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Background Sleep-related problems are highly prevalent comorbidities in Attention-Deficit/Hyperactivity Disorder (ADHD). Objective This study aimed to investigate the associations between sleep-disordered breathing (SDB) and behavioral and cognitive functions in children with and without ADHD. Methods A total of 341 children were included (ADHD group: 155, control group: 186; age: 6–10 years). The participants' sleep-related symptoms were assessed using a parent-rated questionnaire, and they were categorized into low- and high-risk SDB groups based on their scores. Behavioral symptoms were assessed using the Behavioral Assessment System for Children, Second Edition (BASC-2), and cognitive sustained attention and inhibitory control were assessed using a computer-based continuous performance test. Results In the ADHD group, the high-risk SDB children showed significantly higher scores than the low-risk SDB group in externalizing problems (F = 4.22; P = 0.042), including hyperactivity (F = 4.65; P = 0.033) and attention problems (F = 8.19; P = 0.005), but not internalizing problems. Meanwhile, in the control group, the high-risk SDB children showed significantly higher scores than the low-risk SDB group in internalizing problems (F = 9.89; P = 0.002), depression (F = 9.45; P = 0.002), and somatization (F = 7.83; P = 0.006), as well as in externalizing problems (F = 7.72; P = 0.006), including hyperactivity (F = 6.23; P = 0.013), aggression (F = 5.00; P = 0.027), and conduct problems (F = 6.79; P = 0.010). Contrary to the behavioral outcomes, none of the attention performance subscale scores showed significant differences between the high- and low-risk SDB groups in either the ADHD or control group. Conclusions The present findings suggest that SDB is associated with behavioral problems in children with ADHD and controls, with stronger associations in control children. On the contrary, SDB has no association with cognitive attention performance. This study extends our understanding of the associations of SDB with behavioral symptoms and cognitive functions in children.

Background: Depressive disorders have various symptom presentations, which may have complex and dynamic interactions. This study aimed to investigate the network structures underlying the symptoms and to identify the central symptoms of depression in school-aged children. Methods: Participants were a large community sample of elementary school children aged 6 to 12 years (N = 10,233). To assess the depressive symptoms, we utilized the Children's Depression Inventory (CDI). We binarized the scores on the CDI to generate a symptom network using the eLasso method, based on the Ising model. We evaluated the centralities in individual symptoms using the network centrality indices and the associations between symptoms. Results: Of the symptoms, loneliness, self-hatred, school dislike, and low self-esteem were the most central symptoms in the network of depressive symptoms. School work difficulty–school performance decrement, sadness–crying, self-hatred–negative body image, low self-esteem–fight, anhedonia–school dislike, sadness–loneliness, self-deprecation–school work difficulty, and school dislike–lack of friendship had significantly higher edge weight than most edges. The estimated network between the symptoms was robust to stability and accuracy tests. Limitations: Participants were not clinical but community samples, who show lower level of symptoms. Conclusion: The present symptom network analysis provided important insights on various interconnectivities between individual symptoms in childhood depression and on the central symptoms. In addition, our findings presented both similarities and differences with a previous Western study, thus, warranting future cross-cultural studies.

This study investigated the association between parental age at birth and attention-deficit/hyperactivity disorder (ADHD) symptoms in their children. A total of 30,552 children aged 6–12 years participated in the study. ADHD symptoms were rated using the Korean version of the ADHD Rating Scale (K-ARS) by parents. K-ARS scores and odds ratio (OR) for children with high-risk ADHD presented a U-shape curve depending on the age of both parents at birth. The total K-ARS scores and OR for high-risk ADHD were highest in children of fathers and mothers belonging to the youngest age group (aged ≤20) (K-ARS = 12.33, OR = 2.89 vs K-ARS = 10.98, OR = 2.63) and second highest in children whose father's or mother's age at birth was the oldest (K-ARS = 9.63, OR = 1.65 vs K-ARS = 9.95, OR = 1.95). Our study identified that both spectrums of age—young and old of either parent—were associated with ADHD in children. These are new findings considering that old age of parents as the correlates of offspring ADHD is the inconsistent finding with previous studies and warrant future studies in other cultures that include more detailed information on ADHD symptoms of children and their parents are needed to confirm the present findings.

Patients with a distal radius fracture (DRF) have an increased risk of subsequent fractures including hip fractures. The purpose of this study was to evaluate whether women with a DRF have certain hip geometry parameters known to indicate susceptibility to hip fractures.We compared bone mineral density (BMD) and hip geometry parameters (hip axis length, neck shaft angle, mean cortical thickness, femur neck width, cross-sectional area [CSA], cross-sectional moment of inertia, section modulus, and buckling ratio) in 181 women with a DRF (DRF group) and 362 propensity score-matched women without a fracture (control group). We evaluated the associations between DRF and hip geometry parameters using logistic regression analysis.The DRF group had lower hip BMD; lower cortical thickness, CSA, and section modulus; and higher buckling ratio than the control group (all p0.05). The occurrence of a DRF was significantly associated with decreases in neck shaft angle (odds ratio [OR], 1.047; 95% confidence interval [CI], 1.008-1.088) and CSA (OR, 3.114; 95% CI, 1.820-5.326) after adjusting for age, BMI, and total hip BMD.In this study, women with a DRF were more likely than women without a DRF to have hip geometry parameters known to indicate susceptibility to hip fractures. Our results suggest that not only low hip BMD but also a decreased CSA could account for the increased risk of subsequent hip fracture in patients with a DRF.

A (positive definite and non-classic integral) quadratic form is called strongly s-regular if it satisfies a strong regularity property on the number of representations of squares of integers. In this article, we prove that for any integer k ≥ 2 , there are only finitely many isometry classes of strongly s-regular quadratic forms with rank k if the minimum of the nonzero squares that are represented by them is fixed.

Comprehensive molecular analyses revealed that papillary renal cell carcinoma (PRCC) is a heterogenous entity. Papillary renal neoplasm with reverse polarity (PRNRP) is a subset of PRCC with characteristic histomorphologies such as low-grade nuclear features, inverted nuclear location, eosinophilic cytoplasm, and indolent clinical behavior. We tried to define the molecular, clinicopathological, histologic, and immunohistochemical features of PRNRP by comparing them with type 1 PRCC (PRCC1) and type 2 PRCC (PRCC2). A cohort of 30 PRNRP, 23 PRCC1, and 26 PRCC2 cases was used. Targeted sequencing of 90 cancer-related genes including KRAS was performed in 26 PRNRP tumor samples. PNA-mediated clamping PCR of KRAS was performed using paired normal and tumor DNA from 30 PRNRP, 23 PRCC1, and 26 PRCC2 cases. Tissue microarray slides were made in three cores per tumor, which were stained with cytokeratin 7 (CK7), alpha-methylacyl-CoA racemase (AMACR), epithelial membrane antigen (EMA), E-cadherin, vimentin, and CD10. Recurrent mutations in KRAS were detected in 28 of the 30 PRNRPs. However, there were no KRAS mutations in any PRCC1 or PRCC2 cases. PRNRP exhibited distinct clinicopathological features: small tumor size, lower pathologic T stage, and no disease-specific death during the follow-up period. Histologically, peritumoral lymphoid aggregation, prominent papillary architecture (>80% of tumor), hyalinized papillae, inverted nuclear location, and lower nuclear grade were observed. PRNRP was usually positive for CK7, AMACR, EMA, and E-cadherin, and negative for CD10. The findings suggest that PRNRP is a subtype of papillary renal neoplasm that is different from PRCC1 or PRCC2 in terms of molecular, clinicopathological, histological, and immunohistochemical features.

Objectives This study sought to determine whether evaluations of breast arterial calcification (BAC) and low bone mass (LBM) could improve the ability to predict subclinical coronary artery disease (CAD) in asymptomatic women. Background An improved risk stratification strategy beyond the measurement of conventional risk factors is needed to identify women at high risk of CAD. Methods The BBC (Women Health Registry Study for Bone, Breast, and Coronary Artery Disease) enrolled 2,100 asymptomatic women who underwent dual-energy X-ray absorptiometry, digital mammography, and coronary computed tomography angiography. We assessed the predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk and evaluated the presence and severity of BAC, LBM, coronary artery calcification (CAC), and coronary atherosclerotic plaque (CAP). Results CAC and CAP were found in 11.2% and 15.6% of participants, respectively. In women with CAC or CAP, increasing trends in the presence and severity of both BAC and LBM were observed. Both BAC and LBM were found to be associated with the presence of CAC (unadjusted odds ratios [OR]: 3.54 and 2.22, respectively) and CAP (unadjusted OR: 3.02 and 1.91, respectively). However, in multivariate analysis, only the presence of BAC and BAC score remained as independent predictors. For the prediction of CAC and CAP, addition of the BAC presence to the 10-year ASCVD risk significantly increased the areas under the curve (area under the curve: 0.71 to 0.72; p = 0.016; and area under the curve: 0.66 to 0.68; p = 0.010; respectively) and resulted in net reclassification index improvements (area under the curve: 0.304; p Conclusions The presence and severity of BAC and LBM were significantly associated with the risk of subclinical CAD in asymptomatic women. BAC evaluation especially provides an independent and incremental value over conventional risk algorithms. (Women Health Cohort for Breast, Bone and Coronary Artery Disease [BBC]; NCT03235622)

The present study investigated associations between urinary cotinine levels as a biomarker of secondhand smoke exposure and symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).A total of 520 child participants (200 with ADHD, 67 with ASD, and 253 normal control subjects) were assessed using the Korean version of the ADHD rating scale (K-ARS), Autism spectrum screening questionnaire (ASSQ), and Behavioral Assessment System for Children, second edition (BASC-2). The Korean version of the computer-based continuous performance test was used to assess cognitive function. Urinary cotinine was evaluated as a biomarker of secondhand smoke exposure.Urinary cotinine levels were significantly and positively associated with K-ARS score (B = 4.00, p 0.001), ASSQ score (B = 1.71, p = 0.030), the behavioral problem subscales of the BASC-2 (B = 1.68-3.52, p 0.001-0.045), and omission and commission errors in the continuous performance test (B = 6.21-8.42, p 0.001-0.019). Urinary cotinine levels were also associated with the increased odds ratio of ADHD (OR = 1.55, 95% CI 1.05-2.30, p = 0.028) and ASD (OR = 1.89, 95% CI 1.12-3.21, p = 0.018).Urinary cotinine levels were associated with lower behavioral adaptation and cognitive function and increased odds ratios of ADHD and ASD, indicating a negative effect of secondhand smoke exposure on the symptomatic manifestation of ADHD and ASD.

Adipogenesis is the process of differentiation from preadipocytes to adipocytes and is orchestrated by various transcription factors, such as the peroxisome proliferator-activated receptor gamma (PPARγ) and the CCAAT-enhancer-binding protein alpha (C/EBPα). Oxidative stress is also a crucial factor in adipogenesis, and adipocyte differentiation is affected by the cellular redox status. The nuclear factor E2-related factor 2 (Nrf2), which is a basic leucine zipper (bZIP) transcription factor, acts as a regulator of cellular oxidative stress. Although several previous studies examined the function of Nrf2 in adipogenesis, their results were controversial. In this study, we investigated whether the suppression of Nrf2 in 3T3-L1 cells affected adipogenesis. We found that adipogenesis master regulator genes, such as PPARγ and C/EBPα, were downregulated during the differentiation stage in Nrf2-knockdown 3T3-L1 cells. Moreover, the fibroblast growth factor 21 (FGF21) and manganese superoxide dismutase (MnSOD) were markedly downregulated in Nrf2-knockdown 3T3-L1 cells. Taken together, the results of the present study suggest that the suppression of Nrf2 attenuates adipogenesis and decreases FGF21 expression through PPARγ in 3T3-L1 cells.

Objectives The relationship between the renin–angiotensin system (RAS) and diabetes has been studied for many years. However, studies that assessed RAS components comprehensively were limited. We hypothesized that serum RAS components, especially the effector peptide angiotensin-II, might be closely associated with glucose metabolism status and diabetic complications. Methods We investigated the association of individual RAS component with albuminuria in 407 subjects with normal glucose metabolism (NGM), prediabetes, or type 2 diabetes mellitus (T2DM). Anthropometric and biochemical parameters, including glucose homeostasis, albuminuria, and RAS-related parameters such as plasma renin activity (PRA), aldosterone, angiotensin-converting enzyme (ACE), and angiotensin-II levels, were measured. Results The mean±standard deviation (SD) age and body mass index were 57.1±11.1years and 24.7±3.3kg/m 2 , respectively. There were 54 subjects with NGM, 102 with prediabetes, and 251 with T2DM. The mean±SD angiotensin-II levels in these groups were 9.32±6.89, 12.89±10.39, and 17.00±15.28pg/mL, and the respective urinary albumin-to-creatinine ratios (ACRs) were 8.1±5.3, 13.3±17.3, and 30.7±51.9mg/g, which were significantly different among the groups. The serum angiotensin-II levels were correlated with levels of PRA, insulin resistance, C-reactive protein, and urinary ACR. Among RAS-related parameters, only the angiotensin-II level was significantly associated with urinary ACR after adjusting for relevant risk factors. Conclusions Angiotensin-II may play an important role in the development of albuminuria, particularly in subjects with impaired glucose metabolism.

Background and aims Sarpogrelate, a 5-hydroxytryptamine type 2A antagonist, is a potential antiplatelet agent. We performed a randomized study to evaluate the effect of sarpogrelate on vascular health in Korean patients with diabetes. Methods Forty diabetic patients aged 58.6 ± 6.8 years with 10–75% coronary artery stenosis, as assessed by coronary computed tomography angiography, were randomly assigned to sarpogrelate 300 mg/day plus aspirin 100 mg/day (SPG + ASA group) or aspirin 100 mg/day alone (ASA group) for 6 months. The primary endpoint of this study was the change in coronary artery disease including the calcium score (CACS), maximal stenosis, and plaque volume (calcified vs. noncalcified). The secondary endpoints were changes in biochemical parameters related to glucose and lipid metabolism, and in subclinical atherosclerosis assessed by ankle–brachial index and pulse wave velocity. Results After 6-month treatment, there was no significant difference in the changes in CACS, coronary stenosis, ankle–brachial index, and pulse wave velocity, between groups. The total plaque volume decreased from 82.4 ± 14.5 mm 3 to 74.6 ± 14.4 mm 3 in the SPG + ASA group, but increased from 64.9 ± 16.0 mm 3 to 68.6 ± 16.3 mm 3 in the ASA group ( p 3 to 11.2 ± 3.7 mm 3 vs . ASA group 21.2 ± 6.2 mm 3 to 22.8 ± 6.6 mm 3 , p Conclusions The present study demonstrated that sarpogrelate treatment may decrease coronary artery plaque volume, particularly the noncalcified portion, in patients with diabetes.

Angiogenesis is closely associated with osteoblast differentiation. Previously, we demonstrated that bone formation can be accelerated by treatment with COMP-Angiopoietin1, a known angiogenic factor. Angiopoietin1 (Ang1) is a specific growth factor that generates stable and mature vasculature through the Tie2 receptor. In this study, we aimed to identify a novel drug that can activate endogenous Ang1 expression as a pharmacological treatment for bone formation. Therefore, Ang1 expression was examined in U2OS osteoblast-like cells treated with 770 drugs from a library of Food and Drug Administration (FDA)-approved drugs by using ELISA for Ang1. l-thyroxine was selected as a novel drug candidate. l-Thyroxine is a synthetic form of the hormone thyroxine, which is used to treat patients with hypothyroidism. Enzyme-linked immunosorbent assays (ELISAs) were performed to test whether Ang1 is induced in a dose-dependent manner in human osteoblast-like cell lines, U2OS and MG63. The effects of l-thyroxine on osteoblast differentiation and mineralization were evaluated by alkaline phosphatase (ALP) activity and Alizarin red s staining. To determine the molecular mechanism, the expression of proteins related to bone formation and differentiation, such as type I collagen (COL1A1), osteocalcin (OC), bone sialoprotein (BSP), distal-less homeobox 5 (Dlx5), Runt-related transcription factor 2 (Runx2), osterix (OSX), and ALP, was tested by Western blotting analysis. Consequently, l-thyroxine induced Ang1 expression in a dose-dependent manner in both U2OS and M63 cells, which was confirmed by ELISA and Western blotting. Also, l-thyroxine activated ALP activity in U2OS and MG63 cells as well as ALP expression. Furthermore, l-thyroxine enhanced the expression of COL1A1, Runx2, OC, BSP, Dlx5, and OSX mRNA and proteins. Taken together, we demonstrated that l-thyroxine increased Ang1 expression and induces bone formation, differentiation, and mineralization in U2OS and MG63 cell lines, which suggests that l-thyroxine could be a potential bone production agent.

We evaluated size dependent cellular uptake of ZnO nanoparticles utilizing stably introduced Cy5.5, which emits long-wavelength fluorescence. Through (3-aminopropyl)triethoxysilane modification, ZnO nanoparticles of different sizes (20 and 70nm) were functionalized with amine moiety, which was further reacted with Cy5.5-N-hydroxylsuccinimide ester to make covalently conjugated Cy5.5 dye on ZnO nanoparticles. Field emission-scanning electron microscopic images revealed that average particle size as well as particle morphology of ZnO nanoparticles were not altered by Cy5.5 conjugation. Zeta potential measurement confirmed that the positive surface charge of ZnO nanoparticles was well preserved after successive conjugation reactions. Based on infrared, ultraviolet-visible light and photoluminescence spectroscopies, we verify that the Cy5.5 was stably introduced to ZnO nanoparticles without serious aggregation. Surface conjugated Cy5.5 showed high stability in deionized water, phosphate buffered saline and cell culture medium, showing less than 2% of release during 85h. Confocal microscopy and fluorescence-activated cell sorting analysis demonstrated that smaller ZnO nanoparticles were more taken up in greater quantities by HaCaT cells. Moreover, systematic study on cellular uptake pathway showed that smaller ZnO nanoparticles were internalized into cells mainly by clathrin-mediated endocytosis, while larger ZnO nanoparticles entered cells via several pathways.

Objective To evaluate the therapeutic response of pigment epithelial detachment (PED) to anti–vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (nAMD), and identify predictive factors for PED resolution after treatment. Design Retrospective, interventional case series. Methods A total of 202 treatment-naive nAMD eyes presenting PED at baseline were retrospectively included and analyzed. All patients were treated with an initial series of 3 monthly loading injections of ranibizumab or aflibercept, followed by additional injections as required. Results After 12 months of treatment, the mean PED height decreased from 453 ± 261 μm at baseline to 230 ± 142 μm ( P = .002), and the mean best-corrected visual acuity improved from 0.71 ± 0.41 logarithm of the minimal angle of resolution (Snellen equivalent, 20/102) to 0.60 ± 0.36 (20/79) ( P = .024). The proportion of complete PED resolution after treatment was 19.3% (39 eyes). Multivariate logistic regression analysis was used to find baseline characteristics associated with a higher chance of PED resolution, including lower PED height at baseline ( P = .018), polypoidal choroidal vasculopathy ( P = .015), or retinal angiomatous proliferation ( P = .010) compared to typical nAMD; serous PED ( P = .022) compared to fibrovascular PED; and aflibercept ( P = .039) compared to ranibizumab. Conclusions PEDs secondary to nAMD showed significant functional and anatomic improvement after intravitreal anti-VEGF injections over 12 months. However, the anti-VEGF treatment showed limited efficacy for the complete resolution of PED. The PED type, nAMD subtype, baseline PED height, and anti-VEGF drug type was associated with a higher probability of PED resolution after treatment.

This study provides the physical and durable properties of chemically bonded cements (CBC)-based repair materials containing magnesium potassium phosphate ceramics (MKPC) for concrete slab under laboratory atmospheric conditions, comparing it to the existing calcium sulfoaluminate (CSA) type commercial ultra-rapid hardening cement for concrete repair. Also, this paper presents the field application of MKPC-based repair material. The results obtained from the laboratory tests during the fresh state show similar levels of workability and working time to the commercial repair material. Regarding the physical and durable properties of hardened MKPC-based mortar, it shows more desirable characteristics than the commercial repair material. In the field application, the MKPC-based repair material for cracks demonstrates considerable volume stability for a year, not showing any crack propagation and reoccurrence. Furthermore, for overlay repair, MKPC-based material shows good bonding strength to old substrate concrete slab.

Background The possible involvement of microRNAs (miRNA) in psychiatric disorders has been recently recognized. Several miRNA polymorphisms have been found to be associated with panic disorder (PD) in European populations. However, the association of miRNA polymorphisms on PD has not been reported in Asian populations. We evaluated the effect of miR-22 and miR-491 polymorphisms on susceptibility to PD in a Korean population. Methods Genotyping for four polymorphic variants of the primary miRNA (pri-miRNA) regions of miR-22 (rs8076112 and rs6502892) and miR-491 (rs4977831 and rs2039391) was performed using blood samples of 341 Korean patients with PD and 229 healthy control subjects. To evaluate PD phenotypes, the Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Inventory-Revised (ASI-R) were administered. Results Three single-nucleotide polymorphisms (SNPs) were found to be associated with PD: rs8076112 miR-22 and rs4977831 and miR-491 rs2039391. The rs8076112C/rs6502892C haplotypes of miR-22 and rs4977831G/rs2039391G and rs4977831A/rs2039391A haplotypes of miR-491 were significantly overrepresented in patients with PD than in healthy control subjects. In combination analysis, miR-22 rs8076112AC/rs6502892CC and rs8076112CC/rs6502892CC and miR-491 rs4977831AG/rs2039391AA were more frequent in patients with PD. Among the phenotype assessments, ASI-R scores were significantly associated with miR-22 rs6502892 in the subgroup with the agoraphobic phenotype. Limitations The results should be considered preliminary due to the relatively small sample size and the selection of only four SNPs. Conclusions This is the first report to show possible associations of miR-22 and miR-491 with genetic susceptibility to PD in a Korean population.

Objective The ligand-activated transcription factor peroxisome proliferator-activated receptor gamma (PPARγ) is a key factor in adipogenesis, insulin sensitivity, and cell cycle regulation. Activated PPARγ might also have anti-inflammatory and antiatherogenic properties. We tested whether lobeglitazone, a new PPARγ agonist, might protect against atherosclerosis. Methods A rat model of balloon injury to the carotid artery, and high-fat, high-cholesterol diet-fed apolipoprotein E gene knockout (ApoE −/− ) mice were studied. Results After the balloon injury, lobeglitazone treatment (0.3 and 0.9 mg/kg) caused a significant decrease in the intima-media ratio compared with control rats (2.2 ± 0.9, 1.8 ± 0.8, vs. 3.3 ± 1.2, P −/− mice fed a high-fat diet, lobeglitazone treatment (1, 3, and 10 mg/kg) for 8 weeks reduced atherosclerotic lesion sizes in the aorta compared with the control mice in a dose-dependent manner. Treatment of vascular smooth muscle cells with lobeglitazone inhibited proliferation and migration and blocked the cell cycle G 0 /G 1 to S phase progression dose-dependently. In response to lobeglitazone, tumor necrosis factor alpha (TNFα)-induced monocyte-endothelial cell adhesion was decreased by downregulating the levels of adhesion molecules. TNFα-induced nuclear factor kappa-B (NF-κB) p65 translocation into the nucleus was also blocked in endothelial cells. Insulin resistance was decreased by lobeglitazone treatment. Circulating levels of high sensitivity C-reactive protein and monocyte chemoattractant protein-1 were decreased while adiponectin levels were increased by lobeglitazone in the high-fat diet-fed ApoE −/− mice. Conclusion Lobeglitazone has antiatherosclerotic properties and has potential for treating patients with diabetes and cardiovascular risk.

The synthesis and photochemical characteristics of a fumaronitrile (FN)-based π-conjugated molecule, dibiphenyl fumaronitrile ( BP - FN ), comprising two biphenyl aggregation-induced emission (AIE) activators linked by an FN core were investigated. Upon illumination with a UV light, the emission from the Z -isomer, (Z)BP - FN , was more intense than that of the E -isomer, (E)BP - FN , due to conformational restriction of the former. (E)BP - FN exhibited J -aggregation behavior in mixed THF–H 2 O solvents when the H 2 O content exceeded 70 vol%, illustrative of typical AIE characteristics. (Z)BP - FN presented significant aggregation causing quenching in emission when the H 2 O content exceeded 80 vol%. In-situ photoisomerization of (E)BP - FN to (Z)BP - FN proceeded successfully even in the H 2 O-induced aggregated state in THF solution; however, the emission of the in-situ photoisomerized (Z)BP - FN aggregates was significantly quenched in solutions with high H 2 O contents of above 80 vol%.

The need for isolation of nontuberculous mycobacteria (NTM) from clinical specimens has increased in recent years. Our aim was to determine the clinical usefulness of PCR for differential diagnosis of tuberculosis and nontuberculous mycobacterial infection in lung tissue that show chronic granulomatous inflammation. A total of 199 formalin-fixed, paraffin-embedded specimens, including 137 Mycobacterium tuberculosis (MTB), 17 NTM cases, and 45 other than mycobacterial cases were collected. We performed acid-fast staining, MTB and NTM nested PCRs, and MTB and NTM real-time PCRs. No histologic difference between MTB and NTM infections was observed. Sensitivity and specificity for detecting MTB were 70.1% and 95.1% by nested PCR, respectively, and 70.8% and 100.0% by real-time PCR, respectively. Sensitivity and specificity for detecting NTM were 52.9% and 96.15% by nested PCR, respectively, and 35.3% and 100.0% by real-time PCR, respectively. Mycobacteria were identified by acid-fast staining in 50 of 154 cases (32.5%). All 50 acid-fast staining-positive cases showed positive nested and real-time PCR results (n = 47 MTB PCR positive; n = 3 NTM PCR positive), and results agreed with final diagnosis. PCR will be useful for the rapid diagnosis of mycobacterial infection and differentiation of MTB from NTM in formalin-fixed, paraffin-embedded specimens, especially in acid-fast staining-positive specimens.

The aim of present study is to compare the efficacy and safety of adding vildagliptin with sulfonylurea dose-increasing as an active comparator in patients who had inadequately controlled type 2 diabetes mellitus (T2DM) using metformin plus sulfonylurea in real clinical practice. Patients using metformin plus sulfonylurea were assigned to either vildagliptin add-on (50 mg twice a day, n=172) or sulfonylurea dose-increasing by 50% (n=172) treatment groups. The primary endpoint was a change in HbA(1c) after 24 weeks. The secondary endpoints were patients achieving HbA(1c)≤7.0% (53 mmol/mol) and changes in the fasting plasma glucose (FPG), 2-h postprandial glucose (2pp), lipid profiles, and urine albumin-to-creatinine ratio. Body weight and hypoglycemia were also investigated. The mean HbA(1c) at baseline was 8.6% (70 mmol/mol) in both groups. At week 24, the adjusted mean HbA(1c) levels decreased by -1.19% (-13.09 mmol/mol) with vildagliptin add-on and -0.46% (-5.06 mmol/mol) with sulfonylurea (P0.001). Significantly more vildagliptin add-on patients achieved HbA(1c)≤7.0% (53 mmol/mol) than did sulfonylurea patients (40.1% vs. 7.9%; P0.001). Greater reductions in FPG and 2pp were observed with vildagliptin add-on than with sulfonylurea (P0.001). The vildagliptin add-on group exhibited no clinically relevant weight gain and had a lower incidence of hypoglycemia compared with the sulfonylurea group. Vildagliptin add-on therapy might be a suitable option for patients with T2DM that is controlled inadequately by metformin and sulfonylurea, based on its greater glucose control and better safety profile (ClinicalTrial.gov: NCT01099137).

In this paper, the migrating behavior of air bubbles in fresh state cement mortar was studied. Since the air content of fresh concrete and further hardened concrete influences the durability and surface conditions of concrete after formwork is removed, the air content of fresh state concrete is a very important factor in determining durability of hardened concrete. To evaluate the influence of viscosity in fresh cement paste on air bubbles’ migrating behaviors under vibrating conditions, various viscosity conditions were controlled with Viscosity Modifying Admixtures (VMA) and vibration was applied for various time durations. Modeling of the air bubble migration was conducted with expandable polystyrene (EPS) beads where distribution of EPS was measured along with density according to the unit volume weight of three divided layers in a cylinder. Results showed that air bubbles migrate with and without vibration achieving relatively stable conditions with increased viscosity. Therefore, this study was designed to add to the knowledge of how viscosity influences the quality of hardened state cementitious materials.

The clinical implications of prediabetes for development of type 2 diabetes may differ for Asian ethnicity. We investigated various indices derived from a 2-h oral glucose tolerance test (OGTT) in people with prediabetes to predict their future risk of diabetes.We recruited 406 consecutive subjects with prediabetes from 2005 to 2006 and followed them up every 3-6 months for up to 9 years. Prediabetes was defined as isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), combined glucose intolerance (CGI), or isolated elevated HbA1c (5.7-6.4%, 39-46 mmol/mol) without IFG or IGT. The rate of diabetes conversion was compared between prediabetes categories. The association of glycemic indices with development of diabetes was also investigated.Eighty-one patients were diagnosed with diabetes during the 9-year follow-up (median 46.0 months). The rate of diabetes conversion was higher in subjects with CGI (31.9%), or isolated IGT (18.5%) than in those with isolated IFG (15.2%) or isolated elevated HbA1c (10.9%). Surrogate markers reflecting β-cell dysfunction were more closely associated with diabetes conversion than insulin resistance indices. Subjects with a 30-min postload glucose ≥ 165 mg/dL and a 30-min C-peptide5 ng/mL had 8.83 times greater risk (95% confidence interval 2.98-26.16) of developing diabetes than other prediabetic subjects.In Asians, at least Koreans, β-cell dysfunction seems to be the major determinant for diabetes conversion. A combination of high glucose and low C-peptide levels at 30 min after OGTT may be a good predictor for diabetes conversion in this population.

Background Sarcopenia, the loss of muscle mass, contributes to various adverse health outcomes in the elderly. It may be associated with cardiometabolic risk. The aim of this study was to investigate the relationships between sarcopenia and cardiometabolic risks and to determine an appropriate operational definition for sarcopenia from a cardiometabolic perspective. Material and methods Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2010 (n=20,812, ≥20years old), appendicular skeletal muscle mass (ASM), measured by dual energy X-ray absorptiometry, divided by height squared (ASM/ht 2 ) or ASM divided by weight (ASM/wt) were calculated to define sarcopenia. Class I or class II sarcopenia was defined as one or two standard deviations, respectively, below the sex-specific means of reference values obtained from adults aged 20–29years. Results The respective prevalence rates of class I and class II sarcopenia based on ASM/ht 2 were 18.6% and 3.5% in men and 6.1% and 0.2% in women. The rates based on ASM/wt were 25.1% and 4.7% in men and 23.6% and 5.5% in women, respectively. The rate of metabolic syndrome and insulin resistance index increased with the severity of sarcopenia defined by ASM/wt, but there were opposite associations for ASM/ht 2 in both sexes. Subjects with sarcopenia based on the ASM/wt index had higher Framingham 10-year scores and greater risk of cardiovascular diseases, but these relationships were not provided consistently using the ASM/ht 2 measure. Conclusions Sarcopenia, defined by the ASM/wt index, but not by ASM/ht 2 , was significantly associated with an increased risk of cardiometabolic disorders in Korean adults.

MicroRNAs (miRNAs) are noncoding, single-stranded RNAs that regulate the expression of target genes by binding their 3'-untranslated region. miRNAs are important regulators of various biological processes, including cellular differentiation, proliferation, apoptosis, and tissue development. Furthermore, aberrant miRNA expression has emerged as an important pathomechanism in various human diseases, including osteoporosis. Thus, the therapeutic potential of miRNA has attracted great interest recently. Here, we focused on the roles of miRNAs in bone homeostasis and the potential of miRNAs as therapeutic targets.

This study proposes using sodium silicate-based nano-silica (SS) in cement composites. The effect of the addition of the proposed nano-silica on cement composites was compared to that of conventional ethyl silicate-based nano-silica (ES) and silica fume (SF). This study found that the inclusion of SS in cement composites has mainly two effects on their properties: one is a fast pozzolanic reaction, and the other is a pore-filling effect in a cement matrix. As a result, SS dramatically improves the early-age strength of cement composites by up to 184% and 152%, compared to a control specimen and the specimen with ES inclusion, respectively. Calorimetry, X-ray diffraction (XRD), scanning electron microscope (SEM) and mercury intrusion porosimetry (MIP) tests were conducted to monitor the effects of these nano-silicas.

This paper suggested simulation approaches for quantifying and reducing the effects of National Forest Inventory (NFI) plot location error on aboveground forest biomass and carbon stock estimation using the k-Nearest Neighbor (kNN) algorithm. Additionally, the effects of plot location error in pre-GPS and GPS NFI plots were compared. Two South Korean cities, Sejong and Daejeon, were chosen to represent the study area, for which four Landsat TM images were collected together with two NFI datasets established in both the pre-GPS and GPS eras. The effects of plot location error were investigated in two ways: systematic error simulation, and random error simulation. Systematic error simulation was conducted to determine the effect of plot location error due to mis-registration. All of the NFI plots were successively moved against the satellite image in 360° directions, and the systematic error patterns were analyzed on the basis of the changes of the Root Mean Square Error (RMSE) of kNN estimation. In the random error simulation, the inherent random location errors in NFI plots were quantified by Monte Carlo simulation. After removal of both the estimated systematic and random location errors from the NFI plots, the RMSE% were reduced by 11.7% and 17.7% for the two pre-GPS-era datasets, and by 5.5% and 8.0% for the two GPS-era datasets. The experimental results showed that the pre-GPS NFI plots were more subject to plot location error than were the GPS NFI plots. This study’s findings demonstrate a potential remedy for reducing NFI plot location errors which may improve the accuracy of carbon stock estimation in a practical manner, particularly in the case of pre-GPS NFI data.

Recently in construction industry, there increases the tendency of the use of fly-ash and ground granulated blast furnace slag, which are industrial by-products, as alternative materials for ordinary portland cement (OPC) in order to reduce the amount of OPC use. However, as the substitution ratio of the alternative materials for OPC increases, a hydration reaction will be delayed, and therefore it will be difficult to have early age desired mechanical performance. Therefore, this study has researched into the utilization of ultra-fine particles collected in the separator bag filter during the process of manufacturing cement as a substitution material for cement (SBFC), as a way to secure excellent early strength development of concrete and efficiency as well. Consequently, the initial and final setting time of the concrete substituted by 20% of SBFC in OPC weight were accelerated by more than 3%, when compared to those of the one using 100% of OPC; compressive strength increased by the maximum 57% in the early age and the maximum 7% in the 28 days of the ages; carbonation and freeze–thaw resistance had similar trends in both types of concretes. Therefore, concrete substituted by less than 20% of SBFC in OPC weight will enhance the early compressive strength of concrete, and workability and mechanical characteristics are considered to have more than equivalent performance when compared to concrete using 100% of OPC.

A scale-down SMART reactor model was constructed to evaluate flow-induced pressure variation under normal operating conditions. The flow rate and number of operating pumps were varied, and pressure fluctuations along the reactor internals surface of the model were measured by pressure transducers. The measured transient pressure was separated into the mean and fluctuating pressure, which was evaluated by analyzing the data of two distinct regions. Specifically, the pressure obtained at frequencies less than 10 Hz was analyzed separately from those obtained at frequencies greater than 10 Hz. In the present study, the mean pressure distribution was dependent on the pressure loss due to the skin friction and changes in the static pressure due to height level differences at the measuring points. The mean pressures were similar, regardless of the location of the operating pump, because the fluid was fully mixed in the upper shell. The normalized mean pressure ratio, excluding the hydrostatic pressure change, kept constant regardless of the flow rate and number of operating pumps. It was observed that the RMS of the fluctuating pressure at frequencies less than 10 Hz did not depend on the measuring points for all of the surfaces of the model. And, periodic pressure fluctuation generated by the inlet region is not reachable to the fuel assembly region because of the structural arrangement of SMART.

Objective Acute otitis media (OM) is a common pediatric disease. Recent research into the pathogenesis of OM has focused on oxidative damage, induced by oxygen free radicals, to the middle ear mucosa along with inflammation. Caffeic acid phenethyl ester (CAPE) is a biologically active ingredient of propolis honey bees, with antioxidative and anti-inflammatory activities. The effect of CAPE on hydrogen peroxide (H 2 O 2 )-induced inflammatory and oxidative reactions in the middle ear is still not known. The aim of this study was to evaluate the anti-inflammatory and antioxidative effects of CAPE on cultured human middle ear epithelial cells (HMEECs). Methods The inflammatory injury of H 2 O 2 and the anti-inflammatory effect of CAPE were determined by measuring levels of pro-inflammatory cytokines (tumor necrosis factor (TNF)-α and COX-2) with real-time reverse transcription polymerase chain reaction and Western blot analysis. Oxidative stress induced by H 2 O 2 and antioxidative effects of CAPE were evaluated directly by reactive oxygen species (ROS) production using flow cytometric analysis of 5-(and-6)-chloromethyl-2′,7′-dichlorodihydrofluorescein diacetate, acetyl ester (CM-H 2 DCFDA), and indirectly by the expression of superoxide dismutase (SOD) using Western blot analysis. The effect of CAPE was compared with N-acetyl cysteine (NAC) which has well-known antioxidative and anti-inflammatory effects. Results CAPE significantly inhibited H 2 O 2 -induced upregulation of TNF-α and COX-2 expression in a dose and time dependent manner. ROS accumulation induced by H 2 O 2 stimulation was decreased by CAPE pretreatment. Induced SOD expression after H 2 O 2 stimulation was diminished by CAPE pretreatment. The anti-inflammatory and antioxidative effects of CAPE were similar to those of NAC. Conclusions These findings suggest that inflammation induced by H 2 O 2 can be inhibited by CAPE via inhibition of the expression of pro-inflammatory cytokines such as TNF-α and COX-2. Furthermore, CAPE has antioxidative effects, which decreases the need for endogenous SOD expression.

Vitamin D may play a role in glucose metabolism. A low vitamin D level has been associated with increased risk of diabetes mellitus, but the association has not been confirmed in Asians. Our objective was to examine the association of serum 25-hydroxyvitamin D [25(OH)D] levels with insulin resistance and diabetes mellitus in Korean adults based on a large population-based survey. Cross-sectional analyses were carried out on 5787 Korean adults (2453 men and 3334 women) who were 20 y or older and participated in the Fourth Korea NHANES conducted in 2008. Diabetes mellitus was defined as fasting plasma glucose ≥7 mmol/L or current use of oral hypoglycemic agents or insulin. Insulin resistance was estimated by homeostatic model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Compared to individuals with a sufficient serum 25(OH)D concentration ≥75 nmol/L, the OR (95% CI) for diabetes mellitus were 1.73 (1.09-2.74), 1.30 (0.91-1.84), and 1.40 (0.99-1.98) for serum 25(OH)D concentrations

This paper presents the feasibility of incorporating ultra-fine particles collected in the separator bag filter during the process of manufacturing cement (SBFC) as an substitution material for cement. Approximately 2.5% of SBFC is produced during OPC manufacturing process. Also, the average size of SBFC particles is about 5 μm, the average size of OPC particles is about 14 μm. This method does not require additional processes needed in the existing processes to manufacture high early strength cement such as modifying mineral components and adjusting the firing temperature. Moreover, it can also solve the issue of efficiency decrease resulted from the increase of the grinding time applied in the existing process of manufacturing microcement. In order to investigate the characteristic properties of this cement mixture, cement blends have been produced by using different amounts of SBFC. While the blaine value of 100% SBFC was significantly higher (6953 cm 2 /g) than that of Ordinary Portland Cement (OPC), its chemical composition showed no significant difference. Cement paste, mortar mixtures have been prepared by using cement blends incorporating 0, 50 and 100% SBFC by weight. Flowability, setting time and compressive strength tests has been performed. Test results showed that substitution of SBFC negatively affect the flowability of cement paste and mortar mixtures. Moreover, setting times shortened, compressive and flexural strength values increased by the substitution of SBFC. Finally, microstructure analysis of cement paste samples showed that incorporation of SBFC reduced the internal porosity by 9% as determined by the proposed method. The internal porosity of paste was measured by mercury intrusion porosimetry (MIP). The compressive strength and bending strength of mortar were higher in the order of 100, 50 and 0% SBFC mixed.

As access to information becomes more intensive in society, a great deal of that information is becoming available through diverse channels. Accordingly, users require effective methods for accessing this information. Conversational agents can act as effective and familiar user interfaces. Although conversational agents can analyze the queries of users based on a static process, they cannot manage expressions that are more complex. In this paper, we propose a system that uses semantic Bayesian networks to infer the intentions of the user based on Bayesian networks and their semantic information. Since conversation often contains ambiguous expressions, the managing of context and uncertainty is necessary to support flexible conversational agents. The proposed method uses mixed-initiative interaction (MII) to obtain missing information and clarify spurious concepts in order to understand the intention of users correctly. We applied this to an information retrieval service for websites to verify the usefulness of the proposed method.

In object analysis, line and curve finding plays a universal role, and it can be accomplished by detecting ridges and ravines in digital gray scale images. In this paper, we present a new method of detecting ridges and ravines by using local min and max operations. This method uses erosion and dilation properties of fuzzy logic operations and requires no information of ridge or ravine direction, so that the method is simple and easy in comparison with the conventional analytical methods. Experimental results from different types of images show that the proposed technique is both effective and efficient.