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COVID-19 vaccination is essential in cancer patients. However, there is limited evidence of the prognosis of these patients, especially for those taking immune checkpoint inhibitors (ICIs). We present a patient on pembrolizumab for advanced endometrioid adenocarcinoma experiencing continuous diarrhea and subsequent episodes of fever with pain in multiple joints following a second dose of the BNT162b2 mRNA COVID-19 vaccine. An ICI-induced immune-related adverse effect (irAE) was the main diagnosis; cytokine release syndrome and rheumatoid arthritis were also considered. Notably, the novel irAE occurred after the 19th pembrolizumab trial, highlighting the potential effect of changes in systemic immunogenicity after BNT162b2 vaccination. Ultimately, the patient was treated with steroid, which alleviated her symptoms. Here, we report a rare adverse effect after COVID-19 vaccination in an endometrioid carcinoma patient on ICI therapy. This report shows that there is a need to consider and investigate vaccine-related adverse events.

Intensive research on energy harvested sensor nodes with traditional battery powered devices has been driven by the challenges in achieving the stringent design goals of battery lifetime, information accuracy, transmission distance, and cost. This challenge is further amplified by the inherent power intensive nature of long-range communication when sensor networks are required to span vast areas such as agricultural fields and remote terrain. Solar power is a common energy source is wireless sensor nodes, however, it is not reliable due to fluctuations in power stemming from the changing seasons and weather conditions. This paper tackles these issues by presenting a perpetually-powered, energy-harvesting sensor node which utilizes a minimally sized solar cell and is capable of long range communication by dynamically co-optimizing energy consumption and information transfer, termed as Energy-Information Dynamic Co-Optimization (EICO). This energy-information intelligence is achieved by adaptive duty cycling of information transfer based on the total amount of energy available from the harvester and charge storage element to optimize the energy consumption of the sensor node, while employing in-sensor analytics (ISA) to minimize loss of information. This is the first reported sensor node < 35cm2 in dimension, which is capable of long-range communication over > 1Km at continuous information transfer rates of upto 1 packet/second which is enabled by EICO and ISA.

Objective: In posterior fossa surgery such as microvascular decompression (MVD), cerebrospinal fluid (CSF) leakage is a crucial problem. In this study, we explored the accurate diagnosis and effective non-surgical management of postoperative CSF leakage.Methods: We reviewed 749 patients who underwent MVD surgery from August 2018 to April 2022. Although we significantly reduced the CSF leakage problem by using the triple-layer closing technique (TLCT), CSF leakage was still a problem in a few cases. We managed these patients with the same diagnostic flow and treatment regimen using a lumbar drain (LD).Results: Among the 749 patients in the cohort, 11 (1.4%) had CSF leakage, and each of those cases presented with rhinorrhea. Five patients (45.5%) had the symptom on the first day, two patients (18.2%) on the second day, one patient (9.1%) on the third day, and three patients (27.3%) on the fifth day after surgery. After conservative treatment including CSF drainage via LD for 5.4 days on average, none of the patients had recurrent symptoms suggesting CSF leakage; thus, there was no need for wound repair surgery.Conclusion: Despite diligent attempts to prevent CSF leakage in open microsurgery, leaks inevitably occur in some cases and are more frequent in posterior fossa surgery. Although we cannot fully prevent leakage, we should limit the complication to ensure that it does not progress into other severe problems, such as meningitis. A closing technique such as TLCT is useful, but the early diagnosis and management of CSF leakage with LD is also important.

Sole vein offenders are rare and can be difficult to identify on preoperative magnetic resonance imaging (MRI) and intraoperative microscopy. The objective of this case review was to investigate factors resulting in successful decompression in venous offender cases. Among 234 cases of microvascular decompression surgery performed for hemifacial spasm from September 2020 to April 2022 at Konkuk University Medical Center, only two cases were identified as having a definite venous offender. We reviewed preoperative MRI and intraoperative microscopic findings and studied the correlation between decompression and lateral spread response (LSR) changes. Our two patients had possibility of a small venous offender on preoperative MRI, but it was ambiguous. A definite venous offender was identified on the operative microscopic findings and decompressed successfully, referring to the disappearance of the LSR waveform. Postoperatively, spasm disappeared or significantly improved. A venous offender is difficult to identify on preoperative MRI findings or even on intraoperative microscopic findings. In such cases, changes in the LSR waveform in response to decompressing the suspected vein can be a valuable reference for successful facial outcomes.

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

The process safety management system for chemical plants was introduced approximately 25 years ago. With the improvement in the safety management levels for the safe operation of the chemical plants, the number of serious industrial accidents has gradually decreased; however, increased damages have been observed when accidents do occur. The cause of accidents has also increased in cases where several factors, including social and cultural factors, are complexly related, in addition to facility and human factors. The need for an overall integrated systemic approach related to society, technology, and organization, and a sequential approach for finding the direct cause of accidents, is growing while analyzing the accidents. For this reason, foreign countries have introduced and applied a method to analyze accidents in an integrated manner from a systemic point of view; however, reports of cases or research results used in Korea. In this study, the case of explosion accidents, which occurred during a trial operation at a domestic chemical plant, was analyzed using Systems-Theoretic Accident Model and Processes, a systematic accident analysis technique, to reveal the primary cause, organizational, and operational problems, so that it can be used for future investigations when other accidents occur.

Owing to its exceptional physicochemical properties, graphene has demonstrated unprecedented potential in a wide array of scientific and industrial applications. By exploiting its chemically inert surface endowed with unique barrier functionalities, we herein demonstrate antiadhesive monolayer graphene films for realizing a peel-and-pick transfer process of target materials from the donor substrate. When the graphene antiadhesion layer (AAL) is inserted at the interface between the metal and the arbitrary donor substrate, the interfacial interactions can be effectively weakened by the weak interplanar van der Waals forces of graphene, enabling the effective release of the metallic electrode from the donor substrate. The flexible embedded metallic electrode with graphene AAL exhibited excellent electrical conductivity, mechanical durability, and chemical resistance, as well as excellent performance in flexible heater applications. This study afforded an effective strategy for fabricating high-performance and ultraflexible embedded metallic electrodes for applications in the field of highly functional flexible electronics.

Decades of continuous scaling has reduced the energy of unit computing to virtually zero, while energy-efficient communication has remained the primary bottleneck in achieving fully energy-autonomous Internet-of-Things (IoT) nodes. This article presents and analyzes the tradeoffs between the energies required for communication and computation in a wireless sensor network, deployed in a mesh architecture over a 2400-acre university campus, and is targeted toward multisensor measurement of temperature, humidity and water nitrate concentration for smart agriculture. Several scenarios involving in-sensor analytics (ISA), collaborative intelligence (CI), and context-aware switching (CAS) of the cluster head during CI has been considered. A real-time co-optimization algorithm has been developed for minimizing the energy consumption in the network, hence maximizing the overall battery lifetime. Measurement results show that the proposed ISA consumes $\approx 467\times $ lower energy as compared to traditional Bluetooth low energy (BLE) communication, and $\approx 69500\times $ lower energy as compared with long-range (LoRa) communication. When the ISA is implemented in conjunction with LoRa, the lifetime of the node increases from a mere 4.3 h to 66.6 days with a 230-mAh coin cell battery, while preserving >99% of the total information. The CI and CAS algorithms help in extending the worst case node lifetime by an additional 50%, thereby exhibiting an overall network lifetime of $\approx 104$ days, which is >90% of the theoretical limits as posed by the leakage current present in the system, while effectively transferring information sampled every second. A Web-based monitoring system was developed to continuously archive the measured data, and for reporting real-time anomalies.

Mathematically secure cryptographic algorithms, when implemented on a physical substrate, leak critical “side-channel” information, leading to power and electromagnetic (EM) analysis attacks. Circuit-level protections involve switched capacitor, buck converter, or series low-dropout (LDO) regulator-based implementations, each of which suffers from significant power, area, or performance tradeoffs and has only achieved a minimum traces to disclosure (MTD) of $10M$ till date. Utilizing an in-depth white-box model, this work, for the first time, focuses on signature suppression in the current domain, which provides an $Attenuation^{2}$ enhancement in MTD, leading to orders of magnitude improvement in both power and EM side-channel analysis (SCA) immunities. Using a combination of current-domain “signature attenuation” (CDSA) along with local lower level metal routing, the critical correlated information in the crypto current is significantly suppressed before it reaches the supply pin. Especially, to prevent the EM leakage from its source (metal layers carrying the correlated crypto current acting as antennas), this work embraces lower level metal routing of the CDSA embedding the crypto-IP so that the signature becomes highly suppressed before it passes through the higher metal layers (which radiates significantly) to connect to the external pin. The 65-nm CMOS test chip contains both protected and unprotected parallel AES-256 implementations, running at a clock frequency of 50 MHz. Test vector leakage assessment (TVLA) on the protected CDSA-AES, demonstrated with on-chip measurements for the first time, shows that the higher level metal layers leak significantly more compared with the lower level metal routing. Correlational power and EM analysis (CPA/CEMA) attacks on the unprotected implementation were able to extract the secret key within $8k$ and $12k$ traces, respectively, while the protected CDSA-AES could not be broken even after $1B$ encryptions for both power and EM SCA, evaluated both in the time and frequency domains, showing an improvement of $100\times $ over the prior state-of-the-art countermeasures with comparable power and area overheads.

Radiation, being invisible and odorless, has become a major concern in modern-day healthcare, mining, security, and nuclear applications that require professionals to work in environments involving radioactive materials, often with only elementary training. Furthermore, the scenario is worsened by the absence of a real-time, accumulative radiation dosimeter of small/wearable form factor that can provide direct digital output for long-term continuous monitoring. In this article, we present the first monolithically integrated CMOS wearable radiation dosimeter, consisting a floating-gate (FG) resistive sensor with a sensitivity of 14 $\Omega $ /rad, and a time-domain resistance-to-digital-converter (RDC) that functions as an 18-bit voltage-controlled oscillator (VCO)-based ADC, consuming 861 nJ for 10-ms active read time (which translates to 861-nW at 1 S/s), with 3.29-pJ/conversion step energy efficiency. The proposed time-based RDC exhibits programmable energy-resolution scalability by controlling the measurement time (unlike traditional voltage/current-mode ADCs) and achieves 6-bit better resolution than the state-of-the-art VCO-based ADCs at low frequency (conversion time ≈10 ms). The implemented integrated dosimeter achieves 8-bit better resolution, 7.5 $\times $ lower power, and 40 $\times $ better sensitivity (up to 10-mrad dose) than the current CMOS FG dosimeters.

Background & Aims: Several models have recently been developed to predict risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Our aims were to develop and validate an artificial intelligence-assisted prediction model of HCC risk. Methods: Using a gradient-boosting machine (GBM) algorithm, a model was developed using 6,051 patients with CHB who received entecavir or tenofovir therapy from 4 hospitals in Korea. Two external validation cohorts were independently established: Korean (5,817 patients from 14 Korean centers) and Caucasian (1,640 from 11 Western centers) PAGE-B cohorts. The primary outcome was HCC development. Results: In the derivation cohort and the 2 validation cohorts, cirrhosis was present in 26.9%-50.2% of patients at baseline. A model using 10 parameters at baseline was derived and showed good predictive performance (c-index 0.79). This model showed significantly better discrimination than previous models (PAGEB, modified PAGE-B, REACH-B, and CU-HCC) in both the Korean (c-index 0.79 vs. 0.64-0.74; all p

Electromagnetic (EM) side-channel analysis (SCA) attack, which breaks cryptographic implementations, has become a major concern in the design of circuits and systems. This paper presents the design and analysis of the EM side-channel attack detection system utilizing patterned-ground co-planar capacitive asymmetry sensing (PG-CAS) for approaching probe, targeting to improve sensitivity, detection range, and power consumption compared to LC oscillator utilizing inductive sensing. The PG-CAS consists of a grid of four metal plates of the same size at the top metal layer and a patterned ground plane at a lower metal. As an EM probe approaches, electric field lines between the plates and plate-ground get distorted, thereby breaking the symmetry of the inter-plate and the plate-ground capacitance system and this change in capacitance is sensed. The PG-CAS circuit consists of two LC oscillators, mixer, low pass filter (LPF), resistive feedback amplifier (RFA) and a digital logic. By down-converting sensing signal to low-frequency using mixer, LPF, RFA and digital logic, the detection range is significantly improved. At a distance of 1 mm between the sensing metal plates and the approaching EM probe, system-level simulation results using TSMC 65nm technology and Ansys Maxwell show a > 10% change in the output frequency from the baseline frequency, leading to a > 10× improvement in the detection range and a ~ 3× improvement in power consumption over existing inductive sensing methods.

The emerging Narrowband Human Body Communication (NB-HBC) technology, as well as MedRadio communication in the 400 MHz band promise better energy efficiencies than traditional Bluetooth Low Energy for wireless body area networks (WBAN) due to lower channel losses and lower frequencies, respectively. Although HBC offers less than 10pJ/bit energy efficiencies, it strictly demands both the transmitter and receiver to be on the body. Traditional MedRadio enables data transfer even when either devices are not on the body, but consumes orders of magnitude more energy than HBC, primarily due to large power consumption in LO generation. In this work, for the first time, we demonstrate a COntext-aware, Reconfigurable transmitter (COR-Tx) consisting sub-3pJ/bit HBC and sub-5pJ/bit MedRadio modes (both state-of-the-art), while supporting opportunistic switching between the two modes depending on the location of the receiver (on-body/off-body) for achieving optimum system-level energy with seamless communication. For 10 Mbps data rate, the HBC mode achieves an energy efficiency of 2.24pJ/bit, while the MedRadio mode achieves 4.93pJ/bit using a shared LO generation scheme that utilizes direct-modulated edge combination (EC) for minimizing energy consumption. The energy-efficiency improvement over the state-of-the-art is ~2.1X for HBC and ~90X for MedRadio.

Computationally-secure cryptographic algorithms when implemented on physical platforms leak critical physical signals correlated with the secret key in the form of power consumption and electromagnetic (EM) emanations. This can be exploited by an adversary, leading to side-channel attacks (SCA) that can recover the secret key. Circuit-level on-chip countermeasures include a switched-capacitor current equalizer [1], charge-recovery logic [2], an integrated voltage regulator (IVR) [3], and an all-digital low-dropout (LDO) regulator [4], which suffer from performance degradation, high power/area overheads because of large embedded passives, as well as EM leakage from large metal-insulator-metal (MIM) capacitor top plates. Alternatively, simulations of shunt LDO-based regulators have been shown to be effective for power SCA resistance [5]. Noting that the correlated current is the source of both power (at supply pin) and EM leakage (radiation throughout current path), this work embraces current-domain ‘signature attenuation’ (CDSA) as a low-overhead generic countermeasure against both EM and power side-channel attacks to achieve the highest minimum traces to disclosure (MTD $> 1\mathrm{B})$ reported to date.

Muscle atrophy is defined as the decrease in the size and number of muscle fibers, and is associated with injury to muscle structures. Recently, biophysical therapies using laser, ultrasound, and vibration has been widely used to improve muscle atrophy. However, although the effects of these stimuli seem to be similar, the mechanisms by which they stimulate biological tissue may be different. From this point of view, we expected that it would be possible to produce synergetic effects through combining these three different types of biophysical stimuli on biological tissues, based on the therapeutic benefit of each stimulus. For this, 35 males, 12-week old, C57BL/6 mice (21 ± 1.2 g), were randomly assigned to five groups: a) a sciatic nerve neurectomized “control” group (C, n = 7), b) a MILNS (Minimally Invasive Laser Needle System) therapy after sciatic nerve neurectomized group (L, n = 7), c) a LIPUS (Low-Intensity Pulsed Ultrasound) therapy after sciatic nerve neurectomized group (U, n = 7), e) a PVS (Partial Vibration Stimulation) therapy after sciatic nerve neurectomized group (V, n = 7), and e) a multimodal biophysical stimulation after sciatic nerve neurectomized group (MS, n = 7).

Obesity is generally caused by quantitative changes in adipocyte differentiation and fat metabolism. Only a few studies have been determined the effect of red beans extract on obesity and plasma cholesterol concentration. We have been studied the functional activities of red-bean extracts including anti-oxidative effect against DNA and cell damages. Histological study including micro CT analysis showed that the accumulation of fat in hepatocytes and intestines was significantly decreased in red bean extract treated group. In addition, plasma cholesterol and triglyceride levels were decreased in blood samples. In addition, it was confirmed that the red bean extract inhibited the expression of PPARγ, Fabp4 and RETN genes, which regulate total adipocyte differentiation and lipid metabolism. Red bean extract inhibits the expressions of transcription factors associated with adipocyte differentiation in a dose-dependent manner, thereby inhibiting fat accumulation and decreasing blood lipid levels in obese mice induced by high fat diet.

The circadian rhythm controls several biological activities; therefore, a disorganized circadian rhythm may cause fatal health problems. The aim of this study was to assess the effects of circadian rhythm disturbances induced by simulated night shift activities on the abdominal adipose tissue, bone microstructures and muscle volume in the tibiae of mice. Moreover, we evaluated the effects of multi-frequency whole-body vibration as a countermeasure against the consequences of circadian rhythm disturbances. Twenty-four 5-week-old C57BL/6J male mice were equally assigned to three groups: the normal group (Nor), night shift group (NS), and night shift with multi-frequency whole-body vibration group (NS + V). The NS and NS + V groups were exposed to circadian rhythm disturbances for 4 weeks with 3-day intervals by changing the day and night cycle based on 7 o’clock. After 4 weeks, morphological changes in the adipose tissue, bone microstructures and muscle volume in the tibiae were evaluated from three-dimensional images using in vivo micro-computed tomography. As a result, the volume of the abdominal adipose tissue was significantly higher in the NS than in the Nor and NS + V groups. Also, the microstructures of the tibia were more enhanced in the NS + V than the NS group. The volume of tibial muscle was increased in all groups, while there were no significant changes in muscle volume. From these results, we can conclude that circadian rhythm disturbances induced by night shift activities may reduce bone condition and increase the accumulation of abdominal adipose tissue and these negative effects may be prevented or improved through applying multi-frequency whole-body vibration.

Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data—including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention—were collected. Results: The mean age of the patients was 69.4±11.1 years and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in t he i ntensive c are u nit and in t he h ospital were 1 .5 a nd 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of 85.3%±0.09% and a 5-year MACCE-free survival rate of 72.8%±0.1%. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at 9.7±10.8 months postoperatively. Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.

Excessive bone resorption caused by increased osteoclast number or activity leads to a variety of bone diseases including osteoporosis, rheumatoid arthritis and periodontitis. Thus, the therapeutic strategy for these diseases has been focused primarily on the inhibition of osteoclast formation and function. This study shows that euphorbia factor L1 (EFL1), a diterpenoid isolated from Euphorbia lathyris, inhibited osteoclastogenesis and induced osteoclast apoptosis. EFL1 suppressed osteoclast formation and bone resorption at both initial and terminal differentiation stages. EFL1 inhibited receptor activator of NF-κB ligand (RANKL)-induced NFATc1 induction with attenuated NF-κB activation and c-Fos expression. EFL1 decreased the level of reactive oxygen species by scavenging them or activating Nrf2, and inhibited PGC-1β that regulates mitochondria biogenesis. In addition, EFL1 induced apoptosis in differentiated osteoclasts by increasing Fas ligand expression followed by caspase activation. Moreover, EFL1 inhibited inflammation-induced bone erosion and ovariectomy-induced bone loss in mice. These findings suggest that EFL1 inhibits osteoclast differentiation by regulating cellular redox status and induces Fas-mediated apoptosis in osteoclast, and may provide therapeutic potential for preventing or treating bone-related diseases caused by excessive osteoclast.

본 연구는 공업계열 특성화고 학생들을 위한 과학기술사 수업 프로그램을 개발하고 적용함으로써 과학의 본성에 대한 이해에 미치는 교육적 효과를 조사하였다. 프로그램은 고등학교 융합 과학 및 물리 I의 교육과정을 바탕으로 6개의 과학기술사 주제로 개발되었으며, 경기도에 위치한 공업계열 특성화고 학생 290명을 대상으로 적용되었다. 본 연구의 방법은 단일 그룹 사전-사후 검사로 설계되었으며. 학생들의 과학의 본성에 대한 이해를 조사하고자 프로그램 적용 전후에 설문을 실시하여 그 검사 결과를 SPSS 23을 이용하여 통계 분석을 실시하였다. 과학의 본성에 대한 설문도구는 선행연구에서 개발된 4가지 영역의 과학의 본성 개념 틀(Lee, 2014)을 수정 보완하여 사용하였다. 본 연구의 결과는 다음과 같다. 첫째, 공업계열 특성화고 학생들의 과학의 본성에 이해에 대한 사전·사후 비교 결과, 과학기술사 수업 프로그램이 학생들의 이해에 효과가 있는 것으로 나타났다. 둘째, 과학기술사 수업 프로그램의 효과는 특성화고 학생들의 성별 및 전공에 따른 차이는 없는 것으로 나타났다. 셋째, 과학의 본성 4가지 영역간의 상관관계 분석에 의하면, 4가지 영역들은 모두 상호 높은 상관관계가 있는 것으로 나타났으며, 특히 각 개별 영역들은 모두 과학과 기술, 그리고 사회와의 상호작용에 대한 과학의 본성 측면과 상관관계가 있는 것이 발견되었다. 한편, 과학기술사 수업 프로그램은 구체적으로 어떻게 학생들의 과학의 본성에 대한 이해에 효과가 있는지에 대한 후속 연구가 필요하다.