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Taking the Paleozoic of the Sichuan and Tarim basins in China as example, the controlling effects of the Earth system evolution and multi-spherical interactions on the formation and enrichment of marine ultra-deep petroleum in China have been elaborated. By discussing the development of “source-reservoir-seal” controlled by the breakup and assembly of supercontinents and regional tectonic movements, and the mechanisms of petroleum generation and accumulation controlled by temperature-pressure system and fault conduit system, Both the South China and Tarim blocks passed through the intertropical convergence zone (ITCZ) of the low-latitude Hadley Cell twice during their drifts, and formed hydrocarbon source rocks with high quality. It is proposed that deep tectonic activities and surface climate evolution jointly controlled the types and stratigraphic positions of ultra-deep hydrocarbon source rocks, reservoirs, and seals in the Sichuan and Tarim basins, forming multiple petroleum systems in the Ediacaran–Cambrian, Cambrian–Ordovician, Cambrian–Permian and Permian–Triassic strata. The matching degree of source-reservoir-seal, the type of organic matter in source rocks, the deep thermal regime of basin, and the burial-uplift process across tectonic periods collectively control the entire process from the generation to the accumulation of oil and gas. Three types of oil and gas enrichment models are formed, including near-source accumulation in platform marginal zones, distant-source accumulation in high-energy beaches through faults, and three-dimensional accumulation in strike-slip fault zones, which ultimately result in the multi-layered natural gas enrichment in ultra-deep layers of the Sichuan Basin and co-enrichment of oil and gas in the ultra-deep layers of the Tarim Basin.

Background/Aims: Despite advances in imaging and endoscopic technology, diagnostic modalities for small bowel tumors are simultaneously performed. We investigated the discrepancy rate between each modality and predictive factors of discrepancy in patients with definite small bowel tumors. Methods: Data of patients with definite small bowel tumors who underwent both device-assisted enteroscopy (DAE) and computed tomography (CT) were retrieved from web-based enteroscopy registry database in Korea. Predictive risk factors associated with discrepancy were analyzed using logistic regression analysis. Results: Among 998 patients, 210 (21.0%) were diagnosed with small bowel tumor using DAE, in 193 patients with definite small bowel tumor, DAE and CT were performed. Of these patients, 12 (6.2%) showed discrepancy between examinations. Among 49 patients who underwent DAE and video capsule endoscopy (VCE) examination, 13 (26.5%) showed discrepancy between examinations. No significant independent risk factors were associated with concordance between DAE and CT in multivariate logistic regression analysis among the patients. In a multivariate logistic regression analysis, red blood cell transfusion was negatively associated with concordance between DAE and VCE in patients with small bowel tumor (odds ratio, 0.163; 95% confidence interval, 0.026 to 1.004; p=0.050). Conclusion : s: For small bowel tumors, the discrepancy rate between DAE and CT was 6.2%, and 26.5% between DAE and VCE. Despite developments in cross-sectional imaging (VCE and DAE modalities), discrepancies still exist. For small bowel bleeding that require significant transfusion while showing insignificant VCE findings, DAE should be considered as the next diagnostic approach, considering the possibility of missed small bowel tumor.

Abstract Structural deformation modifies the bandgap, exciton fine structure and phonon energy of semiconductors, providing an additional knob to control their optical properties. The impact can be exploited in colloidal semiconductor quantum dots (QDs), wherein structural stresses can be imposed in three dimensions while defect formation is suppressed by controlling surface growth kinetics. Yet, the control over the structural deformation of QDs free from optically active defects has not been reached. Here, we demonstrate strain-graded CdSe-ZnSe core-shell QDs with compositionally abrupt interface by the coherent pseudomorphic heteroepitaxy. Resulting QDs tolerate mutual elastic deformation of varying magnitudes at the interface with high structural fidelity, allowing for spectrally stable and pure emission of photons at accelerated rates with near unity luminescence efficiency. We capitalize on the asymmetric strain effect together with the quantum confinement effect to expand emission envelope of QDs spanning the entire visible region and exemplify their use in photonic applications.

The dynamics of the Rosen–Zener transition (RZT) in interacting two-level systems within nonreciprocal systems is examined, where nonreciprocity stems from asymmetric couplings between energy levels. For the linear case, an analytical expression for the RZT probability is derived. In the nonlinear scenario, numerical experiments are utilized to investigate the impact of various initial states and scanning periods on transition probabilities under adiabatic conditions. Additionally, an equivalent classical Hamiltonian is formulated to elucidate the origin of transition asymmetry under different initial state conditions. The influence of energy level detuning on the RZT is explored, leading to the suggestion of new applications for studying parameters of two-level systems related to nonlinearity and nonreciprocity. This opens avenues for potential Rosen–Zener–Stückelberg interferometry implementations.

The indiscriminate evolution of urban configurations aggravates flood vulnerabilities, threatening sustainable urban expansion. Present methodologies fall short in supplying urban planners with flood mitigative strategies centered on urban configuration facets. Leveraging the power of the XGBoost algorithm, this study posits an advanced optimization schema, adroitly balancing the dual objectives of mitigating urban flooding and enhancing economic growth, with minimal disruption to established urban layouts. Shenzhen serves as the investigative ground, where the model displays exceptional accuracy, resilience, and interpretability in predicting Pluvial Flooding Susceptibility (PFS) and Economic Contribution (EC). Model interpretation divulges the profound influence of three-dimensional urban configuration elements, primarily the Building Congestion Degree, on PFS and EC. Pareto solution exploration for multi-objective optimization unveils the ideal urban configuration interval. To minimize PFS while maximizing EC, the research suggests pertinent measures: augmenting vegetation density, regulating the impervious coverage ratio within 50–70%, limiting two- and three-dimensional building density thresholds, and moderately escalating urban drainage network density. Additionally, it encourages a comprehensive appreciation of function-oriented land usage and intrinsic site topographical characteristics to reconcile varied urban development goals during planning. By fusing data-derived insights with multi-objective optimization, this research anticipates influencing urban planning models, thus enhancing decision-making related to urban configuration and fostering flood-resilient, sustainable, and economically prosperous urban habitats.

SMART100 has a containment pressure and radioactivity suppression system (CPRSS) for passive containment cooling system (PCCS). This prevents overheating and over-pressurization of a containment through direct contact condensation in an in-containment refueling water storage tank (IRWST) and wall condensation in a CPRSS heat exchanger (CHX) in an emergency cool-down tank (ECT). The Korea Atomic Energy Research Institute (KAERI) constructed scaled-down test facilities, SISTA1 and SISTA2, for the thermal-hydraulic validation of the SMART100 CPRSS. Three separate effect tests were performed using SISTA1 to confirm the heat removal characteristics of SMART100 CPRSS. When the low mass flux steam with or without non-condensable gas is released into an IRWST, the conditions for mitigation of the chugging phenomenon were identified, and the physical variables were quantified by the 3D reconstruction method. The local behavior of the non-condensable gas was measured after condensation inside heat exchanger using a traverse system. Stratification of non-condensable gas occurred in large tank of the natural circulation loop. SISTA2 was used to simulate a small break loss-of-coolant accident (SBLCOA) transient. Since the test apparatus was a metal tank, compensations of initial heat transfer to the material and effect of heat loss during long-term operation were important for simulating cooling performance of SMART100 CPRSS. The pressure of SMART100 CPRSS was maintained below the design limit for 3 days even under sufficiently conservative conditions of an SBLOCA transient.

ABSTRACTLactate plays an important role in shaping immune tolerance in tumor microenvironment (TME) and correlates with poor prognosis in various solid tumors. Overcoming the immune resistance in an acidic TME may improve the anti-tumor immunity. Here, this study elucidated that via G-protein-coupled receptor 81 (GPR81), lactate could modulate immune tolerance in TME by recruiting regulatory T cells (Tregs) in vitro and in vivo. A high concentration of lactate was detected in cell supernatant and tissues of gastric cancer (GC), which was modulated by lactic dehydrogenase A (LDHA). GPR81 was the natural receptor of lactate and was overexpressed in different GC cell lines and samples, which correlated with poor outcomes in GC patients. Lactate/GPR81 signaling could promote the infiltration of Tregs into TME by inducing the expression of chemokine CX3CL1. GPR81 deficiency could decrease the infiltration of Tregs into TME, thereby inhibiting GC progression by weakening the inhibition of CD8+T cell function in a humanized mouse model. In conclusion, targeting the lactate/GPR81 signaling may potentially serve as a critical process to overcome immune resistance in highly glycolytic GC.

The recent emergence of innovative learning spaces, Future Classroom Lab (FCL), provides educators the use of physical learning spaces (to research, interact, exchange, develop, create, and present) and diverse technological tools to work according to active methodologies. Learners become more active in the learning process with the introduction of innovative learning environments that enable the application of interdisciplinary STEAM methodology and foster the development of 21st century competences. This study aims to uncover the probable link between application active and gamified STEAM educational interventions in the FCL and Pre-Service Teachers’ (PSTs) affective domain. The findings obtained showed statistically significant variations and, therefore, positive effects on the PSTs’ affective domain (self-efficacy, attitude, and emotion) after performing the intervention. The sample consisted of a total of 54 PSTs enrolled in the second year of Primary Education. Limited studies regarding the affective domain in the FCL were found, which restricted the comparison with prior research. This study has several implications, such as the introduction of innovative educational proposals to PSTs at the university level and, consequently, the implementation of similar interventions in elementary schools. This research intended to reveal how the different variables work as a support system for students’ learning process in mathematics and science disciplines.

The Lower Cambrian petroleum system in the Tarim Basin has undergone multiple periods of tectonic movements, leading to successive hydrocarbon expulsion events and adjustments. The complex process of hydrocarbon accumulation occurred under deep burial conditions, persisting at depths of nearly 6,000 m over an extended period. This has resulted in the current occurrence of various phases including light oil, condensate, and gas in the deep-ultradeep strata of the Tarim Basin. The intricacies of formation of hydrocarbon accumulations and phase evolution have posed challenges to understanding the accumulation mechanisms and enrichment patterns of the Cambrian in the Tarim Basin, consequently lowering the success rate of oil and gas exploration. Such characteristics of multi-stage accumulation and adjustment are prevalent in deep hydrocarbon systems. Therefore, based on data from Well ZH1 in the Tazhong Uplift, combined with basin simulation, Compositional kinetics model, and PVT performance simulation, this study investigates the hydrocarbon generation and phase evolution processes in the deep hydrocarbon systems of the Tazhong Uplift. The results indicate that Well ZH1 entered the hydrocarbon generation peak during the Late Ordovician, followed by secondary cracking as the predominant hydrocarbon evolution process. Hydrocarbon fluids within the Lower Cambrian reservoir transitioned into the condensate phase towards the end of the Cambrian, with increasing depth resulting in higher gas-oil ratios and a decreasing trend in viscosity and density.

ABSTRACT This study aimed to characterize the composition of intestinal and nasal microbiota in septic patients and identify potential microbial biomarkers for diagnosis. A total of 157 subjects, including 89 with sepsis, were enrolled from the affiliated hospital. Nasal swabs and fecal specimens were collected from septic and non-septic patients in the intensive care unit (ICU) and Department of Respiratory and Critical Care Medicine. DNA was extracted, and the V4 region of the 16S rRNA gene was amplified and sequenced using Illumina technology. Bioinformatics analysis, statistical processing, and machine learning techniques were employed to differentiate between septic and non-septic patients. The nasal microbiota of septic patients exhibited significantly lower community richness (P = 0.002) and distinct compositions (P = 0.001) compared to non-septic patients. Corynebacterium, Staphylococcus, Acinetobacter, and Pseudomonas were identified as enriched genera in the nasal microbiota of septic patients. The constructed machine learning model achieved an area under the curve (AUC) of 89.08, indicating its efficacy in differentiating septic and non-septic patients. Importantly, model validation demonstrated the effectiveness of the nasal microecological diagnosis prediction model with an AUC of 84.79, while the gut microecological diagnosis prediction model had poor predictive performance (AUC = 49.24). The nasal microbiota of ICU patients effectively distinguishes sepsis from non-septic cases and outperforms the gut microbiota. These findings have implications for the development of diagnostic strategies and advancements in critical care medicine.IMPORTANCEThe important clinical significance of this study is that it compared the intestinal and nasal microbiota of sepsis with non-sepsis patients and determined that the nasal microbiota is more effective than the intestinal microbiota in distinguishing patients with sepsis from those without sepsis, based on the difference in the lines of nasal specimens collected.

ABSTRACT The upper and lower respiratory tract may share microbiome because they are directly continuous, and the nasal microbiome contributes partially to the composition of the lung microbiome. But little is known about the upper and lower airway microbiome of early postoperative lung transplant recipients (LTRs). Using 16S rRNA gene sequencing, we compared paired nasal swab (NS) and bronchoalveolar lavage fluid (BALF) microbiome from 17 early postoperative LTRs. The microbiome between the two compartments were significantly different in Shannon diversity and beta diversity. Four and eight core NS‐associated and BALF‐associated microbiome were identified, respectively. NS samples harbored more Corynebacterium, Acinetobacter, and Pseudomonas, while BALF contained more Ralstonia, Stenotrophomonas, Enterococcus, and Pedobacter. The within-subject dissimilarity was higher than the between-subject dissimilarity, indicating a greater impact of sampling sites than sampling individuals on microbial difference. There were both difference and homogeneity between NS and BALF microbiome in early postoperative LTRs. High levels of pathogens were detected in both samples, suggesting that both of them can reflect the diseases characteristics of transplanted lung. The differences between upper and lower airway microbiome mainly come from sampling sites instead of sampling individuals.IMPORTANCELung transplantation is the only therapeutic option for patients with end-stage lung disease, but its outcome is much worse than other solid organ transplants. Little is known about the NS and BALF microbiome of early postoperative LTRs. Here, we compared paired samples of the nasal and lung microbiome from 17 early postoperative LTRs and showed both difference and homogeneity between the two samples. Most of the “core” microbiome in both NS and BALF samples were recognized respiratory pathogens, suggesting that both samples can reflect the diseases characteristics of transplanted lung. We also found that the differences between upper and lower airway microbiome in early postoperative LTRs mainly come from sampling sites instead of sampling individuals.

Introduction: Acute respiratory distress syndrome (ARDS) is a leading cause of respiratory failure, with substantial attributable morbidity and mortality. The small animal models that are currently used for ARDS do not fully manifest all of the pathological hallmarks of human patients, which hampers both the studies of disease mechanism and drug development. Objectives: To examine whether the phenotypic changes of primate-like tree shrews in response to a one-hit lipopolysaccharides (LPS) injury resemble human ARDS features. Methods: LPS was administered to tree shrews through intratracheal instillation; then, the animals underwent CT or PET/CT imaging to examine the changes in the structure and function of the whole lung. The lung histology was analyzed by H&E staining and immunohistochemical staining of inflammatory cells. Results: Results demonstrated that tree shrews exhibited an average survival time of 3–5 days after LPS insult, as well as an obvious symptom of dyspnea before death. The ratios of PaO2 to FiO2 (P/F ratio) were close to those of moderate ARDS in humans. CT imaging showed that the scope of the lung injury in tree shrews after LPS treatment were extensive. PET/CT imaging with 18F-FDG displayed an obvious inflammatory infiltration. Histological analysis detected the formation of a hyaline membrane, which is usually present in human ARDS. Conclusion: This study established a lung injury model with a primate-like small animal model and confirmed that they have similar features to human ARDS, which might provide a valuable tool for translational research.

Recent studies actively researching user identification utilizing physiological information to verify identity. However, there is a problem with biometric information exposed to the outside of the body being susceptible to forgery and falsification. Therefore, studies on user identification systems based on biometric signals generated as electrical signals inside the body are necessary to strengthen security with high security and continuous authentication. Among the time-frequency (TF) features applied to existing nonlinear biosignals, short-time fourier transform (STFT) cannot simultaneously improve time-frequency resolution, so there is a limit to improving user identification accuracy. Therefore, this paper introduces a customized constant q transform (CQT) for time-frequency resolution adjustment applied to multiple biosignals. Additionally, a multi-stream conformer combining a convolutional neural network (CNN) and transformer is employed to improve user identification accuracy. Test results confirmed that when using CQT features and a multi-stream conformer for electrocardiogram (ECG) and electroencephalogram (EEG) signals, the accuracy of user identification using both ECG and EEG signals was 97.6%, an improvement of 0.8% or more compared to the accuracy of ECG and EEG single biosignals and CNN-based user identification.

Abstract Introduction Recent studies showed the presence of microplastic in human lungs. There remains an unmet need to identify the biodistribution of microplastic after inhalation. In this study, we traced the biodistribution of inhaled micro-sized polystyrene (mPS) and/or nano-sized PS (nPS) using 64Cu with PET in mice. Methods We used 0.2–0.3-µm sized mPS and 20-nm sized nPS throughout. 64Cu-DOTA-mPS, 64Cu-DOTA-nPS and/or 64CuCl2 were used to trace the distribution in the murine inhalation model. PET images were acquired using an INVEON PET scanner at 1, 12, 24, 48, and 72 h after intratracheal instillation, and the SUVmax for interesting organs were determined, biodistribution was then determined in terms of percentage injected dose/gram of tissue (%ID/g). Ex vivo tissue-radio thin-layer chromatography (Ex vivo-radioTLC) was used to demonstrate the existence of 64Cu-DOTA-PS in tissue. Results PET image demonstrated that the amount of 64Cu-DOTA-mPS retained within the lung was significantly higher than 64Cu-DOTA-nPS until 72 h; SUVmax values of 64Cu-DOTA-mPS in lungs was 11.7 ± 5.0, 48.3 ± 6.2, 65.5 ± 2.3, 42.2 ± 13.1, and 13.2 ± 2.3 at 1, 12, 24, 48, and 72 h respectively whereas it was 31.2 ± 3.1, 17.3 ± 5.9, 10.0 ± 3.4, 8.1 ± 2.4 and 8.9 ± 3.6 for 64Cu-DOTA-nPS at the corresponding timepoints. The biodistribution data supported the PET data with a similar pattern of clearance of the radioactivity from the lung. nPS cleared rapidly post instillation in comparison to mPS within the lungs. Higher accumulation of %ID/g for nPS (roughly 2 times) were observed compared to mPS in spleen, liver, intestine, thymus, kidney, brain, salivary gland, ovary, and urinary bladder. Ex vivo-radioTLC was used to demonstrate that the detected gamma rays originated from 64Cu-DOTA-mPS or nPS. Conclusion PET image demonstrated the differences in accumulations of mPS and/or nPS between lungs and other interesting organs. The information provided may be used as the basis for future studies on the toxicity of mPS and/or nPS. Graphical abstract

Abstract Background Recent studies using single-cell transcriptomic analysis have reported several distinct clusters of neoplastic epithelial cells and cancer-associated fibroblasts in the pancreatic cancer tumor microenvironment. However, their molecular characteristics and biological significance have not been clearly elucidated due to intra- and inter-tumoral heterogeneity. Methods We performed single-cell RNA sequencing using enriched non-immune cell populations from 17 pancreatic tumor tissues (16 pancreatic cancer and one high-grade dysplasia) and generated paired spatial transcriptomic data from seven patient samples. Results We identified five distinct functional subclusters of pancreatic cancer cells and six distinct cancer-associated fibroblast subclusters. We deeply profiled their characteristics, and we found that these subclusters successfully deconvoluted most of the features suggested in bulk transcriptome analysis of pancreatic cancer. Among those subclusters, we identified a novel cancer cell subcluster, Ep_VGLL1, showing intermediate characteristics between the extremities of basal-like and classical dichotomy, despite its prognostic value. Molecular features of Ep_VGLL1 suggest its transitional properties between basal-like and classical subtypes, which is supported by spatial transcriptomic data. Conclusions This integrative analysis not only provides a comprehensive landscape of pancreatic cancer and fibroblast population, but also suggests a novel insight to the dynamic states of pancreatic cancer cells and unveils potential therapeutic targets. Graphical Abstract

In the information age, people are increasingly being exposed to stress as societies are experiencing sudden changes fueled by advancements in cutting-edge scientific technology and the Information Technology (IT) industry. Consequently, research has been actively conducted on stress classification to mitigate psychological and physical diseases caused by constantly feeling stressed. Specifically, the number of studies examining electrocardiograms (ECGs), which record biosignals that provide insight into the response level of the body’s autonomic nervous system, has increased. However, previous studies on stress classification based on ECG used only one-dimensional feature data, thus entailing difficulties in analyzing the data more closely and comprehensively owing to bias toward a specific aspect. Therefore, to overcome the limitations of conventional stress classification based on ECGs, this paper developed a stress classification method based on multi-dimensional feature fusion of LSTM and Xception using ECGs from which outliers have been removed. Experimental results showed that applying multi-dimensional feature fusion of the weighted average method using ECG data with outlier signals removed resulted in a stress classification of 99.51%, a 1.25% improvement from previous studies which used only one-dimensional feature data of ECGs, thus highlighting the excellent performance of the proposed stress classification method using ECGs based on multi-dimensional feature fusion of LSTM and Xception.

This study presents a comprehensive methodology for the implementation of Nature-based Solutions (NbS) in the context of urban flood mitigation, specifically within the heritage city of Guangzhou, China. The investigation delves into the roles of urban morphology and impermeability in exacerbating flood risk through enhanced runoff accumulation and reduced infiltration. A key focus is the spatial heterogeneity of flood susceptibility, influenced by the disparate distribution of various building types and demographic segments. This research integrates susceptibility and vulnerability assessments with spatial analysis of NbS and multi-criteria decision-making, facilitating the identification of pivotal zones for NbS application. Findings underscore the critical role of urban design in flood risk management and reveal the efficacy of vegetation-based strategies, namely vegetated swales and bioretention cells, which account for 8.41% and 7.08% of the total area, respectively, in curbing urban flood impacts. Recommendations for heritage city innovation include the prioritization of vegetation-integrated road layouts coupled with a gradual enhancement of grey infrastructure in historical areas. The study culminates in providing strategic insights for policymakers and urban planners in heritage cities, underscoring the necessity of a balanced approach to technical feasibility and conservation imperatives in NbS deployment.

Abstract Objectives To identify, describe and synthesise the views and experiences of adults living with asthma regarding shared decision‐making (SDM) in the existing qualitative literature Methods We conducted a comprehensive search of 10 databases (list databases) from inception until September 2023. Screening was performed according to inclusion criteria. Tools from the Joanna Briggs lnstitute were utilised for the purposes of data extraction and synthesis in this study. The data extraction process in this study employed the Capability, Opportunity and Motivation Model of Behaviour (COM‐B model) as a framework, and a pragmatic meta‐aggregative approach was employed to synthesise the collected results. Results Nineteen studies were included in the metasynthesis. Three synthesised themes were identified: the capability of people living with asthma, the opportunities of people living with asthma in SDM, and the motivation of the people living with asthma in SDM. Conclusions We have identified specific factors influencing people living with asthma engaging in SDM. The findings of this study can serve as a basis for the implementation of SDM in people living with asthma and provide insights for the development of their SDM training programs. The ConQual score for the synthesised findings was rated as low. To enhance confidence, future studies should address dependability and credibility factors. Practice Implications This review contemplates the implementation of SDM from the perspective of people living with asthma, with the aim of providing patient‐centred services for them. The results of this review can benefit the implementation of SDM and facilitate information sharing. It offers guidance for SDM skills training among adults living with asthma, fosters a better doctor–patient relationship and facilitates consensus in treatment decisions, thereby enabling personalised and tailored medical care. Patient or Public Contribution Three nursing graduate students participated in the data extraction and integration process, with two students having extensive clinical experience that provided valuable insights for the integration.

Polymer solar cells (PSCs) with high power conversion efficiency (PCE) and environment-friendly fabrication are the main requirements enabling their production in industrial scale. While the use of non-halogenated solvent processing is inevitable for the PSC fabrication, it significantly reduces the processability of polymer donors (PDS) and small-molecule acceptors (SMAs). This often results in unoptimized blend morphology and limits the device performance. To address this issue, hydrophilic oligoethylene glycol (OEG) side-chains are introduced into a PD (2EG) to enhance the molecular compatibility between the PD and L8-BO SMA. The 2EG PD induces higher crystallinity and alleviates phase separation with the SMA compared to the reference PD (PM7) with hydrocarbon side-chains. Consequently, the 2EG-based PSCs exhibit a higher PCE (15.8%) than the PM7-based PSCs (PCE = 14.4%) in the ortho-xylene based processing. Importantly, benefitted from the reduced phase separation and increased crystallinity of 2EG PDS, the 2EG-based PSCs show enhanced thermal stability (84% of initial PCE after 120 h heating) compared to that of the PM7-based PSCs (60% of initial PCE after 120 h heating). This study demonstrates the potential of OEG side-chain-incorporated materials in developing efficient, stable, and eco-friendly PSCs.

Objectives. Cochlear implants are widely used for hearing rehabilitation in patients with profound sensorineural hearing loss. However, Cochlear implants have variable results, and central neural plasticity is considered to be a reason for this variability. We hypothesized that resting-state cortical networks play a role in conditions of profound hearing loss and are affected by cochlear implants. To investigate the resting-state neuronal networks after cochlear implantation, we acquired 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) images in experimental animals. Methods. Eight adult domestic cats were enrolled in this study. The hearing threshold of the animals was within the normal range, as measured by auditory evoked potential. They were divided into control (n=4) and hearing loss (n=4) groups. Hearing loss was induced by co-administration of ethacrynic acid and kanamycin. FDG-PET was performed in a normal hearing state and 4 and 11 months after the deafening procedure. Cochlear implantation was performed in the right ear, and electrical cochlear stimulation was performed for 7 months (from 4 to 11 months after the deafening procedure). PET images were compared between the two groups at the three time points. Results. Four months after hearing loss, the auditory cortical area’s activity decreased, and activity in the associated visual area increased. After 7 months of cochlear stimulation, the superior marginal gyrus and cingulate gyrus, which are components of the default mode network, showed hypermetabolism. The inferior colliculi showed hypometabolism. Conclusion. Resting-state cortical activity in the default mode network components was elevated after cochlear stimulation. This suggests that the animals’ awareness level was elevated after hearing restoration by the cochlear implantation.

Juvenile polyp makes up 70% to 80% of pediatric colon polyp, and the average age of diagnosis is 2 to 5 years. The treatment of juvenile polyp in children is polypectomy through colonoscopy. The fact that the lumen of intestine is much smaller than that of adults and the need to perform polypectomy is a heavy burden on the endoscopists. Recently, fecal calprotectin (FC) has been found to be related to juvenile polyp. A previously healthy 34-month-old female patient presented to the pediatric gastroenterology department with intermittent bloody stools that were progressively worsening. FC level was abnormally elevated at 2,719 µg/g (normal, < 50 µg/g). The polyp was successfully removed with a endoscopic polypectomy. This is the first case in Korea to show that FC can be used to screen juvenile polyp in children. Caution must be taken that FC levels can increase with inflammation, regardless of the number or size of the polyps.

Abstract Background Nutrition service needs are huge in China. Previous studies indicated that personalized nutrition (PN) interventions were effective. The aim of the present study is to identify the effectiveness and feasibility of a novel PN approach supported by artificial intelligence (AI). Methods This study is a two-arm parallel, randomized, controlled trial in real world scenario. The participants will be enrolled among who consume lunch at a staff canteen. In Phase I, a total of 170 eligible participants will be assigned to either intervention or control group on 1:1 ratio. The intervention group will be instructed to use the smartphone applet to record their lunches and reach the real-time AI-based information of dish nutrition evaluation and PN evaluation after meal consumption for 3 months. The control group will receive no nutrition information but be asked to record their lunches though the applet. Dietary pattern, body weight or blood pressure optimizing is expected after the intervention. In phase II, the applet will be free to all the diners (about 800) at the study canteen for another one year. Who use the applet at least 2 days per week will be regarded as the intervention group while the others will be the control group. Body metabolism normalization is expected after this period. Generalized linear mixed models will be used to identify the dietary, anthropometric and metabolic changes. Discussion This novel approach will provide real-time AI-based dish nutrition evaluation and PN evaluation after meal consumption in order to assist users with nutrition information to make wise food choice. This study is designed under a real-life scenario which facilitates translating the trial intervention into real-world practice. Trial registration This trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2100051771; date registered: 03/10/2021).

Background: We analyzed the impact of social distancing (SD) on vitamin D status and associated morbidity in neonates during the coronavirus disease (COVID-19) pandemic. Methods: Serum levels of 25-hydroxy vitamin D (25OHD) and clinical characteristics of newborn infants before (2019) and during SD (2021) were compared. Results: A total of 526 neonates (263 in 2019 and 263 in 2021) were included. The rate of vitamin D deficiency in neonates (47.1% vs. 35.4 %, p = 0.008) decreased and the rate of maternal vitamin D intake increased (6.8% vs. 37.6%, p < 0.001), respectively, during SD compared to those in 2019. The rates of hypocalcemia (12.5% vs. 3.8%, p < 0.001) and respiratory illness (57.0% vs. 43.0%, p = 0.002) decreased during SD. Neonatal vitamin D deficiency during SD was associated with maternal vitamin D supplementation (odds ratio [OR] = 0.463, p = 0.003) but was not associated with SD (OR = 0.772, p = 0.189). The mediation effect of SD on neonatal morbidity by neonatal vitamin D status was statistically insignificant. Conclusions: SD might affect the increased maternal vitamin D intake and decreased neonatal vitamin D deficiency. However, neonatal morbidity was not affected by SD, even with neonatal vitamin D status changes.

PURPOSE This study aimed to establish a standardized evaluation of the consistency and reliability of the results of the 2018 Buenos Aires Youth Olympics. METHODS The results of the preliminary and the final rounds of the individual Boys and Girls competition of the 2018 Buenos Aires Youth Olympics were collected. Data were organized using Microsoft Windows Excel 2021. Windows SPSS 26.0 was used for descriptive statistics. Intraclass correlation coefficient calculation was used to analyze the evaluation score. The winner/loser decision, and the evaluation interrater agreement was confirmed using Fleiss' kappa. RESULTS There was a difference in the scores given by the judges in both the preliminary and final rounds of both competitions. A low correlation was observed between the decided winner of the judges, and the point variance for each item. CONCLUSIONS In the trivium value system, differences in the evaluation strategies of the judges may exist. Thus, improvements to standardize evaluation should be implemented. In addition, this scoring system considers various factors in the evaluation process, and the scoring system is complicated. Therefore, there may be a need to revise the evaluation system and find the optimal number of judges to create a better evaluation.

Abstract Background Patients’ perception of receiving overtreatment can cause distrust in medical services. Unlike outpatients, inpatients are highly likely to receive many medical services without fully understanding their medical situation. This information asymmetry could prompt inpatients to perceive treatment as excessive. This study tested the hypothesis that there are systematic patterns in inpatients’ perceptions of overtreatment. Methods We examined determinant factors of inpatients’ perception of overtreatment in a cross-sectional design that used data from the 2017 Korean Health Panel (KHP), a nationally representative survey. For sensitivity analysis, the concept of overtreatment was analyzed by dividing it into a broad meaning (any overtreatment) and a narrow meaning (strict overtreatment). We performed chi-square for descriptive statistics, and multivariate logistic regression with sampling weights employing Andersen’s behavioral model. Results There were 1,742 inpatients from the KHP data set that were included in the analysis. Among them, 347 (19.9%) reported any overtreatment and 77 (4.42%) reported strict overtreatment. Furthermore, we found that the inpatient’s perception of overtreatment was associated with gender, marital status, income level, chronic disease, subjective health status, health recovery, and general tertiary hospital. Conclusion Medical institutions should understand factors that contribute to inpatients’ perception of overtreatment to mitigate patients’ complaints due to information asymmetry. Moreover, based on the result of this study, government agencies, such as the Health Insurance Review and Assessment Service, should create policy-based controls and evaluate overtreatment behavior of the medical providers and intervene in the miscommunication between patients and providers.

Cartilage has limited self-repair ability, leading to osteoarthritis postinjury and ultimately physical disability in people. In addition, cartilage injury is accompanied by loss of extracellular matrix (ECM) and infiltration of inflammation, which makes cartilage regeneration more difficult. In this study, a hybrid hydrogel of hydroxypropyl chitin and oxidized chondroitin sulfate (HPCH-OCS) with injectable and thermosensitive properties was prepared by a Schiff base reaction. In vitro, the HPCH-OCS hydrogel showed desirable biocompatibility and bioactivity by promoting chondrogenic differentiation of stem cells, maintaining the chondrocyte phenotype, and inhibiting proteins related to cartilage ECM catabolism under inflammatory conditions. In vivo, the HPCH-OCS hydrogel combined with microfracture could effectively repair cartilage defects and promote cartilage regeneration. In conclusion, the HPCH-OCS hydrogel has good biological and mechanical properties, and its combination with microfracture provides an effective strategy for clinical cartilage regeneration.

Suicide among the older population is a significant public health concern in South Korea. As the older individuals have long considered suicide before committing suicide trials, it is important to analyze the suicidal ideation that precedes the suicide attempt for intervention. In this study, six machine learning algorithms were employed to construct a predictive model for suicidal thinking and identify key variables. A traditional logistic regression analysis was supplementarily conducted to test the robustness of the results of machine learning. All analyses were conducted using a hierarchical approach to compare the model fit of each model in both machine learning and logistic regression. Three models were established for analysis. In Model 1, socioeconomic, residential, and health behavioral factors were incorporated. Model 2 expanded upon Model 1 by integrating physical health status, and Model 3 further incorporated mental health conditions. The results indicated that the gradient boosting algorithm outperformed the other machine learning techniques. Furthermore, the household income quintile was the most important feature in Model 1, followed by subjective health status, oral health, and exercise ability in Model 2, and anxiety and depression in Model 3. These results correspond to those of the hierarchical logistic regression. Notably, economic and residential vulnerabilities are significant factors in the mental health of the older population with higher instances of suicidal thoughts. This hierarchical approach could reveal the potential target population for suicide interventions.

BackgroundNeonates are at risk of nosocomial tuberculosis (TB) infection from health care workers (HCWs) in neonatal care facilities, which can progress to severe TB diseases. Tuberculin skin test (TST) is commonly used for TB diagnosis, but its accuracy in neonates is influenced by various factors, including bacilli Calmette-Guérin (BCG) vaccination. This study aimed to identify predictors of positive TSTs in neonates exposed to HCWs with pulmonary TB.MethodsA retrospective observational study was conducted to compare the frequency of predictors between TST-positive and TST-negative neonates. Demographic, epidemiological, and clinical data of neonates exposed to TB, along with that of HCW and household contacts, were collected retrospectively through contact investigations with the Korean National TB Surveillance System (KNTSS) database. TSTs using 2 tuberculin units of purified protein derivative RT23 were performed on exposed neonates at the end of preventive TB treatment. Firth logistic regression was performed to identify predictors of TST positivity.ResultsContact investigations revealed that 152 neonates and 54 HCWs were exposed to infectious TB index cases in 3 neonatal care facilities. Of 152 exposed neonates, 8 (5.3%) had positive TST results. Age of 6 days or more at the initial exposure is a statistically significant predictor of positive TST (Firth coefficient 2.1, 95% confidence interval 0.3-3.9, P = 0.024); BCG vaccination showed no statistical significance in both univariable and multivariable analysis. Sex, prematurity, exposure duration, duration from initial exposure to contact investigation, and isoniazid preventive treatment duration were not significant predictors.ConclusionAge at the initial exposure is a significant predictor of positive TST in neonates exposed to active pulmonary TB. Given the complexities of TST interpretation, including false positives due to BCG vaccination, careful risk assessment is necessary for appropriate decision-making and resource allocation in the management of neonatal TB exposure.

Category: Ankle; Sports Introduction/Purpose: Acute ankle ligament rupture is usually treated conservatively. However, it sometimes progresses to chronic ankle instability. We suspected that there is a tendency for calcaneal-side calcaneofibular ligament (CFL) ruptures to progress to chronic ankle instability. Methods: Fourteen athletes with calcaneal-side CFL ruptures who were treated conservatively and followed for a mean period of 35.2 months were included in the study. Proximal migration of the stump of CFL (mm) was evaluated using magnetic resonance imaging at a 45° oblique coronal plane. A Stener lesion was defined as severe migration outside the peroneal tendon. The results of manual anterior drawer, varus stress tests, and stress radiographs at the initial and final follow-up visits were compared. The time to return to running, team training, and sporting competitions were recorded. At the final follow-up, patient satisfaction and Cumberland Ankle Instability Tool (CAIT) were used to assess ankle function. Results: The mean proximal migration of CFL was 11.2 mm. Four Stener lesions were found. However, neither proximal migration nor Stener lesions were significantly related to CAIT scores (rho = 0.288 and rho = 0.082, respectively) instability significantly decreased after conservative treatment from a mean grade of 2.0 to 1.4 in the anterior drawer test (P = 0.032). The varus stress test results showed a decrease from grade 2.2 to 1.8 (P = 0.053) without significance. Radiologically, decreases in anterior translation from 6.1 mm to 5.4 mm (P = 0.205) and talar tilt angles from 7.2° to 6.5° (P = 0.500) were observed without significance. It took 12.2, 14.7, and 18.0 weeks to return to running, team training, and sporting competitions. Seven athletes (50%) reported unsatisfactory results. Conclusion: Conservative treatment for CFL rupture with proximal migration was associated with poor outcomes in athletes.

Category: Ankle; Sports Introduction/Purpose: A lateral ankle sprain is one of the most common musculoskeletal injuries for both athletes and non- athletes, causing chronic ankle instability. Talar tilt angle on a radiograph used for diagnosis of chronic ankle instability(CAI), however, there were no reports of instability of calcaneofibular ligament(CFL) itself through an MRI. This study aimed to determine whether measuring tortuosity angles of CFL through oblique coronal imaging of MRI in CAI. We compared CFL’s tortuosity angle with the talar tilt angle, Cumberland ankle instability tool(CAIT), and ankle strength in patients without a history of ankle sprain or not. Methods: From March 2020 to May 2022, Of the total 120 cases, the CAI group (82 patients) took CFL’s tortuosity angle in MRI and talar tilt angle inradiograph. The control group (38 patients) included those without an ankle sprain who visited this hospital due to an Achilles tendon rupture. In the control group, the talar tilt angle could not be achieved due to pain. Results: CFL’s tortuosity angle in MRI showed a significant difference of 76.5 ± 18.3º in the CAI group and 31.9 ± 5.4º in the control group(P < 0.001). The diagnostic cutoff value for CAI was more than 40º of the tortuosity angle. According to the measure of the isokinetic machine(Biodex), the CAI group shows a 22.8% deficit of the eversion strength. The tortuosity angle, talar tilt angle, and manual stress test show significantly different between both groups. However, CAIT and strength defect showed no significant results between both groups. Conclusion: CFL’s tortuosity angle through oblique coronary imaging of MRI, it’s average value was 31º degrees, and we can diagnose as CAI if CFL’s tortuosity angle is more than 40º.

Introduction Idiopathic pulmonary fibrosis is a progressive fibrotic lung disease with limited therapeutic options and high lethality, related to alveolar type II epithelial (ATII) cell dysregulation, the abnormal repair of alveolar epithelial cells and activation of fibroblasts promote the development of pulmonary fibrosis. Fatty acid binding protein 1 (FABP1) was significantly downregulated in the fibrotic state by proteomics screening in our previous date, and the ATII cell dysregulation can be mediated by FABP1 via regulating fatty acid metabolism and intracellular transport. The aim of this study was to evaluate the role and potential mechanism of FABP1 in the development of pulmonary fibrosis.Methods Proteomics screening was used to detect changes of the protein profiles in two different types (induced by bleomycin and silica, respectively) of pulmonary fibrosis models. The localisation of FABP1 in mouse lung was detected by Immunofluorescence and immunohistochemistry. Experimental methods such as lung pathology, micro-CT, western blotting, small animal imaging in vivo, EdU, etc were used to verify the role of FABP1 in pulmonary fibrosis.Results The expression of FABP1 in the mouse lung was significantly reduced in the model of pulmonary fibrosis from our proteomic analysis and immunological methods, the double immunofluorescence staining showed that FABP1 was mainly localised in type II alveolar epithelial cells. Additionally, the expression of FABP1 was negatively correlated with the progression of pulmonary fibrosis. Further in vivo and in vitro experiments showed that overexpression of FABP1 alleviated pulmonary fibrosis by protecting alveolar epithelium from injury and promoting cell survival.Conclusion Our findings provide a proof-of-principle that FABP1 may represent an effective treatment for pulmonary fibrosis by regulating alveolar epithelial regeneration, which may be associated with the fatty acid metabolism in ATII cells.

Abstract Chemical modifications of porous materials almost always result in loss of structural integrity, porosity, solubility, or stability. Previous attempts, so far, have not allowed any promising trend to unravel, perhaps because of the complexity of porous network frameworks. But the soluble porous polymers, the polymers of intrinsic microporosity, provide an excellent platform to develop a universal strategy for effective modification of functional groups for current demands in advanced applications. Here, we report complete transformation of PIM-1 nitriles into four previously inaccessible functional groups – ketones, alcohols, imines, and hydrazones – in a single step using volatile reagents and through a counter-intuitive non-solvent approach that enables surface area preservation. The modifications are simple, scalable, reproducible, and give record surface areas for modified PIM-1s despite at times having to pass up to two consecutive post-synthetic transformations. This unconventional dual-mode strategy offers valuable directions for chemical modification of porous materials.

Abstract Galloping of ice-coated transmission lines is occasionally observed under oblique wind directions. However, most current investigations on the galloping mechanisms are for flow perpendicular to the span of the transmission lines. In order to address this gap, this research studies the galloping characteristics of ice-coated transmission lines under oblique flows based on wind tunnel tests. The wind-induced displacement of an aero-elastic iced-coated transmission line model was measured with a noncontact displacement measurement equipment in a wind tunnel at different wind speeds and directions. The results show that galloping is characterized by elliptical trajectories and negative damping, which is more likely to occur under oblique flows than the direct flow (0°). At 15° wind direction, a galloping in vertical direction was observed at wind speeds above 5 m/s. At 30° wind direction, galloping was observed over the entire range of the tested wind speeds. Moreover, the galloping amplitudes under oblique flows are observed to be larger than that at the direct flows. Consequently, when the wind direction between the major winter monsoon azimuth and the lateral direction of transmission line route is between 15° and 30°, appropriate anti-galloping devices are highly recommended in practice.

Abstract Rheumatoid arthritis (RA) is a systemic immune disease characterized by synovial inflammation. Patients with RA commonly experience significant damage to their hand and foot joints, which can lead to joint deformities and even disability. Traditional treatments have several clinical drawbacks, including unclear pharmacological mechanisms and serious side effects. However, the emergence of antibody drugs offers a promising approach to overcome these limitations by specifically targeting interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and other cytokines that are closely related to the onset of RA. This approach reduces the incidence of adverse effects and contributes to significant therapeutic outcomes. Furthermore, combining these antibody drugs with drug delivery nanosystems (DDSs) can improve their tissue accumulation and bioavailability.Herein, we provide a summary of the pathogenesis of RA, the available antibody drugs and DDSs that improve the efficacy of these drugs. However, several challenges need to be addressed in their clinical applications, including patient compliance, stability, immunogenicity, immunosupression, target and synergistic effects. We propose strategies to overcome these limitations. In summary, we are optimistic about the prospects of treating RA with antibody drugs, given their specific targeting mechanisms and the potential benefits of combining them with DDSs.

Current advancements in biosignal-based user recognition technology are paving the way for a next-generation solution that addresses the limitations of face- and fingerprint-based user recognition methods. However, existing biosignal benchmark databases (DBs) for user recognition often suffer from limitations, such as data collection from a small number of subjects in a single session, hindering comprehensive analysis of biosignal variability. This study introduces CSU_MBDB1 and CSU_MBDB2, databases containing electrocardiogram (ECG) and electromyogram (EMG) signals from diverse experimental subjects recorded across multiple sessions. These in-house DBs comprise ECG and EMG data recorded in multiple sessions from 36 and 58 subjects, respectively, with a time interval of more than one day between sessions. During the experiments, subjects performed a total of six gestures while comfortably seated at a desk. CSU_MBDB1 and CSU_MBDB2 consist of three identical gestures, providing expandable data for various applications. When the two DBs are expanded, ECGs and EMGs from 94 subjects can be used, which is the largest number among the multi-biosignal benchmark DBs built by multi-sessions. To assess the usability of the constructed DBs, a user recognition experiment was conducted, resulting in an accuracy of 66.39% for ten subjects. It is important to emphasize that we focused on demonstrating the applicability of the constructed DBs using a basic neural network without signal denoising capabilities. While this approach results in a sacrifice in accuracy, it concurrently provides substantial opportunities for performance enhancement through the implementation of optimized algorithms. Adapting signal denoising processes to the constructed DBs and designing a more sophisticated neural network would undoubtedly contribute to improving the recognition accuracy. Consequently, these constructed DBs hold promise in user recognition, offering valuable research for future investigations. Additionally, DBs can be used in research to analyze the nonlinearity characteristics of ECG and EMG.

The escalating utilization of plastics in daily life has resulted in pervasive environmental pollution and consequent health hazards. The challenge of detecting and capturing microplastics, which are imperceptible to the naked eye, is exacerbated by their diminutive size, hydrophobic surface properties, and capacity to absorb organic compounds. This study focuses on the application of peptides, constituted of specific amino acid sequences, and microneedles for the rapid and selective identification of microplastics. Peptides, due to their smaller size and greater environmental stability compared with antibodies, emerge as a potent solution to overcome the limitations inherent in existing detection methodologies. To immobilize peptides onto microneedles, this study employed microneedles embedded with gold nanorods, augmenting them with sulfhydryl (SH) groups at the peptides’ termini. The sensor developed through this methodology exhibited efficient peptide binding to the microneedle tips, thereby facilitating the capture of microplastics. Raman spectroscopy was employed for the detection of microplastics, with the results demonstrating successful attachment to the microneedles. This novel approach not only facilitates localized analysis but also presents a viable strategy for the detection of microplastics across diverse environmental settings.

El aprendizaje de contenidos científicos puede generar cierto desinterés en el estudiantado. El empleo de metodologías docentes apropiadas y no desatender la dimensión afectiva pueden ayudar a revertir esta situación. En este estudio se presenta un escape room diseñado con el objeto de trabajar contenidos científicos con docentes en formación. Para comprobar su influencia en las dimensiones afectiva y cognitiva, se han analizado emociones, autoeficacia y actitudes, así como el aprendizaje de las y los participantes antes y después de la intervención en un estudio llevado a cabo durante dos cursos académicos. Los resultados muestran un incremento en las emociones positivas, autoeficacia y actitudes, así como en el aprendizaje de las y los participantes después de la intervención. A la luz de estos resultados, esta intervención tiene efectos positivos en las dimensiones afectiva y cognitiva.

Driven by the change in intense land use and land cover (LULC) due to fast urbanization, urban flooding events have become the most frequent and influential hazards over the last few decades. Accurately predicting possible flood-prone locations under the dynamic fluctuations of LULC is crucial for sustainable urban development. However, there has been sparse studies on systematic integration of LULC changes into anticipate urban development scenarios coupled with flooding vulnerability assessment. Therefore, this study proposed a robust and powerful cascade modeling chain consisting of Maximum Entropy, System Dynamics and Patch-generating Land Use Simulation in combination with shared socio-economic pathways for projecting temporal and spatial dynamic changes associated with urban flooding vulnerability. Taking Guangdong Hong Kong Macao Greater Bay Area (GBA) as case study, the results showed that the increase in urban flooding was largely caused by the expansion of construction land. Overall, a substantial distinction within the scenarios was observed and the flooding vulnerability was ranked in the order of SSP126

The introduction of device-assisted enteroscopy (DAE) in the beginning of 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of the small bowel diseases, DAE has the unique advantages of observing the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how to perform it and what technical factors should be considered. In response to these needs, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on the performance of DAE by reviewing the current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points.

Background/Aims Women with rheumatoid arthritis (RA) are often diagnosed with the disease during their reproductive years; however, its incidence and prevalence among women of childbearing age have not been studied. The objective of this study was to estimate the incidence and prevalence of seropositive rheumatoid arthritis (SPRA) among Korean women of childbearing age. Methods Women aged 20 to 44 years with SPRA were identified from National Health Insurance Service-National Health Information Database (2009 to 2016). SPRA was defined by International Classification of Diseases, 10th revision code, M05. Incidence and prevalence were calculated per 100,000 person-years and stratified by year and age. Results The average incidence and prevalence of SPRA from 2011 to 2016 among women of childbearing age was 24.1/100,000 person-years (95% confidence interval [CI], 23.7 to 24.5) and 105.2/100,000 person-years (95% CI, 100.9 to 109.5), respectively. The incidence increased annually from 21.0/100,000 person-years (95% CI, 20.1 to 21.9) in 2009 to 28.4 person-years (95% CI, 27.3 to 29.5) in 2016. Similarly, the prevalence increased annually from 95.7/100,000 person-years (95% CI, 93.7 to 97.6) in 2009 to 111.0 person-years (95% CI, 108.9 to 113.2) in 2015, with a slight decrease in 2016 (110.4 person-years; 95% CI, 108.2 to 112.6). The incidence and prevalence of SPRA increased with advancing age. The peak age for both incidence and prevalence of SPRA among women of childbearing age was 40 to 44 years. Conclusions The risk of SPRA is high in women during their childbearing years; this population bears a significant disease burden. This calls for special attention to this particular population group to reduce the risk and burden of this disease.

The introduction of device-assisted enteroscopy (DAE) in the beginning of the 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of small bowel diseases, DAE has the unique advantages of allowing the observation of the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how it is to be performed and what technical factors should be taken into consideration. In response to these needs, the Korean Association for the Study of Intestinal Diseases has developed an expert consensus statement on the performance of DAE by reviewing current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points.

We report the results of investigating and managing a tuberculosis (TB) exposure in a postpartum care center. Among the contacts exposed to a nursing assistant with subclinical TB, 5 of 44 neonates (11.4%) had positive tuberculin skin tests (TSTs) at 3 months of age, and all the TST-positive neonates received the Bacille Calmette-Guérin vaccination. Seven of 28 healthcare workers (25.0%) and 1 of 3 household contacts (33.3%) were positive in the initial or repeated interferon-gamma release assay. None of the contacts developed TB disease during the study period. Annual TB examinations of healthcare personnel at a postpartum care center under the Tuberculosis Prevention Act in South Korea enabled the early detection of subclinical TB, which reduced the risk of transmission to neonates under strict coronavirus disease 2019 prevention measures.

In order to reduce various environmental pollutants and green house gas emissions caused by the use of fossil fuels, countries around the world are making various efforts to revitalize the supply of eco-friendly vehicles such as FCEVs(fuel cell electric vehicles) and electric vehicles. As a policy to revitalize the supply of eco- friendly cars, it is pushing for purchase subsidies and tax reduction policies, and aims to supply 6.7 million fuel cell electric vehicles and 310 hydrogen charging stations by 2022. Meanwhile in order for eco-friendly cars to be activated, various policies such as subsidies, vehicle price reduction, easing various regulatory policies, and promoting incentive policies are needed, but above all, installing charging facilities is important to revitalize eco-friendly vehicles. In this study, the current status of the FCEV industry and the promotion strategy according to the supply of FCEVs were presented to revitalize the supply of the FCEVs suitable for the situation in Gyeongsangbuk-do. The first, practical hydrogen utilization measures should be prepared first in purchasing business vehicles through a plan to supply FCEVs, expand subsides to revitalize the supply of FCEVs, and secure subsidies for operation of hydrogen charging stations. The second, it is necessary to build a hydrogen production base in Gyeongsangbuk-do to expand the FCEV infrastructure, build an institutional plan to revitalize FCEVs, and reduce hydrogen costs through green hydrogen production and production base construction. The third, it is necessary to train professionals, in the hydrogen industry and promote the transformation of local people’s perception of hydrogen and hydrogen charging stations. Therefore, Gyeongsangbuk-do can secure competitiveness in the hydrogen industry by supplying FCEVs and expanding hydrogen charging stations, and contribute for forstering the hydrogen economy, a key driving force for future innovation growth and energy conversion.

Abstract Background While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design. Methods A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied “Clinical Critical Thinking Training” together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann–Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience. Results The students’ interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p

Major traumatic tissue defects are common clinical problems often complicated by infection and local vascular dysfunction, processes which hinder the healing process. Although local application of growth factors or stem cells through various tissue engineering techniques are promising methods for the repair of tissue defects, limitations in their clinical application exist. Herein, we synthesized multifaceted nanohybrids composed of Quaternized chitosan (QCS), Graphene oxide (GO), and Polydopamine (PDA; QCS-GO-PDA). Covalent grafting of QCS and GO at a mass ratio of 5:1 (5QCS-1GO) displayed excellent biocompatibility and enhanced osteogenic ability, while addition of PDA (5QCS-1GO-PDA) reduced the level of reactive oxygen species (ROS). 5QCS-1GO-PDA was able to achieve wound tissue regeneration by reducing the inflammatory response and enhancing angiogenesis. Furthermore, Polylactic acid/hydroxyapatite (PLA/HA) composite scaffolds were printed using Selective Laser Sintering (SLS) and the hybrid nanomaterial (5QCS-1GO-PDA) was used to coat the PLA/HA scaffold (5QCS-1GO-PDA@PLA/HA) to be used for rapid bone regeneration. 5QCS-1GO-PDA not only improved angiogenesis and osteogenic differentiation, but also induced M2-type polarization of macrophages and promoted bone regeneration via the BMP2/BMPRs/Smads/Runx2 signaling pathway. The bidirectional enhanced healing ability of the multifaceted nanohybrids 5QCS-1GO-PDA provides a promising method of effectively treating tissue defects.

BackgroundThe use of heating and ventilation air conditioning (HVAC) in public places is conducive to improving indoor air quality and increasing the users comfort level. However, HVAC may also become potential carriers of indoor airborne microbial contamination.ObjectiveTo understand the characteristics of microbial pollution and distribution of related pathogenic microorganisms in HVAC of star-rated hotels, and to provide a basis for effective control of such pollution.MethodsAccording to the requirements of the Hygienic specification of central air conditioning ventilation system in public buildings (WS 394-2012), two sets of HVAC in two star-rated hotels (A and B, inaugurated in 2002 and 1998, respectively) in the central area of Shanghai were randomly selected on September 9, 2020 for the hygienic evaluation of microorganisms in the air supply and respirable particulate matter (PM10) in the air supply, dust accumulation and microorganisms on the inner surface of the ducts, as well as Legionella pneumophila in cooling water and condensate water. At the same time, 3 samples from the inner surface of ducts, 1 sample from the surface of the filter, 1 sample from the condensate, and 1 sample from the cooling water were collected from each set of HVAC, a total of 12 sample from 2 sets of HVAC, for Illumina HiSeq metagenomic sequencing，and the samples are divided into 3 groups according to their types: duct group, filter group, and water sample group. The α-diversity indices (Shannon index, Simpson index, Chao1 index, ACE index, and goods_coverage index) were calculated to reflect the microbial community composition; and the β-diversity of the three groups were studied by principal component analysis to determine the similarity of the microbial communities.ResultsThe maximum total number of bacteria and fungi in the air supply of the HVAC were 1158 CFU·m−3 and 344 CFU·m−3 for Hotel A respectively; and 2000 CFU·m−3 and 532 CFU·m−3 for Botel B respectively. β-hemolytic streptococci were negative in all samples; the respirable particulate matter, microorganisms and dust accumulation on the inner surface of air ducts, Legionella pneumophila IN cooling water and condensate samples all met the standards. The results of Illumina HiSeq sequencing showed that a total of 17322 microorganisms were reported in the 12 samples, with bacterial microbiota accounting for 97.31% of the classified genes and the remaining 2.69% were from fungi, viruses, and parasites. At the species level, Staphylococcus epidermidis, Pseudomonas, Alternaria, and Malassezia were the dominant microbial taxa measured in this survey. The results of α-diversity analysis showed that the values of Shannon index, Simpson index, and Chao1 index for the three groups of samples were duct > filter > water sample. The goods coverage indices of all sample groups s were close to 1. The principal component analysis showed that the contributions of two principal components were 19.27% and 14.25%, respectively, in which the samples of the filter and duct groups were better clustered into one category.ConclusionThe overall hygiene conditions of the two hotels are good, except for the serious microbial contamination in the air supply of HVAC. Metagenomic sequencing reveals complex microbial communities of HVAC, including bacteria, fungi, viruses, and parasites. The species composition vary by sample groups, particularly the species compositions of the samples from filters and ducts are close and dominated by pathogenic microorganisms of human origin, suggesting that the potential biosafety hazards of HVAC should not be ignored.

Abstract Background Adjuvant chemoradiotherapy (CRT) has been shown to reduce the risk of recurrence for patients with risk factors after radical hysterectomy (RH). Early initiated CRT could result in superior oncological outcomes. Here, we aimed to compare the survival outcome of intermediate- or high-risk cervical cancer (CC) patients who, received adjuvant CRT between minimally invasive surgery (MIS) and open surgery. Methods Data on stage IB1-IIA2 patients who underwent RH and postoperative CRT in our institution, from 2014 to 2017, were retrospectively collected. Patients with high or intermediate-risk factors who met the Sedlis criteria received sequential chemoradiation (SCRT). According to the surgical approaches, the enrolled patients were divided into MIS and open surgery groups. Then, the disease-free survival (DFS), overall survival (OS), and prognostic factors were analyzed. Results Among 129 enrolled CC patients, 68 received open surgery and 61 received MIS. The median time interval from surgery to chemotherapy and to radiotherapy was shorter in the MIS group (7 days vs. 8 days, P=0.014; 28 days vs. 35, P4 cm and time interval from surgery to radiotherapy beyond 7 weeks were adverse independent prognostic factors for DFS. Conclusion Based on the population we studied, for early-stage (IB1-IIA2) CC patients with intermediate- or high-risk factors who received postoperative SCRT, although the difference was not significant, the DFS and OS in the MIS group were slightly lower than the ORH group, and tumor size >4 cm and delayed adjuvant radiotherapy beyond 7 weeks were risk factors for recurrence.

Background/Aims We aimed to estimate the prevalence of comorbidities and medication use in Korean women with rheumatic diseases (RDs) during their childbearing years. Methods We included women aged 20 to 44 years with seropositive rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS) (n = 41,547) and age-matched women without seropositive RA, SLE, and AS (n = 208,941) from the National Health Insurance Service-National Health Information Database (2009 to 2016). The prevalence of hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), and cancer and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids (CSs), and disease-modifying anti-rheumatic drugs (DMARDs) were estimated. Results Women of childbearing age with RDs were more likely to have at least one of the measured comorbidities than the controls (odds ratio [OR], 3.0; 95% confidence interval [CI], 2.9 to 3.1). The OR (95% CI) was 2.9 (2.8 to 3.0) for HTN, 2.8 (2.7 to 2.9) for HLD, 1.4 (1.4 to 1.5) for DM, and 1.3 (1.3 to 1.4) for cancer. The SLE group had the highest prevalence and odds of all four measured comorbidities. Almost all (97.9%) women of childbearing age with RDs were taking RD-related medications (NSAIDs, 81.6%; CSs, 77.8%; DMARDs, 87.3%). The RD group was 13.8 times more likely to take NSAIDs and 68.2 times more likely to take CSs than the controls. Use of NSAIDs was more prevalent in RA and AS than SLE, whereas use of CSs and DMARDs was more prevalent in RA and SLE than AS. Conclusions Korean women with RDs have a greater burden of comorbidities and medication use during their childbearing years than women without RDs of the same age.

Background/Aims: There have been few studies regarding the prognosis of intestinal Behçet’s disease (iBD) patients according to consensus-based diagnostic categories, which reflects the typicality of intestinal ulcers, the presence of oral ulcers, and the accompanying systemic manifestations. Methods: The medical records of patients who had ileocolonic ulcers with a clinical impression of iBD were reviewed. The patients were categorized according to the diagnostic algorithm at the time of diagnosis. Adverse events were defined as major surgery or admission related to iBD deterioration. Results: A total of 163 patients were included in the study. The male-to-female ratio was 1:1.2, and the mean age at the time of diagnosis was 48.9±15.9 years. The numbers of patients who met the definite, probable, suspected, and nondiagnostic iBD criteria were 19 (11.7%), 61 (37.4%), 38 (23.3%), and 45 (27.6%), respectively. The event-free survival of patients with definite, probable, and suspected iBD was significantly shorter than that of patients with nondiagnostic iBD (p=0.026), while there was no significant difference among the definite iBD, probable iBD, and suspected iBD groups (p=0.596). After excluding patients with nondiagnostic iBD, multivariate analysis showed that anemia, fever, colonic involvement other than the ileocecum, and accompanying hematologic disorders at the time of diagnosis were significantly associated with the development of adverse events. Conclusions: The clinical course of patients with definite, probable, and suspected iBD is distinguished from that of patients with nondiagnostic iBD, but patients with definite, probable, and suspected iBD share similar clinical courses.