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Abstract Patients with diabetes mellitus (DM) are at a higher risk of infectious diseases, and exercise is an important treatment modality for DM. Despite their susceptibility to infection in diabetic patients, the association between the amount of physical activity and the incidence of infective endocarditis (IE) is unclear. We attempted to demonstrate risk reduction by physical activity in diabetic patients with IE. From the National Health Insurance database, patients with DM were verified, and the incidence of IE was investigated. The level of physical activity was categorized into

Abstract Background The demand for organ transplants, both globally and in South Korea, substantially exceeds the supply, a situation that might have been aggravated by the enactment of the Life-Sustaining Treatment Decision Act (LSTDA) in February 2018. This legislation may influence emergency medical procedures and the availability of organs from brain-dead donors. This study aimed to assess LSTDA’s impact, introduced in February 2018, on organ donation status in out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city and identified related factors. Methods We conducted a retrospective analysis of a regional cardiac arrest registry. This study included patients aged 16 or older with cardiac arrest and a cerebral performance category (CPC) score of 5 from January 2015 to December 2022. The exclusion criteria were CPC scores of 1–4, patients under 16 years, and patients declared dead or transferred from emergency departments. Logistic regression analysis was used to analyse factors affecting organ donation. Results Of the 751 patients included in this study, 47 were organ donors, with a median age of 47 years. Before the LSTDA, there were 30 organ donations, which declined to 17 after its implementation. In the organ donation group, the causes of cardiac arrest included medical (34%), hanging (46.8%), and trauma (19.2%). The adjusted odds ratio for organ donation before the LSTDA implementation was 6.12 (95% CI 3.09–12.12), with non-medical aetiology as associated factors. Conclusion The enactment of the LSTDA in 2018 in South Korea may be linked to reduced organ donations among patients with OHCA, underscoring the need to re-evaluate the medical and legal aspects of organ donation, especially considering end-of-life care decisions.

Background: We identified the uptake of people living with HIV (PLWH) using health-screening services and compared the screening rate with the general population, to identify factors associated with the use of screening services by PLWH. Methods: This population-based study used data from the Korean National Health Insurance, a single mandatory health insurance system covering all residents. The uptake rates for screening for general health, gastric cancer, and colorectal cancer, which were provided by a national health screening program with free of charge or minimal cost in Korea from 2010–2020. Factors associated with general health, gastric cancer, and colorectal cancer screening were also explored. Results: Screening uptake rates for general health, gastric cancer, and colorectal cancer in PLWH increased from 2010–2019 but decreased in 2020. The standardized screening ratio showed lower screening rates for general health, gastric cancer, and colorectal cancer in PLWH with 0.80 (95 % confidence interval (CI) = 0.77–0.83), 0.64 (95 % CI = 0.61–0.67), and 0.67 (95 % CI = 0.64–0.71) in 2019. Increased age, Charlson Comorbidity Index, and years since HIV diagnosis were associated with increased screening uptake in PLWH. Otherwise, PLWH recipients of medical aid programs received less for each screening compared to PLWH who paid insurance premiums higher than 50 %. An increased medication possession ratio of highly active antiretroviral therapy was associated with decreased general health and gastric cancer screening uptake but increased colorectal cancer screening uptake. Conclusions: Significant disparities in health-screening uptake were observed in PLWH compared to the general population in a nationwide organized screening setting without cost barriers.

Abstract Lithium‐sulfur batteries (LSBs) have garnered attention from both academia and industry because they can achieve high energy densities (>400 Wh kg–1), which are difficult to achieve in commercially available lithium‐ion batteries. As a preparation step for practically utilizing LSBs, there is a problem, wherein battery cycle life rapidly reduces as the loading level of the sulfur cathode increases and the electrode area expands. In this study, a separator coated with boehmite on both sides of polyethylene (hereinafter denoted as boehmite separator) is incorporated into a high‐loading Li‐S pouch battery to suppress sudden capacity drops and achieve a longer cycle life. We explore a phenomenon by which inequality is generated in regions where an electrochemical reaction occurs in the sulfur cathode during the discharging and charging of a high‐capacity Li‐S pouch battery. The boehmite separator inhibits the accumulation of sulfur‐related species on the surface of the sulfur cathode to induce an even reaction across the entire cathode and suppresses the degradation of the Li metal anode, allowing the pouch battery with an areal capacity of 8 mAh cm–2 to operate stably for 300 cycles. These results demonstrate the importance of customizing separators for the practical use of LSBs.

All‐solid‐state batteries (ASSBs), configured with solid electrolytes, have received considerable attention as a future energy solution across diverse sectors of modern society. Unlike conventional liquid electrolytes in particular, sulfide solid electrolytes have various advantages, such as high ionic conductivity (>10−3 S cm−1), good ductile properties, and thermal stability. Despite these advantages, the practical application of sulfide solid electrolytes in ASSBs is still limited due to their interfacial instability with commercial cathode materials. Unfortunately, the spontaneous formation of a space charge layer (SCL) at the interface between the cathode material and the solid electrolyte leads to heightened interfacial resistance, obstructing Li+ transport. To address this issue, proper interfacial engineering is still required to facilitate smooth Li+ migration across the interfaces. In this respect, various functional materials have been under exploration as buffer layers, which are intended to suppress the formation of the SCL at these interfaces. Herein, focus is given on the critical significance of these buffer layers between cathode materials and sulfide solid electrolytes in the development of ASSBs. Considering the present limitations, future research directions for next‐generation ASSBs are discussed. These insights are poised to offer valuable guidance for the strategic design and development of highly reliable ASSBs.

ABSTRACT Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by the SFTS virus (SFTSV). CP-COV03 is a novel antiviral candidate that significantly enhanced the bioavailability of niclosamide through inorganic-based drug delivery technology. The active pharmaceutical ingredient of CP-COV03, niclosamide, has been previously shown to possess broad-spectrum antiviral activity against over 30 different viruses in the in vitro tests. The aim of this study is to confirm the antiviral activity of CP-COV03 against the SFTSV in an in vitro model. Vero cells and SFTS viral stock NCCP43270, a 2015 Gangwon Province isolate, were used to obtain the 50% tissue culture infective dose of the virus. Vero cells seeded in 96-well plates were infected with SFTSV for 1 h. SFTSV-infected cells were treated with CP-COV03 at various concentrations of 0.1–100 μM and incubated for 7 days. On the seventh day of the culture, the cytopathic effect (CPE) of SFTSV was checked by microscopy and the cell viability was checked by using Cell Counting Kit-8 assay. The CPE reduced as the CP-COV03 concentration increased. The 50% inhibitory concentration (IC50) range of CP-COV03 was below 0.125 µM, as determined from the viral titers of culture supernatants collected on the third day posttreatment of CP-COV03. The plaque reduction assay showed that the IC50 of CP-COV03 was 1.893 µM, as determined from the percentage reduction of plaque counts for each drug concentration on the second day posttreatment with CP-COV03. This study suggests that CP-COV03 could be used as a potential antiviral agent for SFTS.IMPORTANCEWe demonstrated a concentration-dependent response and identified low a IC50 of CP-COV03. This result is comparable to other antiviral drugs used against viruses like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We believe that our study makes a significant contribution to the literature as our findings suggest that CP-COV03 may serve as a potential treatment for SFTS, highlighting its importance in the field of antiviral research.

Abstract Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (LSIE) and exhibits distinct epidemiological, clinical, and microbiological characteristics. Previous studies have focused primarily on RSIE in patients with intravenous drug use. We investigated the characteristics and risk factors for RSIE in an area where intravenous drug use is uncommon. A retrospective cohort study was conducted at a tertiary hospital in South Korea. Patients diagnosed with infective endocarditis between November 2005 and August 2017 were categorized into LSIE and RSIE groups. Of the 406 patients, 365 (89.9%) had LSIE and 41 (10.1%) had RSIE. The mortality rates were 31.7% in the RSIE group and 31.5% in the LSIE group (P = 0.860). Patients with RSIE had a higher prevalence of infection with Staphylococcus aureus (29.3% vs. 13.7%, P = 0.016), coagulase-negative staphylococci (17.1% vs. 6.0%, P = 0.022), and gram-negative bacilli other than HACEK (12.2% vs. 2.2%, P = 0.003). Younger age (adjusted odds ratio [aOR] 0.97, 95% confidence interval [CI] 0.95–0.99, P = 0.006), implanted cardiac devices (aOR 37.75, 95% CI 11.63–141.64, P ≤ 0.001), and central venous catheterization (aOR 4.25, 95% CI 1.14–15.55, P = 0.029) were independent risk factors for RSIE. Treatment strategies that consider the epidemiologic and microbiologic characteristics of RSIE are warranted.

Abstract High electrochemical stability and safety make Na+ superionic conductor (NASICON)‐class cathodes highly desirable for Na‐ion batteries (SIBs). However, their practical capacity is limited, leading to low specific energy. Furthermore, the low electrical conductivity combined with a decline in capacity upon prolonged cycling (>1000 cycles) related to the loss of active material‐carbon conducting contact regions contributes to moderate rate performance and cycling stability. The need for high specific energy cathodes that meet practical electrochemical requirements has prompted a search for new materials. Herein, we introduce a new carbon‐coated Na3VFe0.5Ti0.5(PO4)3 (NVFTP/C) material as a promising candidate in the NASICON family of cathodes for SIBs. With a high specific energy of ∼457 Wh kg−1 and a high Na+ insertion voltage of 3.0 V versus Na+/Na, this cathode can undergo a reversible single‐phase solid‐solution and two‐phase (de)sodiation evolution at 28 C (1 C = 174.7 mAh g−1) for up to 10,000 cycles. This study highlights the potential of utilizing low‐cost and highly efficient cathodes made from Earth‐abundant and harmless materials (Fe and Ti) with enriched Na+‐storage properties in practical SIBs.

A new waveguide-based diode limiter is proposed to protect microwave-amplifying receivers from high-power electromagnetic pulses. The diode limiter was designed and fabricated to exhibit low insertion loss for normal signals while effectively blocking high-power transient signals. The proposed structure incorporates a diode element positioned between vertically connected cylinders inside the waveguide, with a square-integrated structure symmetrically placed on both the top and bottom. The diode element is inserted beneath a thin rod. Under low incident power, the diode remains inoperative, maintaining an electrically open state. In the presence of high incident power, the diode activates, transitioning into an electrically short state. The newly proposed structure enables the cylinder’s vertical movement, providing the advantage of adjustability to shift the center operating frequency of the diode limiter. It incorporates a band-pass filter structure for normal signals and a band-stop filter characteristic for transient signals. Moreover, the symmetrical square-integrated structure is employed to concentrate the surface current at the diode element, enhancing the changing state of the diode limiter. This configuration demonstrates a low insertion loss of 0.38 dB for normal signals and a blocking coefficient of 8 dB for transient signals at the 5.68 GHz operating frequency.

The development of superconducting joining technology for reacted magnesium diboride (MgB2) conductors remains a critical challenge for the advancement of cryogen-free MgB2-based magnets for magnetic resonance imaging (MRI). Herein, the fabrication of superconducting joints using reacted carbon-doped multifilament MgB2 wires for MRI magnets is reported. To achieve successful superconducting joints, the powder-in-mold method was employed, which involved tuning the filament protection mechanism, the powder compaction pressure, and the heat treatment condition. The fabricated joints demonstrated clear superconducting-to-normal transitions in self-field, with effective magnetic field screening up to 0.5 T at 20 K. To evaluate the interface between one of the MgB2 filaments and the MgB2 bulk within the joint, serial sectioning was conducted for the first time in this type of superconducting joint. The serial sectioning revealed space formation at the interface, potentially caused by the volume shrinkage associated with the MgB2 formation or the combined effect of the volume shrinkage and the different thermal expansion coefficients of the MgB2 bulk, the filament, the mold, and the sealing material. These findings are expected to be pivotal in developing MgB2 superconducting joining technology for MRI magnet applications through interface engineering.

Background/Objectives: Controlling colonoscopic quality is important in the detection of colon polyps during colonoscopy as it reduces the overall long-term colorectal cancer risk. Artificial intelligence has recently been introduced in various medical fields. In this study, we aimed to validate a previously developed artificial intelligence (AI) computer-aided detection (CADe) algorithm called ALPHAON® and compare outcomes with previous studies that showed that AI outperformed and assisted endoscopists of diverse levels of expertise in detecting colon polyps. Methods: We used the retrospective data of 500 still images, including 100 polyp images and 400 healthy colon images. In addition, we validated the CADe algorithm and compared its diagnostic performance with that of two expert endoscopists and six trainees from Gachon University Gil Medical Center. After a washing-out period of over 2 weeks, endoscopists performed polyp detection on the same dataset with the assistance of ALPHAON®. Results: The CADe algorithm presented a high capability in detecting colon polyps, with an accuracy of 0.97 (95% CI: 0.96 to 0.99), sensitivity of 0.91 (95% CI: 0.85 to 0.97), specificity of 0.99 (95% CI: 0.97 to 0.99), and AUC of 0.967. When evaluating and comparing the polyp detection ability of ALPHAON® with that of endoscopists with different levels of expertise (regarding years of endoscopic experience), it was found that ALPHAON® outperformed the experts in accuracy (0.97, 95% CI: 0.96 to 0.99), sensitivity (0.91, 95% CI: 0.85 to 0.97), and specificity (0.99, 95% CI: 0.97 to 0.99). After a washing-out period of over 2 weeks, the overall capability significantly improved for both experts and trainees with the assistance of ALPHAON®. Conclusions: The high performance of the CADe algorithm system in colon polyp detection during colonoscopy was verified. The sensitivity of ALPHAON® led to it outperforming the experts, and it demonstrated the ability to enhance the polyp detection ability of both experts and trainees, which suggests a significant possibility of ALPHAON® being able to provide endoscopic assistance.

Abstract Background Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea. Methods This study included adult medical OHCA patients enrolled prospectively, using data from the citywide OHCA registry for patients registered between 2018 and 2021. The primary outcome was survival to hospital discharge. Multivariable logistic regression analysis was conducted to determine the factors associated with the study population’s clinical outcomes, adjusting for covariates. We performed a sensitivity analysis for clinical outcomes only for patients without prehospital return of spontaneous circulation prior to emergency medical service departure from the scene. Results In multivariable logistic regression analysis, older age (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.95–0.97), endotracheal intubation (adjusted odds ratio [aOR] 0.29; 95% [CIs] 0.17–0.51), supraglottic airway (aOR 0.29; 95% CI 0.17–0.51), prehospital mechanical chest compression device use (OR 0.13; 95% CI 0.08–0.18), and longer scene time interval (OR 0.96; 95% CI 0.93–1.00) were negatively associated with survival. Shockable rhythm (OR 24.54; 95% CI 12.99–42.00), pulseless electrical activity (OR 3.11; 95% CI 1.74–5.67), and witnessed cardiac arrest (OR 1.59; 95% CI 1.07–2.38) were positively associated with survival. In the sensitivity analysis, endotracheal intubation, supraglottic airway, prehospital mechanical chest compression device use, and longer scene time intervals were associated with significantly lower survival to hospital discharge. Conclusions Regional resuscitation protocol should be revised based on the results of this study, and modifiable prehospital factors associated with lower survival of OHCA should be improved.

Abstract Background Interest in complications and sequelae following Coronavirus disease 2019 (COVID-19) is increasing. Several articles have reported COVID-19-associated autoimmune diseases and the association between autoantibodies and the severity of COVID-19. Thromboembolic complications are frequent in patients with COVID-19, and the anti-phospholipid antibodies (aPL) is frequently detected. We conducted this study to investigate the prevalence, clinical significance, and persistence of anti-nuclear antibodies (ANA) and aPLs in COVID-19. Methods We enrolled patients diagnosed with COVID-19 with oxygen demand and admitted to a tertiary hospital in South Korea between July 2020 and March 2022. ANA and aPLs levels were assessed using an immunoassay kit. Results A total of 248 patients were enrolled in the study. Among them, five patients were ANA-positive, and 41 were aPL-positive (IgM anti-cardiolipin (aCL) antibody in seven patients, IgG aCL in seven patients, IgM anti-β2Glycoprotein1 antibody (aβ2-GPI) in 32 patients, and IgG aβ2-GPI in one patient). Two of five ANA-positive patients, 13 of 32 IgM aβ2-GPI-positive patients, 5 of 7 IgM aCL-positive patients, and 2 of 7 IgG aCL-positive patients were eligible for follow-up analysis, and 100%, 69.2%, 40%, and 50% of the patients remained autoantibody-positive, respectively. There were no differences in clinical outcomes between the autoantibody-positive and autoantibody-negative groups, except for the IgG aCL group showing a tendency for worse outcomes. Conclusion A significant proportion of COVID-19 patients with oxygen demand were autoantibody-positive, and autoantibodies persisted for several months after symptom onset. Whether these autoantibodies are related to long-term sequelae in COVID-19 patients requires further investigation.

Solid organ transplant (SOT) recipients are at significant risk of hepatitis B (HB) virus (HBV) reactivation (HBVr). Despite the clinical significance of HBVr after solid organ transplantation, data on the risk factors for HBVr and vaccine effectiveness in SOT recipients with resolved HBV infection are limited. This study evaluated the risk factors for HBVr and the seroconversion rates after HBV vaccination in SOT recipients. Patients who had undergone solid organ transplantation and those with a resolved HBV infection were identified. We matched patients who experienced post-transplantation HBVr with those who did not. We also explored the characteristics and seroconversion rates of HBV-vaccinated patients following transplantation. In total, 1299 SOT recipients were identified as having a resolved HBV infection at the time of transplantation. Thirty-nine patients experienced HBVr. Pre-transplant HB surface antibodies (anti-HBs) positivity and allograft rejection within 3 months after transplantation were independently associated with HBVr. Among the 17 HBV-vaccinated patients, 14 (82.4%) received three or fewer vaccine doses, and 13 (76.5%) had seroconversion with positive anti-HBs results. Pre-transplant anti-HBs(−) status and allograft rejection were risk factors for HBVr in SOT recipients with a resolved HBV infection, and HBV vaccination after transplantation resulted in a high rate of anti-HBs seroconversion. HBV vaccination after transplantation should be considered to reduce the HBVr risk.

Abstract Regulatory T cells (Treg) are CD4+ T cells with immune-suppressive function, which is defined by Foxp3 expression. However, the molecular determinants defining the suppressive population of T cells have yet to be discovered. Here we report that the cell surface protein Lrig1 is enriched in suppressive T cells and controls their suppressive behaviors. Within CD4+ T cells, Treg cells express the highest levels of Lrig1, and the expression level is further increasing with activation. The Lrig1+ subpopulation from T helper (Th) 17 cells showed higher suppressive activity than the Lrig1- subpopulation. Lrig1-deficiency impairs the suppressive function of Treg cells, while Lrig1-deficient naïve T cells normally differentiate into other T cell subsets. Adoptive transfer of CD4+Lrig1+ T cells alleviates autoimmune symptoms in colitis and lupus nephritis mouse models. A monoclonal anti-Lrig1 antibody significantly improves the symptoms of experimental autoimmune encephalomyelitis. In conclusion, Lrig1 is an important regulator of suppressive T cell function and an exploitable target for treating autoimmune conditions.

Abstract Progressive multifocal leukoencephalopathy (PML) is a rare but fatal opportunistic infection and mainly occurs in patients with immunosuppressive conditions. Despite the increasing number of patients receiving immunosuppressive treatments, studies on PML are still lacking due to its low prevalence and incidence. We retrospectively reviewed patients diagnosed with PML in two tertiary hospitals in South Korea from 1999 to 2021. Total of 47 PML patients were included. Of 27 patients (57.4%) were diagnosed with human immunodeficiency virus (HIV). Median last follow-up modified Rankin Scale (mRS) score was higher in the non-HIV PML group than that in the HIV group (5 vs. 4, p = 0.020). Median survival duration was lower in the non-HIV group (184 vs. 1,564 days). The 1-year and overall mortality rates of PML patients were significantly higher in the non-HIV group than that in HIV group (60.0% vs. 25.9%, p = 0.019; 80.0% vs. 40.7%, p = 0.007). Initial mRS score (HR 1.685, p = 0.038) and highly active antiretroviral therapy (HAART) in HIV patients (HR 0.374, p = 0.013) had a significant effect on overall mortality. Our findings suggest that early detection of PML with low mRS score and early initiation of HAART in patients with HIV may improve prognosis.

Background/Aims: Low-volume preparations for colonoscopy are gaining attention for their higher acceptability. However, the efficacy and safety of oral sulfate solution (OSS) preparations in patients with ulcerative colitis (UC) has not been well known. Therefore, we aimed to compare OSS and 2-L polyethylene glycol with ascorbic acid (PEG+Asc) for bowel preparation in inactive UC. Methods: A multicenter, randomized, single-blind study was conducted at six tertiary referral hospitals in Korea. Outpatients with UC who had stable disease activity were randomly allocated to the OSS group or the 2-L PEG+Asc group for bowel preparation before colonoscopy. The study outcomes included treatment efficacy, safety, tolerability, and acceptability. Bowel cleansing was assessed using the Boston Bowel Preparation Scale and rated as successful cleansing if the score was ≥6. Patient acceptance and tolerability were assessed using a 4-point ordinal scale. Additionally, disease activity and laboratory data before and after colonoscopy were evaluated to check for safety. Results: The OSS and 2-L PEG+Asc groups included 92 and 93 participants, respectively. No significant between-group difference was noted in successful cleansing (OSS [96.7%] vs 2-L PEG+Asc [97.8%], p=0.64). Moreover, the safety, acceptance, and tolerability were not significantly different (all p>0.05). Furthermore, no significant changes were found in serum electrolytes or disease activity in either group. Conclusions: OSS is effective for colonoscopy cleansing, has acceptable tolerability, and does not affect disease activity; thus, it can be used safely for bowel preparation in patients with inactive UC.

[This corrects the article DOI: 10.1371/journal.pone.0266610.].

Abstract Chronic colonic inflammation is a feature of cancer and is strongly associated with tumorigenesis, but its underlying molecular mechanisms remain poorly understood. Inflammatory conditions increased ITF2 and p65 expression both ex vivo and in vivo, and ITF2 and p65 showed positive correlations. p65 overexpression stabilized ITF2 protein levels by interfering with the binding of Parkin to ITF2. More specifically, the C-terminus of p65 binds to the N-terminus of ITF2 and inhibits ubiquitination, thereby promoting ITF2 stabilization. Parkin acts as a E3 ubiquitin ligase for ITF2 ubiquitination. Intestinal epithelial-specific deletion of ITF2 facilitated nuclear translocation of p65 and thus increased colitis-associated cancer tumorigenesis, which was mediated by Azoxymethane/Dextran sulfate sodium or dextran sulfate sodium. Upregulated ITF2 expression was lost in carcinoma tissues of colitis-associated cancer patients, whereas p65 expression much more increased in both dysplastic and carcinoma regions. Therefore, these findings indicate a critical role for ITF2 in the repression of colitis-associated cancer progression and ITF2 would be an attractive target against inflammatory diseases including colitis-associated cancer.

Abstract The beginning of human immunodeficiency virus (HIV) infection treatment depends on various factors, which are significantly correlated with the initial CD4 cell number. However, a covariate correlation between these factors may not reflect the correct outcome variable. Thus, we evaluated the effects of a combination of fixed factors (reduced dimensions), which determine when to start treatment for the first time, on short-term outcome, long-term outcome, and survival, considering correlations between factors. Multiple correspondence analysis was performed on variables obtained from 925 patients who participated in a Korean HIV/acquired immunodeficiency syndrome cohort study (2006–2017). Five reduced dimension groups were derived according to clinical data, viral load, CD4 cell count at diagnosis, initial antiretroviral therapy, and others. The dimension group with high initial viral loads (55,000 copies/mL) and low CD4 cell counts ( 350 cells/mm3) that did not require immediate treatment according to previous guidelines had a higher failure rate for long-term relative CD4 recovery. Our results highlight the importance of early diagnosis and treatment to positively influence long-term disease outcomes, even if the initial immune status is poor, given the patient’s combination of early diagnostic symptoms.

ABSTRACTUltraviolet (UV) radiation causes serious health risks. Inorganic metal oxides, such as titanium dioxide (TiO2) and zinc oxide (ZnO), have long been recognized for their effectiveness as UV radiation filters/blockers in sunscreen formulations. TiO2 and ZnO as UV-blocking materials have some limitations and issues such as producing harmful radicals and toxicity, respectively. As a result, there is a growing need to develop efficient and safe UV-blocking materials to overcome these limitations associated with the conventional TiO2 and ZnO materials. Zinc stannate (Zn2SnO4), as a ternary metal oxide, is expected to be a promising candidate due to its optical properties and potential for UV-blocking capability. This study presents a comprehensive investigation into the development and characterization of Zn2SnO4 as a potential alternative UV filter to TiO2 and ZnO. The fundamental characteristics, including structural, optical, and photocatalytic characteristics, as well as cell viability, were investigated for two Zn2SnO4 morphologies: cubic aggregate Zn2SnO4 nanoparticles (ZTO CANP) and Zn2SnO4 nanoparticles (ZTO NP), which were compared with the performance of TiO2 nanoparticles (TiO2 NP) and ZnO nanoparticles (ZnO NP). Interestingly, in addition to their promising UVB and partial UVA blocking properties, ZTO CANP and ZTO NP were found to be relativity photocatalytically inactive materials, which means they produce less free radical species as in the case of TiO2 NP, and they cannot be considered as toxic materials as in the case of ZnO NP. To the best of our knowledge, this is the first direct comparison study examining the performance of Zn2SnO4 ternary metal oxide for its potential use as a UV filter. Further research and optimization need to be conducted on these materials, particularly on ZTO CANP as a promising alternative UV filter.

Chemical vapor deposition (CVD) can produce wafer-scale transition-metal dichalcogenide (TMD) monolayers for the integration of electronic and optoelectronic devices. Nonetheless, the material quality of the CVD-grown TMDs still remains controversial. Here, we compare the quality of representative WSe2 monolayers grown by CVD compared to that obtained by other synthesis methods: bulk-grown-chemical vapor transport (CVT) and flux. Through the use of a deep-learning–based algorithm to analyze atomic-resolution scanning transmission electron microscopy images, we confirm that Se vacancies (VSe) are the primary defects in WSe2, with a defect density of ∼5.3 × 1013 cm−2 in the CVD-grown sample, within the same order of magnitude of other methods (∼3.9 × 1013 cm−2 from CVT-grown samples and ∼2.7 × 1013 cm−2 from flux-grown samples). The carrier concentration in field-effect transistors at room temperature is ∼5.84 × 1012 cm−2 from a CVD-grown sample, comparable to other methods (6–7 × 1012 cm−2). The field-effect mobility of the CVD-grown sample is slightly lower than that of other synthesis methods, together with similar trends in on-current. While the difference in photoluminescence intensity is not appreciable at room temperature, different intensities of defect-related localized states appear below 60 K. We conclude that the wafer-scale CVD-grown samples can be utilized without loss of generality in the integration of electronic/optoelectronic devices.

Lithium metal batteries (LMBs) are in the spotlight as a next‐generation battery due to their high theoretical capacity. However, LMBs still suffer from inferior cycle stability owing to dendritic lithium (Li) growth during Li plating and stripping, leading to battery explosion. To solve this problem, solid electrolytes have emerged as a promising candidate by suppressing the dendritic Li growth. Despite numerous efforts, however, many challenges, such as low ionic conductivity, air stability, space charge layer, and contact loss issues, have been encountered. This review aims to provide the current challenges and new insights of solid electrolytes and then explore optimal solutions for next‐generation solid electrolytes.

Abstract Background During the novel coronavirus disease-2019 pandemic, a considerable number of pneumothorax (PNX)/pneumomediastinum (PNM) associated with COVID-19 have been reported, and the incidence is higher in critically ill patients. Despite using a protective ventilation strategy, PNX/PNM still occurs in patients on invasive mechanical ventilation (IMV). This matched case–control study aims to identify the risk factors and clinical characteristics of PNX/PNM in COVID-19. Methods This retrospective study enrolled adult patients with COVID-19, admitted to a critical care unit from March 1, 2020, to January 31, 2022. COVID-19 patients with PNX/PNM were compared, in a 1–2 ratio, to COVID-19 patients without PNX/PNM, matched for age, gender, and worst National Institute of Allergy and Infectious Diseases ordinal scale. Conditional logistic regression analysis was performed to assess the risk factors for PNX/PNM in COVID-19. Results 427 patients with COVID-19 were admitted during the period, and 24 patients were diagnosed with PNX/PNM. Body mass index (BMI) was significantly lower in the case group (22.8 kg/m2 and 24.7 kg/m2; P = 0.048). BMI was statistically significant risk factor for PNX/PNM in univariate conditional logistic regression analysis [odds ratio (OR), 0.85; confidence interval (CI), 0.72–0.996; P = 0.044]. For patients on IMV support, univariate conditional logistic regression analysis showed the statistical significance of the duration from symptom onset to intubation (OR, 1.14; CI, 1.006–1.293; P = 0.041). Conclusions Higher BMI tended to show a protective effect against PNX/PNM due to COVID-19 and delayed application of IMV might be a contributive factor for this complication.

Abstract Realizing a lithium sulfide (Li2S) cathode with both high energy density and a long lifespan requires an innovative cathode design that maximizes electrochemical performance and resists electrode deterioration. Herein, a high‐loading Li2S‐based cathode with micrometric Li2S particles composed of two‐dimensional graphene (Gr) and one‐dimensional carbon nanotubes (CNTs) in a compact geometry is developed, and the role of CNTs in stable cycling of high‐capacity Li–S batteries is emphasized. In a dimensionally combined carbon matrix, CNTs embedded within the Gr sheets create robust and sustainable electron diffusion pathways while suppressing the passivation of the active carbon surface. As a unique point, during the first charging process, the proposed cathode is fully activated through the direct conversion of Li2S into S8 without inducing lithium polysulfide formation. The direct conversion of Li2S into S8 in the composite cathode is ubiquitously investigated using the combined study of in situ Raman spectroscopy, in situ optical microscopy, and cryogenic transmission electron microscopy. The composite cathode demonstrates unprecedented electrochemical properties even with a high Li2S loading of 10 mg cm–2; in particular, the practical and safe Li–S full cell coupled with a graphite anode shows ultra‐long‐term cycling stability over 800 cycles.

Abstract Since the beginning of human history, the demand for effective healthcare systems for diagnosis and treatment of health problems has grown steadily. However, traditional centralized healthcare requires hospital visits, making in‐time and long‐term healthcare challenging. Bioelectronics has shown potential in patient‐friendly healthcare owing to the rapid advances in diverse fields of biology and electronics. In particular, wearable and implantable bioelectronics have emerged as an alternative or adjunct to conventional healthcare. To develop into next‐generation healthcare systems, however, custom designs for biological targets with a deepened understanding of the intrinsic features of the target are essential. In addition, bioelectronic systems must be designed eco‐friendly for sustainable healthcare. In this review, bioelectronics as eco‐friendly and patient‐friendly integrated nanoarchitectonics as next‐generation smart healthcare technology are described. For an in‐depth understanding of biological targets and guidelines for target‐tailored design, we discuss target‐specific considerations and relevant key parameters of bioelectronic systems with the representative examples.

Abstract Extracorporeal membrane oxygenation (ECMO) provides hemodynamic and oxygenation support to critically ill patients. Due to multiple catheter cannulations, patients on ECMO are vulnerable to bloodstream infections (BSIs). We aimed to investigate the incidence, clinical characteristics, risk factors, and microorganisms associated with BSIs during ECMO. This single-center retrospective cohort study was conducted between January 2015 and May 2021. Patients aged 18 years or older with an ECMO duration of > 48 h for cardiogenic or respiratory support were included in the study. Patients who developed bacteremia or candidemia from 12 h after ECMO cannulation to 7 days after de-cannulation were included. The clinical factors between non-BSI and BSI were compared, along with an analysis of the risk factors associated with BSI during ECMO. A total of 480 patients underwent ECMO for cardiogenic shock (n = 267, 55.6%) or respiratory failure (n = 213, 44.4%) during the study period. The incidence was 20.0 episodes per 1000 ECMO-days. Approximately 20.2% (97/480) and 5.4% (26/480) of the patients developed bacteremia and candidemia, respectively. The median numbers of days of BSI development were 8.00 days for bacteremia and 11.0 days for candidemia. The most common pathogens were methicillin-resistant coagulase-negative staphylococci (n = 24), followed by vancomycin-resistant Enterococcus (n = 21). Multivariable logistic analysis demonstrated that hemodialysis (odds ratio [OR] 2.647, p

Abstract Background Tumor budding is associated with lymph node (LN) metastasis in submucosal colorectal cancer (CRC). However, the rate of LN metastasis associated with the number of tumor buds is unknown. Here, we determined the optimal tumor budding cut-off number and developed a composite scoring system (CSS) for estimating LN metastasis of submucosal CRC. Methods In total, 395 patients with histologically confirmed T1N0–2M0 CRC were evaluated. The clinicopathological characteristics were subjected to univariate and multivariate analyses. The Akaike information criterion (AIC) values of the multivariate models were evaluated to identify the optimal cut-off number. A CSS for LN metastasis was developed using independent risk factors. Results The prevalence of LN metastasis was 13.2%. Histological differentiation, lymphatic or venous invasion, and tumor budding were associated with LN metastasis in univariate analyses. In multivariate models adjusted for histological differentiation and lymphatic or venous invasion, the AIC value was lowest for five tumor buds. Unfavorable differentiation (odds ratio [OR], 8.16; 95% confidence interval [CI], 1.80–36.89), lymphatic or venous invasion (OR, 5.91; 95% CI, 2.91–11.97), and five or more tumor buds (OR, 3.01; 95% CI, 1.21–7.69) were independent risk factors. In a CSS using these three risk factors, the rates of LN metastasis were 5.6%, 15.5%, 31.0%, and 52.4% for total composite scores of 0, 1, 2, and ≥ 3, respectively. Conclusions For the estimation of LN metastasis in submucosal CRC, the optimal tumor budding cut-off number was five. Our CSS can be utilized to estimate LN metastasis.

Abstract Background Despite medical advances, septic shock remains one of the main causes of high mortality in critically ill patients. Although sarcopenia is considered a predictor of mortality in septic shock patients, most studies have only investigated short‐term mortality, and those on long‐term prognosis are limited. We investigated the impact of sarcopenia on long‐term mortality in a large patient population with septic shock. Methods A retrospective cohort study comprising 905 patients with septic shock was conducted from 2008 to 2019. Sarcopenia was defined based on the measurement of the total abdominal muscle area, assessed using abdominal computed tomography scans. Thereafter, we stratified the patients into two groups—sarcopenia and non‐sarcopenia groups—and compared the impact of sarcopenia on short‐term (28 days) and long‐term (1 year and overall) mortality using multivariable Cox proportional analysis. Results A total of 905 patients were included, and the mean age was 65.7 ± 15.1 years. Among them, 430 (47.5%) patients were male and 407 (45.0%) had sarcopenia. We found that the 28 day, 1 year, and overall mortality rates in the sarcopenia group were significantly higher than those in the non‐sarcopenia group (13.8% vs. 6.4%, P

Abstract Background Gastric cancer (GC) is one of the most fatal cancers worldwide and is generally only detected after it has progressed to an advanced stage. Since there is a lack of comprehensive data on RHOA protein expression of patients with GC, this study utilized a systematic review and meta-analysis to address the limitation. The objective of this meta-analysis was to link GC clinical features with RHOA protein high- vs. low-expressing patients with GC. Methods The PubMed and Web of Science were used for a systematic literature review of GC related to RHOA. The included studies were obtained from two literature databases from past to Aug 31, 2021, by searching keywords. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The odds ratios (ORs) and 95% confidential intervals (CIs) for clinical features were estimated according to the high and low protein expression levels of RhoA. The mean effect sizes of ORs were obtained using the random-effects and fixed-effects models of meta-analysis. Heterogeneity of the studies was assesed by using statistics: τ2, I2; and Q values. The symmetry of funnel plots were inspected for publication bias. Results Finally, 10 studies including 1,389 patients with GC (735 RHOA-positive and 654 RHOA-negative) were eligible for our meta-analysis to estimate associations between the protein expression and clinical features (e.g., Union for International Cancer Control [UICC] stage progression, differentiation, Lauren histological classification, and vascular invasion). In our meta-analysis, RHOA positive expression was determined to have a statistically significant association with UICC stage progression (P = 0.02) and poorly differentiated status (P = 0.02). The association between RHOA positivity and Lauren subtypes was not statistically significant (P = 0.07). Conclusions This meta-analysis suggested that RhoA protein expression in patients with GC was associated with clinical features: UICC stage progression and poorly differentiated status. Our findings are inconclusive but indicate that high RHOA protein expressing patients with GC could predict advanced UICC stages. A large prospective cohort study is required for validation in future.

The strategic design of the cathode is a critical feature for high-performance and long-lasting reversibility of an energy storage system. In particular, the round-trip efficiency and cycling performance of nonaqueous lithium–oxygen batteries are governed by minimizing the discharge products, such as Li2O and Li2O2. Recently, a metal–organic framework has been directly pyrolyzed into a carbon frame with controllable pore volume and size. Furthermore, selective metallic catalysts can also be obtained by adjusting metal ions for outstanding electrochemical reactions. In this study, various bimetallic zeolitic imidazolate framework (ZIF)-derived carbons were designed by varying the ratio of Zn to Co ions. Moreover, carbon nanotubes (CNTs) are added to improve the electrical conductivity further, ultimately leading to better electrochemical stability in the cathode. As a result, the optimized bimetallic ZIF–carbon/CNT composite exhibits a high discharge capacity of 16,000 mAh·g−1, with a stable cycling performance of up to 137 cycles. This feature is also beneficial for lowering the overpotential of the cathode during cycling, even at the high current density of 2,000 mA·g−1.

Modern inelastic X-ray spectrometers employ curved, bent and diced analyzers to capture sufficiently large solid angles of radially emitted scattered radiation emanating from the sample. Fabricating these intricate analyzers, especially when a high energy resolution of a few millielectronvolts is required, is very time-consuming, expensive and often a hit-or-miss affair. A novel fabrication technique is introduced, utilizing a concave-spherical, microporous aluminium base to hold an assembly of a thin glass substrate with a diced crystal wafer bonded to it. Under uniform vacuum forces, the glass substrate is drawn into the aluminium base, achieving the desired bending radius, while dicing of the diffracting crystal layer prevents bending strain from being imposed on the individual crystal pixels. This technique eliminates the need for permanently bonding the crystal assembly to the concave lens, offering the opportunity for correcting figure errors, avoiding long-term degradation of the permanent bond, and making both lens and crystal reusable. Process and material costs are thus substantially decreased. Two analyzers, Si(844) and Ge(337) with intrinsic resolutions of 14.6 meV and 36.5 meV, respectively, were produced in this fashion and characterized in resonant inelastic X-ray scattering (RIXS) measurements. The achieved overall energy resolutions for both analyzers were 29.4 meV for Si(844) and 56.6 meV for Ge(337). Although the RIXS technique is veru sensitive to analyzer imperfections, the analyzers were found to be equal, if not superior, in quality to their traditional, permanently bonded counterparts.

Background/Aims: Previous studies have reported the protective effects of tauroursodeoxycholic acid (TUDCA) on gastric epithelial cells in some animal models, but the precise mechanisms are unclear. This study examined the effects of TUDCA on NF-κB signaling in gastric epithelial cells. Moreover, the protective effects of TUDCA in experimental gastritis models induced by ethanol and NSAID were evaluated and compared with ursodeoxycholic acid (UDCA). Methods: After a pretreatment with TUDCA or UDCA, human gastric epithelial MKN-45 cells were stimulated with tumor necrosis factor (TNF)-α to activate NF-κB signaling. A real-time PCR (RT-PCR) for human interleukin (IL)-1 mRNA was performed. An electrophoretic mobility shift assay (EMSA) and immunoblot analyses were carried out. In murine models, after a pretreatment with TUDCA or UDCA, ethanol and indomethacin were administered via oral gavage. Macroscopic and microscopic assessments were performed to evaluate the preventive effects of TUDCA and UDCA on murine gastritis. Results: A pretreatment with TUDCA downregulated the IL-1α mRNA levels in MKN-45 cells stimulated with TNF-α, as assessed by RT-PCR. As determined using EMSA, a pretreatment with TUDCA reduced the TNF-α-induced NF-κB DNA binding activity. A pretreatment with TUDCA inhibited IκBα phosphorylation induced by TNF-α, as assessed by immunoblot analysis. TUDCA attenuated the ethanol-induced and NSAID-induced gastritis in murine models, as determined macroscopically and microscopically. Conclusions: TUDCA inhibited NF-κB signaling in gastric epithelial cells and ameliorated ethanol- and NSAID-induced gastritis in murine models. These results support the potential of TUDCA for the prevention of gastritis in humans.

Background To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. Methods We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. Results During the strike period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. Conclusion The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

Abstract Background Multidrug-resistant organisms (MDROs) such as vancomycin-resistant enterococci (VRE) and carbapenemase-producing Enterobacteriaceae (CPE) are associated with prolonged hospitalisation, increased medical costs, and severe infections. Faecal microbiota transplantation (FMT) has emerged as an important strategy for decolonisation. This study aimed to evaluate the genetic response of MDROs to FMT. Methods A single-centre prospective study was conducted on patients infected with VRE, CPE, or VRE/CPE who underwent FMT between May 2018 and April 2019. Genetic response was assessed as the change in the expression of the resistance genes VanA, bla KPC, bla NDM, and bla OXA on days 1, 7, 14, and 28 by real-time reverse-transcription polymerase chain reaction. Results Twenty-nine patients received FMT, of which 26 (59.3%) were infected with VRE, 5 (11.1%) with CPE, and 8 (29.6%) with VRE/CPE. The mean duration of MDRO carriage before FMT was 71 days. Seventeen patients (63.0%) used antibiotics within a week of FMT. In a culture-dependent method, the expression of VanA and overall genes significantly decreased (p = 0.011 and p = 0.003 respectively). In a culture-independent method, VanA, bla NDM, and overall gene expression significantly decreased over time after FMT (p = 0.047, p = 0.048, p = 0.002, respectively). Similar results were confirmed following comparison between each time point in both the culture-dependent and -independent methods. Regression analysis did not reveal important factors underlying the genetic response after FMT. No adverse events were observed. Conclusion FMT in patients infected with MDROs downregulates the expression of resistance genes, especially VanA, and facilitates MDRO decolonisation.

A high field magnet is a key element of cryogenic electron beam ion sources (EBISs), which are known for generating highly charged ions through the magnetic compression of an electron beam. Herein, we report the design, fabrication, and evaluation of a 7 T niobium-titanium superconducting magnet capable of persistent-mode operation. The magnet was designed using finite element analysis by considering its magnetic, thermal, and mechanical properties. The designed magnet was then fabricated, assembled, and evaluated for various design parameters in a recondensing-type liquid helium cryostat. After several quench trainings, the magnet reached a target magnetic field of 7 T with an operating current of 200 A, a magnetic field uniformity of 0.24%, and an electron beam focusing length of 1.3 m inside the bore. The magnet was successfully operated in the persistent-mode for 9.5 days (228 hours) and achieved a field-decay rate of 0.42 ppm $\cdot \text{h}^{-1}$ . The magnet evaluation results confirm that our superconducting magnet system can be applied to an EBIS to carry out stable and effective electron beam compression.

Abstract Batteries are a promising technology in the field of electrical energy storage and have made tremendous strides in recent few decades. In particular, lithium‐ion batteries are leading the smart device era as an essential component of portable electronic devices. From the materials aspect, new and creative solutions are required to resolve the current technical issues on advanced lithium (Li) batteries and improve their safety. Metal‐organic frameworks (MOFs) are considered as tempting candidates to satisfy the requirements of advanced energy storage technologies. In this review, we discuss the characteristics of MOFs for application in different types of Li batteries. A review of these emerging studies in which MOFs have been applied in lithium storage devices can provide an informative blueprint for future MOF research on next‐generation advanced energy storage devices.

Many researchers working on the development of dye-sensitized solar cells (DSCs) continue to focus on the synthesis of photoanode materials with high surface area, along with high light scattering ability to enhance light harvesting efficiency (LHE). Meanwhile, dye packing density, which also impacts the LHE significantly, is often overlooked. Solvothermally synthesized anatase TiO2 nanoparticles (SANP) were obtained by a new and simple approach using a mixed solvent, ethanol and acetic acid. SANP were applied in photoanodes of DSCs using either metal-free organic dye (D149) or organometallic (N719) dyes. Dye loading (packing density) was correlated with the isoelectric point (IEP) in addition to light scattering effects were shown to determine the devices photovoltaic efficiency (PCE); specifically when compared with ones employing commercially available TiO2 nanoparticles. SANP photoanodes sensitized with D149 dye were found to be optimised at 10 µm, yielding a PCE of 6.9%, superior to for transparent or transparent + scattering films from the commercial source (5.6% and 5.9%, respectively). Furthermore, a 7.7% PCE was achieved using a SANP photoanode sensitized with N719 dye, with 7.2% seen for the transparent photoanode and 7.9% with a scattering layer. The high PCEs of of SANP devices are attributed to the high dye loading capability in addition to light scattering. A further point of interest is that even with the increased reactivity of the surface towards dye adsorption, we did not observe any significant increase in recombination with the redox mediator, presumably due to the increased dye loading providing better shielding.

Abstract Background Pharmacokinetic-pharmacodynamic (PK/PD) targets of vancomycin therapy have been recognized for methicillin-resistant Staphylococcus aureus infections but not for other gram-positive bacterial infections. Therefore, we investigated whether vancomycin concentration targets such as the trough level and ratio of the area under the curve to minimum inhibitory concentration (AUC/MIC) are associated with the treatment outcome in enterococcal bacteremia. Methods A retrospective cohort analysis enrolled patients with bacteremia caused by vancomycin-susceptible Enterococcus faecium and Enterococcus faecalis who were treated with vancomycin from January 2007 to December 2017 at a tertiary hospital located in Seoul, South Korea. Patients without vancomycin concentrations were excluded from the study. The primary outcome was 28-day all-cause mortality. Results A total of 37 patients were enrolled—26 with E. faecium infection and 11 with E. faecalis infection. The 28-day all-cause mortality rate was 21.6 %. In univariate analysis, vancomycin trough level (≤ 15 µg/mL; p = 0.042), age (p = 0.044), and septic shock (p = 0.049) were associated with 28-day mortality but not AUC24/MIC (> 389; p = 0.479). In multivariate analysis, vancomycin trough concentration (≤ 15 µg/mL; p = 0.041) and younger age (p = 0.031) were associated with 28-day mortality in patients with enterococcal bacteremia. Conclusions In this study, a vancomycin trough level of 15 µg/mL or lower was associated with 28-day mortality in enterococcal bacteremia. However, relatively large prospective studies are needed to examine the efficacy of vancomycin PK/PD parameters in patients with enterococcal bacteremia.

ABSTRACT The human-pathogenic yeast Cryptococcus neoformans assembles two types of O-linked glycans on its proteins. In this study, we identified and functionally characterized the C. neoformans CAP6 gene, encoding an α1,3-mannosyltransferase responsible for the second mannose addition to minor O-glycans containing xylose in the Golgi apparatus. Two cell surface sensor proteins, Wml1 (WSC/Mid2-like) and Wml2, were found to be independent substrates of Cap6-mediated minor or Ktr3-mediated major O-mannosylation, respectively. The double deletion of KTR3 and CAP6 (ktr3Δ cap6Δ) completely blocked the mannose addition at the second position of O-glycans, resulting in the accumulation of proteins with O-glycans carrying only a single mannose. Tunicamycin (TM)-induced phosphorylation of the Mpk1 mitogen-activated protein kinase (MAPK) was greatly decreased in both ktr3Δ cap6Δ and wml1Δ wml2Δ strains. Transcriptome profiling of the ktr3Δ cap6Δ strain upon TM treatment revealed decreased expression of genes involved in the Mpk1-dependent cell wall integrity (CWI) pathway. Consistent with its defective growth under several stress conditions, the ktr3Δ cap6Δ strain was avirulent in a mouse model of cryptococcosis. Associated with this virulence defect, the ktr3Δ cap6Δ strain showed decreased adhesion to lung epithelial cells, decreased proliferation within macrophages, and reduced transcytosis of the blood-brain barrier (BBB). Notably, the ktr3Δ cap6Δ strain showed reduced induction of the host immune response and defective trafficking of ergosterol, an immunoreactive fungal molecule. In conclusion, O-glycan extension in the Golgi apparatus plays critical roles in various pathobiological processes, such as CWI signaling and stress resistance and interaction with host cells in C. neoformans. IMPORTANCE Cryptococcus neoformans assembles two types of O-linked glycans on its surface proteins, the more abundant major O-glycans that do not contain xylose residues and minor O-glycans containing xylose. Here, we demonstrate the role of the Cap6 α1,3-mannosyltransferase in the synthesis of minor O-glycans. Previously proposed to be involved in capsule biosynthesis, Cap6 works with the related Ktr3 α1,2-mannosyltransferase to synthesize O-glycans on their target proteins. We also identified two novel C. neoformans stress sensors that require Ktr3- and Cap6-mediated posttranslational modification for full function. Accordingly, the ktr3Δ cap6Δ double O-glycan mutant strain displays defects in stress signaling pathways, CWI, and ergosterol trafficking. Furthermore, the ktr3Δ cap6Δ strain is completely avirulent in a mouse infection model. Together, these results demonstrate critical roles for O-glycosylation in fungal pathogenesis. As there are no human homologs for Cap6 or Ktr3, these fungus-specific mannosyltransferases are novel targets for antifungal therapy.

Abstract Wearable devices are widely used in the smart healthcare monitoring system to detect changes in user parameters through applications such as wristwatches, bands, and clothing electronic skin. In addition, multimode devices enable monitoring of vital signs, helping diagnose and prevent diseases. A wearable device detects the user's biological signals such as body temperature, movement, heartbeat, and humidity level, transmits the information to the mobile phone, and sends the information to an emergency center/family/clinician through cloud computing or wireless communication systems. This all‐day monitoring system enables the user's status information to be monitored 24 h a day to ensure appropriate treatment, thereby facilitating highly personalized care due to its human‐centricity. When integrated with higher‐level infrastructure, it is expected to be useful in healthcare scenarios, providing benefits to multiple stakeholders. In addition, it will help protect people exposed to potentially life‐threatening environments such as military personnel, first responders, and deep‐sea and space explorers. In this review, the components for implementing an all‐day monitoring system are described, including the electrode design strategy for realizing a skin attachable e‐skin device. Issues related to flexible storage devices and recent research results are also discussed.

Objective This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city. Methods This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre- and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis. Results This study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05–0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02–0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods. Conclusion During the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

Abstract The development of lithium (Li)-metal anode is high priority research to initiate next-generation Li batteries. Applying Li-metal in practical applications as anode still has many hurdles to clear away, such as low Coulombic efficiency and capacity degradation by the continuous formation of dead Li. We demonstrate that cobalt (Co) nanoparticle incorporation in a porous carbon host anode can play a critical role in the formation of a thick lithium fluoride dominated solid-electrolyte interphase in ether-based electrolyte. As a result, the host anode containing Co nanoparticles shows excellent electrochemical performance with high Li-metal reversible capacity and even stable long-term cyclability with no dead Li formation.

Abstract Background Coronavirus disease 2019 (COVID-19) is associated with acute respiratory distress syndrome, and corticosteroids have been considered as possible therapeutic agents for this disease. However, there is limited literature on the appropriate timing of corticosteroid administration to obtain the best possible patient outcomes. Methods This was a retrospective cohort study including patients with severe COVID-19 who received corticosteroid treatment from March 2 to June 30, 2020 in seven tertiary hospitals in South Korea. We analyzed the patient demographics, characteristics, and clinical outcomes according to the timing of steroid use. Twenty-two patients with severe COVID-19 were enrolled, and they were all treated with corticosteroids. Results Of the 22 patients who received corticosteroids, 12 patients (55%) were treated within 10 days from diagnosis. There was no significant difference in the baseline characteristics. The initial PaO2/FiO2 ratio was 168.75. The overall case fatality rate was 25%. The mean time from diagnosis to steroid use was 4.08 days and the treatment duration was 14 days in the early use group, while those in the late use group were 12.80 days and 18.50 days, respectively. The PaO2/FiO2 ratio, C-reactive protein level, and cycle threshold value improved over time in both groups. In the early use group, the time from onset of symptoms to discharge (32.4 days vs. 60.0 days, P = 0.030), time from diagnosis to discharge (27.8 days vs. 57.4 days, P = 0.024), and hospital stay (26.0 days vs. 53.9 days, P = 0.033) were shortened. Conclusions Among patients with severe COVID-19, early use of corticosteroids showed favorable clinical outcomes which were related to a reduction in the length of hospital stay.

Abstract Kikuchi-Fujimoto disease (KFD) is usually self-limiting, but prolonged systemic symptoms often result in frequent hospital visits, long admission durations, or missed workdays. We investigated the role of fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing KFD severity. We reviewed the records of 31 adult patients with pathologically confirmed KFD who underwent 18F-FDG PET/CT between November 2007 and April 2018 at a tertiary-care referral hospital. Disease severity was assessed using criteria based on clinical manifestations of advanced KFD. Systemic activated lymph nodes and severity of splenic activation were determined using semi-quantitative and volumetric PET/CT parameters. The median of the mean splenic standardized uptake value (SUVmean) was higher in patients with severe KFD than those with mild KFD (2.38 ± 1.18 vs. 1.79 ± 0.99, p = 0.058). Patients with severe KFD had more systemically activated volume and glycolytic activity than those with mild KFD (total lesion glycolysis: 473.5 ± 504.4 vs. 201.6 ± 363.5, p = 0.024). Multivariate logistic regression showed that myalgia (odds ratio [OR] 0.035; 95% confidence interval [CI] 0.001–0.792; p = 0.035), total lymph node SUVmax (cutoff 9.27; OR 24.734; 95% CI 1.323–462.407; p = 0.032), and spleen SUVmean (cutoff 1.79; OR 37.770; 95% CI 1.769–806.583; p = 0.020) were significantly associated with severe KFD. 18F-FDG PET/CT could be useful in assessing KFD severity.

Hierarchical aggregates of anatase TiO2 nanoribbons/nanosheets (TiO2-NR) and anatase TiO2 nanoparticles (TiO2-NP) were produced through a one-step solvothermal reaction using acetic acid or ethanol and titanium isopropoxide as solvothermal reaction systems. The crystalline structure, crystalline phase, and morphologies of synthesized materials were characterized using several techniques. According to our findings, both TiO2-NR and TiO2-NP were found to have polycrystalline structures, with pure anatase phases. TiO2-NR has a three-dimensional hierarchical structure made up of aggregates of TiO2 nanoribbons/nanosheets, while TiO2-NP has a nanoparticulate structure. The photocatalytic and photocurrent activities for TiO2-NR and TiO2-NP were investigated and compared with the widely used commercial TiO2 (P25), which consists of anatase/rutile TiO2 nanoparticles, as a reference material. Our findings showed that TiO2-NR has higher photocatalytic and photocurrent performance than TiO2-NP, which are both, in turn, higher than those of P25. Our developed solvothermal method was shown to produce a pure anatase TiO2 phase for both synthesized structures, without using any surfactants or any other assisted templates. This developed solvothermal approach, and its anatase TiO2 nanostructure output, has promising potential for a wide range of energy harvesting applications, such as water pollution treatment and solar cells.

Background: Bloodstream infection (BSI) caused by carbapenem-resistant Enterobacteriaceae (CRE) significantly influences patient morbidity and mortality. We aimed to identify the characteristics, outcomes, and risk factors of mortality in adult patients with CRE bacteremia and elucidate the differences between carbapenemase-producing (CP)-CRE BSI and non-CP-CRE BSI. Methods: This retrospective study included 147 patients who developed CRE BSI between January 2016 and January 2019 at a large tertiary care hospital in South Korea. The patient demographic characteristics and clinical and microbiological data including the Enterobacteriaceae species and carbapenemase type were obtained and analyzed. Results: Klebsiella pneumoniae was the most commonly detected pathogen (80.3%), followed by Escherichia coli (15.0%). In total, 128 (87.1%) isolates were found to express carbapenemase, and most CP-CRE isolates harbored blaKPC. The 14-day and 30-day mortality rates for CRE BSI were 34.0% and 42.2%, respectively. Higher body mass index (odds ratio (OR), 1.123; 95% confidence interval (CI), 1.012–1.246; p = 0.029), higher sequential organ failure assessment (SOFA) score (OR, 1.206; 95% CI, 1.073–1.356; p = 0.002), and previous antibiotic use (OR, 0.163; 95% CI, 0.028–0.933; p = 0.042) were independent risk factors for the 14-day mortality. A high SOFA score (OR, 1.208; 95% CI; 1.081–0.349; p = 0.001) was the only independent risk factor for 30-day mortality. Carbapenemase production and appropriate antibiotic treatment were not associated with high 14- or 30-day mortality rates. Conclusions: Mortality from CRE BSI was related to the severity of the infection rather than to carbapenemase production or antibiotic treatment, showing that efforts to prevent CRE acquisition rather than treatment following CRE BSI detection would be more effective at reducing mortality.

This study investigated the immunogenicity of, and reactogenicity to, the ChAdOx1 nCoV-19 vaccine according to pre-existing adenovirus immunity. Individuals scheduled for COVID-19 vaccination were prospectively enrolled in a tertiary hospital with 2400 beds from March 2020 onwards. Pre-existing adenovirus immunity data was obtained before ChAdOx1 nCoV-19 vaccination. A total of 68 adult patients administered two doses of the ChAdOx1 nCoV-19 vaccine were enrolled. Pre-existing adenovirus immunity was identified in 49 patients (72.1%), but not in the remaining 19 patients (27.9%). The geometric mean titer of S-specific IgG antibodies was statistically higher in individuals without pre-existing adenovirus immunity at several time points: before the second ChAdOx1 nCoV-19 dose (56.4 (36.6–125.0) vs. 51.0 (17.9–122.3), p = 0.024), 2–3 weeks after the second ChAdOx1 nCoV-19 dose (629.5 (451.5–926.5) vs. 555.0 (287.3–926.0), p = 0.049), and 3 months after the second ChAdOx1 nCoV-19 dose (274.5 (160.5–655.3) vs. 176.0 (94.3–255.3), p = 0.033). In the absence of pre-existing adenovirus immunity, systemic events were observed with higher frequency, especially chills (73.7% vs. 31.9%, p = 0.002). In conclusion, individuals without pre-existing adenovirus immunity showed a higher immune response to ChAdOx1 nCoV-19 vaccination and a higher frequency of reactogenicity to ChAdOx1 nCoV-19 vaccination was observed.

A young man with smoldering multiple myeloma died of hypotensive shock 2.5 days after severe acute respiratory syndrome coronavirus 2 vaccination. Clinical findings suggested systemic capillary leak syndrome (SCLS); the patient had experienced a previous suspected flare episode. History of SCLS may indicate higher risk for SCLS after receiving this vaccine.