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The incidence of invasive fungal infection (IFI) in patients with acute myeloid leukemia (AML) has decreased with the introduction of antimold prophylaxis. Although acute lymphoblastic leukemia (ALL) has a lower risk of IFI than does AML, the incidences of IFI in both AML and ALL in the era of antimold prophylaxis should be re-evaluated. We analyzed adults with AML or ALL who had undergone induction, re-induction, or consolidation chemotherapy from January 2017 to December 2019 at Seoul National University Hospital. Their clinical characteristics during each chemotherapy episode were reviewed, and cases with proven or probable diagnoses were regarded as positive for IFI. Of 552 episodes (393 in AML and 159 in ALL), 40 (7.2%) were IFI events. Of the IFI episodes, 8.1% (12/148) and 5.9% (13/220) (P = 0.856) occurred in cases of ALL without antimold prophylaxis and AML with antimold prophylaxis, respectively. After adjusting for clinical factors, a lack of antimold prophylaxis (adjusted odds ratio [aOR], 3.52; 95% confidence interval [CI], 1.35–9.22; P = 0.010) and a longer duration of neutropenia (per one day, aOR, 1.02; 95% CI, 1.01–1.04; P = 0.001) were independently associated with IFI. In conclusion, the incidence of IFI in ALL without antimold prophylaxis was not lower than that in AML. A lack of antimold prophylaxis and prolonged neutropenia were independent risk factors for IFI. Clinicians should be on guard for detecting IFI in patients with ALL, especially those with risk factors.

Clerodendrum trichotomum has been reported to possess beneficial properties for human health, but its effects on metabolic syndrome have not been reported. In this study, we investigated the effect of C. trichotomum leaf extract (CT) on the metabolic derangements induced by a high-fructose (HF) diet. Sprague–Dawley rats were fed with a 46% carbohydrate diet (HC group), 60% high-fructose diet (HF group), or HF diet supplemented with CT (500 mg/kg of body weight/day, CT group) via drinking water for 16 weeks. Results showed that CT alleviated HF diet-induced insulin resistance, dyslipidemia, and hepatic steatosis In liver tissues, CT affected the signaling pathways of AMP-activated protein kinase, peroxisome proliferator-activated receptor α (PPARα), and sterol regulatory element binding protein 1. CT enriched the genes that were mainly involved in cytokine-cytokine receptor interaction, PPAR, PI3K-Akt signaling pathways, and fatty acid metabolism pathway. These results suggest that CT is a promising therapeutic against metabolic disorders.

This study performed the forensic anthropological sex estimation of Koreans in a non-metric way by reconstructing three-dimensional (3D) computed tomography (CT) images of skulls. The skull CT images used in this study were 100 (51 males, 49 females), and all CT images were taken with a slice thickness of 0.75 mm and then reconstructed into 3D images using the MIMICS 23.0 program. Using the reconstructed 3D image, measurements were repeated twice. The sex determination was male if the 4 point to 5 point was relatively more in five landmarks, and female if the points of 1 to 2 were relatively more. Results of the study show that, 88 of the 100 cases matched the actual sex. Among the 12 discrepant cases, ten cases were mismatched with the actual sex even though the estimation and repeated estimation readout of sexestimating were the same. Two cases, were “unknown,” showing different sexes in the first and repeated estimations. In conclusion, this study indicated that a forensic anthropological analysis from 3D images provided accurate point information on the landmarks of skulls, showing as high an accuracy as the sex estimation method using real bones. The ten cases of sex mismatch, except the two “Unknown” cases, are considered to be errors that did not consider differences in population groups. In further studies, further establishing a nonmetric, specifically Korean methods to increase the accuracy and reliability of sex estimation is need.

BACKGROUND: Molecular characterization in pediatric papillary thyroid cancer (PTC), distinct from adult PTC, is important for developing molecularly targeted therapies for progressive radioiodine-refractory ((131)I-refractory) PTC. METHODS: PTC samples from 106 pediatric patients (age range: 4.3–19.8 years; n = 84 girls, n = 22 boys) who were admitted to SNUH (January 1983–March 2020) were available for genomic profiling. Previous transcriptomic data from 125 adult PTC samples were used for comparison. RESULTS: We identified genetic drivers in 80 tumors: 31 with fusion oncogenes (RET in 21 patients, ALK in 6 patients, and NTRK1/3 in 4 patients); 47 with point mutations (BRAF(V600E) in 41 patients, TERT(C228T) in 2 patients [1 of whom had a coexisting BRAF(V600E)], and DICER1 variants in 5 patients); and 2 with amplifications. Fusion oncogene PTCs, which are predominantly detected in younger patients, were at a more advanced stage and showed more recurrent or persistent disease compared with BRAF(V600E) PTCs, which are detected mostly in adolescents. Pediatric fusion PTCs (in patients

Legalization of medical and recreational cannabis is a major contributor to pediatric cannabis exposures. The trends and magnitude of pediatric cannabis exposures in Michigan after medical cannabis legalization in 2008 have not been assessed.To describe the temporal trends of pediatric cannabis exposures reported to the Michigan Poison Center (MiPC) after medical cannabis was legalized in 2008 and 1 year after legalization of recreational cannabis in 2018.Retrospective electronic chart review of pediatric (18 years old) single-substance cannabis exposures reported to the MiPC from January 1, 2008 to December 31, 2019. Routes of cannabis exposure were reported as ingestion, inhalation, and unknown. Types of ingested cannabis products were also documented.Between 2008 and 2019, 426 pediatric cannabis single exposures were reported. The median patient age was 6.0 years (interquartile range 2-15 years). Age distribution was bimodal. A total of 327 (76.8%) exposures were from cannabis ingestion, 79 (18.5%) from inhalation, 2 (0.5%) from both ingestion and inhalation, and 18 (4.2%) from unknown route. The doubling time for number of cases was 2.1 years, and the total number of annual reported cases increased after 2016. Teenagers (13-17 years) had the highest number of inhalational exposures, whereas young children (0-5 years) had the highest number of ingestions.Single-substance pediatric cannabis exposures reported to the Michigan Poison Center increased after medical cannabis was legalized in 2008 through recreational legalization in 2018.

MXenes based on titanium carbide are promising next-generation transparent electrode materials due to their high metallic conductivity, optical transparency, mechanical flexibility, and abundant hydrophilic surface functionality. MXene electrodes offer a much wider conductive surface coverage than metal nanowires, thereby gaining popularity as flexible electrode materials in supercapacitors and energy devices. However, given that monolayer MXene nanosheets are only a few nanometers thick, meticulous surface treatments and deposition technologies are required for a practical implementation of these transparent electrodes. Unfortunately, a capacitor produced by forming high-quality transparent MXene electrodes on both sides of a film has not yet been reported. We report the successful development of a one-way continuous deposition technology to form high-quality MXene nanosheet-based transparent electrodes on both surfaces of a polymer film without large physical stresses on the MXene nanosheets. One transparent electrode was formed by transferring MXene nanosheets predeposited on a temporary glass substrate to the film surface, while the other was directly deposited on the exposed film surface. The Ti3AlC2 precursor (MAX) was synthesized via a spark plasma sintering crystallization, and the MXene nanosheets were prepared via a subsequent Al-selective etching and delamination. We used this material to implement a capacitive photodetector consisting of two layers of opposing transparent electrodes. The flexible photodetector was based on poly(vinyl butyral) (PVB), which was solidly bonded with MXene nanosheets to serve as a free-standing binder for the Cu-doped ZnS semiconductor particles. The fabricated device exhibited excellent mechanical stability due to the high affinity between the MXene nanosheets and PVB. Furthermore, the device exhibited an initial capacitance of 2 nF, photosensitivity of 12.5 μF/W, and rise and decay times of 0.031 and 0.751 s, respectively. All these parameters were 1 to 2 orders of magnitude higher or faster than reported capacitive photodetectors. Overall, the proposed approach resolves the core issues associated with existing metal nanowire-based electrodes, and it is a breakthrough in the development of next-generation flexible devices comprising two layers of confronting transparent electrodes.

STUDY OBJECTIVES: To assess the seasonality of restless legs syndrome (RLS) using data from the Korean national health insurance database. METHODS: We retrospectively reviewed a randomly selected sample representing 3% of the national health insurance claims database in South Korea. From this sample, we obtained the monthly numbers of patients with RLS and diagnoses from 2009 to 2016, along with prescriptions for monthly dopamine agonists and clonazepam for patients with RLS from 2009 to 2013. Total dopamine agonist and clonazepam doses were converted to levodopa-equivalent doses, and the monthly cumulative prescription dose was calculated. Cosinor analysis was used to evaluate the seasonal pattern of each variable. RESULTS: This study included 11,466 patients with RLS and their diagnoses and 4,887 prescriptions for dopamine agonists and clonazepam. There were significant seasonal patterns in the numbers of patients with RLS (P < .001) and diagnoses (P < .001), both of which peaked in August. The magnitude of the greatest difference in the number of patients with RLS between August (highest) and February (lowest) was 29.96% (95% confidence interval, 24.03–100.80), and that of the number of RLS diagnoses was 39.56% (95% confidence interval, 31.24–47.89). The cumulative prescription dose of medication showed no significant seasonality. CONCLUSIONS: Our findings suggest that the prevalence of RLS is seasonally affected, with an increase during summer. CITATION: Oh SM, Son K-L, Choi S-J, Lee MH, Yoon SY, Lee YJ. The seasonal pattern of restless legs syndrome in a sample from the Korean health insurance review and assessment service national database. J Clin Sleep Med. 2021;17(5):1051–1056.

Predictive models trained on sequencing profiles often fail to achieve expected performance when externally validated on unseen profiles. While many factors such as batch effects, small data sets, and technical errors contribute to the gap between source and unseen data distributions, it is a challenging problem to generalize the predictive models across studies without any prior knowledge of the unseen data distribution. Here, this study proposes DeepBioGen, a sequencing profile augmentation procedure that characterizes visual patterns of sequencing profiles, generates realistic profiles based on a deep generative model capturing the patterns, and generalizes the subsequent classifiers. DeepBioGen outperforms other methods in terms of enhancing the generalizability of the prediction models on unseen data. The generalized classifiers surpass the state-of-the-art method, evaluated on RNA sequencing tumor expression profiles for anti-PD1 therapy response prediction and WGS human gut microbiome profiles for type 2 diabetes diagnosis. VT's OASF Published version This work is partially supported by VT's OASF support.

The aim of this study is to propose a new detection method for determining the damage locations in pile foundations based on deep learning using acoustic emission data. First, the damage location is simulated using a back propagation neural network deep learning model with an acoustic emission data set acquired from pile hit experiments. In particular, the damage location is identified using two parameters: the pile location (PL) and the distance from the pile cap (DS). This study investigates the influences of various acoustic emission parameters, numbers of sensors, sensor installation locations, and the time difference on the prediction accuracy of PL and DS. In addition, correlations between the damage location and acoustic emission parameters are investigated. Second, the damage step condition is determined using a classification model with an acoustic emission data set acquired from uniaxial compressive strength experiments. Finally, a new damage detection and evaluation method for pile foundations is proposed. This new method is capable of continuously detecting and evaluating the damage of pile foundations in service.

The objectives of this study were to evaluate convolutional neural network models and computer vision techniques for the classification of swine posture with high accuracy and to use the derived result in the investigation of the effect of dietary fiber level on the behavioral characteristics of the pregnant sow under low and high ambient temperatures during the last stage of gestation. A total of 27 crossbred sows (Yorkshire × Landrace; average body weight, 192.2 ± 4.8 kg) were assigned to three treatments in a randomized complete block design during the last stage of gestation (days 90 to 114). The sows in group 1 were fed a 3% fiber diet under neutral ambient temperature; the sows in group 2 were fed a diet with 3% fiber under high ambient temperature (HT); the sows in group 3 were fed a 6% fiber diet under HT. Eight popular deep learning-based feature extraction frameworks (DenseNet121, DenseNet201, InceptionResNetV2, InceptionV3, MobileNet, VGG16, VGG19, and Xception) used for automatic swine posture classification were selected and compared using the swine posture image dataset that was constructed under real swine farm conditions. The neural network models showed excellent performance on previously unseen data (ability to generalize). The DenseNet121 feature extractor achieved the best performance with 99.83% accuracy, and both DenseNet201 and MobileNet showed an accuracy of 99.77% for the classification of the image dataset. The behavior of sows classified by the DenseNet121 feature extractor showed that the HT in our study reduced (p < 0.05) the standing behavior of sows and also has a tendency to increase (p = 0.082) lying behavior. High dietary fiber treatment tended to increase (p = 0.064) lying and decrease (p < 0.05) the standing behavior of sows, but there was no change in sitting under HT conditions.

Respiration monitoring and human sweat sensing have promising application prospects in personal healthcare data collection, disease diagnostics, and the effective prevention of human-to-human transmission of fatal viruses. Here, we have introduced a unique respiration monitoring and touchless sensing system based on a CsPb2Br5/BaTiO3 humidity-sensing layer operated by water-induced interfacial polarization and prepared using a facile aerosol deposition process. Based on the relationship between sensing ability and layer thickness, the sensing device with a 1.0 μm thick layer was found to exhibit optimal sensing performance, a result of its ideal microstructure. This sensor also exhibits the highest electrical signal variation at 0.5 kHz due to a substantial polarizability difference between high and low humidity. As a result, the CsPb2Br5/BaTiO3 sensing device shows the best signal variation of all types of breath-monitoring devices reported to date when used to monitor sudden changes in respiratory rates in diverse situations. Furthermore, the sensor can effectively detect sweat evaporation when placed 1 cm from the skin, including subtle changes in capacitance caused by finger area and motion, skin moisture, and contact time. This ultrasensitive sensor, with its fast response, provides a potential new sensing platform for the long-term daily monitoring of respiration and sweat evaporation.

Recently, the number of patients with coronavirus disease 2019 (COVID-19) who have tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), via the reverse transcription polymerase chain reaction (RT-PCR) test, after recovery has increased; this has caused a dilemma regarding the medical measures and policies. We evaluated the dynamics of viral load and anti-SARS-CoV-2 antibodies in four patients with positive RT-PCR results after recovery. In all patients, the highest levels of immunoglobulin G (IgG) and IgM antibodies were reached after about a month of the onset of the initial symptoms. Then, the IgG titers plateaued, and the IgM titers decreased, regardless of RT-PCR results. The IgG and IgM levels did not increase after the post-negative positive RT-PCR results in any of the patients. Our results reinforced that the post-negative posi tive RT-PCR results may be due to the detection of RNA particles rather than re infection in individuals who have recovered from COVID-19.

Purpose. Xanthelasma palpebrarum manifests as a yellowish placoid on the medial aspect of the upper eyelids, often in middle and old age. Aggravated lateral hooding of the eyelid might cause a deformity with conventional surgery, which appears to be more deficient on the medial side with excess hooding of the lateral skin. The authors suggest a novel surgical technique to solve this problem and reconstruct the defect appropriately. Methods. From July 2017 to December 2018, our method of combining excision with blepharoplasty was performed on 8 patients, consisting of 15 lesions on the upper eyelid and 6 lesions on the lower lid. Lesion removal incorporating blepharoplasty incision was done. After resection, the orbicularis oculi musculocutaneous flap was widely elevated extending through the whole upper eyelid with the lateral flap first along with fat maneuver. The flap was advanced into the defect, with even distribution of tension, after lower flap fixation to the required height of the eyelid fold. Taping was done with a hydrocolloid bandage and kept for 2 weeks. Results. The wounds were healed primarily, and no cases of recurrence, lagophthalmos, hypertrophic scar, pigmentation, or remarkable deformity were noted. All patients were satisfied, and the functional outcomes were excellent. Two patients had trivial complications specific to our method, that of triple fold and neo-Mongolian fold, which were simply revised later. Conclusions. This modality overcame the drawbacks of eyelid deformity observed in previous surgical methods, giving excellent results without any critical complications.

Radiation-based imaging systems comprise multiple radiation sensors that are assembled with coupled Si PIN (positive — intrinsic — negative) photodetectors and scintillators. This paper describes the fabrication and characterization of a four-channel array Si PIN photodetector for security inspection systems. The Si PIN photodetector was fabricated using conventional (CMOS) processes at the Radiation Equipment Fab. The junction depth, passivation, and anti-reflection layer of the photodetector were controlled to maximize the light detection efficiency and the signal-to-noise ratio. The spectral responsivity obtained was 0.28 A/W for the cadmium tungstate (CWO) emission at a wavelength of 475 nm. Finally, a line pattern image was acquired using the fabricated Si PIN sensor and a self-developed readout and data acquisition system. The significance of this study is it confirms the feasibility of using the developed array-type Si PIN photodetectors in radiation-based imaging systems.

BACKGROUND Traditionally, lymphovenous anastomosis is not routinely performed in patients with advanced stage lymphedema because of difficulty with identifying functioning lymphatics. This study presents the use of duplex ultrasound and magnetic resonance lymphangiography to identify functional lymphatics and reports the clinical outcome of lymphovenous anastomosis in advanced stage lower extremity lymphedema patients. METHODS This was a retrospective study of 42 patients (50 lower limbs) with advanced lymphedema (late stage 2 or 3) that underwent functional lymphovenous anastomoses. Functional lymphatic vessels were identified preoperatively using magnetic resonance lymphangiography and duplex ultrasound. RESULTS An average of 4.64 lymphovenous anastomoses were performed per limb using the lymphatics located in the deep fat underneath the superficial fascia. The average diameter of lymphatic vessels was 0.61 mm (range, 0.35 to 1 mm). The average limb volume was reduced 14.0 percent postoperatively, followed by 15.2 percent after 3 months, and 15.5 percent after 6 months and 1 year (p < 0.001). For patients with unilateral lymphedema, 32.4 percent had less than 10 percent volume excess compared to the contralateral side postoperatively, whereas 20.5 percent had more than 20 percent volume excess. The incidence of cellulitis decreased from 0.84 per year to 0.07 per year after surgery (p < 0.001). CONCLUSION This study shows that functioning lymphatic vessels can be identified preoperatively using ultrasound and magnetic resonance lymphangiography; thus, lymphovenous anastomoses can effectively reduce the volume of the limb and improve subjective symptoms in patients with advanced stage lymphedema of the lower extremity. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.

Introduction We aimed to determine the optimal placement of electrodes for neuromuscular electrical stimulation (NMES) for post-stroke dysphagia therapy. Methods 31 patients with post-stroke dysphagia were randomised to three groups according to NMES electrode placement. In Group A (n = 10), two pairs of electrodes were attached horizontally on the suprahyoid and infrahyoid muscles. In Group B (n = 11), one pair of electrodes was attached horizontally on the suprahyoid muscles while the other was attached vertically on the infrahyoid muscles. In Group C (n = 10), the electrodes were attached vertically, with one pair above the hyoid bone and the other above the cricoid cartilage. All patients received rehabilitation treatment via NMES combined with effortful swallowing training five times weekly for four weeks. The effect of NMES electrode placement was assessed in terms of the Functional Dysphagia Scale (FDS) and Dysphagia Outcome and Severity Scale (DOSS) scores. Results Group A showed significantly greater improvement than Group B in overall FDS (p = 0.009) and pharyngeal-phase FDS (FDS-P; p = 0.005) scores. Group A also showed significant improvement when compared with Group C in overall FDS (p = 0.001) and FDS-P (p = 0.001) scores. Conclusion Horizontal placement of the NMES electrodes on the suprahyoid and infrahyoid muscles for the treatment of post-stroke dysphagia by NMES combined with effortful swallowing was more effective than the horizontal and vertical placement of electrodes on the suprahyoid and infrahyoid muscles, respectively, and their vertical placement above the hyoid bone and cricoid cartilage.

Monolayer transition metal dichalcogenides (TMDs) with a direct band gap are suitable for various optoelectronic applications such as ultrathin light emitters and absorbers. However, their weak light absorption caused by the atomically thin layer hinders more versatile applications for high optical gains. Although plasmonic hybridization with metal nanostructures significantly enhances light-matter interactions, the corrosion, instability of the metal nanostructures, and the undesired effects of direct metal-semiconductor contact act as obstacles to its practical application. Herein, we propose a dielectric nanostructure for plasmon-enhanced light-matter interaction of TMDs. TiO

In this study, we aimed to reveal the long-term impact of radiotherapy on recovery of facial animation function after facial nerve repair using sural nerve grafting in patients undergoing parotid gland surgery. We reviewed the medical records of patients who did or did not undergo radiotherapy following sural nerve graft repair after parotid gland surgery. Facial function metrics, such as House–Brackmann (HB) scale scores and FACEgram measurements, were used to compare facial muscle function between groups. Postoperative radiotherapy was performed in 14 of 21 patients. There was no significant difference regarding successful repair (HB I–III), which was achieved in three of 14 irradiated patients and two of seven non-irradiated patients (p = 0.181). On FACEgram analysis, there was no significant difference in mean smile excursion length between the radiotherapy group (9.16 ± 8.48 mm) and the control group (6.15 ± 4.24 mm) (p = 0.392). There was no significant difference in the mean angle of excursion between the irradiated group (3.59 ± 3.73°) and the non-irradiated group (1.06 ± 5.24°) (p = 0.216). In this study, postoperative radiotherapy did not appear to prevent successful recovery of facial function after sural nerve grafting in parotid gland surgery.

Glioblastoma (GBM) is the most prevalent malignant tumour of the central nervous system and carries a poor prognosis; average survival time after diagnosis is 14 months. Because of its unfavourable prognosis, novel therapies are needed. The aim of this study was to assess whether inhibition of GBM and GBM-derived cancer stem cells (CSCs) by a new tyrosine kinase inhibitor (TKI), K905-0266, is possible. To do this, we generated GBM (D54 and U87MG) cells expressing luciferase and characterised the inhibitory effects of the TKI with bioluminescent imaging (BLI) and western blot (WB). The effect of the TKI was then evaluated in CSCs. BLI showed significant inhibition of D54 and U87MG cells by TKI treatment. WB showed that the TKI decreased pERK and Bcl-2 level and increased cleaved caspase-3 level. Sphere formation was significantly reduced by the TKI in CSCs. Our results showed that a new TKI, K905-0266, effectively inhibited GBM and CSCs, making this a candidate for GBM therapy.

Purpose As filler procedures have increased in popularity, serious injection-related complications (e.g., blindness and stroke) have also increased in number. Proper and effective training is important for filler procedure safety; however, limitations exist in traditional training methods (i.e. anatomical illustrations and cadaver studies). We aimed to describe the development process and evaluate the usability of a virtual reality (VR)-based aesthetic filler injection training system. Materials and Methods We developed the virtual reality hardware for the training system and a short guide, with a lecture regarding safe filler injection techniques. One hundred clinicians who attended a conference tested the training system. Participants completed system usability scale (SUS) and satisfaction questionnaires. Results Nearly half of the participants were aged 35–50 years, and 38% had more than 5 years of aesthetic experience. The mean SUS score was 59.8 (standard deviation, 12.23), with no significant differences among the evaluated subgroups. Approximately 76% of participants provided SUS scores of more than 51, indicating acceptable usability. Participants aged 35–50 years were more likely to rate the system as having poor usability than were those aged Conclusions This study was the first to develop and explore the usability of a VR-based filler training system. Nearly three-fourths of participants indicated that the training system has an acceptable level of usability. However, assessments in precise target audiences and more detailed usability information are necessary to further refine the training system. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Objective Particulate matter (PM), which contains organic compounds and toxic metals, is the major cause of air pollution. PM enters the body, causing various health problems. Although the effects of PM on the lower respiratory tract have been extensively investigated, the effects on the upper respiratory tract (including the nasal cavity) require further evaluation. To investigate the effect of fluticasone propionate (FP) on nasal fibroblasts exposed to UPM. Methods Samples of inferior turbinate tissue were obtained from six patients. The fibroblasts isolated from these samples were exposed to UPM and/or FP. The expression of interleukin (IL)-6, CXC chemokine ligand (CXCL) 1, IL-1β, and tumour necrosis factor-alpha (TNF-α) in nasal fibroblasts was analysed using real-time PCR and enzyme-linked immunosorbent assays. The protein levels of nuclear factor kappa B (NF-κB) and signal transducer and activator of transcription 3 (STAT3) were analysed by western blotting. Results FP reversed the UPM-induced reduction in cell viability. The mRNA and protein levels of IL-6, CXCL1, IL-1β, and TNF-α were significantly increased by UPM. FP reversed the UPM-induced increases in the protein levels of NF-κB and phosphorylated-STAT3 in a dose-dependent manner. In addition, TNF-α, an inducer of NF-κB, reversed the FP-induced reduction in the levels of signalling molecules. Conclusion UPM induces the expression of IL-6, CXCL1, IL-1β, and TNF-α in nasal fibroblasts and this effect is reversed by FP via the STAT3 and NF-κB signalling pathways. These results suggest that FP has therapeutic potential for nasal diseases related to UPM, such as allergic and chronic rhinitis.

WHAT IS KNOWN AND OBJECTIVE We evaluated the effect of the proportion of time maintained within the target international normalized ratio (INR) postoperatively in hospitalized patients who underwent On-X mechanical heart valve replacement on warfarin therapy after discharge. METHODS Inclusion was patients who were ≥18 years, received warfarin for a minimum of 10 days without any interruptions during hospitalization and followed by the anticoagulation service (ACS) clinic after discharge between June 2006 and June 2016. Patients were excluded if they had incomplete medical records, INR goal changes, known as warfarin resistance, transferred to another facility or expired during the study. The patients were divided into 3 groups according to the proportion of time maintained within therapeutic INR range (TTR) from day 4 to 10 of warfarin initiation (low

Objective This study was performed to investigate the associations of life event stress with impulsivity, anxiety, and depressed mood as a function of the presence of a sleep disturbance.Methods In total, 214 participants (age 38.96±10.53 years; 111 females) completed self-report questionnaires, including the Life Experience Survey (LES), Pittsburgh Sleep Quality Index (PSQI), Barratt’s Impulsivity Scale (BIS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The presence of a sleep disturbance was defined as a PSQI score >5.Results In total, 127 participants presented with a sleep disturbance (age 39.33±10.92 years; 64 females), whereas the remaining 87 did not (age 38.43±9.97 years; 47 females). Negative LES scores were significantly correlated with BIS (r=0.22, p=0.001), BAI (r=0.46, p< 0.001), and BDI (r=0.51, p

We study the electronic and optoelectronic properties of a broken-gap heterojunction composed of SnSe2 and MoTe2 with gate-controlled junction modes. Owing to the interband tunneling current, our device can act as an Esaki diode and a backward diode with a peak-to-valley current ratio approaching 5.7 at room temperature. Furthermore, under an 811 nm laser irradiation the heterostructure exhibits a photodetectivity of up to 7.5 × 1012 Jones. In addition, to harness the electrostatic gate bias, Voc can be tuned from negative to positive by switching from the accumulation mode to the depletion mode of the heterojunction. Additionally, a photovoltaic effect with a fill factor exceeding 41% was observed, which highlights the significant potential for optoelectronic applications. This study not only demonstrates high-performance multifunctional optoelectronics based on the SnSe2/MoTe2 heterostructure but also provides a comprehensive understanding of broken-band alignment and its applications.

Background/Aims: This study aimed to evaluate the correlation between clinical risk factors of post-extubation dysphagia (PED) and the severity of impaired pha ryngeal swallowing function assessed via videofluoroscopic swallowing studies (VFSSs). Methods: This study was a retrospective review of medical records. Of 116 patients who were admitted to the intensive care unit and underwent VFSS, 32 who had non-neurologic disorders and experienced prolonged intubation (for more than 48 hours) were diagnosed with PED. The severity of PED was evaluated by using a functional dysphagia scale (FDS) and a penetration aspiration scale (PAS), on the basis of VFSS. Results: The Simplified Acute Physiology Score 3 and total FDS score were posi tively correlated (r = 0.40, p = 0.02). Intubation duration was positively correlated with total PAS and FDS scores (r = 0.62, p < 0.001; r = 0.65, p < 0.001, respectively). The amounts of residue in the valleculae (RV) and pyriform sinuses (RP) were as sociated with intubation duration (r = 0.58, p < 0.001; r = 0.57, p < 0.001, respective ly). Multivariate regression analysis revealed that intubation duration was signifi cantly associated with the total FDS score, RV and RP subscales of the FDS, and total PAS score. Conclusions: The severity of impaired swallowing function, particularly the amount of residue in the pharyngeal recesses assessed via VFSS, was strongly as sociated with both severity of medical illness and intubation duration. Intubation duration could be a prognostic factor for assessing impaired swallowing function on the basis of VFSS.

In this study, we evaluated clinical parameters to predict the primary resistance of palbociclib in combination with endocrine therapy as the first-line treatment in patients with hormone receptor (HR)+, human epidermal growth factor receptor 2 (HER2)- metastatic breast cancer (MBC). We performed a data analysis of patients diagnosed with HR+, HER2-MBC who received palbociclib plus letrozole as the first-line treatment in the metastatic setting from the clinical data warehouse in Samsung Medical Center. In this study, 305 patients were included in the final data analysis. The median follow-up duration was 31 months, and we observed 123 cases of disease progression. The median progression-free survival (PFS) was 28.7 months, and 38 patients (12.5%) had less than a 6-month PFS. The multivariate analysis suggested that primary resistance to adjuvant endocrine therapy (ET) (hazard ratio: 1.91), presence of liver metastasis (hazard ratio: 2.17), initial elevation of serum CA-15-3 (hazard ratio: 1.99), weak positivity of estrogen receptor (ER) (hazard ratio: 2.28), Ki-67 3+ or 4+ (hazard ratios: 2.58 and 10.28), and presence of mutation (hazard ratio: 9.59) were associated with a short PFS duration. A further prediction model was developed with data from 256 patients and 33 cases of disease progression in 6 months. This model included five factors—primary resistance to adjuvant ET (odds ratio, OR: 1.14), liver metastasis (OR: 1.56), initial CA-15-3 elevation (OR: 1.51), weak ER expression (OR: 2.22), and BRCA2 mutation (OR: 2.85)—and the area under the receiver operating characteristic curve was 0.842 (95% CI: 0.775, 0.909; p < 0.001). Finally, we divided them into four risk groups according to the prediction model with the five risk factors. These four groups had different PFS (p < 0.001) and primary resistance of palbociclib with letrozole [OR of group 2 vs. group 1 (ref): 2.18 (p = 0.002), OR of group 3: 3.91 (p < 0.001), and OR of group 4: 4.25 (p < 0.001)]. We developed a prediction model of primary resistance to palbociclib with letrozole as the first-line treatment for HR+, HER2-MBC. Our prediction model might be helpful for considering the first-line treatment strategies. Further well-designed clinical trials would be warranted to validate our prediction model.

Spherical mullite (M)-cordierite (C) composite granules were prepared by spray drying the fine starting powders obtained from attrition milling to produce sintered mullite-cordierite composite pellets with a dense structure. The effects of attrition milling on the morphology, size and size distribution of the formed composite granules were investigated. The results showed that the milled starting powders formed the spherical granules with homogeneous size distribution. The composition ratio (M:C = 100:0, M:C = 90:10, M:C = 70:30, M:C = 50:50, M:C = 30:70, M:C = 0:100) and sintering temperature (1300–1450℃) were optimized to fabricate the sintered mullite-cordierite composite pellets with low thermal expansion coefficients (TECs) and excellent mechanical properties. Samples of 70 wt% mullite-30 wt% cordierite sintered at 1350℃ exhibited excellent bulk density, porosity, TEC, and flexural strength. Based on these results, a large-area mullite-cordierite composite substrate was fabricated for application in semiconductor probe card. The changes in sheet resistance and flexural strength were measured to study the influence of the environmental tests, including high temperature storage test, damp heat test, and thermal shock test, on the large-area substrate. A low rate of change in sheet resistance and flexural strength was observed. After the environmental tests, the sheet resistance and flexural strength were confirmed to be within 10% of their values prior to the tests. These results show that the fabricated mullite-cordierite composite exhibits high reliability and durability and is a suitable for semiconductor probe cards.

Objectives: Evidence suggests that emotion regulation difficulty may play an important role in the association between life stress, sleep disturbance and depressive symptoms. We proposed two models depicting the possible moderating roles of prefrontal cortex activation during emotion regulation in the associations among these variables and tested them. We hypothesized that (1) the association between stress and sleep disturbance would differ across prefrontal cortex activation during emotion regulation (moderation model) and (2) the indirect effects of stress on depressive symptoms through sleep disturbance would depend on prefrontal cortex activation during emotion regulation (moderated mediation model). Methods: Forty-eight healthy adults without sleep disorders based on nocturnal polysomnography participated in this study. They received functional magnetic resonance imaging scans while performing an emotion regulation task. They also completed questionnaires assessing life stress, sleep disturbance and depressive symptoms. The proposed models were tested using the PROCESS macro for SPSS. Results: As hypothesized, there was a significant moderating effect of prefrontal cortex activation during emotion regulation on the association between life stress and sleep disturbance. Furthermore, right lateral prefrontal cortex activation had a moderating role in the indirect effect of life stress on depressive symptoms through sleep disturbance. Conclusion: These findings highlight the important role of prefrontal cortex function during emotion regulation in the associations between stress, sleep disturbance and depressive symptoms. Increasing lateral prefrontal cortex recruitment when regulating the emotional response to negative life events may be critical for the prevention and intervention of depression as well as sleep problems.

Betweenness centrality (BC) was proposed as an indicator of the extent of an individual's influence in a social network. It is measured by counting how many times a vertex (i.e., an individual) appears on all the shortest paths between pairs of vertices. A question naturally arises as to how the influence of a team or group in a social network can be measured. Here, we propose a method of measuring this influence on a bipartite graph comprising vertices (individuals) and hyperedges (teams). When the hyperedge size varies, the number of shortest paths between two vertices in a hypergraph can be larger than that in a binary graph. Thus, the power-law behavior of the team BC distribution breaks down in scale-free hypergraphs. However, when the weight of each hyperedge, for example, the performance per team member, is counted, the team BC distribution is found to exhibit power-law behavior. We find that a team with a widely connected member is highly influential.

With different computational tools, simulations ranging from detailed and rigorous mathematical models to overall process plant of black box models can be carried out. Whereas most of these computational tools cannot practically execute different scales of models at the same time, it becomes relevant to devise strategies in coupling two or more of them for better analysis of processes. In this light, this study proposes Excel as an interactive scale bridge of data exchange to aid the multiscale modeling and dynamic simulation of combined cycle (CC) power plant integration with two-tank thermal energy storage (TES) system using gPROMS and SimCentral. This is relevant to analyze not only the performance of TES, but the feasibility of its integration with CC in augmenting energy production to meet daily power demand. The integrated system modeled in four operational modes of CC increased in power generation by 7.3 MW at an efficiency of 98.30%. The study validated the usefulness of the TES integration of 99.66% efficiency. The research results provide a communication strategy for different computational tools and an approach to effectively increase CC power production to meet varying daily demand.

Dense SiC layers with a thickness of 150 nm were prepared on n- and p-type Si substrates using aerosol deposition (AD) at room temperature. The contribution of electrons and holes to the conductivity in Ni/i-SiC/Si structures was investigated by conducting experiments involving the injection of carriers from silicon. Our results showed that the injection of carriers via light illumination and temperature experiments led to the generation of minority carriers, which contributed to the conductivity in the Ni/i-SiC/Si structures. The activation energies were found to be 0.8 eV and 0.4 eV for i-SiC/n-Si and i-SiC/p-Si, respectively. The conductivity of these Ni/i-SiC/Si structures was also affected by the trap-assisted tunneling process. The results indicate that the AD-prepared SiC/Si heterostructures could possibly be used to control bipolar conductivity and hold potential for application in temperature sensors and photovoltaics.