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Purpose The aim of this study was to examine whether gonadotropin-releasing hormone (GnRH) agonist treatment is effective in preserving final height in patients with central precocious puberty (CPP) or early puberty (EP). Methods The medical records of 40 patients with CPP and 206 patients with EP who completed GnRH agonist treatment following diagnosis were analyzed retrospectively. Height and height standard deviation (height SDS) scores based on bone age (BA) were measured and calculated at baseline, after treatment completion, and at final follow-up to compare changes within and between groups. Predicted adult height (PAH) was estimated by the height corresponding to height SDS for BA in girls at 18 years 11 months of age based on the growth chart. Results PAH at baseline did not differ significantly between the CPP group (153.67±4.95) and the EP group (154.77±3.72). In the CPP group, PAH significantly increased at treatment completion (156.01±4.61) and at final follow-up (158.52±6.04) compared to baseline. In the EP group, PAH significantly increased at treatment completion (157.7±3.60) and at final follow-up (159.31±4.26) compared to baseline. The increase in PAH at all timepoints compared to baseline did not significantly differ between the CPP and EP groups. Conclusions Both CPP and EP groups had significantly greater PAH after treatment, with no difference in the amount of increase between groups. These results show that GnRH agonist treatment can help increase final height even in patients diagnosed with EP after the age of 8 years.

PURPOSE Although the prevalence of periodontal disease in adults over the age of 50 is rapidly increasing, the association between serum lipid levels and periodontal disease in Korean adults over the age of 50 still remains to investigate. Thus, the aim was to determine the effect of serum lipid levels on periodontal disease in older adults over the age of 50 using data from the seventh Korea National Health and Nutrition Examination Survey. METHODS The study used the data of 809 adults aged ≥50 years targeted in the 7th Korea National Health and Nutrition Examination Survey, 2016–2018. Levels of total cholesterol, triglyceride, high density- lipoprotein (HDL-cholesterol), and low density-lipoprotein (LDL-cholesterol) and periodontal conditions were measured. Complex-sample chi square test and linear regression were used to analyze the relationship serum lipid levels with periodontal disease. RESULTS The results of chi square tests showed that the prevalence of periodontal disease among the elderly ≥50 years were statistically significant differences according to gender, age, education level, marital status, and smoking status. After adjusting for all confounding factors, HDL-cholesterol alleviated periodontal disease, while LDL-cholesterol exacerbates periodontal disease. However, total cholesterol and triglycerides were not connected with periodontal disease. CONCLUSIONS Therefore, controlling HDL and LDL cholesterol levels through physical exercise could be a preventative measure for periodontal disease.

New BVR photometric and high-resolution spectroscopic observations of V505 Lac are presented with Transiting Exoplanet Survey Satellite (TESS) photometric data. The orbital period has experienced a secular decrease during the past 16 yr. A clear anticorrelation in the primary and secondary eclipse timing variation (PSETV) obtained from the TESS data is also identified. A double-lined radial velocity (RV) curve is secured, and the effective temperatures of the less- and more-massive stars (Stars 1 and 2, respectively) are measured. Using a spectral subtraction technique, excess emissions are detected in the time-series Ca ii H and K and H α lines for Star 2. Simultaneous analysis of the light and RV curves using the Wilson–Devinney (WD) code reveals that V505 Lac is a photospherically and chromospherically active W-subtype contact binary system. The component-star masses and radii are determined to an accuracy of approximately 1%. The WD spot model is individually applied to 221 light curves segmented from the TESS data so as to derive the spot parameters of a cool spot on Star 2. The combined variations in both longitude and colatitude among the spot parameters appear to be strongly associated with those of both the anticorrelation in the PSETV and the O’Connell effect in the TESS light curves. Robust negative linear relationships between the PSETV anticorrelation size and the O’Connell effect magnitude are found for the first time. Mass–radius, mass–luminosity, and mass ratio–mass diagrams of contact binaries, along with the mass ratio frequency distribution, are presented in an attempt to elucidate the evolutionary characteristics of these systems.

Fluorosilicone rubber, essential in automotive and aerospace owing to its excellent chemical resistance, plays a pivotal role in sealing technology, addressing the industry’s evolving demands. This study explores the preparation and properties of fibrillated cellulose-reinforced fluorosilicone rubber composites to enhance their stiffness and oil resistance. Fibrillated cellulose sourced as a wet cake and subjected to processing and modification is incorporated into a fluorosilicone rubber matrix. The resulting composites are analysed by tensile and compression tests, along with compressive stress-relaxation testing in air and in an oil-immersed environment. The findings demonstrate significant improvements in the mechanical properties, including an increased Young’s modulus and elongation at break, whereas the tensile strength remained uncompromised throughout the testing procedures. Morphological analysis of the fracture surfaces revealed a remarkable interfacial affinity between the fibrillated cellulose and rubber matrix, which was attributed in part to the modified fatty acids and inorganic nanoparticles. The presence of fibrillated cellulose enhanced the stress-relaxation characteristics under oil-immersion conditions. These results contribute to the domain of advanced elastomer materials, with potential for applications requiring enhanced mechanical properties and superior oil resistance.

Abstract Background Respiratory infections among children, particularly community-acquired pneumonia (CAP), is a major disease with a high frequency among outpatient and inpatient visits. The causes of CAP vary depending on individual susceptibility, the epidemiological characteristics of the community, and the season. We performed this study to establish a nationwide surveillance network system and identify the causative agents for CAP and antibiotic resistance in Korean children with CAP. Methods The monitoring network was composed of 28 secondary and tertiary medical institutions. Upper and lower respiratory samples were assayed using a culture or polymerase chain reaction (PCR) from August 2018 to May 2020. Results A total of 1023 cases were registered in patients with CAP, and PCR of atypical pneumonia pathogens revealed 422 cases of M. pneumoniae (41.3%). Respiratory viruses showed a positivity rate of 65.7% by multiplex PCR test, and human rhinovirus was the most common virus, with 312 cases (30.5%). Two hundred sixty four cases (25.8%) were isolated by culture, including 131 cases of S. aureus (12.8%), 92 cases of S. pneumoniae (9%), and 20 cases of H. influenzae (2%). The cultured, isolated bacteria may be colonized pathogen. The proportion of co-detection was 49.2%. The rate of antibiotic resistance showed similar results as previous reports. Conclusions This study will identify the pathogens that cause respiratory infections and analyze the current status of antibiotic resistance to provide scientific evidence for management policies of domestic respiratory infections. Additionally, in preparation for new epidemics, including COVID-19, monitoring respiratory infections in children and adolescents has become more important, and research on this topic should be continuously conducted in the future.

Abstract In vivo presentation of airway hyper-responsiveness (AHR) at the different time points of the allergic reaction is not clearly understood. The purpose of this study was to investigate how AHR manifests in the airway and the lung parenchyma in vivo following exposure to different stimuli and in the early and late phases of asthma after allergen exposure. Ovalbumin (OVA)-induced allergic asthma model was established using 6-week female BALB/c mice. Enhanced pause was measured with a non-invasive method to assess AHR. The dynamic changes of the airway and lung parenchyma were evaluated with ultra-high-resolution computed tomography (128 multi-detector, 1024 × 1024 matrix) for 10 h. While the methacholine challenge showed no grossly visible changes in the proximal airway and lung parenchyma despite provoking AHR, the OVA challenge induced significant immediate changes manifesting as peribronchial ground glass opacities, consolidations, air-trapping, and paradoxical proximal airway dilatations. After resolution of immediate response, multiple episodes of AHRs occurred with paradoxical proximal airway dilatation and peripheral air-trapping in late phase over a prolonged time period in vivo. Understanding of airflow limitation based on the structural changes of asthmatic airway would be helpful to make an appropriate drug delivery strategy for the treatment of asthma.

Introduction Globally, pneumococcal disease represents a significant burden. South Korea implemented the 7-valent pneumococcal conjugate vaccine (PCV7) in 2003, replaced with the 10-valent (PCV10) and 13-valent (PCV13) vaccine in 2010. In 2014, both vaccines were introduced in the national immunization program (NIP) for infants with 3 primary doses and one booster dose We performed a cost-effectiveness evaluation to elucidate which vaccine may be expected to provide greater impact if included in a NIP. Methodology Using an established model, we estimated the impact of introducing either PCV13 or PCV10 into the South Korean NIP in 2015. Vaccine impact was based on historic observed impact of PCV13 from 2010 to 2015 in Korea given high uptake of PCV13, and PCV10 impact was estimated based on experiences in countries using PCV10. Incidence and costs for all ages and including invasive pneumococcal disease, pneumonia, and acute otitis media were derived from the literature and Health Insurance Review and Assessment database. Results In the base-case, over 5-years PCV13 was estimated to avert 550,000 more cases of pneumococcal disease compared to PCV10, driven by broader serotype coverage and less replacement due to serotypes 3 and 19A. This translated to a cost-savings of $47.4 million USD despite PCV13’s higher cost. Sensitivity analysis found incremental cost-effectiveness ratios (ICERs) ranged from cost-saving to $7,300 USD per quality-adjusted life year (QALY). Conclusion A NIP using PCV13 was estimated to have a more substantial public health impact and be cost-saving compared to a program with PCV10 due to broader serotype coverage.

Purpose Foot reflexology has become popular for sustainable health management because it is free from side effects, easy to learn and perform. The purpose of this study was to investigate the effects of foot reflexology on the physical symptoms of cancer patients. Methods The systematic review and meta-analysis was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Data were pooled using fixed− or random-effects models. Pain, sleep, fatigue, and nausea and vomiting were analyzed for the main effects. Eighteen studies were included, representing 931 participants. Results Foot reflexology was effective in alleviating pain (d=−1.05; 95% CI: −1.52, −0.59), promoting sleep (d=1.15; 95% CI: 0.45, 1.85), and relieving fatigue (d=−1.46; 95% CI: −1.79, −1.14), but it was not significantly effective in reducing nausea and vomiting (d=−0.53; 95% CI: −1.29, 0.22). Conclusions Based on these findings, there is clear evidence that foot reflexology has significant positive effects on the physical symptoms of cancer patients. Further study is needed, however, to perform subgroup analysis using the frequency of sessions as predictors.

Purpose Trauma is the leading cause of death and disability in children. We aimed to compare the clinical characteristics of children with trauma and disease. Methods We reviewed the medical records of children (< 19 years) who visited the emergency department of Pusan National University Hospital from 2016 through 2018. Data on the age, age group, sex, details of trauma or disease, severe trauma or disease (Korean Triage Acuity Scale 1-2), hospitalization rate (overall and intensive care unit [ICU]), hospital length of stay, in-hospital mortality, and the Injury Severity Score were compared between the children with trauma and those with disease. Results In a total of 10,205 children, 3,028 (29.7%) had trauma. The children with trauma were older than those with disease (median age, 78.5 months [interquartile range, 35.0-165.0] vs. 49.0 [16.0-120.0]; P < 0.001). Boys were more common in the former group than the latter (63.7% vs. 56.3%; P < 0.001). The most common injury mechanism was traffic accident (16.0%), followed by fall and foreign body. The overall hospitalization rate was higher in the children with disease (17.1% vs. 35.9%; P < 0.001). However, the children with trauma underwent more frequent ICU hospitalization, and showed higher in-hospital mortality rate and longer hospital length of stay than those with disease (all P < 0.001). The children with severe trauma showed higher median age, percentage of boys, in-hospital mortality, and ICU hospitalization rate, and longer hospital length of stay than those with severe disease (all P < 0.001). Conclusion Children with trauma tend to be older, and their condition may be more critical in severity than those with disease. This difference is more prominent in those with severe trauma or disease.

Background While aging causes muscle weakness, type 2 diabetes mellitus (T2DM) is also considered a high-risk factor for the induction of skeletal muscle weakness. Previous studies have reported increased collagen content in insulin-resistant skeletal muscles. Here, we studied the mechanical properties of aged skeletal muscle in patients with T2DM to investigate whether aged skeletal muscles with T2DM induce higher passive tension due to the abundance of extracellular matrix (ECM) inside or outside of the muscle fibers. Methods Samples from the gluteus maximus muscles of older adults with diabetes (T2DM) and non-diabetic (non-DM) older adults who underwent elective orthopedic surgery were collected. Permeabilized single muscle fibers from these samples were used to identify their mechanical properties. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was used to quantify titin and fiber type distributions in these samples. Results We confirmed a significant predominance of type I fiber ratio in both T2DM and non-DM aged muscles. While the average cross-sectional area and maximal active tension of the single fibers were smaller in the T2DM group than those in the non-DM group, the difference was not statistically significant. T2DM subjects showed significantly greater passive tension and lower titin-/ECM-based passive tension ratios than those in non-DM subjects, which indicated that more ECM but less titin contributed to the total passive tension. Conclusion Based on our findings, we concluded that T2DM may cause increased passive stiffness of single skeletal muscle fibers in older adults because of an excessive accumulation of ECM in and around single muscle fibers due to increased insulin resistance.

Purpose To investigate the effect of lifestyle changes on patterns of carbon monoxide (CO) exposure and the association between neurologic symptoms and outcomes in Korean children with CO intoxication. Methods We reviewed the medical records of patients (< 18 years) with CO intoxication who visited the emergency department of Pusan National University Hospital between February 2012 and January 2020. We collected clinical findings, including age and sex, transfer from other hospitals, source, time and duration of exposure, manifestations with neurologic symptoms (syncope, seizure, and altered mental status), intensive care unit hospitalization, hospital length of stay, implementation of hyperbaric oxygen therapy, and findings of neuroimaging. These variables were compared between children with and without neurologic symptoms. In addition, levels of carboxyhemoglobin and lactate were compared between patients with and without specific manifestations. Results The enrolled 47 patients’ median age was 10 years (interquartile range, 4.5-14.0). The most common source of exposure was fire (46.8%), followed by camping (23.4%). The most common times of exposure were night (44.7%) and winter (44.7%). The patients with neurologic symptoms (14 [29.8%]) showed longer duration of exposure and hospital length of stay (P < 0.001 and P = 0.007, respectively). Of the 14 patients, 2 were hospitalized to the intensive care unit without an in-hospital mortality. A significant association was found between dyspnea and lactate level (P = 0.049), also between syncope or presyncope and carboxy hemoglobin level (P = 0.017). Conclusion CO intoxication in Korean children is most often caused by fire and camping, and at night and in winter. There is a correlation between neurologic symptoms and duration of exposure to CO.

Abstract Background Although urinary angiotensinogen (AGT) and renin reflect intrarenal renin-angiotensin system activity and are enhanced in proteinuric chronic kidney disease, the clinical value of urinary AGT and renin levels during antiproteinuric treatment has yet to be determined. We investigated the clinical usefulness of initial urinary AGT or renin to determine the antiproteinuric effects of angiotensin receptor blockers (ARBs). Methods This multicenter, prospective, single-arm study included 205 patients with overt proteinuria (urinary protein/creatinine ratio [uPCR] ≥ 1 mg/mg) enrolled between April 2009 and December 2011. All patients were treated with valsartan. The urinary AGT/creatinine ratio (uAGT/Cr) was measured at the baseline and 24 weeks, and the renin/creatinine ratio (uR/Cr) was measured at the baseline. Fifty-six patients were followed-up for 5 years. Results The mean age was 47.6 years and 51.2% were male. The mean uPCR was 2.32 mg/mg and the mean eGFR was 63.2 mL/min/1.73m2. Natural logarithms (ln) (uAGT/Cr), ln(uR/Cr), and diabetes mellitus were associated with proteinuria decrement (decrease in uPCR ≥1 mg/mg). Ln(uAGT/Cr) was an independent predictor for proteinuria decrement (OR 1.372, 95% CI, 1.068–1.762, P = 0.013). Among the 56 patients followed-up for 5 years, Δln(uAGT/Cr) at 24 weeks was an independent predictor for uPCR

In modern smart factories, quality estimation is vital for maximum productivity. However, quality estimation by definition relies on an imbalanced dataset, as most smart factories are highly efficient. In this research, we propose a guided quality estimation system that can recognize faulty data among a highly imbalanced production dataset. We also propose a customized LSTM model that is trained to ensure high accuracy in the quality estimation system. This is achieved by our proposed batch-wise balanced training method. Moreover, traditional means of evaluation for this type of method are not suitable, again due to the highly imbalanced nature of the dataset. Thus, a proper evaluation metric is also discussed. The proposed customized LSTM model with custom batch-wise SMOTE + ENN achieved 99.9% accuracy with an f1 score of 95%. This new proposed method for the imbalanced smart factory quality estimation will improve drastically and give pathway to more improved quality. Finally, we discuss practical implementation for the edge server consisting of the proposed guided production estimation system and real-time visualization. Feasibility analysis of this virtual environment-based application of the proposed framework ensured low computational overhead and faster processing.

The rise in popularity of farmers markets in the United States reflects consumers’ negative response to more traditional food distribution systems. Farmers markets provide consumers with a more local and often more personal food purchasing experience. The purpose of this study was to examine consumer motivations to patronize farmers markets through the lens of social, spatial, and natural embeddedness. A qualitative approach was employed utilizing semi-structured, in-depth interviews. These interviews were conducted in person using a set of predetermined questions and revealed nine themes. The findings indicate that two types of consumer choices with different properties exist in farmers market patronage (e.g., the choice of a particular farmers market vs. the choice of a particular vendor at the market). Inconsistency occurs in consumer choice patterns (e.g., economic saving does not greatly affect the choice to shop at a particular farmers market but can determine whom to buy from once at the market), implying that situational dynamics play a critical role at the point of purchase. While this study supports the usefulness of embeddedness as a conceptual framework for understanding farmers’ market patronage, it demonstrates a distinction between motivation to patronize the market and shopping behaviors exhibited once there.

We present detailed analyses of updated eclipse timing diagrams for 32 contact binary merger candidates in the Galactic bulge. The photometric data was obtained from 2016 to 2021 using the Korea Microlensing Telescope Network with the 1.6 m telescopes located at three southern sites (CTIO, SAAO, and SSO). The times of minimum lights were determined by applying the binary-star model to full light curves created at half-year intervals from the observations. The orbital period variations of the binary systems were analyzed using the O − C diagrams from our new timings with the others published in the literature, which are based on the OGLE observations from 2001 to 2015. As results, the orbital periods and period-decreasing rates of 32 binary systems were located to be in the ranges of 0.370 to 1.238 days and from −3.0 to −13.1 × 10 ^−6 day yr ^−1 , respectively. Out of these stars, 24 systems show a combination effect of a parabola and a light travel time caused by a third body, and their outer orbital periods are in the range of 9.1–26.5 yr. We propose that all of our merger candidates need additional monitoring observations to study a luminous-red nova progenitor.

We present new BVRI light curves of UY UMa with no O’Connell effect and a flat bottom secondary eclipse. Light curve synthesis with the Wilson-Devinney code gives a new solution, which is quite different from the previous study: UY UMa is an A-subtype over-contact binary with a small mass ratio of q = 0.21, a high inclination of 81˚.4, a small temperature difference of ΔT = 18˚, a large fill-out factor of f = 0.61, and a third light of approximately 10% of the total systemic light. The absolute dimensions were newly determined. Seventeen new times of minimum light have been calculated from our observations. The period study indicates that the orbital period has intricately varied in a secular period increase in which two cyclical terms with periods of 12y.0 and 46y.3 are superposed. The secular period increase was interpreted to be due to a conservative mass transfer of 2.68 × 10^–8 M⊙/yr from the less massive to the more massive star. The cyclical components are discussed in terms of double-light time contributions from two additional bound stars. The statistical relations of Yang & Qian (2015) among the physical parameters of 45 deep, low mass ratio contact binaries were revisited by using the physical parameters of UY UMa and 25 Kepler contact binaries provided by Şenavci et al. (2016).

Background: Little information exists regarding the differences in the clinical and laboratory characteristics of Kikuchi-Fujimoto disease (KFD) according to age.Objective: To evaluate the clinical and laboratory characteristics of KFD according to age.Methods: The relevance of sex, age, clinical features, laboratory findings, courses, and follow-up results were retrospectively evaluated in patients diagnosed with KFD at Pusan National University Hospital between 2010 and 2020.Results: Eighty patients (46 children and 34 adults) with a mean age of 21.5 ± 11.8 years (range, 3–49 years) were included in the study. Those aged 10–19 years accounted for the largest number of patients (42.5%). Among children, the male sex ratio was higher, especially for patients aged ≤ 9 years. In adults, the female sex ratio was higher, especially for patients aged 20–29 years. Fever, tenderness in the lymph node, and skin rashes were more common in children, while myalgia and weight loss were more common in adults. In children, the recurrence rate was significantly higher among boys than among girls (15.8 vs. 0.0%, P = 0.001); lower platelet count and higher CRP levels were observed among boys than among girls. EBV and ANA positivity rates were higher in boys than in girls. In adults, the recurrence rate was significantly higher in women than in men (18.2 vs. 0.0%, P = 0.005). ANA positivity rates were higher in women than in men.Conclusion: The clinical features, laboratory findings, and recurrence of KFD may differ depending on age and sex. Clinicians should be aware of this.

Summary: Despite the worldwide effect of the coronavirus disease 2019 (COVID-19) pandemic, the underlying mechanisms of fatal viral pneumonia remain elusive. Here, we show that critical COVID-19 is associated with enhanced eosinophil-mediated inflammation when compared to non-critical cases. In addition, we confirm increased T helper (Th)2-biased adaptive immune responses, accompanying overt complement activation, in the critical group. Moreover, enhanced antibody responses and complement activation are associated with disease pathogenesis as evidenced by formation of immune complexes and membrane attack complexes in airways and vasculature of lung biopsies from six fatal cases, as well as by enhanced hallmark gene set signatures of Fcγ receptor (FcγR) signaling and complement activation in myeloid cells of respiratory specimens from critical COVID-19 patients. These results suggest that SARS-CoV-2 infection may drive specific innate immune responses, including eosinophil-mediated inflammation, and subsequent pulmonary pathogenesis via enhanced Th2-biased immune responses, which might be crucial drivers of critical disease in COVID-19 patients.

For the reliable applications of silver nanowires, AgNW, which is used as a conductive transparent film in electronic devices, the isothermal degradation behaviors of AgNW films with and without overcoating were investigated. Accelerated isothermal degradation was performed as a function of temperature, time, and atmosphere. Electrical resistance and optical transmittance were measured and correlated with the microstructural damages, such as formation of oxide particles and fragmentations of AgNW, which were quantitatively determined from the scanning electron micrographs. The overcoating retarded the formation of oxide particles and subsequent fragmentations as well as resulting degradation in electrical resistance without affecting the optical transmittance.

Abstract Background Chronic kidney disease (CKD) is strongly associated with cardiovascular disease and is a significant risk factor for increased morbidity and mortality. In contrast, GLP-1 receptor (GLP-1R) activation has been shown to confer both renal and cardiovascular protection, though its relationship with CKD and CKD with myocardial ischemia/reperfusion (MI/R) remains poorly understood. Here, we investigated changes in renal and myocardial GLP-1R expression in the CKD rat model with MI/R. Methods Male Sprague Dawley rats with 5/6 nephrectomy were used as a rat model of CKD and CKD with MI/R. For myocardial ischemia, the left coronary artery was ligated and released for 30 min 1 week after 5/6 nephrectomy. Dipeptidyl-peptidase 4 (DPP-4) inhibitors were administered orally with linagliptin once daily for 8 weeks. Renal cortical and myocardial GLP-1R expression were measured via immunohistochemistry and western blot analysis. Results DPP-4 activity was increased in CKD. Western blot density of GLP-1R in renal cortex extracts revealed increased abundance 2 weeks after 5/6 nephrectomy, followed by a decrease at 8 weeks. In contrast, CKD and CKD with MI/R rats showed decreases in renal and cardiac expression of GLP-1R; these effects were attenuated in rats treated with linagliptin. Conclusions In CKD with MI/R, linagliptin attenuated renal injury and increased renal and myocardial GLP-1R expression. These data suggest that activation of renal and myocardial GLP-1R expression may provide both cardio- and renoprotective effects.

Background: Although the prevalence of anaphylaxis is increasing worldwide, the large-scale studies in Asia evaluating anaphylaxis in all age groups are limited. We aimed to collect more precise and standardized data on anaphylaxis in Korea using the first multicenter web-based registry. Methods: Twenty-two departments from 16 hospitals participated from November 2016 to December 2018. A web-based case report form, designed by allergy specialists, was used to collect anaphylaxis data. Results: Within the 2-year period, 558 anaphylaxis cases were registered. The age of registered patients ranged from 2 months to 84 years, and 60% were aged

This outreach research project was designed to provide beneficial insight regarding Hmong-owned small businesses in Minnesota. Specifically, objectives of the study were to (a) investigate characteristics of successful Hmong-owned small businesses, (b) identify unique problems encountered by Hmong entrepreneurs and small business owners, and (c) develop recommendations for Extension educators and program developers. The theoretical framework for understanding Hmong-owned small businesses was built on three interactive components: opportunity structures, group characteristics, and ethnic strategies. In-depth interviews were conducted to collect the data. A snowball sampling method was used. A Hmong community organization located in the Twin Cities Area was used as a sampling frame. A total of three community leaders (one female and two males, age range 29 to 55) and seven business owners (five males and two females, age range 30 to 52) participated in the study. Eleven themes were identified from the data within the theoretical framework. Findings suggest that designing new programs or adapting existing programs to the Hmong community’s needs and interests could be an excellent opportunity for both urban and rural Extension units to ensure that Hmong migrators build a stable community with their own needed ethnic small businesses.

Purpose: The purpose of this descriptive survey study was to characterize the relationship between clinical decision-making and job satisfaction among pediatric nurses and to elucidate the mediating effects of the nurse-parent partnership on that relationship. Methods: The subjects of the study were 174 nurses who had worked in a pediatric ward in a university hospital, general hospital, or children's hospital. Data were collected from June 20, 2016 to August 10, 2016 and analysed using descriptive statistics, the t-test, analysis of variance, the Pearson correlation coefficient, and three-step mediated regression analysis in SPSS version 22.0 for Windows. Results: The nurse-parent partnership had significant effects on clinical decision-making and job satisfaction, with an explanatory power of 19% and 26%, respectively. The nurse-parent partnership had a partial mediating effect on the relationship between clinical decision-making and job satisfaction (Sobel test: Z=4.31, p

Historically, South Korean society has been deeply influenced by Confucianism, which has an emphasis on the traditional family structure. If a given family does not belong in the “traditional” norm, which is composed of husband, wife, and children, they are often discriminated against and ostracized. Despite the increasing number of nonmarital cohabiters in South Korea, research is still insufficient to understand the phenomenon. This study explores the prevalence of nonmarital cohabitation in South Korea, which is still met with discrimination. Online surveys and in-depth interviews were conducted with cohabiters to gain an understanding of the phenomenon and to explore their marriage and family values. The findings of this study indicate that cohabiters who chose cohabitation as an alternative to marriage had more progressive values. Findings from the study provide implications for practice and policy.

Current deep learning convolutional neural network (DCNN) -based hand gesture detectors with acute precision demand incredibly high-performance computing power. Although DCNN-based detectors are capable of accurate classification, the sheer computing power needed for this form of classification makes it very difficult to run with lower computational power in remote environments. Moreover, classical DCNN architectures have a fixed number of input dimensions, which forces preprocessing, thus making it impractical for real-world applications. In this research, a practical DCNN with an optimized architecture is proposed with DCNN filter/node pruning, and spatial pyramid pooling (SPP) is introduced in order to make the model input dimension-invariant. This compact SPP-DCNN module uses 65% fewer parameters than traditional classifiers and operates almost 3× faster than classical models. Moreover, the new improved proposed algorithm, which decodes gestures or sign language finger-spelling from videos, gave a benchmark highest accuracy with the fastest processing speed. This proposed method paves the way for various practical and applied hand gesture input-based human-computer interaction (HCI) applications.

New multiband BVRI light curves of NSVS 1461538 were obtained as a byproduct during the photometric observations of our program star PV Cas for three years from 2011 to 2013. The light curves indicate characteristics of a typical W-subtype W UMa eclipsing system, displaying a flat bottom at primary eclipse and the O’Connell effect, rather than those of an Algol/b Lyrae eclipsing variable classified by the northern sky variability survey (NSVS). A total of 35 times of minimum lights were determined from our observations (20 timings) and the SuperWASP measurements (15 ones). A period study with all the timings shows that the orbital period may vary in a sinusoidal manner with a period of about 5.6 yr and a small semiamplitude of about 0.008 day. The cyclical period variation can be interpreted as a light-time effect due to a tertiary body with a minimum mass of 0.71 M⊙. Simultaneous analysis of the multiband light curves using the 2003 version of the Wilson-Devinney binary model shows that NSVS 1461538 is a genuine W-subtype W UMa contact binary with the hotter primary component being less massive and the system shows a low mass ratio of q(mc/mh)=3.51, a high orbital inclination of 88.7°, a moderate fill-out factor of 30 %, and a temperature difference of ΔT=412 K. The O’Connell effect can be similarly explained by cool spots on either the hotter primary star or the cool secondary star. A small third-light corresponding to about 5 % and 2 % of the total systemic light in the B and V bandpasses, respectively, supports the third-body hypothesis proposed by the period study. Preliminary absolute dimensions of the system were derived and used to look into its evolutionary status with other W UMa binaries in the mass-radius and mass-luminosity diagrams. A possible evolution scenario of the system was also discussed in the context of the mass vs mass ratio diagram.

PurposeThis study investigated the prevalence and risk factors associated with vitamin D deficiency in children.MethodsWe analyzed the medical records of 330 patients from the age of 6 to 12, who visited the endocrinology clinic of the Department of Pediatrics at Pusan National University Hospital, from September, 2013 to May, 2014. According to their serum 25-hydroxyvitamin D (25(OH)D) levels, the patients were grouped into either the deficiency group (25(OH)D

This paper proposes a real-time chain and a novel embedded Markovian queueing model with variable bulk arrival (VBA) and variable bulk service (VBS) in order to establish and assure a theoretical foundation to design a blockchain-based real-time system with particular interest in Ethereum. Based on the proposed model, various performances are simulated in a numerical manner in order to validate the efficacy of the model by checking good agreements with the results against intuitive and typical expectations as a baseline. A demo of the proposed real-time chain is developed in this work by modifying the open source of Ethereum Geth 1.9.11. The work in this paper will provide both a theoretical foundation to design and optimize the performances of the proposed real-time chain, and ultimately address and resolve the performance bottleneck due to the conventional block-synchrony by employing an asynchrony by the real-time deadline to some extent.

Minnesota has become a “new destination” state for Latino migrants in the United States. What has made Latinos in Minnesota successful? In a narrower sense, what has provided them with a route out of poverty and an alternative to unemployment or discrimination in the labor market? Our purpose was to (a) compile characteristics associated with the Latino community and successful Latino-owned retail businesses in Minnesota, (b) identify unique problems encountered by Latino retail entrepreneurs, and (c) develop recommendations to overcome obstacles encountered. To meet our objectives, we employed two methods: a Delphi study with Latino community leaders and a case study with Latino retail entrepreneurs. Implications for Extension educators are discussed.

Tracheoinnominate artery fistula is a rare, fatal complication of tracheostomy, and prompt diagnosis and management are imperative. We report the case of tracheoinnominate artery fistula after tracheostomy in a 14-year-old boy with a history of severe periventricular leukomalacia, hydrocephalus, cerebral palsy, and epilepsy. The tracheoinnominate artery fistula was successfully treated with a stent graft insertion via the right common femoral artery. Endovascular repair of the tracheoinnominate artery fistula via stent grafting is a safe, effective, and minimally invasive treatment for patients in poor clinical conditions and is an alternative to traditional open surgical treatment.

BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia. Magnesium has been reported to be effective in reducing the incidence or prophylaxis of AF. Magnesium is also an essential constituent of many enzyme systems and plays a physiological role in coagulation regulation. The aim of the present study was to examine the effects of magnesium, whether magnesium infusion might decrease the incidence of AF and induce hypocoagulable state in patients with AF, who were undergoing mitral valve annuloplasty.MethodsThis prospective laboratory study was performed using blood from patients with AF undergoing mitral valve annuloplasty. The radial artery was punctured with a 20 gauge catheter and used for monitoring continuous arterial pressure and blood sampling. After anesthesia induction, 4 g of magnesium was mixed with 100 ml normal saline and infused for 5 minutes. Magnesium, calcium, activated clotting time (ACT) and thromboelastographic parameters were checked before and 60 minutes after the magnesium infusion. The electrocardiography changes after magnesium infusion were also checked before commencing cardiopulmonary bypass.ResultsAfter magnesium infusion, the serum level of magnesium increased significantly but serum calcium did not change significantly. ACT did not change significantly before or after magnesium infusion. The thromboelastographic parameters showed no significant changes before or after magnesium infusion. None of the patients converted to sinus rhythm from AF after the magnesium infusion.ConclusionsA magnesium infusion did not influence the course of AF and coagulation in patients during prebypass period with AF undergoing mitral valve annuloplasty.

Inflammation is thought to be partly responsible for metabolic syndrome (MetS). Recently, dietary inflammatory index (DII) was developed to calculate the overall inflammatory potential of a diet. The objective of this study was to investigate the association between DII and MetS, as well as MetS components, using nationally representative survey data. The study sample consisted of 9291 Korean adults (aged 19–65 years, 3682 men and 5609 women) who participated in the sixth (2013–2015) Korea National Health and Nutrition Examination Survey. DII values were calculated using 24-h dietary recall data. Multivariable-adjusted logistic regression analysis was performed to identify the association between DII and MetS by sex. In the multivariate logistic regression model, the top DII quartile (Q4), was positively associated with MetS prevalence in men (Q4 vs. Q1, OR = 1.40; 95% CI = 1.06–1.85; p for linear trend = 0.008) and in postmenopausal women (Q4 vs. Q1, OR = 1.67; 95% CI = 1.15–2.44; p for linear trend = 0.008). The top DII quartile was also positively associated with the prevalence of hyperglycemia in men and the prevalence of central obesity in postmenopausal women. Further studies using prospective cohorts are needed to identify the causal relationship between DII and MetS.

ObjectivesThis study was designed to evaluate the normal development of the nasal septum in Koreans using sagittal MRI for the valuable clinical information on septal procedures.MethodsTwo hundred eighty patients who had their whole nasal septum visualized in the midline sagittal view were selected among the 3,904 patients with brain MRI from January, 2004 to December, 2006 at Dankook University Hospital. The patients who had a history of nasal septal surgery or nasal trauma were excluded. Following parameters are calculated and analyzed: lengths of bony and cartilage dorsum and septal cartilage-nasal bone overlap, total septal area, septal cartilage area and, the proportion of the cartilage area to septal area and the maximal harvestable cartilage for grafting were calculated using the PAC™ program.ResultsAll the parameters were increased until adolescence. Thereafter, bony dorsal length, cartilage dorsal length, total dorsal length, total septal area and maximal harvestable cartilage for grafting have not changed significantly with age, while SC-NB overlap length, septal cartilage area, and proportion of the cartilage area to the total septal area were significantly decreased with age. The SC-NB overlap length was positively correlated with the septal cartilage area and the proportion of the cartilage area to the total septal area.ConclusionThe small septal cartilage area and its proportion to the total septal area were significantly correlated with a short overlap length of the septal cartilage under the nasal bone. Septal procedures should be carefully performed in the elderly due to the risk of incurring saddle nose.

Ethanol is worldwide favored beverage among the young adults, but heavy drinking cause many social problems and medical problems such as liver cirrhosis, central nervous system problem. These toxic effects are mainly caused by acetaldehyde, the metabolyte of ethanol. Usual dose of ethanol consumption can cause dehydration and mild metabolic acidosis, there is few experimental human data that explain about the association of blood ethanol and acetaldehyde level and aciduria. We investigated urine electrolyte and pH changes after moderate amount of ethanol ingestion in healthy young men for urine acidification change by ethanol and acetaldehyde level. Materials and Methods: 30 Healthy young male volunteers were enrolled with informed consent. They ingested 1.3 g/kg of ethanol in fasting state, and blood and urine samples were taken at before ingestion, 1, 3, 5, 7 hours after ethanol ingestion. Snack was supplied after 4 hours of alcohol intake, and 500 mL of free water was allowed. Urine pH was measured by pH meter and blood and urine electrolytes were measured by indirect method. Blood ethanol was measured by enzymatic method and acetaldehyde was measured by spectrophotometer assay. Results: 30 Volunteers were all males, age was 27.40±2.7 years old, body weight was 72.83±7.9 kg. Their usual limit of alcohol intake by history taking were 78.35±56.7 gram, and average amount of ingested ethanol was 98.63±10.7 gram. Blood ethanol concentrations were 0.131, 0.097, 0.098, 0.027% in 1 hr, 3 hrs, 5 hrs, 7 hrs after drinking respectively, and blood acetaldehyde concentrations were 1.480, 1.734, 1.221, 1.462% in 1 hr, 3 hrs, 5 hrs, 7 hrs after drinking respectively. Urine pH were 6.056 in before ethanol ingestion, and 5.724, 5.598 each of 3 hours and 7 hours after ethanol ingestion, respectively. Post-alcohol ingestion urine pH was significantly decreased (p=0.002). Urine sodium and chloride excretions were not changed after ethanol, but urinary potassium excretion was significantly decreased (61.09±25.3 to 40.16±11.9, p

A wireless network consists of a large number of nodes with limited resources. The large number of event data will be generated over a period of time in a wireless network. Also, faced with high resource demand variability and with misfit resource renting policies, the current practices is to overprovision for each game tens of owned data. In a wireless network, the agent node may become easily overloaded by the high demand from the players for updates. So, we propose a hybrid load balancing scheme for games in wireless networks which is based on allocating load on wireless mobile nodes proportionally to each of the agent's capacities. This proposed scheme is a combined dynamic provisioning algorithm based on greedy graph and user-oriented load balancing scheme for maintaining the performance and stability of distributed system in wireless networks. We address the key functions for our proposed scheme and simulate the efficiency of our proposed scheme using mathematical analyses. We then testify that the proposal has best performance compared with previous researches.

Abstract Mesenchymal stem cells (MSCs) possess immunomodulatory properties that have therapeutic potential for the treatment of inflammatory diseases. This study investigates the effects of direct MSC administration on asthmatic airways. Umbilical cord MSCs (ucMSCs) were intratracheally administered to six-week-old female BALB/c mice sensitized and challenged with ovalbumin; airway hyperresponsiveness (AHR), analyses of airway inflammatory cells, lung histology, flow cytometry, and quantitative real-time PCR were performed. Furthermore, ex vivo and in vitro experiments were performed to assess the effects of ucMSC on M2 activation. Intratracheally administered ucMSCs decreased degree of airway resistance and the number of inflammatory cells such as T helper 2 (Th2) cells, type 2 innate lymphoid cells (ILC2), and macrophages in the murine asthma model. Particularly, MHCII and CD86 expression diminished in dendritic cells and alveolar macrophages (AMs) following ucMSC treatment. SiglecF+CD11c+CD11b- AMs show a negative correlation with type II inflammatory cells including Th2 cells, ILC2, and eosinophils in asthmatic mice and were restored following intratracheal ucMSCs treatment. In addition, ucMSCs decreased the macrophage polarization to M2, particularly M2a. The expression levels of markers associated with M2 polarization and Th2 inflammation were also decreased. ucMSC reduced Il-12 and Tnfa expression as well as that of M2 markers such as Cd206 and Retnla ex vivo. Furthermore, the in vitro study using IL-4 treated macrophages confirmed that both direct and indirect MSC treatment significantly reduced the expression of Il-5 and Il-13. In conclusion, ucMSCs appear to suppress type II inflammation by regulating lung macrophages via soluble mediators.

Background/Aims We aimed to define an optimal target population and drug-specific biomarkers that may predict dipeptidyl peptidase (DPP)-4 inhibitor responses in non-alcoholic fatty liver disease (NAFLD). Methods An exploration study (study I) was performed using three different NAFLD models (basket study design; high-fat diet [HFD], methionine choline-deficient diet [MCD], and high-cholesterol Western diet [WD] models). RNA transcriptome analysis was performed on pre-studied liver tissues to identify biomarkers that could predict the response to DPP-4 inhibitors. In the validation study (study II), the HFD-induced NAFLD model was divided into high and low hepatic insulin-like growth factor binding protein 1 (Igfbp-1) groups based on the pre-study liver biopsy. Results DPP-4 inhibitor attenuated the NAFLD activity score and fibrosis stage in the HFD model but not in the WD and MCD models. The overall response rate was 19% across the modified basket NAFLD trial and 42%, 25%, and 0% in the HFD, WD, and MCD models. Hepatic Igfbp-1 expression was higher in the responder group than in the non-responder group in pre-study biopsy samples. In contrast, hepatic Igfbp-1 expression was lower in the responder group than in the non-responder group in the end-study biopsy samples. DPP-4 inhibitor response rates were 83% and 17% in the baseline hepatic high Igfbp-1 and low Igfbp-1 groups, respectively. Hepatic messenger RNA Igfbp-1 expression was positively correlated with serum IGFBP-1 levels. Conclusions The DPP-4 inhibitor response was higher in the HFD phenotype and pre-treatment levels of hepatic or serum IGFBP-1 were high.

Upon encountering allergens, CD4+ T cells differentiate into IL-4-producing Th2 cells in lymph nodes, which later transform into polyfunctional Th2 cells producing IL-5 and IL-13 in inflamed tissues. However, the precise mechanism underlying their polyfunctionality remains elusive. In this study, we elucidate the pivotal role of NRF2 in polyfunctional Th2 cells in murine models of allergic asthma and in human Th2 cells. We found that an increase in reactive oxygen species (ROS) in immune cells infiltrating the lungs is necessary for the development of eosinophilic asthma and polyfunctional Th2 cells in vivo. Deletion of the ROS sensor NRF2 specifically in T cells, but not in dendritic cells, significantly abolished eosinophilia and polyfunctional Th2 cells in the airway. Mechanistically, NRF2 intrinsic to T cells is essential for inducing optimal oxidative phosphorylation and glycolysis capacity, thereby driving Th2 cell polyfunctionality independently of IL-33, partially by inducing PPARγ. Treatment with an NRF2 inhibitor leads to a substantial decrease in polyfunctional Th2 cells and subsequent eosinophilia in mice and a reduction in the production of Th2 cytokines from peripheral blood mononuclear cells in asthmatic patients. These findings highlight the critical role of Nrf2 as a spatial and temporal metabolic hub that is essential for polyfunctional Th2 cells, suggesting potential therapeutic implications for allergic diseases. [ABSTRACT FROM AUTHOR]

Purpose: Patients' perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients. Methods: For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald's omega coefficient was used to examine the internal consistency of reliability. Results: In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald's omega coefficient was .90. Conclusion: The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary. [ABSTRACT FROM AUTHOR]