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Abstract Diagnosing post‐gastrectomy hypoglycemia is challenging, often relying on medical history with documented low plasma glucose levels. Here, we present three cases of patients who presented a high probability of post‐gastrectomy hypoglycemia diagnosed and managed successfully using “theragnostic” continuous glucose monitoring and alpha‐glucosidase inhibitors. In the first week, patients maintained their current lifestyle without medical intervention; in the second week, voglibose 0.2 mg before meals was prescribed. Continuous glucose monitoring data from the first week confirmed the diagnosis with multiple hypoglycemic events after postprandial peaks, whereas data from the second week showed reduced hypoglycemic events and lower glycemic variability, demonstrating voglibose's therapeutic effect. This report highlights the effective management of post‐gastrectomy hypoglycemia using voglibose and theragnostic continuous glucose monitoring, showing its potential benefits and safety for similar cases.

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 Mycoprotein is critical in a dietary shift toward a more sustainable food system. However, the strain improvement for enhancing mycoprotein via genetic manipulation is lacking. Here, we investigated the functions of proteins related to ubiquitin and small ubiquitin‐like modifier (SUMO) modifications using a gene‐knockout strategy in Fusarium venenatum, a mycoprotein fungus closely related to the fungal genetics model species Fusarium graminearum. Among the candidate genes, we specifically focused on the putative SUMO‐associated gene UBQ14 based on phenotypic characteristics in F. graminearum. In the FvUBQ14 knockout mutant in F. venenatum, nutritional profiles showed prominent differences in amino acid and fatty acid composition compared to the wild‐type strain. Furthermore, through proteomic analysis, we confirmed that the loss of FvUBQ14 leads to metabolic changes, particular in amino acid biosynthesis and degradation, resulting in an increase in amino acid composition in F. venenatum. Our findings provide new insights into filamentous fungal food improvement through genetic engineering and contribute to advances in alternative protein industry.

Abstract The advancement of Photovoltaic technology has undergone rapid acceleration in recent years. Nonetheless, the most significant drawback of Photovoltaic is its intermittence, making it an obvious source of power fluctuation. This study proposes a novel scheme for real‐time or intraday PV power forecasting by adopting two predictive models, namely, White‐box and Combination. The White‐box model is implemented employing mathematical calculations and statistics called Exceedance Probability. Meanwhile, the Combination model is an aggregation of several predictive models' outputs including the White‐box model and benchmark ones by dynamically adjusting the weight coefficient of each model based on their forecasting accuracy. The experimental results, which are verified on two PV systems corresponding to two case studies located at Vietnam and Australia, indicate that the two proposed models outperform other referenced models as nMAPE improves approximately 40% and 38% in terms of the first and second case study, respectively. In particular, the White‐box model shows superiority by updating the forecast every 10 min, which can adapt to the fluctuation of weather conditions whereas the Combination one yields acceptable precision, indicating its flexible application.

Abstract Background and Objectives Cardiovascular implantable electronic devices can detect atrial high‐rate episodes (AHREs). However, the predictors of clinically relevant AHREs have not been well identified. Methods This prospective study included 145 patients (median age 64.5 ± 16.4 years, 53.1% females) without atrial fibrillation (AF) from December 2020 to January 2022. AHREs were defined as a programmed atrial detection rate >190 beats per minute. Cox regression analysis was used to identify the risk factors of AHREs. Results During 6 months of follow‐up, AHREs occurred in 30.3% of patients. Multivariable Cox regression analysis showed factors related to development of AHREs including using anti‐arrhythmic drugs (AAD) before implantation (Hazard ratio (HR) 7.71; 95% confidence interval [95% CI], 2.58–23.02, p

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 Autosomal dominant Fanconi syndrome due to a GATM variant (GATM‐FS), causes accumulation of misfolded arginine‐glycine amidinotransferase (AGAT) in proximal renal tubules leading to cellular injury. GATM‐FS presents during childhood and progresses to end‐stage kidney disease (ESKD) in adults. We study creatine metabolism in two individuals of unrelated families with a known GATM variant and the effect of creatine supplementation in kidney organoids. Plasma and urine metabolites were measured by mass spectrometry. Brain creatine was assessed by magnetic resonance spectroscopy (MRS). Guanidinoacetate (GAA) synthesis by the AGAT mutant was measured in patient‐derived immortalized lymphocytes using stable isotopes of arginine and glycine. The effect of creatine on GATM expression was assessed in human kidney cells and organoids. Several family members from two unrelated families were diagnosed with Fanconi syndrome and had the c.1022C>T (p. P341L) variant in GATM. Two affected individuals in both families had moderately reduced plasma GAA levels. In comparison to wild‐type cells, GAA synthesis by patient‐derived GATMP341L+/− lymphoblastoid cell lines (LCL) was reduced, but not absent as in GATM cells from a patient with creatine deficiency syndrome. In vitro studies on human kidney organoids revealed reduced AGAT expression after treatment with creatine. Finally, we showed in one patient that creatine supplementation (5 g daily) substantially increased plasma creatine levels. We report low plasma and urine GAA in patients with autosomal dominant GATM‐FS and show that creatine downregulates AGAT in human kidney cells.

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 The routine practice accompanying the operation of nuclear facilities involves the discharge of radioactive effluents from nuclear power plants (NPPs). Regulation of this discharge to the environment hinges on three criteria: radioactivity concentration, public dose, and radioactivity. Among these, radioactive carbon‐14 holds particular significance as it possesses an extensive half‐life of 5730 years, making it a primary source of radiation dose to communities residing around NPPs. In Korea, the monitoring of carbon‐14 discharges from pressurized water reactors (PWRs) in gaseous effluents has been ongoing since 2012, whereas before 2012, monitoring exclusively focused on carbon‐14 discharges from pressurized heavy water reactors (PHWRs). Analysis of carbon‐14 discharges from Korean PHWRs indicates that their emission constituted less than 1% of total radioactive effluents over the past two decades. In the context of Korean PWRs, carbon‐14 discharge monitoring was absent from 2002 to 2011, resulting in an absence of data regarding such discharges during that period. After introducing carbon‐14 discharge monitoring in gaseous effluents from Korean PWRs, emissions from 2012 to 2021 contributed 3% of the total gaseous effluents. These findings indicate that despite being the primary contributor to public dose, carbon‐14 discharges from NPPs constitute a minor portion of the radioactive effluent discharge.

Abstract Background Pre‐haemodialysis (HD) serum creatinine levels are reliable and inexpensive markers of muscle mass and important predictors of survival in patients with stable chronic HD. We aimed to assess whether changes in pre‐HD serum creatinine levels during a 2‐year period are linked to long‐term patient survival. Methods We retrospectively analysed patients enrolled in a periodic HD quality assessment program. Of the 21 846 participants in the fourth HD quality assessment program, 13 765 were presented in the fifth, of which 10 299 eligible patients were included in this study. We assessed the change in serum creatinine levels over 2 years. The patients were categorized into the following three groups: stable group (patients with change in serum creatinine

Abstract Objective The effect of body composition change on the risk of dementia is not clear. This study analyzed the associations of changes in predicted lean body mass index (pLBMI), predicted appendicular skeletal muscle mass index (pASMI), and predicted body fat mass index (pBFMI) with the risk of dementia. Methods In this nationwide cohort study, data were obtained from the Korean National Health Insurance Service database. The exposure was defined as changes in pLBMI, pASMI, and pBFMI derived from validated prediction equations. The outcome was dementia, defined based on the dementia diagnosis with prescription of anti‐dementia medication. Cox proportional hazards regression analyses were performed to obtain the hazard ratio with a 95% confidence interval for risk of dementia according to changes in predicted body composition. Results A total of 13,215,208 individuals with no prior record of dementia who underwent health screenings twice between 2009–2010 and 2011–2012 were included. A 1‐kg/m2 increase in pLBMI and pASMI had an association with reduced risk of dementia (aHR: 0.85, 95% CI 0.84–0.87; aHR: 0.70, 95% CI 0.69–0.72, respectively for men, and aHR: 0.69, 95% CI 0.67–0.71; aHR: 0.59, 95% CI 0.57–0.61, respectively for women). A 1‐kg/m2 increase in pBFMI had an association with a raised risk of dementia (aHR: 1.19, 95% CI 1.17–1.21 for men and aHR: 1.53, 95% CI 1.48–1.57 for women). These results remained consistent regardless of sex or weight change. Interpretation Increase in pLBMI or pASMI, or reduction in pBFMI was linked to lower risk of dementia.

ABSTRACT Background Multi‐cancer early detection (MCED) through a single blood test significantly advances cancer diagnosis. However, most MCED tests rely on a single type of biomarkers, leading to limited sensitivity, particularly for early‐stage cancers. We previously developed SPOT‐MAS, a multimodal ctDNA‐based assay analyzing methylation and fragmentomic profiles to detect five common cancers. Despite its potential, SPOT‐MAS exhibited moderate sensitivities for early‐stage cancers. This study investigated whether integrating hotspot mutations into SPOT‐MAS could enhance its detection rates. Method A targeted amplicon sequencing approach was developed to profile 700 hotspot mutations in cell‐free DNA and integrated into the SPOT‐MAS assay, creating a single‐blood draw workflow. This workflow, namely SPOT‐MAS Plus was retrospectively validated in a cohort of 255 non‐metastatic cancer patients (breast, colorectal, gastric, liver, and lung) and 304 healthy individuals. Results Hotspot mutations were detected in 131 of 255 (51.4%) cancer patients, with the highest rates in liver cancer (96.5%), followed by colorectal (59.3%) and lung cancer (53.7%). Lower detection rates were found for cancers with low tumor mutational burden, such as breast (31.3%) and gastric (41.9%) cancers. In contrast, SPOT‐MAS demonstrated higher sensitivities for these cancers (51.6% for breast and 62.9% for gastric). The combination of hotspot mutations with SPOT‐MAS predictions improved early‐stage cancer detection, achieving an overall sensitivity of 78.5% at a specificity of 97.7%. Enhanced sensitivities were observed for colorectal (81.36%) and lung cancer (82.9%). Conclusion The integration of genetic and epigenetic alterations into a multimodal assay significantly enhances the early detection of various cancers. Further validation in larger cohorts is necessary to support broader clinical applications.

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 MnO2 nanowires coated with conjugated microporous polymers (CMP) are applied as triboelectric energy harvesting materials. The tribopositive performance of the CMP shells is enhanced with the assistance of MnO2 nanowires (MnO2 NW), likely due to cationic charge transfer from the tribopositive CMP layers to the surface Mn2+ and Mn3+ species of MnO2 NW. This is supported by model studies. The MnO2@CMP‐2 with sub‐10 nm thick CMP layers shows promising triboelectric output voltages up to 576 V and a maximum power density of 1.31 mW cm−2. Spring‐assisted triboelectric nanogenerators fabricated with MnO2@CMP‐2/PVP‐3 films are used as power supplies to operate electronic devices.

Abstract To realize the practical application of rechargeable Zn–Air batteries (ZABs), it is imperative to develop a non‐noble metal‐based electrocatalyst with high electrochemical performance for the oxygen reduction reaction (ORR) and oxygen evolution reaction (OER). Herein, Ni‐doped Co9S8 nanoparticles dispersed on an inverse opal‐structured N, S co‐doped carbon matrix (IO─NixCo9‐xS8@NSC) as a bifunctional electrocatalyst is presented. The unique 3D porous structure, arranged in an inverse opal pattern, provides a large active surface area. Also, the conductive carbon substrate ensures the homogeneous dispersion of NixCo9‐xS8 nanocrystals, preventing aggregation and increasing the exposure of active sites. The introduction of heteroatom dopants into the Co9S8 structure generates defect sites and enhances surface polarity, thereby improving electrocatalytic performance in alkaline solutions. Consequently, the IO─NixCo9‐xS8@NSC shows excellent bifunctional activity with a high half‐wave potential of 0.926 V for ORR and a low overpotential of 289 mV at 10 mA cm−2 for OER. Moreover, the rechargeable ZAB assembled with prepared electrocatalyst exhibits a higher specific capacity (768 mAh gZn−1), peak power density (180.2 mW cm−2), and outstanding stability (over 160 h) compared to precious metal‐based electrocatalyst.

Abstract The economies and livelihoods of many coastal megacities are at serious risk from flooding, despite investments in flood defenses. For instance, in Ho Chi Minh City, the construction of a large‐scale ring‐dike has mitigated negative effects from storm surges, yet damage is still frequently caused by high‐intensity rainfalls leading to nuisance flooding, which is responsible for the highest proportion of flood losses in the city today. Because sustainable flood risk management requires detailed spatial information, we analyze the local risk and its components based on a chain of novel models previously calibrated and validated for Ho Chi Minh City. Furthermore, we assess the effectiveness of two decentralized adaptation options, namely private precautionary measures and rainwater retention, for mitigating pluvial flooding. Our integrated risk assessment reveals that the approaches are complementary, which is a major advantage for their implementation. Implementation of both approaches has the potential to reduce the expected annual damage and the number of annually affected households by 16% and 56%, respectively. This is also reflected in a significant reduction of annual losses per household, which we propose as an additional, people‐centered indicator of flood risk. Moreover, these measures are well‐suited to strengthen citizen participation in risk reduction beyond top‐down protection schemes. Complementing the ring‐dike with decentralized adaptation options can therefore be seen as an effective and generic strategy to alleviate the impacts of nuisance flooding in coastal megacities, such as Ho Chi Minh City, and should be incentivized by decision‐makers. Aside from hydrological and metocean site conditions, both the methodology and findings of this study are transferrable to any coastal megacity facing similar challenges.

Key Clinical Message Differentiating Adult‐Onset Still's Disease (AOSD) from lymphoma is challenging. A 23‐year‐old female presented with polyarthralgia, fever, rash, lymphadenopathy, and abnormal labs. She met AOSD criteria and was diagnosed with non‐Hodgkin lymphoma. Treatment led to improvement. Abstract The differentiation between Adult‐onset Still's Disease (AOSD) and lymphoma remains challenging in our context. The Faustrel score facilitates the simultaneous diagnosis of these conditions. A 23‐year‐old woman presented with chronic polyarthralgia in a febrile context. A physical examination revealed peripheral joint syndrome, a maculopapular rash on the trunk, and peripheral lymphadenopathy. Laboratory tests showed neutrophils leukocytosis, hyperferritinemia, and a glycosylated ferritin fraction of 12%. A lymph node biopsy revealed a malignant non‐Hodgkin lymphoma, and the patient met the diagnostic criteria for AOSD according to Faustrel. She received corticosteroid therapy and four courses of Rituximab. After 6 months, clinical and biological improvements were noted. It is essential to consider the possibility of an association between atypical clinical presentations of lymphoma and AOSD.

Various representations of real‐life scenarios by algebraic structures are of vital importance in the modern era of Industrial Revolution 4.0 as it enables such data to be interpreted and processed by artificial intelligence, thus bridging the interaction gap between humans and machines. In response to that, this article proposes a new decision making model for traffic control among shopping complexes utilizing the novel concept of the complex intuitionistic fuzzy soft lattice of the circular type (CIFSL‐C), which takes the time within a day as truly directional entities. As a result, CIFSL‐C possesses the combined structural complexity and the level of sophistication of all the previous algebraic models which they are derived from, enabling them to be utilized in representing many real‐life scenarios, including those related to the pandemic, which will be rigorously discussed in this article. In addition, the complex intuitionistic fuzzy soft lattice of the quaternion type (CIFSL‐Q) will also be established.

Abstract Gastric cancer (GC) is recognized as the fifth most prevalent malignant tumor worldwide. It is characterized by diverse clinical symptoms, treatment responses, and prognoses. In GC prognosis, the promotion of epithelial–mesenchymal transition (EMT) fosters cancer cell invasion and metastasis, thereby triggering the dissemination of tumor cells. This study proposes a nucleic acid amplification circuit‐based hydrogel (NACH) assay for identifying exosomal miRNA derived from metastatic GC. The NACH assay employs the rolling circle amplification method and targets miRNA‐21, a tumor‐related oncogene, and miRNA‐99a, which promotes EMT. Specific amplification probes for each target are immobilized within the hydrogel, enabling a streamlined, one‐step amplification reaction. The NACH assay exhibits a detection limit of 1 fm for miRNA‐21 and miRNA‐99a, thereby enabling rapid and highly sensitive on‐site detection. Performance evaluation using exosomal miRNA extracted from cell culture media, mouse plasma, and human plasma revealed fluorescence intensity patterns similar to those obtained in qRT‐PCR. Furthermore, deploying a custom‐developed portable fluorometer for the NACH assay allows for diagnostic performance assessment and point‐of‐care testing using clinical samples from GC patients. These findings emphasize the potential of the NACH assay to be used as a robust tool for the genetic diagnosis of GC based on exosome detection.

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 Objective This study aimed to evaluate the intraoperative use of a drain line for smoke suction during robotic thyroidectomy using a gas insufflation one‐step single‐port transaxillary (GOSTA) approach and its impact on surgical outcomes. Study Design Retrospective cohort study. Setting University tertiary care facility. Methods A comprehensive retrospective analysis was conducted in patients divided into 2 groups: the Drain group, where a drain line was directly inserted into the surgical space during surgery (n = 53), and the Control group (n = 83). The 2 groups were compared in terms of perioperative surgical outcomes, including operative time, number of endoscope cleaning, and the number of patients with endoscopes that did not require cleaning. Results The operative time was significantly shorter in the Drain group than in the Control group (P = .003). The number of endoscope cleaning procedures was considerably lower in the Drain group (P

Abstract Chirality‐induced spin selectivity observed in chiral 2D organic–inorganic hybrid perovskite holds promise to achieve spin‐dependent electrochemistry. However, conventional chiral 2D perovskites suffer from low conductivity and hygroscopicity, limiting electrochemical performance and operational stability. Here, a cutting‐edge material design is introduced to develop a stable and efficient chiral perovskite‐based spin polarizer by employing fluorinated chiral cation. The fluorination approach effectively promotes the charge carrier transport along the out‐of‐plane direction by mitigating the dielectric confinement effect within the multi‐quantum well‐structured 2D perovskite. Integrating the fluorinated cation incorporated spin polarizer with BiVO4 photoanode considerably boosts the photocurrent density while reducing overpotential through a spin‐dependent oxygen evolution reaction. Furthermore, the hydrophobic nature of fluorine in spin polarizer endows operational stability to the photoanode, extending the durability by 280% as compared to the device with non‐fluorinated spin polarizer.

Abstract DDT (dichlorodiphenyltrichloroethane) is a commonly used insecticide that is recalcitrant and highly stable in the environment. Currently, DDT residue contamination, especially in agricultural soil, is still a concern in many countries, threatening human health and the environment. Among the approaches to resolve such an issue, novel biodegradation‐based methods are now preferred to physicochemical methods, due to the sustainability and the effectiveness of the former. In this study, we explored the possibility of building mixed microbial cultures that can offer improved DDT‐degrading efficiencies and be more environmentally transilient, based on genome annotation using the KEGG database and prediction of interactions between single strains using the obtained metabolic maps. We then proposed 10 potential DDT‐degrading mixed cultures of different strain combinations and evaluated their DDT degradation performances in liquid, semi‐solid and solid media. The results demonstrated the superiority of the mixtures over the single strains in terms of degrading DDT, particularly in a semi‐solid medium, with up to 40–50% more efficiency. Not only did the mixed cultures degrade DDT more efficiently, but they also adapted to broader spectra of environmental conditions. The three best DDT‐degrading and transilient mixtures were selected, and it turned out that their component strains seemed to have more metabolic interactions than those in the other mixtures. Thus, our study demonstrates the effectiveness of exploiting genome‐mining techniques and the use of constructed mixed cultures in improving biodegradation.

Abstract This study explores a symmetric configuration approach in anion exchange membrane (AEM) water electrolysis, focusing on overcoming adaptability challenges in dynamic conditions. Here, a rapid and mild synthesis technique for fabricating fibrous membrane‐type catalyst electrodes is developed. Our method leverages the contrasting oxidation states between the sulfur‐doped NiFe(OH)2 shell and the metallic Ni core, as revealed by electron energy loss spectroscopy. Theoretical evaluations confirm that the S–NiFe(OH)2 active sites optimize free energy for alkaline water electrolysis intermediates. This technique bypasses traditional energy‐intensive processes, achieving superior bifunctional activity beyond current benchmarks. The symmetric AEM water electrolyzer demonstrates a current density of 2 A cm−2 at 1.78 V at 60°C in 1 M KOH electrolyte and also sustains ampere‐scale water electrolysis below 2.0 V for 140 h even in ambient conditions. These results highlight the system's operational flexibility and structural stability, marking a significant advancement in AEM water electrolysis technology.

Abstract Thermoelectric devices have received significant attention because of their potential for sustainable energy recovery. In these devices, a thermal design that optimizes heat transfer and dissipation is crucial for maximizing the power output. Heat dissipation generally requires external active or passive cooling devices, which often suffer from inevitable heat loss and heavy systems. Herein, the design of heat‐sink integrated thermoelectric legs is proposed to enhance heat dissipation without external cooling devices, realized by finite element model simulation and 3D printing of ternary silver chalcogenide‐based thermoelectric materials. Owing to the self‐induced surface charges of the synthesized AgBiSe2 (n‐type) and AgSbTe2 (p‐type) particles, these particle‐based colloidal inks exhibited high viscoelasticity, which enables the creation of complex heat‐dissipation architectures via 3D printing. Power generators made from 3D‐printed heat‐dissipating legs exhibit higher temperature differences and output power than traditional cuboids, offering a new strategy for enhancing thermoelectric power generation.

Abstract Objective Patient violence in emergency departments (EDs) may be prevented with proactive mitigation measures targeting potentially violent patients. We aimed to evaluate the effects of two interventions guided by a validated risk‐assessment tool. Methods A prospective interventional study was conducted among patients ≥10 years who visited two EDs in Michigan, USA, from October 2022 to August 2023. During triage, the ED nurses completed the Aggressive Behavior Risk Assessment Tool for EDs (ABRAT‐ED) to identify high‐risk patients. Following the baseline observational period, interventions were implemented stepwise for the high‐risk patients: phase 1 period with signage posting and phase 2 period with a proactive Behavioral Emergency Response Team (BERT) huddle added to the signage posting. Before ED disposition, any violent events and their severities were documented. The data were retrieved retrospectively after the study was completed. Results Of 77,424 evaluable patients, 546 had ≥1 violent event. The violent event rates were 0.93%, 0.68%, and 0.62% for baseline, phase 1, and phase 2, respectively. The relative risk of violent events for phase 1 compared to the baseline was 0.73 (95% confidence interval [CI]: 0.59‒0.90; p = 0.003). The relative risk for phase 2 compared to phase 1 was 0.92 (95% CI: 0.76‒1.12; p = 0.418). Conclusion The use of signage posting as a persistent visual cue for high‐risk patients identified by ABRAT‐ED appears to be effective in reducing the overall violent event rates. However, adding proactive BERT huddle to signage posting showed no significant reduction in the violent event rates compared to signage posting alone.

Abstract North Atlantic midlatitude cyclones are among the most severe weather systems, causing enormous economic damages and threatening human lives. The cyclone is typically characterized by cyclonic convergent surface winds, strong updrafts, and precipitation. However, extreme surface winds are often observed within the cyclone where downdrafts develop. The present study investigates the dynamical and thermodynamical characteristics of the horizontal winds impinging on the cold frontal surface and the associated downdrafts. It is shown that the cyclonic winds into the cold frontal surface are mainly responsible for the downdrafts that transport the high‐altitude horizontal momentum to the surface and cause intense surface winds. About half of the North Atlantic midlatitude cyclones are accompanied by the downdrafts especially in the southern and western parts of the cyclone center.

Abstract Background De novo variations are a primary cause of Rett syndrome and Tubulinopathy, accounting for over 90% of cases. Some studies have identified and documented parental inheritance by mosaicism in these two disorders, albeit with limited data. Methods Clinical characteristics and diagnosis, including genetic tests of members of two families, were obtained from medical reports. Results The first family with Rett syndrome (RTT) presented with two offspring carrying FOXG1 c.460dup. Both affected RTT pregnancies did not show anomalies within the first trimester, preventing prenatal recognition at an early stage. The second family had two of three offspring confirmed with TUBA1A c.172G>A related to Tubulinopathy. Both young couples from the two families harbored none of the variants correlating to their children's conditions. Diagnosis of parental mosaics with higher rates of recurrence was reasonably determined, and genetic counseling played a major role in guiding and managing their subsequent pregnancies. Conclusion In genetic disorders with a high penetration of de novo variants, the risk of having a recurrent baby is an important topic to discuss with affected families. By examining variants that siblings share, clinical diagnosis can offer valuable information about the presence of mosaic inheritance. To effectively manage in the long term, adequate genetic counseling and strategic planning for future pregnancies should be emphasized to mitigate the risk of recurrent offspring.

Abstract This study aimed to compare and evaluate the efficacy of the blood pressure (BP) control and cholesterol‐lowering effects and safety of combination therapy with telmisartan, rosuvastatin, and ezetimibe versus rosuvastatin and ezetimibe double therapy or telmisartan single therapy in dyslipidemia patients with hypertension. After a wash‐out/therapeutic lifestyle change period of ≥4 weeks, a total of 100 eligible patients were randomized and received one of three treatments for 8 weeks: (1) telmisartan 80 mg/rosuvastatin 20 mg/ezetimibe 10 mg (TRE), (2) rosuvastatin 20 mg/ezetimibe 10 mg (RE), or (3) telmisartan 80 mg (T). The primary endpoint was the efficacy evaluation of TRE by comparing changes in mean sitting systolic blood pressure (msSBP) and mean percentage change in low‐density lipoprotein‐C (LDL‐C) from baseline after 8 weeks of treatment. The least square (LS) mean (SE) changes in msSBP at 8 weeks compared with baseline were −23.02 (3.04) versus −7.18 (3.09) mmHg in the TRE and RE groups, respectively (p

Abstract On May 27, 2022, the Asia Pacific Heart Rhythm Society and the Heart Rhythm Society convened a meeting of leaders from different professional societies of healthcare providers committed to arrhythmia care from the Asia Pacific region. The overriding goals of the meeting were to discuss clinical and health policy issues that face each country for providing care for patients with electrophysiologic issues, share experiences and best practices, and discuss potential future solutions. Participants were asked to address a series of questions in preparation for the meeting. The format of the meeting was a series of individual country reports presented by the leaders from each of the professional societies followed by open discussion. The recorded presentations from the Asia Summit can be accessed at https://www.heartrhythm365.org/URL/asiasummit‐22. Three major themes arose from the discussion. First, the major clinical problems faced by different countries vary. Although atrial fibrillation is common throughout the region, the most important issues also include more general issues such as hypertension, rheumatic heart disease, tobacco abuse, and management of potentially life‐threatening problems such as sudden cardiac arrest or profound bradycardia. Second, there is significant variability in the access to advanced arrhythmia care throughout the region because of differences in workforce availability, resources, drug availability, and national health policies. Third, collaboration in the area already occurs between individual countries, but no systematic regional method for working together is present.

Abstract Introduction In Viet Nam, key populations (KPs) face barriers accessing HIV services. Virtual platforms can be leveraged to increase access for KPs, including for HIV self‐testing (HIVST). This study compares reach and effectiveness of a web‐based HIVST intervention from pilot to scale‐up in Viet Nam. Methods A mixed‐methods explanatory sequential design used cross‐sectional and thematic analysis. The pilot launched in Can Tho in November 2020, followed by Hanoi and Nghe An in April 2021. Scale‐up included Can Tho and Nghe An, with 21 novel provinces from April to December 2022. After risk assessment, participants registered on the website, receiving HIVST (OraQuick®) by courier, peer educator or self‐pick‐up. Test result reporting and completing satisfaction surveys were encouraged. Intervention reach was measured through numbers accessing the testing, disaggregated by demographics, and proportion of individuals reporting self‐testing post‐registration. Effectiveness was measured through numbers reporting self‐test results, testing positive and linking to care, and testing negative and using HIVST to manage pre‐exposure prophylaxis (PrEP) use. Thematic content analysis of free‐text responses from the satisfaction survey synthesized quantitative outcomes. Results In total, 17,589 participants registered on the HIVST website; 11,332 individuals ordered 13,334 tests. Participants were generally young, aged

Abstract The El Niño–Southern Oscillation (ENSO) has a significant impact on the surface climate of East Asia by modulating the atmospheric circulation over the Kuroshio Extension. Here, we show that the ENSO–East Asia teleconnections are strongest in early winter due to the combined effects of the Indian Ocean and Maritime Continent convections, but weakest in mid‐winter as these tropical convections weaken. During the early El Niño winter, convection is enhanced over the Indian Ocean and suppressed over the Maritime Continent. The associated Rossby wave trains constructively interfere over the Kuroshio Extension, resulting in anticyclonic circulation anomalies. The equatorial central Pacific convection has a minimal impact on the East Asia. This result suggests that the Indian Ocean and the Maritime Continent convections, rather than the equatorial central Pacific convection, are the precursors of the early winter ENSO–East Asia teleconnections, and need to be considered for subseasonal‐to‐seasonal prediction in East Asia.

Abstract A universal approach for enhancing water affinity in polymer photocatalysts by covalently attaching hydrophilic photocrosslinkers to polymer chains is presented. A series of bisdiazirine photocrosslinkers, each comprising bisdiazirine photophores linked by various aliphatic (CL‐R) or ethylene glycol‐based bridge chains (CL‐TEG), is designed to prevent crosslinked polymer photocatalysts from degradation through a safe and efficient photocrosslinking reaction at a wavelength of 365 nm. When employing the hydrophilic CL‐TEG as a photocrosslinker with polymer photocatalysts (F8BT), the hydrogen evolution reaction (HER) rate is considerably enhanced by 2.5‐fold compared to that obtained using non‐crosslinked F8BT photocatalysts, whereas CL‐R‐based photocatalysts yield HER rates comparable to those of non‐crosslinked counterparts. Photophysical analyses including time‐resolved photoluminescence and transient absorption measurements reveal that adding CL‐TEG accelerates exciton separation, forming long‐lived charge carriers. Additionally, the in‐depth study using molecular dynamics simulations elucidates the dual role of CL‐TEG: it enhances water penetration into the polymer matrix and stabilizes charge carriers after exciton generation against undesirable recombination. Therefore, the strategy highlights endowing a high‐permittivity environment within polymer photocatalyst in a controlled manner is crucial for enhancing photocatalytic redox reactivity. Furthermore, this study shows that this hydrophilic crosslinker approach has a broad applicability in general polymer semiconductors and their nanoparticulate photocatalysts.

Abstract Various electrocatalysts are extensively examined for their ability to selectively produce desired products by electrochemical CO2 reduction reaction (CO2RR). However, an efficient CO2RR electrocatalyst doesn't ensure an effective co‐catalyst on the semiconductor surface for photoelectrochemical CO2RR. Herein, Bi2S3 nanorods are synthesized and electrochemically reduced to Bi nanoplates that adhere to the substrates for application in the electrochemical and photoelectrochemical CO2RR. Compared with commercial‐Bi, the Bi2S3‐derived Bi (S‐Bi) nanoplates on carbon paper exhibit superior electrocatalytic activity and selectivity for formate (HCOO−) in the electrochemical CO2RR, achieving a Faradaic efficiency exceeding 93%, with minimal H2 production over a wide potential range. This highly selective S‐Bi catalyst is being employed on the Si photocathode to investigate the behavior of electrocatalysts during photoelectrochemical CO2RR. The strong adhesion of the S‐Bi nanoplates to the Si nanowire substrate and their unique catalytic properties afford exceptional activity and selectivity for HCOO− under simulated solar irradiation. The selectivity observed in electrochemical CO2RR using the S‐Bi catalyst correlates with that seen in the photoelectrochemical CO2RR system. Combined pulsed potential methods and theoretical analyses reveal stabilization of the OCHO* intermediate on the S‐Bi catalyst under specific conditions, which is critical for developing efficient catalysts for CO2‐to‐HCOO− conversion.

Abstract Background The risk of carpal injury in racehorses may be related to the morphology, yet whether carpal morphologies are set from birth or change through growth remains unclear. Objective To quantify carpal bone changes through growth. Method Twenty privately owned Thoroughbred foals born between January 2022 and May 2023 were radiographed bimonthly from birth to 10 months of age. Imprint training was used to take radiographs safely without chemical restraints. Fifteen individual and 11 relative angular carpal parameters were measured using ImageJ on dorsopalmar radiographs of the carpus at zero degrees of vertical and horizontal rotation. Associations with age (growth), sex and the differences between left and right limbs were analysed separately using a linear mixed effects model. Results Six individual carpal parameters changed with age (radial carpal joint [RCJ], Prx.dor. radial carpal [Cr], Prx.Cu, Dis.dor. third carpal [C3], Dis.pal.C3 and Dis.pal. intermediate carpal), and one was influenced by side, that is higher in the left carpus (Dis.pal.Cr). Seven relative parameters changed with age, and one relative parameter was influenced by side, that is higher in the left (Ra.met‐RCJ). The proximo‐dorsal bone surface angle of Cr and disto‐dorsal bone surface angle of C3 became flatter over time, which may be associated with the re‐direction of the load towards the sagittal carpal plane. Sex did not influence any of the carpal parameters, nor did the combined effect of age, side of the limb and sex. Conclusion Specific individual and relative angular carpal parameters changed significantly over time and some differed between the left and right limb, whereas other parameters did not change. The steeper carpal bone angles achieved proximally with the parameters that did change may improve stability by redirecting the load more medially through the carpus and the proximal and distal bones.

Abstract This study examined the effects of exercise and detraining at a young age on fat accumulation in various organs. Four‐week‐old male Otsuka Long‐Evans Tokushima Fatty (OLETF) rats were assigned to either the non‐exercise sedentary (OLETF Sed) or exercise groups. The exercise group was subdivided into two groups: exercise between 4 and 12 weeks of age (OLETF Ex) and exercise between 4 and 6 weeks of age followed by non‐exercise between 6 and 12 weeks of age (OLETF DT). Body weight was significantly lower in the OLETF Ex group than in the OLETF Sed group at 12 weeks of age. Fat accumulation in the epididymal white adipose tissue, liver, and brown adipose tissue was suppressed in the OLETF Ex group. During the exercise period, body weight and food intake in the OLETF DT group were significantly lower than those in the OLETF Sed group. However, food intake was significantly higher in the OLETF DT group than in the OLETF Sed group after exercise cessation, resulting in extreme obesity with fatty liver and brown adipose tissue whitening. Detraining after early‐onset exercise promotes hyperphagia, causing extreme obesity. Overeating should be avoided during detraining periods in cases of exercise cessation at a young age.

Abstract Objectives This study aims to evaluate and compare the surgical outcomes of endoscopic malleostapedotomy (EMS) and endoscopic incudostapedotomy (EIS). Methods A retrospective analysis was conducted on 36 consecutive ears in 33 patients who underwent stapes surgery using either EMS (EMS group) or EIS (EIS group). Operational practicability across surgical steps, postoperative hearing, operation time, switch of approach, and complications were compared between the two groups. Results The EMS and EIS groups comprised seven (19.4%) and 29 ears (80.6%), respectively. The EMS group exhibited a greater proportion of moderate practicability in anchoring site exposure (42.9%, three of seven) and in securing the prosthesis (100%, seven of seven) in comparison to the EIS group, which had 0% (0 out of 29) and 41.4% (12 out of 29), respectively. Postoperative hearing improvements were equivalent between the groups, with EMS achieving a mean air‐bone gap improvement of 28.8 dB and EIS of 23.2 dB. The ABG closure rates within 10 dB and 20 dB for the EMS group were 28.6% and 100%, respectively, and not significantly different from the EIS group (p = .103). However, the average surgical duration for EMS was extended by 77.4 min. The rate of complications was comparable between the groups (EMS 14.3%, EIS 10.3%, p = 1.000). Conclusion The findings indicate that while EMS requires a longer operation time because of decreased practicability in specific surgical steps, it provides comparable outcomes to EIS, underscoring the potential of endoscopic techniques to establish malleostapedotomy as a surgical option as it is with traditional incudostapedotomy. Level of Evidence 4.

Abstract Marine heatwave (MHW), a prolonged period of anomalously warm seawater, has a catastrophic repercussion on marine ecosystems. With global warming, MHWs have become increasingly frequent, intense, and prolonged. To avoid irreversible damages from such extreme events, net‐zero carbon emissions by the 2050s, called carbon neutrality, were proposed. Here, we evaluate the impact of carbon neutrality on MHWs in the late 21st century using multi‐model projections from the Coupled Model Intercomparison Project Phase 6 (CMIP6) Shared Socioeconomic Pathway (SSP) 1–1.9 and SSP3‐7.0 scenarios. It is found that if the current regional rivalry over carbon emissions continues (i.e., SSP3‐7.0), the MHWs in the late 21st century will become stronger and longer than historical ones, especially in the western boundary current and equatorial current regions. Approximately 68% of the global ocean will be exposed to permanent MHWs, regionally 93% in the Indian Ocean, 76% in the Pacific Ocean, 68% in the Atlantic Ocean, 65% in the Coastal Ocean, and 48% in the Southern Ocean. Such MHWs can be significantly reduced by achieving carbon neutrality (i.e., SSP1‐1.9). In particular, the spatial proportion of the ocean exposed to permanent MHWs can be reduced to as low as 0.02%–0.07%, depending on the regions. This result underscores the critical importance of ongoing efforts to achieve net‐zero carbon emissions to reduce the potential ecological risks induced by extreme MHWs.

Abstract Biological invasion consists of spatially and temporally varying stages, accompanied by ecological and evolutionary changes. Understanding the genomics underlying invasion dynamics provides critical insights into the geographic sources and genetic diversity, contributing to successful invasions across space and time. Here, we used genomic data and model‐based approaches to characterize the invasion dynamics of Hypochaeris radicata L., a noxious weed in Korea. Genetic diversity and assignment patterns were investigated using 3563 SNPs of 283 individuals sampled from 22 populations. We employed a coalescent‐based simulation method to estimate demographic changes for each population and inferred colonization history using both phylogenetic and population genetic model‐based approaches. Our data suggest that H. radicata has been repeatedly been introduced to Korea from multiple genetic sources within the last 50 years, experiencing weak population bottlenecks followed by subsequent population expansions. These findings highlight the potential for further range expansion, particularly in the presence of human‐mediated dispersal. Our study represents the first population‐level genomic research documenting the invasion dynamics of the successful worldwide invader, H. radicata, outside of Europe.

Abstract Background Polydactyly, particularly of the index finger, remains an intriguing anomaly for which no specific gene or locus has been definitively linked to this phenotype. In this study, we conducted an investigation of a three‐generation family displaying index finger polydactyly. Methods Exome sequencing was conducted on the patient, with a filtration to identify potential causal variation. Validation of the obtained variant was conducted by Sanger sequencing, encompassing all family members. Results Exome analysis uncovered a novel heterozygous missense variant (c.1482A>T; p.Gln494His) at the zinc finger DNA‐binding domain of the GLI3 protein within the proband and all affected family members. Remarkably, the variant was absent in unaffected individuals within the pedigree, underscoring its association with the polydactyly phenotype. Computational analyses revealed that GLI3 p.Gln494His impacts a residue that is highly conserved across species. Conclusion The GLI3 zinc finger DNA‐binding region is an essential part of the Sonic hedgehog signaling pathway, orchestrating crucial aspects of embryonic development through the regulation of target gene expression. This novel finding not only contributes valuable insights into the molecular pathways governing polydactyly during embryonic development but also has the potential to enhance diagnostic and screening capabilities for this condition in clinical settings.

Abstract The development of in vitro transcribed mRNA (IVT mRNA)‐based therapeutics/vaccines depends on the management of IVT mRNA immunogenicity. IVT mRNA, which is used for intracellular protein translation, often triggers unwanted immune responses, interfering with protein expression and leading to reduced therapeutic efficacy. Currently, the predominant approach for mitigating immune responses involves the incorporation of costly chemically modified nucleotides like pseudouridine (Ψ) or N1‐methylpseudouridine (m1Ψ) into IVT mRNA, raising concerns about expense and the potential misincorporation of amino acids into chemically modified codon sequences. Here, an Additional Chimeric Element incorporated mRNA (ACE mRNA), a novel approach incorporating two segments within a single IVT mRNA structure, is introduced. The first segment retains conventional IVT mRNA components prepared with unmodified nucleotides, while the second, comprised of RNA/DNA chimeric elements, aims to modulate immunogenicity. Notably, ACE mRNA demonstrates a noteworthy reduction in immunogenicity of unmodified IVT mRNA, concurrently demonstrating enhanced protein expression efficiency. The reduced immune responses are based on the ability of RNA/DNA chimeric elements to restrict retinoic acid‐inducible gene I (RIG‐I) and stimulator of interferon genes (STING)‐mediated immune activation. The developed ACE mRNA shows great potential in modulating the immunogenicity of IVT mRNA without the need for chemically modified nucleotides, thereby advancing the safety and efficacy of mRNA‐based therapeutics/vaccines.

Abstract The industrial potential of Saccharomyces cerevisiae has extended beyond its traditional use in fermentation to various applications, including recombinant protein production. Herein, comparative genomics was performed with three industrial S. cerevisiae strains and revealed a heterozygous diploid genome for the 98‐5 and KSD‐YC strains (exploited for rice wine fermentation) and a haploid genome for strain Y2805 (used for recombinant protein production). Phylogenomic analysis indicated that Y2805 was closely associated with the reference strain S288C, whereas KSD‐YC and 98‐5 were grouped with Asian and European wine strains, respectively. Particularly, a single nucleotide polymorphism (SNP) in FDC1, involved in the biosynthesis of 4‐vinylguaiacol (4‐VG, a phenolic compound with a clove‐like aroma), was found in KSD‐YC, consistent with its lack of 4‐VG production. Phenotype microarray (PM) analysis showed that KSD‐YC and 98‐5 displayed broader substrate utilization than S288C and Y2805. The SNPs detected by genome comparison were mapped to the genes responsible for the observed phenotypic differences. In addition, detailed information on the structural organization of Y2805 selection markers was validated by Sanger sequencing. Integrated genomics and PM analysis elucidated the evolutionary history and genetic diversity of industrial S. cerevisiae strains, providing a platform to improve fermentation processes and genetic manipulation.

Abstract Background Although nurses are expected to address the social determinants of health (SDH) in clinical settings, the perspectives of front‐line nurses on the integration of SDH into their clinical practice remain unclear. Understanding the dynamism of this integration and its outcomes can yield crucial insights into effective nursing care. This study aims to elucidate the integration and adoption of tool‐based SDH assessment nursing programs and their impacts on daily nursing care. Methods We conducted qualitative research at a small community‐based hospital in Japan, where a tool‐based program characterized by social background interviews and documentation was implemented. Nurses at the hospital were recruited via purposive and snowball sampling. After hypothesis generation, semi‐constructed in‐depth online interviews were conducted. Each interview lasted between 30 and 50 min. The data were analyzed via thematic analysis using the framework approach. Results A total of 16 nurses participated. Participants' incorporation of the novel SDH assessment program was bolstered by prior learning and their recognition of its practical value. Institutional support and collaborative teamwork further facilitated the adoption of this innovation. Enhanced knowledge about the social contexts of their patients contributed to increased respect, empathy, and self‐affirmation among participants, consequently enhancing the quality of nursing care. Conclusion Through team‐based learning, reflection, and support, nurses can integrate a tool‐based SDH assessment program into their daily nursing practice. This program has the potential to empower nurses to deliver more holistic care and redefine their professional identity. Further research is warranted to assess patient‐reported outcomes.

Abstract This paper investigates intelligent reconfigurable surface‐assisted non‐orthogonal multiple access (NOMA) networks for short packet communications where the source with multiple antennas utilizes beamforming technology to serve two end users including a near user and a far user. The analysis system, closed‐form expressions of the average block error rates (BLERs), latency and reliability at all users are derived under assuming perfect channel state information over quasi‐static Rayleigh fading channels. For evaluating the improvement of the network system, a deep neural network (DNN) framework is designed to predict the performance parameters in two cases: (i) BLERs prediction of the users, (ii) transmit power allocation under the constraints of BLERs at each user which satisfy the extremely high reliability requirements of uRLLCs. The extensive results demonstrate that first, the DNN‐based estimation results are more accurate than Monte‐Carlo simulation results with low execution time. Second, the allocated power for each user can be accurately predicted at the high layers. Finally, two methods of evaluating the effectiveness of the DNN model, i.e. root mean square error and mean absolute percentage error, reach low error which verify the power of the designed DNN model for future analysis.

Objective Lung disease (LD) is an increasingly recognized complication of systemic juvenile idiopathic arthritis (sJIA). As there are no currently available guidelines for pulmonary screening in sJIA, we sought to develop such an algorithm at our institution. Methods A multidisciplinary workgroup was convened, including members representing rheumatology, pulmonary, stem cell transplantation, and patient families. The workgroup leaders drafted an initial algorithm based on published literature and experience at our center. A modified Delphi approach was used to achieve agreement through three rounds of anonymous, asynchronous voting and a consensus meeting. Statements approved by the workgroup were rated as appropriate with moderate or high levels of consensus. These statements were organized into the final approved screening algorithm for LD in sJIA. Results The workgroup ultimately rated 20 statements as appropriate with a moderate or high level of consensus. The approved algorithm recommends pulmonary screening for newly diagnosed patients with sJIA with clinical features that the workgroup agreed may confer increased risk for LD. These “red flag features” include baseline characteristics (young age of sJIA onset, human leukocyte antigen type, trisomy 21), high disease activity (macrophage activation syndrome [MAS], sJIA‐related ICU admission, elevated MAS biomarkers), respiratory symptoms or abnormal pulmonary examination findings, and features of drug hypersensitivity‐like reactions (eosinophilia, atypical rash, anaphylaxis). The workgroup achieved consensus on the recommended pulmonary work‐up and monitoring guidelines. Conclusion We developed a pulmonary screening algorithm for sJIA‐LD through a multidisciplinary consensus‐building process, which will be revised as our understanding of sJIA‐LD continues to evolve.

Abstract Background Unhealthy body composition, including high fat mass, low muscle mass and low bone mass, is a critical health issue in adults. The weight‐adjusted waist index (WWI) estimates fat and muscle mass and may have implications for bone health. We examined its association with body composition outcomes in a large Korean adult cohort. Methods This study used data from the Korean National Health and Nutrition Examination Survey (2008–2011). WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). Dual‐energy X‐ray absorptiometry was used to measure bone mineral density (BMD), appendicular lean mass (ALM) and total body fat percentage. Unhealthy body composition was defined as combined presence of high fat mass, low bone mass and low muscle mass. Results A total of 5983 individuals (3034 men [50.7%] and 2949 women [49.3%]; mean age: 63.5 ± 8.7 years) were included. WWI was positively correlated with total body fat percentage (r = 0.478, P

Abstract Objective To identify the risk factors for failure of first‐line poly (ADP‐ribose) polymerase inhibitor (PARPi) maintenance therapy in patients with advanced ovarian cancer. Method Patients with stage III‐IV epithelial ovarian cancer who received first‐line PARPi maintenance therapy were retrospectively reviewed. Clinicopathologic factors were compared between two groups—recur/progression of disease (PD) and non‐recur/PD. Results In total, 191 patients were included. Median follow‐up was 9.9 months, and recurrence rate was 20.9%. BRCA mutations were found in 63.4% patients. Postoperative residual tumor (60.5% vs. 37.8%), non‐high grade serous carcinoma (HGSC) (15.0% vs. 6.0%), neoadjuvant chemotherapy (NAC) (55.0% vs. 35.8%), and pre‐PARPi serum CA‐125 levels ≥23.5 U/mL (35.9% vs. 15.2%) were more frequently observed in the recur/PD group. Multivariate Cox‐regression analysis revealed pre‐PARPi serum CA‐125 levels ≥23.5 U/mL (HR, 2.17; 95%CI, 1.03–4.57; p = 0.042), non‐HGSC (3.28; 1.20–8.97; p = 0.021), NAC (2.11; 1.04–4.26; p = 0.037), and no BRCA mutation (2.23; 1.12–4.44; p = 0.023) as independent risk factors associated with poor progression‐free survival (PFS). A subgroup analysis according to BRCA mutation status showed that pre‐PARPi serum CA‐125 levels ≥26.4 U/mL were the only independent risk factor for poor PFS in women with BRCA mutations (2.75; 1.03–7.39; p = 0.044). Non‐HGSC (5.05; 1.80–14.18; p = 0.002) and NAC (3.36; 1.25–9.04; p = 0.016) were independent risk factors in women without BRCA mutations. Conclusion High pre‐PARPi serum CA‐125 levels, non‐HGSC histology, NAC, and no BRCA mutation might be risk factors for early failure of first‐line PARPi maintenance therapy. In women with BRCA mutations, high pre‐PARPi serum CA‐125 levels, which represent a large tumor burden before PARPi, were the only independent risk factor for poor PFS.