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Abstract Aims Assessing the risk for HF rehospitalization is important for managing and treating patients with HF. To address this need, various risk prediction models have been developed. However, none of them used deep learning methods with real‐world data. This study aimed to develop a deep learning‐based prediction model for HF rehospitalization within 30, 90, and 365 days after acute HF (AHF) discharge. Methods and results We analysed the data of patients admitted due to AHF between January 2014 and January 2019 in a tertiary hospital. In performing deep learning‐based predictive algorithms for HF rehospitalization, we use hyperbolic tangent activation layers followed by recurrent layers with gated recurrent units. To assess the readmission prediction, we used the AUC, precision, recall, specificity, and F1 measure. We applied the Shapley value to identify which features contributed to HF readmission. Twenty‐two prognostic features exhibiting statistically significant associations with HF rehospitalization were identified, consisting of 6 time‐independent and 16 time‐dependent features. The AUC value shows moderate discrimination for predicting readmission within 30, 90, and 365 days of follow‐up (FU) (AUC:0.63, 0.74, and 0.76, respectively). The features during the FU have a relatively higher contribution to HF rehospitalization than features from other time points. Conclusions Our deep learning‐based model using real‐world data could provide valid predictions of HF rehospitalization in 1 year follow‐up. It can be easily utilized to guide appropriate interventions or care strategies for patients with HF. The closed monitoring and blood test in daily clinics are important for assessing the risk of HF rehospitalization.

Abstract Aims Both patients with heart failure (HF) with reduced ejection fraction (HFrEF) and those with HF with preserved ejection fraction (HFpEF) present with elevated N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and have multiple comorbidities; consequently, the prognostic effect of NT‐proBNP according to beta‐blocker (BB) use is unknown. Methods This retrospective study evaluated patients admitted for acute HF between January 2012 and December 2017 at Ulsan University Hospital. Clinical, echocardiographic, laboratory and drug prescription data, including BB data, were collected from the hospital database. Information on mortality was collected by reviewing medical records or using national death data. Results Of the 472 patients evaluated, 216 (45.8%) and 256 (54.2%) patients were and were not prescribed BB at discharge, respectively. A total of 224 (47.5%) patients died within a median follow‐up duration of 44 months. The Kaplan–Meier analysis showed reduced all‐cause mortality with BB in HFrEF (ejection fraction ≤ 40%) but not in HFpEF (ejection fraction > 40%). In the multivariate Cox regression analysis, transmitral to tissue Doppler imaging, early diastolic velocity ratio (E/E′), NT‐proBNP and BB use were independent predictors of all‐cause mortality in HFrEF. Meanwhile, haemoglobin and NT‐proBNP levels were independent predictors of HFpEF. The NT‐proBNP cut‐off value for determining all‐cause mortality was set to 4800 pg/mL. Among HFrEF patients with NT‐proBNP

Abstract Aims An association between obesity, metabolic abnormalities and clinical hypertrophic cardiomyopathy (HCM) expression has been reported. We investigated whether managing dyslipidaemia with fibrates could affect the clinical expression of HCM. Methods We screened patients who used fibrates between 2010 and 2017 from a nationwide database. After excluding patients with a history of HCM, we identified fibrate‐user group (n = 412 823). We then constructed a 1:1 matched cohort of fibrate‐naïve participants (n = 412 823). After a 1 year lag period, we identified the incident HCM cases for the following 5 years. Results During a median follow‐up period of 3.96 years, we identified 454 incident clinical HCM cases. After adjusting for covariates, fibrate use was associated with a lower risk of clinical HCM expression [hazard ratio (HR) 95% confidence interval (CI): 0.763 (0.630–0.924)]. In subgroup analyses, fibrate use was associated with a reduced risk of clinical HCM expression in patients with a body mass index ≥25 kg/m2 and those with abdominal obesity [HR (95% CI): 0.719 (0.553–0.934) and 0.655 (0.492–0.872)], but not in those without obesity. Fibrate use was also associated with lower risks of incident clinical HCM in patients with triglyceride levels ≥150 mg/dL and those with metabolic syndrome [HR (95% CI): 0.741 (0.591–0.929) and 0.750 (0.609–0.923)], but not in their counterparts. Regarding lifestyle behaviours, fibrate use appeared to provide more prognostic benefits in patients who currently smoked, consumed alcohol or did not engage in regular physical activities. Conclusion The use of fibrates is associated with a lower incidence of clinical HCM expression. This association was also more prominent in those with obesity, unhealthy metabolic profiles and poor lifestyle behaviours.

Alzheimer's disease (AD) is characterized by significant alterations in hippocampal function and structure, but the molecular mechanisms underlying the hippocampal region remain elusive. We integrated multiple transcriptome datasets including human or rat hippocampus (GSE173955, GSE129051, GSE84422) to identify candidate genes. Subsequent analyses including gene ontology analysis and protein–protein interaction mapping were performed to identify key genes and pathways. We found that glutamate ionotropic receptor NMDA‐type subunit 3A (GRIN3A) and glutamate metabotropic receptor 8 (GRM8), which are related to the glutamatergic system, were the top two annotated genes and directly related to MAPT, which encodes a tau protein. Since there is no direct evidence of interaction between tauopathy and these genes in AD, further transcriptomic data (GSE125957, GSE56772) from tau transgenic mice and experimental validations through primary rat hippocampal neurons and induced pluripotent stem cell (iPSC)‐derived brain organoids were performed. Interestingly, we identified that decreased NR3A (encoded by GRIN3A) and mGluR8 (encoded by GRM8) are correlated with tauopathy and loss of postsynaptic function in AD. Taken together, our results identified a novel tauopathy biomarker GRIN3A in AD. Furthermore, our findings suggest that an integrated approach combining public databases and diverse experimental validations can contribute to the advancement of precision medicine therapies.

Abstract For adopting recently introduced hypertension phenotypes categorized using office and out of office blood pressure (BP) for the diagnosis of hypertension and antihypertension drug therapy, it is mandatory to define the corresponding out of office BP with the specific target BP recommended by the major guidelines. Such conditions include white‐coat hypertension (WCH), masked hypertension (MH), white‐coat uncontrolled hypertension (WUCH), and masked uncontrolled hypertension (MUCH). Here, the authors review the relevant literature and discuss the related issue to facilitate the use of corresponding BPs for proper diagnosis of WCH, MH, WUCH, and MUCH in the setting of standard target BP as well as intensive target BP. The methodology of deriving the corresponding BP has evolved from statistical methods such as standard deviation, percentile value, and regression to an outcome‐based approach using pooled international cohort study data and comparative analysis in randomized clinical trials for target BPs such as the SPRINT and STEP studies. Corresponding BPs to 140/90 and 130/80 mm Hg in office BP is important for safe and strict achievement of intensive BP targets. The corresponding home, daytime, and 24‐h BPs to 130/80 mm Hg in office BP are 130/80, 130/80, and 125/75 mm Hg, respectively. However, researchers have found some discrepancies among the home corresponding BPs. As tentative criterion for de‐escalation of antihypertensive therapy as shown in European guidelines was 120 mm Hg in office BP, corresponding home, daytime, and 24‐h systolic BPs to 120 mm Hg in office systolic BP are 120, 120, and 115 mm Hg, respectively.

Abstract Conflicting driving behaviours between automated vehicles and manually driven vehicles may compromise driving safety. The aim of this study is to analyse the safety of mixed traffic on urban roads. The driving simulation tests were conducted using a multi‐agent driving simulator, which allows real‐time synchronization of multiple simulators. These data were further processed to derive the driving behaviour parameters of manually driven vehicles in VISSIM traffic simulations. Driving safety evaluation indicators included conflict‐related indicators, as well as individual safety indicators. The safety evaluation indicators were normalized through min–max normalization, and the risk scores were summed to evaluate the urban roads. The analysis revealed that driving safety was poor at unsignalized intersections with a market penetration rate of 10% and 50% and at signalized intersections with traffic islands and a market penetration rate of 100%, where conflicts arise from the deceleration of leading vehicles and lane changes. This finding is about the driving behaviour of automated vehicles, which maintain a greater distance from the leading vehicle than manually driven vehicles, resulting in poorer driving safety due to lane changes rather than deceleration. Using the findings of this study, criteria for assessing the safety of mixed traffic situations in existing road infrastructures can be established.

Objective Glucocorticoids (GCs) can be beneficial from both clinical and patient perspectives, but side effects are well documented. We examined patterns of GC use over 15 years (2006–2021) and occurrence of adverse health conditions (AHCs) and health care use by GC exposure in two longitudinal cohorts with systemic lupus erythematosus (SLE). Methods Data from the Lupus Outcomes Study (LOS; 2003–2015) and FORWARD cohort (2015–2021) were used. AHCs examined were diabetes, osteoporosis, nontraumatic fractures, cataracts, and infections. Health care use measures examined were the number of rheumatology and other provider visits, hospitalizations, and specific diagnostic tests. Kaplan–Meier analyses examined time to occurrence of each AHC. Cox regression analyses estimated the risk of occurrence of AHCs, controlling for covariates by GC use and by GC dose (0, 1–5, 5–7.5, and ≥7.5 mg). Results GC use was relatively consistent over time. At baseline, individuals who used GCs in the LOS were more likely to report osteoporosis (adjusted odds ratio [aOR] 1.7, 95% confidence interval [CI] 1.2–2.6) and cataracts (aOR 1.6, 95% CI 1.04–2.6); individuals who used GCs in the FORWARD cohort were more likely to report diabetes (aOR 5.1, 95% CI 2.2–12.0), osteoporosis (aOR 4.5, 95% CI 2.6–8.0), and fractures (aOR 6.5, 95% CI 3.8–11.1). Individuals who used high doses of GCs in the LOS had greater incidence of osteoporosis, fracture, and cataracts. In the FORWARD cohort, a significant difference in incidence was noted only for infections. In both cohorts, individuals who used GCs had more rheumatology and other physician visits, and greater risk of hospitalization. Conclusion Despite recommendations on steroid sparing, a large portion of people with SLE appear to remain on steroids. These analyses provide additional evidence of the potential health and health care burden of GC use, underscoring the need for other effective treatments for individuals with SLE.

Abstract Objectives This study aimed to investigate the differences in structural connectivity and glymphatic system function between patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) and healthy controls. Additionally, we analyzed the association between structural connectivity, glymphatic system function, and antiseizure medication (ASM) response. Methods We retrospectively enrolled patients with TLE and HS and healthy controls who underwent diffusion tensor imaging at our hospital. We assessed structural connectivity in patients with TLE and HS and healthy controls by calculating network measures using graph theory and evaluated glymphatic system function using the diffusion tensor image analysis along the perivascular space (DTI‐ALPS) index. Patients with TLE and HS were categorized into two groups: ASM poor and good responders. Results We enrolled 55 patients with TLE and HS and 53 healthy controls. Of the 55 patients with TLE and HS, 39 were ASM poor responders, and 16 were ASM good responders. The assortativity coefficient in patients with TLE and HS was higher than that in healthy controls (0.004 vs. −0.007, p = 0.004), and the assortativity coefficient in ASM poor responders was lower than that in ASM good responders (−0.001 vs. −0.197, p = 0.003). The DTI‐ALPS index in patients with TLE and HS was lower than that in healthy controls (1.403 vs. 1.709, p

ABSTRACT Background Sarcopenia is an aging‐related condition characterized by loss of skeletal muscle mass and is an indicator of subclinical atherosclerosis. The relationship between reduced muscle mass and long‐term clinical outcomes in patients with advanced coronary artery disease who have undergone coronary artery bypass grafting (CABG) is not fully understood. This study is sought to evaluate the prognostic implications of sarcopenia screening in patients undergoing CABG. Methods A total of 2810 patients who underwent CABG were analysed and classified according to presence of reduced muscle mass. The skeletal muscle index (SMI) was calculated as L3 muscle area (cm2)/height (m)2 on computed tomography. Reduced SMI was defined as SMI ≤ 45 cm2/m2 in male and ≤ 38 cm2/m2 in female. The primary outcome was all‐cause mortality, and survival analysis was performed using the Kaplan–Meier method and compared with the log‐rank test. Results The median follow‐up was 8.7 years, and 924 patients (32.9%) had reduced SMI. Patients with reduced SMI were older (67.7 ± 8.8 vs. 62.2 ± 9.8 years; p

Abstract This paper presents a nonlinear higher‐order sliding mode control (HO‐SMC) designed for a droop control‐based grid‐forming converter. In weak grid scenarios, where the rate of change of frequency is notably high, achieving a rapid frequency response becomes imperative. The stable operation of a grid‐forming converter using droop control, coupled with classical vector control that employs cascaded voltage and current loops (multiloop) with PI controllers, faces limitations when higher droop coefficients are applied. This constraint on the application of classical vector control in weak grid conditions necessitates alternative solutions. Operating as a grid‐forming converter, the grid‐connected converter with an LCL filter represents a second‐order system. HO‐SMC mitigates the switching challenges associated with conventional SMC by integrating robust feedback linearized control. A graphical method is proposed for designing the switching gain using Lyapunov's direct method to counteract the impact of a matched disturbance. The study demonstrates that the implementation of HO‐SMC in the grid‐forming converter enhances fast frequency response by increasing the gain margin of the power frequency (P--f) loop. Finally, it is illustrated that the proposed control method also improves the transient response of the converter.

Abstract A two‐step framework that integrates real‐time data collection with time series forecasting models for predicting traffic volume is proposed. In the first step, the framework utilizes live highway surveillance video data and YOLO‐v7 object detector to construct accurate traffic volume data. In the second step, an ARIMA–LSTM time series model is applied to forecast future traffic volumes. Experimental results show that YOLO‐v7 achieved a vehicle detection accuracy of over 93.30%, ensuring high precision in traffic volume data construction. The ARIMA–LSTM model demonstrated superior performance in traffic volume prediction, with a mean squared error of 87.97, root mean squared error of 10,388.57, and mean absolute error of 101.39. YOLO‐v7's detection speed of 7.8 ms per frame further validates the feasibility of real‐time data construction. The findings indicate that the combination of YOLO‐v7 for vehicle detection and ARIMA–LSTM for traffic prediction is highly effective, offering a significant reduction in training time compared to more complex deep learning models while maintaining high prediction accuracy. This research presents a unified solution for traffic data collection and prediction, enhancing transportation infrastructure planning and optimizing traffic flow. Future work will focus on extending the prediction intervals and further refining the models to improve performance.

ABSTRACT Introduction Cardiovascular autonomic neuropathy (CAN) is a chronic complication of diabetes. As obesity is a major risk factor for CAN, we hypothesized that metabolic bariatric surgery (MBS) could improve CAN indices in Korean patients with obesity. Materials and Methods Patients who underwent bariatric surgery between February 2020 and June 2022 were prospectively recruited. CAN was conducted once before surgery and again after surgery, using the Ewing method and heart rate variability (HRV) analysis (standard deviation of the NN interval [SDNN], root mean square of successive RR interval difference [RMSSD], and spectral analysis). Results A total of 47 patients were included. The mean age was 39.8 ± 8.7 years, 15 (31.9%) were male, and 26 (55.3%) had diabetes. Resting HR before surgery was 81.0 ± 12.3 bpm, which decreased significantly to 68.0 ± 9.3 bpm after surgery (P

Abstract We introduce a new “ecosystem‐scale” experiment at the Cedar Creek Ecosystem Science Reserve in central Minnesota, USA to test long‐term ecosystem consequences of tree diversity and composition. The experiment—the largest of its kind in North America—was designed to provide guidance on forest restoration efforts that will advance carbon sequestration goals and contribute to biodiversity conservation and sustainability. The new Forest and Biodiversity (FAB2) experiment uses native tree species in varying levels of species richness, phylogenetic diversity and functional diversity planted in 100 m2 and 400 m2 plots at 1 m spacing, appropriate for testing long‐term ecosystem consequences. FAB2 was designed and established in conjunction with a prior experiment (FAB1) in which the same set of 12 species was planted in 16 m2 plots at 0.5 m spacing. Both are adjacent to the BioDIV prairie‐grassland diversity experiment, enabling comparative investigations of diversity and ecosystem function relationships between experimental grasslands and forests at different planting densities and plot sizes. Within the first 6 years, mortality in 400 m2 monoculture plots was higher than in 100 m2 plots. The highest mortality occurred in Tilia americana and Acer negundo monocultures, but mortality for both species decreased with increasing plot diversity. These results demonstrate the importance of forest diversity in reducing mortality in some species and point to potential mechanisms, including light and drought stress, that cause tree mortality in vulnerable monocultures. The experiment highlights challenges to maintaining monoculture and low‐diversity treatments in tree mixture experiments of large extent. FAB2 provides a long‐term platform to test the mechanisms and processes that contribute to forest stability and ecosystem productivity in changing environments. Its ecosystem‐scale design, and accompanying R package, are designed to discern species and lineage effects and multiple dimensions of diversity to inform restoration of ecosystem functions and services from forests. It also provides a platform for improving remote sensing approaches, including Uncrewed Aerial Vehicles (UAVs) equipped with LiDAR, multispectral and hyperspectral sensors, to complement ground‐based monitoring. We aim for the experiment to contribute to international efforts to monitor and manage forests in the face of global change.

Over the past few decades, VEGF‐targeted antiangiogenic therapy for cancers has gained increasing attention. Nevertheless, there are still several limitations such as the potential resistance mechanisms arising in cancer cells against these therapies and their potential adverse effects. These limitations highlight the need for novel anti‐angiogenesis molecules and better understanding of the mechanisms of tumor angiogenesis. In the present study, we investigated the antiangiogenic properties of a novel 14‐mer antiangiogenic peptide (14‐MAP) derived from N‐terminal 14 kDa buffalo prolactin and characterized its mode of action. 14‐MAP at the picomolar concentration inhibited VEGF‐ and bradykinin (an autacoid peptide expressed in vascular tissues in pathophysiology, BK)‐stimulated endothelial nitric oxide (eNO) production, cell migration, and proliferation in endothelial cells and vessel development in the chick embryo. Although this peptide inhibited both VEGF‐ and BK‐dependent angiogenic processes, its action was more pronounced in the latter. Moreover, the interference of 14‐MAP with the eNO synthase (eNOS)‐cyclic GMP pathway was also identified. A combination of a low dose of Avastin, a widely used drug targeting VEGF‐dependent angiogenesis, and 14‐MAP significantly reduced tumor size in an in vivo model of human colon cancer. Taken together, our results suggest that 14‐MAP, a BK‐ and eNOS‐dependent antiangiogenic peptide, might be useful for overcoming the limitation of VEGF‐targeted antiangiogenic therapy in cancer patients. However, further studies will be required to further characterize its mode of action and therapeutic potential.

Abstract The globalization of food distribution has made it necessary to ensure the delivery of fresh food to the consumers. Protein‐rich foods produce a significant amount of tyramine when spoiled. Therefore, it was envisaged to develop localized surface plasmon resonance (LSPR)—sensor for monitoring tyramine content in beef, mackerel, and cheese. For this purpose, the sensors were developed by coating the LSPR chip with gold nanoparticles (AuNPs) followed by conjugation of tyramine‐specific peptide (TYR1). The TYR1 was synthesized and screened by phage display and binding efficiency was evaluated by DockThor. The optimized LSPR sensor showed highest binding efficiency at TYR1 concentration of 20 µg/mL with reaction time of 40 min. The sensor also showed an excellent detection range for beef, mackerel, and cheese were 0.01–10 ppb, 0.01–10 ppm, and 0.01–10 ppb, respectively, in comparison to standard. These findings indicated that this sensor can be used as a promising tool for on‐site monitoring of food quality.

Abstract This study investigates the impact of environmental factors on the quality changes of mackerel (Scomber japonicus), a globally significant fish species valued for its high nutritional content, especially its unsaturated fatty acids and proteins. In South Korea, marine products like mackerel undergo auction, sorting, packaging, and transportation. Assessing the fish freshness and quality during these processes, before it reaches consumers, is crucial. This research aimed to track the changes in mackerel quality indicators after the auction and correlate them with the environmental factors affecting transportation. Using a transportation model established for both summer and winter, mackerel samples were categorized by their weight (200 and 300 g). Results show poorer quality indicators in summer compared to winter, particularly in the 200 g group. Microbiological indicators such as the total viable count (0.923) and total coliforms (0.958) were most strongly correlated with the season, whereas the lipid oxidation indicators acid value (0.627) and peroxide value (0.536) were moderately correlated with the season. Interestingly, the wider standard deviation distribution observed in summer suggests that individual mackerel characteristics may influence the degree of quality changes. These findings offer insights into mackerel quality fluctuations during auction and transportation, aiding in future efforts to maintain seafood quality amidst climate change.

Abstract Vehicle‐to‐everything communication systems play a crucial role in enhancing road safety and traffic efficiency through vehicle and roadside infrastructure interactions. To provide robust defences against external threats in secure and trustworthy information exchange, these systems utilise public key infrastructure to authenticate vehicle‐to‐everything participant identities with digital certificates and security credential management systems to administer these certificates and encryption keys. However, even with these defences, vulnerabilities persist, particularly from vehicles with legitimate certificates that may malfunction or be exploited for malicious purposes. To address these issues, this paper introduces a misbehaviour detection (MBD) system, notable for its combined use of local and global MBD algorithms. This system is specifically designed to combat both conventional and novel threats, including slander attacks, in which vehicles with legitimate certificates may be falsely accused, and sophisticated attacks targeting the global MBD system itself. The efficacy of our MBD system was rigorously validated at K‐City, the leading autonomous vehicle technology testing facility in Korea, demonstrating its ability to identify and counter internal misbehaviours precisely.

Abstract Background Loss of muscle strength and endurance with aging or in various conditions negatively affects quality of life. Resistance exercise training (RET) is the most powerful means to improve muscle mass and strength, but it does not generally lead to improvements in endurance capacity. Free essential amino acids (EAAs) act as precursors and stimuli for synthesis of both mitochondrial and myofibrillar proteins that could potentially confer endurance and strength gains. Thus, we hypothesized that daily consumption of a dietary supplement of nine free EAAs with RET improves endurance in addition to the strength gains by RET. Methods Male C57BL6J mice (9 weeks old) were assigned to control (CON), EAA, RET (ladder climbing, 3 times a week), or combined treatment of EAA and RET (EAA + RET) groups. Physical functions focusing on strength or endurance were assessed before and after the interventions. Several analyses were performed to gain better insight into the mechanisms by which muscle function was improved. We determined cumulative rates of myofibrillar and mitochondrial protein synthesis using 2H2O labelling and mass spectrometry; assessed ex vivo contractile properties and in vitro mitochondrial function, evaluated neuromuscular junction (NMJ) stability, and assessed implicated molecular singling pathways. Furthermore, whole‐body and muscle insulin sensitivity along with glucose metabolism, were evaluated using a hyperinsulinaemic–euglycaemic clamp. Results EAA + RET increased muscle mass (10%, P

ABSTRACT Background Leber congenital amaurosis (LCA), the most severe form of inherited retinal dystrophy, is a rare, heterogeneous, genetic eye disease associated with severe congenital visual impairment. RPE65, one of the causative genes for LCA, encodes retinoid isomerohydrolase, an enzyme that plays a critical role in regenerating visual pigment in photoreceptor cells. Methods Exome sequencing (ES) was performed on a patient with suspected LCA. Results Here, we report a 33‐year‐old male patient diagnosed with RPE65‐related LCA caused by uniparental isodisomy (UPiD) who received gene therapy as treatment, fourth patient to receive it in Korea. His fundus examinations showed salt‐and‐pepper retinal dystrophy, with diffuse extinguished signal on fundus autofluorescence and attenuated amplitude on electroretinogram. A homozygous frameshift variant NM_000329.3:c.1067del (p.Asn356MetfsTer17) in RPE65 was identified by ES with the entire chromosome 1 proving to be paternal UPiD. Within 5 months after the molecular diagnosis, the patient was treated with subretinal voretigene neparvovec (VN) therapy and is being followed up for prognosis. Conclusions To our knowledge, this patient is the first UPiD case to receive VN treatment. Performing ES as a first‐tier test was favourable because it allowed to identify UPiD that needed to be detected in addition to the disease‐causing variant.

ABSTRACT Background Studies are currently being conducted on rabbits requiring serial glucose monitoring. The FreeStyle Libre 2 (FSL2), a serial glucose monitoring device, has been validated in humans, dogs and cats, but not in rabbits. Objectives This study aimed to evaluate the accuracy of the FSL2 in rabbits. Methods Six healthy rabbits were used in this study. Interstitial glucose (IG) was measured using the FSL2, and blood glucose (BG) was measured using a portable blood glucose meter (PBGM); their results were compared with those from a clinical chemistry analyser. For the first 3 h, IG and BG were measured at 1‐h intervals. Subsequently, they were measured every 8 h over a 48‐h period. Regular insulin 0.2 U/kg was then administered to the rabbits, and IG and BG were measured every 15 min over a 90‐min period. Results Before insulin treatment, no measurements fell within the hypoglycaemic range (BG < 100 mg/dL). In the euglycaemic range (BG ≥ 100 mg/dL), the PBGM and FSL2 showed 85.7% and 23.8% accuracies, respectively. After insulin treatment, the PBGM showed 95.5% and 81.3% accuracies in the hypoglycaemic and euglycaemic ranges, respectively. The FSL2 showed 68.1% and 37.5% accuracies in the hypoglycaemic and euglycaemic ranges, respectively. Parkes consensus error grid analysis showed that the PBGM and FSL2 had 100% agreement for Zones A (no effect on clinical action) and B (altered clinical action unlikely to affect outcome) in rabbits with and without insulin treatment. Conclusions There was limited agreement between the FSL2 and reference standard BG measurements. However, the FSL2 allows clinically acceptable identification of hypoglycaemic states in rabbits.

ABSTRACT Background This study aimed to compare long‐term clinical outcomes of percutaneous needle biopsy (PCNB) versus surgical biopsy in patients with peripheral, small‐sized clinical stage 1 non‐small cell lung cancer (NSCLC) with computed tomography (CT)‐defined visceral pleural invasion (VPI). Methods We retrospectively analyzed patients who underwent surgery for NSCLC with CT‐defined VPI between 2010 and 2017. We excluded patients with non‐peripheral NSCLC, or cancers > 3 cm. Propensity score matching was carried out to adjust for confounding variables. The primary endpoint was ipsilateral pleural recurrence‐free survival, while secondary endpoints included overall survival and recurrence‐free survival. Results Of the 1671 patients with peripheral, small‐sized clinical stage 1 NSCLC with CT‐defined VPI, 805 underwent PCNB, and 866 had a surgical biopsy. Propensity score matching assigned 562 patients to each group. Before matching, the PCNB group demonstrated worse baseline characteristics, including older age, higher smoking history, and more adverse pathological findings. After matching, the 5‐year recurrence‐free survival for ipsilateral pleural recurrence (98.6% vs. 96.0%, p = 0.002) and overall survival (93.8% vs. 90.2%, p = 0.003) were significantly higher in the surgical biopsy group compared with the PCNB group. Multivariable analysis revealed that PCNB significantly increased the risks of all‐cause mortality and various recurrences before and after matching. Conclusions Compared with surgery biopsy, PCNB was associated with higher risks of all‐cause mortality and recurrences, including ipsilateral pleural recurrence. PCNB should be considered with caution in cases of peripheral stage 1 NSCLC where CT‐defined VPI is suspected.

Abstract In oxygen evolution reaction (OER), the participation of lattice oxygen can break the limitation of adsorption evolution mechanism, but the activation of lattice oxygen remains a critical challenge. Herein, a surface fluorinated highly active 2D/2D FeNi layered double hydroxide/MXene (F‐LDH/MX) is demonstrated, boosting OER with the enhanced lattice‐oxygen‐mediated path. The introduction of fluorine promotes the self‐evolution of catalyst in an alkaline environment, even without an external current. It further accelerates the formation of active metal oxyhydroxides with abundant oxygen vacancies under the operating potential. The introduced oxygen vacancy activates the lattice oxygen, increasing the proportion of lattice oxygen mechanism in OER. Owing to the synergistic effects of the 2D/2D hierarchical structure and the modulated active surface, F‐LDH/MX possesses excellent electrochemical performances, including a low overpotential of 251 mV at 10 mA cm−2, a low Tafel slope of 40.28 mV dec−1, and robust stability. The water electrolyzer system with F‐LDH/MX as the anode offers the benchmark current density at a low cell voltage of 1.53 V, while the Zn‐air battery with F‐LDH/MX as the air electrode exhibits a higher power density of 75.43 mW cm−2. This study presents a promising strategy to design highly active electrocatalysts for energy conversion and storage.

ABSTRACT Background The prognostic significance of extranodal sites in stage IV diffuse large B‐cell lymphoma (DLBCL) remains uncertain, making it challenging to select appropriate treatment strategies for individual patients. In this study, we aimed to evaluate the influence of different extranodal sites on prognosis in young patients with stage IV DLBCL who achieved complete remission (CR) following initial chemo‐immunotherapy and to explore the potential of autologous hematopoietic stem cell transplantation (ASCT) as a consolidation treatment for specific patient subgroups. Methods We retrospectively reviewed data from 119 patients with DLBCL aged

Abstract Autophagy is a crucial quality control mechanism that degrades damaged cellular components through lysosomal fusion with autophagosomes. However, elevated autophagy levels can promote drug resistance in cancer cells, enhancing their survival. Downregulation of autophagy through oxidative stress is a clinically promising strategy to counteract drug resistance, yet precise control of oxidative stress in autophagic proteins remains challenging. Here, a molecular design strategy of biocompatible neutral Ir(III) photosensitizers is demonstrated, B2 and B4, for precise reactive oxygen species (ROS) control at lysosomes to inhibit autophagy. The underlying molecular mechanisms for the biocompatibility and lysosome selectivity of Ir(III) complexes are explored by comparing B2 with the cationic or the non‐lysosome‐targeting analogs. Also, the biological mechanisms for autophagy inhibition via lysosomal oxidation are explored. Proteome analyses reveal significant oxidation of proteins essential for autophagy, including lysosomal and fusion‐mediator proteins. These findings are verified in vitro, using mass spectrometry, live cell imaging, and a model SNARE complex. The anti‐tumor efficacy of the precise lysosomal oxidation strategy is further validated in vivo with B4, engineered for red light absorbance. This study is expected to inspire the therapeutic use of spatiotemporal ROS control for sophisticated modulation of autophagy.

Abstract The application of extracellular vesicles (EVs) as vehicles for anti‐Parkinson's agents represents a significant advance, yet their clinical translation is hampered by challenges in efficient brain delivery and complex blood‐brain barrier (BBB) targeting strategies. In this study, we engineered dopamine onto the surface of adipose‐derived stem cell EVs (Dopa‐EVs) utilizing a facile, two‐step cross‐linking approach. This engineering enhanced neuronal uptake of the EVs in primary neurons and neuroblastoma cells, a process shown to be competitively inhibited by dopamine pretreatment and dopamine receptor antibodies. Notably, Dopa‐EVs demonstrated increased brain accumulation in mouse Parkinson's disease (PD) models. Therapeutically, Dopa‐EVs administration led to the rescue of dopaminergic neuronal loss and amelioration of behavioural deficits in both 6‐hydroxydopamine (6‐OHDA) and α‐Syn PFF‐induced PD models. Furthermore, we observed that Dopa‐EVs stimulated autophagy evidenced by the upregulation of Beclin‐1 and LC3‐II. These findings collectively indicate that surface modification of EVs with dopamine presents a potent strategy for targeting dopaminergic neurons in the brain. The remarkable therapeutic potential of Dopa‐EVs, demonstrated in PD models, positions them as a highly promising candidate for PD treatment, offering a significant advance over current therapeutic modalities.

Abstract Acoustofluidics is a promising technology that leverages acoustic waves for precise manipulation of micro/nano‐scale flows and suspended objects within microchannels. Despite many advantages, the practical applicability of conventional acoustofluidic platforms is limited by irreversible bonding between the piezoelectric actuator and the microfluidic chip. Recently, reconfigurable acoustofluidic platforms are enabled by reversible bonding between the reusable actuator and the replaceable polydimethylsiloxane (PDMS) microfluidic chip by incorporating a PDMS membrane for sealing the microchannel and coupling the acoustic waves with the fluid inside. However, a quantitative guideline for selecting a suitable PDMS membrane for various acoustofluidic applications is still missing. Here, a design rule for reconfigurable acoustofluidic platforms is explored based on a thorough investigation of the PDMS thickness effect on acoustofluidic phenomena: acousto–thermal heating (ATH), acoustic radiation force (ARF), and acoustic streaming flow (ASF). These findings suggest that the relative thickness of the PDMS membrane (t) for acoustic wavelength (λPDMS) determines the wave attenuation in the PDMS and the acoustofluidic phenomena. For t/λPDMS ≈ O(1), the transmission of acoustic waves through the membrane leads to the ARF and ASF phenomena, whereas, for t/λPDMS ≈ O(10), the acoustic waves are entirely absorbed within the membrane, resulting in the ATH phenomenon.

Abstract All‐solid‐state battery (ASSB) systems have attracted significant attention due to their high energy density and safety compared with conventional batteries. Moreover, the application of Mn‐based cation‐disordered rock‐salt (DRX) that possesses cost‐effectiveness and high energy density on the ASSB system as a cathode is expected to be the superior next‐generation battery system. However, DRX cathodes require high carbon contents due to their low electronic conductivity, leading to challenges in introducing them in ASSB systems, as the high carbon levels can cause electrolyte decomposition which potentially affects overall electrochemical performance. In this work, we applied Mn‐based DRX cathodes to ASSB systems within a voltage range of 1.5–4.8 V and evaluated the suitability of cathode composites using halide and sulfide electrolytes as catholytes, respectively. The experimental results showed that the high carbon contents induced side reactions with the argyrodite, resulting in electrochemical degradation such as the drop of initial discharge voltage and the capacity fading. Meanwhile, cathode composites using a halide electrolyte exhibited relatively enhanced electrochemical performance due to its high oxidation stability regardless of the high amount of carbon contents. Consequently, the electrochemical reactions of the electrolyte, influenced by the content of conductive additives and the type of electrolyte, had a great impact on the performance of ASSB systems. This study provides a deep understanding of the interplaying among solid electrolytes, cathodes, and conductive additives and offers an important foundation for future research and development in ASSB systems.

Background Sedentary behavior elevates cardiovascular disease (CVD) risk in patients with dyslipidemia. Increasing physical activity (PA) is recommended alongside pharmacological therapy to prevent CVD, though benefits across environmental conditions are unclear. Methods and Results We analyzed data from 113 918 newly diagnosed patients with dyslipidemia (2009–2012) without prior CVD, sourced from the Korea National Health Insurance Service. Ambient particulate matter (PM) 2.5 and PM10 levels were collected from the National Ambient Air Monitoring System in South Korea. Changes in PA, measured in metabolic equivalents of task–min/wk before and after dyslipidemia diagnosis, were evaluated for associations with air pollution levels and CVD risk using Cox proportional hazards regression. Patients were followed from January 1, 2013, until CVD onset, death, or December 31, 2021. Among patients exposed to low to moderate PM2.5 levels (≤25 μg/m3), increasing PA from inactive to ≥1000 metabolic equivalents of tasks–min/wk was associated with a lower risk of CVD (adjusted hazard ratio, 0.82 [95% CI, 0.70–0.97]; P for trend=0.022). In high PM2.5 (>25 μg/m3) conditions, increasing PA from inactive and decreasing PA from ≥1000 metabolic equivalents of task–min/wk was associated with reduced (P for trend=0.010) and elevated (P for trend=0.028) CVD risks, respectively. For PM10, increased PA was linked to reduced CVD risk (P for trend=0.002) and decreased PA to elevated risk (P for trend=0.042) in low to moderate PM10 (≤50 μg/m3) conditions, though benefits diminished at high PM10 (>50 μg/m3) exposures. Conclusions Promoting PA, while considering the high potential cardiovascular risk associated with air pollution, may be an effective intervention against CVD in patients with dyslipidemia.

Abstract To enhance our understanding of the carbon cycle in the Arctic Ocean, comprehensive observational data are crucial, including measurements from the underlying ice water. This study proposed a practical method for calibrating pCO2 sensor using measured dissolved inorganic carbon and total alkalinity. Our findings suggested the minimum number of bottle samples needed for calibration to ensure 1% accuracy. Additionally, we identified the significant role of a decrease in dissolved inorganic carbon due to photosynthesis and the increase in buffer capacity of the seawater from the release of excess alkalinity by sea ice in regulating pCO2. The mean air–sea CO2 fluxes were −48.9 ± 44.6, −7.3 ± 14.6, and −1.4 ± 2.8 mmol m−2 d−1 in the southern Chukchi Sea, northern Chukchi Sea, and northern East Siberian Sea, respectively. We found a robust negative correlation between the flux and sea ice concentration in the Arctic Sea ice regions.

Abstract Aims This study evaluated how well serial pulse pressure (PP) and PP adjusted by the vasoactive inotropic score (VIS) predicted venoarterial extracorporeal membrane oxygenation (VA‐ECMO) weaning success and clinical outcomes in acute myocardial infarction complicated by cardiogenic shock (AMI‐CS) patients. Methods and results A total of 213 patients with AMI‐CS who received VA‐ECMO between January 2010 and August 2021 were enrolled in the institutional ECMO registry. Serial PP and VIS were measured immediately, 12, 24, and 48 h after VA‐ECMO insertion. PP adjusted by VIS was defined as PP/√VIS. The primary outcome was successful VA‐ECMO weaning. Successful weaning from VA‐ECMO was observed in 151 patients (70.9%). Immediately after VA‐ECMO insertion, PP [successful vs. failed weaning, 26.0 (15.5–46.0) vs. 21.0 (12.5–33.0), P = 0.386] and PP/√VIS [11.1 (5.1–25.0) vs. 6.0 (3.1–14.2), P = 0.118] did not differ between the successful and failed weaning groups. Serial PP and PP adjusted by VIS at 12, 24, and 48 h after VA‐ECMO insertion were significantly higher in patients with successful weaning than those with failed weaning [successful vs. failed weaning, 24.0 (4.0–38.0) vs. 12.5 (6.0–25.5), P = 0.007 for 12 h PP, and 10.1 (5.7–22.0) vs. 2.9 (1.7–5.9), P 7). Conclusions PP adjusted by VIS taken 12 h following VA‐ECMO initiation can predict weaning from VA‐ECMO more successfully than PP alone, and its low value was associated with a higher risk of mortality in AMI‐CS patients.

Abstract Background Intensive care unit‐acquired weakness (ICU‐AW) is a syndrome characterized by a long‐term muscle weakness often observed in sepsis‐surviving patients during the chronic phase. Although ICU‐AW is independently associated with increased mortality, effective therapies have yet to be established. Programmed death‐1 (PD‐1) inhibitors have attracted attention as potential treatments for reversing immune exhaustion in sepsis; however, its impact on ICU‐AW remains to be elucidated. Here, we study how PD‐1 deficiency affects sepsis‐induced skeletal muscle dysfunction in a preclinical sepsis model. Methods Chronic sepsis model was developed by treating wild‐type (WT) and PD‐1 knockout (KO) mice with caecal slurry, followed by resuscitation with antibiotics and saline. Mice were euthanized on days 15–17. Body weights, muscle weights, and limb muscle strengths were measured. Interleukin 13 (IL‐13) and PD‐1 expressions were examined by flow cytometry. Messenger RNA (mRNA) expressions of slow‐twitch muscles were measured by reverse transcription and quantitative polymerase chain reaction (RT‐qPCR). In an in vitro study, C2C12 myotubes were treated with lipopolysaccharide (LPS) and recombinant IL‐13 followed by gene expression measurements. Results WT septic mice exhibited decreased muscle weight (quadriceps, P

Abstract Introduction Relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LL) remains a therapeutic challenge. Preclinical data in both B‐ and T‐ALL suggests synergy of venetoclax (VEN) with vincristine (VCR). We designed a phase I/II trial (EA9152) of the combination of L‐VCR and VEN for patients with r/r B‐or T‐cell ALL or LL. Here, we report the safety and efficacy outcomes of the phase I portion of this trial (NCT03504644). Methods In a 3+3 dose escalation design, r/r ALL subjects were given single‐agent VEN doses reaching 400, 600, or 800 mg for the three respective dose levels. Weekly L‐VCR at 2.25 mg/m2 IV was started on D15 of cycle 1. The primary phase I objective was to determine the maximum tolerated dose (MTD) of the combination. Results Among the 18 patients in phase I, grade ≥ 3 treatment‐related adverse events were reported in 89% of treated patients. Two patients (two of three) at dose level 3 experienced dose‐limiting toxicities. Therefore, the MTD of the combination was determined to be dose level 2 (VEN 600 mg). Twenty‐two percent of evaluable patients (N = 4) achieved a complete response, with two of them showing no evidence of measurable residual disease (MRD). Conclusion The combination of VEN and L‐VCR was found to be safe for patients with r/r ALL and encouraging preliminary efficacy, including MRD negative responses. With the removal of L‐VCR from the US market, the phase 2 portion of this trial is actively enrolling with vincristine sulfate.

Abstract Background Increased Galectin 3‐binding protein (LGALS3BP) serum levels have been used to assess hepatic fibrosis stages and the severity of hepatocellular carcinoma (HCC). Considering the crucial role of transforming growth factor‐β1 (TGF‐β1) in the emergence of these diseases, the present study tested the hypothesis that LGALS3BP regulates the TGF‐β1 signaling pathway. Methods The expression levels of LGALS3BP and TGFB1 were analyzed in patients with metabolic dysfunction‐associated steatohepatitis (MASH) and HCC. Multiple omics techniques, such as RNA‐sequencing, transposase‐accessible chromatin‐sequencing assay, and liquid chromatography‐tandem mass spectrometry proteomics, were used to identify the regulatory mechanisms for the LGALS3BP‐TGF‐β1 axis. The effects of altered TGF‐β1 signaling by LGALS3BP were investigated in conditional LGALS3BP‐knockin and LGALS3BP‐knockout mice. Results In patients with MASH and HCC, the levels of LGALS3BP and TGFB1 exhibited positive correlations. Stimulation of LGALS3BP by the inflammatory cytokine interferon α in HCC cells or ectopic overexpression of LGALS3BP in hepatocytes promoted the expression levels of TGFB1. Aggravated fibrosis was observed in the livers of hepatocyte‐specific LGALS3BP‐knockin mice, with increased TGFB1 levels. LGALS3BP directly bound to and assembled integrin αV, an integral mediator required for releasing active TGF‐β1 from extracellular latent complex with the rearranged F‐actin cytoskeleton. The released TGF‐β1 activated JunB transcription factor, which in turn promoted the TGF‐β1 positive feedback loop. LGALS3BP deletion in the hepatocytes downregulated TGF‐β1 signaling and CCl4 induced fibrosis. Moreover, LGALS3BP depletion hindered hepatocarcinogenesis by limiting the availability of fibrogenic TGF‐β1. Conclusion LGALS3BP plays a crucial role in hepatic fibrosis and carcinogenesis by controlling the TGF‐β1 signaling pathway, making it a promising therapeutic target in TGF‐β1‐related diseases.

Abstract Background Paranasal sinus retention cysts are non‐neoplastic psuedocysts that accumulate nasal fluids. Since most of these cysts are incidentally diagnosed and may even diminish spontaneously, no further diagnosis or therapies are needed for most patients. In contrast, when an abrupt, unilateral, watery nasal discharge is noticed, cerebrospinal fluid (CSF) rhinorrhea should be suspected, which is a true “red flag sign,” since ignored CSF rhinorrhea may be fatal. Case Report Herein we report a case of a 42‐year‐old male with an acute, unilateral, profusely projectile serous rhinorrhea without any trauma or sinonasal surgery history. Following an urgent computed tomography, no skull base abnormalities were seen, ruling out the possibility of CSF rhinorrhea. However, a “ruptured” retention cyst in the maxillary sinus was noticed. Thus, it was concluded that the patient’s projectile unilateral serous rhinorrhea was due to a rupturing of the retention cyst in the affected maxillary sinus. The patient remained asymptomatic afterwards, negating the surgical removal or further follow‐up visits. Conclusion While the majority of paranasal sinus retention cyst cases are symptomless, spontaneous rupture of these cysts may take place and result in a sudden and vigorous release of nasal secretions, mimicking CSF rhinorrhea, as seen in our case.

Abstract Sufentanil is frequently used as an anesthetic agent in cardiac surgery owing to its cardiovascular safety and favorable pharmacokinetics. However, the pharmacokinetics profiles of sufentanil in patients undergoing cardiopulmonary bypass (CPB) surgery remain less understood, which is crucial for achieving the desired level of anesthesia and mitigating surgical complications. Therefore, this study aimed to develop a population pharmacokinetic model of sufentanil in patients undergoing CPB surgery and elucidate the clinical factors affecting its pharmacokinetic profile. Adult patients who underwent cardiac surgery with CPB and were administered sufentanil for anesthesia were enrolled. Arterial blood samples were collected to quantify plasma concentrations of sufentanil and clinical laboratory parameters, including inflammatory cytokines. A population pharmacokinetic model was established using nonlinear mixed‐effects modeling. Simulations were performed using the pharmacokinetic parameters of the final model. Overall, 20 patients were included in the final analysis. Sufentanil pharmacokinetics were modeled using a two‐compartment model, accounting for CPB effects. Sufentanil clearance increased 2.80‐fold during CPB and warming phases, while the central compartment volume increased 2.74‐fold during CPB. CPB was a significant covariate affecting drug clearance and distribution volume. No other significant covariates were identified despite increased levels of the inflammatory cytokines, including IL‐6, IL‐8, and TNF‐α during CPB. The simulation indicated a 30 μg loading dose and 40 μg/h maintenance infusion for target‐controlled infusion. Additionally, a bolus dose of 60 μg was added at CPB initiation to adjust for exposure changes during this phase. Considering the target sufentanil concentrations, a uniform dosing regimen was acceptable for effective analgesia.

Abstract Cytomegalovirus (CMV) commonly infects immunocompromised individuals, such as cancer patients. We present a case involving a 60‐year‐old male with Stage 3A lung adenocarcinoma and chronic obstructive pulmonary disease (COPD) diagnosed with CMV tracheobronchitis, initially suspected as cancer progression. Treatment with ganciclovir led to partial improvement in symptoms of shortness of breath and cough, as well as bronchoscopic findings. However, due to ganciclovir‐induced neutropenia, the therapy was switched to foscarnet. Distinguishing between cancer progression and infectious tracheobronchitis through physical examination and chest CT scans remains challenging. In lung cancer patients presenting with airway and bronchial narrowing along with ulcerative mucosal lesions, CMV infection should be considered. A bronchoscopic biopsy is crucial for accurate diagnosis and determining the appropriate treatment in these patients.

Abstract A synaptic protein, Neuronal Pentraxin 2 (NPTX2), has emerged as a pivotal biomarker for Alzheimer's dementia (AD). We identified candidate miRNAs targeting NPTX2 and performed association and mediation analyses using multi‐omics data (N = 702). Among 44 candidate miRNAs, miR‐133b was significantly associated with AD and Braak positivity. Higher miR‐133b expression was also associated with higher NPTX2 gene expression and better cognition. Mediation analysis showed that miR‐133b partially influences AD and cognition through the NPTX2 protein. Our integrated approach suggests a potential role of miR‐133b in synaptic integrity and offers new insights into AD pathogenesis.

Abstract The authors propose a compression strategy for a 3D human pose estimation model based on a transformer which yields high accuracy but increases the model size. This approach involves a pruning‐guided determination of the search range to achieve lightweight pose estimation under limited training time and to identify the optimal model size. In addition, the authors propose a transformer‐based feature distillation (TFD) method, which efficiently exploits the pose estimation model in terms of both model size and accuracy by leveraging transformer architecture characteristics. Pruning‐guided TFD is the first approach for 3D human pose estimation that employs transformer architecture. The proposed approach was tested on various extensive data sets, and the results show that it can reduce the model size by 30% compared to the state‐of‐the‐art while ensuring high accuracy.

Abstract This review article explores advanced surgical approaches and anatomical insights for tailoring rectal cancer surgery, particularly focusing on low‐lying rectal cancer. With the evolution of imaging technologies, precise preoperative planning has become possible, enhancing the visualization of anatomy surrounding the rectum and enabling more accurate assessments of circumferential resection margin (CRM) involvement. The article emphasizes the dynamic nature of rectal cancer treatment, advocating for individualized surgical planning based on comprehensive preoperative imaging and intraoperative assessment. This approach aims to optimize patient care by integrating recent advancements and anatomical insights into clinical practice for the management of low‐lying rectal cancer. Particularly, the article discusses the importance of customizing the excision of Denonvilliers' fascia (DVF) based on tumor characteristics for optimal oncologic and functional outcomes, especially for anteriorly located tumors. It highlights the need for precise dissection techniques to ensure a negative CRM while preserving critical anatomical structures. Additionally, the review addresses the surgical management of tumors at the anorectal ring and introduces the Gate Approach for deep anterolateral pelvic dissection. Special attention is given to tumors impacting the membranous and prostate urethra, emphasizing tailored surgical approaches to balance complete tumor resection with the preservation of urogenital functions.

Abstract A 14‐year‐old spayed female Miniature Pinscher presented with tongue curling, dysphagia, hypersalivation, and sublingual gland swelling. Comprehensive evaluation, including neurologic and musculoskeletal examinations, blood work, and urinalysis, revealed no abnormalities other than tongue‐related signs. Magnetic resonance imaging (MRI) revealed a multilobed cystic structure in the occipito‐atlanto‐axial joint, compressing the right hypoglossal canal. The lesion appeared cerebrospinal fluid (CSF)‐like on T1‐weighted and T2‐weighted images, and hyperintense compared with CSF on fluid‐attenuated inversion recovery T2‐weighted images. The scans suggested mucinous content with enhanced peripheral areas on contrast‐enhanced images. Surgical removal and drainage of this cyst were performed, and clinical signs improved markedly. The dorsal cyst was tentatively diagnosed as a ganglion cyst based on histopathologic and imaging findings. Ganglion cysts should be considered in the differential diagnosis for dogs with similar MRI findings and neurologic signs.

Glucose is essential for energy metabolism, and its usage can determine other cellular functions, depending on the cell type. In some pathological conditions, cells are exposed to high concentrations of glucose for extended periods. In this study, we investigated metabolic, oxidative stress, and cellular senescence pathways in human bronchial epithelial cells (HBECs) cultured in media with physiologically low (5 mm) and high (12.5 mm) glucose concentrations. HBECs exposed to 12.5 mm glucose showed increased glucose routing toward the pentose phosphate pathway, lactate synthesis, and glycogen, but not triglyceride synthesis. These metabolic shifts were not associated with changes in cell proliferation rates, oxidative stress, or cellular senescence pathways. Since hyperglycemia is associated with fibrosis in the lung, we asked whether HBECS could activate fibroblasts. Primary human lung fibroblasts cultured in media conditioned by 12.5 mm glucose‐exposed HBECs showed a 1.3‐fold increase in the gene expression of COL1A1 and COL1A2, along with twofold increased protein levels of smooth muscle cell actin and 2.4‐fold of COL1A1. Consistently, HBECs cultured with 12.5 mm glucose secreted proteins associated with inflammation and fibrosis, such as interleukins IL‐1β, IL‐10, and IL‐13, CC chemokine ligands CCL2 and CCL24, and with extracellular matrix remodeling, such as metalloproteinases (MMP)‐1, MMP‐3, MMP‐9, and MMP‐13 and tissue inhibitors of MMPs (TIMP)‐1 and ‐2. This study shows that HBECs undergo metabolic reprogramming and increase the secretion of profibrotic mediators following exposure to high concentrations of glucose, and it contributes to the understanding of the metabolic crosstalk of neighboring cells in diabetes‐associated pulmonary fibrosis.

Abstract In Korea, Kori Unit 1 was permanently closed in 2017 and scheduled for decommissioning. Kori Unit 1 is currently scheduled to undergo system decontamination and to be decommissioned by December 2038. Measures to properly control and remove radiological hazards must be established to go through decommissioning a nuclear power plant (NPP). Radiological characterization must precede NPP decommissioning. Radiological characterization generates a lot of data during this process. The consistency of radiological characterization data is important for systematically decommissioning NPPs. However, the data generated from radiological characterization may not be systematically managed because a database of radiological characterizations for Kori Unit 1 has not been properly established. Therefore, this study has proposed a database to be filled during radiological characterization in terms of occupational radiation exposure of personnel and decommissioning waste safety using key performance indicators presented by the International Atomic Energy Agency. From the perspective of occupational exposure, databases have been proposed for operational history investigations, decommissioning source term calculations, and investigation of the level of radiological contamination. From the perspective of the safety of decommissioning waste, databases were proposed for operational history investigation, decommissioning source term calculation, investigation of the level of radiological contamination, and investigation of radiological characteristics of decommissioning waste.

Abstract Background The association between the adiponectin‐to‐leptin ratio (A/L ratio) and the risk of incident chronic kidney disease (CKD) is poorly understood. This study aimed to investigate the association between A/L ratio and the risk of incident CKD and to examine whether such a relationship varied according to sex and body composition. Methods In this prospective community‐based cohort, participants with normal kidney function were analysed (N = 5192). The association between the A/L ratio at baseline and the risk of incident CKD, defined as two or more occasions with an estimated glomerular filtration rate of

Abstract Background There is limited research on the intra‐individual efficacy of ventricular pacing minimization algorithms developed by Biotronik—the Ventricular Pace Suppression algorithm (VpS) and the Intrinsic Rhythm Support plus algorithm (IRSplus) (BIOTRONIK SE & Co. KG, Berlin, Germany). We performed a randomized pilot trial that evaluated the efficacy of two algorithms in patients with symptomatic sinus node dysfunction (SND) who received a dual‐chamber pacemaker. Methods The trial was conducted in 11 tertiary hospitals in South Korea. The patients were randomized to either the VpS or IRSplus algorithm group after a 3‐month period of fixed atrioventricular (AV) delay. The primary outcome was the ventricular pacing percentage (Vp%) at each follow‐up visit. The secondary outcomes were the occurrence of heart failure (HF) and atrial fibrillation (AF) during the study period. Results Data from 131 patients were analyzed. Initially, their average Vp% over 3 months with a fixed AV interval was 14.1 ± 19.4%. Patients were randomly assigned to VpS and IRSplus groups, with 66 and 65 in each. Algorithms reduced average Vp% to 4.0 ± 11.3% at 9 months and 6.7 ± 14.9% at 15 months. These algorithms were more effective for patients with paced AV delay (PAVD) ≤300 ms compared to those with PAVD >300 ms. Both algorithms were equally effective in reducing Vp%. Clinical AF or HF hospitalization was not observed during the study period. Conclusion The VpS and IRSplus algorithms are effective and safe in minimizing unnecessary ventricular pacing in patients with SND.

Abstract Objective Conventionally, MRI aids in differentiating acute unilateral peripheral vestibulopathy/vestibular neuritis (AUPV/VN) from mimickers. Meanwhile, the diagnostic utility of MRIs dedicated to the inner ear remains to be elucidated for diagnosing AUPV/VN. Methods We prospectively recruited 53 patients with AUPV/VN (mean age ± SD = 60 ± 15 years, 29 men). Initial MRIs were performed with a standard protocol, and an additional axial 3D‐fluid‐attenuated inversion recovery (3D‐FLAIR) sequence was obtained 4 h after intravenous injection of gadoterate meglumine. Abnormal enhancement was defined as a signal intensity that exceeded the mean + 2SD value on the healthy side. The findings of neurotologic evaluation and MRIs were compared. Results Overall, the inter‐rater agreement for gadolinium enhancement was 0.886 (Cohen's kappa coefficient). Enhancement was observed in 26 patients (49%), most frequently in the vestibule (n = 20), followed by the anterior (n = 12), horizontal (HC, n = 8), posterior canal (n = 5), and superior (n = 3) and inferior (n = 1) vestibular nerves. In multivariable logistic regression analysis, the enhancement was associated with decreased HC gain in video head‐impulse tests (p = 0.036), increased interaural difference in ocular vestibular‐evoked myogenic potentials (p = 0.001), and a longer onset‐to‐MRI time span (p = 0.024). The sensitivity and specificity were 92.3% and 81.5%, respectively, with an area under the curve of 0.90 for predicting gadolinium enhancement. Interpretation Robust gadolinium enhancement was observed on 4‐hour‐delayed 3D‐FLAIR images in nearly half of the patients with AUPV/VN, with a good correlation with the results of neurotologic evaluation. The positivity may be determined by the extent of vestibular deficit, timing of imaging acquisition, and possibly by the underlying etiology causing AUPV/VN. MRIs may aid in delineating the involved structures in AUPV/VN.

Glioblastoma recruits various nontransformed cells from distant tissues. Although bone marrow‐derived mesenchymal stem cells (MSCs) have been observed migrating to glioblastoma, the underlying mechanism driving MSC migration toward glioblastoma remains unclear. Tumor vascularity is critical in the context of recurrent glioblastoma and is closely linked to the expression of stromal cell‐derived factor‐1 (SDF‐1). We demonstrated that cadherin‐6 mediated MSC migration both toward SDF‐1 and toward glioblastoma cells. Cadherin‐6 knockdown resulted in the downregulation of MSCs capacity to migrate in response to SDF‐1. Furthermore, MSCs with cadherin‐6 knockdown exhibited impaired migration in response to conditioned media derived from glioblastoma cell lines (U87 and U373) expressing SDF‐1, thus simulating the glioblastoma microenvironment. Moreover, MSCs enhanced the vasculogenic capacity of U87 cells without increasing the proliferation, cancer stem cell characteristics, or migration of U87. These results suggest that the current strategy of utilizing MSCs as carriers for antiglioblastoma drugs requires careful examination. Furthermore, cadherin‐6 may represent a novel potential target for controlling the recruitment of MSCs toward glioblastoma.

Abstract We construct a linear model of microseism power as a function of sea‐ice concentration and ocean‐wave activity with a seismic station located on northern Ellesmere Island. The influence of wind‐ice‐ocean interactions on microseism has been taken into account. We find the increase in microseism power over the last 32 years reflects the long‐term loss of sea ice and increasing ocean‐wave activity in the Arctic Ocean likely associated with climate change. We further assess model performance to determine a representative region over which sea‐ice concentration and ocean‐wave activity most directly influence the microseism power. The seismological methods developed here suggest that there is the potential to augment or refine observations of sea‐ice conditions obtained from satellites and from in‐situ observations. Seismological methods may thus help determine properties such as sea‐ice thickness, which are less amenable to conventional observations, under a changing climate, particularly in remote areas like the High Arctic.

Abstract Lower risk (LR) myelodysplastic syndromes (MDS) are heterogeneous hematopoietic stem and progenitor disorders caused by the accumulation of somatic mutations in various genes including epigenetic regulators that may produce convergent DNA methylation patterns driving specific gene expression profiles. The integration of genomic, epigenomic, and transcriptomic profiling has the potential to spotlight distinct LR‐MDS categories on the basis of pathophysiological mechanisms. We performed a comprehensive study of somatic mutations and DNA methylation in a large and clinically well‐annotated cohort of treatment‐naive patients with LR‐MDS at diagnosis from the EUMDS registry (ClinicalTrials.gov.NCT00600860). Unsupervised clustering analyses identified six clusters based on genetic profiling that concentrate into four clusters on the basis of genome‐wide methylation profiling with significant overlap between the two clustering modes. The four methylation clusters showed distinct clinical and genetic features and distinct methylation landscape. All clusters shared hypermethylated enhancers enriched in binding motifs for ETS and bZIP (C/EBP) transcription factor families, involved in the regulation of myeloid cell differentiation. By contrast, one cluster gathering patients with early leukemic evolution exhibited a specific pattern of hypermethylated promoters and, distinctly from other clusters, the upregulation of AP‐1 complex members FOS/FOSL2 together with the absence of hypermethylation of their binding motif at target gene enhancers, which is of relevance for leukemic initiation. Among MDS patients with lower‐risk IPSS‐M, this cluster displayed a significantly inferior overall survival (p

Abstract Moiré superlattice of twisted hexagonal boron nitride (hBN) has emerged as an advanced atomically thin van der Waals interfacial ferroelectricity platform. Nanoscale periodic ferroelectric moiré potentials in twisted hBN allow the hosting of remote Coulomb superlattice potentials to adjacent 2D materials. Therefore, the new strategies for engineering moiré length, angle, and potential strength are essential for developing programmable quantum materials. Here, it demonstrates the realization of twisted hBN‐based moiré superlattice platforms and visualizes the moiré domains and ferroelectric properties using Kelvin probe force microscopy (KPFM). Also, the regular moiré superlattice in the large area is reported. It offers the possibility to reproduce uniform moiré structures with precise control piezo stage stacking and heat annealing. It demonstrates cumulative multi‐ferroelectric polarization and multi‐level domains with multiple angle mismatched interfaces. Additionally, it observes the quasi‐1D anisotropic moiré domains and show the highest resolution analysis of the local built‐in strain between adjacent hBN layers compared to the conventional methods. Furthermore, in‐situ manipulation of moiré potential is demonstrated using femtosecond pulse laser, which results in the optical phonon‐induced atomic displacement at the hBN moiré interfaces. The results pave the way to develop precisely programmable moiré superlattice platforms and investigate strongly correlated physics.