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BackgroundPrevious studies have argued that attention deficit hyperactivity disorder (ADHD) is associated with asthma. However, reliable evidence to verify this association has not yet been reported.ObjectivesTo investigate the bidirectional association between asthma and ADHD through a 12-year big data cohort study.MethodsThe independent variable group was extracted from 3.5 million individuals randomly sampled by the National Health Insurance Service (NHIS). In Study 1, the incidence of ADHD according to asthma was evaluated, while in Study 2, the incidence of asthma according to ADHD was analyzed. Propensity score (PS) matching with several variables was used to obtain a control group.Measurements and main resultsIn Study 1, the asthma group included 131,937 individuals and the non-asthma group included 131,937 individuals. The adjusted hazard ratio (aHR) for ADHD in the asthma group was 1.17 [95% confidence interval (CI): 1.11–1.23]. In subgroup analysis, the aHRs for ADHD of individuals in the subgroups male sex, 0–5 years old, 6–10 years old, atopic dermatitis, allergic rhinitis, Charlson comorbidity index (CCI) 1, and CCI > 2 were significant (aHR: 2.83, 1.70, 1.79, 1.09, 1.15, 1.06, and 1.49, respectively). In Study 2, ADHD was found to significantly affect asthma in all age groups (aHRs of the subgroups 0∼60 and 0∼17 years old were 1.10 and 1.09, respectively). In the 0∼17 years old subgroup, the association of ADHD with asthma was greater with younger age (aHRs of the subgroups 0∼5 and 6∼10 years old were 2.53 and 1.54, respectively).ConclusionFrom long-term follow-up, the incidence of ADHD was 1.17 times higher in the asthma group than in the control group. The incidence of asthma was 1.10 times higher in the ADHD group than in the control group. Asthma and ADHD have a bidirectional relationship, and childhood asthma and ADHD should be rigorously managed.

BackgroundProton pump inhibitors (PPIs) are acid suppressants that are frequently prescribed in many countries to reduce heartburn. A potassium-competitive acid blocker (P-CAB; tegoprazan) was launched relatively recently that also inhibits gastric acid secretion. This study aimed to compare the hepatotoxicity of the six existing PPIs with P-CAB.MethodsThis retrospective cohort study was conducted between January 2019 and December 2020 and included data from the total population of 50 million inhabitants in Korea. Propensity score (PS) matching was performed using 10 variables, and the differences in hepatotoxicity between P-CAB and the six PPIs were compared in a similar distribution. The primary endpoint was hepatotoxicity which included toxic liver disease, hepatitis, hepatic failure, liver transplantation, and other liver diseases.ResultsThe risk ratios (RR) of tegoprazan vs. the six PPIs (dexlansoprazole, esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole) were all significant [RR: 0.70 (95% CI: 0.69–0.72), 0.81 (95% CI: 0.79–0.83), 0.61 (95% CI: 0.59–0.63), 1.17 (95% CI: 1.13–1.20), 0.61 (95% CI: 0.59–0.62), and 0.73 (95% CI: 0.71–0.75), respectively]. The risk ratio of tegoprazan vs. the six existing PPIs was 0.73 (95% CI: 0.72–0.75). The hazard ratios (HRs) of hepatotoxicity of the six PPIs to tegoprazan showed significantly higher values apart from omeprazole (HR: dexlansoprazole, 1.13; esomeprazole, 1.04; lansoprazole, 1.25; omeprazole, 0.77; pantoprazole, 1.26; rabeprazole, 1.15, respectively, and the six existing PPIs, 1.10).ConclusionUsing a large-scale data cohort analysis consisting of 50 million Koreans, tegoprazan did not induce higher hepatotoxicity compared with the six conventional PPIs.

Some patients with postoperative atrial fibrillation (POAF) after non-cardiac surgery need treatment, and a predictive model for these patients is clinically useful. Here, we developed a predictive model for POAF in non-cardiac surgery based on machine learning techniques. In a total of 201,864 patients who underwent non-cardiac surgery between January 2011 and June 2019 at our institution, 5,725 (2.8%) were treated for POAF. We used machine learning with an extreme gradient boosting algorithm to evaluate the effects of variables on POAF. Using the top five variables from this algorithm, we generated a predictive model for POAF and conducted an external validation. The top five variables selected for the POAF model were age, lung operation, operation duration, history of coronary artery disease, and hypertension. The optimal threshold of probability in this model was estimated to be 0.1, and the area under the receiver operating characteristic (AUROC) curve was 0.80 with a 95% confidence interval of 0.78–0.81. Accuracy of the model using the estimated threshold was 0.95, with sensitivity and specificity values of 0.28 and 0.97, respectively. In an external validation, the AUROC was 0.80 (0.78–0.81). The working predictive model for POAF requiring treatment in non-cardiac surgery based on machine learning techniques is provided online (https://sjshin.shinyapps.io/afib_predictor_0913/). The model needs further verification among other populations.

Abstract The cryogenic pump is a crucial component of the magnetic resonance imaging (MRI) system for delivering liquid helium to a magnet for superconductivity, thereby generating a mechanical vibration. Thus, the cryogenic pump for liquid helium (helium pump) contaminates the electroencephalography (EEG) simultaneously acquired with functional MRI. The recursive approach of EEG‐segment‐based principal component analysis (rsPCA) has recently demonstrated its efficacy in removing this helium pump artefact. In the rsPCA, the recursion depth and EEG‐segment size are crucial hyperparameters. rsPCA's performance and computational time across recursion depth (1, 2, 3) and segment sizes (165, 220, 265) are systematically evaluated. It is found that the recursion depth of 2 yielded significant reductions in the computational time compared to the depth of 3 across all segment sizes while maintaining the denoising performance. The binary classification performance (left‐hand versus right‐hand clenching) was also enhanced in this scenario (especially the use of EEG‐segment size of 165 and 220) by using EEG gamma‐band activity (30–50 Hz), which is predominantly contaminated by the helium‐pump artefact.

Abstract Chemotherapy is an important method in the field of cancer treatment and often follows surgery and/or radiotherapy to remove as many tumor cells as possible. In particular, among the chemotherapy methods, treatment using electromagnetic-based actuation systems is considered an effective method owing to the remote control of nanorobots. The existing electromagnetic-based actuation systems, however, have certain disadvantages such as the lack of degrees of freedom and the difficulty of manipulating large numbers of nanorobots (i.e., nanorobot clusters). Herein, we report that nanorobot clusters can be manipulated with high degrees of freedom through a simple parameter alpha that easily controls the gradient of the magnetic field of a multi-coil electromagnetic actuation system. The simulation results show that the gradient of the magnetic field is controlled using an introduced parameter, alpha, and the corresponding velocity is also controlled. Not only the velocity of the nanorobot cluster but also the unrestricted spatial control is enabled in two- and three-dimensions. We believe this study highlights an efficient method of electromagnetic control for cluster-based drug delivery.

Abstract Background Inflammatory bowel disease (IBD) commonly occurs in dogs, but there is lack of information about potential biomarkers of clinical and histopathologic severity. Objective To examine the role of serum C‐reactive protein (CRP) and high‐mobility group box 1 (HMGB1) concentrations in dogs with IBD. Animals Seventeen dogs with IBD and 25 healthy dogs. Methods In this prospective study, duodenal histopathologic severity was graded, and the clinical severity of IBD was assessed by the canine IBD assessment index (CIBDAI) score in dogs with IBD. Serum CRP and HMGB1 concentrations were compared between IBD and healthy dogs and analyzed according to histopathologic grade in dogs with IBD. The correlations between serum CRP and HMGB1 concentrations and the CIBDAI score were evaluated. Results Dogs with IBD had higher serum CRP (median [range] = 20.39 [1.53‐67.69] μg/mL vs 2.31 [0.17‐11.49] μg/mL; P

BackgroundPostoperative atrial fibrillation (POAF) is related to mortality after non-cardiac surgery. Left atrial volume index (LAVI) is known to be associated with prognosis and development of atrial fibrillation, but it has not been fully investigated in patients undergoing non-cardiac surgery.Materials and methodsA total of 203,787 consecutive adult patients underwent non-cardiac surgery at our institution between January 2011 and June 2019. After identifying those with available LAVI estimated during preoperative echocardiography, we divided them into those with LAVI higher and lower than 34 mL/m2. The primary outcome was incidence of POAF.ResultsA total of 83,097 patients were enrolled in this study. The study patients were divided into the low (57,838 [69.6%]) and high (25,259 [30.4%]) LAVI groups. After an adjustment, higher LAVI was associated with increased incidence of POAF (5.1% vs. 8.1%; odds ratio [OR], 1.33; 95% confidence interval [CI], 1.25–1.41; p < 0.001). In 24,549 pairs of propensity-score-matched population, the result was similar (6.2% vs. 7.9%; OR, 1.30; 95% CI, 1.21–1.39; p < 0.001). The estimated threshold of LAVI associated with POAF was 36.4 mL/m2 with an area under the curve of 0.571. Subgroup analysis in non-thoracic and thoracic surgery showed that the association between preoperative LAVI and POAF significantly interacted with diastolic dysfunction (p for interaction < 0.001), and the observed association was valid in patients without diastolic dysfunction.ConclusionPreoperative LAVI was shown to be associated with POAF in non-cardiac surgery. Our result needs verification in further studies.

The fabrication of multi-dimensional nanocomposites has been extensively attempted to achieve synergistic performance through the uniform mixing of functional constituents. Herein, we report a one-pot fabrication of nanocomposites composed of carbon nanotubes (CNTs) and Al2O3 powder. Our strategy involves a synthesis of CNTs on the entire Al2O3 surface using a rotatable chemical vapor deposition system (RCVD). Ehylene and ferritin-induced nanoparticles were used as the carbon source and wet catalyst, respectively. The RCVD was composed of a quartz reaction tube, 5.08 cm in diameter and 150 cm in length, with a rotation speed controller. Ferritin dissolved in deionized water was uniformly dispersed on the Al2O3 surface and calcinated to obtain iron nanoparticles. The synthesis temperature, time, and rotation speed of the chamber were the main parameters used to investigate the growth behavior of CNTs. We found that the CNTs can be grown at least around 600 °C, and the number of tubes increases with increasing growth time. A faster rotation of the chamber allows for the uniform growth of CNT by the tip-growth mechanism. Our results are preliminary at present but show that the RCVD process is sufficient for the fabrication of powder-based nanocomposites.

Background Cardiac complications are associated with perioperative mortality, but perioperative adverse cardiac events (PACEs) that are associated with long‐term mortality have not been clearly defined. We identified PACE as a composite of myocardial infarction, coronary revascularization, congestive heart failure, arrhythmic attack, acute pulmonary embolism, cardiac arrest, or stroke during the 30‐day postoperative period and we compared mortality according to PACE occurrence. Methods and Results From January 2011 to June 2019, a total of 203 787 consecutive adult patients underwent noncardiac surgery at our institution. After excluding those with 30‐day mortality, mortality during a 1‐year follow‐up was compared. Machine learning with the extreme gradient boosting algorithm was also used to evaluate whether PACE was associated with 1‐year mortality. After excluding 1203 patients with 30‐day mortality, 202 584 patients were divided into 7994 (3.9%) patients with PACE and 194 590 (96.1%) without PACE. After an adjustment, the mortality was higher in the PACE group (2.1% versus 7.7%; hazard ratio [HR], 1.90; 95% CI, 1.74–2.09; P

Background The number of patients with operable lung cancer with a history of percutaneous coronary intervention (PCI) has increased. However, cardiovascular outcomes and mortality, according to the time from PCI to surgery, and the follow‐up time after surgery are largely unknown. Here, we aimed to compare the cardiovascular outcomes and mortality of these patients with a history of PCI to those of patients without a history of PCI. Methods Using the Korean National Health Insurance Service Database, we selected 30 750 patients who underwent surgery for lung cancer between 2006 and 2014. Study outcome variables were all‐cause mortality, revascularization, intensive care unit (ICU) readmission, and stroke incidence. Patients were followed‐up until 2016. Results Of the 30 750 patients, 513 (1.7%) underwent PCI before surgery. The PCI group did not show an increased risk of death, ICU readmission, or stroke within one year of surgery, despite an increased risk of revascularization. However, one year after surgery, they showed a higher risk of death and revascularization than the non‐PCI group. The risk of revascularization was highest when the interval between PCI and surgery was 3 years. Conclusions Patients who underwent PCI before surgery for lung cancer were at a higher risk of death than those in the non‐PCI group at one year after surgery. In addition, they showed higher short‐ and long‐term risks of revascularization than patients in the non‐PCI group. Careful long‐term management of cardiovascular risk is necessary for this population.

BackgroundElectronic cigarettes (e-cigs) as substitute devices for regular tobacco cigarettes (r-cigs) have been increasing in recent times. We investigated neuronal substrates of vaping e-cigs and smoking r-cigs from r-cig smokers.MethodsTwenty-two r-cig smokers made two visits following overnight smoking cessation. Functional magnetic resonance imaging (fMRI) data were acquired while participants watched smoking images. Participants were then allowed to smoke either an e-cig or r-cig until satiated and fMRI data were acquired. Their craving levels and performance on the Montreal Imaging Stress Task and a 3-back alphabet/digit recognition task were obtained and analyzed using two-way repeated-measures analysis of variance. Regions-of-interest (ROIs) were identified by comparing the abstained and satiated conditions. Neuronal activation within ROIs was regressed on the craving and behavioral data separately.ResultsCraving was more substantially reduced by smoking r-cigs than by vaping e-cigs. The response time (RT) for the 3-back task was significantly shorter following smoking r-cigs than following vaping e-cigs (interaction: F (1, 17) = 5.3, p = 0.035). Neuronal activations of the right vermis (r = 0.43, p = 0.037, CI = [-0.05, 0.74]), right caudate (r = 0.51, p = 0.015, CI = [0.05, 0.79]), and right superior frontal gyrus (r = −0.70, p = 0.001, CI = [−0.88, −0.34]) were significantly correlated with the RT for the 3-back task only for smoking r-cigs.ConclusionOur findings suggest that insufficient satiety from vaping e-cigs for r-cigs smokers may be insignificant effect on working memory function.

Despite an association between obesity and increased mortality in the general population, obesity has been paradoxically reported with improved mortality of surgery and some types of cancer. However, this has not been fully investigated in patients undergoing cancer surgery. Using a cohort consisting of mostly Asian population, we enrolled 87,567 adult patients who underwent cancer surgery from March 2010 to December 2019. They were divided into three groups according to body mass index (BMI): 53,980 (61.6%) in the normal (18.5-25 kg/m2), 2,787 (3.2%) in the low BMI (

Tracheostomy is increasingly performed in children for upper airway anomalies. Here, an 18-month-old child (height 84.1 cm, weight 12.5 kg) presented to the emergency department with dyspnea, stridor, and chest retraction. However, exploration of the airways using a bronchoscope failed due to subglottic stenosis. Therefore, a surgical tracheostomy was successfully performed with manual mask ventilation. However, pneumomediastinum was found in the postoperative chest radiograph. Although an oxygen saturation of 99% was initially maintained, oxygen saturation levels dropped, due to sudden dyspnea, after 3 hours. A chest radiograph taken at this time revealed a left tension pneumothorax and small right pneumothorax. Despite a needle thoracostomy, the pneumothorax was aggravated, and cardiac arrest occurred. Cardiopulmonary-cerebral resuscitation was performed, but the patient was declared dead 30 minutes later. This study highlights the fatal complications that can occur in children during tracheostomy. Therefore, close monitoring, immediate suspicion, recognition, and aggressive management may avoid fatal outcomes.

Uranium (U) is one of the typical naturally occurring radioactive elements enriched in groundwater through geological mechanisms, thereby bringing about adverse effects on human health. For this reason, some countries and the World Health Organization (WHO) regulate U with drinking water standards and monitor its status in groundwater. In Korea, there have been continuous investigations to monitor and manage U in groundwater, but they have targeted only public groundwater wells. However, the features of private wells differ from public ones, particularly in regard to the well’s depth and diameter, affecting the U distribution in private wells. This study was initiated to investigate U concentrations in private groundwater wells for potable use, and the significant factors controlling them were also elucidated through statistical methods. The results obtained from the analyses of 7036 groundwater samples from private wells showed that the highest, average, and median values of U concentrations were 1450, 0.4, and 4.0 μg/L, respectively, and 2.1% of the wells had U concentrations exceeding the Korean and WHO standard (30 μg/L). In addition, the U concentrations were highest in areas of the Jurassic granite, followed by Quaternary alluvium and Precambrian metamorphic rocks. A more detailed investigation of the relationship between U concentration and geology revealed that the Jurassic porphyritic granite, mainly composed of Daebo granite, showed the highest U contents, which indicated that U might originate from uraninite (UO2) and coffinite (USiO4). Consequently, significant caution should be exercised when using the groundwater in these geological areas for potable use. The results of this study might be applied to establish relevant management plans to protect human health from the detrimental effect of U in groundwater.

Real-time fMRI neurofeedback is an increasingly popular neuroimaging technique that allows an individual to gain control over his/her own brain signals, which can lead to improvements in behavior in healthy participants as well as to improvements of clinical symptoms in patient populations. However, a considerably large ratio of participants undergoing neurofeedback training do not learn to control their own brain signals and, consequently, do not benefit from neurofeedback interventions, which limits clinical efficacy of neurofeedback interventions. As neurofeedback success varies between studies and participants, it is important to identify factors that might influence neurofeedback success. Here, for the first time, we employed a big data machine learning approach to investigate the influence of 20 different design-specific (e.g. activity vs. connectivity feedback), region of interest-specific (e.g. cortical vs. subcortical) and subject-specific factors (e.g. age) on neurofeedback performance and improvement in 608 participants from 28 independent experiments.With a classification accuracy of 60% (considerably different from chance level), we identified two factors that significantly influenced neurofeedback performance: Both the inclusion of a pre-training no-feedback run before neurofeedback training and neurofeedback training of patients as compared to healthy participants were associated with better neurofeedback performance. The positive effect of pre-training no-feedback runs on neurofeedback performance might be due to the familiarization of participants with the neurofeedback setup and the mental imagery task before neurofeedback training runs. Better performance of patients as compared to healthy participants might be driven by higher motivation of patients, higher ranges for the regulation of dysfunctional brain signals, or a more extensive piloting of clinical experimental paradigms. Due to the large heterogeneity of our dataset, these findings likely generalize across neurofeedback studies, thus providing guidance for designing more efficient neurofeedback studies specifically for improving clinical neurofeedback-based interventions. To facilitate the development of data-driven recommendations for specific design details and subpopulations the field would benefit from stronger engagement in open science research practices and data sharing.

Deep-learning methods based on deep neural networks (DNNs) have recently been successfully utilized in the analysis of neuroimaging data. A convolutional neural network (CNN) is a type of DNN that employs a convolution kernel that covers a local area of the input sample and moves across the sample to provide a feature map for the subsequent layers. In our study, we hypothesized that a 3D-CNN model with down-sampling operations such as pooling and/or stride would have the ability to extract robust feature maps from the shifted and scaled neuronal activations in a single functional MRI (fMRI) volume for the classification of task information associated with that volume. Thus, the 3D-CNN model would be able to ameliorate the potential misalignment of neuronal activations and over-/under-activation in local brain regions caused by imperfections in spatial alignment algorithms, confounded by variability in blood-oxygenation-level-dependent (BOLD) responses across sessions and/or subjects. To this end, the fMRI volumes acquired from four sensorimotor tasks (left-hand clenching, right-hand clenching, auditory attention, and visual stimulation) were used as input for our 3D-CNN model to classify task information using a single fMRI volume. The classification performance of the 3D-CNN was systematically evaluated using fMRI volumes obtained from various minimal preprocessing scenarios applied to raw fMRI volumes that excluded spatial normalization to a template and those obtained from full preprocessing that included spatial normalization. Alternative classifier models such as the 1D fully connected DNN (1D-fcDNN) and support vector machine (SVM) were also used for comparison. The classification performance was also assessed for several k-fold cross-validation (CV) schemes, including leave-one-subject-out CV (LOOCV). Overall, the classification results of the 3D-CNN model were superior to that of the 1D-fcDNN and SVM models. When using the fully-processed fMRI volumes with LOOCV, the mean error rates (± the standard error of the mean) for the 3D-CNN, 1D-fcDNN, and SVM models were 2.1% (± 0.9), 3.1% (± 1.2), and 4.1% (± 1.5), respectively (p = 0.041 from a one-way ANOVA). The error rates for 3-fold CV were higher (2.4% ± 1.0, 4.2% ± 1.3, and 10.1% ± 2.0; p < 0.0003 from a one-way ANOVA). The mean error rates also increased considerably using the raw fMRI 3D volume data without preprocessing (26.2% for the 3D-CNN, 75.0% for the 1D-fcDNN, and 75.0% for the SVM). Furthermore, the ability of the pre-trained 3D-CNN model to handle shifted and scaled neuronal activations was demonstrated in an online scenario for five-class classification (i.e., four sensorimotor tasks and the resting state) using the real-time fMRI of three participants. The resulting classification accuracy was 78.5% (± 1.4), 26.7% (± 5.9), and 21.5% (± 3.1) for the 3D-CNN, 1D-fcDNN, and SVM models, respectively. The superior performance of the 3D-CNN compared to the 1D-fcDNN was verified by analyzing the resulting feature maps and convolution filters that handled the shifted and scaled neuronal activations and by utilizing an independent public dataset from the Human Connectome Project.

Soil health deteriorates through the contamination and remediation processes, resulting in the limitation of the reuse and recycling of the remediated soils. Therefore, soil health should be recovered for the intended purposes of reuse and recycling. This study aimed to evaluate the applicability and effectiveness of several amendments to revitalize total petroleum hydrocarbon contaminated soils remediated by the landfarming process. Ten inorganic, organic, and biological amendments were investigated for their dosage and duration, and nine physicochemical, four fertility, and seven microbial (soil enzyme activity) factors were compared before and after the treatment of amendments. Finally, the extent of recovery was quantitatively estimated, and the significance of results was confirmed with statistical methods, such as simple regression and correlation analyses assisted by principal component analysis. The landfarming process is considered a somewhat environmentally friendly remediation technology to minimize the adverse effect on soil quality, but four soil properties—such as water holding capacity (WHC), exchangeable potassium (Ex. K), nitrate-nitrogen (NO3-N), available phosphorus (Av. P), and urease—were confirmed to deteriorate through the landfarming process. The WHC was better improved by organic agents, such as peat moss, biochar, and compost. Zeolite was evaluated as the most effective material for improving Ex. K content. The vermicompost showed the highest efficacy in recovering the NO3-N content of the remediated soil. Chlorella, vermicompost, and compost were investigated for their ability to enhance urease activity effectively. Although each additive showed different effectiveness according to different soil properties, their effect on overall soil properties should be considered for cost-effectiveness and practical implementation. Their overall effect was evaluated using statistical methods, and the results showed that compost, chlorella, and vermicompost were the most relevant amendments for rehabilitating the overall health of the remediated soil for the reuse and/or recycling of agricultural purposes. This study highlighted how to practically improve the health of remediated soils for the reuse and recycling of agricultural purposes.

The naturalistic viewing of a video clip enables participants to obtain more information from the clip compared to conventional viewing of a static image. Because changing the field-of-view (FoV) allows new visual information to be obtained, we were motivated to investigate whether naturalistic viewing with varying FoV based on active eye movement can enhance the viewing experience of natural stimuli, such as those found in a video clip with a 360° FoV in an MRI scanner. To this end, we developed a novel naturalistic viewing paradigm based on real-time eye-gaze tracking while participants were watching a 360° panoramic video during fMRI acquisition. The gaze position of the participants was recorded using an eye-tracking computer and then transmitted to a stimulus presentation computer via a TCP/IP connection. The identified gaze position was then used to alter the participants' FoV of the video clip in real-time, so the participants could change their FoV to fully explore the 360° video clip (referred to in this paper as active viewing). The gaze position of one participant while watching a video was used to change the FoV of the same video clip for a paired participant (referred to as yoked or passive viewing). Four 360° panoramic videos were used as stimuli, divided into categories based on the brightness level (i.e., bright vs. dark) and location (i.e., nature vs. city). Each of the subjects participated in the active viewing of one of the two nature videos and one of the two city videos and then engaged in the passive viewing of the other video in each category, followed by conventional viewing with a fixed FoV (referred to as fixed viewing) after each of the active or passive viewings. Forty-eight healthy volunteers participated in the study, and data from 42 of these participants were used in the analysis. Representational similarity analysis (RSA) was conducted in a multiple regression framework using representational dissimilarity matrix (RDM) codes to accommodate all of the information regarding neuronal activations from fMRI analysis and the participants' subjective ratings of their viewing experience with the four video clips and with the two contrasting viewing conditions (i.e., “active–fixed” and “passive–fixed”). It was found that the participants' naturalistic viewing experience of the video clips was substantially more immersive with active viewing than with passive and fixed viewing. The RSA using the RDM codes revealed the brain regions associated with the viewing experience, including eye movement and spatial navigation in the superior frontal area (of Brodmann's area 6) and the inferior/superior parietal areas, respectively. Brain regions potentially associated with cognitive and affective processing during the viewing of the video, such as the default-mode networks and insular/Rolandic operculum areas, were also identified. To the best of our knowledge, this is the first study that has used the participants' eye movements to interactively change their FoV for 360° panoramic video clips in real-time. Our method of utilizing the MRI environment can be further extended to other environments such as electroencephalography and behavioral research. It would also be feasible to apply our method to virtual reality and/or augmented reality systems to maximize user experience based on their eye movement.

We evaluated whether volatile anesthetics can improve the postoperative outcomes of non-cardiac surgery in patients with preoperative myocardial injury defined by the cardiac troponin elevation. From January 2010 to June 2018, 1254 adult patients with preoperative myocardial injury underwent non-cardiac surgery under general anesthesia and were enrolled in this study. Patients were stratified into following two groups according to anesthetic agents; 115 (9.2%) patients whose anesthesia was induced and maintained with continuous infusion of propofol and remifentanil (TIVA group) and 1139 (90.8%) patients whose anesthesia was maintainted with volatile anesthetics (VOLATILE group). The primary outcome was 30-day mortality. To diminish the remifentanil effect, a further analysis was conducted after excluding the patients who received only volatile anesthetics without remifentanil infusion. In a propensity-score matched analysis, 30-day mortality was higher in the TIVA group than the VOLATILE group (17.0% vs. 9.1%; hazard ratio [HR] 2.60; 95% confidence interval [CI], 1.14-5.93; p = 0.02). In addition, the TIVA group showed higher 30-day mortality than the VOLATILE group, even after eliminating the effect of remifentanil infusion (15.8% vs. 8.3%; HR 4.62; 95% CI, 1.82-11.74; p = 0.001). In our study, the use of volatile anesthetics showed the significant survival improvement after non-cardiac surgery in patients with preoperative myocardial injury, which appears to be irrelevant to the remifentanil use. Further studies are needed to confirm this beneficial effect of volatile anesthetics. Clinical trial number and registry URL: KCT0004349 (www.cris.nih.go.kr).

BackgroundWe evaluated whether a simulation-based training with a vessel phantom improves the basic skills of a novice required for ultrasound-guided radial artery cannulation in real patients. In addition, we analysed whether repeated simulation training sets with an inter-training interval would accelerate the learning curve.MethodsFrom March 2019 to July 2019, twenty-one anesthesiology residents were randomized into either a simulation group (n = 11) or control group (n = 10). Residents performed a total of 84 ultrasound-guided radial artery cannulations in real patients. The simulation group participated in two sets of simulation training on a vessel phantom (10 sessions per set) with a one-month inter-training interval. Trainee's performance proficiency was scored using a developed checklist, and a learning curve for each training set was constructed. To evaluate the effectiveness of our training curriculum in skill transfer, each resident performed four ultrasound-guided radial artery cannulations in real patients. The primary outcome was first attempt success rate and the secondary outcome was dynamic needle-tip positioning ability in real patients.ResultsThe first attempt success rate and dynamic needle-tip positioning ability by ultrasound transducer were significantly higher in the simulation group than the control group (81.8% vs. 50%, P = 0.002 and 68.2% vs. 7.5%, P < 0.001, respectively). A reduced number of sessions was required to reach a plateau score on the learning curve in the repeated training set compared in the first-set (7 (5-8) vs. 3 (2-4), P = 0.003, respectively).ConclusionsSimulation-based training using a vessel phantom effectively improved the first attempt success rate for ultrasound-guided radial artery cannulation in real patients and the dynamic needle-tip positioning ability by ultrasound transducer in novice anesthesiology residents. In addition, repeated training curriculum accelerated the learning curve for recall skill proficiency and reduced inter-individual variability for skill acquisition.Clinical trial registrationClinical Research Information Service (KCT0003471, Principle investigator: Jeong Jin Min, Date of registration: 06/March/2019).

Coronavirus disease 2019 (COVID-19), the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is characterized by symptoms such as fever, fatigue, a sore throat, diarrhea, and coughing. Although various new vaccines against COVID-19 have been developed, early diagnostics, isolation, and prevention remain important due to virus mutations resulting in rapid and high disease transmission. Amino acid substitutions in the major diagnostic target antigens of SARS-CoV-2 may lower the sensitivity for the detection of SARS-CoV-2. For this reason, we developed specific monoclonal antibodies that bind to epitope peptides as antigens for the rapid detection of SARS-CoV-2 NP. The binding affinity between antigenic peptides and monoclonal antibodies was investigated, and a sandwich pair for capture and detection was employed to develop a rapid biosensor for SARS-CoV-2 NP. The rapid biosensor, based on a monoclonal antibody pair binding to conserved epitopes of SARS-CoV-2 NP, detected cultured virus samples of SARS-CoV-2 (1.4 × 103 TCID50/reaction) and recombinant NP (1 ng/mL). Laboratory confirmation of the rapid biosensor was performed with clinical specimens (n = 16) from COVID-19 patients and other pathogens. The rapid biosensor consisting of a monoclonal antibody pair (75E12 for capture and the 54G6/54G10 combination for detection) binding to conserved epitopes of SARS-CoV-2 NP could assist in the detection of SARS-CoV-2 NP under the circumstance of spreading SARS-CoV-2 variants.

Consumers often develop preferences toward consumer electronics based not only on the visual appearance of a product, but also on its haptic interface. If consumers express a strong haptic preference for a consumer electronic product, they are more likely to purchase it. Hence, it is important to understand how consumers' haptic preference for consumer electronics is formed. Conventional paper-based methods may not provide sufficient information for this purpose, because they provide post-event (i.e., after haptic experience) and environment-dependent (i.e., depending on the manner of asking questions, the person asking the questions, and so on.) data. Therefore, the present study investigated haptic preferences for consumer electronics using neural responses during haptic experiences, which provide the advantage of observing changes while the user is manipulating the product and obtaining environment-independent data. We measured neural responses using non-invasive electroencephalography (EEG). Eighteen volunteers participated in the study and manipulated a haptic dial knob that generates four different haptic profiles; during the manipulation, their EEG signals were recorded. After experiencing different haptic profiles, participants reported their level of preference for each profile. The analysis of EEG revealed that frontal gamma oscillations correlate with the level of haptic preferences, with oscillations becoming stronger with increasing haptic preference. The highest correlation between frontal gamma power and haptic preference was found in the early period of the dial task. Therefore, the frontal gamma oscillation of the EEG may represent a neural correlate of the haptic preference and provides a neural basis for understanding this preference in relation to consumer electronics.

Background Although many patients with coronary artery disease are using statins before off‐pump coronary artery bypass grafting (OPCAB) following current guidelines, recent studies have raised concerns regarding adverse effects of preoperative statins on postoperative kidney function. We evaluated the effects of preoperative statins on acute kidney injury (AKI) after OPCAB. Methods and Results We enrolled 1783 consecutive OPCAB patients in either a statin or nonstatin group based on preoperative use of statins. Propensity scores were used to adjust the differences between the groups. The primary outcome was incidence of postoperative AKI according to Kidney Disease: Improving Global Outcomes criteria. To evaluate the dose‐related renal effects of statins, the statin group was divided into low‐ and moderate‐ or higher dose groups based on preoperative statin dose. The incidence of postoperative AKI was 15.7% and 13.5% in the nonstatin and statin groups, respectively, and preoperative statins did not increase the incidence of postoperative AKI (odds ratio: 0.84; 95% CI, 0.61–1.15; P=0.27). In dose‐related analysis, the moderate‐ or higher dose group showed lower incidence of postoperative AKI in comparison with the nonstatin group (odds ratio: 0.61; 95% CI, 0.39–0.95; P=0.03). However, no difference was found between low‐dose and nonstatin groups (odds ratio: 1.17; 95% CI, 0.75–1.84; P=0.49) or between moderate‐ or higher dose and low‐dose statin groups (odds ratio: 0.84; 95% CI, 0.5–1.41; P=0.51) in the incidence of postoperative AKI. Conclusions Neither preoperative statin use nor statin dose increased the risk of AKI after OPCAB. Preoperative statin therapy is not harmful in patients receiving OPCAB.

BackgroundSerum phosphorus is a well-known marker of vascular calcification, but the effects of serum phosphorus abnormalities defined by clinical criteria on the outcomes of coronary artery bypass grafting (CABG) remain unclear. We aimed to evaluate whether preoperative serum phosphorus abnormalities defined based on clinical criteria are associated with outcomes of CABG using a relatively new statistical technique, inverse probability weighting (IPW) adjustment.MethodsFrom January 2001 to December 2014, 4,989 consecutive patients who underwent CABG were stratified into normal (2.5-4.5 mg/dl; n = 4,544), hypophosphatemia (4.5 mg/dl; n = 207) groups depending on preoperative serum phosphorus level.ResultsThe primary outcome was all-cause death during a median follow-up of 48 months. Secondary outcomes were cardiovascular death, graft failure, myocardial infarction, repeat revascularization, and stroke. In multivariate Cox analysis, preoperative hypophosphatemia was significantly associated with all-cause death (hazard ratio [HR] 1.76; 95% confidence interval [CI] 1.13-2.76; P = 0.01). However, this association varied depending on chronic kidney disease and emergent operation (p for interaction = 0.05 and 0.03, respectively). In addition, analysis after IPW adjustment demonstrated that preoperative serum phosphorus abnormalities were not significantly associated with all-cause death (P = 0.08) or any secondary outcomes except graft failure. Graft failure was significantly associated with preoperative hypophosphatemia (HR 2.51; 95% CI 1.37-4.61; P = 0.003).ConclusionOur study showed that preoperative serum phosphorus abnormalities in clinical criteria were not associated with outcomes after CABG except for graft failure. And, the association of hypophosphatemia with graft failure remains to be evaluated.

The surface-enhanced Raman scattering (SERS) technique, that uses magnetic plasmonic particles (MPPs), is an advanced SERS detection platform owing to the synergetic effects of the particles’ magnetic and plasmonic properties. As well as being an ultrasensitive and reliable SERS material, MPPs perform various functions, such as aiding in separation, drug delivery, and acting as a therapeutic material. This literature discusses the structure and multifunctionality of MPPs, which has enabled the novel application of MPPs to various biological fields.

In this study, we investigated the expression of nuclear factor erythroid-derived 2-related factor 2 (Nrf2) in the spinal cord using an experimental autoimmune encephalomyelitis (EAE) model. MOG35-55 was injected into female mice to induce an autoimmune response. Clinical scoring and a behavioral rotarod test were conducted to assess the successful modeling of EAE. Animals were sacrificed 1, 2, and 3 weeks after immunization. Spinal cords were prepared for morphometry, immunohistochemistry, and western blotting. Multifocal demyelination was observed in the white matter. Nrf2 immuno-reactivity was detected in astrocytes and neurons in spinal cord. Nrf2 immuno-reactive neurons and astrocytes had increased by 2 weeks after immunization, and their up-regulation was maintained until 3 weeks after immunization. Additionally, time-dependent up-regulation of Nrf2 in the spinal cord was investigated by western blotting. The level of NAD(P)H quinine oxidoreductase-1 protein, an Nrf2 target gene, was not changed during week 1, but showed a significant decrease 2 and 3 weeks after immunization. Parallel to upregulated Nrf2, heme oxygenase-1, another target gene of Nrf2, was significantly augmented until 3 weeks after immunization. We conclude that Nrf2 expression in neurons is involved in an autoimmune attack in the spinal cord in an EAE model. [ABSTRACT FROM AUTHOR]

BACKGROUND:Despite many previous studies, the optimal oxygen fraction during general anesthesia remains controversial. This study aimed to evaluate the effects of lowering intraoperative fraction of inspired oxygen on postoperative gas exchange in patients undergoing microvascular decompression (MVD). METHODS:We conducted a pre-post study to compare postoperative gas exchange with different intraoperative oxygen fractions. From April 2010 to June 2017, 1456 consecutive patients who underwent MVD were enrolled. Starting in January 2014, routine oxygen fraction was lowered from 1.0 to 0.3 during anesthetic induction/awakening and from 0.5 to 0.3 during anesthetic maintenance. Postoperative gas exchange, presented as the minimum value of PaO2/FIO2 ratio within 48 hours, were compared along with adverse events. RESULTS:Among 1456 patients, 623 (42.8%) patients were stratified into group H (high FIO2) and 833 (57.2%) patients into group L (low FIO2). Intraoperative positive end-expiratory pressure was used in 126 (15.1%) patients in group H and 90 (14.4%) patients in group L (p = 0.77).The minimum value of PaO2/ FIO2 ratio within 48 hours after surgery was significantly greater in the group L (226.13 vs. 323.12; p < 0.001) without increasing any adverse events. CONCLUSION:In patients undergoing MVD, lowering routine FIO2 and avoiding 100% O2 improved postoperative gas exchange.

Although statins have been suggested to attenuate the progression of diabetic cardiomyopathy, its effect without glycemic control remains unclear. Therefore, we evaluated the effect of pravastatin on diabetic rat hearts according to glycemic control. Rats were randomly divided into five groups: control (C), diabetes (D), diabetes with insulin (I), diabetes with pravastatin (P), and diabetes with insulin and pravastatin (IP). Eight weeks after allocated treatments, the heart was extracted and analyzed following echocardiography. Cardiac fibrosis was measured using Masson’s trichrome stain. Cardiac expression of collagen I/III, matrix metalloproteinase (MMP)-2, MMP-9, and angiotensin-converting enzyme (ACE)/ACE2 was evaluated by immunohistochemistry and/or Western blot. Enzyme-linked immunosorbent assay was used for measuring reactive oxygen species (ROS). Diabetic groups without glycemic control (D and P) showed significantly impaired diastolic function and increased levels of cardiac fibrosis, collagen I/III, MMP-2, MMP-9, and ROS production. However, there were little significant differences in the outcomes among the control and two glucose-controlled diabetic groups (I and IP). Groups C and IP showed more preserved ACE2 and lower ACE expressions than the other groups did (D, I, and P). Our study suggested glycemic control would be more important to attenuate the progression of diabetic cardiomyopathy than pravastatin medication.

This review is focused on carbon nanotube (CNT)-elastomeric polymer nanocomposites, which have attracted industrial and academic interest over the years due to their enhanced properties. Major factors notably CNT type, surface modification, dispersion of CNT, and processing techniques that affect the physical properties of CNT-elastomeric polymer nanocomposites are reviewed, and several key physical properties, including tensile, electrical, and thermal properties, were also included in this review. Some of the key challenges that undermine the effectiveness of CNTs and their composites with elastomeric polymers, and the potential applications of CNT-elastomeric composites are also captured.

Fungi tolerate exposure to various abiotic stresses, including cytotoxic compounds and fungicides, via their ATP-driven efflux pumps belonging to ATP-binding cassette (ABC) transporters. To clarify the molecular basis of interaction between the fungus and various abiotic stresses including fungicides, we constructed a cDNA library from germinated conidia of Colletotrichum acutatum, a major anthracnose pathogen of pepper (Capsicum annum L.). Over 1,000 cDNA clones were sequenced, of which single clone exhibited significant nucleotide sequence homology to ABC transporter genes. We isolated three fosmid clones containing the C. acutatum ABC1 (CaABC1) gene in full-length from genomic DNA library screening. The CaABC1 gene consists of 4,059 bp transcript, predicting a 1,353-aa protein. The gene contains the typical ABC signature and Walker A and B motifs. The 5′-flanking region contains a CAAT motif, a TATA box, and a Kozak region. Phylogenetic and structural analysis suggested that the CaABC1 is a typical ABC transporter gene highly conserved in various fungal species, as well as in Chromista, Metazoans, and Viridiplantae. We also found that CaABC1 was up-regulated during conidiation and a minimal medium condition. Moreover, CaABC1 was induced in iprobenfos, kresoxim-methyl, thiophanate-methyl, and hygromycin B. These results demonstrate that CaABC1 is necessary for conidiation, abiotic stress, and various fungicide resistances. These results will provide the basis for further study on the function of ABC transporter genes in C. acutatum.

Despite numerous previous studies, there is little data on the effects of anesthetics on clinical outcome after off-pump coronary arterial bypass grafting (OPCAB). Therefore, we retrospectively compared the effects of anesthetic choice on in-hospital major adverse events (MAEs) and one-year major adverse cardiovascular and cerebral events (MACCEs) in patients undergoing OPCAB. Electronic medical records were reviewed in 192 patients who received propofol-remifenanil total intravenous anesthesia (TIVA) and propensity score-matched 662 patients who received isoflurane anesthesia. The primary endpoints were in-hospital MAEs and one-year MACCEs. The components of in-hospital MAEs were in-hospital death, myocardial infarction (MI), coronary revascularization, stroke, renal failure, prolonged mechanical ventilation longer than 72 h, and postoperative new cardiac arrhythmia requiring treatment. One-year MACCEs was defined as a composite of all-cause mortality, MI, coronary revascularization, and stroke. There was no significant difference in risk of in-hospital MAEs (OR = 1.29, 95% CI = 0.88-1.88, P = 0.20) or one-year MACCEs (OR = 0.81; 95% CI = 0.46-1.42, P = 0.46) between the groups. The risk of postoperative new arrhythmia including new atrial fibrillation significantly increased in the TIVA group compared to the isoflurane anesthesia group (OR = 1.72, 95% CI = 1.12-2.63, P = 0.01). In conclusion, the choice between propofol-remifentanil TIVA and isoflurane anesthesia did not show differences in incidence of in-hospital MAEs or one-year MACCEs in patients undergoing OPCAB. However, further studies on the effects of anesthetics on development of in-hospital new arrhythmia will be needed.

To find the faster and easier way than the existing intubating technique for double-lumen tube, we modified the angle of double-lumen tube according to an individual's upper airway anatomy and compared the time needed and the number of attempts for successful intubation between individually angle-modified and non-modified double-lumen tubes. Adult patients undergoing elective thoracic surgery were randomly allocated in either non-angle-modified (Group N, n = 54) or angle-modified (Group M, n = 54) groups. During mask ventilation in the sniffing position, angle-modification was performed in Group M as follows: the distal tip of the tube was placed at the level of the cricoid cartilage and the shaft was bent at the intersection of the oral and pharyngeal axes estimated from the patient's surface anatomy. The time needed and the number of attempts for successful intubation and Cormack and Lehane (C-L) grade were recorded. Overall median intubation time (sec) was significantly shorter in Group M than in Group N [10.2 vs. 15.1, P

The beneficial effects of adipose-derived stem cell conditioned medium (ADSC-CM) on skin regeneration have been reported. Although the mechanism of how ADSC-CM promotes skin regeneration is unclear, ADSC-CM contained various growth factors and it is an excellent raw material for skin treatment. ADSC-CM produced in a hypoxia condition of ADSC—in other words, Advanced Adipose-Derived Stem cell Protein Extract (AAPE)—has great merits for skin regeneration. In this study, human primary keratinocytes (HKs), which play fundamental roles in skin tissue, was used to examine how AAPE affects HK. HK proliferation was significantly higher in the experimental group (1.22 μg/mL) than in the control group. DNA gene chip demonstrated that AAPE in keratinocytes (p < 0.05) notably affected expression of 290 identified transcripts, which were associated with cell proliferation, cycle and migration. More keratinocyte wound healing and migration was shown in the experimental group (1.22 μg/mL). AAPE treatment significantly stimulated stress fiber formation, which was linked to the RhoA-ROCK pathway. We identified 48 protein spots in 2-D gel analysis and selected proteins were divided into 64% collagen components and 30% non-collagen components as shown by the MALDI-TOF analysis. Antibody array results contained growth factor/cytokine such as HGF, FGF-1, G-CSF, GM-CSF, IL-6, VEGF, and TGF-β3 differing from that shown by 2-D analysis. Conclusion: AAPE activates HK proliferation and migration. These results highlight the potential of the topical application of AAPE in the treatment of skin regeneration.

BackgroundThe aim of this study was to evaluate whether slow injection of diluted rocuronium could reduce rocuronium-induced withdrawal movements effectively in children.MethodsAfter loss of consciousness, rocuronium 0.6 mg/kg was administered into 171 children according to the pre-assigned groups as follows: Group CF, injection of non-diluted rocuronium over 5 seconds; Group CS, injection of non-diluted rocuronium over 1 minute; Group DF, injection of diluted rocuronium (10 times) over 5 seconds; Group DS, injection of diluted rocuronium over 1 minute. An investigator who was blind to the injection techniques recorded patient movements followed by rocuronium injection.ResultsThe incidence of withdrawal movement in Group CF was highest among the groups (all P < 0.0001). Moreover, withdrawal movement was less frequently observed in Group DS than in Groups CS and DF (P = 0.021 and P = 0.007, respectively).ConclusionsSlow injection of diluted rocuronium reduced the incidence of withdrawal movements in children.

BackgroundThe aim of this study was to evaluate the effect of diabetes on the function and distribution of vascular α1-adrenoceptors in the abdominal aorta and distal mesenteric artery from streptozotocin (STZ)-induced diabetic rats at the level of the α1-adrenoceptor subtypes.MethodsDiabetes was induced by a single intravenous injection of STZ (60 mg/kg) in 8 week-old male Sprague-Dawley rats (n = 11). Age-matched normal rats (n = 14) were used as a control group. Four weeks after STZ injection, the tilting-induced change of the mean arterial pressure was recorded. The α1-adrenoceptor subtypes mediating the contractions of the distal mesenteric artery and abdominal aorta were investigated using the agonist phenylephrine and subtype-selective antagonists that included prazocin, 5-methylurapidil and BMY 7378. The expressions of the α1-adrenoceptor subtypes of each artery were examined by immunofluorescence staining using the subtype selective antibodies.ResultsThe recovery of the mean arterial pressure was delayed after positional change in the diabetic rats. Compared with that of the normal rats, the contractile response to phenylephrine was increased in the abdominal aortas and it was decreased in the distal mesenteric arteries in the diabetic rats. In addition, compared with the normal rats, the fluorescent intensity of all the α1-adrenoceptor subtypes was increased in the abdominal aortas and it was decreased in the mesenteric arteries of the diabetic rats.ConclusionsDiabetes increased the contractility of the abdominal aorta in response to phenylephrine, yet diabetes decreased that of the mesenteric arteries in the STZ-induced diabetic rats. Those results are mainly based on the overall change of the α1-adrenoceptor, and not on the change of the specific α1-adrenoceptor subtypes.

Pregabalin, a Ca2+ channel α2δ-subunit antagonist with analgesic and antiepileptic activity, reduced neuronal loss and improved functional outcome in a mouse model of focal ischemic stroke. Pregabalin administration (5–10 mg/kg, i.p.) 30–90 min after transient middle cerebral artery occlusion/reperfusion reduced infarct volume, neuronal death in the ischemic penumbra and neurological deficits at 24 h post-stroke. Pregabalin significantly decreased the amount of Ca2+/calpain-mediated α-spectrin proteolysis in the cerebral cortex measured at 6 h post-stroke. Together with the extensive clinical experience with pregabalin for other neurological indications, our findings suggest the potential for a therapeutic benefit of pregabalin in stroke patients.