differentiate to form outgrowth endothelial cells (OECs) was assessed by observing both their morphology, and the number and size of generated OECs colonies. Likewise, OECs angiogenic function was evaluated via migration, adhesion, and tube-formation assays. EPCs from preeclampsia were cultured in normal-, and preeclampsia-derived serum-conditioned media to assess the effects of environmental factors on EPC differentiation potency and OEC angiogenic function, and finally, EPCs H3K4, H3K9, and H3K27 trimethylation levels were assayed. Results The preeclampsia-derived CKL− EPCs exhibited decreased H3K4 and H3K9 trimethylation levels, significantly delayed differentiation times, and a significant reduction in both their number of generated OECs colonies, and exhibited reduced OECs migration, adhesion, and tube formation activities compared to those achieved by the normal-derived EPCs. Interestingly, the reduced differentiation potency of the preeclampsia-derived EPCs was not rescued via exposure to normal serum. Conclusions Exposure to preeclampsia significantly and irreversibly reduced CKL− EPC differentiation potency and OEC angiogenic function, likely reflecting incurred irreversible epigenetic changes.

본 연구에서는 13명의 교사들을 대상으로 초점 집단 면담(Focus Group Interview)을 실시하여 서술형 평가의 의미, 서술형 평가 시행의 난점, 서술형 평가 결과의 활용 등에 대한 교사들의 인식을 조사하고, 이를 토대로 서술형 평가의 활성화를 위한 지원 방안과 지능정보도구의 활용 방안을 탐색하였다. 본 연구의 결과로서, 서술형 평가의 명확한 의미 규정, 예시답안, 채점기준, 피드백 제시 방식 등이 종합적으로 수록된 문제은행의 구축, 다양한 층위의 서술형 문항을 지도할 수 있는 수업 환경 구축 및 교과서 구성, 교사의 서술형 평가 전문성 개발 프로그램 실시 및 대학수학능력시험의 서술형 문항으로의 전환 등을 지원 방안으로 제안하였다. 또한 미래 시대에 더욱 활성화될 것으로 예측되는 지능정보도구의 활용 방식을 서술형 문항의 선별 및 개발, 채점, 피드백 제공 등으로 제안하였다.

Intercellular interaction is the most crucial factor in promoting cell viability and functionality in an engineered tissue system. Of the various shapes available for cell-laden constructs, spheroidal multicellular microarchitectures (SMMs) have been introduced as building blocks and injectable cell carriers with substantial cell-cell and cell-extracellular matrix (ECM) interactions. Here, we developed a precise and expeditious SMM printing method that can create a tissue-specific microenvironment and thus be potentially useful for cell therapy. This printing strategy is designed to manufacture SMMs fabricated with optimal bioink blended with decellularized ECM and alginate to enhance the functional performance of the encapsulated cells. Experimental results showed that the proposed method allowed for size controllability and mass production of SMMs with high cell viability. Moreover, SMMs co-cultured with endothelial cells promoted lineage-specific maturation and increased functionality compared to monocultured SMMs. Overall, it was concluded that SMMs have the potential for use in cell therapy due to their high cell retention and proliferation rate compared to single-cell injection, particularly for efficient tissue regeneration after myocardial infarction. This study suggests that utilizing microextrusion-based 3D bioprinting technology to encapsulate cells in cell-niche-standardized SMMs can expand the range of possible applications.

Previous studies demonstrated an association between cervical strain and risk of spontaneous preterm delivery (sPTD). The present study aimed to assess the efficacy of elastography in predicting sPTD at &lt, 32 weeks of gestation in women with singleton pregnancies receiving progesterone for short cervix (≤2.5 cm) diagnosed between 16 and 28 weeks of gestation Among 115 participants eligible for analysis, nine had sPTD at &lt, 32 weeks. Preprogesterone (PP0) mean internal os strain (IOS), elasticity contrast index (ECI), hardness ratio (HR), one-week postprogesterone (PP1) IOS, mean external os strain (EOS), ECI, and HR were significantly different between groups. Higher PP0 IOS, PP1 IOS, and PP1 EOS were associated with a 2.92, 4.39 and 3.65-fold increase in the risk of sPTD at &lt, 32 weeks, respectively (adjusted for cervical length (CL) at diagnosis, p = 0.04, 0.012 and 0.026, respectively). A combination of CL at diagnosis, PP0 IOS and PP1 EOS showed a significantly higher area under the receiver operating characteristic curve (0.858) than that of CL alone (p = 0.041). In women with singleton pregnancies receiving progesterone for short cervix, cervical elastography performed before and one week after progesterone treatment may be useful in predicting sPTD at &lt, 32 weeks of gestation.

Inflammation is an important part of human response to pathogen to recruit immune cells and remove infected or damaged cells from the system. However, immune response should be fine tuned as uncontrolled proinflammatory response leads to extensive tissue damage and organ failure. Immune homeostasis at the maternal-fetal interface is crucial in the maintenance of healthy pregnancy. TAM receptor tyrosine kinase is known to be present in immune, nervous, and reproductive systems and has been reported to have biological function in the immunological aspect including cell debris clearance, cytokine secretion modulation, and regulation of innate immunity. The presence of TAM receptors at the maternal-fetal interface has been reported and its role in pregnancy has been in question. In the present review, functional aspects of TAM receptors, clinical implications in other diseases in an immunological context, and what is known about association of TAM receptors in complicated pregnancy are discussed with suggestion of potential area of future research.

Recent advances in canine intestinal organoids have expanded the option for building a better in vitro model to investigate translational science of intestinal physiology and pathology between humans and animals. However, the three-dimensional geometry and the enclosed lumen of canine intestinal organoids considerably hinder the access to the apical side of epithelium for investigating the nutrient and drug absorption, host-microbiome crosstalk, and pharmaceutical toxicity testing. Thus, the creation of a polarized epithelial interface accessible from apical or basolateral side is critical. Here, we demonstrated the generation of an intestinal epithelial monolayer using canine biopsy-derived colonic organoids (colonoids). We optimized the culture condition to form an intact monolayer of the canine colonic epithelium on a nanoporous membrane insert using the canine colonoids over 14 days. Transmission and scanning electron microscopy revealed a physiological brush border interface covered by the microvilli with glycocalyx, as well as the presence of mucin granules, tight junctions, and desmosomes. The population of stem cells as well as differentiated lineage-dependent epithelial cells were verified by immunofluorescence staining and RNA in situ hybridization. The polarized expression of P-glycoprotein efflux pump was confirmed at the apical membrane. Also, the epithelial monolayer formed tight- and adherence-junctional barrier within 4 days, where the transepithelial electrical resistance and apparent permeability were inversely correlated. Hence, we verified the stable creation, maintenance, differentiation, and physiological function of a canine intestinal epithelial barrier, which can be useful for pharmaceutical and biomedical researches.

Tremendous advances have been made toward accurate recapitulation of the human intestinal system in vitro to understand its developmental process, and disease progression. However, current in vitro models are often confined to 2D or 2.5D microarchitectures, which is difficult to mimic the systemic level of complexity of the native tissue. To overcome this problem, we develop physiologically relevant intestinal models with a 3D hollow tubular structure using 3D bioprinting strategy. A tissue-specific biomaterial, colon-derived decellularized extracellular matrix (Colon dECM) has been developed and it provides significant maturation-guiding potential to human intestinal cells. To fabricate a perfusable tubular model, we develop a simultaneous printing process of multiple materials through concentrically assembled nozzles and employ a light-activated Colon dECM bioink by supplementing with ruthenium/sodium persulfate as a photoinitiator. The bioprinted intestinal tissue models show spontaneous 3D morphogenesis of the human intestinal epithelium without any external stimuli. In consequence, the printed cells form multicellular aggregates and cysts and then differentiate into several types of enterocytes, building junctional networks. This system can serve as a platform to evaluate the effects of potential drug-induced toxicity on the human intestinal tissue and create a co-culture model with commensal microbes and immune cells for future therapeutics. This article is protected by copyright. All rights reserved.

Given that systems based on artificial intelligence (AI) technologies now match or surpass human levels, more firms are adopting these technologies to gain a competitive advantage. However, the lit...

Purpose The purpose of this paper is to examine how clarity of corporate social responsibility (CSR) orientation of Japanese small and medium enterprises (SMEs) achieves constructive firm performance outcomes. Design/methodology/approach On the basis of the literature review, the authors present a research model that defines key constructs and provide propositions that explain the interrelationships with theoretical rationale and practical implications. Using careful selection criteria, the authors have further conducted the in-depth interviews of the executives of two prominent Japanese SMEs. Findings The results suggest that CEOs with strong CSR orientation are more likely to influence their firms to achieve effective firm performance. If CSR philosophy is strategically formulated, clearly communicated, and widely accepted, then such firm is more likely to attain desirable business performance outcomes for larger stakeholders. Furthermore, CSR implementation of SMEs is not necessarily too costly; in fact, the long-term rate of return on SMEs’ CSR investment, with proper priority and prudent focus, is quite competitive. Research limitations/implications In spite of the specificity of the two case studies, the research model and the study findings give valuable insight on the role of CEO’s philosophy on CSR implementation in the international market. The linkage mechanism between business operation and CSR by these SMEs is applicable to many innovative entrepreneurial firms that target beyond domestic markets. Originality/value The authors highlight how the clarity of CSR philosophy in terms of firm orientation and linkage mechanism aids SMEs in overcoming their resource constraints. Furthermore, well-implemented CSR activities may become instrumental in achieving long-term desirable performance in the form of customer loyalty, employee’s sense of pride, and corporate socio-economic reputation.

Solution-based direct patterning on an elastomer substrate with meniscus-dragging deposition (MDD) enables fabrication of very thin carbon nanotube (CNT) layers in the nanometer scale (80&ndash, 330 nm). To fabricate the CNT pattern with CNT solution, contact angle, electrical variation, mechanical stress, and surface cracks of elastomer substrate were analyzed to identify the optimal conditions of O2 treatment (treatment for 30 s with RF power of 50 W in O2 atmosphere of 50 sccm) and mixture ratio between Ecoflex and polydimethylsiloxane (PDMS) (Ecoflex:PDMS = 5:1). The type of mask for patterning of the CNT layer was determined through quantitative analysis for sharpness and uniformity of the fabricated CNT pattern. Through these optimization processes, the CNT pattern was produced on the elastomer substrate with selected mask (30 &mu, m thick oriented polypropylene). The thickness of CNT pattern was also controlled to have hundreds nanometer and 500 &mu, m wide rectangular and circular shapes were demonstrated. Furthermore, the change in the current and resistance of the CNT layer according to the applied strain on the elastomer substrate was analyzed. Our results demonstrated the potential of the MDD method for direct CNT patterning with high uniformity and the possibility to fabricate a stretchable sensor.

Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortality. Due to the lack of effective preventive measures, its prediction is essential to its prompt management. This study aimed to develop models using machine learning to predict late-onset preeclampsia using hospital electronic medical record data. The performance of the machine learning based models and models using conventional statistical methods were also compared. A total of 11,006 pregnant women who received antenatal care at Yonsei University Hospital were included. Maternal data were retrieved from electronic medical records during the early second trimester to 34 weeks. The prediction outcome was late-onset preeclampsia occurrence after 34 weeks' gestation. Pattern recognition and cluster analysis were used to select the parameters included in the prediction models. Logistic regression, decision tree model, naive Bayes classification, support vector machine, random forest algorithm, and stochastic gradient boosting method were used to construct the prediction models. C-statistics was used to assess the performance of each model. The overall preeclampsia development rate was 4.7% (474 patients). Systolic blood pressure, serum blood urea nitrogen and creatinine levels, platelet counts, serum potassium level, white blood cell count, serum calcium level, and urinary protein were the most influential variables included in the prediction models. C-statistics for the decision tree model, naive Bayes classification, support vector machine, random forest algorithm, stochastic gradient boosting method, and logistic regression models were 0.857, 0.776, 0.573, 0.894, 0.924, and 0.806, respectively. The stochastic gradient boosting model had the best prediction performance with an accuracy and false positive rate of 0.973 and 0.009, respectively. The combined use of maternal factors and common antenatal laboratory data of the early second trimester through early third trimester could effectively predict late-onset preeclampsia using machine learning algorithms. Future prospective studies are needed to verify the clinical applicability algorithms.

The estimation of antenatal amniotic fluid (AF) volume (AFV) is important as it offers crucial information about fetal development, fetal well-being, and perinatal prognosis. However, AFV measurement is cumbersome and patient specific. Moreover, it is heavily sonographer-dependent, with measurement accuracy varying greatly depending on the sonographer's experience. Therefore, the development of accurate, robust, and adoptable methods to evaluate AFV is highly desirable. In this regard, automation is expected to reduce user-based variability and workload of sonographers. However, automating AFV measurement is very challenging, because accurate detection of AF pockets is difficult owing to various confusing factors, such as reverberation artifact, AF mimicking region and floating matter. Furthermore, AF pocket exhibits an unspecified variety of shapes and sizes, and ultrasound images often show missing or incomplete structural boundaries. To overcome the abovementioned difficulties, we develop a hierarchical deep-learning-based method, which consider clinicians' anatomical-knowledge-based approaches. The key step is the segmentation of the AF pocket using our proposed deep learning network, AF-net. AF-net is a variation of U-net combined with three complementary concepts - atrous convolution, multi-scale side-input layer, and side-output layer. The experimental results demonstrate that the proposed method provides a measurement of the amniotic fluid index (AFI) that is as robust and precise as the results from clinicians. The proposed method achieved a Dice similarity of 0.877±0.086 for AF segmentation and achieved a mean absolute error of 2.666±2.986 and mean relative error of 0.018±0.023 for AFI value. To the best of our knowledge, our method, for the first time, provides an automated measurement of AFI.

Objective: Staphylococcal scalded skin syndrome (SSSS) is a relatively rare superficial blistering skin disease caused by exfoliating toxins produced by Staphylococcus aureus. We experienced a 3-month outbreak of neonatal SSSS in a maternal unit. Methods: The medical records of newborns who were diagnosed with SSSS were retrospectively reviewed. Results: Eleven newborns with SSSS were transferred to our hospital between January and March 2019. The median age of the newborns was 18.0 (11.0-22.5) days. Of the 11 newborns, 2 (18%) showed the generalized type of SSSS, 4 (36%) the intermediate type, and 5 (45%) the abortive type. S. aureus was isolated in 10 of the newborns and found to be methicillin-resistant in 9 cases. All the newborns were treated with intravenous cefazolin, and two newborns with the generalized type were also treated with clindamycin. The median duration of antibiotic use is 8 (6-14) days. All the newborns responded well to antibiotics and were discharged without complications. Conclusion: We recently experienced an outbreak of neonatal SSSS. To manage problems associated with such an outbreak, periodic monitoring is required, along with guidelines for infection control, such as thorough infection education, isolation of infected newborns, and antiseptic handwashing.

Since separation of target biomolecules is a crucial step for highly sensitive and selective detection of biomolecules, hence, various technologies have been applied to separate biomolecules, such as deoxyribonucleic acid (DNA), protein, exosome, virus, etc. Among the various technologies, dielectrophoresis (DEP) has the significant advantage that the force can provide two different types of forces, attractive and repulsive DEP force, through simple adjustment in frequency or structure of microfluidic chips. Therefore, in this review, we focused on separation technologies based on DEP force and classified various separation technologies. First, the importance of biomolecules, general separation methods and various forces including DEP, electrophoresis (EP), electrothermal flow (ETF), electroosmosis (EO), magnetophoresis, acoustophoresis (ACP), hydrodynamic, etc., was described. Then, separating technologies applying only a single DEP force and dual force, moreover, applying other forces simultaneously with DEP force were categorized. In addition, advanced technologies applying more than two different kinds of forces, namely complex force, were introduced. Overall, we critically reviewed the state-of-the-art of converged various forces for detection of biomolecules with novelty of DEP.

Ultrasound-based fetal biometric measurements, such as head circumference (HC) and biparietal diameter (BPD), are commonly used to evaluate the gestational age and diagnose fetal central nervous system (CNS) pathology. Since manual measurements are operator-dependent and time-consuming, there have been numerous researches on automated methods. However, existing automated methods still are not satisfactory in terms of accuracy and reliability, owing to difficulties in dealing with various artifacts in ultrasound images. This paper focuses on fetal head biometry and develops a deep-learning-based method for estimating HC and BPD with a high degree of accuracy and reliability. The proposed method effectively identifies the head boundary by differentiating tissue image patterns with respect to the ultrasound propagation direction. The proposed method was trained with 102 labeled data set and tested to 70 ultrasound images. We achieved a success rate of 92.31% for HC and BPD estimations, and an accuracy of 87.14 % for the plane acceptance check.

Individuals delivered from preeclamptic pregnancies exhibit a long-term increased risk of developing cardiovascular and metabolic diseases, likely caused by aberrant fetal cell reprogramming incurred in utero. The present study investigated the functional impairment and epigenetic changes exhibited by endothelial progenitor cells derived from offspring born to preeclamptic pregnancies.The capacity of CD133The preeclampsia-derived CKLExposure to preeclampsia significantly and irreversibly reduced CKL

Objective In this study, we evaluated the prevalence of allergic disease in offsprings delivered via the delivery modes of vaginal delivery vs. planned Cesarean section vs. Cesarean section with labor. Methods This study included 175 mother-neonate pairs from Severance Hospital who were enrolled in the Cohort for Childhood Origin of Asthma and allergic diseases study. Information regarding prenatal environmental factors, delivery, and diagnosis of allergic diseases was obtained from a questionnaire and medical record review. Patients with at least 3 years of follow-up data were included in this study. Results were adjusted for sex, birth weight, gestational age at birth, season of birth, neonatal intensive care unit admission, parity, breastfeeding, and maternal factors. Results A total of 175 offsprings were eligible for analysis. Among the subjects, 52.0% were delivered by vaginal delivery, 34.3% by planned Cesarean section, and 16.6% by Cesarean section with labor. Fifty-nine offsprings (33.7%) were diagnosed with allergic disease at a median age of 1 year (range 0.5-3 years). The prevalence of allergic disease was not associated with delivery mode after adjusting for confounding variables. Time period from membrane rupture to delivery, duration of the active phase, and the beginning of the pelvic division prior to Cesarean section were not associated with allergic disease development in offsprings. Conclusion Cesarean section, irrespective of the occurrence of labor before surgery, did not increase the prevalence of allergic disease in infants up to 3 years of age.

Problem The lymphatic vasculature controls leukocytes trafficking and limits the adaptive immune response. In previous models of preeclampsia (PE), defective immune function caused by disruption of lymphangiogenesis was shown to be involved in the disease pathophysiology. Especially, the dysfunction of regulatory T cells (Treg) at the maternal-fetal interface may be one of the causes of severe PE. In particular, activation of Tregs to obtain immune tolerance requires adequate antigen presentation through the lymphatic system. We hypothesized that impaired lymphangiogenesis and imbalanced Tregs at the maternal-fetal interface are associated with the pathophysiology of severe PE. However, the current research addressing this hypothesis is limited. Therefore, to compare differences in lymphangiogenesis in severe PE and normal conditions, we aimed to examine the location of lymphatics at the maternal-fetal interface and to investigate the association between lymphangiogenesis and Tregs in severe PE. Method of study We obtained entire uterus from normal pregnant mice. Placental and fetal membranes, including decidua, were obtained from 10 pregnant women with severe PE and 10 gestational age-matched controls. Immunohistochemistry for LYVE1 was used to localize the distribution of lymphatic vessels and CD4, CD25, and FOXP3 for Treg. Results LYVE1-positive vessels were present in the uterine wall of mice. LYVE1-positive lymphatic vessels were localized on the human decidua. Tubular lymphatics were abundant in the control decidua, but significantly reduced in severe PE. Furthermore, lymphatic vessel density correlated with the number of decidual Tregs. Conclusion Abnormal decidual lymphangiogenesis is associated with reduced numbers of decidual Tregs in severe PE.

Background Multiple studies have been reported regarding preeclampsia as a possible risk factor of cerebrovascular disease (CVD). However, the correlation of preeclampsia and CVD, whether it is a cause-effect relationship or they are sharing common predisposing condition, is not well understood. Therefore, the aim of this study was to investigate the association between the preeclampsia during pregnancy and development of postpartum CVD. Methods A total of 1,384,550 Korean women who had a delivery between January 1, 2010 and December 31, 2012, were enrolled. Women with the risk of CVD within 1 year prior to pregnancy were excluded based on the Charlson comorbidity index. Primary endpoint was the event of CVD within a year from delivery. After exclusion, 1,075,061 women were analyzed. Results During the follow-up of 1 year postpartum, there were 25,577 preeclampsia out of 1,072,041 women without postpartum CVD (2.39%), and 121 of 3,020 women with postpartum CVD had preeclampsia before delivery (4.01%). In multivariate logistic regression analysis, women who had preeclampsia during pregnancy showed a higher risk for postpartum CVD (odds ratio, 1.64; 95% confidence interval, 1.37–1.98). Conclusion The incidence of CVD after delivery was higher in women who had preeclampsia during pregnancy., Graphical Abstract