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Purpose: University students have been one of the most affected groups worldwide during the COVID-19 pandemic, having experienced increased stress, anxiety, and depression. Resilience is reported as the most predictive factor in decreasing the impact of the threats of the COVID-19 pandemic. However, university students’ resilience during the COVID-19 pandemic has not received much attention; this is a research gap that this study aimed to address. Methods: Seventeen 2nd- and 4th-year South Korean students who had experienced at least one year of university life during the COVID-19 pandemic participated in this study between June and July 2021.This study involved three focus-group interviews that were recorded and transcribed verbatim, and data were analyzed using qualitative content analysis. Results: Eight conceptual categories emerged from the three main themes distilled from participants’ responses: 1) factors impeding resilience: experience of loss, experience of a dangerous situation, expansion of uncertainty, and accumulated stress; 2) strategies to strengthen resilience: change and innovation, loss and confrontation, and transcendence; and 3) outcomes from strengthening resilience: adapting to the changing world (“the new normal”). Conclusion: s: This study found several factors that impede resilience and strategies to further support resilience. Universities and relevant community organizations can use these findings to develop educational programs and interventions to strengthen resilience in university students, helping them to better cope with future challenges and overcome adversity.

We aimed to identify the level of stress, ego-resiliency (ER), and coping strategies of university students during the onset of coronavirus disease 2019 (COVID-19) and examine the mediating role of ER in the relationship between stress and coping strategies (e.g., problem-solving, social support seeking, and avoidance). We analyzed responses from 160 university students and found that problem-solving was the most common coping strategy (26.02 ± 4.65), followed by social support-seeking (25.08 ± 5.23), and avoidance (19.21 ± 3.78). ER was negatively associated with stress and showed a mediating effect on the relationship between stress and social support, and stress and problem-solving coping strategies. These findings indicate that ER helps decrease stress caused by the pandemic among university students and should be considered a significant factor for developing adaptive stress coping strategies.

Sexual and gender minoritized (SGM) adolescents negotiate their outness in various social contexts as they navigate a heteronormative system. For many SGM adolescents, outness is associated with peer victimization, while for others, it is associated with increased feelings of connectedness. To support SGM adolescents in their outness journey, researchers and practitioners often use various tools to measure outness. Specifically, the outness inventory (OI) is the oldest and most widely used outness measure to date. However, while the OI appears to be a vigorous inventory to measure outness among SGM adults, it has never been validated with an SGM adolescent population. This study tests the psychometric defensibility of the OI among an SGM adolescent population. Results provide evidence that a two-structure model of outness to family and world, represents the social contexts in which SGM adolescents negotiate outness.

Background This study investigated depression, problematic alcohol use, and non-suicidal self-injury (NSSI) of university students in Korea during COVID-19 lockdown and evaluated the moderating effect of problematic alcohol use in the relationship between depression and NSSI. Methods In this descriptive cross-sectional study, 234 Korean university students’ data were used to analyze the relationship between depression and NSSI and the moderating effect of problematic alcohol use. To analyze the moderating effect, Hayes PROCESS macro (model 1) was used. Results Of the participants, 69.7% were problematic alcohol drinkers and 58.1% were binge drinkers. Depression and NSSI scores were 13.948 and 0.901, respectively. Of the participants, 33.3% had experienced NSSI for 6 months. Depression was positively associated with NSSI among university students. Furthermore, problematic alcohol use had a conditional moderating effect on the relationship between depression and NSSI. Conclusions Problematic alcohol use had conditional moderating effects on the relationship between depression and NSSI. Additionally, since the COVID-19 pandemic is ongoing, to prevent NSSI, health care professionals in the university should screen students with problematic alcohol use and depressive symptoms.

Researchers and practitioners in the field of second language acquisition have come to realize the importance of non-cognitive skills such as self-efficacy and self-regulation in students' learning of a second language. However, there has been limited systematic research on such measures in the second language context and the validity and reliability of their intended use and interpretation. The Questionnaire of English Self-Efficacy (QESE) was designed to measure English language learners' self-efficacy beliefs. This study applied the Rasch model to evaluate the item-level psychometric properties of QESE and its adequacy for use in the Vietnamese context. The results demonstrated that the QESE items predominantly measured a unidimensional construct (i.e. self-efficacy beliefs in learning English as a second language). The scale was highly reliable, and its rating categories functioned effectively, reflecting varying levels of self-efficacy beliefs. Although the item difficulty hierarchical order was generally consistent with the anticipated hierarchy within the Vietnamese context, there were a few surprising results, contradicting what was previously found with Chinese students. For example, item 28 (writing diaries in English) was a very difficult task for Vietnamese students, but a previous study showed that it was a moderately difficult task for Chinese students. Item 5 (writing blogs on the Internet) was an easy task for Vietnamese students, but it was a difficult task for Chinese students. The findings provide directions for future research and have implications for helping professionals provide best practices that meet the unique educational needs of English language learners.

Recently, acupuncture has demonstrated extraordinary clinical results in the treatment of several categories of health conditions worldwide. The mechanisms of action of acupuncture (including immune mechanisms) have been investigated by biomedical studies over the last few decades. The immune mechanisms of representative clinical conditions and their clinical effects were thoroughly assessed, with a comprehensive investigation into the mechanisms of action of acupuncture (including immune responses) in this study. Conditions such as stroke, migraine, depression, chronic fatigue syndrome, lower back pain, hypertension, irritable bowel syndrome, sepsis, and allergic diseases were meticulously examined. This in-depth analysis aims to ensure a foundational understanding of the immune mechanisms involved in acupuncture, thereby serving as an initial step toward integrating the impact of acupuncture on the immune system.

Background: The aim of this study is to determine the antioxidant and anti-inflammatory effects of Dusokohwaeum (DOE). Methods: To measure the antioxidant and anti-inflammatory effects of DOE, the total flavonoid and polyphenol contents and radical scavenging activity were measured. Furthermore, reactive oxygen species (ROS), nitric oxide, and cytokine production were measured by treating lipopolysaccharide-induced RAW264.7 cells with DOE, and gene expression levels of inducible cyclooxygenase-2, nitric oxide synthase, and cytokines were evaluated. Results: Radical scavenging experiments revealed a significant concentration-dependent increase in scavenging capacity. The production of ROS, nitric oxide, and cytokines in the cells showed a significant concentration-dependent decrease when compared with the control group. The gene expression levels of inducible cyclooxygenase-2, nitric oxide synthase, and cytokines also showed a significant concentration-dependent decrease when compared with the control group. Conclusion: Interestingly, the antioxidant and anti-inflammatory effects of DOE were 23.42 ± 0.64 mg GAE/g and 20.83 ± 0.98 mg QE/g, respectively. The administration of DOE resulted in a concentration-dependent increase in scavenging ability in the 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline- 6-sulfonic acid) (ABTS) radical scavenging ability experiments. The production of intracellular ROS and nitric oxide was significantly reduced in the presence of DOE. The production of inflammatory cytokines (prostaglandin E2, tumor necrosis factor-alpha [TNF-α], interleukin-1 beta [IL-1β], and IL-6) was significantly reduced in the presence of DOE. Finally, the expression levels of inducible nitric oxide synthase, cyclooxygenase-2, TNF-α, IL-1β, and IL-6 were significantly decreased in the presence of DOE.

Cardiovascular disease (CVD) poses a significant health challenge globally, including in Korea, due to its status as a leading cause of death and its impact on cardiopulmonary function. Cardiac rehabilitation (CR) is a well-established program that not only aids in restoring cardiopulmonary function, but also improves physical and social conditions. The benefits of CR are widely recognized, and it is implemented globally. While the effectiveness of CR has been proven in Korea, it is underutilized. This fact sheet summarizes the current status of CR in Korea, including the prevalence of CVD, the clinical practice guidelines for CR programs, and the challenges of implementing CR in Korea.

Purpose: Healthy aging is an important concern in an aging society. Although the causal relationship between hypogonadism and erectile dysfunction in elderly men remains unclear, many physicians have achieved positive results after implementing exogenous testosterone supplementation therapy in patients with normal or slightly low blood testosterone. The purpose of this study was to conduct a systematic review and meta-analysis on whether testosterone replacement therapy (TRT) could improve sexual function in the elderly, as reported recently. Materials and Methods: As a comprehensive literature search was performed to find articles published in PubMed, Embase, and Cochrane databases by January 2022. The search used keywords of ‘aged’, ‘male’, ‘sexual behavior’, and ‘testosterone’. Randomized controlled trials (RCTs) were finally selected. As the main effect variable, results of a questionnaire on sexual function were analyzed and the effects of TRT were compared to those of placebo control. Results: Five RCT studies were included in this meta-analysis. The overall improvement by mean difference of sexual function for testosterone supplementation was 0.082 (95% CI: -0.049 to 0.213). In subgroup analysis, only intramuscular injection of 1,000 mg testosterone significantly improved sexual function of the elderly (0.229, 95% CI: 0.112 to 0.347). There was no significant difference in sexual function according to testosterone dose in meta-ANOVA (p=0.957). The difference was not statistically significant either in the meta-regression test (p=0.310). Egger’s regression coefficient test did not indicate a publication bias (p=0.132). Conclusions: Although our overall effect size (that is, sexual function effect of TRT) did not show a significant improvement, the direction of improvement in erection and motivation was clearly shown. The injection formulation resulted in a significant sexual function improvement. Since only a few RCTs were included in the analysis, more well-designed prospective studies are needed to have a definite conclusion.

This study addresses the propagation challenges faced by ‘Shine Muscat’, a newly introduced premium grapevine cultivar in South Korea, where multiple viral infections pose considerable economic loss. The primary objective was to establish a robust in vitro propagation method for producing disease-free grapes and to identify effective plant growth regulators to facilitate large-scale mass cultivation. After experimentation, 2.0 µM 6-benzyladenine (BA) exhibited superior shoot formation in the Murashige and Skoog medium compared with kinetin and thidiazuron. Conversely, α-naphthaleneacetic acid (NAA) hindered shoot growth and induced callus formation, while indole-3-butyric acid (IBA) and indole-3-acetic acid (IAA) demonstrated favorable root formation, with IBA showing better results overall. Furthermore, inter simple sequence repeat analysis confirmed the genetic stability of in vitro-cultivated seedlings using 2.0 μM BA and 1.0 μM IBA, validating the suitability of the developed propagation method for generating disease-free ‘Shine Muscat’ grapes. These findings offer promising prospects for commercial grape cultivation, ensuring a consistent supply of healthy grapes in the market.

Abstract Background Radiofrequency ablation (RFA) is one of the treatment options for lung nodules. However, the need for exact delivery of the rigid metal electrode into the center of the target mass often leads to complications or suboptimal results. To overcome these limitations, a concept of conforming electrodes using a flexible material has been tested in this study. Methods A bronchoscopy-guided RFA (CAROL) under a temperature-controlled mode was tested in in-vivo and ex-vivo porcine lungs. Gallium-based liquid metal was used for turning the bronchial tree into temporary RF electrodes. A customized bronchoscopy-guided balloon-tipped guiding catheter (CAROL catheter) was used to make the procedure feasible under fluoroscopy imaging guidance. The computer simulation was also performed to gain further insight into the ablation results. Safety was also assessed including the liquid metal remaining in the body. Results The bronchial electrode injected from the CAROL catheter was able to turn the target site bronchial air pipe into a temporally multi-tined RF electrode. The mean volume of Gallium for each effective CAROL was 0.46 ± 0.47 ml. The ablation results showed highly efficacious and consistent results, especially in the peripheral lung. Most bronchial electrodes were also retrieved by either bronchoscopic suction immediately after the procedure or by natural expectoration thereafter. The liquid metal used in these experiments did not have any significant safety issues. Computer simulation also supports these results. Conclusion The CAROL ablation was very effective and safe in porcine lungs showing encouraging potential to overcome the conventional approaches.

This study aimed to evaluate the clinical efficacy and safety of acupuncture and electroacupuncture for temporomandibular joint disorder (TMD). We searched 11 databases to find randomized-controlled trials (RCTs) published between January 2018 and January 2023 that used acupuncture and electroacupuncture to treat patients with TMD. We performed a meta-analysis of 18 RCTs involving 1,109 patients. Nine studies reported that the treatment and control groups showed improvement in the evaluation index post-treatment. The results of the meta-analysis showed that the treatment groups receiving acupuncture combined with manual therapy had significantly improved visual analog scale score and dysfunction index than the control groups receiving manual therapy. Moreover, the treatment groups receiving acupuncture combined with Western medicine had statistically improved maximum mouth opening than the control groups using Western medicine. In conclusion, acupuncture and electroacupuncture have clinical effects on TMD patients. Given that 11 studies were obtained from the Chinese database, a regional bias would be considered. Furthermore, the included studies had high a risk of bias in terms of randomization, concealment, and blinding. Further studies are required to correct these limitations.

Abstract Prediction of bacteremia is a clinically important but challenging task. An artificial intelligence (AI) model has the potential to facilitate early bacteremia prediction, aiding emergency department (ED) physicians in making timely decisions and reducing unnecessary medical costs. In this study, we developed and externally validated a Bayesian neural network-based AI bacteremia prediction model (AI-BPM). We also evaluated its impact on physician predictive performance considering both AI and physician uncertainties using historical patient data. A retrospective cohort of 15,362 adult patients with blood cultures performed in the ED was used to develop the AI-BPM. The AI-BPM used structured and unstructured text data acquired during the early stage of ED visit, and provided both the point estimate and 95% confidence interval (CI) of its predictions. High AI-BPM uncertainty was defined as when the predetermined bacteremia risk threshold (5%) was included in the 95% CI of the AI-BPM prediction, and low AI-BPM uncertainty was when it was not included. In the temporal validation dataset (N = 8,188), the AI-BPM achieved area under the receiver operating characteristic curve (AUC) of 0.754 (95% CI 0.737–0.771), sensitivity of 0.917 (95% CI 0.897–0.934), and specificity of 0.340 (95% CI 0.330–0.351). In the external validation dataset (N = 7,029), the AI-BPM’s AUC was 0.738 (95% CI 0.722–0.755), sensitivity was 0.927 (95% CI 0.909–0.942), and specificity was 0.319 (95% CI 0.307–0.330). The AUC of the post-AI physicians predictions (0.703, 95% CI 0.654–0.753) was significantly improved compared with that of the pre-AI predictions (0.639, 95% CI 0.585–0.693; p-value

Background/purpose: Human dental pulp stem cells (hDPSCs) are an emerging source of mesenchymal stem cells (MSCs) for bone tissue regeneration and engineering. In bone regeneration using transplanted MSCs, the extracellular environment or co-injected drugs can affect their success or failure. In this study, we investigated the effects and signaling mechanisms of lidocaine on osteogenic differentiation of hDPSCs after inducing inflammatory conditions with lipopolysaccharide (LPS) and tumor necrosis factor-alpha (TNF-α). Materials and methods: To investigate the effect of lidocaine on the osteogenic differentiation of LPS/TNF-α-treated hDPSCs, alkaline phosphatase (ALP) and Alizarin red S (ARS) staining were conducted. The expression of osteogenesis-related genes was assessed using quantitative real-time polymerase chain reaction and western blotting. The expression of mitogen-activated protein kinases was analyzed to evaluate the effect of lidocaine on osteogenic differentiation of LPS/TNF-α-treated hDPSCs. Results: Various concentrations of lidocaine (0.05, 0.2, and 1 mM) further decreased ALP and ARS staining of LPS/TNF-α-treated hDPSCs. Similarly, the mRNA and protein expression of osteogenesis-related genes was suppressed via lidocaine treatment in LPS/TNF-α-treated hDPSCs. Lidocaine treatment downregulated the protein expression of p-ERK and p-JNK in LPS/TNF-α-treated hDPSCs. Conclusion: Lidocaine intensified the inhibition of osteogenic differentiation on inflammation-induced hDPSCs by inhibiting the ERK and JNK signaling pathways. This in vitro study suggested that lidocaine may have an inhibitory effect on bone regeneration.

Abstract Lung adenocarcinoma is the most common type of lung cancer. Known risk variants explain only a small fraction of lung adenocarcinoma heritability. Here, we conducted a two-stage genome-wide association study of lung adenocarcinoma of East Asian ancestry (21,658 cases and 150,676 controls; 54.5% never-smokers) and identified 12 novel susceptibility variants, bringing the total number to 28 at 25 independent loci. Transcriptome-wide association analyses together with colocalization studies using a Taiwanese lung expression quantitative trait loci dataset (n = 115) identified novel candidate genes, including FADS1 at 11q12 and ELF5 at 11p13. In a multi-ancestry meta-analysis of East Asian and European studies, four loci were identified at 2p11, 4q32, 16q23, and 18q12. At the same time, most of our findings in East Asian populations showed no evidence of association in European populations. In our studies drawn from East Asian populations, a polygenic risk score based on the 25 loci had a stronger association in never-smokers vs. individuals with a history of smoking (Pinteraction = 0.0058). These findings provide new insights into the etiology of lung adenocarcinoma in individuals from East Asian populations, which could be important in developing translational applications.

Abstract The factors affecting the outcomes of segmental femoral shaft fractures are currently unknown. We evaluated the outcomes of intramedullary (IM) nail fixation and investigated factors affecting nonunion of femoral shaft segmental fractures. A total of 38 patients who underwent IM nail fixation for femoral shaft segmental fractures (AO/OTA 32C2) at three university hospitals with a minimum 1-year follow-up period were retrospectively reviewed. The patients were divided into union (n = 32) and nonunion (n = 6) groups. We analyzed smoking status, diabetes mellitus, location of the segmental fragment, segment comminution, filling of the IM nail in the medullary canal, residual gap at the fracture site, use of a cerclage wire or blocking screws as factors that may affect the surgical outcome. In the union group, the average union time was 5.4 months (4–9 months). In the nonunion group, five patients required additional surgery within an average of 7.2 months (5–10 months) postoperatively, whereas one patient remained asymptomatic and did not require further intervention. On comparing the two groups, insufficient canal filling of the IM nail (union, 25.0%; nonunion, 83.3%; p = 0.012) and the presence of a residual gap at the fracture site after reduction (union, 31.3%; nonunion, 83.3%; p = 0.027) were significantly different. In the multivariate analysis, only insufficient canal filling of the IM nail was found to be a factor affecting nonunion, with an odds ratio of 13.3 (p = 0.036). In this study, a relatively high nonunion rate (15.8%) was observed after IM nail fixation. Insufficient IM nail canal filling and a residual gap at the fracture site post reduction were factors affecting segmental femoral shaft fracture nonunion after IM nail fixation.

Abstract Background In this randomized phase II study, we evaluated the efficacy and safety of sorafenib in combination with capecitabine and cisplatin (XP) as first‐line chemotherapy in advanced gastric cancer. Patients and Methods Patients with metastatic gastric or gastroesophageal junction adenocarcinoma were randomized (1:1) to receive either sorafenib plus XP (S + XP) or XP alone. In cases of disease progression in the XP arm, crossover to sorafenib alone was allowed. The primary endpoint was progression‐free survival (PFS). The secondary endpoints included overall survival (OS), response rates, safety profiles, and biomarkers, and the response rates and PFS with secondline sorafenib alone after progression in the XP arm. Results Between Jan 2011 and Feb 2013, a total of 195 patients were accrued (97 in the S + XP arm and 98 in the XP alone arm). The overall response rate was 54% with S + XP, and 52% with XP alone (p = 0.83). With a median follow‐up of 12.6 months (range, 0.1–29.2), the median PFS assessed by independent review was 5.6 months in the S + XP arm and 5.3 months in the XP arm (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.67–1.27, p = 0.61). Overall survival was not different between the two arms (median 11.7 vs. 10.8 months; HR 0.93, 95% CI 0.65–1.31, p = 0.66). Frequencies of grade 3/4 toxicities were similar between the S + XP and XP alone arms, except for neutropenia (21% vs. 37%), anorexia (0% vs. 5%), and hand‐foot skin reaction (7% vs. 1%). Among 51 patients who crossed over to sorafenib alone after disease progression in the XP arm, there was no objective response and their median PFS was 1.3 months (95% CI, 1.2–1.7). Conclusion The addition of sorafenib to XP chemotherapy was safe but not more effective than XP alone for first‐line treatment of metastatic gastric cancer.

Abstract Microplastics (MPs) are now a global issue due to increased plastic production and use. Recently, various studies have been performed in response to the human health risk assessment. However, these studies have focused on spherical MPs, which have smooth edges and a spherical shape and account for less than 1% of MPs in nature. Unfortunately, studies on fragment-type MPs are very limited and remain in the initial stages. In this study, we studied the effect that 16.4 µm fragment type polypropylene (PP) MPs, which have an irregular shape and sharp edges and form naturally in the environment, had on breast cancer. The detrimental effects of PPMPs on breast cancer metastasis were examined. Here, 1.6 mg/ml of PPMP, which does not induce cytotoxicity in MDA-MB-231, was used, and at this concentration, PPMP did not induce morphological changes or cellular migrating in the MDA-MB-231 and MCF-7 cells. However, PPMP incubation for 24 hours in the MDA-MB-231 cells significantly altered the level of cell cycle-related transcripts in an RNA-seq analysis. When confirmed by qRT-PCR, the gene expression of TMBIM6, AP2M1, and PTP4A2 was increased, while the transcript level of FTH1 was decreased. Further, secretion of the pro-inflammatory cytokine IL-6 from cancer cells was elevated with the incubation of PPMP for 12 hours. These results suggest that PPMP enhances metastasis-related gene expression and cytokines in breast cancer cells, exacerbating breast cancer metastasis.

Abstract Background Remimazolam is a recently approved, ultra-short-acting benzodiazepine. However, few studies have investigated remimazolam in relation to postoperative nausea and vomiting (PONV). This study aimed to compare the effects of remimazolam and propofol on PONV in patients undergoing oral and maxillofacial surgery. Methods Patients (n = 206) aged 19–65 years who were scheduled for oral and maxillofacial surgery were randomized into two groups, the remimazolam (R) and propofol group (P). In the R group (n = 94), remimazolam was used to induce anesthesia at 12 mg/kg/h and to maintain anesthesia at 1–2 mg/kg/h. In the P group (n = 95), anesthesia was induced and maintained with propofol (target effect-site concentration: 3–5 µg/ml). In both groups, remifentanil was administered at a target effect-site concentration of 2.5-4 ng/ml. The primary outcome was the overall incidence of PONV during the first 24 h after surgery. Secondary outcomes included the severity of nausea, use of rescue antiemetics, severity of postoperative pain, use of rescue analgesia, and quality of recovery. Results The incidence of PONV during the first 24 h after surgery was 11.7% and 10.5% in the R group and P group, respectively, and there was no significant difference in the severity of nausea (P > 0.05). Ten patients in the R group and ten patients in the P group required rescue antiemetics during the first 24 h after surgery (P = 0.98). No inter-group differences were observed in terms of postoperative pain score, use of rescue analgesia, and quality of recovery (P > 0.05). Conclusions In this study, remimazolam did not increase the incidence and severity of PONV compared with propofol. Trial registration KCT0006965, Clinical Research Information Service (CRIS), Republic of Korea. Registration date: 26/01/2022.

Abstract Background Evidence and guidelines for Non-vitamin K antagonist oral anticoagulants (NOACs) use when prescribing concurrent rifampin for tuberculosis treatment in patients with non-valvular atrial fibrillation (NVAF) are limited. Methods Using the Korean National Health Insurance Service database from January 2009 to December 2018, we performed a population-based retrospective cohort study to assess the net adverse clinical events (NACE), a composite of ischemic stroke or systemic embolism and major bleeding, of NOACs compared with warfarin among NVAF patients taking concurrent rifampin administration for tuberculosis treatment. After a propensity matching score (PSM) analysis, Cox proportional hazards regression was performed in matched cohorts to investigate the clinical outcomes. Results Of the 735 consecutive patients selected, 465 (63.3%) received warfarin and 270 (36.7%) received NOACs. Among 254 pairs of patients after PSM, the crude incidence rate of NACE was 25.6 in NOAC group and 32.8 per 100 person-years in warfarin group. There was no significant difference between NOAC and warfarin use in NACE (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.48–1.14; P = 0.172). Major bleeding was the main driver of NACE, and NOAC use was associated with a statistically significantly lower risk of major bleeding than that with warfarin use (HR, 0.63; 95% CI, 0.40–1.00; P = 0.0499). Conclusions In our population-based study, there was no statically significant difference in the occurrence of NACE between NOAC and warfarin use. NOAC use may be associated with a lower risk of major bleeding than that with warfarin use.

The traditional instantaneous unit hydrograph (IUH) is very useful for theoretical analysis and practical forecasting of floods owing to its linear assumptions. Although various revised methods to overcome the unphysical assumptions have been proposed, it is still difficult to obtain efficiently a nonlinear IUH of diverse rainfall excess intensities in a watershed. In this study, we proposed practical and physical interpolation techniques to derive new IUHs from at least two existing IUHs corresponding to diverse rainfall excess intensities in a watershed. To interpolate the new IUHs, mass conservation law and power–law relationships between rainfall excess intensities and the peak flow and time to peak of IUHs were used. By employing convolution integration, surface rainfall–runoff hydrographs for timely varying rainfall events were derived. For verification, we applied the proposed technique to three real watersheds with different sizes ranging from 0.036 to 1,047 km2. All flood prediction procedures were completed instantly, stably and the prediction results showed the accuracy of Nash–Sutcliffe efficiency (NSE) = 0.55–0.93 and coefficient of determination (R2) = 0.72–0.94. HIGHLIGHTS A new instantaneous, physical, and stable rainfall–runoff prediction technique based on IUH is proposed.; A power–law relationship between peak flow and time to peak of IUH and rainfall excess intensity is employed.;

Abstract Background Cathepsin B, a cysteine protease, is considered a potential biomarker for early diagnosis of cancer and inflammatory bowel diseases. Therefore, more feasible and effective diagnostic method may be beneficial for monitoring of cancer or related diseases. Results A phage-display library was biopanned against biotinylated cathepsin B to identify a high-affinity peptide with the sequence WDMWPSMDWKAE. The identified peptide-displaying phage clones and phage-free synthetic peptides were characterized using enzyme-linked immunosorbent assays (ELISAs) and electrochemical analyses (impedance spectroscopy, cyclic voltammetry, and square wave voltammetry). Feasibilities of phage-on-a-sensor, peptide-on-a-sensor, and peptide-on-a-AuNPs/MXene sensor were evaluated. The limit of detection and binding affinity values of the peptide-on-a-AuNPs/MXene sensor interface were two to four times lower than those of the two other sensors, indicating that the peptide-on-a-AuNPs/MXene sensor is more specific for cathepsin B (good recovery (86–102%) and %RSD (

Abstract Background Although various coronavirus disease 2019 (COVID‐19) vaccines have been delivered to the public worldwide, data on cancer populations are limited. Vaccine hesitancy related to safety concerns is observed among cancer patients. We report the perception of COVID‐19 vaccines and their safety profile after vaccination among cancer patients. Materials and Methods Between April and November 2021, a multicenter survey was conducted on 318 patients treated in any hemato‐oncology outpatient clinic among three hospitals under the Korea University Medical Center. The medical records of the patients were reviewed to obtain detailed clinical and hematological toxicity data. Results A perception survey was conducted among 293 patients. Among them, 53.9% were concerned about developing vaccine‐related adverse events (VRAEs) and 23.5%, about negative effects on cancer treatment. During the study period, 255 and 186 patients participated in a safety survey after the first and second doses, respectively. After the first dose, 62% of patients reported VRAEs (2.4%, grade 3), whereas 48.9% reported VRAEs (2.7%, grade 3) after the second dose. For both doses, injection‐site pain and sore arm pain were the most common VRAEs, followed by myalgia, fatigue, and headache. No grade 4/5 VRAEs were observed, and there were no differences in complete blood count after vaccination. Multivariate analysis revealed female sex, active cancer treatment, and mRNA vaccines as independent risk factors for VRAE development in cancer patients. Conclusion Despite high levels of concern, COVID‐19 vaccines were well tolerated by cancer patients, with a safety profile consistent with that of the general population.

Background Human coronaviruses (HCoV) cause mild upper respiratory infections; however, in 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged, causing an acute respiratory disease pandemic. Coronaviruses exhibit marked epidemiological and clinical differences. Purpose This study compared the clinical, laboratory, and radiographic findings of children infected with SARS-CoV-2 versus HCoV. Methods SARS-CoV-2 data were obtained from the Korea Disease Control and Prevention Agency (KDCA) registry and 4 dedicated coronavirus disease 2019 (COVID-19) hospitals. Medical records of children admitted with a single HCoV infection from January 2015 to March 2020 were collected from 10 secondary/tertiary hospitals. Clinical data included age, sex, underlying disease, symptoms, test results, imaging findings, treatment, and length of hospital stay. Results We compared the clinical characteristics of children infected with HCoV (n=475) to those of children infected with SARS-CoV-2 (272 from KDCA, 218 from COVID-19 hospitals). HCoV patients were younger than KDCA patients (older than 9 years:3.6% vs. 75.7%; P

BLT2 is a low-affinity leukotriene B4 receptor that plays an essential role in the pathogenesis of various inflammatory diseases, including asthma and cancer. BLT2 is minimally expressed in a normal internal environment but is overexpressed in a stress-induced inflammatory environment. Recent research indicated that human BLT2 has two distinct forms. Although their functions are likely to be different, very few studies investigated these differences. Therefore, this paper will discuss about the two distinct forms of human BLT2; the short-form of BLT2 and the long-form of BLT2.

IntroductionLate diagnosis of hydroxychloroquine retinopathy remains a major concern, with the potential for irreversible visual impairment. This study aimed to investigate the causes of late diagnosis in a hospital-based cohort of Korean patients with hydroxychloroquine retinopathy and assess the trend of late diagnosis from 2015 to 2022.MethodsThirty-eight patients with a late diagnosis (severe stage at diagnosis) among 94 patients with hydroxychloroquine retinopathy were included in the analysis. The causes of late diagnosis were categorized as referral-related, patient-related, and screening-related factors.ResultsThe most prevalent cause was no or late referral to ophthalmologists, contributing to a significant gap in timely identification. Patient-related causes included delayed monitoring visits despite scheduled appointments and early-onset disease. Screening-related causes encompassed an insufficient number of sensitive tests, leading to inadequate evidence for diagnosis, and missed or wrong diagnoses by screening physicians. The proportion of late diagnoses decreased over time, indicating improvements in overall screening and detection. The decreasing proportions of screening-related causes suggest advancements in screening practices and the use of multiple sensitive tests for screening.DiscussionEfforts to further reduce late diagnoses and improve screening and diagnostic processes are necessary. Our data emphasize the importance of timely referral to ophthalmologists for early detection and management.

This paper presents a deep neural network (DNN)-based slip ratio estimator fused with an invariant extended Kalman filter (IEKF) for lugged-wheel robot localization using an inertial sensor and an encoder. Among various sensors used in wheeled mobile robot (WMR) localization, inertial sensors and encoders are most commonly used because these sensors are inexpensive and have low computational requirements. However, inertial sensors and encoders can cause large drifts in localization due to inherent sensor characteristics and wheel slippage, respectively. Most studies on wheel slippage have primarily focused on rubber tires, and using this slip ratio model for WMRs with lugged-wheels operating in outdoor environments can result in significant estimation errors in slip ratios. This paper develops a DNN-based slip ratio estimator and IEKF for WMR localization that is robust to wheel slippage even in rugged outdoor environments. The performance of the proposed localization is demonstrated through experiments using outdoor datasets where WMRs with lugged-wheels experience various slip conditions. Experiments are conducted in wet and dry conditions on a sloped grass field. Results show that the proposed localization method reduces accumulated localization errors by 53.5% compared to integration-based localization and by 13.5% compared to IEKF-based localization.

Pyocele in infants is rarely described in the literature, but it is an emergent condition that requires rapid recognition and treatment to prevent testicular loss. If peritonitis due to gastrointestinal perforation occurs, abdominal contamination may spread through a patent processus vaginalis in an infant, which may lead to pyocele. We report the cases of three infants with scrotal pyocele due to the spread of infection or inflammatory material from the intraperitoneal cavity through a patent processus vaginalis. Two infants were surgically treated, while the other was treated with percutaneous aspiration and intravenous antibiotic administration. Although rare, pyocele should be considered in the differential diagnosis of acute scrotum in infants, especially in infants who previously had peritonitis due to gastrointestinal perforation.

Abstract This study investigated the efficiency of CO2 curing in blast-furnace slag pastes activated with three concentrations of KOH solution (3, 4, and 5 M). The CO2 curing was applied into the alkali-activated slag paste for 3 days. The CO2-cured pastes were subjected to subsequent curing in a water bath or exposed to seawater. The mechanical properties and characteristics of the reaction products were compared. Full strength can be obtained within 3 days of the early CO2 curing. The strength remained almost constant regardless of the activator concentration. The CO2-cured samples produced more CaCO3 after exposure to the seawater. The carbonates filled the micropores of the samples, and no strength reduction was observed. The hydrates Ca(OH)2 and C–S–H(I) are carbonated, forming calcite and amorphous CaCO3 during the subsequent curing and exposure to seawater as well as the CO2 curing. A less dense matrix with a lower activator concentration facilitated the diffusion of CO2 and promoted early carbonation in the paste. The polymerization of C–S–H(I) was relatively slow with low activity, and within the period of CO2 curing, more carbonates were produced in the sample prepared at a low activator concentration.

Abstract Endophytes can facilitate the improvement of plant growth and health in agriculturally important crops, yet their genomes and secondary metabolites remain largely unexplored. We previously isolated Saccharibacillus brassicae strain ATSA2T from surface-sterilized seeds of kimchi cabbage and represented a novel species of the genus Saccharibacillus. In this study, we evaluated the plant growth-promoting (PGP) effect of strain ATSA2T in kimchi cabbage, bok choy, and pepper plants grown in soils. We found a significant effect on the shoot and root biomass, and chlorophyll contents following strain ATSA2T treatment. Strain ATSA2T displayed PGP traits such as indole acetic acid (IAA, 62.9 μg/mL) and siderophore production, and phosphate solubilization activity. Furthermore, genome analysis of this strain suggested the presence of gene clusters involved in iron acquisition (fhuABD, afuABC, fbpABC, and fepCDG) and phosphate solubilization (pstABCHS, phoABHLU, and phnCDEP) and other phytohormone biosynthesis genes, including indole-3-acetic acid (trpABCDEFG), in the genome. Interestingly, the secondary metabolites cerecidin, carotenoid, siderophore (staphylobactin), and bacillaene underlying plant growth promotion were found in the whole genome via antiSMASH analysis. Overall, physiological testing and genome analysis data provide comprehensive insights into plant growth-promoting mechanisms, suggesting the relevance of strain ATSA2T in agricultural biotechnology.

Objective This study aimed to evaluate the association between prehospital recognition of acute myocardial infarction (AMI) and length of stay (LOS) in the emergency department (ED) of emergency medical service (EMS)-transported AMI patients. Methods A multicenter retrospective observational study was conducted using prehospital and hospital data from three tertiary emergency departments. Patients diagnosed with AMI between January 2015 and December 2018 were enrolled. Study groups were categorized according to prehospital recognition and prehospital 12-lead electrocardiography (ECG) into three groups based on an EMS cardiovascular registry: group A, no prehospital recognition (reference group); group B, prehospital recognition without 12-lead ECG; and group C, prehospital recognition with 12-lead ECG. The primary outcome was an ED LOS of less than 4 hours. Results Among 1,237 study participants, 722 (58.4%) were in group A, 325 (26.3%) were in group B, and 190 (15.4%) were in group C. Multivariable logistic regression showed that groups B and C had a higher likelihood of a short ED LOS (adjusted odds ratio [95% confidence interval]: group B, 1.64 [1.21–2.22] and group C, 1.88 [1.30–2.71]) than group A. There was no significant difference in ED LOS according to whether prehospital 12-lead ECG was conducted. Conclusion Prehospital recognition of AMI by EMS personnel, with or without 12-lead ECG, was associated with a short ED LOS.

Objective This study aimed to evaluate the association between the number and level of emergency medical technicians (EMTs) in the first-contact emergency medical services (EMS) unit and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) with a dual dispatch response. Methods Adult nontraumatic EMS-treated OHCAs between 2015 and 2018 in a nationwide database, were enrolled. The main exposure was the number and certification level of first-contact EMS crew: three versus two members, proportion of EMT intermediate level (EMT-I) over 50% versus under or equal to 50%. Good neurologic recovery was selected as the primary outcome. Multilevel multivariable logistic regression analysis was conducted to calculate adjusted odds ratios and confidence intervals. Results A total of 26,867 patients were enrolled and analyzed. Good neurologic recovery was different across the study groups: 5.4% in the two-member crews, 7.2% in the three-member crews, 5.9% in the low EMT-I proportion crews, and 6.8% in the high EMT-I proportion crews. In the main analysis, statistically significant differences for favorable outcomes were found between the three-member and two-member crews, and the high EMT-I proportion and low EMT-I proportion crews; for good neurologic recovery, adjusted odds ratios (95% confidence interval) were 1.23 (1.06–1.43) for three-member crews, and 1.28 (1.17–1.40) for a high EMT-I proportion. Conclusion The higher number and level of first-contact EMS crew was associated with better neurologic recovery in adult nontraumatic OHCA with a dual-dispatched EMS response.

Much research has shown Bee venom to be an effective neuroprotective agent. However, the usual transdermal injection of bee venom poses many pharmacokinetic disadvantages. Here, we compared the administration of bee venom via subcutaneous injection (SC) and via Microneedle patch (MN). Both administrated routes produce significant recovery effects, however: the MN significantly prolongs the bio-significant-and-yet-lower concentration of bee venom in mice bodies. In contrast, SC could produce only a short period of much higher bee venom levels in the blood and brain. We also see that due to the concentration-response-curve of bee venom (represented by melittin): mice bodies do not require much higher bee venom concentration (seen in the SC group) to produce a much more significant neuroprotective effect (than seen in those treated with the MN method). Therefore, a MN could maintain bee venom levels in mice bodies at lower-yet-more-efficient concentrations. This is important, as bee venom can cause more adverse effects and pain sensations, at higher concentrations. For the first time, we confirmed that the pharmacokinetic advantages of MN delivered bee venom also guarantee a holistic neuroprotection effect (which was shown by SC delivered bee venom in previous research). This was proven via the results of the water maze experiments for long-term learning memory assessment and protein analysis of key neuronal regulatory proteins: BDNF, p-CREB, iNOS, and mArhR 1. In conclusion, for situations where we ought to administrate drugs at a more downward amount, such as bee venom, MN can keep the therapeutic concentrations at a lower, yet interestingly, more-efficient level.

Background This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis. Methods There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara’s unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis. Results On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1–3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted. Conclusion We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2–5 weeks after onset.

Objective Unilateral biportal endoscopic (UBE) discectomy and tubular microdiscectomy (TMD) are widely practiced methods for treatment of lumbar disc herniation. Good clinical outcomes of these methods are reported in many papers, but there are a few comparative studies. This study reports the clinical outcomes of UBE and TMD as minimally invasive surgery methods for lumbar disc herniations and discusses the effectiveness of UBE. Methods Sixty-seven patients who had undergone single-level discectomy using one of two methods, UBE or TMD, underwent a prospective follow-up examination. Thirty-four of these patients underwent discectomy using UBE, and the remaining 33 patients underwent TMD. In addition to the traditional measures of outcome, the improvement of generic health-related quality of life and disease-specific measurements like Visual Analogue Scale (VAS) score, Short-form 36 (SF-36), and Oswestry Disability Index (ODI) were evaluated and compared. Results Sixty-seven patients with more than 6 months of post-operative follow-up evaluations were included. The mean improvements in the VAS scores for back pain and leg pain and ODI were 2.0, 3.7, and 26.5 for the UBE group and 1.6, 3.0, and 19.4 for the TMD group. The SF-36 physical health component subscale score improved from 35.4 pre-operatively to 54.8 at the last follow-up in the UBE group, and the mental health score improved from 43.5 to 55.1 (TMD group: from 34.9 to 54.3 and 44.2 to 57.1, respectively). Conclusion The clinical outcomes of the UBE group are comparable to those of the TMD group. The results indicate that UBE for lumbar disc herniation can be performed safely and effectively as a treatment modality.

Background/purpose: Various studies have used stem cells in the field of bone tissue engineering to repair bone defects. Dental pulp stem cells (DPSCs) have multipotent properties and can be acquired in a noninvasive manner; therefore, they are frequently used in experiments in regenerative medicine. The objective of this study was to investigate the odontogenic/osteogenic differentiation of human DPSCs (hDPSCs) using propofol, a widely used intravenous anesthetic agent. Materials and methods: Alkaline phosphatase (ALP) staining was used to investigate the effects of various concentrations of propofol (5, 20, 50 and 100 μM) on the osteogenic differentiation of hDPSCs. Real-time qPCR and Western blot analysis were used to detect the effect of propofol on the expression of odontogenic/osteogenic genes, such as DMP1, RUNX2, OCN, and BMP2. Odontogenic/osteogenic differentiation of hDPSCs was estimated at days 7 and 14. Results: ALP staining of hDPSCs was significantly decreased by propofol treatment. The mRNA expression of DMP1, RUNX2, OCN, and BMP2 decreased after propofol treatment for 14 days. The protein expression of DMP1 and BMP2 was decreased by propofol at days 7 and 14, and that of RUNX2 was decreased by propofol at day 14 only. Conclusion: Propofol attenuated odontogenic/osteogenic differentiation of hDPSCs in vitro. This result suggests that propofol, which is widely used for dental sedation, may inhibit the odontogenic/osteogenic differentiation of hDPSCs.

Abstract This study investigates the contributing factors of East Asian heatwaves (EAHWs) linked to the Arctic-Siberian Plain (ASP) over the past 42 years (1979–2020). EAHWs are mainly affected by two time scales of variabilities: long-term externally forced and interannual variabilities. The externally forced EAHWs are attributed to the increasing global warming trend, while their interannual variability is related to the circumglobal teleconnection (CGT) and the ASP teleconnection patterns. In addition to the CGT, the Rossby wave energy originating from the ASP propagates to East Asia through the upper troposphere, amplifying the EAHWs. The stationary high pressure in the ASP is generated by vorticity advection in the upper troposphere. Enhanced surface radiative heating and evaporation on the ASP surface increase the specific humidity and temperature, amplifying the thermal high pressure via positive water vapor feedback. Thermal high-pressure amplified by land–atmosphere interactions in the ASP during the peak summer season leads to EAHWs by the propagation of stationary Rossby wave energy. The results indicate that our enhanced understanding of the ASP teleconnection can improve forecasting of the EAHWs not only on a sub-seasonal time scale but also in future projections of global climate models.

Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263–2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266–0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

Objective We hypothesized that a multi-tier response (MTR) will provide high-quality cardiopulmonary resuscitation including airway management. However, the type of tier response system and airway management will have different interactive effects resulting in varying outcomes following out-of-hospital cardiac arrest (OHCA). This study aimed to determine whether the advanced airway management method has an effect on OHCA outcomes and to compare the size of the effect across MTR types. Methods This is a retrospective population-based observational study using the Korea OHCA Registry. Airway management methods were categorized into endotracheal intubation (ETI) and supraglottic airway (SGA) groups. The tier system was categorized into single-tier response (STR) or two types of MTR: ambulance-ambulance MTR or fire engine-ambulance MTR. Results In total, 45,264 patients were analyzed among the 89,087 emergency medical service assessed OHCAs. The SGA group was significantly associated with a lower prehospital return of spontaneous circulation (ROSC) rate compared to the ETI group (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.72–0.88). Both MTR with an ambulance or fire engine were significantly associated with higher prehospital ROSC rates compared to STR (STR vs. MTR with an ambulance: aOR, 1.33; 95% CI, 1.21–1.47; STR vs. MTR with a fire engine: aOR, 1.43; 95% CI, 1.20–1.71). Prehospital SGA was significantly associated with poor neurological outcomes in MTR with fire engine (aOR, 0.71; 95% CI, 0.53–0.96). Conclusion In this nationwide observational study, we observed that MTR was associated with higher prehospital ROSC than STR. Moreover, SGA is associated with a lower prehospital ROSC rate regardless of tier response type compared to ETI.

Reconfigurable intelligent surfaces (RISs) represent a highly promising technology that enhances the capacity and coverage of wireless networks by intelligently reconfiguring the wireless propagation environment in highly advanced wireless communications. The objective of this study is to solve the problem of secrecy rate maximization for multiple RIS-aided millimeter-wave communications by jointly optimizing the active RISs and the RIS phase shifts of the considered system. For this nonconvex problem, we propose multitask learning in a deep neural network to predict the RIS phase shift and active RISs. Numerical results based on realistic, three-dimensional, ray-tracing simulations show that the proposed solution can predict the RIS phase and active RIS with an accuracy rate > 96%. These results confirm the viability of RIS-aided secure wireless communications.