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Microalgae have demonstrated biostimulant potential owing to their ability to produce various plant growth-promoting substances, such as amino acids, phytohormones, polysaccharides, and vitamins. Most previous studies have primarily focused on the effects of microalgal biostimulants on plant growth. While biomass extracts are commonly used as biostimulants, research on the use of culture supernatant, a byproduct of microalgal culture, is scarce. In this study, we aimed to evaluate the potential of Chlorella vulgaris culture as a biostimulant and assess its effects on the growth and drought tolerance of Arabidopsis thaliana, addressing the gap in current knowledge. Our results demonstrated that the Chlorella cell-free supernatant (CFS) significantly enhanced root growth and shoot development in both seedlings and mature Arabidopsis plants, suggesting the presence of specific growth-promoting compounds in CFS. Notably, CFS appeared to improve drought tolerance in Arabidopsis plants by increasing glucosinolate biosynthesis, inducing stomatal closure, and reducing water loss. Gene expression analysis revealed considerable changes in the expression of drought-responsive genes, such as IAA5, which is involved in auxin signaling, as well as glucosinolate biosynthetic genes, including WRKY63, MYB28, and MYB29. Overall, C. vulgaris culture-derived CFS could serve as a biostimulant alternative to chemical products, enhancing plant growth and drought tolerance. [ABSTRACT FROM AUTHOR]

Background: Recent advancements in hip arthroplasty aim to enhance the stability, longevity, and functionality of femoral implants. However, the distal fitting of femoral stems, often caused by metaphyseal–diaphyseal mismatch, remains a significant issue, particularly in patients with Dorr type A femora. Such mismatches can result in suboptimal implant performance, leading to potential complications. This study focuses on evaluating the anatomical compatibility of five representative single-tapered wedge mid–short stems with the mediolateral (ML) anatomy of the proximal femur in an East Asian population, where these mismatches are often more pronounced. Methods: A total of 742 patients from two hospitals, all of whom underwent unilateral primary total hip arthroplasty, were included in the study. The contralateral proximal femur was confirmed to have normal anatomy in each patient. Hip anteroposterior radiographs were used for measurements, which were standardized in conjunction with CT images. Key anatomical parameters were measured, including proximal and distal medial–lateral canal dimensions, vertical offset, and medial offset. Five femoral stem designs—Tri-lock®, Taperloc®, Anthology®, Accolade II®, and Fit®—were evaluated. R programming was employed for a detailed fit analysis to match stem sizes with patient anatomy, categorizing the fit as proximal, simultaneous proximal–distal, or distal engagement. Results: Among the femoral stems analyzed, the Fit® stem demonstrated the closest alignment with the regression line for ML widths in the study population (slope = 0.69; population ML slope = 0.38). This was followed by Accolade II®, which had a slope of 0.83. In terms of offset options, the Accolade II® offered the largest offset coverage, making it particularly suitable for this population. The fit analysis revealed that the Fit® stem had the highest suitable fit rate (90.56%), followed by Accolade II® (73.04%). Taperloc®, Anthology®, and Tri-lock® had similar fit rates of approximately 59%. Overall, optimal results were obtained for 92.05% of the population in the automated fitting trial, regardless of the product type. Conclusions: When designing modern cementless femoral stems intended for press-fit fixation, it is crucial to account for the anatomical variations specific to the target population. In this study, Fit® and Accolade II® femoral components demonstrated superior compatibility with the femoral anatomy of the East Asian population, particularly in those with a higher incidence of Dorr type A femora. These stems, characterized by slimmer distal dimensions and high-offset options, appear to minimize metaphyseal–diaphyseal mismatch and associated complications. [ABSTRACT FROM AUTHOR]

Background: Early risk stratification is crucial due to septic patients' heterogeneity. Serum albumin level may reflect the severity of sepsis and host status. This study aimed to evaluate the prognostic ability of the initial sequential organ failure assessment (SOFA) score alone and combined with serum albumin levels for predicting 28-day mortality in patients with septic shock. Methods: We conducted an observational study using a prospective, multicenter registry of septic shock patients between October 2015 and May 2022 from 12 emergency departments in the Korean Shock Society and the results were validated by examining those from the septic shock cohort in Asan Medical Center. The primary outcome was 28-day mortality. The area under the receiver operating characteristic (ROC) curve was used to compare the predictive values of SOFA score alone and SOFA score combined with serum albumin level. Results: Among 5805 septic shock patients, 1529 (26.3%) died within 28 days. Mortality increased stepwise with decreasing serum albumin levels (13.6% in albumin ≥3.5, 20.7% in 3.5–3.0, 29.7% in 3.0–2.5, 44.0% in 2.5–2.0, 56.4% in <2.0). The albumin SOFA score was calculated by adding the initial SOFA score to the 4 points assigned for albumin levels. ROC analysis for predicting 28-day mortality showed that the area under the curve for the albumin SOFA score was 0.71 (95% CI 0.70–0.73), which was significantly higher than that of the initial SOFA score alone (0.68, 95% CI: 0.67–0.69). Conclusions: The combination of the initial SOFA score with albumin can improve prognostic accuracy for patients with septic shock, suggesting the albumin SOFA score may be used as an early mortality stratification tool. [ABSTRACT FROM AUTHOR]

Background: Cardiopulmonary resuscitation (CPR) is the cornerstone intervention for cardiac arrest, with extracorporeal CPR (ECPR) demonstrating enhanced survival and neurologic outcomes in in‐hospital cardiac arrest. This study explores the time interval between CPR initiation and the onset of extracorporeal membrane oxygenation (ECMO) in ECPR recipients, investigating its impact on survival outcomes. Methods: This retrospective analysis included 1950 adults who received CPR at a single medical center between March 2019 and April 2023. Data from 198 adult patients who had ECMO inserted during CPR were analyzed. The interval from CPR initiation to ECMO initiation was quantified and categorized as ≤20, 20–40, and >40 min. Cox regression analysis assessed associations between CPR‐to‐ECMO time and short‐ and long‐term mortalities. Results: Among the 198 patients who underwent ECPR, 116 (58.6%) experienced 30‐day mortality. Initiation of ECMO within 20 min occurred in 46 (23.2%), whereas 74 (37.4%) had ECMO initiated after 40 min. Cox regression revealed a significant association between time from CPR to ECMO initiation and 30‐day mortality (adjusted hazard ratio [HR]: 2.20 in >40 min, HR: 2.63 in 20–40 min, p = 0.006) and 6‐month mortality (HR: 1.81, in >40 min, HR: 1.99 in 20–40 min, p = 0.021). Conclusions: This study revealed that, in ECPR recipients, a shorter duration between CPR initiation and ECMO flow commencement is associated with improved short‐ and long‐term patient prognoses. These findings emphasize the critical role of timely ECMO application in optimizing outcomes for patients undergoing ECPR. [ABSTRACT FROM AUTHOR]

Background: We investigated the relationship between employment status, work patterns, and sudden cardiac arrest (SCA). Methods: This was a case–control study from September 2017 through December 2022 involving 17 emergency departments and 9 public health centers. The cases included patients aged 20–79 years with SCA, excluding those with traumatic arrest, terminal illness, pregnancy, unreliable information, or a "Do Not Resuscitate" order. Controls were selected from various health screening centers in Korea. All participants completed structured questionnaires. Propensity score matching was used to ensure comparability by age, sex, and socioeconomic status. Results: Of the 1536 patients enrolled, 116 from the case group were excluded due to missing employment data, leaving 1420 cases and 2304 controls for analysis. Employment was reported by 47.5% of cases and 59.4% of controls. There was no significant difference in the proportion of sole proprietors (20.6% vs. 22.5%, p = 0.39). The case group had a higher proportion of employers (13.2% vs. 6.5%, p < 0.001) and fewer employees (63.3% vs. 69.1%, p = 0.02). Professional roles were more common among controls (23.6% vs. 31.6%, p < 0.001), while labor-intensive jobs were more frequent in cases (27.7% vs. 17.8%, p < 0.001). The case group had more evening and night shifts (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.01–1.06; OR: 1.05, 95% CI: 1.01–1.09) and longer workdays (OR: 1.06, 95% CI: 1.03–1.08). Conclusions: SCA patients were more likely to work evening and night shifts and have longer workdays, often exceeding 10 h. [ABSTRACT FROM AUTHOR]