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Background Enterococcus faecium (E. faecium) is a member of symbiotic lactic acid bacteria in gastrointestinal tract and it was successfully used to treat diarrhea cases in humans. For a lactobacteria to survive during the pasteurization process, resistance of proteins to denaturation at high temperatures is crucial. Pyruvate kinase (PYK) is one of the proteins possessing such property. It plays a major role during glycolysis by producing pyruvate and adenosine triphosphate (ATP). Objective To assess the acquired thermostability of PYK of ALE strain using in silico methods. Methods First, we predicted and assessed tertiary structures of our proteins using SWISS-MODEL homology modelling server. Second, we then applied molecular dynamics (MD) simulation to simulate and assess multiple properties of molecules. Therefore, we implemented comparative MD to evaluate thermostability of PYK of recently developed high temperature resistant strain of E. faecium using Adaptive Laboratory Evolution (ALE) method. After 20ns of simulation at different temperatures, we observed that ALE enhanced strain demonstrated slightly better stability at 300, 340 and 350 K compared to that of the wild type (WT) strain. Results We collected the results of MD simulation at four temperature points: 300, 340, 350 and 400 K. Our results showed that the protein demonstrated increased stability at 340 and 350 K. Conclusion Results of these study suggest that PYK of ALE enhanced strain of E. faecium demonstrates overall better stability at elevated temperatures compared to that of WT strain.

Objectives: The purpose is to study how the perception of home training has changed through data comparison before and after the COVID-19 pandemic, to find out the changes in people’s perception of home training, which has become a new sports culture, to provide basic data and to suggest directions on how research using big data can be used in the sports field.Methods: In order to compare before and after the COVID-19 pandemic, text mining analysis was conducted by setting keywords as home training in Naver and Daum by setting from February 1, 2020 to November 30, 2020, when the first COVID-19 confirmed patient in Korea came out, and from February 1, 2019, to November 30, 2019.Results: As a result of CONCOR analysis between words related to home training, a total of 16 clusters were formed, eight each, including smart home training, YouTube, and health programs before COVID-19, and eight each, including smart home training, YouTube, and home training exercise equipment and types.Conclusions: This study can be used as a tool to understand the market status, trends, and directions of interest by grasping the public’s perception and status of home training.

Aims/hypothesis Non-alcoholic fatty liver disease (NAFLD) associated with type 2 diabetes may more easily progress towards severe forms of non-alcoholic steatohepatitis (NASH) and cirrhosis. Although the Wnt effector transcription factor 7-like 2 (TCF7L2) is closely associated with type 2 diabetes risk, the role of TCF7L2 in NAFLD development remains unclear. Here, we investigated how changes in TCF7L2 expression in the liver affects hepatic lipid metabolism based on the major risk factors of NAFLD development. Methods Tcf7l2 was selectively ablated in the liver of C57BL/6N mice by inducing the albumin (Alb) promoter to recombine Tcf7l2 alleles floxed at exon 5 (liver-specific Tcf7l2-knockout [KO] mice: Alb-Cre;Tcf7l2f/f). Alb-Cre;Tcf7l2f/f and their wild-type (Tcf7l2f/f) littermates were fed a high-fat diet (HFD) or a high-carbohydrate diet (HCD) for 22 weeks to reproduce NAFLD/NASH. Mice were refed a standard chow diet or an HCD to stimulate de novo lipogenesis (DNL) or fed an HFD to provide exogenous fatty acids. We analysed glucose and insulin sensitivity, metabolic respiration, mRNA expression profiles, hepatic triglyceride (TG), hepatic DNL, selected hepatic metabolites, selected plasma metabolites and liver histology. Results Alb-Cre;Tcf7l2f/f essentially exhibited increased lipogenic genes, but there were no changes in hepatic lipid content in mice fed a normal chow diet. However, following 22 weeks of diet-induced NAFLD/NASH conditions, liver steatosis was exacerbated owing to preferential metabolism of carbohydrate over fat. Indeed, hepatic Tcf7l2 deficiency enhanced liver lipid content in a manner that was dependent on the duration and amount of exposure to carbohydrates, owing to cell-autonomous increases in hepatic DNL. Mechanistically, TCF7L2 regulated the transcriptional activity of Mlxipl (also known as ChREBP) by modulating O-GlcNAcylation and protein content of carbohydrate response element binding protein (ChREBP), and targeted Srebf1 (also called SREBP1) via miRNA (miR)-33-5p in hepatocytes. Eventually, restoring TCF7L2 expression at the physiological level in the liver of Alb-Cre;Tcf7l2f/f mice alleviated liver steatosis without altering body composition under both acute and chronic HCD conditions. Conclusions/interpretation In mice, loss of hepatic Tcf7l2 contributes to liver steatosis by inducing preferential metabolism of carbohydrates via DNL activation. Therefore, TCF7L2 could be a promising regulator of the NAFLD associated with high-carbohydrate diets and diabetes since TCF7L2 deficiency may lead to development of NAFLD by promoting utilisation of excess glucose pools through activating DNL. Data availability RNA-sequencing data have been deposited into the NCBI GEO under the accession number GSE162449 (www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE162449). Graphical abstract

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

A dual-band branch-line coupler with ultra-wideband harmonic suppression is proposed in this paper. The conventional quarter-wavelength transmission lines are replaced with π-shaped lines to achieve a dual band. In addition, ultra-wideband harmonic suppression is obtained by the frequency-selecting coupling structure (FSCS) providing three transmission zeros. The two operating frequencies are 0.9 GHz and 2.0 GHz, and the corresponding -10 dB bandwidth at 0.9 GHz and 2.0 GHz is 18.9% and 10.5%, respectively. A wide harmonic suppression band is generated from 3.7 GHz to 8.3 GHz. The simulation and measurement results are in good agreement.

Heritability of stroke is assumed not to be low, especially in the young-age stroke population. However, most genetic studies have been performed in highly selected patients with typical clinical or neuroimaging characteristics. We investigated the prevalence of 15 Mendelian stroke genes and explored the relationships between variants and the clinical and neuroimaging characteristics in a large, unselected, young stroke population.We enrolled patients aged ≤55 years with stroke or transient ischemic attack from a prospective, nationwide, multicenter stroke registry. We identified clinically relevant genetic variants (CRGV) in 15 Mendelian stroke genes (GLA, NOTCH3, HTRA1, RNF213, ACVRL1, ENG, CBS, TREX1, ABCC6, COL4A1, FBN1, NF1, COL3A1, MT-TL1, and APP) using a customized, targeted next-generation sequencing panel.Among 1,033 patients, 131 (12.7%) had 28 CRGV, most frequently in RNF213 (n=59), followed by ABCC6 (n=53) and NOTCH3 (n=15). The frequency of CRGV differed by ischemic stroke subtypes (p0.01)-highest in other determined etiology (20.1%), followed by large artery atherosclerosis (13.6%). It also differed between patients aged ≤35 years and those aged 51-55 years (17.1% vs. 9.3%, p=0.02). Only 27.1% and 26.7% of patients with RNF213 and NOTCH3 variants had typical neuroimaging features of the corresponding disorders, respectively. Variants of uncertain significance (VUS) were found in 15.4% patients.CRGV in 15 Mendelian stroke genes may not be uncommon in the young stroke population. The majority of patients with CRGV did not have typical features of the corresponding monogenic disorders. Clinical implications of having CRGV or VUS should be explored. This article is protected by copyright. All rights reserved.

Purpose The advances in the treatment of retinoblastoma have enabled salvaging the globe in advanced stages with intra-arterial chemotherapy (IAC). We developed a strategy of alternate application of systemic intravenous chemotherapy (IVC) and IAC (referred to as alternate systemic IVC and IAC; ASIAC) to reduce central nervous metastases during IAC and examined its efficacy and safety in eye globe salvage in this study.Materials and Methods Between January 2010 and February 2021, 43 eyes of 40 patients received ASIAC treatment for retinoblastoma at the Yonsei Cancer Center, Yonsei University Health System. Their medical records were reviewed retrospectively to evaluate the eye salvage rate (ESR), defined from diagnosis to enucleation. High-risk retinoblastoma was defined as group D or E by the International Classification of Retinoblastoma.Results The study enrolled 38 and five cases of high-risk and low-risk retinoblastoma, respectively. In total, 178 IAC and 410 IVC courses were administered, with a median of 4 (interquartile range [IQR], 3.0 to 5.0) IAC and 9 (IQR, 6.0 to 11) IVC courses per eye, respectively. The 5-year ESR was 60.4%±8.7% for the whole cohort, 100% for low-risk retinoblastoma, and 53.6%±9.8% for high-risk retinoblastoma. Among those diagnosed since 2015, the 5-year ESR for high-risk retinoblastoma was 63.5%±14.0%. Fifteen eyes underwent enucleation; no viable tumor was found in three enucleated eyes. There were no deaths in this cohort.Conclusion Primary IAC-IVC (i.e., ASIAC) for patients with retinoblastoma was tolerable and effective in salvaging the eye and maintaining survival.

Mesoporous silica nanoparticles (MSNs) have modifiable porous surfaces, can be easily modified/functionalized, and have good chemical/thermal stability; thus, they are promising candidates in the field of CO2 conversion/reduction reactions.

Background: We aimed to evaluate covert brain infarction (CBI), frequently encountered during the diagnostic work-up of acute ischemic stroke, as a risk factor for stroke recurrence in patients with atrial fibrillation (AF). Methods: For this prospective cohort study, from patients with acute ischemic stroke hospitalized at 14 centers between 2017 and 2019, we enrolled AF patients without history of stroke or transient ischemic attack and divided them into the CBI (+) and CBI (−) groups. The 2 groups were compared regarding the 1-year cumulative incidence of recurrent ischemic stroke and all-cause mortality using the Fine and Gray subdistribution hazard model with nonstroke death as a competing risk and the Cox frailty model, respectively. Each CBI lesion was also categorized into either embolic-appearing (EA) or non-EA pattern CBI. Adjusted hazard ratios and 95% CIs of any CBI, EA pattern CBI only, non-EA pattern CBI only, and both CBIs were estimated. Results: Among 1383 first-ever stroke patients with AF, 578 patients (41.8%) had CBI. Of these 578 with CBI, EA pattern CBI only, non-EA pattern CBI only, and both CBIs were 61.8% (n=357), 21.8% (n=126), and 16.4% (n=95), respectively. The estimated 1-year cumulative incidence of recurrent ischemic stroke was 5.2% and 1.9% in the CBI (+) and CBI (−) groups, respectively ( P =0.001 by Gray test). CBI increased the risk of recurrent ischemic stroke (adjusted hazard ratio [95% CI], 2.91 [1.44–5.88]) but did not the risk of all-cause mortality (1.32 [0.97–1.80]). The EA pattern CBI only and both CBIs elevated the risk of recurrent ischemic stroke (2.76 [1.32–5.77] and 5.39 [2.25–12.91], respectively), while the non-EA pattern only did not (1.44 [0.40–5.16]). Conclusions: Our study suggests that AF patients with CBI might have increased risk of recurrent stroke. CBI could be considered when estimating the stroke risk in patients with AF.

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This study conducted a discharging experiment of high-expansion foams at a real-scale experimental underground utility tunnel and proposed an effective fire response plan. The study analyzed the discharge and foaming characteristics of high-expansion foam in the event of an underground utility tunnel fire. When high-expansion foams were injected at one point, foam agents started to break out four minutes after reaching reduction time. Meanwhile, when high-expansion foams were injected at three points, the experimental tunnel was filled entirely after seven minutes using 650 L of extinguishing agent. Moreover, in the cellar nozzle experiment, discharging from a nozzle injected horizontally to a manhole was more effective than that from a nozzle vertically injected to push smoke and heat.

A vertebral fracture is the most common type of osteoporotic fracture. Osteoporotic vertebral fractures (OVFs) cause a variety of morbidities and deaths. There are currently few “gold standard treatments” outlined for the management of OVFs in terms of quantity and quality. Conservative treatment is the primary treatment option for OVFs. The treatment of pain includes short-term bed rest, analgesic medication, anti-osteoporotic medications, exercise, and a brace. Numerous reports have been made on studies for vertebral augmentation (VA), including vertebroplasty and kyphoplasty. There is still debate and controversy about the effectiveness of VA in comparison with conservative treatment. Until more robust data are available, current evidence does not support the routine use of VA for OVF. Despite the fact that the majority of OVFs heal without surgery, 15%–35% of patients with an unstable fracture, persistent intractable back pain, or severely collapsed vertebra that causes a neurologic deficit, kyphosis, or chronic pseudarthrosis frequently require surgery. Because no single approach can guarantee the best surgical outcomes, customized surgical techniques are required. Surgeons must stay current on developments in the osteoporotic spine field and be open to new treatment options. Osteoporosis management and prevention are critical to lowering the risk of future OVFs. Clinical studies on bisphosphonate’s effects on fracture healing are lacking. Teriparatide was intermittently administered, which dramatically improved spinal fusion and fracture healing while lowering mortality risk. According to the available literature, there are no standard management methods for OVFs. More multimodal approaches, including conservative and surgical treatment, VA, and medications that treat osteoporosis and promote fracture healing, are required to improve the quality of the majority of guidelines.

The phytohormone abscisic acid (ABA) plays a prominent role in various abiotic stress responses of plants. In the ABA-dependent osmotic stress response, SnRK2.6, one of the subclass III SnRK2 kinases, has been identified as playing a key role by phosphorylating and activating downstream genes. Although several modulatory proteins have been reported to be phosphorylated by SnRK2.6, the identities of the full spectrum of downstream targets have yet to be sufficiently established. In this study, we identified CaSAP14, a stress-associated protein in pepper (Capsicum annuum), as a downstream target of CaSnRK2.6. We elucidated the physical interaction between SnRK2.6 and CaSAP14, both in vitro and in vivo, and accordingly identified a C-terminal C2H2-type zinc finger domain of CaSAP14 as being important for their interaction. CaSAP14-silenced pepper plants showed dehydration- and high salt-sensitive phenotypes, whereas overexpression of CaSAP14 in Arabidopsis conferred tolerance to dehydration, high salinity, and mannitol treatment, with plants showing ABA-hypersensitive phenotypes. Furthermore, an in-gel kinase assay revealed that CaSnRK2.6 phosphorylates CaSAP14 in response to exogenous ABA, dehydration, and high-salinity stress. Collectively, these findings suggest that CaSAP14 is a direct substrate of CaSnRK2.6 and positively modulates dehydration- and high salinity-induced osmotic stress responses.

Background and Objectives The purpose of this study was to examine the benefits of ultrasonography performed by a surgeon rather than a radiologist.Subjects and Method This retrospective study enrolled 122 cases of ultrasonography performed by a head and neck surgeon and 116 cases of the same examination performed by a radiologist before surgery. The time intervals between the first visit and surgery were compared in both groups.Results The average waiting time for surgery after the first hospital visit was significantly reduced when a surgeon performed the ultrasound examination. Furthermore, there was no significant difference in sampling inadequacy rate on thyroid fine needle aspiration (FNA) between FNA performed by a head and neck surgeon and a radiologist.Conclusion Surgeons can utilize ultrasound as a diagnostic and therapeutic tool in an office-based setting. For patients, diagnosis and treatment provided by a single doctor will lead to more efficient outcomes.

Early diagnosis and intervention by visiting the emergency department (ED) are important for traumatic brain injury (TBI). We evaluate the factors associated with delayed ED visits in patients with intracranial TBI.A retrospective multicenter observational study using the ED-based injury in-depth surveillance database (EDIIS) was designed. Patients with intracranial TBI with an alert mentality at ED presentation from 2014 to 2019 were enrolled. Patients were categorized into four groups according to ED visit time after injury (1 h, 1-3 h, 3-12 h, and12 h). ED visits after 12 h were defined as delayed ED visits. The factors associated with delayed ED visits were identified using multivariable logistic regression analysis.Among 15,620 patients with TBI enrolled in the final analysis, 2,190 (14.0%) visited the ED 12 h after injury. Multivariable analysis identified the following factors as independent predictors for delayed ED visit such as unintentionally struck by or against an object or unintentional fall as a trauma mechanism, injury during ordinary activities, indoor injury, injury during nighttime, winter season, combined subdural hemorrhage and epidural hemorrhage.In patients with intracranial TBI with an alert mentality, multiple factors related to patient demographics and injury characteristics were associated with the time interval from injury to ED visit.

Epitaxial growth of inorganic crystals on 2D materials is expected to greatly advance nanodevices and nanocomposites. However, because pristine surfaces of 2D materials are chemically inert, it is difficult to grow inorganic crystals epitaxially on 2D materials. Previously, successful results were achieved only by vapor-phase deposition at high temperature, and solution-based deposition including spin coating made the epitaxial growth unaligned, sparse, or nonuniform on 2D materials. Here, we show that solvent-controlled spin coating can uniformly deposit a dense layer of epitaxial AgCN microwires onto various 2D materials. Adding ethanol to an aqueous AgCN solution facilitates uniform formation of the thin supersaturated solution layer during spin coating, which promotes heterogeneous crystal nucleation on 2D material surfaces over homogeneous nucleation in the bulk solution. Microscopic analysis confirms highly aligned, uniform, and dense growth of epitaxial AgCN microwires on graphene, MoS

The environmental regulations on vessels being strengthened by the International Maritime Organization has led to a steady growth in the eco-friendly ship market. Related research is being actively conducted, including many studies on the maintenance and predictive maintenance of propulsion systems (including electric motors and rotating bodies) in electric propulsion vessels. The present study intends to enhance the artificial intelligence (AI)-based failure-diagnosis rate for electric propulsion vessel propulsion systems. To verify the proposed AI-based failure diagnosis algorithm for electric motors, this study utilized the vibration data of mechanical equipment (electric motors) in an urban railway station. Securing and preprocessing high-quality data is crucial for improving the failure-diagnosis rate, in addition to the performance of the diagnostic algorithm. However, the conventional wavelet transform method, which is generally used for machine signal processing, has a disadvantage of data loss when the data distribution is abnormal or skewed. This study, to overcome this shortcoming, proposes an AI-based denoising auto encoder (DAE) method that can remove noise while maintaining data characteristics for signal processing of mechanical equipment. This study preprocessed vibration data by using the DAE method, and extracted significant features from the data through the feature extraction method. The extracted features were utilized to train the one-class support vector machine model and to allow the model to diagnose the failure. Finally, the F-1 score was calculated by using the failure diagnosis results, and the most meaningful feature extraction method was determined for the vibration data. In addition, this study compared and evaluated the preprocessing performance based on the DAE and the wavelet transform methods.

In traumatic amputations in the upper extremities, replantation has been commonly attempted with high success rates. However, successful replantation implies both the maintenance of length and good functional outcomes of the restored hand. Since the thumb accounts for 40% to 50% of hand function, the utmost priority is on the salvage of the thumb. In cases when replantation is not feasible, various efforts have been made to replace the thumb, including pollicization of the index finger, toe transfer, lengthening of the thumb stump, and deepening of the first web space. Alternatively, heterotopic thumb-to-thumb replantation has been suggested as a rescue plan in rare circumstances of bilateral amputation in the upper extremities. However, even if heterotopic replantation is successful, there are situations in which a severe crushing injury to the thenar muscles of the recipient’s thumb causes opposition failure of the reconstructed thumb. We report a case of functional reconstruction of the thumb in a rare case of bilateral mangling amputations in the upper extremities, by a heterotopic thumb-to-thumb replantation combined with secondary opponensplasty to compensate for the opposition failure.