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Citrus fruits are one of the most widely used fruits around the world and are used as raw fruits, but are also processed into products such as beverages, and large amounts of by-products and waste are generated in this process. Globally, disposal of citrus waste (CW) through simple landfilling or ocean dumping can result in soil and groundwater contamination, which can negatively impact ecosystem health. The case of Korea is not much different in that these wastes are simply buried or recycled wastes are used as livestock feed additives. However, there are many reports that CW, which is a waste, has high potential to produce a variety of products that can minimize environmental load and increase added value through appropriate waste management. In this study, we aim to explore the latest developments in the evaluation and valorization of the growing CW green technologies in an effort to efficiently and environmentally transform these CW for resource recovery, sustainability, and economic benefits. Recent research strategies on integrated biorefinery approaches have confirmed that CW can be converted into various bioproducts such as enzymes, biofuels and biopolymers, further contributing to energy security. It was found that more efforts are needed to scale up green recovery technologies and achieve diverse product profiling to achieve zero waste levels and industrial viability.

The purpose of this work was to examine the effects of potassium poly-γ-glutamate (PGA-K) on mice fed a high-fat diet consisting of 60% of total calories for 12 weeks. PGA-K administration reduced the increase in body weight, epididymal fat, and liver weight caused by a high-fat diet compared to the obese group. The triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels, which are blood lipid indicators, were significantly increased in the obese group but were significantly decreased in the PGA-K-treated group. The administration of PGA-K resulted in a significant inhibition of pro-inflammatory cytokines, including tumor necrosis factor α and interleukin 6. Moreover, the levels of leptin and insulin, which are insulin resistance indicators, significantly increased in the obese group but were significantly decreased in the PGA-K-treated group. These results suggest that PGA-K exhibits a protective effect against obesity induced by a high-fat diet, underscoring its potential as a candidate for obesity treatment.

Background: This study aimed to determine whether self-regulation acts as a mediating factor in the relationship between obesity-related stress and weight control behavior, targeting Korean female college students. Obesity-related stress and weight control behaviors are important factors affecting an individual’s health and well-being, and self-control, a psychological trait, can play a pivotal role in regulating how individuals respond to stress and engage in weight management behaviors. Methods: This study employed a descriptive correlational design. A total of 109 female college students with overweight and obesity participated in the study. We used a self-report questionnaire to measure obesity-related stress, self-control, and degree of weight control behavior. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and bootstrapping using Hayes’ PROCESS macro for mediation. Results: Significant relationships between obesity-related stress and weight control behavior (r = 0.25, p < 0.001), obesity-related stress and self-control (r = −0.36, p < 0.001), and weight control behavior and self-control (r = 0.26, p < 0.001) were observed. Self-control showed an indirect mediating effect on the relationship between obesity-related stress and weight control behavior (Β = 0.37, p = 0.001). Conclusions: Through the research results, it was confirmed that self-control is a factor that has a mediating effect in the relationship between obesity-related stress and weight control behavior among female college students with overweight and obesity. These results underscore the importance of addressing self-control strategies in interventions aimed at promoting healthy weight management among female college students with overweight or obesity.

Sarcopenia is defined as an age-related decline in muscle mass, muscle strength, and physical performance. Eating alone has been linked to various health issues in older adults. This study investigated the relationship between eating alone and handgrip strength (HGS) in older adults using data from 7278 individuals (≥65 years) who participated in the 2014–2019 Korea National Health and Nutrition Examination Survey. HGS was measured using a digital grip strength dynamometer, relative HGS was calculated by dividing HGS by body mass index, and dynapenia was defined as an HGS < 28 kg for men and

Background and Objectives: Posterior lumbar interbody fusion (PLIF) plays a crucial role in addressing various spinal disorders. The success of PLIF is contingent upon achieving bone fusion, as failure can lead to adverse clinical outcomes. Demineralized bone matrix (DBM) has emerged as a promising solution for promoting fusion due to its unique combination of osteoinductive and osteoconductive properties. This study aims to compare the effectiveness of three distinct DBMs (Exfuse®, Bongener®, and Bonfuse®) in achieving fusion rates in PLIF surgery. Materials and Methods: A retrospective review was conducted on 236 consecutive patients undergoing PLIF between September 2016 and February 2019. Patients over 50 years old with degenerative lumbar disease, receiving DBM, and following up for more than 12 months after surgery were included. Fusion was evaluated using the Bridwell grading system. Bridwell grades 1 and 2 were defined as ‘fusion’, while grades 3 and 4 were considered ‘non-fusion.’ Clinical outcomes were assessed using visual analog scale (VAS) scores for pain, the Oswestry disability index (ODI), and the European quality of life-5 (EQ-5D). Results: Fusion rates were 88.3% for Exfuse, 94.3% for Bongener, and 87.7% for Bonfuse, with no significant differences. All groups exhibited significant improvement in clinical outcomes at 12 months after surgery, but no significant differences were observed among the three groups. Conclusions: There were no significant differences in fusion rates and clinical outcomes among Exfuse, Bongener, and Bonfuse in PLIF surgery.

The study presents a controlled nanoscale drug delivery system mediated by polymeric magnetic nanoparticles. Under an alternating magnetic field (AMF), the magnetic nanoparticles act as internal heating sources that increase the surrounding temperature, provoking polymer transitions and thereby releasing the entrapped drug. We explain the drug-release mechanism using different mathematical models including Higuchi, Korsmeyer–Peppas, Hixson–Crowell, and Kopcha. Our results indicate that doxorubicin (DOX) release follows the Hixson–Crowell model with R2 = 0.99, revealing that the changes in the surface areas of the particles are the main driving force for drug release from poly(N-isopropylacrylamide)/N (hydroxymethyl) acrylamide coated SPIONs (SPNH/DOX) at 43 °C. However, at 37 °C, the drug release occurs by the diffusion mechanism. Moreover, in vitro cell culture assays including CCK-8, FACS, confocal and BIO-TEM images have confirmed cytotoxicity and cellular uptake of SPNH/DOX in CT26 cancer cells. Through a synergetic effect between chemotherapy triggered by AMF application and intracellular hyperthermia, significant tumoricidal effects were achieved in the initial 24 h after treatment.

Agricultural byproducts are intermediate products generated during food processing and contain functional ingredients that are suitable for use in the green circular economy. This study aimed to demonstrate the skin-whitening effect of pumpkin tendril extract (PTE) using a mushroom tyrosinase assay, L-DOPA staining, qRT-PCR, western blotting, a zebrafish model, and a reconstituted 3D human skin model. PTE dose-dependently scavenged DPPH free radicals and inhibited melanogenesis stimulated by α-MSH without exhibiting cytotoxicity in 2D- and 3D-cultured B16F10 cells. Interestingly, PTE significantly reduced melanogenesis in zebrafish and 3D-pigmented human skin models. In addition, PTE notably downregulated the expression of proteins related to melanogenesis, such as MITF, TRP-1, TRP-2, and tyrosinase. Phosphorylation of CREB, an upregulator of MITF, was also attenuated by PTE treatment. Component analysis revealed that rutin is an active compound in PTE affecting melanogenesis. These results suggest that PTE suppresses melanogenesis and tyrosinase activity by regulating the CREB/MITF signaling pathway.

Food-borne bacteria have frequently been detected in kimchi, a representative and traditional fermented ethnic food of Korea. This study investigated the effect of atmospheric dielectric barrier discharge (DBD) plasma treatment (1.1 kV, 43 kHz, N2: 1.5 m/s, 5–60 min) on reduction of Yersinia enterocolitica and Staphylococcus aureus and on quality parameters in Geotjeroi, a non-fermented kimchi. A decrease of 0.12/0.09, 0.19/0.19, 0.34/0.45, 0.64/0.72, and 1.13/1.12 log10 CFU/g was observed by 5, 10, 20, 30, and 60 min of DBD plasma, respectively. D-value of 52.83 and 51.95 min was determined for Y. enterocolitica (R2 = 0.99) and S. aureus (R2 = 0.98) using the first order kinetics model. The quality parameters (pH, Brix, and hardness) were not significantly different (P > 0.05) between treated and untreated Geotjeori. Moreover, a decrease of >1 log10 CFU/g, for both bacteria was observed without any change in the quality of Geotjeori. These findings imply that DBD plasma treatment enhances Geotjeori safety and protects product from microbial risk.

Air pollution is a risk factor that increases cardiovascular morbidity and mortality. In this study, we investigated the cardiotoxicity of particulate matter (PM) exposure using a zebrafish embryo model. We found that PM exposure induced cardiotoxicity, such as arrhythmia, during cardiac development. PM exposure caused cardiotoxicity by altering the expression levels of cardiac development (T-box transcription factor 20, natriuretic peptide A, and GATA-binding protein 4)- and ion-channel (scn5lab, kcnq1, kcnh2a/b, and kcnh6a/b)-related genes. In conclusion, this study showed that PM induces the aberrant expression of cardiac development- and ion channel-related genes, leading to arrhythmia-like cardiotoxicity in zebrafish embryos. Our study provides a foundation for further research on the molecular and genetic mechanisms of cardiotoxicity induced by PM exposure.

Acute myeloid leukemia (AML) is a prevalent form of leukemia in adults. As its survival rate is low, there is an urgent need for new therapeutic options. In AML, FMS-like tyrosine kinase 3 (FLT3) mutations are common and have negative outcomes. However, current FLT3-targeting agents, Midostaurin and Gilteritinib, face two significant issues, specifically the emergence of acquired resistance and drug-related adverse events leading to treatment failure. Rearranged during transfection (RET), meanwhile, is a proto-oncogene linked to various types of cancer, but its role in AML has been limited. A previous study showed that activation of RET kinase enhances FLT3 protein stability, leading to the promotion of AML cell proliferation. However, no drugs are currently available that target both FLT3 and RET. This study introduces PLM-101, a new therapeutic option derived from the traditional Chinese medicine indigo naturalis with potent in vitro and in vivo anti-leukemic activities. PLM-101 potently inhibits FLT3 kinase and induces its autophagic degradation via RET inhibition, providing a superior mechanism to that of FLT3 single-targeting agents. Single- and repeated-dose toxicity tests conducted in the present study showed no significant drug-related adverse effects. This study is the first to present a new FLT3/RET dual-targeting inhibitor, PLM-101, that shows potent anti-leukemic activity and fewer adverse effects. PLM-101, therefore, should be considered for use as a potential therapeutic agent for AML.

BackgroundAdvancements in mobile health technologies and machine learning approaches have expanded the framework of behavioral phenotypes in obesity treatment to explore the dynamics of temporal changes. ObjectiveThis study aimed to investigate the dynamics of behavioral changes during obesity intervention and identify behavioral phenotypes associated with weight change using a hybrid machine learning approach. MethodsIn total, 88 children and adolescents (ages 8-16 years; 62/88, 71% male) with age- and sex-specific BMI ≥85th percentile participated in the study. Behavioral phenotypes were identified using a hybrid 2-stage procedure based on the temporal dynamics of adherence to the 5 behavioral goals during the intervention. Functional principal component analysis was used to determine behavioral phenotypes by extracting principal component factors from the functional data of each participant. Elastic net regression was used to investigate the association between behavioral phenotypes and weight change. ResultsFunctional principal component analysis identified 2 distinctive behavioral phenotypes, which were named the high or low adherence level and late or early behavior change. The first phenotype explained 47% to 69% of each factor, whereas the second phenotype explained 11% to 17% of the total behavioral dynamics. High or low adherence level was associated with weight change for adherence to screen time (β=−.0766, 95% CI −.1245 to −.0312), fruit and vegetable intake (β=.1770, 95% CI .0642-.2561), exercise (β=−.0711, 95% CI −.0892 to −.0363), drinking water (β=−.0203, 95% CI −.0218 to −.0123), and sleep duration. Late or early behavioral changes were significantly associated with weight loss for changes in screen time (β=.0440, 95% CI .0186-.0550), fruit and vegetable intake (β=−.1177, 95% CI −.1441 to −.0680), and sleep duration (β=−.0991, 95% CI −.1254 to −.0597). ConclusionsOverall level of adherence, or the high or low adherence level, and a gradual improvement or deterioration in health-related behaviors, or the late or early behavior change, were differently associated with weight loss for distinctive obesity-related lifestyle behaviors. A large proportion of health-related behaviors remained stable throughout the intervention, which indicates that health care professionals should closely monitor changes made during the early stages of the intervention. Trial RegistrationClinical Research Information Science KCT0004137; https://tinyurl.com/ytxr83ay

Background: Pretreatment endocrine symptoms in premenopausal patients might be considered as a potential marker of poor prognosis. We conducted a cohort study to evaluate the association between endocrine symptoms prior to treatment and recurrence-free survival (RFS) among premenopausal patients with breast cancer aged ⩽40 years. Methods: Data were obtained from a prospective cohort study (NCT03131089) conducted at the Samsung Medical Center from 2013 to 2021. We included patients aged ⩽40 years who had been diagnosed with breast cancer. The primary outcome measure was RFS. Endocrine symptoms were measured using the Functional Assessment of Cancer Therapy – Endocrine Symptoms (FACT-ES). We also calculated the hazard ratio (HR) for recurrence or all-cause mortality by comparing the tertiles of the FACT-ES score at diagnosis. Results: Among the 977 participants, the mean (standard deviation) age was 35.3 (3.9) years. At diagnosis, 17.2% of the patients had at least one severe endocrine symptom. During 3512 person-years of follow-up, the high symptom group had a worse RFS than the low-symptom group [HR = 2.05; 95% confidence interval (CI) = 1.19–3.54]. In particular, hot flashes (HR = 5.59; 95% CI = 1.96–15.93) and breast sensitivity (HR = 1.82; 95% CI = 1.00–3.32) were associated with reduced RFS. Conclusion: Close monitoring of pretreatment endocrine symptoms may be important in patients diagnosed with breast cancer at a young age.

To predict the damage resulting from an explosion in the middle of a city, where buildings are concentrated, the peak pressure reaching the walls of the buildings or in between buildings should be accurately and rapidly calculated. However, predicting peak pressure between buildings is known to be very difficult because of the diffraction and reflection of blast waves, which have generally been analyzed by numerical analysis methods. However, numerical analysis is not suitable in a military operation environment which requires rapid analysis, because it takes considerable time and resources. This study proposes a deep neural network that quickly and accurately predicts the peak pressure caused by the propagation of blast waves, for the effective analysis of weapon effectiveness and damage in urban environments. The proposed deep learning model is based on a 3-dimensional convolutional neural network (3D CNN) model that processes the spatial information of explosion and measurement in the 3D spaces using 3D kernels. To predict the peak pressure between buildings separated by an arbitrary distance using a single model, we also propose using conditional convolution, which modulates the prediction output according to the building distance. The proposed models were trained with a dataset constructed through finite element analysis with various building distances, explosion locations, and explosive weights. The experiment with a fixed building distance showed that the relative error of the proposed 3D CNN is less than 7%, which is 2.5 times more accurate than a simple multi-layer perceptron (MLP) model. For unseen building layouts, the conditional 3D convolution showed 3.6 times lower error than the MLP model, demonstrating the effectiveness of the conditional convolution for prediction in arbitrary building layouts. Most importantly, the proposed deep learning models took less than one minute per prediction, which is significantly faster than finite element analysis, which takes 6 to 8 hours to analyze a single simulation case.

Background Congenital hypothyroidism (CH) is the leading cause of preventable physical and intellectual disabilities. This study aimed to assess the incidence and clinical characteristics of CH in newborns. Methods We retrospectively reviewed the medical records of all newborns delivered at the Pusan National University Hospital between January 2011 and March 2021. The incidence of CH was compared according to gestational age, birth weight, and small for gestational age (SGA). The patients aged ≥3 years who could not maintain normal thyroid function and required levothyroxine treatment were diagnosed with permanent CH. Logistic regression analysis was performed to compare CH risks. Results Of 3,722 newborns, 40 were diagnosed with CH (1.07%). Gestational age and birth weight were significantly associated with CH incidence. The odds ratios (ORs) of CH in infants delivered at 32–37, 28–31, and

Abstract Whether metabolic dysfunction-associated fatty liver disease (MAFLD) can replace nonalcoholic fatty liver disease (NAFLD) is under debate. This study evaluated which definition better predicted incident chronic kidney disease (CKD). This was a 5.3-year (range, 2.8–8.3) retrospective cohort study of 21,713 adults who underwent at least two serial health examinations. Cox analyses were used to compare the risk of incident CKD among non-fatty liver disease (FLD) without metabolic dysregulation (MD; reference), non-FLD with MD, MAFLD-only, NAFLD-only, or both-FLD groups. Non-FLD with MD group (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.00–1.53), both-FLD group (HR 1.50, 95% CI 1.19–1.89), and MAFLD-only group (HR 1.97, 95% CI 1.49–2.60), but not NAFLD-only group (HR 1.06, 95% CI 0.63–1.79) demonstrated an increased risk of CKD. The increased risk of CKD was significant in MAFLD subgroups with overweight/obesity (HR 2.94, 95% CI 1.91–4.55), diabetes (HR 2.20, 95% CI 1.67–2.90), MD only (HR 1.50, 95% CI 1.19–1.89), excessive alcohol consumption (HR 2.71, 95% CI 2.11–3.47), and viral hepatitis (HR 2.38, 95% CI 1.48–3.84). The switch from NAFLD to MAFLD criteria may identify a greater number of individuals at CKD risk. The association was also significant in MAFLD patients with excessive alcohol consumption or viral hepatitis.

Abstract Background Early extubation success (ES) in preterm infants may reduce various mechanical ventilation-associated complications; however, extubation failure (EF) can cause adverse short- and long-term outcomes. Therefore, the present study aimed to identify differences in risk factors and clinical outcomes between ES and EF in very early preterm infants. Methods This retrospective study was conducted between January 2017 and December 2021. Premature infants born at 32 weeks’ gestational age in whom extubation had failed at least once were assigned to the EF group. Successfully extubated patients with a similar gestational age and birth weight as those in the EF group were assigned to the ES group. EF was defined as the need for re-intubation within 120 h of extubation. Various variables were compared between groups. Results The EF rate in this study was 18.6% (24/129), and approximately 80% of patients with EF required re-intubation within 90.17 h. In the ES group, there was less use of inotropes within 7 days of life (12 [63.2%] vs. 22 [91.7%], p = 0.022), a lower respiratory severity score (RSS) at 1 and 4 weeks (1.72 vs. 2.5, p = 0.026; 1.73 vs. 2.92, p = 0.010), and a faster time to reach full feeding (18.7 vs. 29.7, p = 0.020). There was a higher severity of bronchopulmonary dysplasia BPD (3 [15.8%] vs. 14 [58.3%], p = 0.018), longer duration of oxygen supply (66.5 vs. 92.9, p = 0.042), and higher corrected age at discharge (39.6 vs. 42.5, p = 0.043) in the EF group. The cutoff value, sensitivity, and specificity of the respiratory severity score (RSS) at 1 week were 1.98, 0.71, and 0.42, respectively, and the cutoff value, sensitivity, and specificity of RSS at 4 weeks were 2.22, 0.67, and 0.47, respectively. Conclusions EF caused adverse short-term outcomes such as a higher BPD severity and longer hospital stay. Therefore, extubation in very early preterm infants should be carefully evaluated. Using inotropes, feeding, and RSS at 1 week of age can help predict extubation success.

Abstract Background Although quality of life (QOL) improves over time for most breast cancer patients after their treatment, some patients may show different patterns of QOL. Beyond determining distinct QOL trajectories, identifying characteristics of patients who have different trajectories can help identify breast cancer patients who may benefit from intervention. We aimed to identify trajectories of QOL in breast cancer patients for one year after the end of primary treatment, to determine the factors influencing these changes. Methods This longitudinal study recruited 140 breast cancer patients. Patients' QOL, symptom experience, self-efficacy, and social support were assessed using the Functional Assessment of Cancer Therapy Scale-G, Memorial Symptom Assessment Scale-Short Form, Self-Efficacy Scale for Self-Management of Breast Cancer, and Interpersonal Support Evaluation List-12. Data were collected immediately after the end of primary treatment (T1) and at three (T2), six (T3), and 12 months (T4) after primary treatment. Group-based trajectory modeling was used to identify distinct subgroups of patients with similar patterns of QOL change after treatment. A one-way analysis of variance was used to determine which variables were associated with trajectory membership. A multinomial logistic regression was performed to identify factors associated with trajectory group membership. Results We analyzed 124 patients (mean age: 48.75 years). Latent class analysis of the QOL identified three trajectory groups: the low QOL group (n = 27; 21.1%), moderate QOL group (n = 57; 45.3%), and high QOL group (n = 40; 33.6%). The low QOL group showed consistently low QOL after the end of primary treatment, and the moderate QOL group showed a slight decrease in QOL from T1 to T3, which returned to the T1 level at T4. The high QOL group maintained a consistently high QOL. By multinomial logistic regression, psychological symptoms (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.22–0.99) predicted a moderate QOL, and both psychological symptoms (OR 0.19, 95% CI 0.07–0.51) and belonging support (OR 1.60, 95% CI 1.06–2.39) predicted a high QOL. Conclusion Identifying high-risk groups for reduced QOL after the end of primary treatment is necessary. Moreover, psychosocial interventions should be provided to alleviate psychological symptoms and increase belonging support to enhance patients' QOL. Trial registration Not registered.

In this paper, we present a digital processing in memory (DPIM) configured as a stride edge-detection search frequency neural network (SE-SFNN) which is trained through spike location dependent plasticity (SLDP), a learning mechanism reminiscent of spike timing dependent plasticity (STDP). This mechanism allows for rapid online learning as well as a simple memory-based implementation. In particular, we employ a ternary data scheme to take advantage of ternary content addressable memory (TCAM). The scheme utilizes a ternary representation of the image pixels, and the TCAMs are used in a two-layer format to significantly reduce the computation time. The first layer applies several filtering kernels, followed by the second layer, which reorders the pattern dictionaries of TCAMs to place the most frequent patterns at the top of each supervised TCAM dictionary. Numerous TCAM blocks in both layers operate in a massively parallel fashion using digital ternary values. There are no complicated multiply operations performed, and learning is performed in a feedforward scheme. This allows rapid and robust learning as a trade-off with the parallel memory block size. Furthermore, we propose a method to reduce the TCAM memory size using a two-tiered minor to major promotion (M2MP) of frequently occurring patterns. This reduction scheme is performed concurrently during the learning operation without incurring a preconditioning overhead. We show that with minimal circuit overhead, the required memory size is reduced by 84.4%, and the total clock cycles required for learning also decrease by 97.31 % while the accuracy decreases only by 1.12%. We classified images with 94.58% accuracy on the MNIST dataset. Using a 100 MHz clock, our simulation results show that the MNIST training takes about 6.3 ms dissipating less than 4 mW of average power. In terms of inference speed, the trained hardware is capable of processing 5,882,352 images per second.

Abstract Plant-induced electrical signals (PIES) can be non-destructively monitored by inserting electrodes into plant stems, which reflect plant nutrient and water uptake. The main objective of this study was to evaluate the growth of pepper plants with different urea applications (low fertilizer: N0, Control: N1, and high fertilizer: N2) in soil by monitoring PIES. The PIES value was found to be low in the low urea treatment group while the two times higher urea applied pepper had the highest PIES value. The nutritional content of the stem, leaves and soil did not correlate with PIES because of dilution effect by high biomass with high urea application, but principal component analysis showed that the PIES was positively associated with pepper biomass and soil EC. The high fertilizer did not affect chlorophyll and proline contents in pepper leaves. The assessment of plant growth by PIES has advantages because non-destructive, real time and remote monitoring is possible. Therefore, PIES monitoring of different plants grown under various cultivation environments is useful method to evaluate plant activity and growth.

Abstract Background The poor performance of conventional techniques used in cardiovascular disease patients requiring hemodialysis or arterial bypass grafting has prompted tissue engineers to search for clinically appropriate off-the-shelf vascular grafts. Most patients with cardiovascular disease lack suitable autologous tissue because of age or previous surgery. Commercially available vascular grafts with diameters of 1.5 years) in large animals with a vasculature similar to humans are needed.

Purpose: Programmed cell death protein 1 (PD-1) and ligand programmed death ligand 1 (PD-L1) are important immune-suppressive regulators in the tumor microenvironment. A vaccine-induced immune effect on tumor cells is blunted by the immunosuppressive tumor microenvironment. Therefore, we hypothesized that a dendritic cell (DC) vaccine combined with anti-PD-1 (αPD-1) antibodies could elicit a synergistic anti-tumor immunity in bladder cancer. Materials and Methods: We produced a model of subcutaneous transplantation in C3H/HeJ mice by transplanting murine MBT-2 bladder cancer cells. DCs were isolated from normal C3H/HeJ mice, followed by stimulation against MBT-2 lysate before injection. Two weeks later of MBT-2 inoculation, αPD-1 and stimulated DCs were injected two times at one-week interval intraperitoneally and intravenously, respectively. Tumor-infiltrating immune cells and splenocytes were analyzed using flow cytometry. T-cell-mediated anti-tumor responses were measured by interferon (IFN)-γ ELISPOT and lactate dehydrogenase assays. Results: The mice treated with DC+αPD-1 showed a significant decrease in tumor volume compared to the DC-treated mice and IgG-treated group. Survival of the DC+αPD-1–treated group was improved compared with that of the IgG-treated mice. IFN-γ secretion from splenocytes against tumor cells was significantly increased in the DC+αPD-1 group compared with that of αPD-1–treated mice. The frequency of CD8+ and CD4+ T-cells in spleens was statistically increased in the DC+αPD-1–treated mice compared to those receiving monotherapy (DC- or αPD-1–treated group). Conclusions: Our results support the hypothesis that the combination therapy of a DC vaccine and αPD-1 antibodies could enhance the anti-tumor immune response against bladder cancer.

Purpose: The purpose of this study is to investigate disease trend of genital wart through changes in each treatment method over the past 10 years in Korea. Materials and Methods: From 2010 to 2019, surgical treatment including cauterization, excision, cryotherapy, and laser therapy, non-surgical treatment such as podophyllin, and surgical treatment for anorectal lesion were extracted and analyzed from 2010 to 2019. For each treatment method, characteristics such as sex, age, region, medical cost and average number of procedures were analyzed. Results: The number of patients following all treatment modalities increased every year. Surgical treatment of genital wart and anorectal wart showed a significant increase in male patients. Number of non-surgical treatment decreased in males but increased in females. Surgical removal of the anorectal wart increased more than 250% in over 10 years, and males underwent surgery 4 times more than females. In both surgery and non-surgery, the mean session was higher in males. Most of them were carried out in primary medical institutions. In Seoul and Gyeonggi-do, the largest number of patients received treatment regardless of treatment method. Conclusions: Treatment for genital warts has increased rapidly over the past 10 years, and the increase in males is remarkable. The main treatment was surgery, and males mainly received surgical treatment, and females mainly received drug treatment. The primary medical institution was in charge of the most treatment. As the number of patients and related medical expenses are increasing rapidly, more attention and response to diseases are needed.

Background & Aims: Binge drinking in patients with metabolic syndrome accelerates the development of alcohol-associated liver disease. However, the underlying mechanisms remain elusive. We investigated if oxidative and nonoxidative alcohol metabolism pathways, diet-induced obesity, and adipose tissues influenced the development of acute liver injury in a single ethanol binge model. Methods: A single ethanol binge was administered to chow-fed or high-fat diet (HFD)-fed wild-type and genetically modified mice. Results: Oral administration of a single dose of ethanol induced acute liver injury and hepatic endoplasmic reticulum (ER) stress in chow- or HFD-fed mice. Disruption of the Adh1 gene increased blood ethanol concentration and exacerbated acute ethanol-induced ER stress and liver injury in both chow-fed and HFD-fed mice, while disruption of the Aldh2 gene did not affect such hepatic injury despite high blood acetaldehyde levels. Mechanistic studies showed that alcohol, not acetaldehyde, promoted hepatic ER stress, fatty acid synthesis, and increased adipocyte death and lipolysis, contributing to acute liver injury. Increased serum fatty acid ethyl esters (FAEEs), which are formed by an enzyme-mediated esterification of ethanol with fatty acids, were detected in mice after ethanol gavage, with higher levels in Adh1 knockout mice than in wild-type mice. Deletion of the Ces1d gene in mice markedly reduced the acute ethanol-induced increase of blood FAEE levels with a slight but significant reduction of serum aminotransferase levels. Conclusions: Ethanol and its nonoxidative metabolites, FAEEs, not acetaldehyde, promoted acute alcohol-induced liver injury by inducing ER stress, adipocyte death, and lipolysis.

Purpose Croup is a clinical manifestation of coronavirus disease 2019 (COVID-19) in children. The Omicron variant of severe acute respiratory syndrome coronavirus 2 usually causes an upper respiratory tract infection. We investigated the differences between croups caused by COVID-19 and by other respiratory viruses (ORV). Methods We reviewed clinical characteristics, therapeutic measures, and the Westley Croup Score of children with croup who visited the emergency department of Gyeongsang National University Hospital from January 1 through April 7, 2022. According to the laboratory-confirmed viruses, they were divided into 2 groups: COVID-19 and ORV. Between the 2 groups, we compared the abovementioned features. Moderate-to-severe croup was defined by a Westley Croup Score of 3 or higher. Results A total of 20 children were diagnosed with croup caused by COVID-19 (n = 11; median age, 18 months) or by ORV (n = 9; 7 months). Median Westley Croup Score was higher in the COVID-19 group than in the ORV group (5.0 [range, 0-10.0] vs. 2.0 [1.0-5.0]; P = 0.031). Among the components of the scoring system, only stridor showed a significant difference (e.g., “stridor at rest”: COVID-19, 8 of 11 vs. ORV, 2 of 9; P = 0.046). Median C-reactive protein concentration was higher in the COVID-19 group (3.2 vs. 0.4 mg/L; P = 0.007). Severity of the COVID-19 group was marginally higher than that of the ORV group in terms of the median oxygen saturation (95% vs. 98%; P = 0.056) and the proportions of moderate-to-severe croup (9 of 11 vs. 3 of 9; P = 0.065) and application of high-flow nasal cannula (4 of 11 vs. 0 of 9; P = 0.094). Conclusion Croup caused by COVID-19 during the period of dominance of the Omicron variant outbreak might be more severe than croup caused by ORV.

A seated saline loading test (SLT) using liquid chromatography-tandem mass spectrometry (LC-MS/MS) is one of the most accepted confirmatory tests of primary aldosteronism. However, LC-MS/MS is time-consuming and is not widely available in diagnostic laboratories compared to immunoassay. With immunoassay, it is unknown whether SLT in the seated position is more accurate than that of the supine position, and a cutoff value of post-seated SLT plasma aldosterone concentration (PAC) must be established in the Korean population. Ninety-eight patients underwent SLT in both positions, and post-SLT PAC was measured by LC-MS/MS and radioimmunoassay. We confirmed primary aldosteronism if post-seated SLT PAC by LC-MS/MS exceeded 5.8 ng/dL. The area under the receiver operating characteristic curve was greater for seated than supine SLT (0.928 vs. 0.834, P=0.003). The optimal cutoff value of post-seated SLT by radioimmunoassay was 6.6 ng/dL (sensitivity 83.3%, specificity 92.2%).

A biosensor is an analytical device that combines certain biological and physical elements. Several types of transducers are used for physical elements, such as optical, electrochemical, thermic, or gravimetric. Nowadays, electrochemical transducers have become widely used for the application of biomedical sensors. Electrochemical measurement devices called screen-printed electrodes (SPEs) are created by printing several types of ink on a ceramic or plastic substrate. SPEs enable speedy in-situ examination with high repeatability, sensitivity, and accuracy. In this study, SPEs were fabricated using a personalized CNC machine with carbon conductive ink as the electrode and polyethylene terephthalate (PET) as the substrate. The mask, stencil, and screen-printing dimensions were measured using a DinoLite microscope. SPEs characterization was performed using Scanning Electron Microscopy (SEM) to observe the surface morphology. This simple approach method shows a promising result that SPEs can be produced up to 5 screen printing layers with the ability to flow the electrical current under a resistance of 350.4 K.

Abstract Background Sepsis is the most common cause of death in hospitals, and intra-abdominal infection (IAI) accounts for a large portion of the causes of sepsis. We investigated the clinical outcomes and factors influencing mortality of patients with sepsis due to IAI. Methods This post-hoc analysis of a prospective cohort study included 2126 patients with sepsis who visited 16 tertiary care hospitals in Korea (September 2019–February 2020). The analysis included 219 patients aged > 19 years who were admitted to intensive care units owing to sepsis caused by IAI. Results The incidence of septic shock was 47% and was significantly higher in the non-survivor group (58.7% vs 42.3%, p = 0.028). The overall 28-day mortality was 28.8%. In multivariable logistic regression, after adjusting for age, sex, Charlson Comorbidity Index, and lactic acid, only coagulation dysfunction (odds ratio: 2.78 [1.47–5.23], p = 0.001) was independently associated, and after adjusting for each risk factor, only simplified acute physiology score III (SAPS 3) (p

This study aimed to investigate the effects of salted shrimp on kimchi fermentation. Four types of kimchi (KWD, KWR, KWC, and KWY), based on the variety of salted shrimp (Detteugijeot, Red shrimp jeot, Chujeot, and Yukjeot, respectively), were prepared and stored at 4°C for 6 weeks. Amino nitrogen content in KWD was significantly higher after 4 weeks (P

Fully vaccinated people remain at risk of Coronavirus Disease 2019 (COVID-19). We examined association between prior vaccination and clinical outcomes in patients with COVID-19. Overall, 387 patients with mild-to-severe COVID-19 were enrolled. Patients were considered fully vaccinated at least 14, 7, and 14 days after receiving the second dose of ChAdOx1 nCoV-19 or mRNA-1273, second dose of BNT162b2, or single dose of Ad26.COV2.S, respectively. The primary outcomes (risk of pneumonia, requirement of supplemental oxygen, and progression to respiratory failure) were compared between vaccinated and unvaccinated patients. Logistic regression analysis was performed to identify factors associated with the outcomes. There were 204 and 183 patients in the vaccinated and unvaccinated groups, respectively. The vaccinated group was significantly older and had more comorbidities than the unvaccinated group. Patients in the unvaccinated group were significantly more likely to develop pneumonia (65.6% vs. 36.8%) or require supplemental oxygen (29.0 vs. 15.7%) than the vaccinated group. The vaccinated group had a significantly shorter time from symptom onset to hospital discharge than the unvaccinated group (10 vs. 11 days; p

Background: Virtual reality (VR) programs based on motion capture camera are the most convenient and cost-effective approaches for remote rehabilitation. Assessment of physical function is critical for providing optimal VR rehabilitation training; however, direct muscle strength measurement using camera-based kinematic data is impracticable. Therefore, it is necessary to develop a method to indirectly estimate the muscle strength of users from the value obtained using a motion capture camera.Objects: The purpose of this study was to determine whether the pedaling speed converted using the VR engine from the captured foot position data in the VR environment can be used as an indirect way to evaluate knee muscle strength, and to investigate the validity and reli-ability of a camera-based VR program.Methods: Thirty healthy adults were included in this study. Each subject performed a 15-sec-ond maximum pedaling test in the VR and built-in speedometer modes. In the VR speedom-eter mode, a motion capture camera was used to detect the position of the ankle joints and automatically calculate the pedaling speed. An isokinetic dynamometer was used to assess the isometric and isokinetic peak torques of knee flexion and extension.Results: The pedaling speeds in VR and built-in speedometer modes revealed a significant-ly high positive correlation (r = 0.922). In addition, the intra-rater reliability of the pedal-ing speed in the VR speedometer mode was good (ICC [intraclass correlation coefficient] = 0.685). The results of the Pearson correlation analysis revealed a significant moderate positive correlation between the pedaling speed of the VR speedometer and the peak torque of knee isokinetic flexion (r = 0.639) and extension (r = 0.598).Conclusion: This study suggests the potential benefits of measuring the maximum pedal-ing speed using 3D depth camera in a VR environment as an indirect assessment of muscle strength. However, technological improvements must be followed to obtain more accurate estimation of muscle strength from the VR cycling test.

Endometrial carcinoma is a common gynecologic malignancy; however, metastasis to the small bowel is rare. Metastatic endometrial carcinoma usually occurs through local extension rather than distant metastasis. Isolated small bowel metastasis is extremely rare; further, intussusception with resultant intestinal obstruction is not common. We report the imaging findings of a patient with isolated small bowel metastasis of endometrial carcinoma with resultant jejunojejunal intussusception.

Abstract Females are known to have a better survival rate than males in the general population, but previous studies have shown that this superior survival is diminished in patients on dialysis. This study aimed to investigate the risk of mortality in relation to sex among Korean patients undergoing hemodialysis (HD) or peritoneal dialysis (PD). A total of 4994 patients with kidney failure who were receiving dialysis were included for a prospective nationwide cohort study. Cox multivariate proportional hazard models were used to determine the association between sex and the risk of cause-specific mortality according to dialysis modality. During a median follow-up of 5.8 years, the death rate per 100 person-years was 6.4 and 8.3 in females and males, respectively. The female-to-male mortality rate in patients on dialysis was 0.77, compared to 0.85 in the general population. In adjusted analyses, the risk of all-cause mortality was significantly lower for females than males in the entire population (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.71–0.87, P

Epstein-Barr virus (EBV)-associated lymphoproliferative diseases represent various clinical manifestations. EBV-associated hemophagocytic lymphohistiocytosis (HLH) and lymphoma are difficult to distinguish due to overlapping characteristics between these two diseases. Here, we present a case of EBV-associated HLH, mimicking disease relapse. A 13-year-old boy with follicular lymphoma presented with fever and dyspnea. The patient was diagnosed with follicular lymphoma (FL) two months prior to the visit and underwent two cycles of CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Physical examination revealed multiple enlarged cervical lymph nodes and hepatomegaly while the following findings were obtained by laboratory data: white blood cell count, 200 cells/µL; hemoglobin concentration, 9.9 g/dL; platelet count, 55,000 platelets/µL; and ferritin level, 3,290 μg/L. Positron-emission tomography revealed newly developed lesions in the neck, chest, and abdominal lymph nodes with fluorine-18 fluoro-deoxy-glucose uptakes not visible at the time of diagnosis. Disease recurrence was suspected by imaging, and the patient underwent a neck lymph node biopsy, following which the chemotherapy regimen was changed. The neck lymph node biopsy revealed hemophagocytosis, and EB-encoding region in situ hybridization revealed scattered cells which were positive for CD3 and CD8 but negative for CD20 and CD56. Finally, the patient was diagnosed with EBV-associated HLH but not with recurrent FL. Therefore, a biopsy is essential for the final diagnosis.

Abstract The waiting time for deceased donor kidney transplants (DDKT) is increasing. We evaluated DDKT prognosis according to the pretransplant dialysis vintage. A total of 4117 first-time kidney transplant recipients were enrolled from a prospective nationwide cohort in Korea. DDKT recipients were divided into tertiles according to pretransplant dialysis duration. Graft failure, mortality, and composite were compared between DDKT and living donor kidney transplant (LDKT) recipients. Pretransplant dialysis vintage was longer annually in DDKT recipients. In the subdistribution of the hazard model for the competing risk, the first tertile did not show an increased risk of graft failure compared with LDKT recipients; however, the second and third tertile groups had an increased risk of graft failure compared to LDKT recipients (adjusted hazard ratio [aHR] 3.59; 95% confidence interval [CI] 1.69–7.63; P

We investigated the efficacy and safety of a trastuzumab biosimilar, Herzuma®, in combination with treatment of physician's choice (TPC) in patients with HER2+ metastatic breast cancer (MBC) who had failed at least two HER2 directed chemotherapies.

Mitotane is an adrenolytic drug that exhibits therapeutic effects within a narrow target range (14–20 μg/dL). Various complications develop if the upper limit is exceeded. We present the case of a 5-year-old girl with breast development, acne, and pubic hair who was diagnosed with an adrenal mass that was subsequently excised. The pathological finding was adrenocortical carcinoma with a high risk of malignancy, and adjuvant therapy (combined mitotane and radiation therapy) was recommended. Mitotane was initiated at a low dose to allow monitoring of the therapeutic drug level, and high-dose hydrocortisone was also administered. However, the patient exhibited elevated adrenocorticotropic hormone levels and vague symptoms such as general weakness and difficulty concentrating. It was important to determine if these symptoms were signs of the neurological complications that develop when mitotane level is elevated. Encephalopathy progression and pubertal signs appeared 6 months after diagnosis, induced by high mitotane level. The mitotane decreased to subtherapeutic level several months after its discontinuation, at which time endocrinopathy (central hypothyroidism, hypercholesterolemia, and secondary central precocious puberty) developed. The case shows that low-dose mitotane can trigger neurological and endocrinological complications in a pediatric patient, indicating that the drug dose should be individualized with frequent monitoring of the therapeutic level.

Abstract Health-related quality of life (HRQOL) is a multifactorial concept in assessing physical and mental health. This study was performed to evaluate the HRQOL of patients undergoing coronary artery bypass graft (CABG) surgery and the predictors of HRQOL in patients until 1 year after surgery. This cross-sectional study included 110 consecutive patients who underwent elective CABG in a medical center in South Korea. The Short-Form Health Survey, cardiac symptom survey, cardiac self-efficacy, and the Interpersonal Support Evaluation List-12 were used to measure the HRQOL, symptom experience, self-efficacy, and social support, respectively. The regression model explained 42% of the variance in the participants' physical HRQOL. The predictors of the physical HRQOL include the presence of a spouse, post-CABG duration, symptom experience, and self-efficacy. The regression model explained 36% of the variance in the participants' mental HRQOL. The predictors of the mental HRQOL included perceived health status, self-efficacy, and social support. The predictive factors for HRQOL after CABG were the presence of a spouse, post-CABG duration, symptom experience, self-efficacy, and social support. Furthermore, a suitable program and nursing interventions could be implemented to improve the HRQOL of post-CABG patients.

Abstract The aim of this study is to investigate the differential expression of microRNAs (miRNAs) in the aqueous humor (AH) of patients with central retinal vein occlusion (CRVO), and their association with AH matrix metalloproteinase (MMP) activity. Eighteen subjects, including 10 treatment naïve patients with CRVO and 8 control subjects, scheduled for intravitreal injection and cataract surgery, respectively, were included. AH samples were collected at the beginning of the procedure. A microarray composed of 84 miRNAs was performed to identify differentially expressed miRNAs in CRVO AH, which were further analyzed using bioinformatic tools to identify directly related cytokines/proteins. Eight miRNAs (hsa-mir-16-5p, hsa-mir-142-3p, hsa-mir-19a-3p, hsa-mir-144-3p, hsa-mir-195-5p, hsa-mir-17-5p, hsa-mir-93-5p, and hsa-mir-20a-5p) were significantly downregulated in the CRVO group. Bioinformatic analysis revealed a direct relationship among downregulated miRNAs, CRVO, and the following proteins: MMP-2, MMP-9, tumor necrosis factor, transforming growth factor beta-1, caspase-3, interleukin-6, interferon gamma, and interleukin-1-beta. Activities of MMP-2 and -9 in AH were detected using gelatin zymography, showing significant increase in the CRVO group compared to the control group (p

Background: The oxygen uptake efficiency slope (OUES) is the most important index for accurately measuring cardiopulmonary function in patients with acute ischemic heart disease. However, the relationship between the OUES variables and important cardiopulmonary func-tion parameters remain unelucidated for patients with acute ischemic heart disease, which accounts for the largest proportion of heart disease.Objects: The present cross sectional clinical study aimed to determine the multiple relation-ships among the cardiopulmonary function variables mentioned above in adults with acute ischemic heart disease.Methods: A convenience sample of 110 adult inpatients with ischemic heart disease (age: 57.4 ± 11.3 y; 95 males, 15 females) was enrolled at the hospital cardiac rehabilitation center. The correlation between the important cardiopulmonary function indicators including peak oxygen uptake (VO2 peak), minute ventilation (VE)/carbon dioxide production (VCO2) slope, heart rate recovery (HRR), and ejection fraction (EF) and OUES was confirmed.Results: This study showed that OUES was highly correlated with VO2 peak, VE/VCO2 slope, and HRR parameters.Conclusion: The OUES can be used as an accurate indicator for cardiopulmonary function. There are other factors that influence aerobic capacity besides EF, so there is no correlation with EF. Effective cardiopulmonary rehabilitation programs can be designed based on OUES during submaximal exercise in patients with acute ischemic heart disease.

Cellular composition and function are not clearly defined in heart failure after myocardial infarction. Here, using single cell and spatial transcriptomics in a MI-HF mouse model, the authors show that macrophages expressing Trem2 are found within the infarcts and this could be a useful biomarker.

Abstract Wearable pressure sensors having versatile device structures have been extensively investigated to achieve high sensitivity under mechanical stimuli. Here, we introduce piezoelectric pressure sensors based on fabrics woven using polyvinylidene fluoride (PVDF) weft and polyethylene terephthalate (PET) warp yarns with different weave structures: 1/1 (plain), 2/2, and 3/3 weft rib patterns. The dependence of the pressure-sensing performance on the weave pattern is demonstrated with an actual large-scale fabric up to the ~2 m scale. An optimized pressure sensor with a 2/2 weft rib pattern produced a high sensitivity of 83 mV N−1, which was 245% higher than that of the 1/1 pattern. The detection performance of the optimal fabric was extensively evaluated with a variety of ambient input sources, such as pressing, bending, twisting, and crumpling, as well as various human motions. Further, a large all-fabric pressure sensor with arrayed touch pixel units demonstrated highly sensitive and stable sensing performance.