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Specimens of Scomberoides tala (Cuvier, 1832) were collected from southwestern Taiwan in the northwestern Pacific Ocean. While this species has been documented in other regions of the northwestern Pacific, our specimens mark its first recorded occurrence in Taiwan, bridging a previously identified distribution gap in this region. Additionally, we suggest that the distribution of this species may be shifting northward, potentially driven by global warming, as the northern records were reported rather recently. [ABSTRACT FROM AUTHOR]

A new species of beardfish, genus Polymixia, is described based on three specimens collected in Taiwanese waters and off the Chesterfield Islands of New Caledonia. It can be distinguished from its congeners by the following characters: dorsal-fin rays IV–V, 35–37; gill rakers on outer face of first gill arch 3+1+6=10; scales row between dorsal-fin origin and lateral line vertically 6–8 (S1) and posteriorly 12–14 (S2); pyloric caeca 40; snout rounded, with its surface rough and gelatinous, its tip evidently protrude anterior margin of premaxilla; ctenii on body scales arranged in a wedge-shape, forming three rows; 4th anal-fin spine long, 1.0%–1.2% eye diameter; longer dorsal-fin, 49.6–53.0% SL ; blackish oral-branchial cavity. Our maximum-likelihood tree based on mitochondrial COI sequences revealed that the new species is distinct from six congeneric species. Our findings indicate the presence of at least six Polymixia species in Taiwan, highlighting Taiwan and adjacent areas as a region with the highest diversity of this genus. [ABSTRACT FROM AUTHOR]

A new species of jawfish genus Opistognathus is described based on a specimen collected from a beach in the Peng-hu Islands during a cold snap. The new species, Opistognathus cryos sp. nov., differs from its congeners in having a rigid upper jaw, 10–11 + 1 + 19–22 = 31–33 gill rakers, 55 scale rows in lateral series, 10 + 16 = 26 vertebrae, the terminus of the lateral line at the base of the fourth segmented dorsal-fin ray (15th in total rays), the head, nape, dorsal-fin base above lateral line, throat, chest, and pectoral-fin base naked, dorsal fin with eight blotches along its entire base, body with five horizontal dark stripes, nape with two dark blotches in front of the dorsal-fin origin, and a caudal fin with five narrow, dark bands. A detailed description is provided and compared to its similar congeners. [ABSTRACT FROM AUTHOR]

The large-mouth pricklefish, Malacosarcus macrostoma (Günther, 1878), previously known from five specimens collected from the central Pacific Ocean, is redescribed based on three specimens collected from the abyssal zone (4,412–4,813 m) off the southeastern coast of Taiwan. These specimens contribute to a more comprehensive description of M. macrostoma and represent this species' westernmost and deepest record. This study provides a detailed description, fresh photographs, and notes on their morphological characteristics of the specimens. Lastly, the distributional records of M. macrostoma are discussed. [ABSTRACT FROM AUTHOR]

Emergence agitation (EA) after (adeno)tonsillectomy (AT) surgery impairs recovery in children. Adequate analgesia plays a crucial role in reducing EA incidence. This study investigated whether hydromorphone infusion (30 μg/kg) during anesthesia induction could reduce EA following AT surgery for obstructive sleep apnea in children.

With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.

Mastication plays an important role in effective food digestion and nutrient absorption. Therefore, regulating masticatory force in people with declining mastication function is significant for maintaining health and quality of life. In this study, we tested the effect of tactile augmentation on mastication force. To augment tactile feedback during mastication, we applied closed-loop electrical stimulation onto the mandibular vestibule using an intraoral tooth-borne electronic system. We hypothesized that closed-loop electrical stimulation, timed with mastication and applied to the nerves delivering tactile feedback to the brain, would evoke an increase in masticatory force. Experiments were completed using the intraoral system with six healthy human subjects who masticated soft and hard foods with and without stimulation during the experiment. Their mastication forces were recorded ten times per condition. The recorded mastication force profile showed that mastication force was higher with the harder food. Also, mastication force increased when electrical stimulation was applied, compared to the non-stimulated condition. These results support the hypothesis that tactile augmentation by intraoral closed-loop electrical stimulation will increase masticatory force. Other mastication parameters including period, spike width, and duty cycle are also changed by electrical stimulation. Further, stimulation left a strong aftereffect on these mastication parameters.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with

Background This study aimed to validate the Geriatric Trauma Outcome Score (GTOS) for predicting mortality associated with trauma in older Korean adults and compare the GTOS with the Trauma and Injury Severity Score (TRISS). Methods This study included patients aged ≥65 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022. We used receiver operating characteristic curves and calibration plots to assess the discrimination and calibration of the scoring systems. Results Among 3,053 patients, the median age was 77 years, and the mortality rate was 5.2%. The overall GTOS-predicted mortality and 1–TRISS were 5.4% (interquartile range [IQR], 3.7–9.5) and 4.7% (IQR, 4.7–4.7), respectively. The areas under the curves (AUCs) of 1–TRISS and GTOS for the total population were 0.763 (95% confidence interval [CI], 0.719–0.806) and 0.794 (95% CI, 0.755–0.833), respectively. In the Glasgow Coma Scale (GCS) ≤12 group, the in-hospital mortality rate was 27.5% (79 deaths). The GTOS-predicted mortality and 1–TRISS in this group were 18.6% (IQR, 7.5–34.7) and 26.9% (IQR, 11.9–73.1), respectively. The AUCs of 1–TRISS and GTOS for the total population were 0.800 (95% CI, 0.776–0.854) and 0.744 (95% CI, 0.685–0.804), respectively. Conclusion The GTOS and TRISS demonstrated comparable accuracy in predicting mortality, while the GTOS offered the advantage of simpler calculations. However, the GTOS tended to underestimate mortality in patients with GCS ≤12; thus, its application requires care in such cases.

Superconducting cyclotron can generate high-energy proton beams and are mainly used for radiation therapy of tumors and cancers. In the superconducting cyclotron SC200, the maximum magnetic induction intensity can typically reach up to 4.6 T, and the magnetic field accuracy is 1e-4. Hall probes are commonly used tools for measuring high-intensity magnetic fields.

Abstract Background Post-operative delirium (PD) is a common post-operative complication with significant clinical and financial impacts on patients. Erythropoietin (EPO), a multi-functional glycoprotein hormone, exhibits erythropoietic and non-erythropoietic anti-inflammatory properties. This study aimed to determine the role of perioperative EPO administration in the development of postoperative delirium in older adult patients undergoing total joint arthroplasty. Methods Seventy-one patients (> 65 years old) scheduled for total joint arthroplasty were randomly assigned to two groups: EPO-treated (EPO, n = 35) and placebo (control, n = 36). All patients completed the Mini Mental State Examination (MMSE) pre-operatively and on post-operative day (POD) 2. The confusion assessment method (CAM) was used to assess the patients until discharge (POD 5). Serum C-reactive protein (CRP) and inflammatory cytokine levels were measured and compared pre- and post-operatively. The development of delirium and cognitive dysfunction was evaluated post-operatively. Results One patient in the control group developed delirium on POD 2 (3.2%), whereas no patient in the EPO group developed PD (0% vs. 3.2%, p = 0.500). Post-operatively there was no significant difference in MMSE scores between groups. Both groups showed increases in pro- and anti-inflammatory cytokine levels, with no significant differences. Similarly, CRP levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) showed no intergroup differences in post-operative inflammatory responses. Conclusions Perioperative EPO reduced the incidence of post-operative delirium, although not statistically significant, with no differences in post-operative cognitive function and inflammatory responses. Trial registration The trial was registered on December 12, 2023 at http//clinicaltrials.gov, registration number NCT06178835.

Background: Delayed hemothorax (dHTX) can occur unexpectedly, even in patients who initially present without signs of hemothorax (HTX), potentially leading to death. We aimed to develop a predictive model for dHTX requiring intervention, specifically targeting those with no or occult HTX. Methods: This retrospective study was conducted at a level 1 trauma center. The primary outcome was the occurrence of dHTX requiring intervention in patients who had no HTX or occult HTX and did not undergo closed thoracostomy post-injury. To minimize overfitting, we employed the least absolute shrinkage and selection operator (LASSO) logistic regression model for feature selection. Thereafter, we developed a multivariable logistic regression (MLR) model and a nomogram. Results: In total, 688 patients were included in the study, with 64 cases of dHTX (9.3%). The LASSO and MLR analyses revealed that the depth of HTX (adjusted odds ratio [aOR], 3.79; 95% confidence interval [CI], 2.10–6.85; p

Purpose The number of elderly patients with trauma is increasing; therefore, precise models are necessary to estimate the mortality risk of elderly patients with trauma for informed clinical decision-making. This study aimed to develop machine learning based predictive models that predict 30-day mortality in severely injured elderly patients with trauma and to compare the predictive performance of various machine learning models. Methods This study targeted patients aged ≥65 years with an Injury Severity Score of ≥15 who visited the regional trauma center at Chungbuk National University Hospital between 2016 and 2022. Four machine learning models—logistic regression, decision tree, random forest, and eXtreme Gradient Boosting (XGBoost)—were developed to predict 30-day mortality. The models’ performance was compared using metrics such as area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, specificity, F1 score, as well as Shapley Additive Explanations (SHAP) values and learning curves. Results The performance evaluation of the machine learning models for predicting mortality in severely injured elderly patients with trauma showed AUC values for logistic regression, decision tree, random forest, and XGBoost of 0.938, 0.863, 0.919, and 0.934, respectively. Among the four models, XGBoost demonstrated superior accuracy, precision, recall, specificity, and F1 score of 0.91, 0.72, 0.86, 0.92, and 0.78, respectively. Analysis of important features of XGBoost using SHAP revealed associations such as a high Glasgow Coma Scale negatively impacting mortality probability, while higher counts of transfused red blood cells were positively correlated with mortality probability. The learning curves indicated increased generalization and robustness as training examples increased. Conclusions We showed that machine learning models, especially XGBoost, can be used to predict 30-day mortality in severely injured elderly patients with trauma. Prognostic tools utilizing these models are helpful for physicians to evaluate the risk of mortality in elderly patients with severe trauma.

Abstract Background To compare and evaluate objective and subjective clinical parameters between 0.05% cyclosporine nanoemulsion (CsN) and 0.15% hyaluronic acid (HA) administration in patients with mild-to-moderate dry eyes. Methods In this prospective, randomized, double-masked, single-center, and placebo-controlled parallel study, patients with mild-to-moderate dry eyes were randomly allocated to be treated with 0.05% CsN or 0.15% HA twice daily. Patients were followed-up at 4, 8, and 12 weeks. Objective and subjective parameters were evaluated during each visit. Results A total of 35 patients were enrolled in this study. Compared with baseline, tear film break-up time and fluorescein staining scores at 4, 8, and 12 weeks significantly improved in the CsN group. However, the Schirmer I test showed no statistically significant change until week 12. Using the Symptom Assessment in Dry Eye (SANDE) score, both groups gradually showed significant improvement compared with baseline values. However, the Dry Eye-Related Quality-of-life Score Questionnaire (DEQS) showed no statistically significant change during the treatment period. Conclusions Both 0.05% CsN and 0.15% HA administration twice a day effectively improved the objective signs and subjective symptoms of patients with mild-to-moderate dry eyes. However, patients treated with 0.05% CsN experienced greater and faster improvement.

Abstract Background Effective interventions for overall healthy subjects with mild cognitive impairment are currently limited. Choline alphoscerate (alpha glyceryl phosphorylcholine, αGPC) is a choline-containing phospholipid used to treat cognitive function impairments in specific neurological conditions. This study aimed to investigate the efficacy and safety of αGPC in individuals diagnosed with mild cognitive impairment. Methods In this multicenter, randomized, placebo-controlled trial, 100 study subjects with mild cognitive impairment underwent a double-blind SHCog™ soft capsule (600 mg αGPC) or placebo treatment for 12 weeks. The primary efficacy outcome included changes from baseline on the Alzheimer’s Disease Assessment Scale–cognitive subscale (ADAS-cog). Safety assessments included regular monitoring of adverse events, and clinical laboratory tests were conducted at baseline and the end of the trial. Results After 12 weeks of αGPC treatment, the ADAS-cog score decreased by 2.34 points, which was significantly greater than the change observed in the placebo group. No serious AEs were reported, and no study subjects discontinued the intervention because of AEs. There was no significant difference in incidence rate of AEs between the αGPC group and the placebo group. Conclusion This study suggests that αGPC is a safe and effective intervention for improving cognitive function in study subjects with mild cognitive impairment. Trial registration Clinical Research Information Service; Osong (Chungcheongbuk-do): Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare (Republic of Korea); KCT0008797; A 12-week, multicenter, randomized, double-blind, placebo-controlled human application study to evaluate the efficacy and safety of SH_CAPK08 on cognitive function improvement in mild cognitive decline.

One in ten women in their reproductive age suffer from polycystic ovary syndrome (PCOS) that, alongside subfertility and hyperandrogenism, typically presents with increased luteinizing hormone (LH) pulsatility. As such, it is suspected that the arcuate kisspeptin (ARNKISS) neurons that represent the GnRH pulse generator are dysfunctional in PCOS. We used here in vivo GCaMP fiber photometry and other approaches to examine the behavior of the GnRH pulse generator in two mouse models of PCOS. We began with the peripubertal androgen (PPA) mouse model of PCOS but found that it had a reduction in the frequency of ARNKISS neuron synchronization events (SEs) that drive LH pulses. Examining the prenatal androgen (PNA) model of PCOS, we observed highly variable patterns of pulse generator activity with no significant differences detected in ARNKISS neuron SEs, pulsatile LH secretion, or serum testosterone, estradiol, and progesterone concentrations. However, a machine learning approach identified that the ARNKISS neurons of acyclic PNA mice continued to exhibit cyclical patterns of activity similar to that of normal mice. The frequency of ARNKISS neuron SEs was significantly increased in algorithm-identified ‘diestrous stage’ PNA mice compared to controls. In addition, ARNKISS neurons exhibited reduced feedback suppression to progesterone in PNA mice and their gonadotrophs were also less sensitive to GnRH. These observations demonstrate the importance of understanding GnRH pulse generator activity in mouse models of PCOS. The existence of cyclical GnRH pulse generator activity in the acyclic PNA mouse indicates the presence of a complex phenotype with deficits at multiple levels of the hypothalamo-pituitary-gonadal axis.

The gonadotropin-releasing hormone (GnRH) neurons represent the key output cells of the neural network controlling mammalian fertility. We used GCaMP fiber photometry to record the population activity of the GnRH neuron distal projections in the ventral arcuate nucleus where they merge before entering the median eminence to release GnRH into the portal vasculature. Recordings in freely behaving intact male and female mice revealed abrupt ~8 min duration increases in activity that correlated perfectly with the appearance of a subsequent pulse of luteinizing hormone (LH). The GnRH neuron dendrons also exhibited a low level of unchanging clustered, rapidly fluctuating baseline activity in males and throughout the estrous cycle in females. In female mice, a gradual increase in basal activity that exhibited ~80 min oscillations began in the afternoon of proestrus and lasted for 12 hr. This was associated with the onset of the LH surge that ended several hours before the fall in the GCaMP signal. Abrupt 8 min duration episodes of GCaMP activity continued to occur on top of the rising surge baseline before ceasing in estrus. These observations provide the first description of GnRH neuron activity in freely behaving animals. They demonstrate that three distinct patterns of oscillatory activity occur in GnRH neurons. These are comprised of low-level rapid baseline activity, abrupt 8 min duration oscillations that drive pulsatile gonadotropin secretion, and, in females, a gradual and very prolonged oscillating increase in activity responsible for the preovulatory LH surge.

Background Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women. Methods and Results A total of 121 286 study‐eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which 16 108 major CVD events were documented. Using generalized structural equations modeling coupled with survival analysis techniques, we estimated the effects of SES on major CVD events through smoking, body mass index, comorbidities, cardiometabolic risk factors, and self‐rated health, controlling for WHI component, region, age, race, ethnicity, marital status, and health care provider access. Among veterans, SES characteristics were indirectly related to major CVD events through body mass index, comorbidities, cardiometabolic risk factors, and self‐rated health. Among nonveterans, lower education (β= 0.2, P

Abstract It is still challenging to predict the efficacy of cisplatin-based therapy, particularly in relation to the activation of macroautophagy/autophagy in oral squamous cell carcinoma (OSCC). We studied the effect of selected chromatin remodeling genes on the cisplatin resistance and their interplay with autophagy in 3-dimensional tumor model and xenografts. We analyzed gene expression patterns in the cisplatin-sensitive UMSCC1, and a paired cisplatin-resistant UM-Cis cells. Many histone protein gene clusters involved in nucleosome assembly showed significant difference of expression. Gain- and loss-of-function analyses revealed an inverse correlation between cisplatin resistance and HIST1H3D expression, while a positive correlation was observed with HIST3H2A or HIST3H2B expression. In UM-Cis, HIST3H2A- and HIST3H2B-mediated chromatin remodeling upregulates autophagy status, which results in cisplatin resistance. Additionally, knockdown of HIST3H2A or HIST3H2B downregulated autophagy-activating genes via chromatin compaction of their promoter regions. MiTF, one of the key autophagy regulators upregulated in UM-Cis, negatively regulated transcription of HIST1H3D, suggesting an interplay between chromatin remodeling-dependent cisplatin resistance and autophagy. On comparing the staining intensity between cisplatin-sensitive and –insensitive tissues from OSCC patients, protein expression pattern of the selected histone protein genes were matched with the in vitro data. By examining the relationship between autophagy and chromatin remodeling genes, we identified a set of candidate genes with potential use as markers predicting chemoresistance in OSCC biopsy samples.

Abstract Titrating tacrolimus concentration in liver transplantation recipients remains a challenge in the early post-transplant period. This multicenter retrospective cohort study aimed to develop and validate a machine-learning algorithm to predict tacrolimus concentration. Data from 443 patients undergoing liver transplantation between 2017 and 2020 at an academic hospital in South Korea were collected to train machine-learning models. Long short-term memory (LSTM) and gradient-boosted regression tree (GBRT) models were developed using time-series doses and concentrations of tacrolimus with covariates of age, sex, weight, height, liver enzymes, total bilirubin, international normalized ratio, albumin, serum creatinine, and hematocrit. We conducted performance comparisons with linear regression and populational pharmacokinetic models, followed by external validation using the eICU Collaborative Research Database collected in the United States between 2014 and 2015. In the external validation, the LSTM outperformed the GBRT, linear regression, and populational pharmacokinetic models with median performance error (8.8%, 25.3%, 13.9%, and − 11.4%, respectively; P

Purpose Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P

Gastritis is a disease characterized by inflammation of the gastric mucosa. It is very common and has various classification systems such as the updated Sydney system. As there is a lot of evidence that Helicobacter pylori infection is associated with the development of gastric cancer and that gastric cancer can be prevented by eradication, H. pylori gastritis has been emphasized recently. The incidence rate of gastric cancer in Korea is the highest in the world, and due to the spread of screening endoscopy, atrophic gastritis and intestinal metaplasia are commonly diagnosed in the general population. However, there have been no clinical guidelines developed in Korea for these lesions. Therefore, this clinical guideline has been developed by the Korean College of Helicobacter and Upper Gastrointestinal Research for important topics that are frequently encountered in clinical situations related to gastritis. Evidence-based guidelines were developed through systematic review and de novo processes, and eight recommendations were made for eight key questions. This guideline needs to be periodically revised according to the needs of clinical practice or as important evidence about this issue is published in the future.

Abstract Introduction Although the risk of CVD is increased in cancer survivors, few studies have investigated the CVD risk in survivors of gastrointestinal (GI) cancer. Therefore, we evaluated the CVD risk using the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score for GI cancer survivors and associated physical activity factors. Methods Using the 2014–2019 Korean National Health and Nutrition Examination Surveys, data were collected for 262 GI cancer survivors and 1,310 cancer-free controls matched at a 1:5 ratio based on age and sex. The International Physical Activity Questionnaire Short-Form was used to assess physical activity, and the Euro QoL Questionnaire 5-Dimensional Classification (EQ-5D) was used to assess the health-related quality of life. Results A multiple logistic regression analysis demonstrated a lower risk of ASCVD in GI cancer survivors than in controls (adjusted odds ratio [aOR] = 0.73, 95% confidence interval [CI] = 0.55-0.97). Moreover, the risk of having a high ASCVD score was significantly lower in individuals who performed sufficient aerobic physical activity (aOR = 0.59, 95% CI = 0.47-0.75) and those with an EQ-5D score 1 or 2 (aOR = 0.36, 95% CI = 0.20-0.65 and aOR = 0.31, 95% CI = 0.16-0.58, respectively). Conclusions This population-based study demonstrated that engaging in sufficient physical activity can reduce the ASCVD risk among GI cancer survivors.

Two species of cusk eels, Neobythites australiensis Nielsen, 2002 and Neobythites japonicus Uiblein et Nielsen, 2023 were collected from southwestern and northeastern Taiwan, respectively. They represent the first record of both species from Taiwan. The former specimen represents the first record from the Northern Hemisphere, and the latter specimen represents the second record of N. japonicus. As a result, eight species of Neobythites are recognized in Taiwan. We provide a detailed description of the two specimens, comparison with other available specimens, discussion of intraspecific variations, and a dichotomous key to species of Neobythites in Taiwan. [ABSTRACT FROM AUTHOR]

Purpose This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory- phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360–0.906; p = 0.017). Conclusion Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

Abstract Silybum marianum (L.) Gaertn., commonly known as milk thistle, is a medicinal plant belonging to the Asteraceae family. This plant has been recognized for its medicinal properties for over 2,000 years. However, the genome of this plant remains largely undiscovered, having no reference genome at a chromosomal level. Here, we assembled the chromosome-level genome of S. marianum, allowing for the annotation of 53,552 genes and the identification of transposable elements comprising 58% of the genome. The genome assembly from this study showed 99.1% completeness as determined by BUSCO assessment, while the previous assembly (ASM154182v1) showed 36.7%. Functional annotation of the predicted genes showed 50,329 genes (94% of total genes) with known protein functions in public databases. Comparative genome analysis among Asteraceae plants revealed a striking conservation of collinearity between S. marianum and C. cardunculus. The genomic information generated from this study will be a valuable resource for milk thistle breeding and for use by the larger research community.

Abstract High-density Lipoprotein Cholesterol (HDL-C) levels have been associated with cancer. In this observational population-based cohort study using data from the Korean National Health Insurance Service system, we investigate the impact of longitudinal changes in HDL-C levels on gastrointestinal cancer risk. Individuals who underwent health examinations in 2010 and 2014 were followed-up through 2021. Among 3.131 million, 40696 gastric, 35707 colorectal, 21309 liver, 11532 pancreatic, 4225 gallbladder, and 7051 biliary cancers are newly detected. The persistent low HDL-C group increases the risk of gastric, liver, and biliary cancer comparing to persistent normal HDL-C group. HDL-C change from normal to low level increases the risk for gastric, colorectal, liver, pancreatic, gallbladder, and biliary cancers. Effects of HDL-C change on the gastrointestinal cancer risk are also modified by sex and smoking status. HDL-C changes affect the gastric and gallbladder cancer risk in age ≥60 years and the pancreatic and biliary cancer risk in age

Background/Aims We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists. Methods In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed. Results In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years. Conclusions A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

ObjectiveTo establish and improve the food composition database of He’nan Province， the nutritional components of fish， shrimp， crab， and shellfish in He’nan province were analyzed.MethodsThe water， ash， protein， fat， carbohydrate， total nitrogen， carbohydrate， multivitamins， and essential minerals of fish and crab from restaurants and supermarkets from December 2017 to December 2020 were determined.ResultsThe water and ash contents were basically the same. Carbohydrate was not detected except in fried food. The energy content of crab was higher than that of fish and shrimp. The energy， protein， total nitrogen， and fat contents of fried fish were higher than those of fresh fish. The total amount of fatty acids in fish， shrimp， crab， and shellfish was normal； EPA and DHA were the major components. The highest content of DHA was observed in squid （0.209 g/100 g）， pasha （0.181 g/100 g）， and cod （0.153 g/100 g）， and the highest content of EPA was observed in crab roe （1.07 g/100 g）， small yellow croaker （0.38 g/100 g）， and golden carp （0.297 g/100 g）. All the amino acids were detected in fish， 90% in shrimp， crab， and shellfish， and the content of amino acids in crab roe was higher.ConclusionFlavoring and cooking oil influenced the food composition in the cooking process of fish， shrimp， and crab products. The content of monounsaturated fatty acids was positively correlated with the total fat content in fresh fish. Fish and crab had higher contents of monounsaturated fatty acids， and shrimp had the recommended proportion.

In response to the surface defects such as concavities， deep vibration marks， cracks， and slag pits on the surface of continuous casting billets during the smelting of N2M2T high-strength welding wire steel in a certain steel plant，combined with theoretical analysis and actual production conditions on site， an analysis was proposed to analyze the surface defects of N2M2T high-strength welding wire steel continuous casting billets from four aspects： the physical and chemical properties of protective slag， mold vibration parameter mode， primary cooling water distribution， and N content in the steel. The analysis results indicate that the surface defects generated by continuous casting billets are mainly related to the physicochemical indicators of the protective slag， mold vibration parameters， and N content in the steel， but not to the primary cooling water distribution. Production practice shows that by increasing the alkalinity of the protective slag from 0. 6 to 1. 19， the C content is reduced from 13. 51% to 8. 21%， and the viscosity is reduced from 0.666 Pa. s to 0.156 Pa. s； The deviation rate of mold vibration parameters has been increased from 0.15 to 0.20， and the vibration frequency formula has been adjusted from 60+50 V to 90+60 V； Control the N content in steel to ＜50 × 10-6， continuous casting process △ N ＜ 7 × 10-6； The surface defects of N2M2T high-strength welding wire steel continuous casting billet have been significantly improved， and the qualification rate of the billet has increased from 85% to over 95%， providing assurance for stable rolling of subsequent steel rolling

Background and Objectives: Two major classification systems exist for rib fracture (RFX) displacement. One system uses a 50% displacement threshold: Grade I (Materials and Methods: We retrospectively reviewed trauma registry and medical records from January 2019 to December 2023. All radiographic parameters were recorded based on initial computed tomography. Primary outcomes were pneumonia and other pulmonary complications requiring surgery. Least absolute shrinkage and selection operator (LASSO) regression was conducted to select risk factors and minimize overfitting. Multivariable logistic regression (MLR) was performed after LASSO. Results: Among the 621 patients, 61 (9.8%) had one or more adverse outcomes. In MLR, regardless of both classifications, the age (p < 0.001), ISS (p < 0.001), and number of completely displaced RFX (p = 0.001) were statistically significant. After excluding 280 patients with completely displaced RFX, we conducted a subgroup analysis with the remaining 341 patients. In this analysis, 22 (6.5%) patients experienced one or more adverse outcomes. Regardless of both classifications, the AIS head (p = 0.006), AIS extremities (p = 0.012), and number of segmental RFX (p < 0.001) were statistically significant in MLR. The area under the receiver operating curve for both MLR models was 0.757 in the total patient group and 0.823 in the subgroup that excluded patients with completely displaced RFX. Conclusions: Completely displaced RFX is the most crucial factor, regardless of the classification criteria. Unless ribs are completely displaced, the degree of displacement may not be crucial, and the number of segmental RFX was a significant risk factor.

Abstract Background This study investigated the frequency of diabetic gastroparesis and associated risk factors in a real-world clinical setting. Methods This retrospective cross-sectional study included patients who underwent assessments of solid gastric emptying time (GET) by technetium-99 m scintigraphy between May 2019 and December 2020. We categorized patients into three groups according to gastric retention of technetium-99 m: rapid ( 60% at 2 h and/or > 10% at 4 h). Results Patients with diabetes mellitus (DM) were more likely to show abnormal GET than those without DM (119 [70.8%] vs. 16 [44.4%]). The mean glycated A1c was 10.3% in DM patients. DM patients with normal GET were significantly younger (57.2 years, P = 0.044) than those with delayed (65.0 years) or rapid GET (60.2 years). Fasting glucose levels were the lowest in the normal GET group and the highest in the rapid GET group (delayed: 176.3 mg/dL, normal: 151.2 mg/dL, rapid: 181.0 mg/dL, P = 0.030). However, glycated A1c was not significantly different among the delayed, normal, and rapid GET groups in patients with DM. Patients with delayed and rapid GET showed a higher frequency of retinopathy (6.0 vs. 15.5%, P = 0.001) and peripheral neuropathy (11.3 vs. 24.4%, P = 0.001) than those with normal GET. In the multinomial logistic regression analysis, retinopathy demonstrated a positive association with delayed GET, while nephropathy showed a significant negative correlation. Conclusion DM gastroparesis in the clinical setting was not uncommon. Abnormal GET, including delayed and rapid GET, was associated with DM retinopathy or peripheral neuropathy.

Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

Supratentorial and infratentorial epidural hematoma (SIEDH) is a rare but life-threatening complication following traumatic brain injury. However, the literature on SIEDH is sparse, consisting only of a few small series. Prompt diagnosis and the application of appropriate surgical techniques are crucial for the rapid and safe management of SIEDH. Herein, we present three cases of SIEDH treated at our institution, employing a range of surgical approaches.

Purpose In this study, we aimed to compare the characteristics of patients with trauma by age group in a single center in Korea to identify the clinical characteristics and analyze the risk factors affecting mortality. Methods Patients aged ≥18 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022 were included. The accident mechanism, severity of the injury, and outcomes were compared by classifying the patients into group A (18–64 years), group B (65–79 years), and group C (≥80 years). In addition, logistic regression analysis was performed to identify factors affecting death. Results The most common injury mechanism was traffic accidents in group A (40.9%) and slipping in group B (37.0%) and group C (56.2%). Although group A had the highest intensive care unit admission rate (38.0%), group C had the highest mortality rate (9.5%). In the regression analysis, 3 to 8 points on the Glasgow Coma Scale had the highest odds ratio for mortality, and red blood cell transfusion within 24 hours, intensive care unit admission, age, and Injury Severity Score were the predictors of death. Conclusions For patients with trauma, the mechanism, injured body region, and severity of injury differed among the age groups. The high mortality rate of elderly patients suggests the need for different treatment approaches for trauma patients according to age. Identifying factors affecting clinical patterns and mortality according to age groups can help improve the prognosis of trauma patients in the future.

Purpose Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria. Methods This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks. Results In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period. Conclusions Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. ClinicalTrials.gov trial registration (NCT0223277)

Accurate implant placement is essential for achieving successful outcomes. To aid in this, digitally designed surgical guides have been introduced. Both closed-sleeve and open-sleeve designs are commonly utilized. However, the closed-sleeve design has limitations with restricted interocclusal distance, interference with irrigation, and limited visibility, while the open-sleeve design is known to be less accurate. To address these limitations, a new slope-sleeve design was introduced. This design reduces the interocclusal distance requirement compared to the closed-sleeve design and provides improved accuracy. A constraint model with a 31 mm interocclusal distance was created, and three types of surgical guides (closed, open, and slope), printed using either a PolyJet or Digital Light Processing (DLP) 3D printer, were tested on resin bone blocks. Horizontal and angular deviations were measured for the accuracy of each guide after drilling, with data analyzed using one-way ANOVA and independent t-tests. The slope-sleeve design showed significantly lower horizontal and angular deviations in wide-sized guides. Additionally, PolyJet-printed guides showed higher accuracy compared to DLP-printed guides. The slope-sleeve guide offers enhanced stability and precision in restricted interarch spaces. When coupled with high-precision 3D printing technologies like PolyJet, the slope-sleeve design provides a reliable solution for improving implant placement accuracy in challenging clinical scenarios.

Native garden plants significantly contribute to the conservation of biodiversity and ecosystem functions in urban environments. This study aimed to identify the physiochemical differences among native herbaceous plants subjected to drought or salinity stress and to assess their potential as garden plants adaptable to outdoor conditions and global climate change. Physiological parameters, such as chlorophyll (SD; −86.7% and −61.5%, SS: −85% and −76.5%) and carotenoid (SD; −84.5% and −58.3%, SS; −80.5% and −76%), decreased in Melica grandiflora and Carex forficula in severe drought or salinity treatment. In contrast, Carex boottiana maintained high water-use efficiency (SD: +97.5%, SS: +262.9%) under severe drought or salinity conditions, with no significant changes observed in chlorophyll (SD: +9.5%, SS: −3.7%) or carotenoid levels (SD: +35.2%, SS: +0.3%) compared to the WW or UT conditions. Biochemical analyses indicated that C. boottiana exhibited lower or slightly higher levels of malondialdehyde in SS (−22.5%) and reactive oxygen species such as O2− (SD: +9.9%; SS: −9.4%) than those observed in the other species under severe stress conditions. Principal component analysis revealed clear differences in tolerance levels among the native species. C. boottiana demonstrated high adaptability to both drought and salinity stress, indicating its potential as a sustainable and resilient garden material for urban landscapes facing severe climatic challenges.

A Banyan switch with bypass queue can overcome the problem of head of line blocking. This paper presents the throughput analysis for such a switch and the optimal window size for the bypass queue is also obtained. Moreover, to reduce the effect of the internal blocking and to increase the throughput, a parallel Banyan switch with bypass queue is also discussed and analyzed.

Abstract Flail chest is a severe injury to the chest wall and is related to adverse outcomes. A flail chest is classified as the physiologic, paradoxical motion of a chest wall or flail segment of rib fracture (RFX). We hypothesized that patients with paradoxical chest wall movement would present different clinical features from patients with a flail segment. This retrospective observational study included patients with blunt chest trauma who visited our level 1 trauma center between January 2019 and October 2022 and were diagnosed with one or more flail segments by computed tomography. The primary outcome of our study was a clinically diagnosed visible, paradoxical chest wall motion. We used the least absolute shrinkage and selection operator (LASSO) logistic regression model to minimize overfitting. After a feature selection using the LASSO regression model, we constructed a multivariable logistic regression (MLR) model and nomogram. A total of five risk factors were selected in the LASSO model and applied to the multivariable logistic regression model. Of these, four risk factors were statistically significant: the total number of RFX (adjusted OR [aOR], 1.28; 95% confidence interval [CI], 1.09–1.49; p = 0.002), number of segmental RFX including Grade III fractures (aOR, 1.78; 95% CI, 1.14–2.79; p = 0.012), laterally located primary fracture lines (aOR, 4.00; 95% CI, 1.69–9.43; p = 0.002), and anterior–lateral flail segments (aOR, 4.20; 95% CI, 1.60–10.99; p = 0.004). We constructed a nomogram to predict the personalized probability of the flail motion. A novel nomogram was developed in patients with flail segments of traumatic RFX to predict paradoxical chest wall motion. The number of RFX, Grade III segmental RFX, and the location of the RFX were significant risk factors.

Abstract Background Many patients with ulcerative colitis (UC) gain weight after treatment. However, the clinical significance of weight gain in these patients remains unclear. This study aimed to evaluate body weight changes after treatment in patients newly diagnosed with moderate-to-severe UC and their effects on patients’ prognosis. Methods The change in weight between diagnosis and 1 year after treatment in 212 patients enrolled in the MOSAIK cohort (mean age, 40 years; males, 60%) was analyzed. Significant weight gain was defined as a weight increase of ≥ 5% from the baseline at 1 year. Factors associated with significant weight gain and the effect of significant weight gain on the risk of major adverse outcomes (clinical relapse, hospitalization, and new use of steroids or biologics) during a follow-up period of 20 months were evaluated. Results Mean weight gain at 1 year was 1.7 ± 4.2 kg. The proportion of overweight/obese patients increased by 9.0% from 37.9% to 46.9%. Thirty-two percent had significant weight gain; extensive colitis at diagnosis was the only factor associated with significant weight gain (odds ratio 6.5, 95% confidence interval 1.4–31.0, p = 0.006). In multivariable analysis, significant weight gain was not associated with the risk of major adverse outcomes. Weight loss symptoms at diagnosis were associated with an increased risk for new steroid use after 1 year. Conclusions Approximately one-third of patients with moderate-to-severe UC had significant weight gain after 1 year of treatment. However, significant weight gain was not associated with the patient’s prognosis.