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Elucidation of the interplay between viruses and host cells is crucial for taming viruses to benefit human health. Cancer therapy using adenovirus, called oncolytic virotherapy, is a promising treatment option but is not robust in all patients. In addition, inefficient replication of human adenovirus in mouse hampered the development of an in vivo model for preclinical evaluation of therapeutically engineered adenovirus. nc886 is a human non-coding RNA that suppresses Protein Kinase R (PKR), an antiviral protein. In this study, we have found that nc886 greatly promotes adenoviral gene expression and replication. Remarkably, the stimulatory effect of nc886 is not dependent on its function to inhibit PKR. Rather, nc886 facilitates the nuclear entry of adenovirus via modulating the kinesin pathway. nc886 is not conserved in mouse and, when xenogeneically expressed in mouse cells, promotes adenovirus replication. Our investigation has discovered a novel mechanism of how a host ncRNA plays a pro-adenoviral role. Given that nc886 expression is silenced in a subset of cancer cells, our study highlights that oncolytic virotherapy might be inefficient in those cells. Furthermore, our findings open future possibilities of harnessing nc886 to improve the efficacy of oncolytic adenovirus and to construct nc886-expressing transgenic mice as an animal model.

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in young children. However, effective treatment against RSV is unavailable. tRNA-derived RNA fragments (tRFs) are a recently discovered family of non-coding RNAs. We made an early observation that RSV infection causes significant induction of tRFs, which are mainly derived from the 5’-end of mature tRNAs (tRF5). However, their functions and biogenesis mechanism are not fully understood. Herein, we identified an enzyme responsible for the induction of a functional tRF5 derived from tRNA-Gln-CTG (tRF5-GlnCTG). We found that tRF5-GlnCTG promotes RSV replication and its induction, assessed by Northern blot and a new qRT-PCR-based method, is regulated by ribonuclease ELAC2. ELAC2-mediated tRF5 induction has never been reported. We also found that ELAC2 is associated with RSV N and NS1 proteins. Given the fact that tRF5-GlnCTG plays a role in RSV replication, the identification of ELAC2 being responsible for tRF5-GlnCTG induction could provide new insights into therapeutic strategy development against RSV infection.

This study examines how a model's pose that signals power influences consumers' recall ability of price information in advertisements. To extend prior findings on social judgments, we suggest that the direction of consumers' gaze and willingness to pay attention to the model vary depending on the model's pose. Study 1 explores how consumers' perception of the power of the model affects their price recall ability. In particular, consumers demonstrate better price recall for items displayed at the bottom of the ad when the model adopts a powerful pose and items displayed at the top when the model in the ad assumes a submissive pose. Study 2 investigates the influence of the perceived power of a model's pose on price recall depending on the visibility of the model's face and reveals that consumers demonstrate better price recall for items displayed at the top when the model's face is not visible even when the model adopts a powerful pose. Ultimately, this research provides new insights to help marketers identify ideal locations for displaying price information in ads. More theoretical and practical implications are also discussed.

Histone variants act as transcriptional activators and repressors and have been linked to cancer progression. Park and Choi et al. show that the histone H3.3 overexpression is associated with early-stage lung cancer, and promotes cancer cell migration by upregulating a G-protein-coupled receptor.

nc886 is a regulatory non-coding RNA (ncRNA) whose expression is frequently silenced in malignancies. In the case of esophageal squamous cell carcinoma (ESCC), nc886 silencing is associated with shorter survival of patients, suggesting nc886′s tumor suppressor role in ESCC. However, this observation has not been complemented by an in-detail study about nc886′s impact on gene expression and cellular phenotypes. Here we have shown that nc886 inhibits AKT, a key protein in a renowned pro-survival pathway in cancer. nc886-silenced cells (nc886- cells) have activated AKT and altered expression of cell cycle genes. nc886- cells tend to have lower expression of CDKN2A and CDKN2C, both of which are inhibitors for cyclin-dependent kinase (CDK), and higher expression of CDK4 than nc886-expressing cells. As a result, nc886- cells are hyperactive in the progression of the G1 to S cell cycle phase, proliferate faster, and are more sensitive to palbociclib, which is a cancer therapeutic drug that targets CDK4/6. Experimentally by nc886 expression and knockdown, we have determined the AKT target genes and cell cycle genes that are controlled by nc886 (nc886-associated gene sets). These gene sets, in combination with pathologic staging and nc886 expression levels, are a vastly superior predictor for the survival of 108 ESCC patients. In summary, our study has elucidated in ESCC how nc886 inhibits cell proliferation to explain its tumor suppressor role and identified gene sets that are of future clinical utility, by predicting patient survival and responsiveness to a therapeutic drug.

Background: Numerous studies have investigated methods of predicting postoperative pulmonary complications (PPCs) in lung cancer surgery, with chronic obstructive pulmonary disease (COPD) and low forced expiratory volume in 1 second (FEV1) being recognized as risk factors. However, predicting complications in COPD patients with preserved FEV1 poses challenges. This study considered various diffusing capacity of the lung for carbon monoxide (DLCO) parameters as predictors of pulmonary complication risks in mild COPD patients undergoing lung resection. Methods: From January 2011 to December 2019, 2,798 patients undergoing segmentectomy or lobectomy for non-small cell lung cancer (NSCLC) were evaluated. Focusing on 709 mild COPD patients, excluding no COPD and moderate/severe cases, 3 models incorporating DLCO, predicted postoperative DLCO (ppoDLCO), and DLCO divided by the alveolar volume (DLCO/VA) were created for logistic regression. The Akaike information criterion and Bayes information criterion were analyzed to assess model fit, with lower values considered more consistent with actual data. Results: Significantly higher proportions of men, current smokers, and patients who underwent an open approach were observed in the PPC group. In multivariable regression, male sex, an open approach, DLCO

Background: Sutureless valves are widely used in aortic valve replacement surgery, with Perceval valves and Intuity valves being particularly prominent. However, concerns have been raised about postoperative thrombocytopenia with Perceval valves (Corcym, UK). We conducted a comparative analysis with the Intuity valve (Edwards Lifesciences, USA), and assessed how thrombocytopenia affected patient and transfusion outcomes. Methods: Among 595 patients who underwent aortic valve replacement from June 2016 to March 2023, sutureless valves were used in 53 (Perceval: n=23; Intuity: n=30). Platelet counts were monitored during hospitalization and outpatient visits. Daily platelet count changes were compared between groups, and the results from patients who underwent procedures using Carpentier Edwards Perimount Magna valves were used as a reference group. Results: Compared to the Intuity group, the Perceval group showed a significantly higher amount of platelet transfusion (5.48±1.64 packs vs. 0.60±0.44 packs, p=0.008). During the postoperative period, severe thrombocytopenia (

Technology can help expand communities of practice in music education and promote a democratic schooling process vital to culturally sustaining pedagogy. Through careful and effective implementation, technology helps connect students to relevant musical communities and supports educators in achieving student-centered thinking and practices. The increased use of technology during the pandemic created a unique opportunity for music educators to reflect on both the educational benefits and challenges of implementing technological resources in the music classroom. From smaller activities to large-scale projects, there are strong implications for how technology can play a role in transformative music education.

ObjectiveThis research conducted two studies in South Korea to explore the relationship between smokers’ self-construals and the types of cigarettes they use, emphasizing their combined effects on cessation campaign effectiveness.MethodsStudy 1 explored how smokers’ self-construals influenced their intentions to quit smoking or vaping, considering their primary cigarette usage. Study 2 further investigated this relationship within cessation campaigns, employing messages framed by both self-construal (independent vs. interdependent) and cigarette type (combustible vs. electronic).ResultsThe results of Study 1 showed that individuals with a strong interdependent self-construal were more likely to express intentions to quit smoking or vaping when using e-cigarettes compared to combustible cigarettes. Similarly, Study 2 demonstrated that cessation messages for e-cigarettes were more effective in eliciting intentions to quit when presented with an interdependent self-construal frame, while messages for combustible cigarettes showed greater effectiveness with an independent self-construal frame.ConclusionCampaigns solely focused on independent self-construals might not effectively persuade e-cigarette users to quit, as they may prioritize communal wellbeing over individual benefits. Adapting anti-e-cigarette campaigns to align with the values of interdependent self-construals could yield better outcomes in promoting cessation among e-cigarette users.

Abstract Pregnancy imposes a substantial metabolic burden on women, but little is known about whether or how multiple pregnancies increase the risk of maternal postpartum diabetes. In this study, we assessed the metabolic impact of multiple pregnancies in humans and in a rodent model. Mice that underwent multiple pregnancies had increased adiposity, but their glucose tolerance was initially improved compared to those of age-matched virgin mice. Later, however, insulin resistance developed over time, but insulin secretory function and compensatory pancreatic β cell proliferation were impaired in multiparous mice. The β cells of multiparous mice exhibited aging features, including telomere shortening and increased expression of Cdkn2a. Single-cell RNA-seq analysis revealed that the β cells of multiparous mice exhibited upregulation of stress-related pathways and downregulation of cellular respiration- and oxidative phosphorylation-related pathways. In humans, women who delivered more than three times were more obese, and their plasma glucose concentrations were elevated compared to women who had delivered three or fewer times, as assessed at 2 months postpartum. The disposition index, which is a measure of the insulin secretory function of β cells, decreased when women with higher parity gained body weight after delivery. Taken together, our findings indicate that multiple pregnancies induce cellular stress and aging features in β cells, which impair their proliferative capacity to compensate for insulin resistance.

PURPOSE This study aimed to investigate the effects of continuous exercise and the accumulation of short-duration exercise for 12 weeks on body composition, physical fitness, and lifestyle disease indices in overweight men in their 30s. METHODS Participants in the continuous exercise group (CE; n=13) performed a circuit exercise program of 30 min/session, 3 sessions/week for 12 weeks. Participants in the accumulation of short duration exercise group (ASE; n=12) performed the same exercise time of 30 min per day, divided into three sessions of 10 min. Body composition, physical fitness, and lifestyle disease indices were measured pre- and post-test and were compared by utilizing a repeated two-way ANOVA. RESULTS 1) Regarding body composition, body weight, body mass index, skeletal muscle mass, waist circumference, and fat mass decreased significantly, while hip circumference increased significantly in the CE group. Waist circumference and skeletal muscle mass decreased significantly, while hip circumference increased significantly in the ASE group. 2) Regarding physical fitness, right grip strength, sit and reach, sit up, and maximal oxygen uptake increased significantly in both groups. 3) Regarding hypertension indices, there were no significant differences in both groups, but they showed a tendency to improve. 4) Regarding hyperlipidemia indices, triglycerides (TG) decreased significantly in both groups, and total cholesterol (TC) decreased significantly in the CE group. 5) Regarding diabetes indices, there were no significant differences in both groups, but a tendency to improve was noticed. 6) Regarding arteriosclerosis indices: TG/high density lipoprotein-cholesterol ratio decreased significantly in both groups, and the TC/high density lipoprotein-cholesterol ratio decreased significantly in the CE group. CONCLUSIONS We concluded that both the accumulation of short duration exercise and continuous exercise can be effective in improving body composition, physical fitness, and lifestyle disease in overweight men.

This study examined the tensile strength and biocompatibility properties of polyvinyl alcohol (PVA) hydrogel tissue regeneration scaffolds with polylactic acid (PLA) mesh fabric added as reinforcement, with a focus on the impact of heat treatment temperature and the number of layers of the PLA mesh fabric. The hydrogel scaffolds were prepared using a freeze–thaw method to create PVA hydrogel, with the PLA mesh fabric placed inside the hydrogel. The swelling ratio of the PVA/PLA hydrogel scaffolds decreased with increasing layer number and heat treatment temperature of the PLA mesh. The gel strength was highest when five layers of PLA mesh fabric were added, heat-treated at 120 °C, and confirmed to be properly placed inside the hydrogel by SEM images. The MTT assay and DAPI staining using HaCaT cells demonstrated that the cell proliferation was uninterrupted throughout the experimental period, confirming the biocompatibility of the scaffold. Therefore, we confirmed the possibility of using PLA mesh fabric as a reinforcement for PVA hydrogel to improve the strength of scaffolds for tissue regeneration, and we confirmed the potential of PLA mesh fabric as a reinforcement for various biomaterials.

Abstract 2D transition‐metal dichalcogenide (TMDC) materials are promising candidates with excellent thermoelectric (TE) properties owing to their low dimensionality in electronic and phonon transport. However, the considerable coupling of the Seebeck coefficient and electrical conductivity in such TE materials eventually results in the limit of the TE power factor increase, which severely hinders potential TE device applications. Herein, an alternative approach is demonstrated for breaking the strong coupling between the Seebeck coefficient and electrical conductivity in single TE materials by adopting a novel stacked PtSe2/PtSe2 homostructure. By alternately piling low‐resistance (LR) PtSe2 (3 nm) onto high‐resistance (HR) PtSe2 (2 nm) as one unit, the Seebeck coefficient and electrical conductivity of such stacked homostructures can be greatly enhanced with slightly improved electrical conductivity, ultimately resulting in a TE power factor in three‐unit‐stacked homostructures that is ≈1,648% higher than that of a single PtSe2 (15 nm) layer with the same thickness. This enhancement is attributed to an independent increase in the Seebeck coefficient, which depends on the interface among the LR and HR PtSe2 layers. The findings pave the way for a method that, unlike power factor optimization in conventional thermoelectric materials, can only utilize the Seebeck coefficient and electrical conductivity of each layer in a stacked homostructure.

Coxsackievirus A6 (CV-A6) has emerged as the predominant causative agent of hand, foot, and mouth disease (HFMD) in young children. Since the declaration of coronavirus disease 2019 (COVID-19) as a global pandemic, the incidence of infectious diseases, including HFMD, has decreased markedly. When social mitigation was relaxed during the COVID-19 pandemic in 2022, the re-emergence of HFMD was observed in Gwangju, South Korea, and seasonal characteristics of the disease appeared to have changed. To investigate the molecular characteristics of enterovirus (EV) associated with HFMD during 2022, 277 specimens were collected. Children aged younger than 5 years accounted for the majority of affected individuals. EV detection and genotyping were performed using real-time RT-PCR and nested RT-PCR followed by sequence analysis. The EV detection rate was found to be 82.3%, and the main genotype identified was CV-A6. Sixteen CV-A6 samples were selected for whole genome sequencing. According to phylogenetic analysis, all CV-A6 strains from this study belonged to the sub-genotype D3 clade based on VP1 sequences. Analysis of 3D polymerase phylogeny showed that only the recombinant RF-A group was identified. In conclusion, circulating EV types should be continuously monitored to understand pathogen emergence and evolution during the post-pandemic era.

Contaminated autonomous-driving sensors frequently malfunction, resulting in accidents; these sensors need regular cleaning. The autonomous-driving sensor-cleaning nozzle currently used is the windshield-washer nozzle; few studies have focused on the sensor-cleaning nozzle. We investigated the flow characteristics of the nozzle to improve its performance in cleaning the autonomous-driving sensor. The nozzle concept was based on the fluidic oscillator nozzle. Various performance parameters of the fluidic oscillator nozzle were selected and investigated. Transient fluid flow was simulated to determine the effect of the design parameters to maximize the oscillation flow phenomenon. Additionally, the spray angle and frequency were calculated. Analysis results showed that the change in flow speed affects the frequency, and the change in feedback-channel-inlet flow rate affects the angle change. To verify the simulation result, the three best models (R4+RC10, R6+RC11, R8+RC10) and the base model were manufactured and tested. The test results were consistent with the simulation results within a 6% error.

Summary: The four-chamber structure of the mammalian heart is established during embryonic development. While key regulators for ventricular development are well studied, regulatory mechanisms for atrial chamber morphogenesis remain poorly understood. Here, we found that angiopoietin-1 (Angpt1), a vascular maturation factor, is highly and specifically expressed in atrial myocardium during heart development. Loss of myocardial Angpt1 in mouse embryo led to severe impairment in atrial chamber morphogenesis. We revealed that Angpt1 deficiency results in excessive deposition of cardiac jelly, which disturbs regulation of myocardial growth, thereby impairing maturation of atrial chambers. Mechanistically, myocardial Angpt1 activates endocardial Tie2 and positively regulates expression of ADAMTS proteases, which is crucial for proper degradation of cardiac jelly. Accordingly, loss of Tie2 also impairs ADAMTS-mediated degradation of cardiac jelly in atrium. Collectively, myocardial Angpt1/endocardial Tie2 signaling in atrium promotes spatiotemporal degradation of cardiac jelly during early cardiac development and is therefore indispensable for atrial chamber morphogenesis. : Kim et al. demonstrate that myocardium-derived Angpt1 is indispensable for atrial chamber morphogenesis. Myocardial Angpt1 activates endocardial Tie2 signaling and positively regulates ADAMTS-dependent degradation of cardiac jelly. Proper distribution of cardiac jelly is critical for the regulation of myocardial growth and chamber morphogenesis in the atrium.

Purpose Colorectal cancer (CRC) is generally considered a disease of old age. Most CRCs are diagnosed at age 50 and over. CRC rarely occurs in teenagers, and the clinical features and prognosis of CRC are not clear in this population. The aim of this study was to uncover the clinicopathologic characteristics of teenage sporadic CRC. Methods Of the 21,042 patients who underwent operation for primary CRC at Asan Medical Center between July 1989 and December 2014, 19 cases (0.09%) without a familial history of CRC before 20 years of age at diagnosis were enrolled in this study. The clinicopathologic features of the teenage sporadic CRC patients were retrospectively reviewed. Results Of the 19 patients, 16 patients (84.2%) were male. The most common primary site was the left colon (descending colon & sigmoid colon) in nine patients. With respect to histologic type, adenocarcinoma represented 57.8% of cases, mucinous adenocarcinoma, 31.5%, and signet ring cell carcinoma, 10.5%. Six (31.5%) patients showed peritoneal seeding at presentation. In survival analysis, the 5-year overall survival rate of the patients who underwent curative surgery was 71.3%. Conclusion Teenage sporadic CRC is a very rare disease and the proportion of patients with a poor histologic subtype is high, but early detection and radical treatment can lead to favorable survival rates.

Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS. [ABSTRACT FROM AUTHOR]

Weaned calves are susceptible to infectious diseases because of the stress and malnutrition that occurs during weaning. Therefore, the dairy industry requires effective feed additives to ameliorate stress responses and promote immunity. This study aimed to investigate the effects of hydrolyzed yeast (HY) supplementation on the growth performance, immune and stress parameters, and health status of calves after weaning. Eighteen Holstein calves were randomly assigned to two groups, either receiving a control calf starter or 0.2% HY calf starter from one week of age. All calves were weaned at six weeks of age as a stress challenge. The HY-fed calves had a significantly-higher body weight gain during the post-weaning period (kg/week) compared to the control. Cortisol levels at three days post-weaning (DPW) were significantly lower in the HY group than the control group. Calves fed HY had significantly-higher serum levels of tumor necrosis factor-α and interleukin-1β at one DPW. The HY-fed calves also had higher concentrations of the acute-phase proteins, haptoglobin, serum amyloid A, and transferrin at one DPW. In addition, the diarrhea severity in HY-fed calves was milder after weaning compared to the control group. Our results indicate that HY supplementation reduces stress responses and may promote innate immunity in newly-weaned calves.

The microbial community within the rumen can be changed and shaped by heat stress. Accumulating data have suggested that different breeds of dairy cows have differential heat stress resistance; however, the underlying mechanism by which nonanimal factors contribute to heat stress are yet to be understood. This study is designed to determine changes in the rumen microbiome of Holstein and Jersey cows to normal and heat stress conditions. Under heat stress conditions, Holstein cows had a significantly higher respiration rate than Jersey cows. Heat stress increased the rectal temperature of Holstein but not Jersey cows. In the Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis, Jersey cows had a significantly higher proportion of genes associated with energy metabolism in the normal condition than that with other treatments. Linear discriminant analysis effect size (LEfSe) results identified six taxa as distinguishing taxa between normal and heat stress conditions in Holstein cows; in Jersey cows, 29 such taxa were identified. Changes in the rumen bacterial taxa were more sensitive to heat stress in Jersey cows than in Holstein cows, suggesting that the rumen mechanism is different in both breeds in adapting to heat stress. Collectively, distinct changes in rumen bacterial taxa and functional gene abundance in Jersey cows may be associated with better adaptation ability to heat stress.

Introduction. Cyclooxygenase-2 (COX-2) expression is elevated in colorectal cancer (CRC). However, data about the relation between COX-2 expression and the impact on the biologic behavior of recurrent disease are inconclusive as yet. The aim of this study is to investigate the relationship between the status of COX-2 expression in the primary CRC and the characteristics of recurrence after curative resection of stage I to III CRC. Materials and Methods. Ninety-eight patients with recurrence in 376 CRC patients, who underwent curative surgery between January 1991 and August 2001, were retrospectively assessed. Immunohistochemical staining, performed for the presence of COX-2 on tissue microarrays, was analyzed. Results. Forty-six patients showed elevated COX-2 expression, and 52 patients did not. The mean time to recurrence was significantly longer in the positive group than in the negative group (34.1 months ± 30.0 versus 21.9 months ± 17.4; P=0.019). Positive COX-2 expression was correlated with late recurrence (>3 years after surgery) [43.5% versus 13.5%; P=0.001]. In multivariate analysis, COX-2 expression was an independent factor associated with late recurrence (OR 4.656; 95% CI, 1.696 to 12.779; P=0.003). Recurrence pattern and postrecurrence survival were not different between the two groups. Conclusions. Elevated COX-2 expression in itself is not a prognostic factor, but COX-2 expression in tumor tissue may be an independent predictive marker of late recurrence for patients with stage I to III CRC.

Little research has been conducted to explain the effects of gay-themed advertising in a cross-cultural context. Such research has been particularly scarce in South Korea. This study is designed to investigate the effects of cultural orientation, gender, and types of gay-themed advertising in evaluation of gay male and female lesbian print ads. The study results indicate that Korean college students (i.e., collectivists) had lower tolerance of homosexuality than did U.S. college students (i.e., individualists). The study also finds that gender-role beliefs lead males to have lower tolerance of homosexuality. However, gender did not have statistically significant impacts on advertising and brand evaluation. Lastly, the study also found that lesbian imagery print ads could lead to greater tolerance of homosexuality and more favorable evaluations of the advertising and brand than could gay male imagery print ads. The current study sheds some light on the characteristics of U.S. consumers and Korean consumers on tolerance of homosexuality and gay-themed ads. Limitations and areas for further research are discussed.

Background/Purpose: The role and optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis without cholangitis (ABPwoC) remains unclear. Using a large national database, we aimed to examine hospitalization outcomes of patients with ABPwoC as a function of the performance and timing of ERCP. Methods: This was a retrospective study of adult patients with ABPwoC utilizing the National Inpatient Sample from 2016–2017. Patients who underwent inpatient ERCP were stratified into performance: within 24, 24–48, 48–72, and >72 h of hospital admission. The primary outcome was all‐cause inpatient mortality as a function of the performance and timing of ERCP; secondary outcomes, including healthcare utilization, were assessed. Multivariate modeling was used to adjust for potential confounders. Statistical analyses were conducted using STATA, version 16.0. Results: Of the 70 030 patients with ABPwoC, 31.37% underwent inpatient ERCP. Performance (aOR: 0.6, p <.05), but not timing (aOR: 0.98, p =.9), of inpatient ERCP was associated with significantly lower all‐cause inpatient mortality. Urgent ERCP (within 24 h) was associated with shorter hospital length of stay, lower charges and cost, and less need for pancreatic drainage procedures, while ERCP within 72 h was associated with less frequent intensive care unit admission (all p <.05). Discussion: Based on this large, nationwide analysis, inpatient ERCP for ABPwoC is associated with lower all‐cause mortality. ERCP within 24 and 72 h, though not associated with lower mortality, are associated with multiple improved clinical outcomes, including lower healthcare charges and costs. [ABSTRACT FROM AUTHOR]

NAD-dependent formate dehydrogenase (FDH) from Candida boidinii (CbFDH) has been widely used in various CO2-reduction systems but its practical applications are often impeded due to low CO2-reducing activity. In this study, we demonstrated superior CO2-reducing properties of FDH from Thiobacillus sp. KNK65MA (TsFDH) for production of formate from CO2 gas. To discover more efficient CO2-reducing FDHs than a reference enzyme, i.e. CbFDH, five FDHs were selected with biochemical properties and then, their CO2-reducing activities were evaluated. All FDHs including CbFDH showed better CO2-reducing activities at acidic pHs than at neutral pHs and four FDHs were more active than CbFDH in the CO2 reduction reaction. In particular, the FDH from Thiobacillus sp. KNK65MA (TsFDH) exhibited the highest CO2-reducing activity and had a dramatic preference for the reduction reaction, i.e., a 84.2-fold higher ratio of CO2 reduction to formate oxidation in catalytic efficiency (kcat/KB) compared to CbFDH. Formate was produced from CO2 gas using TsFDH and CbFDH, and TsFDH showed a 5.8-fold higher formate production rate than CbFDH. A sequence and structural comparison showed that FDHs with relatively high CO2-reducing activities had elongated N- and C-terminal loops. The experimental results demonstrate that TsFDH can be an alternative to CbFDH as a biocatalyst in CO2 reduction systems.

Excellent long-term results have been reported with conventional length cementless femoral stems in total hip arthroplasty; however, proximal stress shielding and thigh pain are still a concern. Metaphyseal engaging bone conserving short stems provide theoretical benefits compared with conventional length cementless stems, including avoiding proximal-distal mismatch, decreasing proximal stress shielding, and limiting perioperative fractures. The purpose of the ultra-short bone conserving cementless stem was to reproduce natural load transfer with an ultra-short stem obtaining optimal stability using the morphology of the proximal femur. Loss of stability of the stem and failure of osseous ingrowth is a potential concern with the use of ultra-short proximal loading cementless femoral stems. Ultra-short, metaphyseal-fitting anatomic or non-anatomic cementless femoral stems provided stable fixation without relying on diaphyseal fixation in young and elderly patients, suggesting that metaphyseal-fitting alone is sufficient in young and elderly patients who have good bone quality. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to determine the long-term clinical and radiographic results, survival rate, prevalence of osteolysis, and prevalence of fracture of the tibial polyethylene insert following total knee arthroplasty (TKA). Three hundred patients (600 knees) were included in this follow-up study. The mean age of the patients (and standard deviation) was 60.3 ± 4.3 years, and the mean duration of follow-up was 13.2 years (range, 12 to 14 years). Revision of the TKA prosthesis was performed in 7 knees (2.3%) with a compression-molded polyethylene (CPE) tibial insert and 6 knees (2%) with a highly cross-linked polyethylene (HXLPE) tibial insert. The rate of survival at 14 years was 97.7% (95% confidence interval [CI], 94%-100%) in the CPE group and 98% (95% CI, 94%-100%) in the HXLPE group with reoperation for any reason as the end point. The rate of survival at 14 years was 98% (95% CI, 94%-100%) in both groups with reoperation for mechanical failure as the end point. No knee had osteolysis or fracture of the tibial polyethylene insert. There were no between-group differences. LEVEL OF EVIDENCE:: Therapeutic Level I. See Instruction for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Despite overall good survivorship and clinical outcomes in the short term after total hip arthroplasty (THA) with use of alumina ceramic-on-highly cross-linked polyethylene (HXLPE) in patients younger than 30 years of age, there is a paucity of long-term data to evaluate the fixation of the components and the prevalence of osteolysis. We reviewed the records of 45 patients (54 hips) who had been included in a previous report to evaluate the long-term functional outcomes as well as radiographic and computed tomographic scan findings (particularly with regard to component fixation and osteolysis) after a mean duration of follow-up of 17.8 years. One femoral stem was revised because of aseptic loosening, and 2 acetabular components were revised because of recurrent dislocation. The survival rate at 17.8 years was 98% for the femoral component and 96% for the acetabular component. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of level of evidence. [ABSTRACT FROM AUTHOR]

In our original report, 97 patients (114 knees) underwent revision total knee arthroplasty with use of a Legacy Constrained Condylar Knee prosthesis (LCCK; Zimmer), with a mean follow-up of 7.2 years (range, 5 to 10 years). The purpose of the present study was to determine the long-term clinical and radiographic results, with a focus on component fixation and the prevalence of osteolysis. At a mean follow-up of 19.2 years (range, 16 to 21 years), re-revision of the LCCK prosthesis had been performed in 10 knees (9%). The rate of survival at 19.2 years was 96% (95% confidence interval [CI], 94% to 100%) with reoperation for mechanical failure as the end point, and 91% (95% CI, 87% to 98%) with reoperation for any reason as the end point. One knee had circumferential osteolysis around the components. LEVEL OF EVIDENCE:: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Background: Robotic-assisted TKA was introduced to enhance the precision of bone preparation and component alignment with the goal of improving the clinical results and survivorship of TKA. Although numerous reports suggest that bone preparation and knee component alignment may be improved using robotic assistance, no long-term randomized trials of robotic-assisted TKA have shown whether this results in improved clinical function or survivorship of the TKA.Questions/purposes: In this randomized trial, we compared robotic-assisted TKA to manual-alignment techniques at long-term follow-up in terms of (1) functional results based on Knee Society, WOMAC, and UCLA Activity scores; (2) numerous radiographic parameters, including component and limb alignment; (3) Kaplan-Meier survivorship; and (4) complications specific to robotic-assistance, including pin-tract infection, peroneal nerve palsy, pin-site fracture, or patellar complications.Methods: This study was a registered prospective, randomized, controlled trial. From January 2002 to February 2008, one surgeon performed 975 robotic-assisted TKAs in 850 patients and 990 conventional TKAs in 849 patients. Among these patients 1406 patients were eligible for participation in this study based on prespecified inclusion criteria. Of those, 100% (1406) patients agreed to participate and were randomized, with 700 patients (750 knees) receiving robotic-assisted TKA and 706 patients (766 knees) receiving conventional TKA. Of those, 96% (674 patients) in the robotic-assisted TKA group and 95% (674 patients) in the conventional TKA group were available for follow-up at a mean of 13 (± 5) years. In both groups, no patient older than 65 years was randomized because we anticipated long-term follow-up. We evaluated 674 patients (724 knees) in each group for clinical and radiographic outcomes, and we examined Kaplan-Meier survivorship for the endpoint of aseptic loosening or revision. Clinical evaluation was performed using the original Knee Society knee score, the WOMAC score, and the UCLA activity score preoperatively and at latest follow-up visit. We also assessed loosening (defined as change in the position of the components) using plain radiographs, osteolysis using CT scans at the latest follow-up visit, and component, and limb alignment on mechanical axis radiographs. To minimize the chance of type-2 error and increase the power of our study, we assumed the difference in the Knee Society score to be 25 points to match the MCID of the Knee Society score with a SD of 5; to be able to detect a difference of this size, we calculated that a total of 628 patients would be needed in each group in order to achieve 80% power at the α = 0.05 level.Results: Clinical parameters at the latest follow-up including the Knee Society knee scores (93 ± 5 points in the robotic-assisted TKA group versus 92 ± 6 points in the conventional TKA group [95% confidence interval 90 to 98]; p = 0.321) and Knee Society knee function scores (83 ± 7 points in the robotic-assisted TKA group versus 85 ± 6 points in the conventional TKA group [95% CI 75 to 88]; p = 0.992), WOMAC scores (18 ± 14 points in the robotic-assisted TKA group versus 19 ± 15 points in the conventional TKA group [95% CI 16 to 22]; p = 0.981), range of knee motion (125 ± 6° in the robotic-assisted TKA group versus 128 ± 7° in the conventional TKA group [95% CI 121 to 135]; p = 0.321), and UCLA patient activity scores (7 points versus 7 points in each group [95% CI 5 to 10]; p = 1.000) were not different between the two groups at a mean of 13 years' follow-up. Radiographic parameters such as the femorotibial angle (mean 2° ± 2° valgus in the robotic-assisted TKA group versus 3° ± 3° valgus in the conventional TKA group [95% CI 1 to 5]; p = 0.897), femoral component position (coronal plane: mean 98° in the robotic-assisted TKA group versus 97° in the conventional TKA group [95% CI 96 to 99]; p = 0.953; sagittal plane: mean 3° in the robotic-assisted TKA group versus 2° in the conventional TKA group [95% CI 1 to 4]; p = 0.612) and tibial component position (coronal plane: mean 90° in the robotic-assisted TKA group versus 89° in the conventional TKA group [95% CI 87 to 92]; p = 0.721; sagittal plane: 87° in the robotic-assisted TKA group versus 86° in the conventional TKA group [95% CI 84 to 89]; p = 0.792), joint line (16 mm in the robotic-assisted TKA group versus 16 mm in the conventional TKA group [95% CI 14 to 18]; p = 0.512), and posterior femoral condylar offset (24 mm in the robotic-assisted TKA group versus 24 mm in the conventional TKA group [95% CI 21 to 27 ]; p = 0.817) also were not different between the two groups (p > 0.05). The aseptic loosening rate was 2% in each group, and this was not different between the two groups. With the endpoint of revision or aseptic loosening of the components, Kaplan-Meier survivorship of the TKA components was 98% in both groups (95% CI 94 to 100) at 15 years (p = 0.972). There were no between-group differences in terms of the frequency with which complications occurred. In all, 0.6% of knees (four) in each group had a superficial infection, and they were treated with intravenous antibiotics for 2 weeks [corrected]. No deep infection occurred in these knees. In the conventional TKA group, 0.6% of knees (four) had motion limitation (< 60°) [corrected].Conclusions: At a minimum follow-up of 10 years, we found no differences between robotic-assisted TKA and conventional TKA in terms of functional outcome scores, aseptic loosening, overall survivorship, and complications. Considering the additional time and expense associated with robotic-assisted TKA, we cannot recommend its widespread use.Level Of Evidence: Level I, therapeutic study. [ABSTRACT FROM AUTHOR]

Background: No study has yet assessed the effect of medial open-wedge high tibial osteotomy (MOWHTO) on the patellofemoral joint according to postoperative alignment. Purpose: To evaluate the effect of MOWHTO on the patellofemoral joint according to postoperative alignment by comparing the cartilage status before and after surgery and assessing the clinical and radiological outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 135 patients who underwent MOWHTO were retrospectively investigated. The patients were divided into 3 groups according to the postoperative weightbearing line ratio (WBLR): undercorrection (WBLR <58.3%, lowest quartile), acceptable correction (WBLR of 58.3%-66.3%, middle 2 quartiles), and overcorrection (WBLR >66.3%, highest quartile). The postoperative change in the cartilage status was assessed arthroscopically during implant removal at 2 years after MOWHTO. The clinical and radiological outcomes were evaluated at a mean follow-up of 52.1 months. A regression analysis was performed to identify the factors affecting the deterioration of the patellofemoral joint cartilage status. A receiver operating characteristic curve was employed to identify the cutoff point for the postoperative WBLR associated with the deterioration of the cartilage status in the patellofemoral joint. Results: Of all patients, progression of cartilage degeneration was noted in 39.3% for femoral trochlea and 23.7% for patella. The incidence of cartilage progression was significantly higher in the overcorrection group than in the undercorrection and acceptable correction groups (femoral trochlea: undercorrection group = 30.3%, acceptable correction group = 32.4%, and overcorrection group = 61.8% [P = .008]; patella: undercorrection group = 15.2%, acceptable correction group = 17.7%, and overcorrection group = 44.1% [P = .005]). The functional outcomes, including Lysholm knee score, Knee injury and Osteoarthritis Outcome Score (Pain, Symptoms, and Activities of Daily Living subscales), and Shelbourne and Trumper score, were significantly worse in the overcorrection group. The regression analysis showed that only the postoperative WBLR had a significant effect on cartilage deterioration. The cutoff point for the postoperative WBLR associated with progression of the International Cartilage Repair Society grade was 62.1% for the femoral trochlea (sensitivity = 61.5%, specificity = 62.7%, accuracy = 66.2%) and 62.2% for the patella (sensitivity = 59.4%, specificity = 60.2%, accuracy = 67.8%). Conclusion: The patellofemoral joint was adversely affected by MOWHTO. Overcorrection causing excessive valgus alignment led to further progression of degenerative changes in the patellofemoral joint and inferior clinical outcomes. The postoperative WBLR can be used as a predictive factor for deterioration of the cartilage status in the patellofemoral joint after MOWHTO. [ABSTRACT FROM AUTHOR]

DNA-reactive compounds are harnessed for cancer chemotherapy. Their genotoxic effects are considered to be the main mechanism for the cytotoxicity to date. Because this mechanism preferentially affects actively proliferating cells, it is postulated that the cytotoxicity is specific to cancer cells. Nonetheless, they do harm normal quiescent cells, suggesting that there are other cytotoxic mechanisms to be uncovered. By employing doxorubicin as a representative DNA-reactive compound, we have discovered a cytotoxic mechanism that involves a cellular noncoding RNA (ncRNA) nc886 and protein kinase R (PKR) that is a proapoptotic protein. nc886 is transcribed by RNA polymerase III (Pol III), binds to PKR, and prevents it from aberrant activation in most normal cells. We have shown here that doxorubicin evicts Pol III from DNA and, thereby, shuts down nc886 transcription. Consequently, the instantaneous depletion of nc886 provokes PKR and leads to apoptosis. In a short-pulse treatment of doxorubicin, these events are the main cause of cytotoxicity preceding the DNA damage response in a 3D culture system as well as the monolayer cultures. By identifying nc886 as a molecular signal for PKR to sense doxorubicin, we have provided an explanation for the conundrum why DNA-damaging drugs can be cytotoxic to quiescent cells that have the competent nc886/PKR pathway. [ABSTRACT FROM AUTHOR]

Background: Methods to reduce the revision rate of total knee prostheses because of wear-related issues are important to examine, particularly because younger patients have a disproportionately high risk of revision.Questions/purposes: (1) Are long-term Knee Society knee and function scores better in younger patients with an oxidized zirconium (OxZr) TKA compared with those with a cobalt-chrome (CoCr) TKA? (2) Are there differences in radiographic signs of loosening or CT findings of osteolysis between OxZr TKAs and CoCr TKAs? (3) Are there fewer polyethylene wear particles in the OxZr TKA than CoCr TKA? (4) Do the groups differ in terms of survivorship free from revision surgery at 13 years?Methods: From April 2003 to January 2007, we enrolled 110 patients younger than 55 years of age in this randomized, double-blind, prospective trial. Each patient served as his or her own control and each received an OxZr femoral component in one knee and a CoCr femoral component in the other. The minimum followup was 10 years (mean, 13 years; range, 10-14 years); two died and nine were lost to followup before that time, leaving 99 patients (198 knees) for analysis. There were 28 men and 71 women with a mean age of 53 ± 6 years (range, 40-55 years). We obtained Knee Society knee scores for each knee, but Knee Society function scores, WOMAC scores, and UCLA activity scores were obtained for each patient preoperatively and at each followup. Additionally, we performed radiographic examination preoperatively and at each followup. At a minimum of 10 years (mean, 13 years) followup, we obtained CT scans in all patients. Polyethylene wear particles in the synovial fluid were analyzed at the final followup using thermogravimetric methods and scanning electron microscopy. Survivorship was ascertained using the Kaplan-Meier calculator. A sample size calculation determined that to detect a difference in the Knee Society knee score of 5 points, assuming a SD of 5 points, with an α = 0.05 and β = 0.80, a total of 90 patients would be needed in each group.Results: At the most recent followup, the mean Knee Society knee scores (92 versus 93 points; p = 0.857), function scores (85 versus 85 points; p = 1.000), WOMAC scores (23 versus 23 points; p = 1.000), UCLA activity scores (6.5 versus 6.5 points; p = 1.000), and range of knee motion (125° versus 127°; p = 0.365) were not different between the two groups. There was no radiographic evidence of loosening and no osteolysis visible on CT scan in either group. The weight of polyethylene wear particles produced at the bearing surface was 0.046 ± 0.010 g in 1 g of synovial fluid in patients with an OxZr femoral component and 0.0448 ± 0.0108 g in patients with a CoCr femoral component (p = 0.583). Kaplan-Meier survivorship free from revision was 97% for the OxZr group (95% confidence interval [CI], 93-100) and 98% for the CoCr group (95% CI, 93-100) at 13 years after surgery (p = 0.918).Conclusions: Given the absence of demonstrated superiority of either the CoCr implant or the OxZr implant, we recommend that surgeons and healthcare systems can reasonably choose the less expensive device for routine use, unless there is some compelling reason in an individual patient to choose one over the other (such as severe, documented metal sensitivity).Level Of Evidence: Level I, therapeutic study. [ABSTRACT FROM AUTHOR]

No study has compared the prevalence of fretting and corrosion at the trunnion of cobalt-chrome (Co-Cr) and zirconia ceramic heads in the same patients. The authors sought to compare the prevalence of fretting and corrosion at the trunnion after total hip arthroplasty with a 32-mm Co-Cr or a 32-mm zirconia ceramic head-on-polyethylene bearing. Isolated revision of the ace-tabular components was performed in 78 patients (156 hips) for polyethylene wear and osteolysis of the acetabulum. Seventy-eight Co-Cr head-titanium alloy stem pairs were compared with 78 zirconia ceramic head-titanium alloy stem pairs in the same patients. Using a visual scoring technique, the 156 head-stem pairs were analyzed for the prevalence of fretting and/or corrosion at the trunnion of the stem and the prevalence of metal transfer to the inner taper of the femoral head. Mean patient age was 48 years, and there were 65 men and 13 women. There was no trunnionosis in either group. Prevalence of fretting (81% vs 83%) and corrosion (4% vs 3%) at the trunnion was not significantly different (P=.518 vs .612, respectively) between the 2 groups. The median fretting scores (1.4±1.1 vs 1.2±1.4 points) and corrosion scores (1.2±0.8 vs 1.3±0.9 points) at the trunnion were not significantly different (P=.893 vs .781, respectively) between the 2 groups. Prevalence of metal transfer to the inner taper of the femoral head (8% vs 10%) and the median metal transfer scores (1.2±0.9 vs 1.4±1.1 points) were not significantly different (P=.213 vs .729, respectively) between the 2 groups. [Orthopedics. 2019; 42(1):e99-e103.]. [ABSTRACT FROM AUTHOR]

The objective of this study was to ascertain whether combined intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) is beneficial for reducing blood loss and the prevalence of deep venous thrombosis (DVT) in primary simultaneous bilateral total knee arthroplasty compared with IV only administration of TXA. One hundred fifty-four patients received a combined IV and IA injection of TXA in 1 knee and an IV only injection of TXA in the other. Transfusion rates and volumes and the amount of blood loss were recorded at 8 hours, 24 hours, and 48 hours. In addition, the authors ascertained whether the prevalence of DVT was higher in the patients with combined IV and IA administration of TXA than in the patients with IV only administration of TXA. Overall total blood loss was not significantly different (299.6 mL vs 280.1 mL, P=.22) between the 2 groups. The prevalence of DVT was 11% (17 knees) in the combined IV and IA group and 14% (22 knees) in the IV only group. This difference was not significant (P=.25). Combined IV and IA administration of TXA in bilateral total knee arthroplasty has no additional benefit in reducing total blood loss when compared with IV only administration. The prevalence of DVT was low and not significantly different between the 2 groups. Furthermore, no pulmonary embolism was found in either group. [Orthopedics. 2018; 41(6):e827-e830.]. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze the 16 patients, with distal radius fracture involving sigmoid notch fracture, who were treated by limited dorsal approach retrospectively. Methods: Between June 2003 and December 2013, 743 patients with distal radius fracture underwent operative treatment. Among them, 16 patients received conventional treatment, with additional limited dorsal approach. The fracture patterns involved sigmoid notch with dorsal lunate fossa depression, as well as distally displaced dorsal rim fragment. Radiologic results were evaluated based on dorsal tilt, radial inclination, and radial shortening. Clinical results were evaluated based on grip strength, motion range of the wrist joint, arm disabilities, shoulder & hand (DASH) score, and visual analogue scale (VAS) score. Results: The average radial inclination was 21°, with 5.6° of volar tilt and 0.1 mm of radial shortening. The average range of motion were 42.6° of flexion, 56.5° of extension, 23.4° of radial tilt, and 24.8° of ulnar tilt. The average grip strength was 81.3% of the opposite side. The average VAS and DASH scores were 1.1 and 21.3, respectively. Conclusion: In the case of sigmoid notch fracture involving dorsal lunate fossa depression fractures and distally displaced dorsal rim fractures, we were able to reduce and fix the fragment conveniently using limited dorsal approach. [ABSTRACT FROM AUTHOR]

The purpose of this study was, therefore, to investigate the mediating effect of level of companies' involvement in consulting on relationship between consultant competence, an external condition, and companies' competence to commercialize technology and on paths among variables and to provide implications. The research model and hypothesis were developed based on previous studies and questionnaire survey was performed on consultant competence, company's involvement level, technology commercialization competence, technology commercialization performance with SMCs that used or is using external consulting in process of technology commercialization and tested research model and hypotheses using statistical analysis. The result of empirical analysis showed positive effects among variables, consistently with previous studies, partial mediating effect of company's involvement on relationship between consultant competence and company's technology commercialization. It is important for SMCs to achieve successful performance in technology commercialization process, company's internal involvement to consulting as well as consultant performance of external expert should be developed and, especially, involvement of senior executives is important factor. It is expected that this study provide useful information for SMCs to develop successful technology commercialization competence. [ABSTRACT FROM AUTHOR]