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This article examines the humanistic relationship between Korean Chinese and North Korean refugees on the Sino–North Korean border in Zhang Lu's film Dooman River (2010) and delineates how the ethical obligation to “our” people, or brethren (dongpo), is removed by understanding North Koreans as potential criminals. The first part conceptualizes Korean Chinese villagers’ ethical obligation toward North Koreans, which I call ethnic ethos, and focuses on how the director preserves the Korean Chinese's conscience by stereotyping North Korean border crossers as “dangerous refugees.” The second part focuses on the meaning of ethnic identity that the director pursues, offering insights into the crisis of community in the context of urbanization and globalization, or the “Korean dream.” The two types of border crossing—the crossing of North Koreans to China and the crossing of Korean Chinese to South Korea—offer clues to the causes of the crisis of community, in which collective ethics and responsibility to others have been eroded. This article answers questions about the death of a Korean Chinese boy, who voluntarily becomes a stranger by entering into the zone of “nonlife” or refugees. I argue that the boy's death is a sacrifice suggested to audiences by the director in an attempt to preserve the communitarian ethics of Korean Chinese and maintain the value of ethnic identity.

Integrins are ubiquitously expressed cell-adhesion proteins. Talin is required for integrin activation through an inside-out signaling pathway, during which talin is recruited to the plasma membrane (PM) by RAP1 directly or through its effector, RAP1-Interacting Adaptor Molecule (RIAM). RIAM also activates talin from autoinhibition by binding to talin head domain. A helical talin-binding segment (TBS) in RIAM mediates both talin activation and recruitment by binding to two distinct sites in talin head and rod domains respectively. The bi-specificity of the TBS fragment allows us to develop a new strategy to suppress talin-induced integrin activation through a “double-hit” approach. We designed an experimental peptidomimetic inhibitor by engineering a hydrocarbon “staple” in the helical TBS fragment to mask the integrin binding site in the talin head. The stapled peptide (S-TBS) exhibits a stronger binding affinity with talin and inhibits talin:integrin interaction. Crystal structure of S-TBS in complex with talin rod domains reveals an interface that overlaps with the TBS-binding site in talin. Consistently, S-TBS also exhibits an inhibitory effect on TBS:talin-rod interaction during the PM recruitment of talin. Importantly, S-TBS possesses excellent cell permeability and inhibits integrin activation in a talin-dependent manner. Hence, our results present a novel approach to design a new class of intracellular inhibitors targeting integrin functions.

This cross-national research investigated nationally representative adolescents from South Korea and the United States, explored similarities and differences in latent profiles of bullying victimization between countries, and examined individual- and school-level variables that predict such latent profiles supported by the Social Disorganization Theory. The fourth-grade sample of the 2015 Trends in International Mathematics and Science Study from South Korea ( N = 4,669) and the United States ( N = 10,029) was used to conduct a latent profile analysis based on eight items of the bullying victimization questionnaire. Multilevel logistic regression was conducted using latent profiles as dependent variables. Independent variables include individual-level (material goods, school absence, academic interest, school belonging) and school-level (concentration of affluent families, school resources, the severity of delinquency, academic commitment) factors. More similarities existed than differences in the latent groups of bullying victimization between South Korea ( rare, low-moderate, verbal-relational-physical, and multi-risk) and the United States ( rare, low-moderate, verbal-relational, and multi-risk). Evidence for school-level variables as predictors of bullying victimization profiles was stronger for adolescents in the United States, with a concentration of affluent families and severity of delinquency being significant in four of the six models. For the South Korean sample, the severity of delinquency predicted bullying victimization in only one model. Examination of both individual- and school-level factors that predict unique bullying victimization experiences grounded in Social Disorganization Theory may be informative for addressing key areas of intervention—especially at the school-level context in which victimization primarily takes place and where anti-bullying intervention programs are often provided.

Tools for the evaluation of gastric emptying have evolved over time. The purpose of this study was to show that the risk of pulmonary aspiration is not increased with carbohydrate drink, by demonstrating that the gastric antral cross-sectional area (CSA) of the NO-NPO group is either equivalent to or less than that of the NPO (nil per os) group.Sixty-four patients scheduled for elective laparoscopic benign gynecologic surgery were enrolled and randomly assigned to the NPO group (n = 32) or the NO-NPO group (n = 32). After having a regular meal until midnight before surgery, the NPO group fasted until surgery, while the NO-NPO group ingested 400 mL of a carbohydrate drink at midnight and freely up to 2 hours before anesthesia. The primary outcome was the gastric antral CSA by gastric ultrasound in right lateral decubitus position (RLDP). Noninferiority was defined as a mean difference of CSA2.8 cm2. Secondary outcomes included CSA in supine position, gastric volume (GV), GV per weight (GV/kg), GV/kg1.5 mL/kg, and Perlas grade.CSA in RLDP was not different between the NPO group (6.25 ± 3.79 cm2) and the NO-NPO group (6.21 ± 2.48 cm2; P = .959). The mean difference of CSA in RLDP (NO-NPO group - NPO group) was 0.04 (95% confidence interval [CI], -1.56 to 1.64), which was within the noninferiority margin of 2.8 cm2. CSA was not different between the 2 groups (4.17 ± 2.34 cm2 in NPO group versus 4.28 ± 1.23 cm2 in NO-NPO group; P = .828). GV in NPO group (70 ± 56 mL) was not different from NO-NPO group (66 ± 36 mL; mean difference, 3.66; 95% CI, -20 to 27; P = .756). GV/kg in the NPO group (1.25 ± 1.00 mL/kg) was not different from the NO-NPO group (1.17 ± 0.67 mL/kg; P = .694). The incidence of GV/kg1.5 mL/kg was not different between NPO (31.3%) and NO-NPO group (21.9%; P = .768). The median (interquartile range) of the Perlas grade was 1 (0-1) in NPO group and 0.5 (0-1) in NO-NPO group (P = .871).Preoperative carbohydrates ingested up to 2 hours before anesthesia do not delay gastric emptying compared to midnight fasting, as evaluated with gastric ultrasound.

The perfusion index (PI), calculated from the photoplethysmographic waveform, reflects peripheral vasomotor tone. As such, the PI serves as a surrogate for quantitative measures of drug-induced vasoconstriction or vasodilation. This study aimed to compare the effect on the PI of desflurane and sevoflurane at equi-anaesthetic concentrations in patients undergoing single-agent inhalation anaesthesia, where equi-anaesthetic dose was based on the known minimum alveolar concentration of these agents.We randomly allocated patients scheduled for arthroscopic knee surgery to receive either desflurane or sevoflurane general anaesthesia after target-controlled induction of anaesthesia with propofol. Anaesthesia was maintained at age-corrected minimum alveolar concentration 1.0, under neuromuscular block (rocuronium). The PI and haemodynamic data were recorded every minute for 35 min after induction of anaesthesia and after standardised nociceptive stimulation. The primary outcome was PI, compared between the groups over time (repeated-measures analysis of variance). Secondary outcomes included MAP and HR.Sixty-nine participants (mean [range] age: 42 yr [19-65 yr]; 49% females) were assigned to either desflurane (n=34) or sevoflurane (n=35). The PI remained higher under desflurane compared with sevoflurane, both before (mean difference [MD]: 3.3; 95% confidence intervals [CIs]: 2.0-4.7; P0.001) and after tetanic stimulation (MD: 2.8; 95% CI: 2.0-3.7; P0.001). Higher PI paralleled lower MAP in participants assigned to desflurane anaesthesia (P0.001), both before (MD: 8 mm Hg; 95% CI: 4-12) and after nociceptive stimulation (MD: 14 mm Hg; 95% CI: 7-22). HR was similar throughout.These findings suggest that at equipotent doses, desflurane exerts more potent vasodilatory properties and lowers blood pressure by a magnitude potentially associated with harm.NCT03570164.

Background and Objectives: Chronic lower back pain (LBP) is a common clinical disorder. The early identification of patients who will develop chronic LBP would help develop preventive measures and treatment. We aimed to develop machine learning models that can accurately predict the risk of chronic LBP. Materials and Methods: Data from the Sixth Korea National Health and Nutrition Examination Survey conducted in 2014 and 2015 (KNHANES VI-2, 3) were screened for selecting patients with chronic LBP. LBP lasting &gt, 30 days in the past 3 months was defined as chronic LBP in the survey. The following classification models with machine learning algorithms were developed and validated to predict chronic LBP: logistic regression (LR), k-nearest neighbors (KNN), naïve Bayes (NB), decision tree (DT), random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), and artificial neural network (ANN). The performance of these models was compared with respect to the area under the receiver operating characteristic curve (AUROC). Results: A total of 6119 patients were analyzed in this study, of which 1394 had LBP. The feature selected data consisted of 13 variables. The LR, KNN, NB, DT, RF, GBM, SVM, and ANN models showed performances (in terms of AUROCs) of 0.656, 0.656, 0.712, 0.671, 0.699, 0.660, 0.707, and 0.716, respectively, with ten-fold cross-validation. Conclusions: In this study, the ANN model was identified as the best machine learning classification model for predicting the occurrence of chronic LBP. Therefore, machine learning could be effectively applied in the identification of populations at high risk of chronic LBP.

The usefulness of the oxygen reserve index (ORi) in reducing hyperoxemia remains unclear. We designed this study to investigate whether fraction of inspired oxygen (FiO2) adjustment under a combination of ORi and peripheral oxygen saturation (SpO2) guidance can reduce intraoperative hyperoxemia compared to SpO2 alone.In this prospective, double-blind, randomized controlled study, we allocated patients scheduled for laparoscopic gastrectomy to the SpO2 group (FiO2 adjusted to target SpO2 ≥ 98%) or the ORi-SpO2 group (FiO2 adjusted to target 00 ORi.3 and SpO2 ≥ 98%). The ORi, SpO2, FiO2, arterial partial pressure of oxygen (PaO2), and incidence of severe hyperoxemia (PaO2 ≥ 200 mm Hg) were recorded before and 1, 2, and 3 hours after surgical incision. Data from 32 and 30 subjects in the SpO2 and ORi-SpO2 groups, respectively, were analyzed.PaO2 was higher in the SpO2 group (250.31 ± 57.39 mm Hg) than in the ORi-SpO2 group (170.07 ± 49.39 mm Hg) 1 hour after incision (P.001). PaO2 was consistently higher in the SpO2 group than in the ORi-SpO2 group, over time (P = .045). The incidence of severe hyperoxemia was higher in the SpO2 group (84.4%) than in the ORi-SpO2 group (16.7%, P.001) 1 hour after incision. Higher FiO2 was administered to the SpO2 group [52.5 (50-60)] than the ORi-SpO2 group [40 (35-50), P.001] 1 hour after incision. SpO2 was not different between the 2 groups.The combination of ORi and SpO2 guided FiO2 adjustment reduced hyperoxemia compared to SpO2 alone during laparoscopic gastrectomy.

This experiment was conducted to investigate the effects of exogenous emulsifier supplementation on growth performance, energy digestibility, and meat quality in broilers. A total of 60 Ross 308 broilers were treated for two weeks. The three dietary treatments were: (CON) basal diet; (T1) basal diet + 0.1% exogenous emulsifier, and (T2) basal diet + 0.2% exogenous emulsifier. In Period 1 (0–7 days), broilers in the T2 group showed significantly higher body weight gain (BWG) (p < 0.05) and broilers in the T1 and T2 treatment groups had significantly lower feed conversion ratios (FCR) (p < 0.05). In Period 2 (8–14 days), broilers in the T2 treatment group had significantly higher feed intake (FI) (p < 0.05). Therefore, in this experiment (from days 0 to 19), BWG and FCR were affected (p < 0.05) by the T1 and T2 treatments. Additionally, the T1 and T2 treatments with added exogenous emulsifier in the broiler feed showed significantly higher energy digestibility (p < 0.05) than the CON treatment. Broilers fed the T2 diet had higher water-holding capacity (WHC) (p < 0.05) and cooking loss than the broilers fed the CON and T1 diets. Moreover, the shearing force in the meat was decreased (p < 0.05) in broilers fed the T2 diet. In conclusion, supplementation with exogenous emulsifier to broiler diets improved growth performance, energy digestibility, and meat quality. The optimal amount of exogenous emulsifier supplementation requires further investigation.

The aim of this prospective study was to evaluate the gastric emptying time of a rice-based meal by serial ultrasonography of the stomach. After baseline ultrasonographic assessment of ten fasted healthy volunteers, volunteers ingested standardized 420 g, 536 kcal rice-based meal (bibimbap), and serial evaluations were performed every hour until the stomach became empty. At baseline, all the participants had an empty stomach. The average time of complete gastric emptying of the rice-based meal was 5.8 ± 0.8 h (95% confidence interval (CI), 5.0 h to 6.5 h). Since the first postintake cross-sectional area (CSA) measurement, a decrease was observed, and CSA was maintained until postprandial 3–4 h (P>0.05). It declined rapidly 4 h after meal intake (P=0.031), reaching the nadir at approximately 6 h after meal intake. The gastric CSA and hunger score showed a positive correlation (correlation r = 0.616, P<0). The rice-based meal is emptied after 5.8 ± 0.8 h on average in healthy volunteers. Based on our results, 6.5 h (upper limit of CI) of fasting after the ingestion of a rice-based meal would be a safe preoperative fasting time, and this is in accordance with the current guidelines for preoperative fasting.

The COVID-19 pandemic has affected the entire world, resulting in a tremendous change to people’s lifestyles. We investigated the Korean public response to COVID-19 vaccines on social media from 23 February 2021 to 22 March 2021. We collected tweets related to COVID-19 vaccines using the Korean words for “coronavirus” and “vaccines” as keywords. A topic analysis was performed to interpret and classify the tweets, and a sentiment analysis was conducted to analyze public emotions displayed within the retrieved tweets. Out of a total of 13,414 tweets, 3509 were analyzed after preprocessing. Eight topics were extracted using the Latent Dirichlet Allocation model, and the most frequently tweeted topic was vaccine hesitation, consisting of fear, flu, safety of vaccination, time course, and degree of symptoms. The sentiment analysis revealed a similar ratio of positive and negative tweets immediately before and after the commencement of vaccinations, but negative tweets were prominent after the increase in the number of confirmed COVID-19 cases. The public’s anticipation, disappointment, and fear regarding vaccinations are considered to be reflected in the tweets. However, long-term trend analysis will be needed in the future.

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Many predictive tools have been reported for assessing osteoporosis risk. The development and validation of osteoporosis risk prediction models were supported by machine learning. Osteoporosis is a silent disease until it results in fragility fractures. However, early diagnosis of osteoporosis provides an opportunity to detect and prevent fractures. We aimed to develop machine learning approaches to achieve high predictive ability for osteoporosis risk that could help primary care providers identify which women are at increased risk of osteoporosis and should therefore undergo further testing with bone densitometry. We included all postmenopausal Korean women from the Korea National Health and Nutrition Examination Surveys (KNHANES V-1, V-2) conducted in 2010 and 2011. Machine learning models using methods such as the k-nearest neighbors (KNN), decision tree (DT), random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), artificial neural networks (ANN), and logistic regression (LR) were developed to predict osteoporosis risk. We analyzed the effect of applying the machine learning algorithms to the raw data and featuring the selected data only where the statistically significant variables were included as model inputs. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were used to evaluate performance among the seven models. A total of 1792 patients were included in this study, of which 613 had osteoporosis. The raw data consisted of 19 variables and achieved performances (in terms of AUROCs) of 0.712, 0.684, 0.727, 0.652, 0.724, 0.741, and 0.726 for KNN, DT, RF, GBM, SVM, ANN, and LR with fivefold cross-validation, respectively. The feature selected data consisted of nine variables and achieved performances (in terms of AUROCs) of 0.713, 0.685, 0.734, 0.728, 0.728, 0.743, and 0.727 for KNN, DT, RF, GBM, SVM, ANN, and LR with fivefold cross-validation, respectively. In this study, we developed and compared seven machine learning models to accurately predict osteoporosis risk. The ANN model performed best when compared to the other models, having the highest AUROC value. Applying the ANN model in the clinical environment could help primary care providers stratify osteoporosis patients and improve the prevention, detection, and early treatment of osteoporosis.

Objective This study was performed to compare two different shapes of stylets, 60° and J-shaped stylets, for intubation using the McGrath MAC® video laryngoscope (MVL). Methods Two hundred twenty-two patients undergoing surgery under general anesthesia were randomly allocated to Group J (n = 111) or Group 60° (n = 111) and intubated using the MVL with the stylet bent into the allocated shape. The time to intubation (TTI) and other intubating profiles were compared between the groups. Multivariate regression analysis was used to determine the relationship between factors related to difficult intubation and TTI. Results The TTI was not different between the two groups. There were also no differences in the intubating profiles between the two groups. In both groups, the TTI was longer with a modified Mallampati score (mMS) of ≥3 and percentage of glottic opening (POGO) score of 2. Conclusion The TTI during tracheal intubation with the MVL was not different between the two groups. The TTI was longer with an mMS of ≥3 and POGO score of 2.

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is a commonly performed minimally invasive procedure that has led to lower levels of pain, as well as procedure-related mortality and morbidity. However, VATS requires analgesia that blocks both visceral and somatic nerve fibers for more effective pain control. This randomized controlled trial evaluated the effect of erector spinae plane block (ESPB) in the postoperative analgesia management of patients undergoing VATS. METHODS: We performed a prospective, randomized, single-center study between December 2018 and December 2019. Fifty-four patients were recruited to two equal groups (ESPB and control group). Following exclusion, 46 patients were included in the final analysis. Patients were randomly assigned to receive preoperative ultrasound-guided ESPB with either ropivacaine or saline. The primary outcome was the numeric rating scale (NRS) score, assessed 12 hours postoperatively. Secondary outcomes were the Riker Sedation-Agitation Scale (SAS) score for emergence agitation, postoperative cumulative opioid consumption, length of post-anesthesia care unit (PACU) stay, incidence of postoperative nausea and vomiting (PONV) and dizziness, and ESPB-related adverse events. RESULTS: The NRS in the ESPB group during the postoperative period immediately after PACU admission was significantly lower than that in the control group (5.96±1.68 and 7.59±1.18, respectively; P

Background: The efficacy of dexamethasone plus palonosetron for postoperative nausea and vomiting (PONV) prophylaxis is not firmly established. This randomized, double-blind, controlled study evaluated whether the combination was superior to palonosetron alone in preventing PONV in patients receiving intravenous patient-controlled analgesia (IV-PCA) after upper extremity surgery. Methods: A total of 202 patients undergoing upper extremity surgery were randomly assigned to group P (palonosetron alone) or group PD (palonosetron plus dexamethasone). Group P patients received palonosetron 0.075 mg and normal saline 1.6 mL; group PD patients received palonosetron 0.075 mg and dexamethasone 8 mg. In both groups, palonosetron was added to the IV-PCA opioid infusion, which was continued for 48 h postoperatively. Incidence and severity of nausea, incidence of vomiting, rescue antiemetic requirements, pain intensity, and rescue analgesic requirements were evaluated for 72 h postoperatively. Quality of recovery was assessed using the quality of recovery-15 (QoR-15) questionnaire. Results: The incidence of PONV was significantly lower in group PD than in group P at 0-48 h postoperatively (61.5% vs 77.1%; p = 0.019). Severity of nausea at 0-6 h postoperatively was significantly less in group PD compared with group P (none/mild/moderate/severe: 49/22/15/10 vs. 36/16/25/19, p = 0.008). The incidence of vomiting and rescue antiemetic requirements were similar between groups. Pain intensity was significantly less in group PD than in group P at 0-48 h and 48-72 h postoperatively. Global QoR-15 was similar 24 h postoperatively between groups. Conclusions: Dexamethasone-palonosetron combination therapy reduced PONV incidence and postoperative pain in patients receiving opioid-based analgesia after upper extremity surgery.

Background: Preoperative carbohydrate loading enhances postoperative recovery and reduces patient discomfort. However, gastric emptying of liquids can be delayed in elderly populations. Therefore, this study aimed to evaluate the gastric emptying of 400 mL of a carbohydrate drink ingested 2 hours before surgery in elderly patients. Methods: In this prospective, randomized controlled study, patients aged >65 years were allocated to either fast from midnight (nil per os [NPO] group, n = 29) or drink 400 mL of a carbohydrate drink 2 hours before surgery (carbohydrate group, n = 29). The gastric antrum was assessed using ultrasonography in the supine position, followed by the right lateral decubitus (RLD) position. The gastric antrum was graded as grade 0 (fluid not seen in both positions), grade 1 (fluid only seen in the RLD position), and grade 2 (fluid seen in both positions). The gastric antral cross-sectional area (CSA) and aspirated residual gastric volume were measured. Results: In 58 patients, the incidence of grade 2 stomach was 13.8% in NPO group and 17.2% in carbohydrate group (P = .790). The gastric antral CSA in the supine position was larger in carbohydrate group than in NPO group (4.42 [3.72–5.18] cm2 vs 5.31 [4.35–6.92] cm2, P = .018). The gastric antral CSA in the RLD position was not different in NPO and carbohydrate groups (P = .120). There was no difference in gastric volume (2 [0–7.5] vs 3 [0–13.4], P = .331) in NPO group versus carbohydrate group. Conclusion: The incidence of grade 2 stomach was not different between NPO group and carbohydrate group in elderly patients.

Objective To construct a prediction model for optimal tracheal tube depth in pediatric patients using machine learning. Methods Pediatric patients aged Results For each method, the percentage with optimal tracheal tube depth predictions in the test set was calculated as follows: 79.0 (95% confidence interval [CI], 73.5 to 83.6) for random forest, 77.4 (95% CI, 71.8 to 82.2; P = 0.719) for elastic net, 77.0 (95% CI, 71.4 to 81.8; P = 0.486) for support vector machine, 76.6 (95% CI, 71.0 to 81.5; P = 1.0) for artificial neural network, 66.9 (95% CI, 60.9 to 72.5; P < 0.001) for the age-based formula, 58.5 (95% CI, 52.3 to 64.4; P< 0.001) for the tube ID-based formula, and 44.4 (95% CI, 38.3 to 50.6; P < 0.001) for the height-based formula. Conclusions In this study, the machine learning models predicted the optimal tracheal tube tip location for pediatric patients more accurately than the formula-based methods. Machine learning models using biometric variables may help clinicians make decisions regarding optimal tracheal tube depth in pediatric patients.

Salicornia europaea L. (SE) has been used as folk medicine for the treatment of various diseases such as obesity, diabetes, and cancer. However, its effects on atherosclerotic events in vascular smooth muscle cells (VSMCs) remain unknown. The present study explored the effects of the ethyl acetate fraction of desalted SE hot water extract (SEWEAF) on atherosclerotic responses (especially migration and proliferation) in VSMCs and vascular neointima formation. Treatment with the SEWEAF significantly suppressed the platelet-derived growth factor (PDGF)-BB-induced VSMC migration and proliferation as well the phosphorylation of mitogen-activated protein kinases (MAPKs) such as the p38 MAPK and extracellular signal-regulated kinase (ERK) 1/2. Moreover, oral administration of the SEWEAF resulted in the attenuation of neointima formation in balloon-injured rat carotid arteries. Additionally, HPLC analysis showed that the major components in the two subfractions of the SEWEAF were five phenolic acids and four flavonols. In the SEWEAF components, for which atherosclerosis-linked responses in VSMCs have not been known, p-coumaric acid, quercetin-3-β-d-glucoside, and isorhamnetin-3-β-d-glucoside inhibited both PDGF-BB-induced migration and proliferation and isorhamnetin attenuated only PDGF-BB-stimulated VSMC proliferation. These results suggest that the SEWEAF may suppress PDGF-BB-induced VSMC migration by downregulating the phosphorylation of p38 MAPK and ERK1/2, thus leading to the reduction of neointimal hyperplasia during vascular remodeling. Therefore, the desalted SE extract, SEWEAF may be a potential ingredient for dietary supplements or nutraceuticals to ameliorate and/or prevent vascular remodeling-related disorders.

Background Spinal nerve ligation (SNL) model is one of the representative models of the neuropathic pain model. Neuropathic pain in a chronic post-ischemic pain (CPIP) mimics the symptoms of complex regional pain syndrome (CRPS). The administration of polydeoxyribonucleotide (PDRN), which has regenerative and anti-inflammatory effects, has been studied and is used in clinical practice treating various diseases. However, the analgesic effect of PDRN in a neuropathic pain or CRPS model remains unknown. Methods PDRN (3.3, 10, and 20 mg/kg) was administered into the subcutaneous (SC) layer of the hind paws of SNL and CPIP models. Mechanical anti-allodynic effects were then investigated using the von Frey test. In the immunohistochemical examination, dorsal root ganglia (DRG) and the spinal cord were harvested and examined for the expression of glial fibrillary acidic protein (GFAP) after the 20 mg PDRN injection. Results Mechanical allodynia was significantly alleviated by administration of PDRN in SNL and CPIP mice at all of the time point. As the dose of PDRN increased, the effect was greater. The 20 mg PDRN injection was found to have the most effective anti-allodynic effect. The increased expression of GFAP in DRG and the spinal cord of SNL and CPIP model decreased following the administration of PDRN than vehicle. Conclusion SC administration of PDRN results in the attenuation of allodynia and activation of astrocytes in neuropathic pain or CRPS models. We propose that PDRN can have significant potential advantages in neuropathic pain treatment., Graphical Abstract

The objective of this study was to determine the effect of replacing corn with soy hulls on nutrient digestibility of growing pigs. Three experimental diets were tested using a 3 × 3 Latin square design using three barrows per group (Landrace × Yorkshire × Duroc, average initial body weight of 36.9 ± 4.0 kg) in individual metabolic cages. The dietary treatments were the control (CON) basal diet (corn-soybean meal based diet), whereas in the test diets, soy hulls were included at 5% (H1), 10% (H2), gradually replacing corn. The daily feed allowance was adjusted to 2.7 times the maintenance requirement for digestible energy (DE) (2.7 × 110 kcal of DE/kg BW0.75). Intake of crude fiber (CF) was different among treatments (p < 0.05). Pigs fed with H2 diet excreted higher concentrations of dry matter (DM), and CF than pigs fed with H1 diet and basal diet (p < 0.05). Pigs fed with H1 and H2 diets excreted higher concentrations of crude protein (CP) than pigs fed with CON diet (p < 0.05). The apparent total tract digestibility (ATTD) of CF from H1 and H2 diets were higher than CON diet (p < 0.05). Pigs fed with H2 diets were significantly lower (p < 0.05) the ATTD of CP than the pigs fed with CON and H1 diets. The current data suggest that 10% inclusion soy hulls can slightly decrease CP digestibility. However, soy hulls considerably increased CF digestibility.It is concluded that 5% soy hulls may be a usable alternative to corn in growing pig diets.

Pain after anterior cruciate ligament (ACL) reconstruction is usually intense in the early postoperative period, but the efficacy of a multimodal analgesia approach remains controversial. This study aimed to investigate the analgesic efficacy of pregabalin in multimodal analgesia after ACL reconstruction. Patients who underwent ACL reconstruction under spinal anesthesia and agreed to use intravenous patient-controlled analgesia (IV-PCA) were randomly administered placebo (control group, n = 47) or pregabalin 150 mg (pregabalin group, n = 46) 1 h before surgery and 12 h after initial treatment. Pain by verbal numerical rating scale (VNRS) at rest and with passive flexion of knee was assessed at postoperative 12, 24, and 36 h and 2 weeks. IV-PCA consumption, rescue analgesic use, and side effects were also evaluated. Lower scores of VNRS were obtained with passive flexion of knee in the pregabalin group than in the control group at postoperative 24 (7(4&ndash, 8) vs. 8(6&ndash, 9), p = 0.043) and 36 h (4(3&ndash, 7) vs. 5(4&ndash, 9), p = 0.042), and lower value of VNRS at rest was observed in the pregabalin group [0(0&ndash, 1)] than in the control group [1(0&ndash, 2)] at postoperative 2 weeks (p &lt, 0.001). No differences were obtained for IV-PCA consumption, rescue analgesic use, and side effects except for dizziness for postoperative 12 h. Pregabalin as an adjuvant to multimodal analgesic regimen significantly reduced early postoperative pain in patients undergoing ACL reconstruction.

Emergence delirium (ED) is common in children after sevoflurane anesthesia and should be prevented for patient safety. A prospective, double-blind, randomized, controlled study was performed to compare the efficacy of minimal dosage of midazolam versus dexmedetomidine to prevent ED in children undergoing tonsillectomy. Seventy children aged 24 months to 12 years were allocated to receive midazolam (0.03 mg/kg) or dexmedetomidine (0.3 µg/kg) 5 min before the end of surgery. The incidence and severity of ED were assessed using a four-point scale and the pediatric anesthesia emergence delirium scale, respectively. The emergence time and postoperative pain scores were also evaluated. The incidence of ED was 31.3% in the midazolam group and 26.5% in the dexmedetomidine group (P = 0.668). The severity of ED was similar in both groups (9.6 ± 5.8 in the midazolam group, vs. 8.1 ± 5.9 in the dexmedetomidine group, P = 0.299). The emergence time was comparable in the two groups [11.0 (8.3–13.8) min in midazolam group vs. 12.0 (10.0–13.5) min in dexmedetomidine group (P = 0.218)]. Postoperative pain score was higher in the midazolam group [0 (0–1)] than in the dexmedetomidine group [0 (0–0)] (P = 0.011). Dexmedetomidine and midazolam at single minimum dosages had equal effectiveness to prevent ED in children without delaying emergence time, when administered at the end of surgery. With regards to postoperative analgesic efficacy, although dexmedetomidine showed statistically significant higher analgesic effect than midazolam, further clinical investigations are needed to validate our findings.

Study Objective To determine whether carbohydrate loading improves the postoperative quality of recovery (QoR) better than the midnight fasting policy in laparoscopic gynecologic surgeries. Design Randomized, parallel-group trial. Setting Tertiary university hospital. Patients Female patients scheduled for laparoscopic gynecologic surgery for nonmalignant gynecologic diseases. Interventions Eighty-eight women were randomly assigned to the midnight fasting group (nil per os, NPO group) or the carbohydrate loading group (carbohydrate group). Patients in both groups adhered to the enhanced recovery after surgery protocol except for carbohydrate intake in the carbohydrate group. Measurements and Main Results The postoperative QoR was evaluated using the QoR 15-item questionnaire on postoperative day 2. The times to readiness for discharge of the groups were compared. The QoR 15-item questionnaire scores were 97.7 ± 23.0 in the NPO group and 99.6 ± 22.4 in the carbohydrate group; they were not statistically different (p = .702). The times to readiness for discharge of both groups were also not different: 36.8 ± 12.2 hours in the NPO group and 37.6 ± 11.8 hours in the carbohydrate group (p = .684). Conclusion The benefit of carbohydrate beverage intake was not significant in laparoscopic gynecologic surgeries when following the enhanced recovery after surgery protocol.

Established conventional treatments for postherpetic neuralgia (PHN) and postherpetic itch (PHI) are difficult and often disappointing. In this study, the authors investigated the effect and mechanisms of extracorporeal shockwave therapy (ESWT) on pain and itch associated with PHN and PHI.Thirteen patients, 50 to 80 years of age, with symptoms associated with PHN or PHI (duration of persistent pain >3 months) and complaints of pain or itch rated >4 on a numerical rating scale (NRS), were included. ESWT was administered using a shockwave device (Piezo Shockwave, Richard Wolf GmbH, Knittlingen, Germany) to skin areas affected by pain or itch. An energy flux density of 0.09 to 0.16 mJ/mm at a frequency of 5 Hz and 2000 impulses was administered at 3-day intervals for 6 sessions. The NRS, 5D-Itch Scale, and Patients Global Impression of Change (PGIC) scale were used to evaluate the efficacy of ESWT.NRS scores of pain and itch and 5D-Itch Scale scores decreased significantly compared with before treatment and at the end of the treatment sessions (P < .0001, P = .001, P = .0002, respectively). There was a statistically significant difference between PGIC scores, which were checked every 2 sessions (P < .0001).ESWT is a noninvasive modality that significantly reduced PHN-associated pain and itch.

Background: Adequate shapes for videolaryngoscopes are important for safer, faster, and successful intubation. The aim of this study was to compare two different shapes of stylets, the 60º and J-shape stylets, for intubation with the McGrath MAC®. Methods: In this multicenter, prospective, randomized controlled study, patients undergoing elective surgery under general anesthesia were randomly assigned into the 60º group or the J group. After anesthetic induction, subjects in both groups were intubated with an endotracheal tube bent into a specific shape according to the group allocation. Time to intubation, difficulty of intubation, glottic view grade, use of external manipulation, and number of intubation attempts were recorded. Results: One hundred and eight patients in the J group and 110 patients in the 60º group were enrolled. Time to intubation in the J group [23.1 (20.6-28.0)] was not different from the 60º group [24.8 (20.5-28.3), P = 0.623). There were no differences in difficulty of intubation, glottic view grade, use of external manipulation, and number of intubation attempts between the two groups. Conclusions: Adding extra curvature to the tube to resemble the shape of the blade did not improve the intubation conditions of the McGrath MAC®.

WhereasVHLinactivation is a primary event in clear cell renal cell carcinoma (ccRCC), the precise mechanism(s) of how this interacts with the secondary mutations in tumor suppressor genes, includingPBRM1,KDM5C/JARID1C,SETD2, and/orBAP1, remains unclear. Gene expression analyses reveal that VHL, PBRM1, or KDM5C share a common regulation of interferon response expression signature. Loss of HIF2α, PBRM1, or KDM5C inVHL-/-cells reduces the expression of interferon stimulated gene factor 3 (ISGF3), a transcription factor that regulates the interferon signature. Moreover, loss of SETD2 or BAP1 also reduces the ISGF3 level. Finally, ISGF3 is strongly tumor-suppressive in a xenograft model as its loss significantly enhances tumor growth. Conversely, reactivation of ISGF3 retards tumor growth by PBRM1-deficient ccRCC cells. Thus afterVHLinactivation, HIF induces ISGF3, which is reversed by the loss of secondary tumor suppressors, suggesting that this is a key negative feedback loop in ccRCC.

Polybromo-1 (PBRM1) is an important tumor suppressor in kidney cancer. It contains six tandem bromodomains (BDs), which are specialized structures that recognize acetyl-lysine residues. While BD2 has been found to bind acetylated histone H3 lysine 14 (H3K14ac), it is not known whether other BDs collaborate with BD2 to generate strong binding to H3K14ac, and the importance of H3K14ac recognition for the molecular and tumor suppressor function of PBRM1 is also unknown. We discovered that full-length PBRM1, but not its individual BDs, strongly binds H3K14ac. BDs 2, 4, and 5 were found to collaborate to facilitate strong binding to H3K14ac. Quantitative measurement of the interactions between purified BD proteins and H3K14ac or nonacetylated peptides confirmed the tight and specific association of the former. Interestingly, while the structural integrity of BD4 was found to be required for H3K14ac recognition, the conserved acetyl-lysine binding site of BD4 was not. Furthermore, simultaneous point mutations in BDs 2, 4, and 5 prevented recognition of H3K14ac, altered promoter binding and gene expression, and caused PBRM1 to relocalize to the cytoplasm. In contrast, tumor-derived point mutations in BD2 alone lowered PBRM1's affinity to H3K14ac and also disrupted promoter binding and gene expression without altering cellular localization. Finally, overexpression of PBRM1 variants containing point mutations in BDs 2, 4, and 5 or BD2 alone failed to suppress tumor growth in a xenograft model. Taken together, our study demonstrates that BDs 2, 4, and 5 of PBRM1 collaborate to generate high affinity to H3K14ac and tether PBRM1 to chromatin. Mutations in BD2 alone weaken these interactions, and this is sufficient to abolish its molecular and tumor suppressor functions.

Author(s): Cho, Eun Ah | Abstract: This article examines how North Korean migrants become subjects of their own narratives in South Korean society, with a focus on gender and class divisions as represented on television programs such as Now on My Way to Meet You (Ije mannarŏ gamnida, 2011–present), Moranbong Club (Moranbong k’ŭlŏp, 2015–present), and Unification of Love: Southern Men, Northern Women (Nam-nam-buk-nyŏ, 2014–2017). These shows aim to depict perfectly assimilated migrants who embody the South Korean government’s image of an ideal citizen and thereby introduce an impression of “North Korean-ness” in the absence of input from the North Korea, a closed country. North Korean migrants “become” North Koreans within the programs’ formats, with mixed results. On the one hand, a “double-paned window” perspective, which relies on the North Korean panelists’ testimonies, complicates the programs’ intended narrative of exemplary migrants. On the other hand, North Korean panelists actively fortify the binary gender frame of South Korean society. For example, North Korean male panelists become antagonists when their rough and unsophisticated characteristics appear to confirm South Korean men’s superiority. These South Korean television programs focus on the polar concept of “Southern men and Northern women,” thereby marginalizing North Korean male migrants and South Korean females. Such a stratified gender structure supports South Korean males’ authority and strengthens the heteronormative structure of South Korean society. Keywords: North Korean migrants, South Korean television, Now on My Way to Meet You, Moranbong Club, Southern Men Northern Women, gender, class, South Korean conservatism