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Objective: The purpose of our study is to develop a spoken dialogue system (SDS) for pain questionnaire in patients with spinal disease. We evaluate user satisfaction and validated the performance accuracy of the SDS in medical staff and patients.Methods: The SDS was developed to investigate pain and related psychological issues in patients with spinal diseases based on the pain questionnaire protocol. We recognized patients’ various answers, summarized important information, and documented them. User satisfaction and performance accuracy were evaluated in 30 potential users of SDS, including doctors, nurses, and patients and statistically analyzed.Results: The overall satisfaction score of 30 patients was 5.5 ± 1.4 out of 7 points. Satisfaction scores were 5.3 ± 0.8 for doctors, 6.0 ± 0.6 for nurses, and 5.3 ± 0.5 for patients. In terms of performance accuracy, the number of repetitions of the same question was 13, 16, and 33 (13.5%, 16.8%, and 34.7%) for doctors, nurses, and patients, respectively. The number of errors in the summarized comment by the SDS was 5, 0, and 11 (5.2%, 0.0%, and 11.6 %), respectively. The number of summarization omissions was 7, 5, and 7 (7.3%, 5.3%, and 7.4%), respectively.Conclusion: This is the first study in which voice-based conversational artificial intelligence (AI) was developed for a spinal pain questionnaire and validated by medical staff and patients. The conversational AI showed favorable results in terms of user satisfaction and performance accuracy. Conversational AI can be useful for the diagnosis and remote monitoring of various patients as well as for pain questionnaires in the future.

Although several types of odontogenic tumors share the same mutations in MAPK pathway genes, their effects on MAPK activation remain unclarified. This study aimed to evaluate the associations between these mutations and ERK phosphorylation in ameloblastoma and mixed odontogenic tumors (MOTs) and to analyze the expression pattern of phosphorylated ERK (p-ERK) for determining the involvement of MAPK activation in the development and progression of odontogenic tumors. Forty-three odontogenic tumors consisting of 18 ameloblastomas and 25 MOTs were analyzed for BRAF, KRAS, and NRAS mutations by Sanger sequencing. The expressions of BRAF

Objectives The objective of this study was to demonstrate the clinical, radiologic, and histologic features of orthokeratinized odontogenic cyst (OOC); determine the characteristics of multiple OOCs; and present rare but significant manifestations of OOC. Study Design A clinical, radiologic, and histopathologic study of 65 primary and 2 recurrent OOC cases was performed retrospectively along with a comprehensive literature review. Results OOCs shared similar radiologic findings with odontogenic keratocyst, yet some showed features that have not been previously described: root resorption and radiopaque foci. Histologic review revealed a unique histiocytic lining and some findings suggestive of the multipotentiality of the odontogenic epithelium. The analysis of patients with multiple OOCs demonstrated that multiple OOCs occurred synchronously with a marked predilection for young male adults. Two unusual cases were also identified: an OOC combined with a BRAFV600E ameloblastoma and a recurrent OOC with malignant transformation. Conclusions This largest series presents previously unreported radiographic and histopathologic features that can be seen in OOC. Multiple OOCs have clinical characteristics distinct from those of solitary cases. The first reported OOC associated with ameloblastoma suggests the involvement of oncogenic mutations in odontogenic tumorigenesis. Although OOC shows a low recurrence rate, the possibility of malignant transformation of recurrent OOCs should be emphasized.

Antarctic continental margin sediments are eroded from the shelf and transported to the slope/rise in association with changing ice sheet configuration. Understanding the dynamics of this transport pathway is important for utilizing distal deep-sea sedimentary archives to determine past changes in the Antarctic ice sheet. However, these connections are poorly understood. Here we present multi-proxy records of two sediment cores (BS17-GC01 and BS17-GC02) from the Bellingshausen Sea continental rise, to explore relationships between depositional regime and ice sheet dynamics. Two cores show depositional/sedimentological variations on glacial-interglacial scales. Biogenic sediments were deposited during MIS 1, 5, and 7 under open ocean conditions. Glacial to deglacial sediments were laminated as a result of varying intensity of bottom currents. Terrestrially derived sediments are inferred to be transported from shelf both as grounded ice advanced during glacial expansion, and as ice retreated during deglacial periods. Sediment color shifted to brown after deglacial periods with high Mn/Ti and occurrence of bioturbation, indicating increasing bottom water oxygenation in the study area. Since surface water production started to increase from deglacial periods, we infer increased bottom water oxygenation in this setting is due to ventilation (i.e., Antarctic Bottom Water (AABW) formation), implying that AABW formation was increased during interglacial periods from deglacial period whereas was decreased during glacial periods. Thus, sedimentary/depositional changes in BS17-GC01 and BS17-GC02 are closely linked to ice sheet dynamics during the late Quaternary.

Background Neuropilin-2 (NRP2) is a multifunctional single-pass transmembrane receptor that binds to two disparate ligands, namely, vascular endothelial growth factors (VEGFs) and semaphorins (SEMAs). It is reportedly involved in neuronal and vascular development. In this study, we uncovered the exact functional role of NRP2 and its molecular mechanism during aggressive behaviors and lymph node (LN) metastasis in human head and neck cancer (HNC) and identified algal methanol extract as a potential novel NRP2 inhibitor. Methods In silico analyses and immunohistochemistry were used to investigate the relationship between NRP2 expression and the prognosis of HNC patients. The functional role of NRP2 on the proliferation, migration, invasion, and cancer stem cell (CSC) properties of HNC cells was examined by MTS, soft agar, clonogenic, transwell migration and invasion assays, and sphere formation assays. Signaling explorer antibody array, western blot, and qPCR were performed toward the investigation of a molecular mechanism that is related to NRP2. Results NRP2 was highly expressed in HNC and positively correlated with LN metastasis and advanced tumor stage and size in patients. Using loss- or gain-of-function approaches, we found that NRP2 promoted the proliferative, migratory, and invasive capacities of human HNC cells. Furthermore, NRP2 regulated Sox2 expression to exhibit aggressiveness and CSC properties of human HNC cells. We demonstrated that p90 ribosomal S6 kinase 1 (RSK1) elevates the aggressiveness and CSC properties of human HNC cells, possibly by mediating NRP2 and Sox2. Zeb1 was necessary for executing the NRP2/RSK1/Sox2 signaling pathway during the induction of epithelial-to-mesenchymal transition (EMT) and aggressive behaviors of human HNC cells. Moreover, the methanol extract of Codium fragile (MECF) repressed NRP2 expression, inhibiting the RSK1/Sox2/Zeb1 axis, which contributed to the reduction of aggressive behaviors of human HNC cells. Conclusions These findings suggest that NRP2 is a critical determinant in provoking EMT and aggressive behaviors in human HNC through the RSK1/Sox2/Zeb1 axis, and MECF may have the potential to be a novel NRP2 inhibitor for treating metastasis in HNC patients.

Patients with acute ischemic stroke can benefit from reperfusion therapy. Nevertheless, there are gray areas where initiation of reperfusion therapy is neither supported nor contraindicated by the current practice guidelines. In these situations, a prediction model for mortality can be beneficial in decision-making. This study aimed to develop a mortality prediction model for acute ischemic stroke patients not receiving reperfusion therapies using a stacking ensemble learning model. The model used an artificial neural network as an ensemble classifier. Seven base classifiers were K-nearest neighbors, support vector machine, extreme gradient boosting, random forest, naive Bayes, artificial neural network, and logistic regression algorithms. From the clinical data in the International Stroke Trial database, we selected a concise set of variables assessable at the presentation. The primary study outcome was all-cause mortality at 6 months. Our stacking ensemble model predicted 6-month mortality with acceptable performance in ischemic stroke patients not receiving reperfusion therapy. The area under the curve of receiver-operating characteristics, accuracy, sensitivity, and specificity of the stacking ensemble classifier on a put-aside validation set were 0.783 (95% confidence interval 0.758–0.808), 71.6% (69.3–74.2), 72.3% (69.2–76.4%), and 70.9% (68.9–74.3%), respectively.

To identify the prognostic markers of oral squamous cell carcinoma (OSCC), the genetic heterogeneity of the pathological stages was investigated.The data of 295 patients with primary OSCC obtained from the Cancer Genome Atlas were studied. The genetic prognostic landscape of the pathological stages was systematically analyzed by Cox regressions, Fisher's exact tests, and Gene Ontology (GO) enrichment.Stage 4 patients had a poor prognosis in univariate and multivariate Cox models. Transforming growth factor-beta (TGF-β) pathway alterations were found more frequently in stage 4, whereas alterations in cell cycle pathways were significant in stages 1, 2, and 3. The differentially mutated genes were divided into three groups: risk genes of high stage, hazardless genes, and risk genes of low stage. The risk genes of low stage (RNF112, AKR7L, ZSCAN5C, and ZPBP) were independent prognostic factors with stage 4 and treatment modality in multivariate Cox regressions. Additionally, in genetic interaction analysis, NOMO1 and ZNF333 had a high co-occurrence in high stage, and WIZ had high co-occurrence in low stage. In GO enrichment, the prognostic genes were clustered at the functional term of RNA polymerase II transcription, and ZNF333 had an association with RNA transcription.The genetic mutation type and ratio of tumor heterogeneity are different for each stage of OSCC, and stratification of OSCC patients with differential therapeutic efficacy is needed. Risk genes of both high and low stages must be identified in patients diagnosed with low-stage OSCC. Mutations in NOMO1, ZNF333, and WIZ should be considered as potential prognostic markers.

Background. Rotational thrombelastometry (ROTEM) has been used to evaluate the coagulation state, predict transfusion, and optimize hemostatic management in trauma patients. However, there were limited studies on whether the prediction value could be improved by adding the ROTEM parameter to the prediction model for in-hospital mortality and massive transfusion (MT) in trauma patients. Objective. This study assessed whether ROTEM data could improve the MT prediction model. Method. This was a single-center, retrospective study. Patients who presented to the trauma center and underwent ROTEM between 2016 and 2020 were included. The primary and secondary outcomes were massive transfusions and in-hospital mortality, respectively. We constructed two models using multivariate logistic regression with backward conditional stepwise elimination (Model 1: without the ROTEM parameter and Model 2: with the ROTEM parameter). The area under the receiver operating characteristic curve (AUROC) was calculated to assess the predictive ability of the models. Result. In total, 969 patients were included; 196 (20.2%) received MT. The in-hospital mortality rate was 14.1%. For MT, the AUROC was 0.854 (95% confidence interval [CI], 0.825–0.883) and 0.860 (95% CI, 0.832–0.888) for Model 1 and 2, respectively. For in-hospital mortality, the AUROC was 0.886 (95% CI, 0.857–0.915) and 0.889 (95% CI, 0.861–0.918) for models 1 and 2, respectively. The AUROC values for models 1 and 2 were not statistically different for either MT or in-hospital mortality. Conclusion. We found that the addition of the ROTEM parameter did not significantly improve the predictive power of MT and in-hospital mortality in trauma patients.

Background: Vasculogenic mimicry (VM) is the formation of an alternative circulatory system by aggressive tumor cells. The characteristics of VM and its underlying mechanism in oral squamous cell carcinoma (OSCC) remain unclear. This study aims to determine the relationship between VM channels in OSCC tissues and clinical outcomes and to investigate the biological role of SOX7 in VM in OSCC cells.Methods: CD31/PAS double staining was performed to evaluate VM status in OSCC tissue. The relationships between VM and clinicopathological variables, and VM and SOX7 levels were analyzed. The correlation between SOX7 levels and head and Neck cancer corhorts were investigated using in silico analysis.VM channel formation assay was performed to observe VM channels in the OSCC cell lines. To investigate the role of SOX7 in VM channel formation, SOX7 was transiently over-expressed in SCC-9 cells. VM-modulating genes were identified by Western blotting.Results: We confirmed the presence of VM channels in OSCC tissue and several cell lines and found a positive correlation between VM and lymph node metastasis and patient survival in OSCC (P = 0.003). In silico analysis from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database showed that down-regulation of SOX7 expression was significantly correlated with head and neck squamous cell carcinoma (HNSCC) patient cohorts (P = 0.0187) and lymph node metastasis (P = 0.0017). We also found that the presence of VM channels in OSCC tissue was inversely associated with SOX7 expression (P = 0.020). We observed that overexpression of SOX7 impaired VM channel formation by reducing the expression of VE-cadherin, thereby inhibiting cell migration and invasion.Conclusion: These results suggest that SOX7 plays an important role in the regulation of VM channel formation and may inhibit OSCC metastasis.

The frequency of CD4+CD8+ double-positive (DP) T cells is highly associated with a variety of diseases. Recently, we used high-throughput single-cell RNA sequencing to show that circulating DP T cells in cynomolgus monkeys comprise nine heterogeneous populations. To better understand the characteristics of DP T cells, we analyzed 7601 cells from a rhesus monkey and detected 14,459 genes. Rhesus monkey DP T cells comprised heterogeneous populations (naïve, Treg-, Tfh-, CCR9+ Th-, Th17-, Th2-, Eomes+ Tr1-, CTL-, PLZF+ innate- and Eomes+ innate-like cells) with multiple potential functions. We also identified two new subsets using aggregated scRNA-seq datasets from the rhesus and the cynomolgus monkey: CCR9+ Th-like cells expressing ICAM2 and ITGA1, and PLZF+ innate-like cells that display innate-associated gene signatures such as ZBTB16, TYROBP, MAP3K8, and KLRB1. Trajectory inference of cell differentiation status showed that most DP T cells in the rhesus monkey were found in the mid-to-late pseudotime, whereas DP T cells from the cynomolgus monkey were found in early pseudotime. This suggests that DP T cells in rhesus monkeys may exhibit more diverse differentiation states than those in cynomolgus monkeys. Thus, scRNA-seq and trajectory inference identified a more diverse subset of the circulating DP T cells than originally thought.

Background Although immunohistochemistry (IHC) along with molecular tests has been investigated in ameloblastoma for BRAF V600E detection, VE1 IHC has not been studied in odontogenic carcinomas (OCs) and benign mixed epithelial and mesenchymal odontogenic tumours (BMOTs). Here, we performed BRAF V600E mutation analysis, examined the expression pattern of VE1 IHC, and comparatively evaluated the performance of two VE1 antibodies in ameloblastomas, OCs and BMOTs. Methods BRAF V600E detection was performed using Sanger sequencing in a total of 47 odontogenic tumours: 28 ameloblastomas, 6 OCs and 13 BMOTs. VE1 IHC was conducted using two different antibodies (IHC-A and IHC-V), and their performance was analysed by calculating the sensitivity and specificity compared with sequencing. Results BRAF V600E mutations were identified in 24/28 (85.7%) ameloblastomas, 2/5 (40.0%) ameloblastic carcinomas (ACs), 3/7 (42.9%) ameloblastic fibromas and 1/2 (50.0%) ameloblastic fibro-odontomas. In the presence of the mutation, VE1 showed diffuse cytoplasmic staining in ameloblastomas and ACs, whereas all BMOTs were negative for VE1. IHC-A and IHC-V yielded a sensitivity of 76.7% and 60.0%, respectively, although both antibodies showed 100% specificity. Conclusion OCs and BMOTs have BRAF V600E mutations in common at lower frequencies than ameloblastoma. Diffuse VE1 cytoplasmic staining in AC suggests the utility of MAPK-targeted therapy as selectively applied in ameloblastoma, and consistent VE1 false-negative expression in BMOTs requires further investigation. Considering the high specificity but low sensitivity of VE1 IHC, molecular tests should be performed to determine the presence of BRAF V600E mutations in odontogenic tumours.

Traumatic retropharyngeal hematoma is a potentially life-threatening complication of cervical spine injury due to possible airway obstruction. Treatment by securing airway and subsequent conservative care is often adequate. However, a rapidly expanding large hematoma requires surgical evacuation. We present a case of 55-year-old man with a retropharyngeal hematoma secondary to cervical vascular injury without associated cervical fracture. The patient was successfully treated with endovascular arterial embolization and subsequent percutaneous drainage under fluoroscopic guidance without any sequelae.

Raised beaches are amongst the most important and direct indicators of relative sea-level change and timing of degladation in Antarctica. Infrared stimulated luminescence dating of cobble surfaces on two sets of raised beaches in Terra Nova Bay in Victoria Land of Antarctica records relative sea-level change since the Mid-Holocene. This study includes dating on five raised beaches on Inexpressible Island (II-1 to II-5) and five raised beaches at Jang Bogo Station (JS-1 to JS-5). The raised beaches at Jang Bogo Station began to form before 6.0 ± 0.8 ka, emerging at an average rate of 0.9 m/ka. The rate of emergence on Inexpressible Island was 1.6+0.2/−0.1 m/ka from 4.8 ± 0.5 to 1.1 ± 0.1 ka, since when the rate has been 14.9+1.8/−1.0 m/ka. The proximity of the two study sites suggests that glacier melting, and associated glacio-isostatic rebound alone cannot explain the difference between the rates of emergence at the two sets of raised beaches. This spatio-temporal difference in the emergence rates is likely the result of both local tectonics and glacio-isostatic rebound. This view is consistent with recent GPS geodetic analyses, albeit the geologic and geodetic data are on different temporal scales. Moreover, the rapid uplift since 1.1 ka on Inexpressible Island is likely due to vertical movement associated with active faulting.

Objectives Leiomyosarcoma is a malignant neoplasm that affects smooth muscle tissue and it is very rare in the field of oral and maxillofcial surgery. The purpose of this study was to obtain information on diagnosis of and treatment methods for leiomyosarcoma by retrospectively reviewing of the cases. Patients and Methods The study included nine patients who were diagnosed with leiomyosarcoma in the Department of Oral and Maxillofacial Surgery at Seoul National University Dental Hospital. The subjects were analyzed with respect to sex, age, clinical features, primary site of disease, treatment method, recurrence, and metastasis. Results Particular clinical features included pain, edema, mouth-opening limitations, dysesthesia, and enlarged lymph nodes. All cases except one were surgically treated, and recurrence was found in two cases. Four of nine patients were followed up without recurrence and one patient underwent additional surgery due to recurrence. Conclusion In our case series, notable symptoms included pain, edema, mouth-opening limitations, and dysesthesia; however, it was difficult to label these as specific symptoms of leiomyosarcoma. Considering the aggressive characteristics of the disease and poor prognosis, surgical treatment is necessary with careful consideration of postoperative radiotherapy and chemotherapy.

Extracranial cerebrovascular diseases represent approximately 20% of ischemic stroke cases. Carotid endarterectomy (CEA) was the gold standard procedure for carotid artery stenosis treatment until the introduction of carotid artery stenting (CAS) in the 1980s. While there have been several multicenter randomized trials comparing CEA and CAS, a more efficacious procedure has not been conclusively distinguished. This study reports the results of CAS versus CEA in patients with symptomatic or asymptomatic carotid stenosis and compares them with those from other studies.This study is a single-center retrospective study and included patients who underwent CAS and CEA as elective surgery between January 2012 and December 2020. The final analysis included patient baseline characteristics, postoperative complications, and patient outcomes.The 235 patients included were assigned to the CAS (n=128) and CEA (n=107) groups. Within 30 days postoperatively, no significant differences were noted in myocardial infarction [n=1, 0.8% (CAS); n=1, 0.9% (CEA); P=0.899], cerebral infarction [n=4, 3.1% (CAS); n=1, 0.9% (CEA); P=0.247], and patient mortality [n=1, 0.8% (CAS); n=0, 0% (CEA); P=0.247].In elective surgery, CAS and CEA had the same effect of preventing cerebral infarction with no difference in postoperative complications.

Infectious bronchitis virus (IBV) is a major pathogen in poultry. The genotypes of IBV vary considerably, and their antigenicity may differ. Nationwide surveillance in South Korea was performed to determine the prevalence and distribution of IBV and its genotypes. By both active and passive surveillance, a total of 939 samples were collected and tested for IBV detection by pathogen-specific reverse transcriptase-PCR. IBV RNA-positive samples were inoculated in embryonated eggs for virus isolation. IBV was genotyped and analyzed phylogenetically based on a partial nucleotide sequence of the S1 gene. A total of 114 IBV strains were isolated; 34 (30.9%) of the 110 samples obtained by passive surveillance, and 80 (9.7%) of the 829 samples obtained by active surveillance, were positive. Most IBVs in both groups were isolated from broilers. Five genotypes (QX-like, B4-like, KM91-like, K40/09-like, and 20AD17-like) were observed in South Korea, with the QX-like genotype being the most common, and the 20AD17-like genotype being a novel genotype. These findings will help to maximize protection against IBV infection by providing a reference for the selection of an avian vaccine for IBV in South Korea.Vigilancia nacional del virus de la bronquitis infecciosa en Corea del Sur del año 2020 al 2021. El virus de la bronquitis infecciosa (IBV) es un patógeno importante en la avicultura. Los genotipos del virus de la bronquitis varían considerablemente y su antigenicidad puede ser diversa. Se realizó un estudio de vigilancia a nivel nacional en Corea del Sur para determinar la prevalencia y distribución del virus de bronquitis y sus genotipos. Mediante vigilancia activa como pasiva, se recolectaron un total de 939 muestras y se analizaron para la detección del virus de la bronquitis infecciosa mediante transcripción reversa y PCR específica para este patógeno. Se inocularon muestras positivas para ARN del virus de bronquitis en huevos embrionados para el aislamiento del virus. Los virus de bronquitis se genotipificaron y analizaron filogenéticamente basándose en una secuencia parcial de nucleótidos del gene S1. Se aislaron un total de 114 cepas del virus de bronquitis; 34 (30.9%) de las 110 muestras obtenidas por vigilancia pasiva y 80 (9.7%) de las 829 muestras obtenidas por vigilancia activa resultaron positivas. La mayoría de los virus de bronquitis en ambos grupos se aislaron de pollos de engorde. Se observaron cinco genotipos (similares a QX, similares a B4, similares a KM91, similares a K40/09 y similares a 20AD17) en Corea del Sur, siendo el genotipo similar a QX el más común y el genotipo similar a 20AD17 que ha sido un genotipo de nueva aparición. Estos hallazgos ayudarán a maximizar la protección contra la infección por el virus de la bronquitis infecciosa al proporcionar una referencia para la selección de vacunas aviares para bronquitis infecciosa en Corea del Sur.