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Abstract In megacities, road traffic is a major source of particulate matter (PM), requiring a critical understanding of effective air pollution control. Despite existing methods to determine PM emission factors (EFs) of vehicles, accurate estimation of PM emissions under real driving conditions remains challenging. We aimed to assess the EFs of organic aerosol (OA) and equivalent black carbon (eBC) from vehicles through on-road measurements in Seoul, Korea, to understand real-world PM emissions. We used a mobile laboratory equipped with an aerosol mass spectrometer and an aethalometer to measure the composition of PM. On-road measurements were conducted in vehicle tunnels, urban roadways, and residential areas, and the characteristics of measurement points were compared and analyzed. Our results showed that concentrations of OA increased proportionally with the influence of vehicle exhaust, while oxidation states of the OA decreased. Mobile measurements revealed spatial heterogeneities in aerosols, highlighting distinct characteristics of fresh OA on vehicle roads and elevated oxidation state values in residential areas. Active nitrate formation near vehicles led to elevated NO3 concentrations on roads compared to residential areas. Our study shows that mobile PM measurements, including OA and eBC, are valuable for the direct evaluation of emission inventories. However, given that the calculated EFs may not be applicable to other cities due to differences in vehicle composition and traffic conditions, the development of city-specific EFs will be necessary in the future. Furthermore, it is recommended to integrate this methodology with conventional emission inventories to identify vehicle-type-specific emissions. Graphical Abstract

Chiton species belonging to the genus Ischnochiton J. E. Gray, 1847 are commonly found in intertidal rocky shores worldwide, with the exception of the northern Atlantic and Arctic oceans. Ischnochiton species are characterised by imbricate girdle scales that are uniform in size, rounded, sculpted with striae or occasionally smooth. However, their species-level taxonomy is complicated due to the high variation in their shell microstructures. Despite more than a hundred species reported worldwide, taxonomic studies of this group remain relatively unexplored in Korean waters, with only a few species recorded to date.In this study, we compared the microstructural characteristics of tegmentum sculpture, girdle scales and radula amongst four Korean Ischnochiton species using high-resolution microscopic images and a scanning electron microscope (SEM). Along with mtDNA cox1 sequence comparison, a comprehensive analysis of their morphology revealed that I. hayamii Owada, 2018 was identified for the first time in Korean waters. This species is morphologically distinguished by its small body size of adults, smooth lateral areas on valves and small perinotum scales sculptured with weak longitudinal ribs. Phylogenetic analysis of the mtDNA cox1 sequence provides distinct resolution at the species level, but interrelationships amongst Ischnochiton species remain unresolved. Results from the morphological and molecular analyses presented in this study offer valuable taxonomic information for accurate species identification amongst closely-related Ischnochiton species.

Abstract Homozygous familial hypercholesterolemia (HoFH) is an underdiagnosed and undertreated ultra-rare disease. We utilized claims data from the Komodo Healthcare Map database to develop a machine-learning model to identify potential HoFH patients. We tokenized patients enrolled in MyRARE (patient support program for those prescribed evinacumab-dgnb in the United States) and linked them with their Komodo claims. A true positive HoFH cohort (n = 331) was formed by including patients from MyRARE and patients with prescriptions for evinacumab-dgnb or lomitapide. The negative cohort (n = 1423) comprised patients with or at risk for cardiovascular disease. We divided the cohort into an 80% training and 20% testing set. Overall, 10,616 candidate features were investigated; 87 were selected due to clinical relevance and importance on prediction performance. Different machine-learning algorithms were explored, with fast interpretable greedy-tree sums selected as the final machine-learning tool. This selection was based on its satisfactory performance and its easily interpretable nature. The model identified four useful features and yielded precision (positive predicted value) of 0.98, recall (sensitivity) of 0.88, area under the receiver operating characteristic curve of 0.98, and accuracy of 0.97. The model performed well in identifying HoFH patients in the testing set, providing a useful tool to facilitate HoFH screening and diagnosis via healthcare claims data.

Objective This experiment was conducted to investigate the effect of grain-based pecking blocks on productivity and welfare status at two commercial broiler welfare-certified farms. Methods Production and welfare indicators were assessed at two farms (designated Farm A and B). Both farms had two windowless houses with forced tunnel-type ventilation and housed broilers at stocking densities of approximately 16.7 birds/m2 (Farm A) and 16.8 birds/m2 (Farm B). Each house was divided into two or three equal sections and was provided with or without pecking blocks. Grain-based pecking blocks, measuring 25 × 25 × 25 cm, were given to broilers in both farms at 1 block per 1,000 birds. Various parameters including productivity (body weight and flock uniformity), corticosterone levels (in fecal droppings and feathers), footpad dermatitis, hock burn, feather dirtiness, gait score, litter quality, body surface temperature, and volatile fatty acids in fecal samples were assessed at 26 days of age, whereas litter quality was analyzed at 13 and 26 days of age. Results There were no significant effects of providing pecking blocks on productivity (body weight and uniformity), fecal and feather corticosterone, welfare indicators (i.e., footpad dermatitis, hock burn, feather cleanliness, and gait score), and litter quality (i.e., moisture, nitrogen, and pH). No differences in body surface temperature between the control and enrichment treatments were noted in Farm B, but body surface temperatures of the head (p = 0.029) and legs (p = 0.011) in the enrichment vs. control group were elevated in Farm A. Butyrate concentration in the enrichment vs control group was higher in Farm B (p = 0.023), but this effect was not detected in Farm A. Conclusion It is concluded that grain-based pecking blocks did not affect performance and welfare indicators. Further studies are warranted to elucidate the potential impact of grain-based pecking blocks on gut health indicators.

The objective of this study was to evaluate the effects of dietary mangosteen peel preparations, either powdered (MspP) or ethanolic extract (MspE), on the growth performance, meat quality, immune response, gut health, serum biochemical profiles, and antioxidant activity of broiler chicks. A total of 480 day-old straight-run broiler chicks (Ross 308) were randomly placed into four treatments, with eight replicates of 12 chicks each, and subjected to one of the four experimental diets for 21 days. The corn and soybean meal-based diet was supplemented with 2% MspP (20 g per kg of diet) or 0.05% and 0.1% MspE (0.5 g and 1.0 g per kg of diet). Data were analyzed using analysis of variance, and post hoc comparisons of treatments were performed using Tukey's Honestly Significant Difference test. From days 0 to 21, dietary mangosteen peel preparations did not affect growth performance (body weight gain, feed intake, and feed conversion ratio), thigh meat and tibia characteristics, serum markers of innate immunity (interferon-r, interleukin-10, alpha-1-acid glycoprotein, and nitric oxide), and ileal morphology in broiler chicks (P > 0.05). Dietary mangosteen peel preparations increased the percentage of high-density lipoprotein cholesterol and decreased the relative concentrations of isobutyrate and branched-chain fatty acids in the cecal digesta compared with the control chickens. Notably, dietary mangosteen peel preparations altered the antioxidant characteristics of the serum, liver, and thigh meat. Dietary MspE increased glutathione peroxidase (P = 0.039) in the serum and catalase in the serum (P = 0.008), liver (P = 0.05), and thigh meat (P = 0.01) compared to the control group. In addition, dietary MspP increased catalase levels in thigh meat compared to those in the control diet-fed chickens (P = 0.01). The concentration of malondialdehyde, an indicator of lipid peroxidation, was lower in all chicks-fed diets containing mangosteen peel preparations; however, statistical significance was only noted in the serum samples (P < 0.0001). Collectively, our study shows that dietary mangosteen peel preparations are potent natural antioxidants that can be used as functional dietary additives to effectively mitigate oxidative stress in broiler chicks.

ABSTRACT: The objective of this study was to determine the effects of dietary available phosphorus (P) levels and dietary phytase added into the very low-P diet on the performance, mineral balance, odor emission, and stress responses in growing pullets and laying hens during 13 to 32 wk of age. One hundred sixty-eight pullets (Hy-Line Brown) were randomly assigned into 1 of 4 dietary treatments with 7 replicates of 6 birds each. Experimental diets were formulated to contain 3 graded P levels at 0.25, 0.35, and 0.45% during 13 to 15 wk (phase 1), 0.25, 0.35, and 0.45% during 16 to 18 wk (phase 2), and 0.20, 0.30, and 0.40% during 19 to 32 wk (phase 3). In addition, dietary phytase (500 FTU/kg matrix values) was added into the very low-P diets (0.20% during 13–15 wk, 0.25% during 16–18 wk, and 0.20% during 19–32 wk) to meet the nutritional adequacy with standard P diets. In all phases, decreasing dietary P levels did not affect (P > 0.05) growth, laying performance, and egg qualities. Decreasing dietary P levels linearly increased the relative duodenal and oviduct weights (P < 0.05), and quadratically increased the relative ovary weight in pullets (P = 0.016). Dietary phytase lowered (P = 0.021) the relative duodenal weight compared with the very low-P diet. Tibia breaking strength and tibia Mg contents in pullets were linearly lowered (P < 0.05) as dietary P levels decreased. Dietary phytase tended to increase (P = 0.091) tibia breaking strength and significantly increased (P = 0.025) tibia Mg content compared with the very low-P diet. Dietary P levels and dietary phytase affected (P < 0.05) ileal crypt depth and ileal villus height: crypt depth ratio in pullets. Decreasing dietary P levels linearly decreased (P < 0.01) crude fat digestibility and P excretion in both pullets and laying hens. Dietary phytase reversed (P < 0.05) the very low-P diet-mediated decrease of crude fat digestibility in pullets and laying hens. Dietary P levels and dietary phytase affected (P < 0.05) odor emission including ammonia in pullets and total volatile fatty acids in laying hens. Finally, lowering dietary P levels increased (P < 0.01) yolk corticosterone concentrations and the increased corticosterone concentration by the very low-P diet was reversed by dietary phytase. Collectively, our study shows that decreasing dietary P levels induced nutritional and physiological responses in pullets and laying hens and these P-mediated negative effects were mitigated by dietary phytase.

Cancer surgery is aimed at complete tumor resection and accurate lymph node detection. However, numerous blood vessels are distributed within the tumor, and the colors of the tumor, blood vessels, and lymph nodes are similar, making observations with the naked eye difficult. Therefore, tumors, blood vessels, and lymph nodes can be monitored via color classification using an operating microscope to induce fluorescence emission. However, as the beam width of the LED required to induce fluorescence emission is narrow and the power loss of the beam is significant at a certain working distance, there are limitations to inducing fluorescence emission, and light reflection occurs in the observation image, obstructing the view of the observation area. Therefore, the removal of reflected light is essential to avoid missing the diagnosis of the lesion under observation. This paper proposes the use of a beam mirror and polarizing filter to increase the beam width and beam intensity. The refraction and reflection effects of the beam were utilized using the beam mirror, and the rotation angle of the polarizing filter was adjusted to remove light reflection. Consequently, the minimum beam power using the beam mirror was 10.9 mW, the beam width was doubled to 40.2°, and more than 98% of light reflection was removed at 90° and 270°. With light reflection effectively eliminated, clear observation of lesions is possible. This method is expected to be used effectively in surgical, procedural, and diagnostic departments.

ABSTRACT: This study was performed to investigate supplementary effects of probiotic Lacticaseibacillus paracasei NSMJ56 strain on laying performance, egg quality, intestinal histology, antioxidant status, gut immunity and microbiota in laying hens. A total of ninety-six 21-wk-old Hy-Line Brown laying hens were randomly subjected to one of 2 dietary treatments: a control group fed a non-supplemented diet, or a probiotic group fed with a diet supplemented with 1 g of Lacticaseibacillus paracasei NSMJ56 (5 × 108 CFU/kg of diet). The trial lasted for 4 wk. Egg weight was increased (P < 0.05) in laying hens fed probiotic-fed diet compared with the control group. Dietary probiotics did not affect egg quality except for Haugh unit, which was improved (P < 0.05) in the probiotic-fed group. Neither jejunal histology nor cecal short-chain fatty acids were affected by dietary treatments. Dietary probiotics increased the activity of catalase compared with the control group. Flow cytometry analysis revealed that dietary probiotics elevated the CD4+ T cells, but not CD8+ T cells, in jejunal lamina propria. Based on the LEfSe analysis at the phylum and genus levels, Erysipelotrichales, Erysipelotrichia, Flintibater, Dielma, Hespellia, Coprobacter, Roseburia, Anaerotignum, and Coprococcus were enriched in the probiotic group compared with the control group. Taken together, our study showed that dietary probiotics could be used to improve some parameters associated with egg freshness and antioxidant capacity, and to partially alter T cell population and microbial community in laying hens.

The primary goal during cancer removal surgery is to completely excise the malignant tumor. Because the color of the tumor and surrounding tissues is very similar, it is difficult to observe with the naked eye, posing a risk of damaging surrounding blood vessels during the tumor removal process. Therefore, fluorescence emission is induced using a fluorescent contrast agent, and color classification is monitored through camera imaging. LEDs must be irradiated to generate the fluorescent emission electromotive force. However, the power and beam width of the LED are insufficient to generate this force effectively, so the beam width and intensity must be increased to irradiate the entire lesion. Additionally, there should be no shaded areas in the beam irradiation range. This paper proposes a method to enhance the beam width and intensity while eliminating shadow areas. A total reflection beam mirror was used to increase beam width and intensity. However, when the beam width increased, a shadow area appeared at the edge, limiting irradiation of the entire lesion. To compensate for this shadow area, a concave lens was combined with the beam mirror, resulting in an increase in beam width and intensity by more than 1.42 times and 18.6 times, respectively. Consequently, the beam width reached 111.8°, and the beam power was 13.6 mW. The proposed method is expected to be useful for observing tumors through the induction of fluorescence emission during cancer removal surgery or for pathological examination in the pathology department.

Background Recent studies have shown that patients with end-stage renal disease (ESRD) are at elevated risk of dementia. However, whether kidney transplantation (KT) lowers the risk for incident dementia remains unclear. Methods From the Korean National Health Insurance Service database, we identified incident KT recipients aged ≥40 years without any history of dementia between 2007 and 2015. We also established a pair of age-, sex-, and inclusion year-matched control cohorts of patients with incident dialysis-dependent ESRD and members of the general population (GP) without a history of dementia, respectively. Cases of incident all-cause dementia, including Alzheimer disease (AD), vascular dementia (VD), and other kinds of dementia, were obtained from baseline until December 31, 2017. Results We followed 8,841 KT recipients, dialysis-dependent ESRD patients, and GP individuals for 48,371, 28,649, and 49,149 patient-years, respectively. Their mean age was 52.5 years, and 60.6% were male. Over the observation period, 55/43/19 KT recipients, 230/188/75 dialysis-dependent ESRD patients, and 38/32/14 GP individuals developed all-cause dementia/AD/VD. The risks of incident all-cause dementia, AD, and VD in KT recipients were similar to those in GP (hazard ratio: 0.74 [p = 0.20], 0.74 [p = 0.24], and 0.59 [p = 0.18], respectively) and significantly lower than those in dialysis-dependent ESRD patients (hazard ratio: 0.17 [p < 0.001], 0.16 [p < 0.001], and 0.16 [p < 0.001], respectively). Older age and diabetes mellitus at the time of KT were risk factors for incident all-cause dementia and AD in KT recipients. Conclusion This is the first study to show a beneficial impact of KT on incident dementia compared to dialysis dependency.

Purpose To investigate the effect of patient positioning on tendinosis grade, visible range, and infraspinatus tendon (IST) thickness, and to determine the feasibility of internal rotation (IR) position to assess IST on ultrasound (US). Materials and Methods This study included 52 shoulders of 48 subjects who were evaluated for IST in three different positions: neutral position (N), IR, and position with the ipsilateral hand on the contralateral shoulder (HC). Two radiologists retrospectively graded IST tendinosis from grade 0 to grade 3 and the visible range from grade 1 to grade 4. The thickness of the IST was measured by another radiologist with a short-axis view. A generalized estimating equation was used for statistical analysis. Results The tendinosis grades were higher in the HC position than in the IR position, with a cumulative odds ratio of 2.087 (p = 0.004, 95% confidence interval [CI]: 1.268–3.433). The tendinosis grades in the HC position (p = 0.370) and IR position (p = 0.146) were not significantly different from those in the N position. The overall difference in IST thickness was significant (p < 0.001), but the visible range (p = 0.530) was not significantly different according to position. Conclusion Patient positioning significantly affected the grade of tendinosis and thickness but not the visible range of the IST. The IR position is a feasible position for assessing the IST on US.

Background : Socioeconomic status is an important factor affecting the accessibility and prognosis of kidney transplantation. We aimed to investigate changes in kidney transplant recipients’ socioeconomic status in South Korea and whether such changes were associated with patient prognosis. Methods : This retrospective nationwide o bservational c ohort s tudy i n S outh Korea included kidney transplant recipients between 2007 and 2016. South Korea provides a single-insurer health insurance service, and information on the socioeconomic status of the recipients is identifiable through the claims database. First, a generalized linear mixed model was used to investigate changes in recipients’ socioeconomic status as an outcome. Second, the risk of graft failure was analyzed using Cox regression as another outcome to investigate whether changes in socioeconomic status were associated with patient prognosis. Results : Among the 15,215 kidney transplant recipients included in the study, economic levels (defined based on insurance fee percentiles) and employment rates declined within the first 2 years after transplantation. Beyond 2 years, the employment rate increased significantly, while no significant changes were observed in economic status. Patients whose economic status did not improve 3 years after kidney transplantation showed a higher risk of death than those whose status improved. When compared to those who remained employed after kidney transplantation, unemployment was associated with a significantly higher risk of death-censored graft failure. Conclusions: The socioeconomic status of kidney transplant recipients changed dynamically after kidney transplantation, and these changes were associated with patient prognosis.

The growth of the broiler industry has been accompanied with concerns over the environmental and social impacts on intensive production systems, as well as the welfare of the animals themselves. As a result, since the 2000s, there has been growing interest in alternative production systems that improve animal welfare and sustainability. In this context, it is important to prioritize the welfare of broilers in commercial production systems and to use reliable welfare indicators to provide consumers with information about the welfare of the animals they consume. Resource-based measures (RBM) are based on assessing the resources available to the birds in terms of their housing, environment, and management practices, such as stocking density, litter quality, lighting and air quality, etc. Outcome-based measures (OBM), also known as animal-based measures, focus on assessing the actual welfare outcomes for the birds, such as footpad dermatitis, hock burn, contamination or damage to feathers, gait score, mortality, etc. These OBM-based measures are one of the more direct indicators of welfare and can help identify any welfare issues. The present review highlighted the factors that affect animal welfare indicators focused on OBMs which can be used in the commercial broiler farms.

Abstract Posttransplantation diabetes mellitus (PTDM) is an important metabolic complication after KT that causes graft failure and cardiovascular complications in kidney transplantation (KT) recipients. Using the national claim data of South Korea, 7612 KT recipients between 2009 and 2017 were analyzed. PTDM was defined as a consecutive 30-day prescription history of antidiabetic medication after KT. Among these patients, 24.7% were diagnosed with PTDM, and 51.9% were diagnosed within 6 months after KT. Compared to patients without PTDM, those with PTDM were older, more likely to be men, more likely to be diagnosed with hypertension and cardio-cerebrovascular disease, and experienced more rejection episodes requiring high-dose steroid treatment after KT. During the follow-up, 607 DCGFs, 230 DWGFs, 244 MACEs, and 260 all-cause mortality events occurred. Patients with PTDM showed a higher risk of DCGF (adjusted hazard ratio [aHR] 1.49; 95% confidence interval [CI] 1.22–1.82; P

Background/Aims: The care cascade for hepatitis C virus (HCV) infection is impeded by multiple barriers, including suboptimal anti-HCV testing, link to care, and diagnosis. We explored the changes in the care cascade of HCV for the past 20 years and its current status in a large cohort from a tertiary referral center. Methods: We analyzed 1,144,468 patients who had anti-HCV testing between January 2001 and June 2020. Metrics related to the care cascade of HCV infection and the long-term prognosis of patients were explored. Results: The seroprevalence of anti-HCV positivity was 1.8%, with a recent decreasing trend. In all, 69.9% of anti-HCV positive patients performed HCV RNA testing, with a 65.7% positivity. Patients who did not have HCV RNA testing were older and more likely to have a non-hepatocellular carcinoma malignancy, normal alanine aminotransferase level, and good liver function. Linkage times for HCV RNA testing from the anti-HCV positivity and for antiviral treatment from HCV diagnosis decreased, notably after 2015, when highly efficacious oral antiviral treatment was introduced to Korea. The average treatment uptake rate was 35.4%, which increased to 38.9% after 2015. Of the 5,302 patients analyzed for long-term prognosis, the annual incidences of hepatocellular carcinoma were 1.02 or 2.14 per 100 person-years in patients with or without a sustained virological response, respectively. Conclusions: The care cascade of HCV infection has been suboptimal for the past 20 years, despite the recent changes. More effort should be made to increase HCV RNA testing and treatment uptake.

ABSTRACT: The objective of this study was to determine the effects of dietary crude protein (CP) levels on production performance, nitrogen balance, and odor emission of excreta in growing pullets and laying hens from 13 to 32 wk of age. Two hundred and forty pullets (Hy-Line Brown) were randomly assigned to 1 of 4 dietary groups with 10 replicates per group, and 6 birds per replicate. Experimental diets were formulated to contain 4 graded CP levels in the diets of pullets ranging from 180, 160, 140, and 120 g/kg of diet during 13 to 18 wk (phase 1) and in the diets of laying hens from 190, 170, 150, and 130 g/kg of diet during 19 to 32 wk (phase 2). The limiting amino acids including lysine, methionine, and threonine were supplemented to maintain constant equal amino acid concentrations in all experiment diets. In phase 1, decreasing dietary CP levels did not affect growth performance but increased (linear and quadratic effect, P < 0.05) the relative abdominal fat contents and triglyceride concentration in serum samples. High-density lipoprotein cholesterol in serum samples decreased as the CP levels decreased in the diets of pullets. Dietary CP levels quadratically increased (P < 0.05) the villus height and the villus height to crypt depth ratio but did not affect tibia traits and relative organ weights in pullets at 18 wk. Apparent digestibility of dry matter and ether extract increased with decreasing dietary CP levels in pullets. Graded CP levels linearly increased the digestibility of dry matter, CP, and ether extracts but lowered that of crude ash in laying hens. Nitrogen excretion was linearly decreased (P < 0.05) as the dietary CP levels decreased in both pullets and laying hens. Dietary CP levels only affected carbon dioxide emission in pullets. In phase 2, dietary CP levels did not affect growth performance and the ages at first egg laying and to reach 50% egg production in laying hens. However, egg weights were decreased (linear and quadratic effect, P < 0.05) as the dietary CP level decreased in laying hens. Increasing dietary CP levels increased Haugh unit at 26 wk but lowered corticosterone concentrations in yolk samples at 22 wk. Collectively, this study shows that dietary CP levels could be decreased to reduce nitrogen excretion without adverse effects on performance and egg quality of growing pullets and laying hens.

The present study investigated the effect of low temperature on laying performance, egg quality, body temperature, yolk malondialdehyde, yolk corticosterone, and serum biochemistry in laying hens. A total of 40 laying hens (Hy-Line Brown) aged 36 weeks were housed in one of two environmental chambers kept at 12 ± 4.5 °C (low temperature) or 24 ± 3 °C (normal temperature) for 4 weeks. Low vs. normal temperature significantly increased (p < 0.05) live body weight, feed intake, and feed conversion ratio in laying hens. Skin surface temperature, but not rectal temperature, was decreased in laying hens exposed to low vs. normal temperature. Hens exposed to low temperature laid an intense eggshell color compared with those raised in a normal temperature. Malondialdehyde concentrations in yolk were increased in low-temperature-exposed laying hens compared with those at normal temperature conditions, but this effect was only noted on day 7, post the low-temperature exposure (p = 0.04). Finally, low vs. normal temperature increased the concentrations of total cholesterol and triglyceride in serum. Collectively, this study indicates that exposure to low temperature in laying hens initially disrupted antioxidant system and altered lipid metabolism in laying hens without inducing stress responses.

Background Long-term outcomes of live kidney donors remain controversial, although this information is crucial for selecting potential donors. Thus, this study compared the long-term risk of all-cause mortality between live kidney donors and healthy control. Methods We performed a retrospective cohort study including donors from seven tertiary hospitals in South Korea. Persons who underwent voluntary health screening were included as controls. We created a matched control group considering age, sex, era, body mass index, baseline hypertension, diabetes, estimated glomerular filtration rate, and dipstick albuminuria. The study outcome was progression to end-stage kidney disease (ESKD), and all-cause mortality as identified in the linked claims database. Results We screened 1,878 kidney donors and 78,115 health screening examinees from 2003 to 2016. After matching, 1,701 persons remained in each group. The median age of the matched study subjects was 44 years, and 46.6% were male. Among the study subjects, 2.7% and 16.6% had underlying diabetes and hypertension, respectively. There were no ESKD events in the matched donor and control groups. There were 24 (1.4%) and 12 mortality cases (0.7%) in the matched donor and control groups, respectively. In the age-sex adjusted model, the risk for all-cause mortality was significantly higher in the donor group than in the control group. However, the significance was not retained after socioeconomic status was included as a covariate (adjusted hazard ratio, 1.82; 95% confidence interval, 0.87–3.80). Conclusion All-cause mortality was similar in live kidney donors and matched non-donor healthy controls with similar health status and socioeconomic status in the Korean population.

Background Considering the growing prevalence of Western lifestyles and related chronic diseases occurring in South Korea, this study aimed to explore the progression of metabolic risk factors in living kidney donors. Methods This study enrolled living kidney donors from seven hospitals from 1982 to 2016. The controls were individuals that voluntarily received health check-ups from 1995 to 2016 that were matched with donors according to age, sex, diabetes status, baseline estimated glomerular filtration rate, and date of the medical record. Data on hyperuricemia, hypertension, hypercholesterolemia, and overweight/obesity were collected to determine metabolic risks. Logistic regressions with interaction terms between the medical record date and donor status were used to compare the trends in metabolic risks over time in the two groups. Results A total of 2,018 living kidney donors and matched non-donors were included. The median age was 44.0 years and 54.0% were women. The living kidney donors showed a lower absolute prevalence for all metabolic risk factors, except for those that were overweight/obese, than the non-donors. The proportion of subjects that were overweight/obese was consistently higher over time in the donor group. The changes over time in the prevalence of each metabolic risk were not significantly different between groups, except for a lower prevalence of metabolic risk factors ≥ 3 in donors. Conclusion Over time, metabolic risks in living kidney donors are generally the same as in non-donors, except for a lower prevalence of metabolic risk factors ≥3 in donors.

A feeding trial was conducted to investigate the effect of dietary supplementation of Chlorella vulgaris (CV) or Tetradesmus obliquus (TO) on laying performance, egg quality, and gut health indicators of laying hens. A total of 144 Hy-Line Brown laying hens aged 21 weeks were randomly assigned to one of three dietary treatments with eight replicates of six hens. Dietary treatments were as follows: CON, basal diet; CV, basal diet + 5 g C. vulgaris/kg of diet; TO, basal diet + 5 g T. obliquus/kg of diet. The results showed that diets supplemented with CV or TO had insignificant effects on laying performance, egg quality (i.e., Haugh unit and eggshell strength and thickness), jejunal histology, cecal short-chain fatty acids, and antioxidant/immune markers in ileal mucosa samples of laying hens. Compared with the control group, the egg yolk color score was higher (p < 0.05) in laying hens fed on diets containing CV and TO, although the former was a more intense yellow than the latter. Small intestinal lamina propria cells were isolated using flow cytometry to examine the percentages of immune cell subpopulations. Dietary microalgae did not affect B cells or monocytes/macrophages but altered the percentage of CD4+ T cells and CD8− TCR γδ T cells. Collectively, diets supplemented with C. vulgaris or T. obliquus can improve egg yolk color and would modulate host immune development and competence in laying hens.

The chronic consumption of diets rich in saturated fats leads to obesity and associated metabolic disorders including diabetes and atherosclerosis. Intake of a high-fat diet (HFD) is also recognized to dysregulate neural functions such as cognition, mood, and behavior. However, the effects of short-term high-fat diets on the brain are elusive. Here, we investigated molecular changes in the mouse brain following an acute HFD for 10 days by employing RNA sequencing and metabolomics profiling. Aberrant expressions of 92 genes were detected in the brain tissues of acute HFD-exposed mice. The differentially expressed genes were enriched for various pathways and processes such as superoxide metabolism. In our global metabolomic profiling, a total of 59 metabolites were significantly altered by the acute HFD. Metabolic pathways upregulated from HFD-exposed brain tissues relative to control samples included oxidative stress, oxidized polyunsaturated fatty acids, amino acid metabolism (e.g., branched-chain amino acid catabolism, and lysine metabolism), and the gut microbiome. Acute HFD also elevated levels of N-acetylated amino acids, urea cycle metabolites, and uracil metabolites, further suggesting complex changes in nitrogen metabolism. The observed molecular events in the present study provide a valuable resource that can help us better understand how acute HFD stress impacts brain homeostasis.

Acute stress response triggers various physiological responses such as energy mobilization to meet metabolic demands. However, the underlying molecular changes in the brain remain largely obscure. Here, we used a brief water avoidance stress (WAS) to elicit an acute stress response in mice. By employing RNA-sequencing and metabolomics profiling, we investigated the acute stress-induced molecular changes in the mouse whole brain. The aberrant expression of 60 genes was detected in the brain tissues of WAS-exposed mice. Functional analyses showed that the aberrantly expressed genes were enriched in various processes such as superoxide metabolism. In our global metabolomic profiling, a total of 43 brain metabolites were significantly altered by acute WAS. Metabolic pathways upregulated from WAS-exposed brain tissues relative to control samples included lipolysis, eicosanoid biosynthesis, and endocannabinoid synthesis. Acute WAS also elevated the levels of branched-chain amino acids, 5-aminovalerates, 4-hydroxy-nonenal-glutathione as well as mannose, suggesting complex metabolic changes in the brain. The observed molecular events in the present study provide a valuable resource that can help us better understand how acute psychological stress impacts neural functions.

This study investigated Groups' awareness of how wall removal affects crime prevention. Group 1 comprised of burglars, Group 2 of non-residents who have not removed walls, and Group 3 of residents who have removed walls and are living in wall removal project areas. First, we examine differences in awareness between Groups 1 and 2 regarding ease of crime in relation to the presence or absence of a wall. Second, we examined the awareness levels of Groups 1 and 2 in relation to important factors considered by intruders when committing a burglary. Finally, we examined how wall removal reduces the fear of crime in Groups 2 and 3. Group 1 believed a house with a wall was an easier target for crime, but Group 2, comprised of residents who did not perform wall removal, had contrary opinions. Group 2 believed that wall removal did not reduce the fear of crime, unlike Group 3. These results indicate that Group 2 has negative perceptions of wall removal in the context of crime prevention, which stems from the common belief that a wall will protect a house from outside threats. Therefore, changes in mindset are needed to create safe environments in detached housing areas.

Scholars have examined the relationship between destination accessibility and various pedestrian-friendly environments in neighborhoods. However, there have been few studies on whether micro-scale environmental features promote access to supermarkets. This study fills these gaps by examining the accessibility of supermarkets and the meso- and micro-scale environmental features. In particular, environmental features that pedestrians can experience at the eye-level were estimated using the Naver pedestrian direction API and semantic segmentation technique. Multivariate regression models were employed to determine whether neighborhoods with high supermarket accessibility ensure walkable environments for the elderly. Our findings have shown that the walkability differs according to different levels of supermarket accessibility. Neighborhoods with high supermarket accessibility had high density and high diversity, and they provided high-quality sidewalk pavement. Conversely, elderly residents in neighborhoods with low accessibility had to pass through more pedestrian crossing facilities and steep slopes to go to do their shopping. These results can provide insight to policymakers and planners about the uneven accessibility of supermarkets and help improve neighborhood walkability for the elderly.

Background: High flow nasal cannula (HFNC) is commonly used as non-invasive respiratory support in critically ill children. There are limited data to inform consensus on optimal device parameters, determinants of successful patient response, and indications for escalation of support. Clinical scores, such as the respiratory rate-oxygenation (ROX) index, have been described as a means to predict HFNC non-response, but are limited to evaluating for escalations to invasive mechanical ventilation (MV). In the presence of apparent HFNC non-response, a clinician may choose to increase the HFNC flow rate to hypothetically prevent further respiratory deterioration, transition to an alternative non-invasive interface, or intubation for MV. To date, no models have been assessed to predict subsequent escalations of HFNC flow rates after HFNC initiation.Objective: To evaluate the abilities of tree-based machine learning algorithms to predict HFNC flow rate escalations.Methods: We performed a retrospective, cohort study assessing children admitted for acute respiratory failure under 24 months of age placed on HFNC in the Johns Hopkins Children's Center pediatric intensive care unit from January 2019 through January 2020. We excluded encounters with gaps in recorded clinical data, encounters in which MV treatment occurred prior to HFNC, and cases electively intubated in the operating room. The primary study outcome was discriminatory capacity of generated machine learning algorithms to predict HFNC flow rate escalations as compared to each other and ROX indices using area under the receiver operating characteristic (AUROC) analyses. In an exploratory fashion, model feature importance rankings were assessed by comparing Shapley values.Results: Our gradient boosting model with a time window of 8 h and lead time of 1 h before HFNC flow rate escalation achieved an AUROC with a 95% confidence interval of 0.810 ± 0.003. In comparison, the ROX index achieved an AUROC of 0.525 ± 0.000.Conclusion: In this single-center, retrospective cohort study assessing children under 24 months of age receiving HFNC for acute respiratory failure, tree-based machine learning models outperformed the ROX index in predicting subsequent flow rate escalations. Further validation studies are needed to ensure generalizability for bedside application.

As the demand for ultra-low-power (ULP) devices has increased tremendously, system-on-chip (SoC) designs based on ultra-low-voltage (ULV) operation have been receiving great attention. Moreover, research has shown the remarkable potential that even more power savings can be achieved in ULV SoCs by exploiting the temperature effect inversion (TEI) phenomenon, i.e., the delay of the ULV SoCs decreases with increasing temperature. However, TEI-aware low-power (TEI-LP) techniques have a critical limitation in practical terms, in that dedicated power management-integrated circuits (PMICs) have not yet been developed. In other words, it is essential to develop PMICs that automatically bring out the full potential of the TEI-LP techniques as the chip temperature changes. With the aim of designing such PMICs, this paper first conducted a study to find the most suitable DC-DC converter for PMICs and then developed a control algorithm to maximize the effectiveness of the TEI-LP techniques. Furthermore, we have developed a compact hardware controller for the algorithm to operate most energy efficiently on ULP-SoCs.

Purpose The purpose of this study was to present a technique for measuring physiologic distal tibiofibular syndesmosis widening using 3-dimensional ultrasonography (3D-US) with an evaluation of its reliability, and to determine whether there were differences in the measurements between different dynamic stress tests. Methods We retrospectively evaluated 3D-US of 20 subjects with normal ankle syndesmosis. 3D-US was performed in neutral (N), dorsiflexion with external rotation (DFER), and weight-bearing standing (WB) positions at the anterior inferior tibiofibular ligament level in both ankles for comparison. Using 3D-US volume data, axial images were reconstructed at the level of the lateral prominence of the anterior tibial tubercle to ensure consistent measurements of the tibiofibular clear space (TFCS) by two radiologists. Results There was a wide range of TFCS values among the subjects (N, 1.2 to 4.2 mm; DFER, 2.3 to 4.8 mm; WB, 1.7 to 4.6 mm). When both ankles of each subject were evaluated, the side-to-side differences were less than 1 mm in all positions, with high intraclass correlation coefficient (ICC) values between both ankles (ICC, 0.85 to 0.93). The inter-rater agreement for all TFCS measurements between the two radiologists was excellent (ICC, 0.81 to 0.96). In comparisons between the two dynamic stress tests, the TFCS was significantly wider in the DFER position than in the WB position (DFER vs. WB, 3.3 mm vs. 2.9 mm; P

Abstract Inositol polyphosphate multikinase (IPMK), the key enzyme responsible for the synthesis of higher inositol polyphosphates and phosphatidylinositol 3, 4, 5-trisphosphate, is known to mediate various biological events, such as cellular growth and metabolism. Conditional deletion of IPMK in excitatory neurons of the mouse postnatal forebrain results in enhanced extinction of fear memory accompanied by activation of p85 S6 kinase 1 signaling in the amygdala; it also facilitates hippocampal long-term potentiation. However, the molecular changes triggered by IPMK deletion in the brain have not been fully elucidated. In the present study, we investigated gene expression changes in the hippocampal region of IPMK conditional knockout (cKO) mice by performing genome-wide transcriptome analyses. Here we show that expression of synaptotagmin 2 (Syt2), a synaptic vesicle protein essential for Ca2+-dependent neurotransmitter release, is robustly upregulated in the forebrain of IPMKcKO mice. Compared to wild-type mice, in which weak Syt2 expression was detected in the forebrain, IPMKcKO mice showed marked increases in both Syt2 mRNA and protein expression in the hippocampus as well as the amygdala. Collectively, our results suggest a physiological role for IPMK in regulating expression of Syt2, providing a potential underlying molecular mechanism to explain IPMK-mediated neural functions.

The objective of this study was to evaluate the effects of dietary sulfur from either organic (methyl sulfonyl methane, MSM) or inorganic (sodium sulfate, SS) sources on the growth performance of broiler chickens challenged against a high-dose coccidiosis vaccine. A total of 320 day-old Ross 308 broiler chicks were randomly placed into 32 pens of 10 birds each (keeping 16 pens/control group and 8 pens/treatment group until 21 days post-hatch) and reared for 28 days. The experimental diets were formulated by mixing a corn and soybean meal-based control diet with MSM or SS. At 21 days post-hatch, half (n = 8) of the control and all of the sulfur-added diet-fed (i.e., MSM and SS) groups were challenged with a 30-fold dose of a commercially available Eimeria vaccine (Livacox® T coccidiosis vaccine). Unchallenged control chicks (n = 8) were considered as the negative control group. At 21 days (before coccidiosis vaccine challenge), the production parameters and cecal short-chain fatty acids were not affected by dietary treatments. The concentrations of total antioxidant capacity in liver samples were elevated in both the MSM and SS groups compared with the control group (p = 0.001). During 21 to 28 days (i.e., one week post coccidiosis vaccine challenge), challenge tended to lower body weight and feed intake by an average of 5.3% (p = 0.262) and 2.8% (p = 0.504), respectively, but to increase the feed conversion ratio by an average of 2.7% (p = 0.087) compared with the non-challenged control groups. None of dietary sulfur groups affected the body weight gain, feed intake, or feed conversion ratio of vaccine-challenged chickens. Mild Eimeria-specific lesions were noted in duodenum (p = 0.006), jejunum (p = 0.017), and ceca (p = 0.047), but dietary sulfur treatments did not affect the Eimeria-induced gut lesion scores. At 28 days, Eimeria challenge significantly impaired (p = 0.001) the apparent ileal digestibility of crude protein and crude ash compared with the naïve control group. Dietary MSM increased the apparent ileal digestibility of crude ash by 15.5% on average compared with the coccidiosis vaccine control group. We conclude that dietary antioxidant sulfur of organic or inorganic origins at the inclusion level (i.e., 0.7 g sulfur/kg of diet) has a limited effect on the growth performance of chickens challenged with coccidiosis vaccine.

Chitons are a group of marine mollusks (class Polyplacophora) characterized by having eight articulating shell plates on their dorsal body surface. They represent suitable materials for studying the spatiotemporal processes that underlie population differentiation and speciation in ocean environments. Here we performed population genetic analyses on the northwestern Pacific chiton Acanthochitona cf. rubrolineata (Lischke, 1873) using two mitochondrial gene fragments (COI and 16S) from 180 individuals sampled from 11 populations among the coastal waters of Korea, Japan, and China. The phylogenetic network uncovered a reticulated relationship with several sub-haplogroups for all A. cf. rubrolineata haplotypes. SAMOVA analyses suggested the best grouping occurred at three groups (ΦCT = 0.151, P

Long-term changes in the East Asian summer monsoon (EASM) lifecycle since 1979 are analyzed based on observational datasets and historical simulations of the Coupled Model Intercomparison Project Phase 6 (CMIP6). According to the observation, the active and break phases of EASM have intensified resulting in a shorter but stronger rainy season, followed by a longer dry spell. This intensification in the active-phase precipitation is accompanied by increased lower tropospheric southwesterly wind and subsequent convergence of water vapor flux. These changes are accompanied by the widely reported westward extension of the North Pacific Subtropical High, which has been associated with the warming climate. CMIP6 models generally underestimated the observed intensification of the EASM lifecycle and the monsoon precipitation. However, some of the models did simulate the intensified EASM lifecycle similar to that observed. The result highlights the reasonable performance on EASM shown in some CMIP6 models and those simulations lend support to a dynamically-driven intensification of the EASM lifecycle in the warmer climate.

Ultrasonography (US) is a useful diagnostic method that can be easily applied to identify the cause of shoulder pain. Its low cost, excellent diagnostic accuracy, and capability for dynamic evaluation are also advantages. To assess all possible causes of shoulder pain, it is better to follow a standardized protocol and to perform a comprehensive evaluation of the shoulder than to conduct a focused examination. Moreover, a proper dynamic study can enhance the diagnostic quality of US, especially when the pathology is not revealed by a static evaluation. The purpose of this article is to review the common indications for dynamic US of the shoulder, and to present the basic techniques and characteristic US findings.

PurposeGonadotropin-releasing hormone agonist (GnRHa) is used as a therapeutic agent for central precocious puberty (CPP); however, increased obesity may subsequently occur. This study compared body mass index (BMI) and insulin resistance during the first year of GnRHa treatment for CPP.MethodsPatient group included 83 girls (aged 7.0–8.9 years) with developed breasts and a peak luteinizing hormone level of ≥5 IU/L after GnRH stimulation. Control group included 48 prepubertal girls. BMI and insulin resistance-related indices (homeostasis model assessment of insulin resistance [HOMA-IR] and quantitative insulin sensitivity check index [QUICKI]) were used to compare the groups before treatment, and among the patient group before and after GnRHa treatment.ResultsNo statistical difference in BMI z-score was detected between the 2 groups before treatment. Fasting insulin and HOMA-IR were increased in the patient group; fasting glucose-to-insulin ratio and QUICKI were increased in the control group (all P

Cilia are highly specialized antennae-like cellular organelles. Inositol polyphosphate 5-phosphatase E (INPP5E) converts PI(4,5)P2 into PI4P and is required for proper ciliary function. Although Inpp5e mutations are associated with ciliopathies in humans and mice, the precise molecular role INPP5E plays in cilia remains unclear. Here, we report that Drosophila INPP5E (dINPP5E) regulates ciliary protein trafficking by controlling the phosphoinositide composition of ciliary membranes. Mutations in dInpp5e lead to hearing deficits due to the mislocalization of dTULP and mechanotransduction channels, Inactive and NOMPC, in chordotonal cilia. Both loss of dINPP5E and ectopic expression of the phosphatidylinositol-4-phosphate 5-kinase Skittles increase PI(4,5)P2 levels in the ciliary base. The fact that Skittles expression phenocopies the dInpp5e mutants confirms a central role for PI(4,5)P2 in the regulation of dTULP, Inactive, and NOMPC localization. These data suggest that the spatial localization and levels of PI(4,5)P2 in ciliary membranes are important regulators of ciliary trafficking and function.

Mechanically gated ion channels convert sound into an electrical signal for the sense of hearing. In Drosophila melanogaster, several transient receptor potential (TRP) channels have been implicated to be involved in this process. TRPN (NompC) and TRPV (Inactive) channels are localized in the distal and proximal ciliary zones of auditory receptor neurons, respectively. This segregated ciliary localization suggests distinct roles in auditory transduction. However, the regulation of this localization is not fully understood. Here we show that the Drosophila Tubby homolog, King tubby (hereafter called dTULP) regulates ciliary localization of TRPs. dTULP-deficient flies show uncoordinated movement and complete loss of sound-evoked action potentials. Inactive and NompC are mislocalized in the cilia of auditory receptor neurons in the dTulp mutants, indicating that dTULP is required for proper cilia membrane protein localization. This is the first demonstration that dTULP regulates TRP channel localization in cilia, and suggests that dTULP is a protein that regulates ciliary neurosensory functions.

We present an experimental observation and comprehensive theory that address the effect of interaction on the phase transition in a many-body system, which is far from equilibrium and does not have detailed balance. In the resonantly driven cold atomic trap, we observe kinetic phase transition (KPT) that is manifested by substantial enhancement of fluctuations, similar to the first-order phase transition in thermal equilibrium. Moreover, we can control the attractive interaction between atoms trapped in the coexisting states by adjusting the total number of atoms, which induces shift of the phase boundaries of KPT. The demonstrated effect is the many-body analogue of KPT that was previously predicted and observed in a single-driven oscillator. Our work provides a unique model platform for quantitative study of nonequilibrium nonlinear dynamics in many-body systems.

Hexagonal Co(OH)2 nanoplates with a diameter of 1.28 ± 0.08 mm and a thickness of 52 ± 14 nm were prepared, showing facile generation of static electricity in a plastic container. Based on this observation, Co(OH)2 nanoplates were incorporated into polymer matrixes such as polyvinylpyrrolidone (PVP) and polyurethane (PU). The resultant PVP– Co(OH)2 (PVP–Co) and PU–Co(OH)2 (PU–Co) films bearing an optimal amount (0.1 wt%) of Co(OH)2 nanoplates showed dramatically-enhanced triboelectric performance, compared with pristine polymer films. While PVP and PU films exhibited output peak-to-peak voltages (Vp–p) of 249 and 423 V and output peak-to-peak currents (Ip–p) of 23 and 60 mA, respectively, with a pushing force of 2 kg f, the PVP–Co0.1 and PU–Co0.1 films showed Vp–p of 407 and 612 V with Ip–p of 41 and 85 mA, respectively. Triboelectric devices fabricated with PVP–Co0.1 and PU–Co0.1 films showed the maximum power densities of 0.38 and 1.22 mW cm−2, respectively, and worked as power sources to charge a capacitor and to operate LEDs and a calculator. We suggest that the enhanced triboelectric performance of PVP– Co0.1 and PU–Co0.1 is attributable to the facile oxidation of Co2+ to Co3+ in Co(OH)2 nanoplates. [ABSTRACT FROM AUTHOR]