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FCPs (free-form concrete panels) can be made using reusable and easily customizable silicone molds tailored to the unique shape of each panel. CNC (Computer Numerical Control)-type rods move vertically to press the silicone plate and shape the lower curved surface. Silicone caps are attached to the ends of the rods to facilitate the formation of smooth curves. However, there is currently no fixing method for the silicone caps and the silicone plate, which makes them vulnerable to the lateral pressure exerted during concrete pouring. Therefore, the current study used magnetic force to improve the lower shape of free-form molds. To this end, a neodymium silicone cap was designed by adding a neodymium magnet to the upper surface of the silicone cap. Moreover, two types of silicone plates were developed for fixing: one type is IS-LSM (Iron Sheet–Silicone Mold), which includes an iron sheet, while the other type is IP-LSM (Iron Powder–Silicone Mold), which is made by mixing iron powder. To verify these two techniques, FCP manufacturing experiments were conducted. The experimental results indicated that IS-LSM had a broader error range than existing techniques, thus rendering it unusable, while IP-LSM yielded significant values. Consequently, a t-test was conducted to validate the data for IP-LSM at 30%, 50%, and 70%, and it was confirmed that the difference in error data was significant at a 95% confidence level. Future research in this area should investigate the addition of iron powder to the silicone plate and a side fixing method for the silicone mold. Such research would help advance the production technology of free-form concrete panels. [ABSTRACT FROM AUTHOR]

Low fertility is a critical social problem worldwide, and infertility has a prevalence of 15%. This cross-sectional study aimed to understand the factors affecting the usage and satisfaction of Korean medicine (KM) in subfertile women. An online survey was conducted from 3 November to 8 November 2021. The survey collected basic information, KM treatment experience, and satisfaction from women who experienced poor pregnancy. The t-test and chi-square test (χ2-test) were used to determine the overall characteristics of the subjects and factors affecting the utilization and satisfaction of KM treatment. Of the total of 29,465 people, 4922 read the survey email, and 601 responded. After excluding 51 respondents with questionable response patterns, 550 respondents were included in the final analysis. Of these, 43.1% (n = 237) had experience with conventional treatment, and 16.5% (n = 91) had received KM treatment. The group that received both KM treatment and CM treatment (n = 59, 24.9%) was significantly more prevalent than the group that received KM treatment alone (n = 32, 10.2%) (p = 0.00). Women who had given birth more than once or held a master's degree were significantly more willing to participate in the 'KM Support Project for Subfertility' program. Our findings suggest that subfertile patients prefer integrated treatment that combines KM and CM treatments. Further studies are needed to assess the status of integrative medicine treatment, satisfaction with each KM intervention, factors for low satisfaction, and patient requirements. [ABSTRACT FROM AUTHOR]

The ability to perceive and adapt to environmental changes is crucial for the survival of all organisms. Neural functional imaging, particularly in model organisms, such as Caenorhabditis elegans, provides valuable insights into how animals sense and process external cues through their nervous systems. Because of its fully mapped neural anatomy, transparent body, and genetic tractability, C. elegans serves as an ideal model for these studies. This review focuses on advanced methods for neural functional imaging in C. elegans, highlighting calcium imaging techniques, lab-on-a-chip technologies, and their applications in the study of various sensory modalities, including chemosensation, mechanosensation, thermosensation, photosensation, and magnetosensation. We discuss the benefits of these methods in terms of precision, reproducibility, and ability to study dynamic neural processes in real time, ultimately advancing our understanding of the fundamental principles of neural activity and connectivity. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this study was to investigate the circadian rhythms of tongue features according to the effects of physiological phases over a 24 h period. (2) Methods: Fifteen healthy participants aged 20 to 69 years were recruited. The participants did not have current chronic diseases or past diseases and had to meet the inclusion and exclusion criteria. The participants stayed at the Gil Hospital for a duration of 2 nights and 3 days. On the first day, at 18:00, they consumed their allocated portions of food and water and then completed a questionnaire. At approximately 21:00, their tongue images were acquired using a computerized tongue image acquisition system, following which they slept for 8 h, commencing at 23:00. Measurements were taken from 07:00 through 21:00 on the second day, and the final acquisition was taken at 07:00 on the following morning, resulting in a total of eight images. The circadian rhythm was authenticated and quantified utilizing the single cosinor analysis, a technique for periodic regression analysis for fitting a 24 h cosine curve. (3) Results: Cosinor analysis revealed that all tongue features were significantly related to circadian rhythm. (4) Conclusions: The results of this study may be important for considering the time of day at which the tongue is observed and tongue status is evaluated. [ABSTRACT FROM AUTHOR]

Hydrometallurgical gold recovery processes play a pivotal role in the gold mining industry, contributing to more than 90% of global gold production. Among the array of techniques available, the Merrill–Crowe process, adsorption, ion exchange, and solvent extraction are central in extracting gold from leach solutions. While the Merrill–Crowe process and gold complex adsorption onto activated carbon represent historical cornerstones, their inherent limitations have prompted the emergence of more recent innovations in ion exchange and solvent extraction, offering enhanced selectivity, control, and sustainability. The evolution of modern organic chemistry has significantly influenced the progress of ion exchange technology, mainly through the introduction of advanced polymer matrix synthetic resins. At the same time, novel solvents tailored to gold complex interactions have revitalized ion exchange and solvent extraction. Introducing ionic liquids and deep eutectic solvents has also added a new dimension to efforts to improve gold extraction metallurgy. This paper reviews these cutting-edge developments and their potential to revolutionize the hydrometallurgical gold recovery process, addressing the pressing need for improved efficiency and environmental responsibility. [ABSTRACT FROM AUTHOR]

Undeniably, COVID-19 disrupted higher education. The concepts of traditional learning were challenged, online learning was thrust into the mainstream in colleges and universities, and the student population was unavoidably affected. It became apparent that maintaining the status quo that existed prior to the pandemic was not the path to the future sustainability of higher education. As higher education institutions began the long road to recovery, important challenges emerged due to increased demand for online learning and emotional health concerns for students. The current research collected data from online undergraduates at private and public universities in the United States for multivariate data analyses to examine controllable elements in the online learning environment that can enhance student quality of life and psychological well-being. These elements relate to perseverance for students and may promote the sustainability of higher education institutions. The focus of this study is to emphasize the importance of reinforcing online students' emotional health as an important sustainability strategy for higher education. The findings confirm that higher education institutions can facilitate online students' quality of life and psychological well-being by implementing elements into the classroom that create procedural and interpersonal justice, which enhances the formation of social and structural bonds. [ABSTRACT FROM AUTHOR]

Our study harnesses the power of natural language processing (NLP) to explore the relationship between dietary patterns and metabolic health outcomes among Korean adults using data from the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). Using Latent Dirichlet Allocation (LDA) analysis, we identified three distinct dietary patterns: "Traditional and Staple", "Communal and Festive", and "Westernized and Convenience-Oriented". These patterns reflect the diversity of dietary preferences in Korea and reveal the cultural and social dimensions influencing eating habits and their potential implications for public health, particularly concerning obesity and metabolic disorders. Integrating NLP-based indices, including sentiment scores and the identified dietary patterns, into our predictive models significantly enhanced the accuracy of obesity and dyslipidemia predictions. This improvement was consistent across various machine learning techniques—XGBoost, LightGBM, and CatBoost—demonstrating the efficacy of NLP methodologies in refining disease prediction models. Our findings underscore the critical role of dietary patterns as indicators of metabolic diseases. The successful application of NLP techniques offers a novel approach to public health and nutritional epidemiology, providing a deeper understanding of the diet–disease nexus. This study contributes to the evolving field of personalized nutrition and emphasizes the potential of leveraging advanced computational tools to inform targeted nutritional interventions and public health strategies aimed at mitigating the prevalence of metabolic disorders in the Korean population. [ABSTRACT FROM AUTHOR]

Natural language processing (NLP) technology has recently used to predict substance properties based on their Simplified Molecular-Input Line-Entry System (SMILES). We aimed to develop a model predicting human skin sensitizers by integrating text features derived from SMILES with in vitro test outcomes. The dataset on SMILES, physicochemical properties, in vitro tests (DPRA, KeratinoSensTM, h-CLAT, and SENS-IS assays), and human potency categories for 122 substances sourced from the Cosmetics Europe database. The ChemBERTa model was employed to analyze the SMILES of substances. The last hidden layer embedding of ChemBERTa was tested with other features. Given the modest dataset size, we trained five XGBoost models using subsets of the training data, and subsequently employed bagging to create the final model. Notably, the features computed from SMILES played a pivotal role in the model for distinguishing sensitizers and non-sensitizers. The final model demonstrated a classification accuracy of 80% and an AUC-ROC of 0.82, effectively discriminating sensitizers from non-sensitizers. Furthermore, the model exhibited an accuracy of 82% and an AUC-ROC of 0.82 in classifying strong and weak sensitizers. In summary, we demonstrated that the integration of NLP of SMILES with in vitro test results can enhance the prediction of health hazard associated with chemicals. [ABSTRACT FROM AUTHOR]

Research has shown that during the COVID-19 pandemic, approximately 20% of children and adolescents in the United States experienced mental health issues that became a significant social concern. However, recent studies have demonstrated that the majority of adolescents maintain positive emotions despite the crisis. This cross-sectional and descriptive study delves into the emotional states of adolescents during the pandemic, considering the viewpoints of both adolescents and their parents, with a specific focus on Hispanic adolescents. Survey results revealed that most adolescents reported positive and happy moods. However, a percentage of adolescents experienced worry, significant changes in feelings, and loneliness as a result of the physical and social isolation associated with virtual learning. Unfortunately, most surveyed Hispanic parents did not adequately recognize their adolescents' mood changes well. This lack of awareness, caused by factors such as an insufficient understanding about the importance of adolescent mental health, cultural reasons, language barriers, low education, unstable jobs, and more, could lead to missed opportunities for timely mental health interventions. This study seeks to provide a comprehensive discussion on the mental health of adolescents, while also advocating for the emotional wellbeing of Hispanic adolescents. [ABSTRACT FROM AUTHOR]

The increasing global incidence of quinolone antimicrobial resistance poses a considerable public health concern. The aquatic environment, particularly wastewater treatment plants (WWTPs), serves as a major reservoir for antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs), leading to the dissemination of antibiotic resistance. This study aimed to assess the prevalence and factors contributing to quinolone antibiotic resistance in Escherichia coli isolates obtained from effluents of 33 WWTPs. A total of 1082 E. coli isolates were analyzed, 32.6% and 17.1% of which showed resistance to nalidixic acid and ciprofloxacin, respectively. Phenotypic and genotypic analyses of antibiotic resistance demonstrated that quinolone resistance primarily originated from chromosomal mutations in the gyrA, parC, and parE genes, known as quinolone resistance-determining regions (QRDRs). The amino acid substitution at codon 83 in gyrA was closely associated with nalidixic acid resistance, whereas substitutions at codon 87 in gyrA and codon 80 in parC were significantly associated with ciprofloxacin resistance. The plasmid-mediated quinolone resistance (PMQR) genes qnrS and qnrB were identified in 41 isolates (11.5%) and 15 isolates (4.2%), respectively. Thus, we confirmed that the quinolone resistance in E. coli in WWTPs primarily occurs through QRDR mutations rather than through the acquisition of PMQR genes. Phylogenetic analysis revealed that most quinolone-resistant isolates belonged to the B1, A, B2, and D phylogenetic groups. Notably, the B2 group, which is responsible for extraintestinal infections, exhibited the highest rate of quinolone resistance. These findings provide novel insights into the presence and mechanisms of quinolone resistance in E. coli isolates from WWTPs, emphasizing the need for further research and understanding of quinolone resistance in the environment. [ABSTRACT FROM AUTHOR]

Non-alcoholic steatohepatitis (NASH) is a complex disease resulting from chronic liver injury associated with obesity, type 2 diabetes, and inflammation. Recently, the importance of developing multi-target drugs as a strategy to address complex diseases such as NASH has been growing; however, their manufacturing processes remain time- and cost-intensive and inefficient. To overcome these limitations, we developed UniStac, a novel enzyme-mediated conjugation platform for multi-specific drug development. UniStac demonstrated high conjugation yields, optimal thermal stabilities, and robust biological activities. We designed a tetra-specific compound, C-192, targeting glucagon-like peptide 1 (GLP-1), glucagon (GCG), fibroblast growth factor 21 (FGF21), and interleukin-1 receptor antagonist (IL-1RA) simultaneously for the treatment of NASH using UniStac. The biological activity and treatment efficacy of C-192 were confirmed both in vitro and in vivo using a methionine-choline-deficient (MCD) diet-induced mouse model. C-192 exhibited profound therapeutic efficacies compared to conventional drugs, including liraglutide and dulaglutide. C-192 significantly improved alanine transaminase levels, triglyceride accumulation, and the non-alcoholic fatty liver disease activity score. In this study, we demonstrated the feasibility of UniStac in creating multi-specific drugs and confirmed the therapeutic potential of C-192, a drug that integrates multiple mechanisms into a single molecule for the treatment of NASH. [ABSTRACT FROM AUTHOR]

Simple Summary: Conventional natural killer (NK)-based anticancer immunotherapy has a limitation: a culture period of approximately 2 weeks is required to increase the number and activity of NK cells. By transferring functional allogeneic mitochondria into NK cells, we demonstrated that the activity of NK cells and their cytotoxicity were significantly enhanced. This approach could potentially offer a timely therapeutic strategy for cancer treatment without the need for in vitro culture, which can be time-consuming and costly. An in vitro culture period of at least 2 weeks is required to produce sufficient natural killer (NK) cells for immunotherapy, which are the key effectors in hematological malignancy treatment. Mitochondrial damage and fragmentation reduce the NK cell immune surveillance capacity. Thus, we hypothesized that the transfer of healthy mitochondria to NK cells could enhance their anticancer effects. Allogeneic healthy mitochondria isolated from WRL-68 cells were transferred to NK cells. We evaluated NK cells' proliferative capacity, cell cycle, and cytotoxic capacity against various cancer cell types by analyzing specific lysis and the cytotoxic granules released. The relationship between the transferred allogenic mitochondrial residues and NK cell function was determined. After mitochondrial transfer, the NK cell proliferation rate was 1.2-fold higher than that of control cells. The mitochondria-treated NK cells secreted a 2.7-, 4.1-, and 5-fold higher amount of granzyme B, perforin, and IFN-γ, respectively, when co-cultured with K562 cells. The specific lysis of various solid cancer cells increased 1.3–1.6-fold. However, once allogeneic mitochondria were eliminated, the NK cell activity returned to the pre-mitochondrial transfer level. Mitochondria-enriched NK cells have the potential to be used as a novel solid cancer treatment agent, without the need for in vitro cytokine-induced culture. [ABSTRACT FROM AUTHOR]

Simple Summary: It is still controversial whether tenofovir disoproxil fumarate (TDF) has a lower risk of hepatocellular carcinoma (HCC) development than entecavir (ETV) in patients with chronic hepatitis B (CHB). Furthermore, other antiviral treatment-related outcomes need to be evaluated between the two antivirals to provide essential information for clinical practice. Using a multicenter cohort of 4210 CHB patients, we demonstrated that ETV and TDF are comparable in terms of HCC development as well as mortality, incidence of liver-related outcome, extrahepatic malignancy or new decompensation events, and seroconversion rates. Patients treated with TDF experienced more side effects than those treated with ETV. The results of this study can be applied to the development of a personalized antiviral treatment strategy for CHB patients. Tenofovir disoproxil fumarate (TDF) is reportedly superior or at least comparable to entecavir (ETV) in preventing hepatocellular carcinoma (HCC) among chronic hepatitis B (CHB) patients; however, it remains controversial. This study aimed to conduct comprehensive comparisons between the two antivirals. CHB patients initially treated with ETV or TDF between 2012 and 2015 at 20 referral centers in Korea were included. The primary outcome was the cumulative incidence of HCC. The secondary outcomes included death or liver transplantation, liver-related outcome, extrahepatic malignancy, development of cirrhosis, decompensation events, complete virologic response (CVR), seroconversion rate, and safety. Baseline characteristics were balanced using the inverse probability of treatment weighting (IPTW). Overall, 4210 patients were enrolled: 1019 received ETV and 3191 received TDF. During the median follow-ups of 5.6 and 5.5 years, 86 and 232 cases of HCC were confirmed in the ETV and TDF groups, respectively. There was no difference in HCC incidence between the groups both before (p = 0.36) and after IPTW was applied (p = 0.81). Although the incidence of extrahepatic malignancy was significantly higher in the ETV group than in the TDF group before weighting (p = 0.02), no difference was confirmed after IPTW (p = 0.29). The cumulative incidence rates of death or liver transplantation, liver-related outcome, new cirrhosis development, and decompensation events were also comparable in the crude population (p = 0.24–0.91) and in the IPTW-adjusted population (p = 0.39–0.80). Both groups exhibited similar rates of CVR (ETV vs. TDF: 95.1% vs. 95.8%, p = 0.38), and negative conversion of hepatitis B e antigen (41.6% vs. 37.2%, p = 0.09) or surface antigen (2.8% vs. 1.9%, p = 0.10). Compared to the ETV group, more patients in the TDF group changed initial antivirals due to side effects, including decreased kidney function (n = 17), hypophosphatemia (n = 20), and osteoporosis (n = 18). In this large-scale multicenter study, ETV and TDF demonstrated comparable effectiveness across a broad range of outcomes in patients with treatment-naïve CHB during similar follow-up periods. [ABSTRACT FROM AUTHOR]

FCP (Free-form Concrete Panel) is used to easily realize the huge and complex curved surfaces of free-form buildings, and research on FCP manufacturing technology is being conducted. However, as the concrete was extruded manually into the manufactured mold, the precision of the FCP was lowered and errors occurred. Therefore, this study developed concrete extrusion equipment that includes a nozzle part, an open/close part, and a control part, according to the required performance derived from previous research analysis. The mixing ratio of concrete was selected at an appropriate value of W/C 38% and extruded uniformly with a width of 60 mm and a thickness of 22 mm. Depending on the opening/closing function, it was possible to open and close at the desired position. The concrete extrusion nozzle for FCP production is the basic equipment, and miniaturization and automation of the nozzle are required in the future. This is expected to contribute to the development of new free-form construction technology and equipment. [ABSTRACT FROM AUTHOR]

Demand for wearable devices and supportive technology is growing as these devices have the potential to enhance physical function and quality of life in users. The purpose of this study was to investigate usability and satisfaction after performing functional and gait exercise with a wearable hip exoskeleton in community-living adults. A total of 225 adults residing in the local community participated in this study. All participants performed 40 min of exercise once with a wearable hip exoskeleton in various environments. The EX1, which functions as a wearable hip exoskeleton, was used. Physical function was assessed before and after exercise with the EX1. After completing exercise with the EX1, the usability and satisfaction questionnaires were evaluated. Gait speed, timed up and go test (TUG), and four square step test (FSST) showed statistically significant improvements after exercise with the EX1 in both groups (p < 0.05). In the 6 min walking test (6MWT), a significant increase was observed in the middle-aged group (p < 0.05). In the short physical performance battery (SPPB), there was a significant improvement in the old-aged group (p < 0.05). On the other hand, positive results in usability and satisfaction were noticed in both groups. These results demonstrate that a single session of exercise with the EX1 was effective in improving physical performance of both middle- and old-aged adults, with positive feedback from most of the participants. [ABSTRACT FROM AUTHOR]

The metaverse-related content market is active and the demand for immersive content is increasing. However, there is no definition for granting copyrights to the content produced using artificial intelligence and discussions are still ongoing. We expect that the need for copyright protection for immersive content used in the metaverse environment will emerge and that related copyright protection techniques will be required. In this paper, we present the idea of 3D-to-2D watermarking so that content creators can protect the copyright of immersive content available in the metaverse environment. We propose an immersive content copyright protection using a deep neural network (DNN), a neural network composed of multiple hidden layers, and a forensic watermark. [ABSTRACT FROM AUTHOR]

Sleep disturbance is prevalent in patients with degenerative spinal disease, and recent studies have reported that surgical treatment is more effective for improving sleep quality than conservative treatment. We aimed to investigate the perioperative changes of sleep problems in patients who underwent surgical treatment for degenerative spinal disease with a concurrent sleep disorder, and presented them according to various clinical profiles possibly associated with sleep disturbance. In addition, we identified factors associated with poor sleep improvement after surgery. This study used data from the Korea Health Insurance Review and Assessment Service database from 2016 to 2018. We included 3183 patients aged ≥19 years who underwent surgery for degenerative spinal disease and had a concurrent sleep disorder. Perioperative changes in the two target outcomes, including the use of sleep medication and hospital visits owing to sleep disorders, were precisely investigated according to factors known to be associated with sleep disturbance, including demographics, comorbidities, and spinal regions. Logistic regression analysis was performed to identify factors associated with poor improvement in terms of sleep medication after surgery. All estimates were validated using bootstrap sampling. During the 1-year preoperative period, the use of sleep medications and hospital visits owing to sleep disorder increased continuously. However, they abruptly decreased shortly after surgical treatment, and throughout the 1-year postoperative period, they remained lower than those in the late preoperative period. At the 1-year follow-up, 75.6% (2407 of 3183) of our cohort showed improvement in sleep medication after surgery. Multivariable analysis identified only two variables as significant factors associated with non-improvement in sleep medication after surgery: depressive disorder (odds ratio (OR) = 1.25 [1.06–1.48]; p = 0.008), and migraine (OR = 1.42 [1.04–1.94]; p = 0.028). We could not investigate the actual sleep quality and resultant quality of life; however, our results justify the necessity for further high-quality studies that include such information and would arouse clinicians' attention to the importance of sleep disturbance in patients with degenerative spinal disease. [ABSTRACT FROM AUTHOR]

It is not easy to dynamically analyze thermal bridges that require multi-dimensional analysis in building energy simulations, which are mostly one-dimensional platforms. To solve this problem, many studies have been conducted and, recently, a study was conducted to model a thermal bridge based on the data obtained by approaching this in a similar way to steady-state analysis, showing high accuracy. This was an early-stage study, which is only applicable when the indoor temperature is constant. By extending the study, a thermal bridge model that can be applied even when the indoor temperature changes over time in building energy simulations is proposed and validated. Since the governing equation, the heat diffusion equation, is linear, the key idea is to create and apply two thermal bridge transfer function models by expressing the heat flow that enters the room as a linear combination of the transfer function for indoor temperature and the transfer function for outdoor temperature. For the proposed thermal bridge model, the NRMSE of the model itself showed a high accuracy of 0.001, and in the verification through annual simulation using the model, the NRMSE showed an accuracy of 0.1. [ABSTRACT FROM AUTHOR]

Neuronal accumulation of parkin-interacting substrate (PARIS), a transcriptional repressor of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), has been observed in Parkinson's disease (PD). Herein, we showed that PARIS can be S-nitrosylated at cysteine 265 (C265), and S-nitrosylated PARIS (SNO-PARIS) translocates to the insoluble fraction, leading to the sequestration of PGC-1α into insoluble deposits. The mislocalization of PGC-1α in the insoluble fraction was observed in S-nitrosocysteine-treated PARIS knockout (KO) cells overexpressing PARIS WT but not S-nitrosylation deficient C265S mutant, indicating that insolubility of PGC-1α is SNO-PARIS-dependent. In the sporadic PD model, α-synuclein preformed fibrils (α-syn PFFs)-injected mice, we found an increase in PARIS, SNO-PARIS, and insoluble sequestration of PGC-1α in substantia nigra (SN), resulting in the reduction of mitochondrial DNA copy number and ATP concentration that were restored by N(ω)-nitro-L-arginine methyl ester, a nitric oxide synthase (NOS) inhibitor. To assess the dopaminergic (DA) neuronal toxicity by SNO-PARIS, lentiviral PARIS WT, C265S, and S-nitrosylation mimic C265W was injected into the SN of either PBS- or α-syn PFFs-injected mice. PARIS WT and C265S caused DA neuronal death to a comparable extent, whereas C265W caused more severe DA neuronal loss in PBS-injected mice. Interestingly, there was synergistic DA loss in both lenti-PARIS WT and α-syn PFFs-injected mice, indicating that SNO-PARIS by α-syn PFFs contributes to the DA toxicity in vivo. Moreover, α-syn PFFs-mediated increment of PARIS, SNO-PARIS, DA toxicity, and behavioral deficits were completely nullified in neuronal NOS KO mice, suggesting that modulation of NO can be a therapeutic for α-syn PFFs-mediated neurodegeneration. [ABSTRACT FROM AUTHOR]

Spinal surgeons have not yet considered sleep disturbance an area of concern; thus, a comprehensive study investigating the epidemiology of sleep disturbance in patients with degenerative spinal disease is yet to be conducted. This study aimed to fill this research gap by investigating the epidemiology of sleep disturbance in patients who underwent spinal surgery for degenerative spinal disease and identifying the associated risk factors. This nationwide, population-based, cohort study, used data from January 2016 and December 2018 from the Korea Health Insurance Review and Assessment Service database. This study included 106,837 patients older than 19 years who underwent surgery for degenerative spinal disease. Sleep disorder was initially defined as a diagnosis of a sleep disorder made within one year before the index surgery and identified using the International Classification of Diseases, 10th revision, codes F51 and G47 (main analysis). We also investigated the use of sleep medication within 90 days prior to the index surgery, which was the target outcome of the sensitivity analysis. The prevalence of sleep disturbance was precisely investigated according to various factors, including demographics, comorbidities, and spinal region. Logistic regression analysis was performed to identify the independent factors associated with sleep disturbance. The results of the statistical analysis were validated using sensitivity analysis and bootstrap sampling. The prevalence of sleep disorder was 5.5% (n = 5847) in our cohort. During the 90 days before spinal surgery, sleep medication was used for over four weeks in 5.5% (n = 5864) and over eight weeks in 3.8% (n = 4009) of the cohort. Although the prevalence of sleep disturbance differed according to the spinal region, the spinal region was not a significant risk factor for sleep disorder in multivariable analysis. We also identified four groups of independent risk factors: (1) Age, (2) other demographic factors and general comorbidities, (3) neuropsychiatric disorders, and (4) osteoarthritis of the extremities. Our results, including the prevalence rates of sleep disturbance in the entire patient population and the identified risk factors, provide clinicians with a reasonable reference for evaluating sleep disturbance in patients with degenerative spinal disease and future research. [ABSTRACT FROM AUTHOR]

We investigated the selective etching of Si versus Si1−xGex with various Ge concentrations (x = 0.13, 0.21, 0.30, 0.44) in tetramethyl ammonium hydroxide (TMAH) solution. Our results show that the Si1−xGex with a higher Ge concentration was etched slower due to the reduction in the Si(Ge)–OH bond. Owing to the difference in the etching rate, Si was selectively etched in the Si0.7Ge0.3/Si/Si0.7Ge0.3 multi-layer. The etching rate of Si depends on the Si surface orientation, as TMAH is an anisotropic etchant. The (111) and (010) facets were formed in TMAH, when Si was laterally etched in the <110> and <100> directions in the multi-layer, respectively. We also investigated the effect of the addition of Triton X-100 in TMAH on the wet etching process. Our results confirmed that the presence of 0.1 vol% Triton reduced the roughness of the etched Si and Si1−xGex surfaces. Moreover, the addition of Triton to TMAH could change the facet formation from (010) to (011) during Si etching in the <100>-direction. The facet change could reduce the lateral etching rate of Si and consequently reduce selectivity. The decrease in the layer thickness also reduced the lateral Si etching rate in the multi-layer. [ABSTRACT FROM AUTHOR]

Plant-based diets have been suggested to be beneficial for type 2 diabetes (T2D). However, studies investigating the association between the healthiness of a plant-based diet and T2D risk are limited. This study explored the prospective association between scores from three different plant-based diet indices and risk of T2D and investigated whether associations differ by demographic and lifestyle factors in the Korean population. Data were derived from the Korean Genome and Epidemiology Study (KoGES), a prospective cohort study initiated between 2001 and 2002. Dietary intakes were assessed using a validated food frequency questionnaire. Scores for three plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI)) were measured. A total of 7363 Korean adults aged 40–69 years without T2D and related chronic diseases at baseline were included. Incident T2D was defined as elevated plasma glucose (≥126 mg/dL), self-report of a doctor's diagnosis of T2D, or use of oral hypoglycemic drug. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for T2D risk. During a follow-up period of 14 years, 977 participants developed T2D. A 10-point higher score in hPDI was associated with a 14% lower risk of T2D (HR: 0.86, 95% CI, 0.77–0.95), adjusting for potential confounders. In subgroup analysis, inverse associations between hPDI and T2D risk were stronger in participants with a family history of T2D (HR: 0.58, 95% CI, 0.44 0.76) or history of hypertension (HR: 0.73, 95% CI, 0.60 0.89) than those without a family history of T2D (p interaction = 0.01) or history of hypertension (p interaction = 0.04). Considering the quality of the plant foods may be important for the prevention of T2D in the Korean population, which habitually consumes diets rich in plant foods. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection remains a threat to global public health. Serum hepatitis B surface antigen (HBsAg) has been used in screening for HBV infection. Quantitative HBsAg assays are useful for monitoring the natural history of HBV infection and its response to therapy. The aim of this study was to determine the relationship between quantitative (qHBsAg; IU/mL) and semi-quantitative (sqHBsAg; signal-to-cutoff ratio [S/Co]) HBsAg titers in patients with chronic hepatitis B (CHB). Methods: We retrospectively included 284 samples with HBV DNA < 20 IU/mL from patients who had simultaneous qHBsAg (using electrochemiluminescence assay) and sqHBsAg tests. Patients were grouped according to their serum HBV-envelope antigen (HBeAg) status (HBeAg-negative, n = 239 and HBeAg-positive, n = 45). The Spearman test was used to analyze the correlation between the quantitative and semi-quantitative assays. Results: There was a significant linear correlation between sqHBsAg and qHBsAg in the HBeAg-negative patients (qHBsAg [IU/mL] = 0.0094 × sqHBsAg [S/Co]1.323; adjusted R2 = 0.8445; p < 0.001). There was a substantial hook effect in the assays from the HBeAg-positive patients, so we performed a stratified analysis according to qHBsAg <1000 IU/mL or ≥1000 IU/mL and found a significant positive linear correlation between sqHBsAg S/Co and qHBsAg (qHBsAg [IU/mL] = 0.072 × sqHBsAg [S/Co]1.331; adjusted R2 = 0.7878; p < 0.001) in HBeAg-positive patients with qHBsAg titers of <1000 IU/mL and a significant negative correlation in HBeAg-positive patients with qHBsAg titers of ≥1000 IU/mL (qHBsAg [IU/mL] = 8.987 × 1014 × sqHBsAg [S/Co]−3.175; adjusted R2 = 0.6350; p < 0.001). Conclusions: There was a highly linear, positive correlation between qHBsAg and sqHBsAg in HBeAg-negative CHB patients. The hook effect led to a negative correlation in HBeAg-positive CHB patients with qHBsAg titers ≥1000 IU/mL. [ABSTRACT FROM AUTHOR]

Reoperation is a major concern in spinal fusion surgery for degenerative spinal disease. Earlier reported reoperation rates were confined to a specific spinal region without comprehensive analysis, and their prediction models for reoperation were not statistically validated. Our study aimed to present reasonable base rates for reoperation according to all possible risk factors and build a validated prediction model for early reoperation. In our nationwide population-based cohort study, data between 2014 and 2016 were obtained from the Korean National Health Insurance claims database. Patients older than 19 years who underwent instrumented spinal fusion surgery for degenerative spinal diseases were included. The patients were divided into cases (patients who underwent reoperation) and controls (patients who did not undergo reoperation), and risk factors for reoperation were determined by multivariable analysis. The estimates of all statistical models were internally validated using bootstrap samples, and sensitivity analyses were additionally performed to validate the estimates by comparing the two prediction models (models for 1st-year and 3rd-year reoperation). The study included 65,355 patients: 2939 (4.5%) who underwent reoperation within 3 years after the index surgery and 62,146 controls. Reoperation rates were significantly different according to the type of surgical approach and the spinal region. The third-year reoperation rates were 5.3% in the combined lumbar approach, 5.2% in the posterior lumbar approach, 5.0% in the anterior lumbar approach, 3.0% in the posterior thoracic approach, 2.8% in the posterior cervical approach, 2.6% in the anterior cervical approach, and 1.6% in the combined cervical approach. Multivariable analysis identified older age, male sex, hospital type, comorbidities, allogeneic transfusion, longer use of steroids, cages, and types of surgical approaches as risk factors for reoperation. Clinicians can conduct comprehensive risk assessment of early reoperation in patients who will undergo instrumented spinal fusion surgery for degenerative spinal disease using this model. [ABSTRACT FROM AUTHOR]

Simple Summary: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are the preferred anti-viral agents used as first-line treatments for chronic hepatitis B. Despite many meta-analyses being conducted, it is still not clear whether TDF is more effective than ETV at reducing the risk of HCC due to the inconsistent statistical methodologies employed in previous observational studies. To reduce heterogeneity, we analysed only hospital cohort data studies with anti-viral naive patients. Additionally, unlike previous studies, we conducted subgroup analyses with enrolment criteria and socioeconomic factors that could not be corrected with statistical techniques. There is no difference between the two drugs in terms of reducing the risk of HCC in a pooled analysis of PS-matched patients. In the subgroup analysis, if there was interval of over three years from the start point of patient enrolment, we found that TDF was associated with significantly lower HCC risk. This result will provide new perspectives for future research. Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are the preferred anti-viral agents used as first-line treatments for chronic hepatitis B (CHB). However, the efficacy of these agents in reducing the incidence of hepatocellular carcinoma (HCC) remains unclear. We conducted this meta-analysis to assess the efficacy of anti-viral agent on preventing HCC in CHB. Two investigators independently searched all relevant studies that examined the efficacy of anti-viral agent for preventing HCC using MEDLINE, Embase, and Cochrane Library databases through August 2021. The extracted data were analysed using a random-effects meta-analysis model based on the inverse-variance method (DerSimonian–Laird) and expressed as hazard ratio (HR) and 95% confidence interval (95% CI). We included 19 retrospective studies in the analysis. Although there was substantial heterogeneity between the studies, the overall pooled HR indicated that TDF significantly lowered the risk of HCC (HR: 0.72, 95% CI: 0.58–0.90, I2 = 66.29%). However, the pooled analysis of propensity score (PS)-matched subpopulations showed no significant differences (HR, 0.83; 95% CI, 0.65–1.06; I2 = 52.30%) between TDF and ETV. In a subgroup analysis, an interval of over three years in the start point of patient enrolment and excluding alcoholic liver disease patients significantly lowered the HCC risk associated with TDF. In conclusion, TDF may be more effective than ETV at reducing HCC incidence in treatment-naive CHB patients, but this effect was not consistent in the PS-matched subpopulation that reduced heterogeneity. As a result of subgroup analysis, the conflicting findings of previous studies may result from heterogeneous inclusion criteria. Further studies with standardised protocols are needed to reduce the residual heterogeneity. [ABSTRACT FROM AUTHOR]

This study aimed to identify age-specific characteristics of respiratory viral infections. Hospitalized patients with confirmed viral respiratory infections were included in the sample. The patients were divided into the pediatric group (<19 years old) and the adult group (≥19 years old). The groups were then subdivided based on age: 0–6, 7–12, 13–18, 19–49, 50–64, and ≥65 years old. These groups were compared to evaluate the differences in the pattern of respiratory viral infections. Among a total of 4058 pediatric patients (mean age 3.0 ± 2.9 years, n = 1793 females), 2829 (48.9%) had mono-infections, while 1229 (51.1%) had co-infections. Co-infections were the most common in the 0–6-year-old group (31.6%). Among 1550 adult patients (mean age 70.2 ± 15.3 years, n = 710 females), 1307 (85.6%) had mono-infections and 243 (14.4%) had co-infections. Co-infections were most common in the ≥65-year-old group (16.8%). Viral infection and co-infection rates decreased with age in pediatric patients but increased with increasing age in adults. In pediatric patients, the rates of viral infections and co-infections were high; the rate of co-infections was higher in younger patients. In adult patients, the rates of viral infections and co-infections were lower than those in pediatric patients; the rate of co-infections was higher in older patients. [ABSTRACT FROM AUTHOR]

Many studies have been conducted for the accuracy of free-form concrete panel fabrication, but there still are errors in the process of fabrication. This study developed a connection technology of detachable shape part that can be applied to the existing multi-point Computer Numerical Control (CNC) to enhance the accuracy of fabrication. The detachable type can place a silicone plate on top of the rod without additional fixtures. The accuracy of the technology was verified by curvature test and free-form concrete panel fabrication test. Three curves were created to compare the discrepancies between the designed shapes and the fabricated shapes through quality test. As a result, the detachable type decreased the error by up to 2 mm. In addition, a panel was fabricated to analyze the error to verify the rigidity of the developed molds. The error caused by concrete deflection under load or the error caused by repeated fabrication was about 0.5 mm. The shape error was within 3.5 mm. This small error proved greater accuracy compared to the existing technology. [ABSTRACT FROM AUTHOR]

With the increase of free-form architecture, many studies have been conducted for producing free-form Concrete Panels (FCP), but there are still areas that are lacking in terms of the technological aspect. In particular, as free-form panels are produced by hand, the precision of the shapes is low and cost and time are high. FCP production equipment was developed to resolve this. In this study, the variable side mold for FCP production used in side control equipment among FCP production equipment was developed. Variable side mold is equipment that satisfies five requirements to configure the form of FCPs. The variable side mold is made with steel plates so that it can withstand the side pressure of concrete. As a result, the material has a uniform thickness throughout and is molded to the desired shape. Therefore, in order to verify this, the panel was manufactured as a variable side mold to compare the side form with the designed form through 3D scanning and quality inspection to check for errors. As a result, there was a 0.276 mm mean difference for both ends of the panel and the central part, and it was therefore verified through t-test that errors occurred within the allowed margin of 95% confidence level. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the association between third-generation cephalosporin resistance and urinary tract infection (UTI) recurrence in patients who underwent voiding cystourethrogram (VCUG). Methods: In this retrospective study, data were obtained from hospitalized pediatric patients who had a first febrile UTI episode and subsequently underwent VCUG. Information based on VCUG was mandatory to identify the presence of vesicoureteral reflux (VUR). A multivariable logistic model was used to identify the risk factors for recurrence. Recurrence was divided into early (90-day) and late (1-year), and sensitivity analyses were performed according to each definition. The estimates of all the statistical models were internally validated using bootstrap samples. Results: A total of 210 patients were included, and the overall recurrence rate of UTI was 26.2% (55 of 210). Third-generation cephalosporin resistance was a significant risk factor for early recurrence (odds ratio: 2.79 [1.08–7.20]) but not for late recurrence. Sensitivity analyses showed that third-generation cephalosporin resistance was a significant risk factor for 60-day recurrence but not for 180-day recurrence. A VUR grade ≥ 3 was identified as a consistent risk factor for both early and late recurrence. Conclusions: Third-generation cephalosporin resistance was a significant risk factor for the early recurrence of pediatric UTI in patients who underwent VCUG. [ABSTRACT FROM AUTHOR]

Patients with pyogenic vertebral osteomyelitis (PVO) often develop concurrent infections, and a significant number of these patients show rapid deterioration in their medical condition, leading to mortality without PVO-related structural instability or neurological deficits. To improve clinical outcomes, we investigated the clinical presentation and treatment outcomes of patients with PVO and concurrent infections. This study included 695 patients with PVO, of which 175 (25%) had concurrent infections and 520 (75%) did not. The clinical characteristics of the two groups were compared, and multivariable analysis was performed to identify the association between concurrent infections and clinical outcomes. Patients with concurrent infections were older and had more comorbidities than those without. Moreover, there were significant intergroup differences in the anatomical involvement of PVO, and patients with concurrent infections had a higher number of regions involved more frequently than those without concurrent infections (15% vs. 6%). In contrast, patients with concurrent infections showed a lower degree of focal invasiveness, including a lower incidence of posterior abscess (47% vs. 59%; p = 0.008) and fewer neurological impairments according to the American Spinal Injury Association grade (p < 0.001) than those without concurrent infections. The causative organisms also differed significantly between the two groups, and patients with concurrent infections had a greater proportion of Gram-negative infections (31% vs. 16%, respectively) and a smaller proportion of methicillin-resistant S. aureus infections than those without concurrent infections (6% vs. 24%). Consequently, their clinical outcomes were significantly different, and patients with concurrent infections showed lower recurrence and higher mortality rates. We investigated the 1-year recurrence and mortality rates and their 95% confidence intervals according to the types of concurrent infections and their time of diagnosis and found variations in these parameters. Our results, based on a large number of patients, can be practically used as a reasonable reference to warn clinicians of the clinical risks of concurrent infections in patients with PVO and to help predict their clinical outcomes. [ABSTRACT FROM AUTHOR]

The present study investigated the effect of a dance-based aerobic exercise, on the affective experiences of participants with different fitness levels. Thirty-two college students were enrolled in the same dance fitness course, tested using a physical fitness test (the National Fitness Project 100) and grouped accordingly to 15 sports majors (high-fit group) and 17 non-sports majors (low-fit group). Together, they participated in a single-session dance fitness program using 11 basic dance steps incorporated in Zumba rhythms of merengue and reggaeton for 47 min including warm-up and cool-down. Pre- and post-exercise affects were measured using the PANAS-X transmitted to each participant's smartphone. During exercise, participants' heart rate (HR) and their responses to the felt arousal scale (FAS) and the feeling scale (FS) by exercise section were measured using tailor-made applications on a smartwatch. Results showed that the intensity of exercise for the same exercise program was lower in the high-fit group than in the low-fit group, as evidenced by %HRmax. In addition, the pattern of affective change throughout the exercise sections was different according to the groups' fitness levels, while the affective improvement was greater in the high-fit group. This study confirmed that physical fitness is a major variable influencing the relationship between exercise and affect. [ABSTRACT FROM AUTHOR]

Herbal medicine is widely prescribed worldwide. To date, however, studies on the prediction of efficacy of herbal medicine based on machine learning have very rarely been reported. The objectives of this study are to predict the efficacy of Taeumjowi-tang (one of herbal medicines) and evaluate the prediction model in treating metabolic abnormalities. Subjects were divided into an improvement group and a non-improvement group based on the difference before and after oral administration of an herbal medicine. Efficacy models of triglyceride level, high-density lipoprotein (HDL) cholesterol level, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were built using a least absolute shrinkage and selection operator (LASSO) based on variables extracted from face shape, face colors, body circumference, questionnaire, voice, and tongue color. In predicting efficacy for four metabolic risk factors, the efficacy model of HDL cholesterol level showed the best the area under the receiver operating characteristic curve (AUC) value among the four models (AUC = 0.785 (confidence interval = 0.693, 0.877)). The AUC value of the efficacy model of triglyceride level was 0.659 (0.551, 0.768). Efficacy models of DBP and SBP showed AUC values of 0.665 (0.551, 0.78) and 0.54 (0.385, 0.694), respectively. The results may provide a clue to predict whether a drug will be effective for each subject with phenotypic information and to reduce the use of an ineffective drug or its side effects. [ABSTRACT FROM AUTHOR]

We examined gender differences in the association between dietary patterns and the risk of hypertension, using the Korean Genome and Epidemiology Study data. A total of 5090 participants (2457 men and 2633 women) aged 40-69 years without hypertension at baseline were selected. Dietary patterns were obtained using factor analysis based on 26 food groups, evaluated by a validated semi-quantitative food frequency questionnaire at baseline. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medication using the biennial measurements. Multivariate Cox proportional hazards models were used to examine the associations between dietary patterns and hypertension. Four dietary patterns were extracted: coffee, fat, and sweets; prudent; whole grains and legumes; and traditional (men)/Western (women). Women in the highest tertile of the whole grains and legumes pattern scores showed a lower risk of incident hypertension compared with those in the lowest tertile (hazard ratio = 0.77, 95% confidence interval = 0.59-1.00, p-trend = 0.048). Other dietary patterns were not associated with hypertension in either men or women. A diet rich in whole grains and legumes is inversely associated with the risk of hypertension in Korean women, suggesting a gender difference in the association between diet and hypertension. [ABSTRACT FROM AUTHOR]

We examined the gender-specific association between dietary pattern and risk of developing cholesterolemia based on the data from the Korean Genome and Epidemiology study. A total of 7515 individuals aged 40-69 years participated in this study between 2005 and 2010. Dietary intake was assessed by a semi-quantitative food frequency questionnaire. Low HDL cholesterolemia was defined as a plasma HDL-C level <1.04 mmol/L (men) or <1.30 mmol/L (women), and high LDL cholesterolemia was defined as a plasma LDL-C level >3.37 mmol/L. Multivariate Cox proportional hazard models were used to examine the risk for incident cholesterolemia according to dietary pattern score. Four dietary patterns were derived by gender using factor analysis: prudent pattern; coffee, fat, and sweet pattern; whole grain (men) or white rice and noodle (women) pattern; and westernized pattern. A prudent pattern was inversely associated with risk of low HDL cholesterolemia in both men (Hazard ratio (HR) = 0.76, p for trend = 0.0098) and women (HR = 0.78, p for trend = 0.0324), whereas the coffee, fat, and sweet pattern was positively associated with risk of high LDL cholesterolemia in men only (HR = 1.26, p for trend = 0.0254) after adjustment for potential confounders. Specific dietary patterns were associated with risk of developing cholesterolemia suggesting gender differences. [ABSTRACT FROM AUTHOR]

Previous studies to identify risk factors for postoperative deep infection following instrumented spinal fusion surgery for degenerative spinal disease are based on insufficient information and have limited use in clinical practice. This study aims to fill this gap by assessing the risk factors and their adjusted relative risks through a comprehensive analysis, including all core information. In this nationwide, population-based, cohort study, data were obtained from the Korean National Health Insurance claims database between 1 January 2014, and 31 December 2018. This study included a cohort of 194,036 patients older than 19 years, who underwent instrumented spinal fusion surgery for degenerative spinal disease. We divided this population into cases (patients with postoperative deep infection) and controls (patients without postoperative deep infection); risk factors for postoperative deep infection were determined by multivariable analysis. The definition of postoperative deep infection varied, and sensitivity analyses were performed according to each definition. The estimates of all the statistical models were internally validated using bootstrap samples. The study included 767 patients (0.39%) with postoperative deep spinal infections and 193,269 controls. The final multivariable model identified the following variables as significant risk factors for postoperative deep infection: age between 60–69 years (OR = 1.6 [1.1–2.3]); age between 70–79 years (OR = 1.7 [1.2–2.5]); age > 80 years (OR = 2.1 [1.3–3.2]); male sex (OR = 1.7 [1.5–2.0]); rural residence (OR = 1.3 [1.1–1.5]); anterior cervical approach (OR = 0.2 [0.1–0.3]); posterior cervical approach (OR = 0.5 [0.2–1.0]); multiple approaches (OR = 1.4 [1.2–1.6]); cerebrovascular disease (OR = 1.5 [1.2–1.8]); peripheral vascular disease (OR = 1.3 [1.1–1.5]); chronic pulmonary disease (OR = 1.2 [1.0–1.4]); rheumatologic disease (OR = 1.6 [1.3–2.1]); liver disease (OR = 1.4 [1.1–1.7]); diabetes (OR = 1.5 [1.3–1.7]); hemiplegia or paraplegia (OR = 2.2 [1.5–3.3]); allogenous transfusion (OR = 1.6 [1.3–1.8]); and use of systemic steroids over 2 weeks (OR = 1.5 [1.1–2.0]). Our results, which are based on homogenous patient groups, provide clinicians with an acceptable tool for comprehensive risk assessment of postoperative deep infection in patients who will undergo instrumented spinal fusion surgery for degenerative spinal disease. [ABSTRACT FROM AUTHOR]

Simple Summary: The effectiveness of surgical resection and radiofrequency ablation in early hepatocellular carcinoma is still controversial because previous studies show conflicting results. In addition, previous studies did not consider the antiviral treatment-related factors, even though there is now robust evidence that antiviral therapy is crucial for determining the prognosis of patients with chronic hepatitis B-related liver cancer. After adjusting for the antiviral treatment, we demonstrated that radiofrequency ablation may provide comparable overall survival to resection in the treatment of very early or early hepatocellular carcinoma, although recurrence-free survival is marginally shorter than in the resection group. It remains controversial whether surgical resection, compared to radiofrequency ablation (RFA), improves overall survival (OS) in patients with early hepatocellular carcinoma (HCC). This study aimed to compare OS after RFA with that after resection for HCC. This retrospective study included patients who underwent RFA or surgical resection as initial treatment for hepatitis B virus (HBV)-related HCC at a very early or early stage. A total of 761 patients (RFA, n = 194; resection, n = 567) from Seoul National University Hospital (Seoul, South Korea) and 1277 patients (RFA, n = 352; resection, n = 925) from the Korean Primary Liver Cancer Registry were included in the hospital and nationwide cohorts, respectively. Primary and secondary endpoints were OS and recurrence-free survival (RFS), respectively. Additional analysis was performed when the history of the antiviral treatment and the type of prescribed nucleos(t)ide analogue were confirmed. The rate of complications was compared between the two treatment groups in the hospital cohort. Baseline characteristics were balanced, using inverse probability of treatment weighting (IPTW). In the hospital cohort, the RFA group had a smaller mean tumor size (1.7 vs. 3.9 cm) but a higher proportion of cirrhotic patients than the resection group (85.6% vs. 63.1%) (both p < 0.01). During 81.0 (interquartile range, 62.3–107.1) months of follow-up, there was no difference in OS (adjusted hazard ratio (aHR) = 0.870, 95% confidence interval (CI) = 0.400–1.897, p = 0.73) and RFA was associated with shorter RFS (aHR = 1.562, 95% CI = 1.099–2.219, p = 0.01) after employing IPTW. Antiviral treatment was independently associated with longer OS (aHR = 0.444, 95% CI = 0.251–0.786, p = 0.01) as well as RFS (aHR = 0.544, 95% CI = 0.391–0.757, p < 0.01) in the hospital cohort. In the nationwide cohort, there was no difference in OS (aHR = 0.981, 95% CI = 0.661–1.456, p = 0.92) between the two treatment groups when adjusted for antiviral treatment, which was a negative independent risk factor for mortality (aHR = 0.655, 95% CI = 0.451–0.952, p = 0.03) after IPTW. Among patients treated with tenofovir (n = 96) or entecavir (n = 184) in the hospital cohort, there was no difference in either OS (aHR = 0.522, 95% CI = 0.058–4.724, p = 0.56) or RFS (aHR = 1.116, 95% CI = 0.738–1.688, p = 0.60). The overall incidence of complications was higher in the resection group (26.3%) than in the RFA group (13.9%) (p < 0.01). RFA may provide comparable OS to resection in the treatment of very early or early HCC with a lower rate of complications, although RFS is marginally shorter than in the resection group after adjusting for antiviral treatment. Regardless of the type of NA, antiviral treatment in patients with HBV-related HCC is strongly associated with both OS and RFS. [ABSTRACT FROM AUTHOR]

The relationship between the various types of diets derived from plants and vulnerability of dyslipidemia has rarely been investigated, and limited data exist in Asians whose dietary pattern is fairly different from that of the Western population. We aim to analyze the relationship between three plant-based diet indices (PDI) and the risk of dyslipidemia. Participants included 173,209 Korean adults who were aged ≥40 years from the Korean Genome and Epidemiology Study_Health Examination (2004–2013). A food frequency questionnaire (FFQ) was used to assess dietary intake. Three PDI were quantified for the study: overall PDI, healthful PDI (hPDI), and unhealthful PDI (uPDI). Among the 147,945 included, 48,166 (32.6%) of participants had dyslipidemia. Great adherence to uPDI was related with 15% greater odds of having dyslipidemia (OR: 1.15; 95% CI: 1.11–1.20, p-trend < 0.0001). No significant association was observed between PDI, hPDI, and dyslipidemia. The association between uPDI and dyslipidemia was significantly stronger among participants aged ≥55 years when compared to participants aged <55 years (p-value for interaction = 0.001). The quality of plant foods is vital in preventing dyslipidemia among people consuming high plant-based food diets. [ABSTRACT FROM AUTHOR]

Older patients with pyogenic vertebral osteomyelitis (PVO) usually have more medical comorbidities compared with younger patients, and present with advanced infections from different causative organisms. To aid surgical decision-making, we compared surgical outcomes of older patients with PVO to those who underwent nonoperative treatment. We identified the risk factors for adverse post-operative outcomes, and analyzed the clinical risks from further spinal instrumentation. This retrospective comparative study included 439 patients aged ≥75 years with PVO. Multivariable analysis was performed to compare treatment outcomes among three groups: 194, 130, and 115 patients in the non-operative, non-instrumented, and instrumented groups, respectively. The risk factors for adverse outcomes after surgical treatment were evaluated using a logistic regression model, and the estimates of the multivariable models were internally validated using bootstrap samples. Recurrence and mortality of these patients were closely associated with neurologic deficits, and increased surgical invasiveness, resulting from additional spinal instrumentation, did not increase the risk of recurrence or mortality. We propose that surgical treatment for these patients should focus on improving neurologic deficits through immediate and sufficient removal of abscesses. Spinal instrumentation can be performed if indicated, within reasonable clinical risk. [ABSTRACT FROM AUTHOR]

Cryptographic circuits generally are used for applications of wireless sensor networks to ensure security and must be tested in a manufacturing process to guarantee their quality. Therefore, a scan architecture is widely used for testing the circuits in the manufacturing test to improve testability. However, during scan testing, test-power consumption becomes more serious as the number of transistors and the complexity of chips increase. Hence, the scan chain reordering method is widely applied in a low-power architecture because of its ability to achieve high power reduction with a simple architecture. However, achieving a significant power reduction without excessive computational time remains challenging. In this paper, a novel scan correlation-aware scan cluster reordering is proposed to solve this problem. The proposed method uses a new scan correlation-aware clustering in order to place highly correlated scan cells adjacent to each other. The experimental results demonstrate that the proposed method achieves a significant power reduction with a relatively fast computational time compared with previous methods. Therefore, by improving the reliability of cryptography circuits in wireless sensor networks (WSNs) through significant test-power reduction, the proposed method can ensure the security and integrity of information in WSNs. [ABSTRACT FROM AUTHOR]

Korea is currently executing a pilot program for community care of its aging population and aims to implement community care systems on a national scale by 2025. This study examines the traditional Korean medicine (TKM) service to be provided within community care by understanding the current status of TKM services. The Ministry of Health and Welfare (MoHW) sent official letters to 242 local governments (cities, districts, and counties) from October to November 2019 to survey the status of the public TKM services provided in 2018. The items of the survey included basic demographic information as well as information that could reveal how the program was implemented. In 112 local government jurisdictions (response rate 46.3%), a total of 867 TKM service programs were in place. As a result of the survey, it was revealed that they did not have any service manuals or evaluation results. To provide home-care-based TKM service for the elderly as an integrated part of a community care system, it is necessary to develop, distribute, and evaluate a standard service manual including an evaluation index by the central government. [ABSTRACT FROM AUTHOR]

This cross-sectional study investigated the correlation between parents' perception and their children's traditional Korean medicine (TKM) use reported by parents in order to discover policy intervention points and provide a reference for establishing generalized TKM policies. Participant data from a 2017 national survey on TKM usage was divided into two groups based on the children's TKM use reported by parents. The female participants' children had a higher rate of experience in using TKM (8.1%; p = 0.029). Additionally, 91.4% of the parent group with a child who used TKM turned out to have used TKM, which was higher than 71.9% of the parents whose children never used TKM (p < 0.001). As for the awareness on the use of TKM, 44.0% of the parents with a child who experienced TKM answered they were aware of it, while only 35.3% of the parent group whose child never experienced TKM did so (p = 0.033). The present study suggests that parental experience in using TKM could have an impact on the children's TKM use reported by parents. Further study is necessary to assess which parental factor (awareness level, medical disorder to be treated, therapy, therapeutic efficacy, the purpose of visit, sex, age, etc.) has a close relationship with TKM usage experience of their children. [ABSTRACT FROM AUTHOR]

Bovine submaxillary mucin (BSM) is a natural polymer used in biomaterial applications for its viscoelasticity, lubricity, biocompatibility, and biodegradability. N-glycans are important for mucin stability and function, but their structures have not been fully characterized, unlike that of O-glycans. In this study, BSM N-glycans were investigated using liquid chromatography-tandem mass spectrometry. The microheterogeneous structures of 32 N-glycans were identified, and the quantities (%) of each N-glycan relative to total N-glycans (100%) were obtained. The terminal N-acetylgalactosamines in 12 N-glycans (sum of relative quantities; 27.9%) were modified with mono- (10 glycans) and disulfations (2 glycans). Total concentration of all sulfated N-glycans was 6.1 pmol in BSM (20 µg), corresponding to 25.3% of all negatively charged glycans (sum of present N-glycans and reported O-glycans). No N-glycans with sialylated or phosphorylated forms were identified, and sulfate modification ions were the only negative charges in BSM N-glycans. Mucin structures, including sulfated N-glycans located in the hydrophobic terminal regions, were indicated. This is the first study to identify the structures and quantities of 12 sulfated N-glycans in natural mucins. These sulfations play important structural roles in hydration, viscoelasticity control, protection from bacterial sialidases, and polymer stabilization to support the functionality of BSM via electrostatic interactions. [ABSTRACT FROM AUTHOR]

We evaluated the associations among different types of plant-based diet indices, risk of dyslipidemia, and individual lipid disorders in Asian populations with different dietary patterns from Western populations. Participants included 4507 Korean adults aged ≥40 years without dyslipidemia and related chronic diseases at baseline (2001–2002). Dietary intakes were assessed using an average of validated food frequency questionnaires measured twice. We calculated three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). During a follow-up of 14 years, 2995 incident dyslipidemia cases occurred. Comparing the highest with lowest quintiles, the multivariable-adjusted hazard ratios (HRs) for incident dyslipidemia were 0.78 (95% CI, 0.69–0.88) for PDI, 0.63 (95% CI, 0.56–0.70) for hPDI, and 1.48 (95% CI, 1.30–1.69) for uPDI (P-trend < 0.0001 for all). Associations between PDI and individual lipid disorders differed by sex. The PDI was inversely associated with risk of developing hypertriglyceridemia in men and with risk of developing low high-density lipoprotein cholesterol in women. The hPDI was inversely associated with risk of all lipid disorders, whereas the uPDI was positively associated with individual lipid disorders. The quality of plant foods is important for prevention of dyslipidemia in a population that consumes diets high in plant foods. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer (PCa) is the most common cancer in men and the second highest contributor to cancer deaths. Targeting lipid catabolism enzymes in PCa may offer new avenues for therapeutic approaches. During the last decade, carnitine palmitoyl transferase I (CPT1A) has been identified as a potential therapeutic target for a growing list of cancers. In this study, we have tested the hypothesis that excess CPT1A plays a key role in supporting adaptation to stress and antioxidant defense production in PCa cells. Specifically, we have studied molecular differences between CPT1A gain and loss of function models, revealing genetic and metabolic vulnerabilities that could be targeted to avoid progression to neuroendocrine differentiation, a lethal form of the disease. Examining public datasets, we have also found that excess CPT1A expression leads to worse progression-free survival in PCa patients. Cancers reprogram their metabolism to adapt to environmental changes. In this study, we examined the consequences of altered expression of the mitochondrial enzyme carnitine palmitoyl transferase I (CPT1A) in prostate cancer (PCa) cell models. Using transcriptomic and metabolomic analyses, we compared LNCaP-C4-2 cell lines with depleted (knockdown (KD)) or increased (overexpression (OE)) CPT1A expression. Mitochondrial reactive oxygen species (ROS) were also measured. Transcriptomic analysis identified ER stress, serine biosynthesis and lipid catabolism as significantly upregulated pathways in the OE versus KD cells. On the other hand, androgen response was significantly downregulated in OE cells. These changes associated with increased acyl-carnitines, serine synthesis and glutathione precursors in OE cells. Unexpectedly, OE cells showed increased mitochondrial ROS but when challenged with fatty acids and no androgens, the Superoxide dismutase 2 (SOD2) enzyme increased in the OE cells, suggesting better antioxidant defenses with excess CPT1A expression. Public databases also showed decreased androgen response correlation with increased serine-related metabolism in advanced PCa. Lastly, worse progression free survival was observed with increased lipid catabolism and decreased androgen response. Excess CPT1A is associated with a ROS-mediated stress phenotype that can support PCa disease progression. This study provides a rationale for targeting lipid catabolic pathways for therapy in hormonal cancers. [ABSTRACT FROM AUTHOR]

Wildcarded identity-based encryption (WIBE) is an encryption system where one can encrypt messages to multiple users by specifying a pattern, which is a set of identity strings or wildcards. It is a useful primitive for practical applications where users are defined with multiple attributes (or affiliations), such as organization networks or IoT firmware updates. However, the ciphertext size in traditional WIBE schemes are linear to the number of wildcards in the pattern; since the ciphertext size determines the payload in network systems, it degrades the practicality when deployed in transmission-sensitive systems. In this paper, we represent scalable wildcarded identity-based encryption (SWIBE), which achieves a constant-size ciphertext regardless of the number of wildcards (or depth of patterns). the SWIBE scheme also allows the wildcard usage key derivation as well as encryption: a user with wildcarded pattern can delegate keys for the fixed pattern. Compared to the existing WIBE schemes, the SWIBE scheme is the first approach to yield constant-size ciphertext. Moreover, SWIBE also improves encryption time and decryption time while maintaining a key size of 2 L , comparable to the key size of L in WIBE schemes (where L is a depth of the pattern). The experimental results show that the decryption time is 3 to 10 times faster than the existing WIBE schemes, and 650 times faster than the attribute-based encryption with constant-size ciphertext. For the security, we first propose the selective-CPA-secure SWIBE scheme in a prime order bilinear group and extend it to be selective-CCA-secure. Then we also propose a fully-secure SWIBE scheme which can overcome the selective security. [ABSTRACT FROM AUTHOR]

In public key broadcast encryption, anyone can securely transmit a message to a group of receivers such that privileged users can decrypt it. The three important parameters of the broadcast encryption scheme are the length of the ciphertext, the size of private/public key, and the performance of encryption/decryption. It is suggested to decrease them as much as possible; however, it turns out that decreasing one increases the other in most schemes. This paper proposes a new broadcast encryption scheme for tiny Internet of Things (IoT) equipment (BESTIE), minimizing the private key size in each user. In the proposed scheme, the private key size is O (log n) , the public key size is O (log n) , the encryption time per subset is O (log n) , the decryption time is O (log n) , and the ciphertext text size is O (r) , where n denotes the maximum number of users, and r indicates the number of revoked users. The proposed scheme is the first subset difference-based broadcast encryption scheme to reduce the private key size O (log n) without sacrificing the other parameters. We prove that our proposed scheme is secure under q-Simplified Multi-Exponent Bilinear Diffie-Hellman (q-SMEBDH) in the standard model. [ABSTRACT FROM AUTHOR]

The Non-Volatile Memory (NVM), such as PRAM or STT-MRAM, is often adopted as the main memory in portable embedded systems. The non-volatility triggers a security issue against physical attacks, which is a vulnerability caused by memory extraction and snapshots. However, simply encrypting the NVM degrades the performance of the memory (high energy consumption, short lifetime), since typical encryption causes an avalanche effect while most NVMs suffer from the memory-write operation. In this paper, we propose NVM-shelf: Secure Hybrid Encryption with Less Flip (shelf) for Non-Volatile Memory (NVM), which is hybrid encryption to reduce the flip penalty. The main idea is that a stream cipher, such as block cipher CTR mode, is flip-tolerant when the keystream is reused. By modifying the CTR mode in AES block cipher, we let the keystream updated in a short period and reuse the keystream to achieve flip reduction while maintaining security against physical attacks. Since the CTR mode requires additional storage for the nonce, we classify write-intensive cache blocks and apply our CTR mode to the write-intensive blocks and apply the ECB mode for the rest of the blocks. To extend the cache-based NVM-shelf implementation toward SPM-based systems, we also propose an efficient compiler for SA-SPM: Security-Aware Scratch Pad Memory, which ensures the security of main memories in SPM-based embedded systems. Our compiler is the first approach to support full encryption of memory regions (i.e., stack, heap, code, and static variables) in an SPM-based system. By integrating the NVM-shelf framework to the SA-SPM compiler, we obtain the NVM-shelf implementation for both cache-based and SPM-based systems. The cache-based experiment shows that the NVM-shelf achieves encryption flip penalty less than 3%, and the SPM-based experiment shows that the NVM-shelf reduces the flip penalty by 31.8% compared to the whole encryption. [ABSTRACT FROM AUTHOR]

Immunotherapy, such as anti-PD1, has improved the survival of patients with metastatic melanoma. However, predicting which patients will respond to immunotherapy remains a significant knowledge gap. In this study we analyzed pre-immunotherapy treated tumors from 52 patients with metastatic melanoma and monitored their response based on RECIST 1.1 criteria. The responders group contained 21 patients that had a complete or partial response, while the 31 non-responders had stable or progressive disease. Whole exome sequencing (WES) was used to identify biomarkers of anti-PD1 response from somatic mutations between the two groups. Variants in codons G34 and G41 in NFKBIE, a negative regulator of NFkB, were found exclusively in the responders. Mutations in NKBIE-related genes were also enriched in the responder group compared to the non-responders. Patients that harbored NFKBIE-related gene mutations also had a higher mutational burden, decreased tumor volume with treatment, and increased progression-free survival. RNA sequencing on a subset of tumor samples identified that CD83 was highly expressed in our responder group. Additionally, Gene Set Enrichment Analysis showed that the TNFalpha signaling via NFkB pathway was one of the top pathways with differential expression in responders vs. non-responders. In vitro NFkB activity assays indicated that the G34E variant caused loss-of-function of NFKBIE, and resulted in activation of NFkB signaling. Flow cytometry assays indicated that G34E variant was associated with upregulation of CD83 in human melanoma cell lines. These results suggest that NFkB activation and signaling in tumor cells contributes to a favorable anti-PD1 treatment response, and clinical screening to include aberrations in NFkB-related genes should be considered. [ABSTRACT FROM AUTHOR]