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The exchange behaviors of hydrogen isotopes between protonated lithium metal compounds and deuterated water or tritiated water were investigated. The various protonated lithium metal compounds were prepared by acid treatment of lithium metal compounds with different crystal structures and metal compositions. The protonated lithium metal compounds could more effectively reduce the deuterium concentration in water compared with the corresponding pristine lithium metal compounds. The H+ in the protonated lithium metal compounds was speculated to be more readily exchangeable with hydrons in the aqueous solution compared with Li+ in the pristine lithium metal compounds, and the exchanged heavier isotopes were speculated to be more stably retained in the crystal structure compared with the light protons. When the tritiated water (157.7 kBq/kg) was reacted with the protonated lithium metal compounds, the protonated lithium manganese nickel cobalt oxide was found to adsorb and retain twice as much tritium (163.9 Bq/g) as the protonated lithium manganese oxide (69.9 Bq/g) and the protonated lithium cobalt oxide (75.1 Bq/g) in the equilibrium state.

A hydrobiotite (HBT) clay contains more cesium (Cs)-specific adsorption sites than illitic clay, and the capacity of frayed edge sites can increase as the weathering of micaceous minerals proceeds. Thus, Cs can be selectively adsorbed to HBT clay. In this study, we investigated the removal efficiency of non-radioactive (133Cs) and radioactive (137Cs) Cs from HBT, using oxalic acid. We found the minimum optimal concentration of 0.15 M oxalic acid removed more than 90% of Cs. Subsequently, cations and Cs ions were removed using Ca(OH)2 and sodium tetraphenylborate (NaTPB) to treat the washing wastewater generated at the optimum concentration of the desorbent (0.15 M oxalic acid). In order to remove cations and heavy metal ions in the waste solution, Ca(OH)2 was treated at a mass ratio of 0.025 g/mL and pH 9–10 to derive optimal conditions. As a final step, to remove Cs, NaTPB was treated with a mass ratio of 2 mg/mL and reduced to below 0.1 mg/L Cs to find the optimal dose. The novelty of this study is that the amount of radioactive waste can be drastically reduced by removing the non-radioactive cations and heavy metals separately in the first step and removing the remaining radioactive Cs in the second step.

Background Inactive or old, healed tuberculosis (TB) on chest radiograph (CR) is often found in high TB incidence countries, and to avoid unnecessary evaluation and medication, differentiation from active TB is important. This study develops a deep learning (DL) model to estimate activity in a single chest radiographic analysis. Methods A total of 3,824 active TB CRs from 511 individuals and 2,277 inactive TB CRs from 558 individuals were retrospectively collected. A pretrained convolutional neural network was fine-tuned to classify active and inactive TB. The model was pretrained with 8,964 pneumonia and 8,525 normal cases from the National Institute of Health (NIH) dataset. During the pretraining phase, the DL model learns the following tasks: pneumonia vs. normal, pneumonia vs. active TB, and active TB vs. normal. The performance of the DL model was validated using three external datasets. Receiver operating characteristic analyses were performed to evaluate the diagnostic performance to determine active TB by DL model and radiologists. Sensitivities and specificities for determining active TB were evaluated for both the DL model and radiologists. Results The performance of the DL model showed area under the curve (AUC) values of 0.980 in internal validation, and 0.815 and 0.887 in external validation. The AUC values for the DL model, thoracic radiologist, and general radiologist, evaluated using one of the external validation datasets, were 0.815, 0.871, and 0.811, respectively. Conclusion This DL-based algorithm showed potential as an effective diagnostic tool to identify TB activity, and could be useful for the follow-up of patients with inactive TB in high TB burden countries.

Abstract The recent use of noble gases in laser devices and semiconductor lithography has greatly increased. However, there is no commercial technology for the storage of noble gases in solid materials owing to their chemical inertness and relative lightness. Here we report the simple synthesis and characteristics of a hydroquinone clathrate that stably captures neon at atmospheric pressure and room temperature. The highly flexible structure enables neon encapsulation in the one-dimensional channels of the clathrate framework despite their inter-cage migration through the hexagonal entrance of the cages. The neon uptake of as-synthesized hydroquinone clathrates is 37.3 g L−1 at 1 bar and 298 K. Increasing the temperature accelerates the release of neon from the flexible hydroquinone clathrate hydrogen-bonded organic framework, leading to guest-free clathrate formation at 1 bar and 400 K. This method represents a technological development for better storage and the controlled release of noble gases in solid structured materials.

Abstract Background Alopecia areata (AA) is an organ‐specific autoimmune disease resulting from the attack of hair follicle (HF) autoantigens through a T‐cell‐mediated mechanism. If there is a depletion of mTregs in HFs, especially around both hair bulge and hair bulb, it could be related to patchy hair loss in the scalp and may affect AA pathogenesis. Objectives we investigated the possible contributory role of tissue‐resident memory T cells (TRMs) and memory regulatory T cells (mTregs), compared to cytotoxic T lymphocytes and Th17 lymphocytes, in the immunopathogenesis of chronic AA. Methods Three hundred and sixty‐seven patients with AA who had biopsies performed in Dong‐A University Hospital between January 1994 and April 2019 were retrospectively reviewed. To investigate the expression of immunoregulatory molecules, we underwent double direct immunofluorescence with paraffin sections from nine AA patients under classified according to the histopathological grading of Uno and Orecchia's classification. Results The number of lesional Foxp3+ Tregs was significantly decreased with an increase in the severity of histopathological gradings at both the hair bulge and hair bulb, in the following order: Type 1 > type 2 > type 3 AA lesions. The number of CD8+ CD69+ TRM cells at both the HF bulge and bulb was increased with the severity of histopathological grades. CD49a was not expressed in the hair bulge and bulb in any type of AA. As for the expression profile of effector T cells, interleukin (IL)‐17 was expressed in a denser pattern around the hair bulge with more severe histopathological grading, but IFN‐γ was expressed only at the hair bulge of type 1 AA. Lesional IL‐17 around the hair bulb also increased with the severity of histopathological grade. In contrast, IFN‐γ was expressed in the hair bulb only in type 1 AA. Conclusions The insidious destruction of hair bulge stem cells and hair bulb matrix stem cells, which is mediated by Th17 lymphocytes and cytotoxic T lymphocyte infiltration, results in more severe hair loss in patients with chronic AA. IL‐17 may play a more important role in the pathogenesis of chronic AA than IFN‐γ.

Abstract We investigated the risk of developing chronic kidney disease (CKD) in patients with young-onset Type 2 diabetes (YOD, diagnosed age

This paper intends to introduce the applicability of HydroQus to a problem of a tanker collision against a semi-submersible type floating offshore wind turbine (FOWT). HydroQus is a plug-in based on potential flow theory that generates interactive hydroforces in a commercial Finite element analysis (FEA) code Abaqus/Explicit. Frequency response analyses were conducted for a 10MW capacity FOWT to obtain hydrostatic and hydrodynamic constants. The tanker was modeled with rigid elements, while elastic-plastic elements were used for the FOWT. Mooring chains were modeled to implement station keeping ability of the FOWT. Two types of fracture models were considered: constant failure strain model and combined failure strain model HC-LN model composed of Hosford-Coulomb (HC) model & localized necking (LN) model. The damage extents were evaluated by hydroforces and failure strain models. The largest equivalent plastic strain observed in the cases where both restoring force and radiation force were considered. Stress triaxiality and damage indicator analysis showed that the application of HC-LN model was suitable. It could be stated that applications of suitable failure strain model and hydrodynamics into the collision simulations were of importance.

Abstract Pterygium is an abnormal growth of fibrous conjunctival tissue that invades the cornea, resulting in corneal distortion, astigmatism, and increased higher-order aberrations (HOAs). However, few studies have compared eyes with pterygium to normal fellow eyes when interpreting HOAs and there is no study that revealed the effect of the thickness or grading of the pterygium on the change of HOAs. Therefore, we evaluated the effects of nasal pterygium by comparing the normal fellow eye of 59 patients. The pterygium significantly increased with-the-rule corneal astigmatism and corneal irregularity. Trefoils, horizontal coma, and quatrefoils were significantly induced by the pterygium. The grading of the pterygium was not correlated with its characteristics except for the thickness. In multiple linear regression analysis, pterygium-induced corneal astigmatic/irregularity values and horizontal trefoil/quatrefoil were associated with the area of the pterygium. The length of the pterygium was an independent inducer of oblique trefoil/quatrefoil, while horizontal coma was independently associated with both its length and width. The thickness was not correlated with any optical parameters. Together, the results demonstrate that nasal pterygium significantly induces corneal astigmatism, irregularity and some HOAs. These pterygium-associated changes in optical parameters could be predicted by the length, width and area of the pterygium.

Abstract Objective To meta-analyze diagnostic performance measures of standardized typical CT findings for COVID-19 and examine these measures by region and national income. Methods MEDLINE and Embase were searched from January 2020 to April 2022 for diagnostic studies using the Radiological Society of North America (RSNA) classification or the COVID-19 Reporting and Data System (CO-RADS) for COVID-19. Patient and study characteristics were extracted. We pooled the diagnostic performance of typical CT findings in the RSNA and CO-RADS systems and interobserver agreement. Meta-regression was performed to examine the effect of potential explanatory factors on the diagnostic performance of the typical CT findings. Results We included 42 diagnostic performance studies with 6777 PCR-positive and 9955 PCR-negative patients from 18 developing and 24 developed countries covering the Americas, Europe, Asia, and Africa. The pooled sensitivity was 70% (95% confidence interval [CI]: 65%, 74%; I 2 = 92%), and the pooled specificity was 90% (95% CI 86%, 93%; I 2 = 94%) for the typical CT findings of COVID-19. The sensitivity and specificity of the typical CT findings did not differ significantly by national income and the region of the study (p > 0.1, respectively). The pooled interobserver agreement from 19 studies was 0.72 (95% CI 0.63, 0.81; I 2 = 99%) for the typical CT findings and 0.67 (95% CI 0.61, 0.74; I 2 = 99%) for the overall CT classifications. Conclusion The standardized typical CT findings for COVID-19 provided moderate sensitivity and high specificity globally, regardless of region and national income, and were highly reproducible between radiologists. Critical relevance statement Standardized typical CT findings for COVID-19 provided a reproducible high diagnostic accuracy globally. Key points Standardized typical CT findings for COVID-19 provide high sensitivity and specificity. Typical CT findings show high diagnosability regardless of region or income. The interobserver agreement for typical findings of COVID-19 is substantial. Graphical abstract

The national healthcare systems of every country in the world cannot sustain the rise in healthcare expenditure caused by chronic diseases and their complications. To sustain the national healthcare system, a novel system should be developed to improve the quality of care and minimize healthcare costs. For 20 years, our team developed patient-communicating digital healthcare platforms and proved their efficacy. National scale randomized control trials are underway to systematically measure the efficacy and economic benefits of this digital health care system. Precision medicine aims to maximize effectiveness of disease management by considering individual variability. Digital health technologies enable precision medicine at a reasonable cost that was not available before. The government launched the “National Integrated Bio-big Data Project” which will collect diverse health data from the participants. Individuals will share their health information to physicians or researchers at their will by gateway named “My-Healthway.’ Taken together, now we stand in front of the evolution of medical care, so-called “Precision medicine.” led by various kinds of technologies and a huge amount of health information exchange. We should lead these new trends as pioneers, not as followers, to establish and implement the best care for our patients that can help them to withstand their devastating diseases.

IntroductionIntensive chemotherapy (IC) can affect all geriatric assessment (GA) domains in older adults with acute myeloid leukemia (AML), but data on the effects of these changes on transplant outcomes are lacking.MethodsTherefore, we prospectively assessed the prognostic role of GA domains at diagnosis and allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 51 patients with AML aged ≥60 years who achieved complete remission after IC. We performed both baseline and pre-allo-HSCT GA; moreover, physical function, including a short physical performance battery (SPPB), cognitive function, psychological function, nutritional status, and social support were examined.ResultsAll GA domains showed dynamic changes between the two time points. The directions of change were statistically significant for social support, self-reported physical and psychological functions, and distress, but not for nutritional status, cognitive function, or physical function. Among all GA domains at each time point, only poor physical function and its submaneuvers at diagnosis but not at allo-HSCT were significantly associated with inferior survival. In particular, since the direction of change varied between patients, we found that patients whose physical function improved before allo-HSCT were more likely to survive longer than those with persistently impaired SPPB (55.6% vs. 28.6%, p=0.268). Finally, persistent impairment in SPPB (28.6% vs. 65.9%, p=0.006), tandem stand (0% vs. 63.3%, p=0.012), sit-and-stand (41.2% vs. 70.6%, p=0.009), and gait speed (38.5% vs. 68.4%, p=0.027) further strongly predicted inferior survival.DiscussionThis study showed that IC courses can induce dynamic changes in different directions in the GA domains of each patient and that changes in objectively measured physical function can predict transplant outcomes.

Background To systematically review studies on inhaled corticosteroids (ICS) and lung cancer incidence in chronic airway disease patients. Methods We conducted electronic bibliographic searches on OVID-MEDLINE, EM-BASE, and the Cochrane Database before May 2020 to identify relevant studies. Detailed data on the study population, exposure, and outcome domains were reviewed. Results Of 4,058 screened publications, 13 eligible studies in adults with chronic obstructive pulmonary disease (COPD) or asthma evaluated lung cancer incidence after ICS exposure. Pooled hazard ratio and odds ratio for developing lung cancer in ICS exposure were 0.81 (95% confidence interval, 0.64 to 1.02; I2=95.7%) from 10 studies and 1.02 (95% confidence interval 0.50 to 2.07; I2=94.7%) from three studies. Meta-regression failed to explain the substantial heterogeneity of pooled estimates. COPD and asthma were variously defined without spirometry in 11 studies. Regarding exposure assessment, three and 10 studies regarded ICS exposure as a time-dependent and fixed variable, respectively. Some studies assessed ICS use for the entire study period, whereas others assessed ICS use for 6 months to 2 years within or before study entry. Smoking was adjusted in four studies, and only four studies introduced 1 to 2 latency years in their main or subgroup analysis. Conclusion Studies published to date on ICS and lung cancer incidence had heterogeneous study populations, exposures, and outcome assessments, limiting the generation of a pooled conclusion. The beneficial effect of ICS on lung cancer incidence has not yet been established, and understanding the heterogeneities will help future researchers to establish robust evidence on ICS and lung cancer incidence.

Abstract Background To evaluate the correlation between single- and multi-slice cross-sectional thoracolumbar and whole-body compositions. Methods We retrospectively included patients who underwent whole-body PET–CT scans from January 2016 to December 2019 at multiple institutions. A priori-developed, deep learning-based commercially available 3D U-Net segmentation provided whole-body 3D reference volumes and 2D areas of muscle, visceral fat, and subcutaneous fat at the upper, middle, and lower endplate of the individual T1–L5 vertebrae. In the derivation set, we analyzed the Pearson correlation coefficients of single-slice and multi-slice averaged 2D areas (waist and T12–L1) with the reference values. We then built prediction models using the top three correlated levels and tested the models in the validation set. Results The derivation and validation datasets included 203 (mean age 58.2 years; 101 men) and 239 patients (mean age 57.8 years; 80 men). The coefficients were distributed bimodally, with the first peak at T4 (coefficient, 0.78) and the second peak at L2-3 (coefficient 0.90). The top three correlations in the abdominal scan range were found for multi-slice waist averaging (0.92) and single-slice L3 and L2 (0.90, each), while those in the chest scan range were multi-slice T12–L1 averaging (0.89), single-slice L1 (0.89), and T12 (0.86). The model performance at the top three levels for estimating whole-body composition was similar in the derivation and validation datasets. Conclusions Single-slice L2–3 (abdominal CT range) and L1 (chest CT range) analysis best correlated with whole-body composition around 0.90 (coefficient). Multi-slice waist averaging provided a slightly higher correlation of 0.92.

Abstract In recent decades, the interior regions of Eurasia and North America have experienced several unprecedentedly cold winters despite the global surface air temperature increases. One possible explanation of these increasing extreme cold winters comes from the so-called Warm Arctic Cold Continent (WACC) pattern, reflecting the effects of the amplified Arctic warming in driving the circulation change over surrounding continents. This study analyzed reanalysis data and model experiments forced by different levels of anthropogenic forcing. It is found that WACC exists on synoptic scales in observations, model’s historical and even future runs. In the future, the analysis suggests a continued presence of WACC but with a slightly weakened cold extreme due to the overall warming. Warm Arctic events under the warmer climate will be associated with not only a colder continent in East Asia but also a warmer continent, depending on the teleconnection process that is also complicated by the warmer Arctic. Such an increasingly association suggests a reduction in potential predictability of the midlatitude winter anomalies.

Guillain-Barré syndrome (GBS) is an autoimmune disease that is generally preceded by an infection. Its typical symptoms are progressive symmetric paresis and an absence of deep tendon reflexes. GBS could be a life-threatening condition due to the paralysis of respiratory muscles, and admission to the intensive care unit should be considered for close monitoring. Intravenous immunoglobulin can improve the course of the disease. Postoperative GBS is most likely to occur after gastrointestinal, cardiac, thoracic, neurological, or orthopedic surgery, as well as surgery in the female reproductive tract. The duration of surgery, age, infectious diseases, preexisting autoimmune diseases, and malignant diseases are associated with postoperative GBS. Patients with these factors have a higher risk of postoperative GBS and therefore require precautions to be taken after surgery. We report a case of 53-year-old woman who had experienced GBS after Nasal surgery preceded by gastrointestinal infection and treated by intravenous immunoglobulin.

Abstract With advancement of technology, requirements for light-emitting devices are increasing. Various types of packaging technologies have been suggested to improve the performance of light-emitting diode (LED). Among them, phosphor in glass (PiG) is attracting attention due to its manufactural facility and easily tunable characteristics. As PiG draws increasing attention, research on glass materials is also being actively conducted. However, studies about glass in the field of phosphor are mainly conducted on fabrication. Only a few studies about recycling have been reported. Thus, the objective of this study was to recycle waste glass discarded in other fields due to breakage and failure and use it to fabricate phosphor in glass. Cylindrical waste glass was pulverized into powder with an average size of 12 μm, mixed with a phosphor and sintered to be reborn as a phosphor in glass to broaden the recycling route for waste glass.

Background The severity of gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes. We aimed to generate a risk model for predicting insulin-requiring GDM before pregnancy in Korean women. Methods A total of 417,210 women who received a health examination within 52 weeks before pregnancy and delivered between 2011 and 2015 were recruited from the Korean National Health Insurance database. The risk prediction model was created using a sample of 70% of the participants, while the remaining 30% were used for internal validation. Risk scores were assigned based on the hazard ratios for each risk factor in the multivariable Cox proportional hazards regression model. Six risk variables were selected, and a risk nomogram was created to estimate the risk of insulin-requiring GDM. Results A total of 2,891 (0.69%) women developed insulin-requiring GDM. Age, body mass index (BMI), current smoking, fasting blood glucose (FBG), total cholesterol, and γ-glutamyl transferase were significant risk factors for insulin-requiring GDM and were incorporated into the risk model. Among the variables, old age, high BMI, and high FBG level were the main contributors to an increased risk of insulin-requiring GDM. The concordance index of the risk model for predicting insulin-requiring GDM was 0.783 (95% confidence interval, 0.766 to 0.799). The validation cohort’s incidence rates for insulin-requiring GDM were consistent with the risk model’s predictions. Conclusion A novel risk engine was generated to predict insulin-requiring GDM among Korean women. This model may provide helpful information for identifying high-risk women and enhancing prepregnancy care.

Abstract Venetoclax (VEN) combined with azacitidine (AZA) or decitabine (DEC) has been approved for older adults with acute myeloid leukemia (AML) unfit for intensive chemotherapy based on the pivotal VIALE-A trial. However, this trial only compared AZA + VEN with AZA monotherapy. Therefore, we compared the outcomes of consecutive older adults (65 years or older) with newly diagnosed AML who received DEC (n = 230) or DEC + VEN (n = 74) after propensity score matching to construct a one-to-one matched cohort by the nearest neighbor algorithm. The median overall survival was longer in the DEC + VEN group than in the DEC group (13.4 months vs. 8.3 months, p = 0.01). The median event-free survivals were 8.6 and 5.8 months in the DEC + VEN and DEC groups, respectively (p = 0.02). The response rate (complete response, complete response with incomplete hematologic recovery, and morphologic leukemia-free state) was significantly higher in the DEC + VEN group than in the DEC group (70.3% vs. 24.3%, p

ABSTRACT Islet transplantation is an important option in the treatment of type 1 diabetes. However, a donor shortage and immunosuppressant‐related complications are the current major hurdles of islet transplantation. In this review, we discuss recent updates on islet transplantation to overcome these current obstacles and we share our perspectives on future β cell replacement therapy.

Abstract This study investigates the characteristics of a ceramic phosphor (CP) for the converter of a high-power laser diode-based automobile headlamp synthesized by high-frequency induction heated press (HFP) sintering. The CP prepared by an HFP method exhibits remarkable optical properties that are comparable to spark plasma sintering. The effects of post-treatment process for controlling residual pores, as well as sintering temperature, sintering pressure and heating rate for optimization of the HFP sintering method, were studied. The HFP sintering process can be widely used in ceramics and lighting fields because it is designed relatively low cost compared to other techniques and exhibits excellent productivity.

Experiments were carried out for the manufactured a printed circuit heat exchanger (PCHE) using nitrogen on the super-critical state. For the core of the PCHE, ‘N’ and reverse N, ‘RN’ shape microchannels were etched on stainless steel 316L plates, and total 120 plates were diffusion bonded. Then, for the PCHE evaluation in which the headers were welded, liquid nitrogen of below -170 °C and about 0.8 MPa was pressurized to about 3.42 ∼4.59 MPa, then was injected to the inlet on the cold side, and nitrogen gas of 72.7 ∼75.1 °C and about 0.6 ∼0.75 MPa was flowed through channels on the hot side. The flow rates were 2401 ∼3211 kg/h and 1592 ∼2357 kg/h on the hot and cold sides, respectively. In particular, the nitrogen on the cold side was pressurized by a pump, and state changes occurred over pseudo critical point. In order to evaluate performance of the PCHE with the super critical state nitrogen, the channels were simplified and discretized, then, effectiveness-number of transfer units (e-NTU) method was applied. Then, a new correlation expecting the thermal-hydraulic performance of PCHE was developed as Nu = 0.023Re0.78Pr0.4.

The prolonged rainy season in 2020 was classified as the second-largest rainfall event since 1961. In this study, we conducted a survey to assess fluctuations in the zooplankton community structure of the northern East China Sea (nECS) after the rainy season in August 2020. We examined 24 stations and observed several environmental factors, including water temperature, salinity, chlorophyll-a concentration, suspended particulate matter (SPM), and phytoplankton density. Zooplankton samples were collected from 12 stations using MOCNESS to target the surface mixed layer (SML), pycnocline layer (PNC), and lower layer (LL). In regions with low water temperatures, the Yellow Sea and northern East China Sea shelf mixed water community in each layer exhibited a decrease in the relative abundance of Calanus sinicus, whereas the incidence of Paracalanus parvus s. l. showed an increasing trend. Similarly, in areas with low salinity, the CDW and northern East China Sea shelf mixed water community in SML and PNC displayed comparable distributions, with a tendency for the relative abundance of Acartia pacifica and Paracalanus parvus s. l. to show a replacement pattern. Moreover, the Tsushima Warm Current (TWC) community in each layer, characterized by high water temperature and salinity, showed a high relative abundance of Oncaea spp. and a diverse species distribution, mainly in the eastern part of the study area. Our study identified multiple vertically distributed communities, providing detailed information on water mass structures through cluster analysis. This approach enhanced previous studies by offering novel insights into the vertical structure of water masses and their association with zooplankton communities in the nECS.