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Background The duration of antiplatelet therapy after endovascular revascularization in patients with lower extremity artery disease (LEAD) has not been well established. This study aimed to evaluate the clinical outcome according to the duration of dual antiplatelet therapy (DAPT) in real practice. Methods From April 2009 to June 2019, 376 patients with LEAD underwent successful endovascular revascularization. After the procedure, the received single antiplatelet therapy (SAPT) or DAPT of various durations were classified into two groups (SAPT or DAPT Results Over the 40-month follow-up period, MACE occurred less frequently in the DAPT ≥6 months group than that in the SAPT or DAPT Conclusions In patients with LEAD, DAPT for ≥6 months after endovascular revascularization was associated with a lower incidence of MACE. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): National Research Foundation of Korea (NRF) grant funded by the government of Korea (MSIT) (No. 2019R1G1A1100442).

Aim Women who inevitably underwent surgical hysterectomy before natural menopause may have an earlier increase in hematocrit and storage iron than women who continue menstruation, thereby increasing the risk of cardiovascular disease (CVD) early. We aimed to evaluate the association of women with hysterectomy vs. without hysterectomy before their 50s with the risk of incident CVD. Methods This was a retrospective-cohort study, 135,575 women aged 40 to 50 years in 2011–2014 were extracted from the Korean Health Insurance Review and Assessment Service data and after propensity score matching, 55,539 pairs were included in hysterectomy and non-hysterectomy group respectively. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of cardiovascular death, myocardial infarction (MI), stroke, and coronary artery revascularization. Results After adjustment for confounding factors, hysterectomy group had an increased risk of MACCE compared with non-hysterectomy group (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.09–1.44). Regarding individual outcomes, cardiovascular death, MI, and coronary revascularization were comparable between the groups, whereas, the risk of stroke was significantly higher in hysterectomy group than non-hysterectomy group (HR, 1.31; 95% CI, 1.12–1.53). Even after excluding women who underwent oophorectomy, hysterectomy group had a higher risk of MACCE than non-hysterectomy group (HR, 1.24; 95% CI 1.06–1.44). Conclusions Early surgical menopause due to hysterectomy, not hormonal menopause, was associated with an increased risk for a composite of CVD, especially stroke. This suggest that the role of “uterus” as well as sex hormones may be important for the sharp increase in the risk of CVD in women after menopause. Funding Acknowledgement Type of funding sources: None.

Purpose There are few Asian studies on the clinical impact of statin intensity on clinical outcomes in patients with peripheral artery disease (PAD). This study investigated the clinical impact of statin intensity in patients with PAD after endovascular revascularization. Material and methods From April 2009 to June 2019, 376 patients with lower extremity PAD treated with endovascular revascularization were enrolled. They were classified into three groups according to statin intensity: no-statin, low-to-moderate intensity (LMI), and high-intensity (HI) groups. The primary outcomes were major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Results During the 40-month follow-up, MACE occurred less in the HI and LMI groups than the no-statin group (11.4% vs. 16.0% vs. 39%, p Conclusions HI and LMI statin use is associated with a significant reduction of MACE than no statin use. Regarding MALE, HI statin use was associated with better outcomes than no statin or LMI statin use. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2019R1G1A1100442).

Type IV pili (T4P) are important virulence factors involved in host attachment and other aspects of bacterial pathogenesis. In Gram-negative bacteria, the T4P filament is polymerized from pilin subunits at the platform complex in the inner membrane (IM) and exits the outer membrane (OM) through the OM secretin channel. Although essential for T4P assembly and function, the OM secretin complexes can potentially impair the permeability barrier function of the OM and allow the entry of antibiotics and other toxic molecules. The mechanism by which Gram-negative bacteria prevent secretin-mediated OM leakage is currently not well understood. Here, we report a discovery of SlkA and SlkB (PA5122 and PA5123) that prevent permeation of several classes of antibiotics through the secretin channel of Pseudomonas aeruginosa type IV pili. We found these periplasmic proteins interact with the OM secretin complex and prevent toxic molecules from entering through the channel when there is a problem in the assembly of the T4P IM subcomplexes or when docking between the OM and IM complexes is defective. Thus, our results indicate that the secretin channel-interacting proteins play an important role in maintaining the OM permeability barrier, suggesting they may be attractive targets for potentiators that sensitize Gram-negative pathogens to antibiotics that are normally ineffective at penetrating the OM.

Serum YKL-40 is an inflammatory biomarker of endothelial dysfunction and may play a role in the inflammatory process of Behçet disease (BD).Serum YKL-40 levels were evaluated in patients with BD in order to identify associations with other inflammatory cytokines and establish laboratory parameters. Serum YKL-40 levels were also compared with BD clinical features and disease activity.In total, 112 patients with BD and 45 age- and sex-matched healthy volunteers were included. Disease activity was assessed with BD Current Activity Form score and Electronic Medical Record-based Activity Index (EMRAI) score.Serum YKL-40 levels were significantly higher in patients with BD (median 41·88, range 12·52-171·30 ng mL(-1) ) than in healthy volunteers (median 20·92, range 5·01-64·20 ng mL(-1) ; P 0·01). The cut-off value for YKL-40 (30·005 ng mL(-1) ) was determined from the receiver operating characteristic curve. EMRAI scores and the proportion of patients in the active phase of BD presenting with two or more major criteria were significantly higher in patients with elevated YKL-40 levels (P = 0·04 and P = 0·04, respectively). A statistically significant elevation in YKL-40 levels was observed in patients with active BD compared with patients with inactive BD (P = 0·05). Serum YKL-40 values were positively correlated with interleukin-6 and EMRAI scores (both P = 0·04), indicating that serum YKL-40 levels are increased in patients with BD and positively correlate with disease activity.YKL-40 may play a role in the pathophysiology of BD and provide a useful marker for monitoring patients with BD.

The optical properties and the deep levels in bulk Si 1− x Mn x formed by using an implantation and annealing method were investigated. Transmission electron microscopy, X-ray diffraction, and Hall-effect measurements showed that the annealed bulk Si 1− x Mn x samples were p-type crystalline semiconductors. The photoluminescence spectra for the annealed bulk Si 1− x Mn x material showed luminescence peaks corresponding to excitons bound to neutral acceptors and related to dislocations due to the existence of Mn impurities. Deep-level transient spectroscopy results for the annealed bulk Si 1− x Mn x showed deep levels related to the interstitial and substitutial sites of the Mn + ions. These results can help improve understanding of the optical properties and the deep levels in annealed bulk Si 1− x Mn x material.

Vertical profiles of near-bottom currents and suspended sediment concentrations were measured on the inner shelf at 20 m depth off the US Army Corps of Engineers Field Research Facility at Duck, NC, U.S.A. over the month of October 1994. The observations embraced an initial period of calm conditions and a prolonged and evolving high-energy event. The data were analyzed to examine the effects of both synoptic and local-scale meteorological events on bed stress and resulting suspended-sediment transport. Four storm phases were identified and related to distinct sets of bottom boundary layer responses: (I) during the initial calm period of low bottom stress, non-diffusive suspended-sediment transport was confined within the thin wave boundary layer; (II) during the onset of the storm, increasingly diffusive suspended-sediment transport and active bedform changes prevailed in association with rapidly increasing wave boundary layer thickness and bed stress; (III) at the peak of the storm, wave boundary layer thickness and bed stress reached their maxima and caused high suspended-sediment transport and sheetflow conditions; and (IV) during the swell-dominated post-storm stage, bedforms developed and suspended-sediment transport was confined within the thick wave boundary layer because of the small current shear. Synoptic-scale winds with local wind perturbation controlled the near-bottom flow during Phase II, whereas local winds dominated during Phase III. Wave-current interactions were most intense during Phase III and were responsible for the high bottom stress.

Aims Atopic dermatitis (AD) is an inflammatory skin disease. Probiotics have been reported to modulate immune responses and thus are now being suggested as potential treatments for allergies. In this study, we investigated the inhibitory effects of Lactobacillus sakei probio 65 isolated from Kimchi on artificially inducing AD in NC/Nga mice. Methods and Results Oral administration of viable or heat-inactivated Lact. sakei probio 65 improved the condition of skin and reduced scratching frequency. Serum levels of IgE and cutaneous T-cell-attracting chemokine (CTACK) were significantly decreased by this therapy. Dead Lact. sakei probio 65 also decreased IL-4 and IL-6 serum concentrations. Moreover, both live and dead Lact. sakei probio 65 inhibited the expression of Thymus and activation-regulated chemokine and CTACK in AD-like skin lesions. The increased levels of Foxp3 expression in the lesional skin and ears were also suppressed by Lact. sakei probio 65. In addition, Lact. sakei probio 65 inhibited β-hexosaminidase release and the secretion of IL-4, TNF-α and IL-6 from RBL-2H3 cells. Conclusions Oral treatment with both viable and heat-inactivated Lact. sakei probio 65 inhibits skin inflammation and AD-like skin lesions, as well as mast cell activation. Significance and Impact of the Study Lactobacillus sakei probio 65 has an inhibitory effect on atopic dermatitis-like skin lesions and may represent an effective new anti-inflammatory agent.

This study was designed to assess body movement during sleep at night unobtrusively using an infrared motion detector and ZigBee communication module. In order to validate the accuracy of this system, motion records and actigraphic data were obtained simultaneously from three young healthy people for three or more consecutive nights. Significant agreement between two data was found by statistical analysis. This body movement monitoring system can assess sleep behaviors on bed without any intervention. Zigbee protocol has an advantage of low power consumption and is suitable for this application.

This paper is concerned with constructing a computational model in the domain of broad rating and implementing the model as an expert system. A bond rating is an assessment of the relative level of risk associated with the timely payments required by the obligation. The primary interest in this paper is in modeling and implementing the qualitative judgment required in bond rating rather than the reasoning process for manipulating financial ratios. >

By impinging a beam of O+2 ions of energy 150 eV