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Study Design: A case report of lumbar synovial chondromatosis with radiculopathy. Objective: To report a case of synovial chondromatosis of a lumbar facet joint that extended into the spinal canal and compromised the lumbar nerve root and raised spinal surgeons' awareness of the possibility of this unusual clinical problem. Summary Of Background Data: Synovial chondromatosis is an uncommon disorder characterized by the formation of multiple cartilaginous nodules in the synovium of a facet joint. It most commonly affects large joints. Synovial chondromatosis in the spine is rare and there is no previous report of associated lumbar radiculopathy. Methods: A 24-year-old woman presented with low back pain and right sciatica lasting 5 months. There was no objective weakness. Computed tomography scans showed multiple calcified nodules anterior and medial to the right apophyseal joint of L5-S1 and extending into the spinal canal. Magnetic resonance imaging showed a lobulated, heterogeneous enhancing extradural mass arising from the anteromedial aspect of the right L5-S1 facet joint. The lesion was removed in multiple pieces with curette after exposure of the corresponding intervertebral space through a conventional interlaminar approach. The histologic examination showed nodules of hyaline cartilage beneath the synovial cell lining. Results: The patient was completely free of low back pain and right sciatica 5 days after the surgery. All neurologic tests were normal from that point onwards. Conclusion: Synovial chondromatosis may compromise lumbar nerve roots when it extends into the spinal canal from the facet joint. Although synovial chondromatosis of the lumbar spine is rare, it should be included in the differential diagnosis of radiculopathy. [ABSTRACT FROM AUTHOR]

Study Design: A case report. Objective: To report a case of myositis ossificans in the psoas muscle after lumbar spine fracture. Summary Of Background Data: Myositis ossificans is a benign condition of heterotopic bone formation in skeletal muscle. It predominantly occurs in large muscles of extremities following injury. Occurrence in the psoas muscle is rare with no previous reports of this condition associated with vertebral fracture in patients without hematologic abnormality. Methods: A 56-year-old man was referred to our hospital for a mass located in the left psoas muscle and an L3 compression fracture. He complained of low back and left leg pain after a fall 2 weeks previously. Magnetic resonance (MR) imaging obtained 12 days after trauma showed an L3 compression fracture with a left psoas mass with low T1 and high T2 signal intensity, associated edema, and enhancement. Computed tomography (CT) scans showed a suspicious slightly high-density mass in the left psoas area. The radiologic features of the mass were consistent with a hematoma. Results: After 1 week, CT scans showed calcification at the hematoma site. Histologic examination following CT-guided biopsy demonstrated new bone formation, atrophy of skeletal muscle fibers, and fibrosis. Lymphocytes were focally infiltrating. Irregularly anastomosing bony trabeculae and fibroblastic cell proliferation were noted. On follow-up MRI and CT scans 2 months later, the previous calcified mass was no longer evident. Conclusion: Myositis ossificans usually occurs in extremities and is very uncommon in the psoas muscle. We report psoas myositis ossificans that developed from hemorrhage and edema associated with a lumbar fracture and required only 2 months to regress completely. When one finds a soft tissue mass with surrounding edema in the psoas muscle combined with a vertebral compression fracture, myositis ossificans should be included in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Background: Compound K [20-O-beta-(D-glucopyranosyl)-20(S)-protopanaxadiol], a metabolite of the protopanaxadiol-type saponins of Panax ginseng C.A. Meyer, has been reported to possess anti-tumor properties to inhibit angiogenesis and to induce tumor apoptosis. In the present study, we investigated the effect of Compound K on apoptosis and explored the underlying mechanisms involved in HL-60 human leukemia cells.Methods: We examined the effect of Compound K on the viabilities of various cancer cell lines using MTT assays. DAPI assay, Annexin V and PI double staining, Western blot assay and immunoprecipitation were used to determine the effect of Compound K on the induction of apoptosis.Results: Compound K was found to inhibit the viability of HL-60 cells in a dose- and time-dependent manner with an IC50 of 14 muM. Moreover, this cell death had typical features of apoptosis, that is, DNA fragmentation, DNA ladder formation, and the externalization of Annexin V targeted phosphatidylserine residues in HL-60 cells. In addition, compound-K induced a series of intracellular events associated with both the mitochondrial- and death receptor-dependent apoptotic pathways, namely, (1) the activation of caspases-3, -8, and -9; (2) the loss of mitochondrial membrane potential; (3) the release of cytochrome c and Smac/DIABLO to the cytosol; (4) the translocation of Bid and Bax to mitochondria; and (5) the downregulations of Bcl-2 and Bcl-xL. Furthermore, a caspase-8 inhibitor completely abolished caspase-3 activation, Bid cleavage, and subsequent DNA fragmentation by Compound K. Interestingly, the activation of caspase-3 and -8 and DNA fragmentation were significantly prevented in the presence of cycloheximide, suggesting that Compound K-induced apoptosis is dependent on de novo protein synthesis.Conclusions: The results indicate that caspase-8 plays a key role in Compound K-stimulated apoptosis via the activation of caspase-3 directly or indirectly through Bid cleavage, cytochrome c release, and caspase-9 activation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nicotine polacrilex lozenges deliver 25% to 27% more nicotine compared with equivalent doses of nicotine polacrilex gum. The increased nicotine exposure from the lozenge has raised questions about the relative safety of the lozenge and gum. OBJECTIVE: The objective of this study was to compare the safety profiles of the 4-mg nicotine lozenge and 4-mg nicotine gum in smokers with selected label-restricted diseases. METHODS: This was a multicenter, randomized, open-label study in adult smokers with heart disease, hypertension not controlled by medication, and/or diabetes mellitus. Patients were randomized in a 1:1 ratio to receive the 4-mg nicotine lozenge or 4-mg nicotine gum. Safety assessments were made at baseline and at 2, 4, 6, and 12 weeks after the start of product use. RESULTS: Nine hundred one patients were randomized to treatment, 447 who received the lozenge and 454 who received the gum (safety population). The majority were women (52.7%). Patients' mean age was 53.9 years, their mean weight was 193.9 pounds, and they smoked a mean of 25.2 cigarettes per day at baseline. Five hundred fifty-three patients, 264 taking the lozenge and 289 taking the gum, used the study product for > or =4 days per week during the first 2 weeks (evaluable population). The nicotine lozenge and nicotine gum were equally well tolerated, despite increased nicotine exposure from the lozenge. The incidence of adverse events in the 2 groups was similar during the first 2 weeks of product use (evaluation population: 55.3% lozenge, 54.7% gum), as well as during the entire study (safety population: 63.8% and 58.6%, respectively). Stratification of patients by sex, age, extent of concurrent smoking, extent of product use, and severity of adverse events revealed no clinically significant differences between the lozenge and gum. The most common adverse events were nausea (17.2% and 16.1%; 95% CI, -3.7 to 6.0), hiccups (10.7% and 6.6%; 95% CI, 0.5 to 7.8), and headache (8.7% and 9.9%; 95% Cl, -5.0 to 2.6). Serious adverse events were reported in 11 and 13 patients in the respective groups. Fewer than 6% of patients in either group were considered by the investigator to have a worsening of their overall disease condition during the study. The majority of patients (>60%) experienced no change in their disease status from baseline. CONCLUSION: The 4-mg nicotine lozenge and 4-mg nicotine gum had comparable safety profiles in these patients with label-restricted medical conditions. [ABSTRACT FROM AUTHOR]

We sought to compare the angiographic findings and mortality in patients with non-ST-segment elevation (NSTEMI) versus ST-segment elevation myocardial infarction (STEMI) undergoing early invasive intervention. Of 11,872 patients enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to January 2008, we studied patients with NSTEMI undergoing early invasive intervention (n = 1,486) and those with STEMI undergoing primary percutaneous coronary intervention (n = 4,392). Multivessel coronary disease, baseline Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and the left circumflex artery as a culprit lesion occurred more frequently in patients with NSTEMI than in those with STEMI. Those with NSTEMI had a significantly lower mortality rate than those with STEMI during a median follow-up of about 12 months (3.8% vs 6.7%, p <0.001). In the patients with NSTEMI, the independent predictors of mortality included postprocedural TIMI flow grade 0 to 2 (hazard ratio [HR] 3.07, 95% confidence interval [CI] 1.01 to 9.29, p = 0.047) and multivessel coronary disease (HR 3.83, 95% CI 1.36 to 10.81, p = 0.010) but not baseline TIMI flow or infarct location. However, baseline TIMI flow grade 0 to 2 (HR 1.56, 95% CI 1.03 to 2.36, p = 0.035), anterior infarction (HR 1.69, 95% CI 1.28 to 2.23, p <0.001), multivessel coronary disease (HR 1.45, 95% CI 1.10 to 1.91, p = 0.008), and postprocedural TIMI flow grade 0 to 2 (HR 2.00, 95% CI 1.42 to 2.82, p <0.001) were all independent predictors of mortality in the patients with STEMI. In conclusion, the angiographic findings in patients from NSTEMI differ from those in patients with STEMI. Postprocedural TIMI flow and multivessel coronary disease were independent predictors of mortality in patients with NSTEMI undergoing early invasive intervention. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to compare the long-term clinical outcomes of patients treated with sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) for coronary bifurcation lesions. Background: There are limited data regarding comparisons of SES and PES for the treatment of bifurcation lesions. Methods: Patients who received percutaneous coronary intervention for non-left main bifurcation lesions were enrolled from 16 centers in Korea between January 2004 and June 2006. We compared major adverse cardiac events (MACE [cardiac death, myocardial infarction, or target lesion revascularization]) between the SES and PES groups in patients overall and in 407 patient pairs generated by propensity-score matching. Results: We evaluated 1,033 patients with bifurcation lesions treated with SES and 562 patients treated with PES. The median follow-up duration was 22 months. Treatment with SES was associated with a lower incidence of MACE (hazard ratio [HR]: 0.53, 95% confidence interval [CI]: 0.32 to 0.89, p < 0.01) and target lesion revascularization (HR: 0.55, 95% CI: 0.31 to 0.97, p = 0.02), but not of cardiac death (HR: 2.77, 95% CI: 0.40 to 18.99, p = 0.62) and cardiac death or myocardial infarction (HR: 0.97, 95% CI: 0.38 to 2.49, p = 0.94). After propensity-score matching, patients with SES still had fewer MACE and target lesion revascularization incidences than did patients with PES (HR: 0.52, 95% CI: 0.30 to 0.91, p = 0.02, and HR: 0.48, 95% CI: 0.25 to 0.91, p = 0.02, respectively). There was no significant difference in the occurrences of stent thrombosis between the groups (0.7% vs. 0.7%, p = 0.94). Conclusions: In patients with bifurcation lesions, the use of SES resulted in better long-term outcomes than did the use of PES, primarily by decreasing the rate of repeat revascularization. (Coronary Bifurcation Stenting Registry in South Korea [COBIS]; NCT00851526). [ABSTRACT FROM AUTHOR]

A critical host response against viral infections entails the activation of innate immune signaling that culminates in the production of antiviral proteins. DNA viruses are sensed by the cytosolic pattern recognition receptor cyclic GMP-AMP synthase (cGAS), which initiates a signaling pathway that results in production of proinflammatory cytokines such as Interferon-β (IFN-β) and activation of the antiviral response. Precise regulation of the antiviral innate immune response is required to avoid deleterious effects of its overactivation. We previously reported that the 4EHP/GIGYF2 translational repressor complex reduces the translation of Ifnb1 mRNA, which encodes IFN-β, upon RNA viral infections. Here, we report a distinct regulatory mechanism by which 4EHP controls replication of DNA viruses by translational repression of the Cgas mRNA, which encodes the DNA viral sensor cGAS. We show that 4EHP is required for effective translational repression of Cgas mRNA triggered by miR-23a. Upon infection, 4EHP deficiency bolsters the elicited innate immune response against the diverse DNA viruses Herpes simplex virus 1 (HSV-1) and Vaccinia Virus (VacV) and concomitantly reduces their rate of replication in vitro and in vivo. This study elucidates an intrinsic regulatory mechanism of the host response to DNA viruses which may provide unique opportunities for countering viral infections., Competing Interests: Competing interests statement:The authors declare no competing interest.

Background and Aims: Liver transplantation (LT) is a curative treatment for end-stage liver disease. Anastomotic biliary strictures (ABS) are more common in living donor LT (LDLT). However, the success rate of endoscopic retrograde cholangiopancreatography (ERCP) for ABS remains unsatisfactory. This study aimed to evaluate the efficacy of single-operator cholangioscopy (SOC) for ABS treatment in LDLT recipients where standard ERCP failed to access the stricture., Methods: This prospective study included 40 LDLT patients undergoing ERCP with SOC (SpyGlass™ DS II) to treat ABS when guidewire placement across the ABS was difficult during conventional ERCP (cannulation time >10 min) between October 2021 and May 2023. Our primary endpoint was technical success defined as successful guidewire placement across the ABS and/or subsequent treatment. The secondary endpoints were rates of clinical success, complication, and re-intervention., Results: The mean patient age was 59.7 (±7.2) years, and the mean time from LDLT to the occurrence of ABS was 212 (±230) days. Technical and clinical successes were achieved in 92.5% (37/40) and 82.5% (33/40) of patients, respectively. The rates of post-ERCP cholangitis, pancreatitis, and bleeding were 10.0%, 15.0%, and 2.5%, respectively. Intestinal perforation did not occur, and all adverse events were mild in severity. Early stent migration within one month occurred in two (5.4%) patients, and four (10.8%) patients required re-intervention within one month., Conclusions: This study shows the efficacy and safety of SOC-facilitated management for difficult ABS in LDLT patients after failure of standard ERCP., (Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

This study aimed to investigate the characteristics of out-of-office blood pressure (BP) measurements in patients with apparent treatment-resistant hypertension (aRH) enrolled from 15 tertiary care centers in South Korea. aRH was defined as having uncontrolled office BP ≥ 130/80 mmHg despite receiving three classes of antihypertensive medication or any level of BP despite receiving ≥4 classes of antihypertensive medication. Patients with complete data for office BP, 24-h ambulatory BP monitoring (ABPM), and home BP measurements at baseline were included. BP control status between ABPM and home BP measurements was compared. Out of 1457 patients, 823 meeting the enrollment criteria were included (mean age: 59.9 ± 13.6 years; 57.5% male patients). Among them, 7.2% had controlled BP, 8.7% had whitecoat uncontrolled hypertension, 15.1% had masked uncontrolled hypertension, and 69% had sustained hypertension, as measured through baseline ABPM. Additionally, 43% of patients with controlled BP based on home BP measurement had nocturnal hypertension. Relying solely on home BP measurement may result in misclassifying 70% of patients as having either controlled BP or whitecoat uncontrolled BP. This study reaffirms the circadian pattern of resistant hypertension, characterized by a higher prevalence of non-dipping and rising patterns, even in patients with BP controlled based on ABPM. Considering the persistent difference between home BP measurement and ABPM, even at a lower home BP threshold, integrating both measurements into the management of aRH is advisable., Competing Interests: Compliance with ethical standards Conflict of interest JS have nothing to declare. CJL received lecture honoraria from Novartis, Hanmi Pharmaceutical, Yuhan, Boryung Pharmaceutical, and Daiichi Sankyo. DHK received honoraria from Viatris, Organon, Boryoung, Hanmi, Daewoong, Celltrion, Daiichi Sankyo, and Chong Kun Dang and a research grant from Daewoong Pharmaceutical. SYK received honoraria from Norvatis, Amgen Korea, BMS Korea, Bayer Korea, Viatris, Boryoung, Hanmi, Menarini, JW Pharmaceutical, Inno N, Dongkook, Yuhan, Chong Kun Dang, GC Biopharma, and Daewon. JHP received honoraria from Viatris, Jeil, Boryoung, Daewoong, Hanmi, Yuhan, Chong Kun Dang, BMS. ICK received honoraria from Abbott, Novartis, Yuhan, Viatris, Organon, Boryoung, Hanmi, Daewoong, Celltrion, Servier, Daiichi Sankyo, Chong Kun Dang, and Daewon. JHL received honoraria from Daewoong Pharmaceutical, Handok Pharmaceuticals, Novartis, Chong Kun Dang Pharmaceutical Corp, Menarini Korea, Samjin Pharmaceuticals Co. Ltd, Daiichi Sankyo Korea, Hanmi Pharmaceutical, Yuhan Corporation, Boryung Pharmaceutical, Bayer. HYL received honoraria from Viatris, Organon, Boryoung, Hanmi, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, Chong Kun Dang, and Daewon, and a research grant from Daiichi Sankyo. HYL also received consultation fee from Skylab. JWC received honoraria from Bayer, Astrazeneca, Organon, Hanmi, Yuhan, Daewoong, Chong Kun Dang, JW, Boryoung, GC Corp, Donga, Handok, Ildong, Jeil, Daewon, Ahn-gook, Samjin, Daiichi Sankyo, Otsuka, Mitsubishi Tanabe, Hyundai, Kuhnil, Bukwang and Aju. JWC also received research grants from Handok, Daewon, Boryung, GC Corp, Addpharma, and Kyung Dong. SHI received honoraria from Boryoung, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, and Menarini, and a research grant from Daiichi Sankyo. SHI has received consultation fee from Skylab. JS received honoraria from Boryoung, Daiichi Sankyo, Chong Kun Dang, and Inno-N and consultaion fee from Skylab and Inbody. SP received honoraria from Viatris, Organon, Boryoung, Hanmi, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, Chong Kun Dang, and Daewon, and a research grant from Daiichi Sankyo. SP has received consultation fee from Skylab. Also, SP has received stock option from Mediwhale. Others have nothing to declare., (© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)

The femoral artery is the preferred access route for neurointerventions. The transfemoral approach (TFA) offers advantages such as a large diameter and easy access. However, it also entails disadvantages such as patient discomfort and high risk of complications. Following the initial report of coronary angiography using the transradial approach (TRA) in 1989, cardiologists discovered the advantages of TRA over the TFA and gradually replaced it with the TRA. In 1997, Matsumoto et al. used the TRA for cerebral angiography and neurointervention. Thereafter, the adoption of TRA for neurointervention gradually increased and good outcomes were reported. However, despite these developments, the adoption rate of TRA is relatively low. We reviewed the relevant studies to increase the accessibility of TRA for neurointerventionists.

The ubiquity of microplastics (MP) in aquatic environments has been raising concerns. Although the μ-Fourier transform infrared spectroscopy (μ-FTIR) technique is commonly used to detect MPs, it is an expensive and time-consuming process that requires expert operation. Moreover, the mass concentration of MPs cannot be determined, thereby necessitating the development of an inexpensive and simple analytical technique for identifying and quantifying MPs in aquatic environments using thermal-based technologies. This study aimed to develop a method for identifying and quantifying MPs using differential scanning calorimetry (DSC), with six types of semi-crystalline polymers (polypropylene, low-density polyethylene, high-density polyethylene, polyamide, polyethylene terephthalate, and polytetrafluoroethylene) and four amorphous polymers (polyvinyl chloride, polystyrene, polycarbonate, and polymethyl methacrylate) as representative polymers. The melting point and glass transition temperature of each polymer were determined using the heating-cooling-heating method (20 °C/min), and Gaussian and asymmetry double sigmoidal models were chosen for peak deconvolution. As a case study, the effluent of a wastewater treatment plant in Chuncheon, South Korea, was analyzed using the established analysis protocol, and the results were compared with those from μ-FTIR analysis. The MP concentration was measured to be 0.70-0.79 μg/L using DSC, meaning that 105-117.75 g/d of MPs were discharged to Uiam Lake. This value differs from the 0.54-2.03 μg/L obtained by μ-FTIR analysis, which might be due to bias from the conversion method. This study demonstrates the feasibility of using DSC analysis as an economical and simple method for identifying and quantifying MPs in aquatic environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Remote epitaxy is taking center stage in creating freestanding complex oxide thin films with high crystallinity that could serve as an ideal building block for stacking artificial heterostructures with distinctive functionalities. However, there exist technical challenges, particularly in the remote epitaxy of perovskite oxides associated with their harsh growth environments, making the graphene interlayer difficult to survive. Transferred graphene, typically used for creating a remote epitaxy template, poses limitations in ensuring the yield of perovskite films, especially when pulsed laser deposition (PLD) growth is carried out, since graphene degradation can be easily observed. Here, we employ spectroscopic ellipsometry to determine the critical factors that damage the integrity of graphene during PLD by tracking the change in optical properties of graphene in situ . To mitigate the issues observed in the PLD process, we propose an alternative growth strategy based on molecular beam epitaxy to produce single-crystalline perovskite membranes.

Ethnopharmacological Relevance: The bitter resins in hops (Humulus lupulus) modulate GABA receptors, leading to central nervous system suppression, which induces sedative effects and enhances sleep., Aim of the Study: This study intends to explore the sleep-enhancing properties of Hongcheon-hop extract, a hop native to Korea, by analyzing sleep structure and its mechanisms through EEG., Materials and Methods: A pentobarbital-induced sleep model was used, along with EEG analysis to study sleep architecture. The receptor binding of Hongcheon-hop extract was analyzed using GABA receptor antagonists., Results: The extract contained 7.44 mg/g of xanthohumol, 133.04 mg/g of α-acids including 13.74 mg/g of humulone and 84.52 mg/g of β-acids. Administration of the extracts resulted in a dose-dependent enhancement of sleep duration. Both low (100 mg/kg) and high doses (200 mg/kg) of the extract increased non-rapid eye movement (NREM) sleep by enhancing δ wave sleep, which represents deep sleep. The extract exerted its sleep-promoting effects by binding to the γ-aminobutyric acid (GABA) binding site on GABA A receptor. In an insomnia model, low dose of the extract was more effective than the same dose of GABA in enhancing sleep. Administration of the extract for 3 weeks increased the expression and protein levels of 5-HT 1A receptors in addition to GABA A receptor, and also increased the content of GABA in the brain. A mixture of xanthohumol (1.49 mg) and humulone (2.75 mg) within Hongcheon-hop extract (200 mg) exhibited a sleep-enhancing effect comparable to that of the extract., Conclusion: These findings suggest that Hongcheon-hop extract, which contains xanthohumol and humulone, improves sleep quality by increasing NREM sleep through the enhancement of δ-wave sleep via GABA A receptors. Hongcheon-hop shows potential as a natural therapeutic agent for treating insomnia and enhancing sleep., Competing Interests: Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

In this study, we aimed to investigate the nationwide utilization of antipsychotic drugs (APDs) during radiotherapy and evaluate their association with survival in patients with breast cancer. This retrospective cohort study used the National Health Insurance Service database in Korea and included patients diagnosed with breast cancer from 2010 to 2020 who received radiotherapy. The APDs included in the analysis were aripiprazole, quetiapine, olanzapine, risperidone, haloperidol, and chlorpromazine, and the APD prescription details included prescription time, dosage, and duration. Among 170,226 patients with breast cancer treated with radiotherapy, 3361 (1.97%) received APD during radiotherapy. Use of APDs was significantly associated with higher mortality in all patients and in a subgroup of patients excluding those with metastasis or other cancers. Among patients taking APD during radiotherapy, those with accompanied psychiatric history and long-term APD use for ≥ 3 months were associated with lower mortality, whereas patients who started APD during radiotherapy had higher mortality than those who started APD before radiotherapy. The high mortality observed in breast cancer patients using APDs during radiotherapy could be influenced by the underlying conditions that necessitated APD use. Further studies are needed to determine the effects of APDs during radiotherapy in patients with breast cancer., (© 2024. The Author(s).)

NH 3 is a versatile solution for the storage and distribution of sustainable energy, offering high energy density and promising applications as a renewable hydrogen carrier. However, electrochemical NH 3 synthesis under ambient conditions remains challenging, such as low selectivity and efficiency, owing to the inertness of N≡N and competing reactions. In this study, a catalyst (MoC/NFC) comprising molybdenum carbide evenly dispersed on carbon doped with N and F heteroatoms was successfully synthesized using liquid-phase plasma. The MoC/NFC catalyst exhibited a maximum NH 3 yield of 115 μg h -1 mg -1 cat. with a faradaic efficiency of 1.15% at -0.7 V vs reversible hydrogen electrode in 0.1 M KOH electrolyte. Pyridinic- and pyrrolic-N atoms adjacent to the carbon pores served as active sites for N 2 adsorption and enabled N 2 triple bond cleavage. In addition, F doping contributed to N 2 activation owing to the high electronegativity of 3.98, resulting in the attraction of more electrons. These findings demonstrate a significant advancement in the development of efficient catalysts for electrochemical ammonia synthesis, potentially paving the way for scalable and sustainable NH 3 production methods that can support the growing demand for renewable energy storage solutions.

Background: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common complication of ERCP, with limited studies comparing combined prophylactic measures and their efficacy relative to individual patient risk profiles. This study aims to perform an individual patient data meta-analysis (IPDMA) to evaluate the contribution of patient and ERCP-related risk factors to PEP development and to identify the best prophylaxis strategies according to the patient's risk profile., Methods: We systematically searched MEDLINE, Embase, and Cochrane databases until November 2022 for randomized controlled PEP prophylaxis trials. We invited authors to share individual patient data, including PEP risk profile and prophylaxes used. PEP incidence rates for different prophylaxis were calculated. Efficacy was compared using multilevel logistic regression and expressed as relative risk (RR). Subgroup analysis evaluated the role of patient and ERCP-related risk factors in developing PEP., Results: Data from 11 studies, including 6430 patients, were analyzed. After adjusting for risk factors, rectal NSAIDs (RR 0.69, 95%CI 0.54-0.88) and peri-procedural high-volume intravenous fluid (IVF) (RR 0.40, 95%CI 0.21-0.79) were effective in reducing PEP incidence, while no benefit was noted with pancreatic duct (PD) stents (RR 1.25, 95%CI 0.91-1.73). In patients receiving rectal NSAIDs (n = 2617), difficult cannulation (RR 1.99, 1.45-2.73), contrast injection into the pancreatic duct (PD) (RR2.37, 1.68-3.32), and prior history of PEP (RR 1.90, 1.06-3.41) were associated with increased PEP risk., Conclusion: This IPDMA confirms that rectal NSAIDs and peri-procedural IVF are effective PEP prophylactic strategies. Further studies focusing on combination therapy or the development of personalized PEP risk calculators are needed to improve prophylactic strategies., (© 2024. The Author(s).)

Ticks pose a significant public health threat due to their ability to transmit various pathogens, including emerging tick-borne diseases. This study conducted a comprehensive surveillance of Haemaphysalis tick species and their severe fever with thrombocytopenia syndrome virus (SFTSV) infection rates in South Korea throughout the year 2023, from January to December. To ensure accurate and rapid identification of the prevalent Haemaphysalis tick species in South Korea, we designed PCR primer sets targeting the ITS1 gene, specifically distinguishing Haemaphysalis longicornis from Haemaphysalis flava . Among the 10,343 ticks collected from wild animals, H. longicornis constituted the majority, accounting for 65.5% (6,784/10,343 ticks), followed by H. flava at 33.8% (3,491/10,343 ticks), and Ixodes nipponensis at 0.7% (68/10,343 ticks). These identified ticks were then categorized into 811 pools, with 63 pools testing positive for SFTSV. Remarkably, the prevalence of SFTSV-positive H. longicornis ticks peaked during the summer months, aligning with heightened human outdoor activities and, consequently, an increased risk of human exposure. Conversely, it is noteworthy that H. flava exhibited a higher prevalence during the winter season, reaching its peak in January, with an SFTSV minimum infection rate similar to that of H. longicornis . These findings underscore the year-round presence of Haemaphysalis ticks as potential vectors for SFTSV, extending the temporal window for potential human exposure. Consequently, these results emphasize the necessity for active and continuous field surveillance to comprehensively understand and mitigate the public health risks associated with these tick-borne pathogens., Importance: To date, the majority of tick surveillance studies have primarily focused on warmer seasons, which are considered optimal periods for ticks to actively seek hosts and transmit pathogens through blood-feeding activities. Consequently, tick species active during winter have often been overlooked, leading to an underestimation of their significance in transmitting severe fever with thrombocytopenia syndrome virus (SFTSV). In this study, we aimed to examine year-round tick prevalence with SFTSV and illuminate the role of the winter-dominant species, Haemaphysalis flav a, in South Korea. Through rigorous identification facilitated by a primer set designed specifically for this purpose, we emphasize that H. flava , a competent vector species, harbors SFTSV in the winter season, thereby acting as an overwintering reservoir for the virus. This phenomenon may contribute to a higher infection rate among ticks in the following year., Competing Interests: The authors declare no conflict of interest.

Background and Purpose: Episodic ataxia type 2 (EA2) is characterized by recurrent vertigo and ataxia due to mutations in CACNA1A that encodes the α 1A -subunit of the P/Q-type voltage-gated calcium channel. This study aimed to determine intellectual function in EA2., Methods: During 2019-2023, 13 patients (6 males, age range=10-52 years, median age=29 years) with a genetically confirmed diagnosis of EA2 had their intellectual function evaluated using the Korean versions of the Wechsler Intelligence Scales (version IV) for adults or children in 3 referral-based university hospitals in South Korea., Results: The full-scale intelligence quotients (FSIQs) among the 13 patients were below the average (90-109) in 11, low average (80-89) in 5 (38.5%), borderline (70-79) in 1 (7.7%), and indicated intellectual disability (≤69) in 5 (38.5%). These patterns of cognitive impairments were observed in all four of the following subtests: verbal comprehension, perceptual reasoning, working memory, and processing speed. The FSIQ was not correlated with the ages at onset for vertigo and ataxia (Pearson correlation: p =0.40)., Conclusions: Patients with EA2 may have hidden intellectual disabilities even without a history of epilepsy or administration of antiepileptic drugs, and should be considered for genetic counseling and therapeutic interventions. Given the availability of medication to control episodic vertigo and ataxia, early diagnosis and management are important in preventing irreversible brain dysfunction in EA2., Competing Interests: Dr. J-S Kim serves as an Associate Editor of Frontiers in Neuro-otology and on the editorial boards of the Journal of Clinical Neurology, Frontiers in Neuro-ophthalmology, Journal of Neuro-ophthalmology, Journal of Vestibular Research, and Clinical Translational Neuroscience. Dr. J-S Kim is a technical director at SLMED. All remaining authors have declared no conflicts of interest., (Copyright © 2024 Korean Neurological Association.)

Study Objectives: The use of sleep tracking devices is increasing as people become more aware of the importance of sleep and interested in monitoring their patterns. With many devices on the market, we conducted a meta-analysis comparing sleep-scoring data from consumer wrist-worn sleep tracking devices with polysomnography to validate the accuracy of devices., Methods: We retrieved studies from the databases of SCOPUS, EMBASE, Cochrane Library, PubMed, Web of Science, and KoreaMed, and OVID Medline up to March 2024. We compared personal data about participants and information on objective sleep parameters., Results: From 24 studies, data of 798 patient using Fitbit, Jawbone, myCadian watch, WHOOP strap, Garmin, Basis B1, Zulu Watch, Huami Arc, E4 wristband, Fatigue Science Readiband, Apple Watch, or Xiaomi Mi Band 5 were analyzed. There were significant differences in total sleep time {mean difference (MD) -16.854, 95% confidence interval (CI) [-26.332; -7.375]}, sleep efficiency (MD -4.691, 95% CI [-7.079; -2.302]), sleep latency (MD 2.574, 95% CI [0.606; 4.542]), and wake after sleep onset (MD 13.255, 95% CI [4.522; 21.988]) between all consumer sleep tracking devices and polysomnography. In subgroup analysis, there was no significant difference of wake after sleep onset between Fitbit and polysomnography. There was also no significant difference sleep latency between other devices and polysomnography. Fitbit measured sleep latency longer than other devices, and other devices measured wake after sleep onset longer. Based on Begg and Egger's test, there was no publication bias in total sleep time and sleep efficiency., Conclusions: Wrist-worn sleep tracking devices, while popular, are not as reliable as polysomnography in measuring key sleep parameters like total sleep time, sleep efficiency, and sleep latency. Physicians and consumers should be aware of their limitations and interpret results carefully, though they can still be useful for tracking general sleep patterns. Further improvements and clinical studies are needed to enhance their accuracy., (© 2024 American Academy of Sleep Medicine.)

Geminal bromofluoroalkenes are an important subclass of versatile organic interhalide, which can serve as useful synthetic precursors to monofluoroalkenes that are valuable amide group isosteres. Nonetheless, despite the vast advancement of olefination methodologies, the broadly applicable stereoselective synthesis remained elusive for geminal bromofluoroalkenes before our work. In particular, the seemingly straightforward Wittig-type approach with interhalogenated phosphorus ylide has been unsuccessful because of the difficulty in the diastereoselective oxaphosphetane formation. Here, we describe a conceptually distinctive strategy, by which the stereoselectivity is gained via the selective decomposition of the oxaphosphetane intermediates. The suitably identified phosphorus(III) reagent and reaction medium enabled efficient kinetic differentiation, which was supported by nuclear magnetic resonance analysis and density functional theory calculation. Through our method, the highly diastereoselective synthesis of geminal E -bromofluoroalkenes was accomplished in one step. Furthermore, the generality was demonstrated by accommodating a wide range of readily available carbonyl compounds, including ketones and pharmaceutical substrates.

Lignin-based supports for metal nanoparticles (NPs) have attracted significant attention due to their abundant functional groups that facilitate NPs loading. However, many studies involve a two-step process: fabricating lignin particles and then reducing metal ions to NPs using physical energy consumption or chemical reduction. A one-step in-situ reduction method for NP synthesis on carrier surfaces, eliminating energy consumption, is needed for environmentally friendly and sustainable approach. Herein, we demonstrate that poly-l-lysine (PL) controls the self-assembly kinetics of kraft lignin (KL), and reduces silver ion (Ag + ) to silver nanoparticles (AgNPs), forming highly monodisperse, co-self-assembled PL-KL particles (Ag@PL-KLPs) without chemical reducing agents or energy consumption. PL facilitated rapid KL desolvation, promoting intermolecular interactions and silver ion adsorption, followed by an efficient, separate nucleation and growth process yielded Ag@PL-KLPs approximately 270 nm in size with a narrow distribution. Notably, Ag@PL-KLPs exhibited enhanced bacteriostatic and bactericidal properties against antibiotic-resistant bacteria (ARB), including both Gram-negative and Gram-positive strains, at concentrations of 250 μg/mL. Leveraging biomass-derived lignin and this cost-effective, one-step green synthesis approach offers a sustainable method for avoiding antibiotic overuse and environmental contamination., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Zn-air battery (ZAB)-driven water splitting holds great promise as a next-generation energy conversion technology, but its large overpotential, low activity, and poor stability for oxygen reduction reaction (ORR), oxygen evolution reaction (OER), and hydrogen evolution reaction (HER) remain obstacles. Here, a trifunctional graphene-sandwiched, heterojunction-embedded layered lattice (G-SHELL) electrocatalyst offering a solution to these challenges are reported. Its hollow core-layered shell morphology promotes ion transport to Co 3 S 4 for OER and graphene-sandwiched MoS 2 for ORR/HER, while its heterojunction-induced internal electric fields facilitate electron migration. The structural characteristics of G-SHELL are thoroughly investigated using X-ray absorption spectroscopy. Additionally, atomic-resolution transmission electron microscopy (TEM) images align well with the DFT-relaxed structures and simulated TEM images, further confirming its structure. It exhibits an approximately threefold smaller ORR charge transfer resistance than Pt/C, a lower OER overpotential and Tafel slope than RuO₂, and excellent HER overpotential and Tafel slope, while outlasting noble metals in terms of durability. Ex situ X-ray photoelectron spectroscopy analysis under varying potentials by examining the peak shifts and ratios (Co 2+ /Co 3+ and Mo 4+ /Mo 6+ ) elucidates electrocatalytic reaction mechanisms. Furthermore, the ZAB with G-SHELL outperforms Pt/C+RuO 2 in terms of energy density (797 Wh kg -1 ) and peak power density (275.8 mW cm -2 ), realizing the ZAB-driven water splitting., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Microplastics (MPs) enter lakes through various pathways, including effluents from wastewater treatment plants (WWTPs), surface runoff, and improperly disposed of plastic waste. In this study, the extent of MPs pollution in Uiam Lake in fall of 2022 and spring of 2023 was assessed by determining both the number (n/m 3 ) and mass concentrations (μg/m 3 ) of MPs. Moreover, the correlation between water quality parameters and MP properties was analyzed, and an ecological risk assessment was conducted. MPs abundance was higher in spring than in fall, probably due to the lifting of coronavirus disease-19 restrictions, melting of ice, higher rainfall, and faster wind speed. Fragment was the dominant shape of the MPs collected, while polyvinyl chloride (PVC) and polyester/polyethylene terephthalate were the frequently detected polymer types of MPs in fall and spring, respectively. There was a moderate positive correlation between the number concentration of MPs and the total nitrogen, total phosphorus (T-P), and total organic carbon levels; in contrast, there was no significant relationship between the mass concentration of MPs and all water quality parameters. However, the abundance (μg/m 3 ) of PVC and polymethyl methacrylate MPs were positively correlated with T-P and electrical conductivity. The pollution load index, polymer hazard index, and potential ecological risk index (PERI) were generally higher when the mass unit of MPs was used due to the presence of large-sized MPs composed of highly hazardous polymers (e.g., polyurethane, PVC, and alkyd). For instance, the PERI value of the WWTP effluent was at the very high level (>1200) in both seasons, regardless of the abundance unit of MPs. Therefore, WWTP effluents may have increased the ecological toxicity of MPs pollution in Uiam Lake., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Agriculture is vital for global food security, and irrigation is essential for improving crop yields. However, irrigation can pose challenges such as mineral scarcity and salt accumulation in the soil, which negatively impact plant growth and crop productivity. While numerous studies have focused on enhancing plant tolerance to high salinity, research targeting various ecotypes of Arabidopsis thaliana has been relatively limited. In this study, we aimed to identify salt-tolerant ecotypes among the diverse wild types of Arabidopsis thaliana and elucidate their characteristics at the molecular level. As a result, we found that Catania-1 (Ct-1), one of the ecotypes of Arabidopsis, exhibits greater salt tolerance compared to Col-0. Specifically, Ct-1 exhibited less damage from reactive oxygen species (ROS) than Col-0, despite not accumulating antioxidants like anthocyanins. Additionally, Ct-1 accumulated more potassium ions (K + ) in its shoots and roots than Col-0 under high salinity, which is crucial for water balance and preventing dehydration. In contrast, Ct-1 plants were observed to accumulate slightly lower levels of Na + than Col-0 in both root and shoot tissues, regardless of salt treatment. These findings suggest that Ct-1 plants achieve high salinity resistance not by extruding more Na + than Col-0, but rather by absorbing more K + or releasing less K + . Ct-1 exhibited higher nitrate (NO 3 - ) levels than Col-0 under high salinity conditions, which is associated with enhanced retention of K + ions. Additionally, genes involved in NO 3 - transport and uptake, such as NRT1.5 and NPF2.3, showed higher transcript levels in Ct-1 compared to Col-0 when exposed to high salinity. However, Ct-1 did not demonstrate significantly greater resistance to osmotic stress compared to Col-0. These findings suggest that enhancing plant tolerance to salt stress could involve targeting the cellular processes responsible for regulating the transport of NO 3 - and K + . Overall, our study sheds light on the mechanisms of plant salinity tolerance, emphasizing the importance of K + and NO 3 - transport in crop improvement and food security in regions facing salinity stress., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Background: Detecting monoclonal protein (M-protein), a hallmark of plasma cell disorders, traditionally relies on methods such as protein electrophoresis, immune-electrophoresis, and immunofixation electrophoresis (IFE). Mass spectrometry (MS)-based methods, such as matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and electrospray ionization-quadrupole time-of-flight (ESI-qTOF) MS, have emerged as sensitive methods. We explored the M-protein-detection efficacies of different MS techniques., Methods: To isolate immunoglobulin and light chain proteins, six types of beads (IgG, IgA, IgM, kappa, lambda, and mixed kappa and lambda) were used to prepare samples along with CaptureSelect nanobody affinity beads (NBs). After purification, both MALDI-TOF MS and liquid chromatography coupled with Synapt G2 ESI-qTOF high-resolution MS analysis were performed. We purified 25 normal and 25 abnormal IFE samples using NBs and MALDI-TOF MS (NB-MALDI-TOF)., Results: Abnormal samples showed monoclonal peaks, whereas normal samples showed polyclonal peaks. The IgG and mixed kappa and lambda beads showed monoclonal peaks following the use of daratumumab (an IgG/kappa type of monoclonal antibody) with both MALDI-TOF and ESI-qTOF MS analysis. The limits of detection for MALDI-TOF MS and ESI-qTOF MS were established as 0.1 g/dL and 0.025 g/dL, respectively. NB-MALDI-TOF and IFE exhibited comparable sensitivity and specificity (92% and 92%, respectively)., Conclusions: NBs for M-protein detection, particularly with mixed kappa-lambda beads, identified monoclonal peaks with both MALDI-TOF and ESI-qTOF analyses. Qualitative analysis using MALDI-TOF yielded results comparable with that of IFE. NB-MALDI-TOF might be used as an alternative method to replace conventional tests (such as IFE) to detect M-protein with high sensitivity.

In evidence-based medicine, systematic review continues to carry the highest weight in terms of quality and reliability, synthesizing robust information from previously published cohort studies to provide a comprehensive overview of a topic. Meta-analysis provides further depth by allowing for comparative analysis between the studied intervention and the control group, providing the most up-to-date evidence on their characteristics and efficacy. We discuss the principles and methodology of meta-analysis, and its applicability to the field of surgical research. The clinical question is defined using PICO framework (Problem, Intervention, Comparison, Outcome). Then a systematic article search is performed across multiple medical databases using relevant search terms, which are then filtered out based on appropriate screening tools. Pertinent data from the selected articles are collected and undergo critical appraisal by at least two independent reviewers. Additional statistical tests may be performed to identify the presence of any significant bias. The data are then synthesized to perform comparative analysis between the intervention and comparison groups. In this article, we discuss specifically the usage of R software (R Foundation for Statistical Computing, Vienna, Austria) for data analysis and visualization. Meta-analysis results of the pooled data are presented using forest plots. Concerns for potential bias may be addressed through the creation of funnel plots. Meta-analysis is a powerful tool to provide highly reliable medical evidence. It may be readily performed by independent researchers with minimal need for funding or institutional approval. The ability to conduct such studies is an asset to budding medical scholars., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Whether angiotensin II receptor blockers (ARBs) can be an alternative to angiotensin-converting enzyme inhibitors (ACEIs) in patients without heart failure (HF) after acute myocardial infarction (MI) remains controversial. The aim of this study was to compare clinical outcomes between initial ARB and ACEI therapy in patients with MI without HF., Methods: Between 2010 and 2016, a total of 31,013 patients who underwent coronary revascularization for MI with prescription of ARBs or ACEIs at hospital discharge were enrolled from the Korean nationwide medical insurance data. Patients who had HF at index MI were excluded. The primary outcome was all-cause death. The secondary outcomes included recurrent MI, hospitalization for new heart HF, stroke, and a composite of each outcome., Results: Of 31,013 patients, ARBs were prescribed in 12,685 (40.9%) and ACEIs in 18,328 (59.1%). Patients receiving ARBs had a lower discontinuation rate compared with those receiving ACEIs (28.2% vs 43.5%, adjusted hazard ratio [HR] 0.34; 95% confidence interval [CI] 0.31-0.37; P < .01). During a median follow-up of 2.2 years, 2480 patients died. The incidence rate of all-cause death in patients receiving ARBs and those receiving ACEIs was 27.7 and 22.9 per 1000 person-years, respectively (adjusted HR 1.04; 95% CI 0.95-1.13; P = .40). There were no significant differences in the secondary outcomes between patients receiving ARBs and those receiving ACEIs, except stroke (19.2 vs 13.6 per 1000 person-years; adjusted HR 1.17; 95% CI 1.04-1.32; P = .01). In a subgroup analysis, a higher mortality was observed with ARBs compared with ACEIs in patients with diabetes., Conclusions: In this nationwide cohort, there was no significant difference in the incidence of all-cause death between ARBs and ACEIs as discharge medications in patients with myocardial infarction without heart failure. Angiotensin II receptor blockers would be an alternative to ACEIs for those intolerant to ACEI therapy., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Designing current collectors and constructing efficient artificial solid electrolyte interphase (SEI) layers are promising strategies for achieving dendrite-free Li deposition and practical applications in Li metal batteries (LMBs). Electrodeposition is advantageous for large-scale production and allows the direct formation of current collectors without binders, making them immediately usable as electrodes. In this study, an adherent Cu 2 S thin-layer on Cu foil is synthesized through anodic electrodeposition from a Na 2 S solution in a one-step process, followed by the generation of Li 2 S layers as artificial SEI layers via a conversion reaction (3DLi 2 S-Cu foil). The Li 2 S layers move from the 3D Cu surface to the deposited Li surface, facilitating uniform and dense Li deposition. The 3DLi 2 S-Cu foil structure demonstrates stable cycling performance over 350 cycles in an asymmetric cell, with a capacity of 1 mAh cm -2 at 1 mA cm -2 . Moreover, symmetric cells with 5 mAh cm -2 of deposited Li exhibit a stable cycle life for over 1200 h. When paired with commercial LiFePO 4 (LFP), the full cells show substantially enhanced cyclability, regardless of the amount of deposited Li. This study provides new insights into the construction of artificial SEIs for facilitating commercial applications., (© 2024 Wiley‐VCH GmbH.)

This study aimed to develop a machine learning (ML) model for predicting pulmonary embolism (PE) in patients with gastrointestinal cancers, a group at increased risk for PE. We conducted a retrospective, multicenter study analyzing patients who underwent computed tomographic pulmonary angiography (CTPA) between 2010 and 2020. The study utilized demographic and clinical data, including the Wells score and D-dimer levels, to train a random forest ML model. The model's effectiveness was assessed using the area under the receiver operating curve (AUROC). In total, 446 patients from hospital A and 139 from hospital B were included. The training set consisted of 356 patients from hospital A, with internal validation on 90 and external validation on 139 patients from hospital B. The model achieved an AUROC of 0.736 in hospital A and 0.669 in hospital B. The ML model significantly reduced the number of patients recommended for CTPA compared to the conventional diagnostic strategy (hospital A; 100.0% vs. 91.1%, P < 0.001, hospital B; 100.0% vs. 93.5%, P = 0.003). The results indicate that an ML-based prediction model can reduce unnecessary CTPA procedures in gastrointestinal cancer patients, highlighting its potential to enhance diagnostic efficiency and reduce patient burden., (© 2024. The Author(s).)

Background: Several Previous studies indicate that consuming krill oil may aid in reducing hypercholesterolemia and improving cholesterol metabolism. Therefore, our study was designed to investigate the effectiveness of Antarctic krill oil ( Euphausia superba ) (ESKO) in combating obesity and lowering fat/lipid/cholesterol levels., Methods: The study aimed to investigate the molecular docking model targeting 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) using ESKO-derived eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and astaxanthin. In this study, histological alterations in the liver of the obesity model (ICR male mouse), obesity-related or antioxidant markers in both liver and serum, the molecular mechanisms in HepG2 cells and liver tissue, and HMGCR activity were analyzed., Results: Our findings revealed that a high-fat diet (HFD) significantly led to increased oxidative stress, obesity-related indicators, and cardiovascular-associated risk indices. However, ESKO effectively mitigated HFD-induced oxidative stress, fat accumulation, and the suppression of low-density lipoprotein receptor (LDLR) or activation of related molecular pathways. This was achieved through improvements in metabolic parameters, including CD36/liver X receptor α (LXRα)/sterol regulatory element-binding protein 1c (SREBP1c), proprotein convertase subtilsin/kexin type 9 (PCSK-9), and HMGCR, ultimately ameliorating HFD-induced hypercholesterolemia and obesity., Conclusions: These beneficial findings indicate that ESKO might have significant potential for preventing and treating obesity-related disorders.

Cerebral revascularization for the treatment of atherosclerotic steno-occlusive disease (ASOD) was found to have no benefit compared with medical treatment. However, there is also criticism that with sufficiently long-term follow-up, a crossover might emerge demonstrating the advantages of surgery. Therefore, we examined the long-term outcome of cerebral revascularization performed on patients with carefully selected ASOD at our center. Patients undergoing bypass surgery for non-moyamoya ischemic disease were retrospectively identified. The inclusion criteria were symptomatic ASOD with hemodynamic insufficiency, follow-up of more than 5 years, and stroke or surgical complications during follow-up. The clinical course and radiological findings were investigated. Poor outcomes were predicted using machine learning (ML) models, and Shapley additive explanation (SHAP) values and feature importance of each model were analyzed. A total of 109 patients were included from 2007 to 2018. The 30-day risk of any stroke or death was 6.4% (7/109). The risk of ipsilateral ischemic stroke during median follow-up of 116 months was 7.3% (8/109). The SHAP values showed that previously and empirically known stroke risk factors exert a relatively consistent effect on the prediction of models. The number of lesions with stenosis > 50% (odds ratio [OR] 5.77), age (OR 1.13), and coronary artery disease (OR 5.73) were consistent risk factors for poor outcome. We demonstrated an acceptable long-term outcome of cerebral revascularization surgery for patients with hemodynamically insufficient and symptomatic ASOD. Multicenter studies are encouraged to predict poor outcomes and suitable patients with large numbers of quantitative and qualitative data., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Well-differentiated hepatocellular lesions (WDHLs) are liver tumors or nonneoplastic lesions in which the cells closely resemble normal hepatocytes. These lesions often include focal nodular hyperplasia, hepatocellular adenoma, macroregenerative nodule, dysplastic nodule, and well-differentiated hepatocellular carcinoma. The diagnosis of these lesions remains challenging because of their morphological similarities, particularly when examined using needle biopsy. The accurate diagnosis of WDHLs is crucial for patient management and prognosis. This review addresses the histopathological characteristics and diagnostic approaches of WDHLs.

The soju (Korean traditional distilled liquor) market is increasing worldwide. However, in contrast to well-explored distilled liquors, including baijiu (China) and shochu (Japan), soju is less investigated, with limited research on its aroma characteristics. To facilitate better understanding of the aroma characteristics of soju , this study aims to overview recent research on the flavor characteristics of soju and compare data with those of baijiu and shochu , well-established products in the market. Soju is generally made using rice and nuruk (a traditional Korean fermentation starter). Previous studies have reflected that the aroma characteristics vary with raw materials' nutrition percentages, microbial taxa influenced in fermentation starters, and/or pressure reduction during distillation. The research on the aroma characteristics of baijiu , characterized by solid-state fermentation involving qu (a traditional Chinese fermentation starter), is focused on differences in regional characteristics of the flavor type. Research on the aroma characteristics of shochu has primarily demonstrated that the microbial community could contribute significantly to the development of specific aromatic compounds and/or attributes. Moreover, the association of the aroma characteristics of baijiu and shochu with their volatile compound development by the determination of selective ingredients has been examined. Understanding the current research progress can potentially facilitate the improvement in the aroma characteristics of soju .

Background: KRAS , TP53 , CDKN2A , and SMAD4 have been the main driver mutations in pancreatic ductal adenocarcinoma (PDAC). Studies on the clinical significance and treatment response to 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) regimen in terms of the presence of these mutations remain inconclusive., Objectives: This study aimed to compare the survival outcome and response to FOLFIRINOX chemotherapy based on the presence of four driver mutation genes., Design: A multi-center retrospective study conducted at two tertiary medical centers., Methods: This study analyzed PDAC patients who were treated with FOLFIRINOX chemotherapy as the initial treatment. Tumor specimens were analyzed by a targeted next-generation sequencing platform at two tertiary referral hospitals from January 2016 to March 2022. Patients' demographics, survival outcomes, and chemotherapeutic response were investigated and compared according to the presence of driver mutations., Results: The analysis included 100 patients. KRAS mutation was identified in 92 (92.0%) patients, followed by TP53 , CDKN2A , and SMAD4 in 63 (63.0%), 18 (18.0%), and 17 (17.0%) patients, respectively. The TP53 wild-type group demonstrated longer overall survival (OS) than the TP53 mutated group (median OS: 29 vs 19 months, p  = 0.03), and TP53 served as a prognostic factor for survival (hazard ratio = 1.74, 95% confidence interval: 1.00-3.00, p  = 0.048). The difference in OS according to TP53 mutation was intensified in localized pancreatic adenocarcinoma (37 vs 19 months, p  = 0.01). The TP53 wild-type group demonstrated a higher objective response rate to FOLFIRINOX chemotherapy than the TP53 mutation group in localized pancreatic adenocarcinoma (50.0% vs 17.6%, p  = 0.024)., Conclusion: PDAC patients with wild-type TP53 demonstrated longer OS than those with TP53 mutation, and this trend was intensified in patients with localized disease. This result may be due to an impaired response to FOLFIRINOX chemotherapy in patients with TP53 mutation., Competing Interests: The authors declare that there is no conflict of interest. Qualified, interested researchers can contact the corresponding author to request additional data. The data cannot be shared publicly as they contain potentially identifying patient data., (© The Author(s), 2024.)

Recent advancements in next-generation sequencing (NGS) technologies have created new opportunities for comprehensive screening of multiple parasite species. In this study, we cloned the 18 S rDNA V9 region of 11 species of intestinal parasites into plasmids. Equal amounts and concentrations of these 11 plasmids were pooled, and amplicon NGS targeting the 18 S rDNA V9 region was performed using the Illumina iSeq 100 platform. A total of 434,849 reads were identified, and all 11 parasite species were detected, although the number of output reads for each parasite varied. The read count ratio, in descending order, was as follows: Clonorchis sinensis, 17.2%; Entamoeba histolytica, 16.7%; Dibothriocephalus latus, 14.4%; Trichuris trichiura, 10.8%; Fasciola hepatica, 8.7%; Necator americanus, 8.5%; Paragonimus westermani, 8.5%; Taenia saginata, 7.1%; Giardia intestinalis, 5.0%; Ascaris lumbricoides, 1.7%; and Enterobius vermicularis, 0.9%. We found that the DNA secondary structures showed a negative association with the number of output reads. Additionally, variations in the amplicon PCR annealing temperature affected the relative abundance of output reads for each parasite. These findings can be applied to improve parasite detection methodologies and ultimately enhance efforts to control and prevent intestinal parasitic infections., (© 2024. The Author(s).)

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are major global health concerns, with inhalation therapy being a primary treatment method. Dry powder inhalers (DPIs) often face challenges related to particle aggregation, which can diminish drug delivery efficiency. This study investigates particle aggregation and aims to optimize the cohesion-adhesion balance to improve inhalation efficiency. Advanced techniques like atomic force microscopy and Raman imaging were used to analyze particle interactions, focusing on lactose ratios, particle morphology, and drug-drug interactions. The therapeutic efficacy of optimized formulations containing budesonide (BUD) and Arformoterol (AFT) was assessed using an asthma model, showing significant improvements in sRAW, neutrophil count, and tidal volume compared to the positive control, with p -values below 0.01. AFT exhibited comparable efficacy to Formoterol at half the dose. Additionally, pharmacokinetic studies demonstrated similar in vivo behavior between the drugs, confirming the therapeutic advantage of AFT, with p -values for AUC 0-t and Cmax of .646 and .153, respectively. The fine particle fractions for AFT and BUD were 39.4% and 50.6%, respectively, indicating improved drug delivery efficiency and potential for better clinical outcomes in asthma and COPD patients.

Objective: The purpose of this study was to compare the effects of foot positioning on muscle activities of the peroneus longus (PL), medial gastrocnemius (MG), and tibialis anterior (TA)/PL ratio in individuals with chronic ankle instabilities (CAI) during wobble board training., Methods: Thirty individuals with CAI were included, and statistical significance of PL and MG muscle activities was determined using 1-way repeated measures analysis of variance alongside TA/PL activity ratio at the university research laboratory. The participants performed the wobble board training in 3 different foot positions: medial from the centerline of the wobble board (WBT-M), middle from the centerline of the wobble board, and lateral from the centerline of the wobble board (WBT-L). Peroneus longus, MG, and TA muscle activities were measured using surface electromyography., Results: Peroneus longus activity was significantly higher in the WBT-L position than in the other 2 positions, and it was significantly higher in the middle from the centerline of the wobble board than in the WBT-M position. Medial gastrocnemius activity was significantly greater in the WBT-L position than in the other 2 positions. Tibialis anterior/PL ratio was higher in the WBT-M position than in the other 2 positions., Conclusion: The findings of this study showed that WBT-L increased PL muscle activity by >70% of the maximal voluntary isometric contraction without increasing TA/PL ratio in individuals with CAI., (Copyright © 2024. Published by Elsevier Inc.)

Background: The purpose of this study was to examine the radiographic and clinical outcomes of stemless reverse total shoulder arthroplasty (RTSA) after a minimum 2-year follow-up., Methods: Between July 2018 and March 2023, 50 patients underwent 50 stemless RTSA with the Lima component. Twenty-eight patients with a follow-up of more than 2 years were reviewed. The average age was 71.9 years (range, 61-85 years), and the average follow-up period was 2.2 years (range, 2.0-5.1). Bone marrow density of the proximal humerus was measured before RTSA. We evaluated preoperative and postoperative range of motion, clinical score, radiographic change, and postoperative complications., Results: Significant increases were observed postoperatively in forward flexion (112.0º-162.5º, P<0.01) and internal rotation (from L3 to T12 level; P<0.05). No changes were observed in external rotation (from 43.0º to 45.2º; P=0.762). The clinical scores improved for Korean Shoulder Scoring system (from 64 to 93, P<0.01) and American Shoulder and Elbow Surgeons score (from 17.5 to 27.3, P<0.01). Although radiolucent lines of less than 2 mm were observed in all cases, no osteolysis and loosening of the stemless humeral component was found. Scapular notching was observed in 18 cases (64.3%)., Conclusions: Stemless RTSA showed good radiographic and clinical results after a minimum 2-year follow-up. Level of evidence: IV.

Objective: Polysomnography (PSG) is unique in diagnosing sleep disorders, notably obstructive sleep apnea (OSA). Despite its advantages, manual PSG data grading is time-consuming and laborious. Thus, this research evaluated a deep learning-based automated scoring system for respiratory events in sleep-disordered breathing patients., Methods: A total of 1000 case PSG data were enrolled to develop a deep learning algorithm. Of the 1000 data, 700 were distributed for training, 200 for validation, and 100 for testing. The respiratory events scoring deep learning model is composed of five sequential layers: an initial layer of perceptrons, followed by three consecutive layers of long short-term memory cells, and ultimately, an additional two layers of perceptrons., Results: The PSG data of 100 patients (simple snoring, mild, moderate, and severe OSA; n = 25 in each group) were selected for validation and testing of the deep learning model. The algorithm demonstrated high sensitivity (95% CI: 98.06-98.51) and specificity (95% CI: 95.46-97.79) across all OSA severities in detecting apnea/hypopnea events, compared to manual PSG analysis. The deep learning model's area under the curve values for predicting OSA in apnea-hypopnea index ≥ 5, 15, and 30 groups were 0.9402, 0.9388, and 0.9442, respectively, showing no significant differences between each group., Conclusion: The deep learning algorithm employed in our study showed high accuracy in identifying apnea/hypopnea episodes and assessing the severity of OSA, suggesting the potential for enhancing both the efficiency and accuracy of automated respiratory event scoring in PSG through advanced deep learning techniques., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Marn Joon Park and Shin Young Kim declare no conflicts of interest. Ji Ho Choi is the principal investigator (PI) of the current study, and is currently serving as the nonexecutive board of Honeynaps Co. Ltd., appointed from March 2024. Tae Kyoung Ha is the president of Honeynaps Co. Ltd. The current investigation was independently conceptualized and designed by Ji Ho Choi, utilizing Dr. Choi's patient data from 2017 to 2019, and received IRB approval from Dr. Choi's institution at 2020. The company had no role in the decision to publish the results., (© The Author(s) 2024.)

Objective: Patients with hepatic type of glycogen storage diseases (GSDs) can manifest endocrine features such as hypoglycemia, dyslipidemia, or osteoporosis. This study aimed to investigate the long-term endocrine consequences in patients with hepatic GSDs., Methods: This study included 64 patients from 52 families with hepatic GSDs including GSD type Ia (41 patients from 37 families), Ib (3 unrelated), III (8 from 6 families), IV (one patient), and IX (11 from 5 families). All patients were genetically confirmed. Clinical and endocrine findings were retrospectively analyzed., Results: The median age at diagnosis and current age were 2.4 years (range, 0.1-42.4 years) and 17.6 years (range, 1.0-47.8 years), respectively. The mean height SDS at diagnosis was -3.5 ± 1.4, and short stature was observed in 35.6% of patients. Patients diagnosed after the age of 3.4 years exhibited a high risk of short stature (OR = 36.1; P-value < 0.001). Among 33 patients who reached final height, 23 (69.7%) showed delayed puberty. Hypertriglyceridemia was observed in 46 patients (71.9%), whereas 25 patients (39%) had elevated low-density lipoprotein cholesterol levels during the follow-up period. Among 24 patients who underwent dual energy X-ray absorptiometry, 22 showed a low bone mineral density Z-score of -3.0 ± 1.3 at the L-spine., Conclusions: This study described the long-term endocrine consequences in patients with hepatic GSDs. Pediatric endocrinologists should be aware of the presenting features and long-term endocrine sequelae of GSDs to provide proper management and decrease its morbidities., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: The potential of microglia as a target for Alzheimer's disease (AD) treatment is promising, yet the clinical and pathological diversity within microglia, driven by genetic factors, poses a significant challenge. Subtyping AD is imperative to enable precise and effective treatment strategies. However, existing subtyping methods fail to comprehensively address the intricate complexities of AD pathogenesis, particularly concerning genetic risk factors. To address this gap, we have employed systems biology approaches for AD subtyping and identified potential therapeutic targets., Methods: We constructed patient-specific microglial molecular regulatory network models by utilizing existing literature and single-cell RNA sequencing data. The combination of large-scale computer simulations and dynamic network analysis enabled us to subtype AD patients according to their distinct molecular regulatory mechanisms. For each identified subtype, we suggested optimal targets for effective AD treatment., Results: To investigate heterogeneity in AD and identify potential therapeutic targets, we constructed a microglia molecular regulatory network model. The network model incorporated 20 known risk factors and crucial signaling pathways associated with microglial functionality, such as inflammation, anti-inflammation, phagocytosis, and autophagy. Probabilistic simulations with patient-specific genomic data and subsequent dynamics analysis revealed nine distinct AD subtypes characterized by core feedback mechanisms involving SPI1, CASS4, and MEF2C. Moreover, we identified PICALM, MEF2C, and LAT2 as common therapeutic targets among several subtypes. Furthermore, we clarified the reasons for the previous contradictory experimental results that suggested both the activation and inhibition of AKT or INPP5D could activate AD through dynamic analysis. This highlights the multifaceted nature of microglial network regulation., Conclusions: These results offer a means to classify AD patients by their genetic risk factors, clarify inconsistent experimental findings, and advance the development of treatments tailored to individual genotypes for AD., (© 2024. The Author(s).)

We propose a closed-loop pretreatment process, wherein volatiles produced during steam explosion pretreatment were recovered and reintroduced as acid catalysts into the pretreatment system. The volatiles were separated through a drastic decompression process followed by a steam explosion process and recovered as a liquified catalyst (LFC) through a heat exchanger. The LFC effectively served as an acid catalyst for hemicellulose hydrolysis, significantly decreasing residence time from 90 min to 30 min to achieve 80 % conversion yield at 170 °C. Hydrolysates with high content of lower molecular weight oligomeric sugars were obtained using LFC, and were considered advantageous for application as prebiotics. These results are attributed to the complementary features of acetic acid and furfural contained within the LFC. Computational simulation using Aspen Plus was used to investigate the effects of recycling on LFC, and it demonstrated the feasibility of the catalyst-recirculating system. A validation study was conducted based on simulation results to predict the actual performance of the proposed pretreatment system. Based on these results, the recirculating system was predicted to improve the conversion yield and low-molecular weight oligomers yield by 1.5-fold and 1.6-fold, respectively., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)