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Every year, the U.S. economy loses more than $411 billion because of work performance reduction, injuries, and traffic accidents caused by microsleep. To mitigate microsleeps consequences, an unobtrusive, reliable, and socially acceptable microsleep detection solution throughout the day, every day is required. Unfortunately, existing solutions do not meet these requirements. In this paper, we propose WAKE, a novel behind-the-ear wearable device for microsleep detection. By monitoring biosignals from the brain, eye movements, facial muscle contractions, and sweat gland activities from behind the user's ears, WAKE can detect microsleep with a high temporal resolution. We introduce a Three-fold Cascaded Amplifying (3CA) technique to tame the motion artifacts and environmental noises for capturing high fidelity signals. Through our prototyping, we show that WAKE can suppress motion and environmental noise in real-time by 9.74-19.47 dB while walking, driving, or staying in different environments ensuring that the biosignals are captured reliably. We evaluated WAKE using gold-standard devices on 19 sleep-deprived and narcoleptic subjects. The Leave-One-Subject-Out Cross-Validation results show the feasibility of WAKE in microsleep detection on an unseen subject with average precision and recall of 76% and 85%, respectively.

Streptococcus parauberis, a gram-positive cocci, causes bacterial disease in farmed fish. The recent increase in S. parauberis infection in aquatic farms in South Korea has justified the importance of vaccine development for the prevention of this disease. In this study, we evaluated the effect of subunit vaccines prepared from recombinant M-like protein (SimA) and fibrinogen-binding protein (FBP) candidates with an aluminum hydroxide adjuvant against S. parauberis infection in olive flounder Paralichthys olivaceus. For the in vivo experiment, fish (average length, 7.18 cm; average weight, 3.5 g) were injected intraperitoneally with: phosphate buffer saline (PBS, group 1), PBS/aluminum hydroxide (group 2), FBP/aluminum hydroxide (group 3), SimA/aluminum hydroxide (group 4), and SimA/FBP/aluminum hydroxide (group 5). After 3 weeks, the fish in each group were boosted using PBS (group 1 and 2), FBP (group 3), SimA (group 4), and SimA/FBP (group 5) without adjuvant. We found that the relative percent survival of fish after S. parauberis exposure in group 2, 3, 4, and 5 was 6.25%, 18.75%, 50%, and 12.5%, respectively, whereas the mortality in groups 1 was 80%, respectively. We performed Western blot, ELISA, and quantitative real time RT-PCR (qRT-PCR) after vaccination to investigate the further efficacy of the vaccine. Western blot and ELISA of vaccinated fish serum confirmed the production of specific antibodies against SimA and FBP. Furthermore, results of qRT-PCR showed that recombinant protein SimA induced a remarkably specific-antibody response compared with that in FBP or control and increased the expression of various immune response-related genes including interleukin-8 (IL-8), toll-like receptor 2 (TLR2), tumor necrosis factor-α (TNF-α), CD4-1, and MHC II. Thus, these results indicate that SimA is a potent vaccine candidate for protection against S. parauberis infection.

Background and Objectives The newly introduced upright head roll test (UHRT), which exploits head rotations in the roll plane with the patient in the upright sitting position, is a diagnostic maneuver for horizontal canal-benign paroxysmal positional vertigo (HC-BPPV). This study is designed to determine whether UHRT, compared to supine head roll test (SHRT), can more accurately diagnose HC-BPPV and determine the subtype of HC-BPPV.Subjects and Method A total of 455 video nystagmus tests performed between April 2019 to June 2021 were retrospectively reviewed, and 63 patients with direction-changing positional nystagmus at UHRT or SHRT were enrolled in this study. UHRT result was classified as negative (if no nystagmus was observed), positive incomplete (if nystagmus was detected in one side), and positive complete (if nystagmus was evoked in both side). The frequency of nystagmus is also included in our assessment. In addition, the results of 4 patients with bow and lean test (BLT) records on videonystagmography were also analysed.Results The concordance rate between UHRT and SHRT was 97.8%, and the positive concordance rate was 91.38%. UHRT and SHRT provided identical subtype diagnosis in 98.1% (52 of 53 cases). In one case, UHRT and SHRT showed opposite results. Evaluating the affected side with bow and lean records, the SHRT, UHRT and BLT showed consistent results. The mean frequency of nystagmus was faster in SHRT than in UHRT.Conclusion UHRT showed equivalent results to SHRT in distinguishing subtype of HC-BPPV. UHRT is a useful method in diagnosing HC-BPPV simply in a sitting position.

Bougination is one of the first-line treatments in benign esophageal stricture (BES). The aim of the study was to identify clinical and endoscopic factors affecting the achievement of a normal diet with only bougie dilation in patients with BES.Patients treated with only bougination for BES at three hospitals were retrospectively investigated. Data including patient demographics, stricture and procedural characteristics were collected. Clinical success was defined as normal diet without additional procedures for two months after bougination. Clinical success rate and associated factors were assessed.A total of 121 patients with BES were included. The most common cause of BES was post-operative stricture (Normal diet is possible in one-third of BES after bougination alone. Predictable factors for achieving a normal diet were less than four sessions of dilation, short length of stricture, pre-procedural dysphagia status and diameter of dilator.

PurposeMelanoma incidence is rising worldwide along with the associated personal and socioeconomic health expenditures. We investigated the incidence and survival-rate patterns of melanoma in South Korea using nationwide data. Materials and MethodsThis retrospective cohort study included patients with melanoma between 2004 and 2017, based on National Health Insurance (NHI) claims data in South Korea. The incidence, prevalence, and survival rate were analyzed along with baseline demographic characteristics. We collected solar irradiation dose (SID) and healthcare ranking score (HRS) according to the administrative district from the Korea Meteorological Administration and Korea Health Promotion Institute. The incidence and survival rates were assessed using Pearson's correlation, the Kaplan-Meier estimation, multiple linear regression, and multiple logistic regression methods.ResultsTwenty-five thousand, five hundred ninety-one patients with melanoma were diagnosed during the study period. The age-standardized incidence of melanoma steadily increased from 2004 to 2017 from 2.6 to 3.0/100,000/yr. The incidence of melanoma increased with significantly higher income (p < 0.05). The prevalence followed a similar pattern as the incidence. According to multivariate analysis, HRS significantly influenced the incidence of melanoma in high sun-exposed sites (p < 0.001). There was no significant change in annual mortality. Women had a higher 5-year survival rate than men (78.4% vs. 72.8%). Mortality by the administrative district was highly correlated with HRS.ConclusionThe incidence of melanoma is increasing in South Korea. A low HRS is associated with both higher incidence and mortality. The findings of this study could be utilized as a guideline for treating melanoma patients.

Benzoxaboroles are a new class of leucyl-tRNA synthetase inhibitors. Epetraborole, a benzoxaborole, is a clinical candidate developed for Gram-negative infections and has been confirmed to exhibit favorable activity against a well known pulmonary pathogen, Mycobacterium abscessus .

Indole is a significant structural moiety and functionalization of the C–H bond in indole-containing molecules expands their chemical space, and modifies their properties and/or activities. Indole prenyltransferases (IPTs) catalyze the direct regiospecific installation of prenyl, C5 carbon units, on indole-derived compounds. IPTs have shown relaxed substrate flexibility enabling them to be used as tools for indole functionalization. However, the mechanism by which certain IPTs target a specific carbon position is not fully understood. Herein, we use structure-guided site-directed mutagenesis, in vitro enzymatic reactions, kinetics and structural-elucidation of analogs to verify the key catalytic residues that control the regiospecificity of all characterized regiospecific C6 IPTs. Our results also demonstrate that substitution of PriB_His312 to Tyr leads to the synthesis of analogs prenylated at different positions than C6. This work contributes to understanding of how certain IPTs can access a challenging position in indole-derived compounds.

Co-development of healthcare technology with users helps produce user-friendly products, ensuring safe device usage and meeting patients' needs. For developers considering healthcare innovations, engaging user experience can reduce production time and cost while maximizing device application. The purpose of this paper is to report lessons learned from the development of a 3D printed origami ventilator prototype in response to the rise of ventilator demand due to the Coronavirus disease (COVID-19) pandemic. We conducted focus groups with frontline clinicians working in an Intensive Care Unit of a large urban hospital in Vancouver, British Columbia, Canada. In the interdisciplinary focus groups, we identified challenges, practical tips about product development, the human needs of technology, and cross-discipline peer learning. The focus group discussions provide useful insight into the technology development for complex clinical contexts. Based on our experiences, we articulate five practical tips for co-development of healthcare technology - AGILE: Analyse users' needs first, Gain insights into complex context, Involve users early and frequently, Lead with a prototype, and Educate and support. Through sharing the tips and lessons learned, we wish to emphasize the necessity of meaningful multi-disciplinary collaboration during healthcare technology development and promote the inclusion of frontline clinicians during these initiatives.The online version contains supplementary material available at 10.1007/s12553-022-00655-w.

A series of oligomeric chain extender-derived AEMs (QPP-b-PSK-w-TMA) are reported for AEMFC and AEMWE. Especially, the QPP-b-PSK-3.5-TMA-based AEMFC showed the highest specific power among the state-of-the-art AEMFCs with noble metal catalysts.

We aimed to present the incidence and risk factors for pancreatic cancer in a multicenter retrospective cohort of patients with chronic pancreatitis (CP). Patients with ICD‒10 codes for CP (K86.0, K86.1) who underwent abdominal CT or MRI between January 2010 and December 2021 in seven academic hospitals were analyzed. After exclusions, we identified 727 patients with definite CP with a median follow‒up of 3.6 years (range 1.0‒12.9). During 3,290 person‒years of observation, pancreatic cancers were diagnosed in 16 patients (2.20%, 0.49% per year) after a median follow‒up of 2.4 years (range 1.4‒6.6), with an age‒ and sex‒standardized incidence ratio of 18.1 (95% CI 10.4‒29.5). The underlying CPs in the 16 pancreatic cancers were classified as chronic obstructive pancreatitis (10, 63%), chronic obstructive and calcifying pancreatitis (4, 25%), chronic calcifying pancreatitis (1, 6%), and autoimmune pancreatitis (1, 6%). Factors associated with pancreatic cancer development included age (HR 4.830, p = 0.006), parenchymal calcification (HR 0.213, p = 0.003), pancreatic duct stricture (HR 2.706, p = 0.048), and serum CA 19‒9 level (HR 22.49, p p = 0.007) and serum CA 19‒9 levels greater 100 U/mL (HR 25.56, p

This study aims to analyze the gap between the level of heat wave adaptation policies and heat wave effects in South Korean municipalities. First, the types of industries in municipalities were classified using factor analysis and cluster analysis. Second, the level of heat wave adaptation policy in the municipalities was assessed using a fuzzy analytic hierarchy process analysis. Third, the gap between the level of heat wave adaptation policy and the heat wave effect was analyzed. The results show that the heat wave adaptation policies were established in accordance with the heat wave effects to at least some degree. However, closer to the long-term future (2095), the policies have not sufficiently matched the level of heat wave effects. The proportion of municipalities with insufficient levels of heat wave adaptation policies against the heat wave effects was higher among urban-type municipalities. The analysis results suggest two policy implications. First, the heat wave adaptation policies of municipalities should be established through continuous feedback on the predictions of future heat wave effects. Second, urban-type municipalities should strengthen their planning authority and competence by securing a professional workforce and budgets for the establishment of heat wave adaptation policies.

This paper reports the first demonstration of super broadband infrared downshifting emission extending from 1640 ​nm to 2200 ​nm with the full width at half maximum of ∼ 417 ​nm in lanthanides (Er3+, Ho3+, and Tm3+)-doped α-SiAlON ceramics upon 793 ​nm excitation. Using α-Si3N4 ceramic as a precursor the lanthanides-doped α-SiAlON ceramics were synthesized by the hot-press method. The lanthanides induced no significant secondary phases in the sintered α-SiAlON ceramics. Strong two-photon upconversion emission bands centered at 547, 671 and 694 ​nm have also been observed upon 793 ​nm excitation. The time-resolved measurements of the upconversion emissions confirm that the efficient energy transfer among the Er3+, Ho3+ and Tm3+ ions as well as the ground state absorption in Er3+ and Tm3+ are responsible for the observed spectroscopic properties.

Sweetpotato (Ipomoea batatas(L.) Lam) is the world’s seventh most important food crop by production quantity. Cultivated sweetpotato is a hexaploid (2n = 6x = 90), and its genome (B1B1B2B2B2B2) is quite complex due to polyploidy, self-incompatibility, and high heterozygosity. Here we established a haploid-resolved and chromosome-scalede novoassembly of autohexaploid sweetpotato genome sequences. Before constructing the genome, we created chromosome-scale genome sequences inI. trifidausing a highly homozygous accession, Mx23Hm, with PacBio RSII and Hi-C reads. Haploid-resolved genome assembly was performed for a sweetpotato cultivar, Xushu18 by hybrid assembly with Illumina paired-end (PE) and mate-pair (MP) reads, 10X genomics reads, and PacBio RSII reads. Then, 90 chromosome-scale pseudomolecules were generated by aligning the scaffolds onto a sweetpotato linkage map.De novoassemblies were also performed for chloroplast and mitochondrial genomes inI. trifidaand sweetpotato. In total, 34,386 and 175,633 genes were identified on the assembled nucleic genomes ofI. trifidaand sweetpotato, respectively. Functional gene annotation and RNA-Seq analysis revealed locations of starch, anthocyanin, and carotenoid pathway genes on the sweetpotato genome. This is the first report of chromosome-scalede novoassembly of the sweetpotato genome. The results are expected to contribute to genomic and genetic analyses of sweetpotato.

In subjects with functional ankle instability, lumbopelvic instability causes instability of the hip and lower extremities. The purpose of this study is to determine whether an ankle exercise program with hip strengthening exercise and lumbopelvic stabilization exercise affects spine and ankle stability through muscle activity in adults with functional ankle instability. Thirty adults with functional ankle instability were randomly assigned to a hip joint strengthening exercise group and a lumbopelvic stabilization exercise group. The subjects participated in the designated program three times a week for 40 minutes a day. In the hip joint strengthening exercise group, a general hip joint strengthening exercise was used, and in the lumbopelvic stabilization exercise group, a lumbopelvic stabilization exercise using a sling was added. The intervention lasted 4 weeks, and both groups were instructed to refrain from other exercise during the 4-week intervention period. The muscle activity of the tibialis anterior, gluteus maximus, external oblique and contralateral latissimus dorsi was measured. Data were collected from the 30 patients. The results showed that the muscle activity of the tibialis anterior, gluteus maximus, lateral oblique muscle, and contralateral latissimus dorsi was significantly increased in both groups. This suggests that the existing hip joint strengthening exercise and lumbopelvic stabilization exercise are effective approaches which not only help reduce hip joint pain and improve function, but also reduce functional ankle instability. Therefore, if an appropriate exercise program is provided for subjects with functional ankle instability, it is expected that it will help improve pain and function by reducing ankle instability and the frequency of re- injury.

To prevent accidents in chemical plants, it is important to identify the root cause of the accident and suggest countermeasures. When accident factors are known, eliminating the cause of the accident can increase its prevention. The number of factors, including social factors, in addition to human factors, is increasing. When analyzing the cause of an accident when it is complex, advanced, and the connection between processes is high, there is a growing need to approach it with an integrated system analysis method related to the organization, along with a sequential approach to determine the direct cause of the accident. Several countries have introduced and applied techniques for integrated analysis of accidents from a systematic viewpoint, such as AcciMap and the functional resonance accident model (FRAM) that were developed around 2000. However, it remains difficult to find cases or research results applied in Korea. In this study, accidents in Korean chemical factories are analyzed using systematic accident analysis techniques, and a plan to utilize systematic analysis techniques for future accident investigations is developed.

This study was aimed at comparing the effects of cervical stabilization exercises with thoracic spine extension exercises and cervical stabilization exercises with breathing exercises on head posture in subjects with the forward head posture (FHP). FHP is a poor habitual neck posture that is defined by the forward translation of the cervical vertebrae and hyperextension of the upper cervical vertebrae. Continuous FHP adds the load to posterior cervical structures, for instance, ligament, and transforms scapular kinetics and kinematics, and affects the quality of life and activities of daily living. The study included 30 adults with FHP, with 15 participants in each group. The experimental group was asked to perform cervical stabilization exercises with thoracic spine extension exercises, and the control group was asked to perform cervical stabilization exercises with breathing exercises. After 4 weeks of exercise, the changes in head posture (cranial rotation angle and craniovertebral angle) were measured again. Craniovertebral angle and craniovertebral angle were assessed using digital, lateral-view photographs of the subjects in their usual standing postures. The results showed that there was a significant difference between experimental group and control group before and after exercise (p < 0.05). In between-group comparison, there were significant differences noted in craniovertebral angle and cranial rotation angle in the experimental group compared to the control group (p < 0.05). Both two groups affect cranial rotation angle, craniovertebral angle, and postural alignment, but it is believed that cervical stabilization exercises with thoracic spine extension exercises directly affect the thoracic and cervical spines. As a result, cervical stabilization exercises and thoracic spine extension exercises are recommended to improve postural alignment.

Introduction The aim of this study was to assess the efficacy and safety of switching to teneligliptin from other dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes mellitus (T2DM) inadequately controlled despite treatment with a stable dose of other DPP-4 inhibitors. Methods Patients with glycosylated hemoglobin (HbA1c) ≥ 7% despite taking DPP-4 inhibitors other than teneligliptin, with or without other antidiabetic agents, for at least 3 months were enrolled in this study. Patients on DPP-4 inhibitors administered prior to participation in this study were switched to 20 mg teneligliptin once daily and the dose was maintained for the 52-week study period. The primary endpoint was the change in HbA1c at week 12. Fasting plasma glucose (FPG) and the blood lipid profile were also evaluated. Adverse events were monitored for safety assessment. Results At weeks 12, 24, and 52, the HbA1c values significantly decreased by − 0.39, − 0.44, and − 0.52%, respectively, compared to the baseline value (p