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Young-Guk Na,1 Jin-Ju Byeon,1 Miao Wang,1 Hyun Wook Huh,1 Gi-Ho Son,1,2 Sung-Hoon Jeon,1,3 Ki-Hyun Bang,1,2 Sung-Jin Kim,1 Hye-Jin Lee,1 Hong-Ki Lee,1 Cheong-Weon Cho1 1College of Pharmacy, Chungnam National University, Daejeon, Republic of Korea; 2Korea United Pharmaceutical Co. Ltd., Sejong, Republic of Korea; 3SamA Pharmaceutical Co. Ltd., Suwon, Republic of Korea Background: Ticagrelor (TCG) is used to inhibit platelet aggregation in patients with acute coronary syndrome, but its poor solubility and low bioavailability limit its in vivo efficacy. The purpose of this study was to manufacture an optimized TCG-loaded self-microemulsifying drug delivery system (SMEDDS) to enhance the oral bioavailability and antiplatelet activity of TCG. Materials and methods: Solubility and emulsification tests were conducted to determine the most suitable oils, surfactants, and cosurfactants. Scheffé’s mixture design was applied to optimize the percentage of each component applied in the SMEDDS formulation to achieve optimal physical characteristics, ie, high solubility of TCG in SMEDDS, small droplet size, low precipitation, and high transmittance. Results: The optimized TCG-loaded SMEDDS (TCG-SM) formulation composed of 10.0% Capmul MCM (oil), 53.8% Cremophor EL (surfactant), and 36.2% Transcutol P (cosurfactant) significantly improving the dissolution of TCG in various media compared with TCG in Brilinta® (commercial product). TCG-SM exhibited higher cellular uptake and permeability in Caco-2 cells than raw TCG suspension. In pharmacokinetic studies in rats, TCG-SM exhibited higher oral bioavailability with 5.7 and 6.4 times higher area under the concentration–time curve and maximum plasma concentration, respectively, than a raw TCG suspension. Antiplatelet activity studies exhibited that the TCG-SM formulation showed significantly improved inhibition of platelet aggregation compared with raw TCG at the same dose of TCG. And, a 10 mg/kg dose of raw TCG suspension and a 5 mg/kg dose of TCG-SM had a similar area under the inhibitory curve (907.0%±408.8% and 907.8%±200.5%·hours, respectively) for antiplatelet activity. Conclusion: These results suggest that the developed TCG-SM could be successfully used as an efficient method to achieve the enhanced antiplatelet activity and bioavailability of TCG. Keywords: ticagrelor, SMEDDS, optimization, bioavailability, platelet aggregation, antiplatelet activity

Remarkable consequences of maritime accident can be various, including structural damage, loss of life and marine pollution. During an accidental phenomenon, such as ship grounding, the amount of oil spillage indicates casualties’ extent of surrounding sea water. Effort to provide protection for sea environment against such event has been conducted actively by developing navigational instruments, and passively using structural development and assessment. The accidental grounding is, however, a very complicated process with high sensitivity to given factors during its occurrence. Variety in ship type, location, obstruction etc. affected by advance improvement in naval technology, invites sustainable analysis for structural crashworthiness and failure to produce evaluation data.

Double-pass Friction Stir Processing (FSP) was applied to fabricate an AZ31/CNT nano-composite for surface hardening of lightweight structural components. The effects of double-pass FSP as well as groove depth (i.e., volume fraction of CNT) on the CNT distribution, dynamically recrystallized grain size, and resulting microhardness were studied. Double-pass FSP was performed for the CNT-filled plate-type specimen with different groove depths of 2, 3, and 4 mm. By applying double-pass FSP, the average size of CNT clusters decreased, implying a more homogeneous distribution. Compared with the FSPed specimen without CNT, grain size was refined from 19 μm to 3 μm and microhardness increased from 52 Hv to 83 Hv (i.e., 71% increase).

The objective of this study was to evaluate the magnitude and contributory factors of socioeconomic differentials in mortality in a cohort of Korean male civil servants. A prospective observational study of male civil servants followed up for five years after baseline measurement. All civil service offices in Korea. The study was conducted on 759,665 Korean male public servants aged 30-64 at baseline examination in 1992. The grade of monthly salary of these participants divided into four groups, a proxy indicator of socioeconomic status (SES), was the main predictive variable. Mortality of the participants was followed up from 1992 to 1996. The causes of deaths were categorised into four groups according to the medical amenability: avoidable, partly avoidable, non-avoidable, and external causes of death. The risk of mortality associated with SES was estimated using the Cox proportional hazard model. Lowest SES group had significantly higher risk of mortality from most causes compared with the highest SES group in the order of external cause (relative risk (RR): 2.26), avoidable (RR: 1.65), all cause (RR: 1.59), and non-avoidable mortality (RR: 1.54). With the adjustment of known risk factors, significantly higher risks of mortality in lowest SES group were attenuated but persisted. Looking at the deaths from partly avoidable causes, significantly higher risks of mortality in the lowest SES group was observed from cerebrovascular disease but not from coronary heart disease. Socioeconomic differentials in non-avoidable as well as avoidable mortality, persisting even under the control of risk factors, suggest that mortality is influenced not only by the quality of health care and different distribution of risk factors but also by other aspects of SES that are yet unknown. [ABSTRACT FROM AUTHOR]

The remarkable influence of the global warming to Arctic environment opens a possibility to conduct a voyage from Asia to Europe through the Northern Sea Route (NSR). This option is considered as a decent solution to reduce fuel consumption and increase time efficiency in delivering cargo to the designated destination. However, this alternative comes with a challenge to keep safety of ship structures against an impact with obstacles which are possibly encountered at the Arctic. Solid ice can be considered as a serious threat to the double bottom of ship structures in impact phenomena, especially ship grounding. In this work, a series of grounding calculations are conducted to produce estimation of structural crashworthiness during interaction between double bottom and conical type ice. Material characteristics based on tensile testing of polar class material are applied to calculation and compared with non-polar steel.

Vibration analysis is a crucial process in ship design to guarantee crew’s comfortability and to save operating costs by predicting problematical resonance in advance. This study focuses on idealizing fluid mass in tanks by positioning point mass element and quad elements inside the tanks. Also, the added mass effect induced sea water surrounding a ship was included in the present study. The natural frequency obtained from free and forced ship vibration analysis were compared and assessed in the manner of ISO regulation. Finally, it was concluded that the quad element was more adequate to idealize fluid entities in tanks since it was difficult in arranging point mass elements at each grid points properly.

A robotic system for manipulating a flexible endoscope in surgery can provide enhanced accuracy and usability compared to manual operation. However, previous studies require large-scale, complex hardware systems to implement the rotational and translational motions of the soft endoscope cable. The conventional control of the endoscope by actuating the endoscope handle also leads to undesired slack between the endoscope tip and the handle, which becomes more problematic with long endoscopes such as a colonoscope. This study proposes a compact quad-roller friction mechanism that enables rotational and translational motions triggered not from the endoscope handle but at the endoscope tip. Controlling two pairs of tilted rollers achieves both types of motion within a small space. The proposed system also introduces an unsynchronized motion strategy between the handle and tip parts to minimize the robot's motion near the patient by employing the slack positively as a control index. Experiments indicate that the proposed system achieves accurate rotational and translational motions, and the unsynchronized control method reduces the total translational motion by up to 88% compared to the previous method.

Purpose: Although numerous studies have identified potential risk factors for ipsilateral lymphedema development in patients with breast cancer following axillary node dissection, the risk factors for lymphedema in patients undergoing sentinel node biopsy without axillary dissection remain unclear. In this study, we aimed to determine the real-world incidence and risk factors for lymphedema in such patients., Methods: We conducted a single-center, retrospective review of medical records of patients with breast cancer who underwent sentinel node biopsy alone. The development cohort (5,051 patients, January 2017-December 2020) was analyzed to identify predictors of lymphedema, and a predictive model was subsequently created. A validation cohort (1,627 patients, January 2014-December 2016) was used to validate the model., Results: In the development cohort, 49 patients (0.9%) developed lymphedema over a median follow-up of 56 months, with most cases occurring within the first three years post-operation. Multivariate analysis revealed that a body mass index (BMI) of 30 kg/m² or above, radiation therapy (RTx), chemotherapy, and more than three harvested lymph nodes significantly predicted lymphedema. The predictive model showed an area under the curve of 0.824 for systemic chemotherapy, with the number of harvested lymph nodes being the most significant factor. Patients were stratified into four risk groups, showing lymphedema incidences of 3.3% in the highest-risk group and 0.1% in the lowest-risk group. In the validation cohort, the incidences were 1.7% and 0.2% for the highest and lowest risk groups, respectively., Conclusion: The lymphedema prediction model identifies RTx, chemotherapy, BMI ≥ 30 kg/m², and more than three harvested lymph nodes as significant risk factors. Although the overall incidence is low, the risk is notably influenced by the extent of lymph node removal and systemic therapies. The model's high negative predictive value supports its application in designing tailored lymphedema surveillance programs for early intervention., Competing Interests: Han-Byoel Lee and Wonshik Han are members of the board of directors and have stock and ownership interests at DCGen Co., Ltd. Other authors declare no conflicts of interest., (© 2024 Korean Breast Cancer Society.)

The pursuit of sub-1-nm field-effect transistor (FET) channels within 3D semiconducting crystals faces challenges due to diminished gate electrostatics and increased charge carrier scattering. 2D semiconductors, exemplified by transition metal dichalcogenides, provide a promising alternative. However, the non-idealities, such as excess low-frequency noise (LFN) in 2D FETs, present substantial hurdles to their realization and commercialization. In this study, ideal LFN characteristics in monolayer MoS 2 FETs are attained by engineering the metal-2D semiconductor contact and the subgap density of states (DOS). By probing non-ideal contact resistance effects using CuS and Au electrodes, it is uncovered that excess contact noise in the high drain current (I D ) region can be substantially reduced by forming a van der Waals junction with CuS electrodes. Furthermore, thermal annealing effectively mitigates sulfur vacancy-induced subgap density of states (DOS), diminishing excess noise in the low I D region. Through meticulous optimization of metal-2D semiconductor contacts and subgap DOS, alignment of 1/f noise with the pure carrier number fluctuation model is achieved, ultimately achieving the sought-after ideal LFN behavior in monolayer MoS 2 FETs. This study underscores the necessity of refining excess noise, heralding improved performance and reliability of 2D electronic devices., (© 2024 The Authors. Advanced Science published by Wiley‐VCH GmbH.)

Preeclampsia is caused by placental hypoxia and systemic inflammation and is associated with reduced placental growth factor (PlGF) and endothelial nitric oxide synthase (eNOS) levels. The molecular signaling axes involved in this process may play a role in the pathogenesis of preeclampsia. Here, we found that hypoxic exposure increased hypoxia-inducible factor-1α (HIF-1α)/Twist1-mediated miR-214-3p biogenesis in trophoblasts, suppressing PlGF production and trophoblast invasion. TNF-α stimulation increased NF-κB-dependent miR-214-3p expression in endothelial cells, impairing eNOS expression and causing endothelial dysfunction. Synthetic miR-214-3p administration to pregnant mice decreased PlGF and eNOS expression, resulting in preeclampsia-like symptoms, including hypertension, proteinuria, and fetal growth restriction. Conversely, miR-214-3p deletion maintained the PlGF and eNOS levels in hypoxic pregnant mice, alleviating preeclampsia-like symptoms and signs. These findings provide new insights into the role of HIF-1/Twist1- and NF-κB-responsive miR-214-3p-dependent PlGF and eNOS downregulation in the pathogenesis of preeclampsia and establish miR-214-3p as a therapeutic or preventive target for preeclampsia and its complications., (© 2024. The Author(s).)

Background: Developing contrast-associated acute kidney injury (CA-AKI) following percutaneous coronary intervention (PCI) is closely related to patient-related risk factors as well as contrast administration. The diagnostic and prognostic roles of neutrophil gelatinase-associated lipocalin (NGAL) in CA-AKI following PCI are not well established., Methods: Consecutive patients undergoing PCI were enrolled prospectively. CA-AKI was defined as an increase in the serum creatinine level ≥0.3 mg/dL within 48 hours or ≥1.5 times the baseline within 7 days after PCI. Serum NGAL concentrations were determined immediately before and 6 hours after PCI. The participants were classified into four NGAL groups according to the pre- and post-PCI NGAL values at 75th percentile., Results: CA-AKI occurred in 38 (6.4%) of 590 patients. With chronic kidney disease status (hazard ratio [HR] 1.63, 95% confidence interval [CI]: 1.06-2.52), NGAL groups defined by the combination of pre- and 6 h post-PCI values were independently associated with the occurrence of CA-AKI (HR 1.69, 95% CI: 1.16-2.45). All-cause mortality for 29-month follow-ups was different among NGAL groups (log-rank p<0.001). Pre-PCI NGAL levels significantly correlated with baseline cardiac, inflammatory, and renal markers. Although post-PCI NGAL levels increased in patients with larger contrast administration, contrast media made a relatively limited contribution to the development of CA-AKI., Conclusion: In patients undergoing PCI, the combination of pre- and post-PCI NGAL values may be a useful adjunct to current risk-stratification of CA-AKI and long-term mortality. CA-AKI is likely caused by systemic reserve deficiency rather than contrast administration itself., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright: © 2024 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Benzoic acid (BA), a secondary metabolite released through root exudates, is considered to be the most common inhibitor that leads to plant autotoxicity, even at low concentrations in closed hydroponic systems. In this study, to mitigate BA-driven autotoxicity, the effects of O 3 and O 3 /H 2 O 2 oxidation treatment (O 3 concentration: 1, 2, 4, 8 mg L -1 , H 2 O 2 concentration: 4, 8 mg L -1 ) on waste nutrient solution (WNS) were investigated in terms of BA degradation, the rate of germination inhibition (GI), and the rate of root growth inhibition (RI). In the case of O 3 treatment, the BA degradation rate improved up to 14.1% as the O 3 concentration increased, while alleviation of GI was insignificant (94.6-100%), confirming that a single O 3 treatment was unsuitable for mitigating autotoxicity. On the other hand, O 3 /H 2 O 2 treatment increased BA degradation by up to 24.8%, thereby significantly reducing GI (up to 7.69%) and RI (up to 0.88%). Both the highest BA mineralization rate and phytotoxicity mitigation was observed at BA 125 (4-4) (BA mineralization: 16.7%, GI: 12.82%, RI: 11.69%) and BA 125 (1-8) (BA mineralization: 17.7%, GI: 7.69%, RI: 0.88%) at each H 2 O 2 concentration. In addition, the operating costs were evaluated by a chemical and electricity cost analysis at the different treatments. As a result, the operating costs of BA 125 (4-4) and BA 125 (1-8) were calculated to be 0.40 and 0.42 $ L -1 mg -1 of mineralized BA, respectively. After consideration of the mineralization rate, autotoxicity mitigation, and operating cost, BA 125 (1-8) was suggested for the optimal treatment condition and our findings would contribute to the alleviation of BA-driven autotoxicity., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Si-Kyung Cho reports financial support was provided by National Research Foundation of Korea (NRF)., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Evidence of the importance of early childhood development (ECD) has transformed child health monitoring and screening tools. Development of the Korean Developmental Screening Test for Infants and Children (K-DST) has expanded the applications of child health screening to a large number of infants and children in Korea and is contributing to the early detection of neurodevelopmental disorders and delivery of timely interventions. The previous screening tool (Korean Ages and Stages Questionnaire) raised some concerns, as its lack of consideration of the cultural background of the Korean population can lead to inaccurate or imprecise diagnoses. The K-DST, a tailored tool for Korean infants and children, is a simple and cost-efficient solution for child health monitoring and screening. This review focuses on the development and role of the K-DST in ensuring ECD. Here we review use of the K-DST for ECD screenings and discuss the best strategy for its use in other countries.

Background: The use of a cardioverter defibrillator for the primary prevention of sudden cardiac death is not recommended within 40 days after acute myocardial infarction (AMI). We investigated the predictors for early cardiac death among patients who were admitted for AMI and successfully discharged., Methods: Consecutive patients with AMI were enrolled in a multicenter prospective registry. Among 10,719 patients with AMI, 554 patients with in-hospital death and 62 patients with early non-cardiac death were excluded. Early cardiac death was defined as a cardiac death within 90 days after index AMI., Results: Early cardiac death after discharge occurred in 168/10,103 (1.7%) patients. A defibrillator was not implanted in all patients with early cardiac death. Killip class ≥3, chronic kidney disease stage ≥4, severe anemia, cardiopulmonary support usage, no dual antiplatelet therapy at discharge, and left ventricular ejection fraction (LVEF) ≤35% were independent predictors for early cardiac death. The incidence of early cardiac death according to the number of factors added to LVEF criteria in each patient was 3.03% for 0 factor, 8.11% for 1 factor, and 9.16% for ≥2 factors. Each model that sequentially added the factors in the presence of LVEF criteria showed a significant gradual increase in predictive accuracy and an improvement in reclassification capability. A model with all factors showed C-index 0.742 [95% CI 0.702-0.781], p < 0.001; IDI 0.024 [95% CI 0.015-0.033], p < 0.001; and NRI 0.644 [95% CI 0.492-0.795], p < 0.001., Conclusion: We identified six predictors for early cardiac death after discharge from AMI. These predictors would help to discriminate high-risk patients over current LVEF criteria and to provide an individualized therapeutic approach in the subacute stage of AMI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Choi, Lee, Kim, Kim, Hwang, Choo, Lim, Kim, Kim, Byeon, Oh, Jeon, Yoo, Park, Kim, Ahn, Ho Jeong, Hwang and Chang.)

An elevated heart rate at admission or discharge is known to be associated with poor cardiovascular outcomes in patients with acute myocardial infarction (AMI). The association between post-discharge average office-visit heart rate and cardiovascular outcomes in patients with AMI has rarely been studied. We analyzed data for 7840 patients from the COREA-AMI registry who had their heart rates measured at least three times after hospital discharge. The office-visit heart rates were averaged and categorized into four groups by quartiles (<68, 68-74, 74-80, and >80 beats per minute). The primary end point was a composite of cardiovascular death, myocardial infarction, and ischemic stroke. During a median of 5.7 years of follow-up, major adverse cardiovascular events (MACE) affected 1357 (17.3%) patients. An average heart rate higher than 80 bpm was associated with an increased incidence of MACE compared to the reference average heart rate of 68-74 bpm. When dichotomized into <74 or ≥74 bpm, a lower average heart rate was not associated with MACE in patients with LV systolic dysfunction, in contrast to those without LV systolic dysfunction. An elevated average heart rate at office visits after AMI was associated with an increased risk of cardiovascular outcomes. Heart rate monitoring at office visits after discharge provides an important predictor related to cardiovascular events.

This study aimed to investigate the effectiveness of a quantitative electroencephalography (qEEG) biomarker in predicting the response to pharmacological treatment in patients with anxiety disorder. A total of 86 patients were diagnosed with anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, and subsequently treated with antidepressants. After 8-12 weeks, the participants were divided into treatment-resistant (TRS) and treatment-response (TRP) groups based on their Clinical Global Impressions-Severity (CGI-S) scores. We obtained the absolute-EEG measurements for 19-channels and analyzed qEEG findings according to the frequency range: delta, theta, alpha, and beta. The beta-wave was subdivided into low-beta, beta, and high-beta waves. The theta-beta ratio (TBR) was calculated, and an analysis of covariance was performed. Of the 86 patients with anxiety disorder, 56 patients (65%) were classified in the TRS group. The TRS and TRP groups did not differ in terms of age, sex, or medication-dosage. However, the baseline CGI-S was higher in the TRP group. After calibration by covariates, the TRP group showed higher beta-waves in T3 and T4, and a lower TBR, especially in T3 and T4, than the TRS group. These results indicate that patients with a lower TBR and higher beta and high-beta waves in T3 and T4 are more likely to respond to medication., (© 2023. The Author(s).)

Background: We evaluated the effectiveness of extended dual antiplatelet therapy (DAPT) usage after 2nd-generation drug elution stent implantation in acute myocardial infarction (AMI) survivors with high ischemic risk characteristics who had no major bleeding for 24 months under at least 1 year of DAPT maintenance., Materials and Methods: The primary ischemic and bleeding endpoints were the risk of mortality and the risk of BARC 3 or 5 (major) bleeding. We investigated the event rates for 2-5 years after the index procedure., Results: Of 3382 post-AMI survivors who met the PEGASUS-TIMI 54 (PEGASUS) criteria and without major bleeding until 2 years, 2281 (67.4%) maintained DAPT over 24 months, and 1101 (32.5%) switched DAPT to a single antiplatelet agent. The >24 M DAPT group showed a lower risk of mortality than the 12-24 M DAPT group (7.2 vs. 9.2%; adjusted hazard ratio: 0.648; 95% confidence interval: 0.595-0.976; p < 0.001). The mortality risk was significantly greater as the number of PEGASUS criteria increased ( p < 0.001). DAPT > 24 months was not significantly associated with a decreased risk for major bleeding in the population meeting the PEGASUS criteria (2.0 vs. 1.1%; p = 0.093). The results were consistent after propensity-score matching and inverse probability weighting to adjust for baseline differences., Conclusion: Extended DAPT over 24 months was associated with a lower risk of mortality without increasing the risk of major bleeding among 2 years survivors after AMI who met the PEGASUS criteria and had no major bleeding events before 24 months., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lee, Hwang, Choo, Lim, Kim, Kim, Byeon, Choi, Oh, Choi, Yoo, Chung, Ahn, Jeong and Chang.)

Regulated in development and DNA damage response 1 (REDD1) expression is upregulated in response to metabolic imbalance and obesity. However, its role in obesity-associated complications is unclear. Here, we demonstrate that the REDD1-NF-κB axis is crucial for metabolic inflammation and dysregulation. Mice lacking Redd1 in the whole body or adipocytes exhibited restrained diet-induced obesity, inflammation, insulin resistance, and hepatic steatosis. Myeloid Redd1-deficient mice showed similar results, without restrained obesity and hepatic steatosis. Redd1-deficient adipose-derived stem cells lost their potential to differentiate into adipocytes; however, REDD1 overexpression stimulated preadipocyte differentiation and proinflammatory cytokine expression through atypical IKK-independent NF-κB activation by sequestering IκBα from the NF-κB/IκBα complex. REDD1 with mutated Lys 219/220 Ala, key amino acid residues for IκBα binding, could not stimulate NF-κB activation, adipogenesis, and inflammation in vitro and prevented obesity-related phenotypes in knock-in mice. The REDD1-atypical NF-κB activation axis is a therapeutic target for obesity, meta-inflammation, and metabolic complications., (© 2022. The Author(s).)

Neutrophil gelatinase-associated lipocalin (NGAL) has been proposed as an early marker for estimating the risk of contrast-induced acute kidney injury (CI-AKI). However, the predictive value of baseline serum NGAL levels for CI-AKI remains unclear. Serum NGAL was measured before percutaneous coronary intervention in 633 patients with coronary artery disease. The primary clinical endpoints were a composite of major adverse cardiac and cerebrovascular events (MACCEs; cardiac death, myocardial infarction, stroke, and any revascularization). The mean follow-up duration was 29.4 months. Ninety-eight (15.5%) patients developed CI-AKI. Compared with patients without CI-AKI, baseline serum NGAL was higher in patients with CI-AKI (149.6 ± 88.8 ng/mL vs. 138.0 ± 98.6 ng/mL, p = 0.0279), although serum creatinine and estimated glomerular filtration rate were not different between groups. Patients in the highest tertile of baseline serum NGAL showed a significantly higher rate of MACCEs (10.5% vs. 3.8%, p = 0.02). Using the first tertile as a reference, the adjusted hazard ratios for MACCEs in patients in the second and third tertiles of NGAL were 2.151 (confidence interval (CI) 0.82 to 5.59, p = 0.116) and 2.725 (CI 1.05 to 7.05, p = 0.039), respectively. Baseline serum NGAL is a reliable marker for predicting CI-AKI, and high serum NGAL levels are associated with a higher incidence rate of long term MACCEs.

Objective: Proper exercise immediately after breast cancer surgery (BCS) may prevent unnecessary physical and psychological decline resulting from the surgery; however, patients' attitude, barriers and facilitators for exercise during this period have not been studied. Hence, this study aims to explore the barriers and facilitators of exercise among patients with breast cancer through multiple interviews immediately after surgery through 4 weeks after BCS., Methods: We conducted three in-depth interviews of 33 patients with breast cancer within 1 month after BCS., Results: We identified 44 themes, 10 codes and 5 categories from interview results. Physical constraints and psychological resistance were identified as the barriers to exercise, while a sense of purpose and first-hand exercise experience were identified as the facilitators of exercise. By conducting the interviews over the course of 4 weeks after surgery, we monitored patterns of changes in barriers and facilitators over time. Overall, our analyses identified that professional intervention based on the time since surgery and the physical state after BCS is essential. The intervention would counteract the overwhelming psychological resistance in the early weeks by developing a sense of purpose in the later weeks., Conclusions: We made suggestions for future research and exercise intervention programmes that can benefit breast cancer survivors based on the categories, codes and themes identified in this study., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Diagnosis of anxiety has relied primarily on self-report. This study aimed to investigate the neural correlates of anxiety with quantitative electroencephalography (qEEG) focusing on the state and trait anxiety defined according to the Research Domain Criteria framework existing across the differential diagnosis, rather than focusing on the diagnosis., Methods: A total of 41 participants who visited a psychiatric clinic underwent resting state EEG and completed the State-Trait Anxiety Inventory. The absolute power of six frequency bands were analyzed: delta (1-4 Hz), theta (4-8 Hz), alpha (8-10 Hz), fast alpha (10-13.5 Hz), beta (13.5-30 Hz), and gamma (30-80 Hz)., Results: State anxiety scores were significantly negatively correlated with absolute gamma power in frontal (Fz, r=-0.484) and central (Cz, r=-0.523) regions, while trait anxiety scores were significantly negatively correlated with absolute gamma power in frontal (Fz, r= -0.523), central (Cz, r=-0.568), parietal (P7, r=-0.500; P8, r=-0.541), and occipital (O1, r=-0.510; O2, r=-0.480) regions., Conclusion: The present study identified the significantly negative correlations between the anxiety level and gamma band power in fronto-central and posterior regions assessed at resting status. Further studies to confirm our findings and identify the neural correlates of anxiety are needed.

We conducted an experiment to confirm the passability of chironomid larvae ( Glyptotendipes tokunagai ) in granular activated carbon (GAC) used in water treatment plants. After injecting larvae at different growth stages (first through fourth instars) into circular columns filled with GAC, the number of individuals and their locations within the GAC columns were recorded after 168 h. We found that more than 80% of the injected larvae in the first instar and 3.3% in the second instar passed, whereas none from the third and fourth instars had passed through the column. The second instar larvae were evenly distributed within the column, whereas the third and fourth instar larvae were mostly distributed within 10 cm of the upper layer of the GAC. Our results demonstrate the passability of chironomid larvae in GAC and can be used as basic information for water quality management in water treatment plants.

Percutaneous transluminal angioplasty (PTA) is considered an effective treatment in patients with critical limb ischemia (CLI). However, the long-term durability of below-the-knee (BTK) PTA is known to be limited. This study sought to compare the 1-year clinical outcomes following stenting versus balloon angioplasty alone in BTK lesions. This study included 357 consecutive patients (400 limbs, 697 lesions) with BTK lesions who underwent PTA from September 2010 to December 2016. All enrolled patients were treated either by stenting (stent group; 111 limbs of 102 patients) or plain old balloon angioplasty (POBA group; 289 limbs of 255 patients). Stent group includes both primary and provisional stenting. Angiographic outcomes, procedural success, complications, and clinical outcomes were compared between the two groups up to 1 year. After propensity score matching (PSM) analysis, 56 pairs were generated, and the baseline and angiographic characteristics were balanced. The procedural success and complications were similar between the two groups; however, the incidence of procedure-related perforation was higher in the POBA group than in the stenting group [5(11.9%) vs.1 (0.9%), P = 0.009]. Six- to 9-month computed tomography or angiographic follow-up showed similar incidences of binary restenosis, primary patency, and secondary patency. In the 1-year clinical follow-up, there were similar incidences of individual hard endpoints, including mortality, myocardial infarction, limb salvage, and amputation rate, with the exception of target extremity revascularization (TER), which tended to be higher in the stenting group than in the POBA group [21 (20.8%) vs. 11 (10.9%), P = 0.054]. Although there was a trend toward a higher incidence of TER risk in the stenting group, stent implantation, particularly in bail-out stenting seemed to have acceptable 1-year safety and efficacy compared to POBA alone in patients undergoing BTK PTA., Competing Interests: The authors have declared that no competing interests exist.

Recently, foldable electronics technology has become the focus of both academic and industrial research. The foldable device technology is distinct from flexible technology, as foldable devices have to withstand severe mechanical stresses such as those caused by an extremely small bending radius of 0.5 mm. To realize foldable devices, transparent conductors must exhibit outstanding mechanical resilience, for which they must be micrometer-thin, and the conducting material must be embedded into a substrate. Here, single-walled carbon nanotubes (CNTs)-polyimide (PI) composite film with a thickness of 7 µm is synthesized and used as a foldable transparent conductor in perovskite solar cells (PSCs). During the high-temperature curing of the CNTs-embedded PI conductor, the CNTs are stably and strongly p -doped using MoO x , resulting in enhanced conductivity and hole transportability. The ultrathin foldable transparent conductor exhibits a sheet resistance of 82 Ω sq. -1 and transmittance of 80% at 700 nm, with a maximum-power-point-tracking-output of 15.2% when made into a foldable solar cell. The foldable solar cells can withstand more than 10 000 folding cycles with a folding radius of 0.5 mm. Such mechanically resilient PSCs are unprecedented; further, they exhibit the best performance among the carbon-nanotube-transparent-electrode-based flexible solar cells., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Advanced Science published by Wiley‐VCH GmbH.)

This study investigated quantitative electroencephalography (QEEG) subtypes as auxiliary tools to assess Attention Deficit Hyperactivity Disorder (ADHD). A total of 74 subjects (58 male and 16 female) were assessed using the Korean version of the Diagnostic Interview Schedule for Children Version IV and were assigned to one of three groups: ADHD, ADHD-Not Otherwise specified (NOS), and Neurotypical (NT). We measured absolute and relative EEG power in 19 channels and conducted an auditory continuous performance test. We analyzed QEEG according to the frequency range: delta (1-4 Hz), theta (4-8 Hz), slow alpha (8-10 Hz), fast alpha (10-13.5 Hz), and beta (13.5-30 Hz). The subjects were then grouped by Ward's method of cluster analysis using the squared Euclidian distance to measure dissimilarities. We discovered four QEEG clusters, which were characterized by: (a) elevated delta power with less theta activity, (b) elevated slow alpha relative power, (c) elevated theta with deficiencies of alpha and beta relative power, and (d) elevated fast alpha and beta absolute power. The largest proportion of participants in clusters (a) and (c) were from the ADHD group (48% and 47%, respectively). Conversely, group (b) mostly consisted of the participants from the NOS group (59%), while group (d) had the largest proportion of participants from the NT group (62%). These results indicate that children with ADHD does not neurophysiologically constitute a homogenous group. We also identified a new subtype with increased alpha power in addition to those commonly reported in ADHD. Given the QEEG characteristics with increased alpha power, we should consider the possibility that this subtype may be caused by childhood depression. In conclusion, we believe that these QEEG subtypes of ADHD are expected to provide valuable information for accurately diagnosing ADHD., Competing Interests: The authors have declared that no competing interests exist.

Objective: Although exercise is beneficial in patients undergoing hematopoietic stem cell transplantation (HSCT), motivating patients to exercise is challenging. We aimed to understand exercise barriers and facilitators during HSCT treatment while participating in a daily unsupervised exercise programme., Participants: Patients scheduled to have HSCT., Study Design: 6 participants were included in this descriptive qualitative study during HSCT treatment while participating in an exercise programme to identify perceived barriers and facilitators of the exercise. An average of three semi-structured interviews were conducted per patient., Setting: Exercise during HSCT treatment in an isolated immune room., Intervention: Daily unsupervised exercise., Results: A total of six patients completed a 6-week exercise programme as well as all scheduled interviews, whose compliance to the exercise programme ranged from 12% to 79%. Based on interview results, three themes were identified as barriers to exercise and four themes were identified as facilitators to exercise. Patients experienced physical and psychological barriers such as nausea, vomiting, sore throat, reduced appetite, decreased willpower and anxiety due to feelings of isolation. Environmental factors included negative opinions about exercise programmes and lack of encouragement from the haematologist. Facilitators of exercise included willpower, easy and simple exercise, convincing explanations from haematologists and supervised support from exercise specialists., Conclusion: Our study has identified potential barriers and facilitators associated with exercise participation during HSCT. Supervised exercise recommended by a haematologist, convincing explanation on the benefit of exercise by medical personnel, positive feedback from other HSCT survivors and supervision by exercise specialists may increase compliance to the exercise programme during HSCT., Trial Registration Number: ISRCTN61498391., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The vascularization of three-dimensional (3D) tissue constructs is necessary for transporting nutrients and oxygen to the component cells. In this study, a vacuum forming method was applied to emboss a vascular pattern on an electrospun membrane so that guided vascular structures could develop within the construct. Two- or six-layer constructs of electrospun membranes seeded with endothelial cells and pericytes were stacked and subcutaneously implanted into mice. Blood vessel formation in the implanted constructs with six alternating layers of flat membranes and membranes embossed with a blood vessel pattern was observed after two weeks of implantation. The formation of blood vessels was observed along the embossed blood vessel pattern in the structure of the embossed membrane laminated at four weeks and eight weeks. Vascular endothelial growth factor (VEGF) and angiopoietin 1 (Ang-1) were highly expressed in the vascularized structures. Therefore, we demonstrated that a structure capable of producing a desired blood vessel shape with electrospun membranes embossed with a blood vessel pattern can be manufactured, and that a variety of structures can be manufactured using electrospun membranes in the tissue engineering era.