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Abstract Tandem autologous stem cell transplantation can improve the prognosis of patients with multiple myeloma. However, the precise role of tandem transplantation remains debatable. We evaluated the clinical benefits of tandem transplantation retrospectively. Of the 655 included patients, 117 underwent tandem transplantation; the remaining were assigned to the control group. After a single transplantation, the tandem group achieved a complete remission (CR) rate of 24.8%, which increased to 46.2% after a second transplantation. The tandem group had a significantly longer median PFS than the control group in patients with International Staging System (ISS) III and high-risk cytogenetics (23.1 vs. 14.7 months, p = 0.007 for ISS III; 21.7 vs. 13.2 months, p = 0.042 for high-risk cytogenetics). The tandem group exhibited significantly superior PFS to the control group (20.3 vs. 12.6 months, p = 0.003) among patients who failed to achieve CR after a single transplantation. Tandem transplantation was associated with significantly improved PFS after adjusting for maintenance therapy in patients with ISS III, those with high-risk cytogenetics, and those who did not achieve CR after a single transplantation. Following propensity score matching, the tandem group exhibited significantly longer PFS than the control group (30.3 vs. 13.5 months, p = 0.028). Tandem transplantation should be considered in high-risk patients.

This study investigates the impact of zirconium-based KZC series crosslinkers with varying zirconium contents and the polyamine-based crosslinker (PBC) on the properties of coated paper, focusing on key performance metrics such as viscosity, wet rub and pick resistance, dry pick resistance, gloss, brightness, ink set-off, and print mottle. The findings reveal that crosslinkers’ type and concentration significantly influence the coating colors’ viscosity, with PBC demonstrating lower low shear viscosity at lower concentrations. The KZC series showed stable viscosity across a zirconium content range of 7% to 20%, and both crosslinker types enhanced wet rub resistance at higher concentrations. Notably, the KZC series, particularly KZC7, exhibited superior wet pick resistance at increased concentrations, highlighting its effectiveness in enhancing the durability of the coating layer. All crosslinkers maintained excellent dry pick resistance, ensuring robust coating performance. While gloss and brightness were generally unaffected, KZC20, which had the highest zirconium content, slightly reduced these optical properties. Ink set-off tests indicated that the KZC series performed better at lower concentrations, whereas higher concentrations led to increased ink set-off, potentially due to over-crosslinking. Print mottle remained consistent across all crosslinkers, indicating uniform coating quality. Overall, the zirconium-based KZC series significantly enhances wet resistance and maintains high performance across various properties, though it may slightly reduce gloss and brightness and increase ink set-off at higher concentrations. PBC offers a balanced performance profile, emphasizing the need for careful crosslinker type and concentration optimization to achieve the desired coating properties for specific applications. This comprehensive evaluation provides valuable insights for developing and optimizing high-performance coated papers.

The effects of torrefaction of the biopellets made from hardwood chip residue (HW), camellia oilseed cake (CO), and pruning remnants of the toothache tree (TA) and mulberry tree (MT) were evaluated. Torrefaction of the biopellets reduced the volatile matter content of biopellets by 18–58% and increased their heating value by 18–58% without negatively impacting durability or fines content. Torrefaction also reduced the initial ignition time of biopellets by 50–59% and prolonged their combustion duration by 15–24%. Regardless of the type of feedstock, all biopellets exhibited mass yields in the range of 60–80% and energy yields ranging from 80–95%. The novelty of this study lies in the application of torrefaction to already-formed biopellets, which enhances pellet quality without the need for binders, and the use of unused forest biomass and wood chip residue from pulp mills. The use of unused forest biomass and wood chip residue from pulp mills for biopellet production not only provides a sustainable and efficient method for waste utilization but also contributes to environmental conservation by reducing the reliance on fossil fuels. Overall, the torrefaction of biopellets represents a promising technology for producing high-quality solid biofuel from a variety of woody biomass feedstocks without compromising pelletizing efficiency.

The growing prevalence of disposable toilet seat covers in public restrooms stems from concerns about personal hygiene, given the direct contact between the seat and various users’ skin. To enable these disposable cover sheets to be flushed down the toilet instead of being discarded in the trash, they must possess specific properties. These include rapid water absorption for quick disintegration, strength to endure user movement or moisture on the toilet seat surface, and a comfortable texture. To address these challenges, the study investigated the disintegration characteristics of flushable cover sheets prepared under different refining conditions. Alkyl ketene dimer (AKD) was also employed to enhance water resistance, while an organic antibacterial agent was used to impart antimicrobial properties. The findings revealed that adding 0.2% AKD and 1% organic antibacterial agent to pulp stock with a freeness of about 650 mL CSF was suitable for manufacturing disposable cover sheets with disintegration characteristics like toilet tissue paper.

This study evaluated the pullout resistance performance of a developed double-arched steel fiber. Pullout experiments were conducted to assess the resistance load, bond strength, and energy absorption capacity of the fiber according to the geometry and tensile strength of the fiber. Double-arched (DA) steel fibers demonstrated peak and residual resistance loads approximately 36–112% and 29–163% higher than hooked-end and single-arched steel fibers, respectively. The DA steel fiber also significantly increased the bond strength and energy absorption capacity by approximately 58–159% and 125–130%, respectively, compared to the hook-end and single-arched steel fibers. Moreover, the DA fiber exhibited a more significant increase rate in pullout resistance load, bond strength, and energy absorption capacity with increasing tensile strength. A prediction model was also developed to incorporate the influence of plastic bending and friction resistance on the pullout behavior of the DA fiber. The resistance loads and decreasing trend obtained from the prediction model exhibited a very close agreement with the experimental results.

Background: Occupational cancer is a global health issue. The Korean CARcinogen EXposure (K-CAREX), a database of CARcinogen EXposure, was developed for the Korean labor force to estimate the number of workers exposed to carcinogens by industry. The present study aimed to estimate the intensity of exposure to carcinogens by industry, in order to supply complementary information about CARcinogen EXposure intensity to the K-CAREX. Methods: We used nationwide workplace monitoring data from 2014 to 2016 and selected target carcinogens based on the K-CAREX list. We computed the 95th percentile levels of measurements for each industry by carcinogens. Based on the 95th percentile level relative to the occupational exposure limit, we classified the CARcinogen EXposure intensity into five exposure ratings (1–5) for each industry. Results: The exposure ratings were estimated for 21 carcinogenic agents in each of the 228 minor industry groups. For example, 3,058 samples were measured for benzene in the manufacturing industry of basic chemicals. This industry was assigned a benzene exposure rating of 3. Conclusions: We evaluated the CARcinogen EXposure ratings across industries in Korean workers. The results will provide information on the exposure intensity to carcinogens for integration into the K-CAREX. Furthermore, it will aid in prioritizing control efforts and identifying industries of concern.

Background: In a previous study, we estimated exposure prevalence and the number of workers exposed to carcinogens by industry in Korea. The present study aimed to evaluate the optimal exposure intensity indicators of airborne lead exposure by comparing to blood lead measurements for the future development of the carcinogen exposure intensity database. Methods: Data concerning airborne lead measurements and blood lead levels were collected from nationwide occupational exposure databases, compiled between 2015 and 2016. Summary statistics, including the arithmetic mean (AM), geometric mean (GM), and 95th percentile level (X95) were calculated by industry both for airborne lead and blood lead measurements. Since many measurements were below the limits of detection (LODs), the simple replacement with half of the LOD and maximum likelihood estimation (MLE) methods were used for statistical analysis. For examining the optimal exposure indicator of airborne lead exposure, blood lead levels were used as reference data for subsequent rank correlation analyses. Results: A total of 19,637 airborne lead measurements and 32,848 blood lead measurements were used. In general, simple replacement showed a higher correlation than MLE. The results showed that AM and X95 using simple replacement could be used as optimal exposure intensity indicators, while X95 showed better correlations than AM in industries with 20 or more measurements. Conclusion: Our results showed that AM or X95 could be potential candidates for exposure intensity indicators in the Korean carcinogen exposure database. Especially, X95 is an optimal indicator where there are enough measurements to compute X95 values.

This study evaluated the impact of soil modifiers on seed germination and soil quality. Mixtures of paper mill sludge (PMS) with camellia oilseed cake (CO) and peat moss (P), as well as with oilseed cake of toothache tree (TO) and peat moss (P), showed promising results as biostimulants for seed germination. The addition of PMS increased the germination index, indicating its beneficial effects on seed performance. The pH levels remained optimal, and the electrical conductivity values stayed within acceptable ranges, suggesting minimal hindrance to plant growth. The cation exchange capacity increased with PMS, enhancing nutrient availability. Composted mixtures exhibited increased phosphorus levels, contributing to soil fertility. While the organic matter content decreased after composting, the carbon-to-nitrogen ratio remained balanced. The bulk density increased after composting, potentially improving soil drainage. Overall, the TO-containing mixture demonstrated superior growth rates compared to the P. These findings support the use of PMS-based soil modifiers for enhancing seed germination and improving soil quality.

Objectives This study explored the relationship between shift intensity and insomnia among hospital nurses. Methods The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8. Results The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p

Abstract The C-reactive protein-to-albumin ratio (CAR) has not been assessed in diffuse large B cell lymphoma (DLBCL, the most common non-Hodgkin lymphoma). This retrospective study evaluated the prognostic value of CAR in 186 DLBCL patients. A CAR value of 0.158 was selected as the most discriminative cut-off for identifying patients with high CAR values (73/141 patients, 51.8%). During a median follow-up of 32.5 months, the high CAR group had significantly poorer complete response to induction therapy (64.4% vs. 92.6%; p 0.158 also showed worse 3-year OS (47.9% vs. 87.2%, p = 0.0035) and 3-year PFS (36.1% vs. 82.1%, p = 0.0011). A high CAR remained significantly associated with poor outcomes for > 60-year-old patients (OS: p = 0.0038, PFS: p = 0.0015) and younger patients (OS: p = 0.0041, PFS: p = 0.0044). Among older patients, a high CAR value also predicted non-relapse mortality (p = 0.035). Therefore, the CAR might complement the International Prognostic Index in DLBCL cases.

This study investigated the factors that influence core muscle endurance, i.e., the symmetry of frontal core motion during indoor walking and cycling, the symmetry of lateral core muscle endurance, the symmetry of the hip abductor strength, the weekly workout time and fast walking and cycling speeds, while controlling for gender. Seventy-nine healthy young adults participated in this study. In a regression analysis, the core muscle endurance time was the dependent variable. The independent variables were the symmetry of frontal core motion (measured using a wireless earbud sensor during walking and cycling), the symmetry of side plank time and of hip abductor strength, the weekly workout time and fast walking and cycling speeds. In the multiple regression analysis, weekly workout time, fast walking speed, symmetry of frontal core motion during fast cycling and symmetry of lateral side plank time predicted core muscle endurance (adjusted R2 = 0.42). Thus, clinicians and fitness personnel should consider the association of core muscle endurance with the symmetry of frontal core motion during cycling and the symmetry of side plank holding time, as well as with the weekly workout time and a fast walking speed, when designing core muscle exercise programmes.

The present study was performed to investigate the validity of a wireless earbud-type inertial measurement unit (Ear-IMU) sensor used to estimate head angle during four workouts. In addition, relationships between head angle obtained from the Ear-IMU sensor and the angles of other joints determined with a 3D motion analysis system were investigated. The study population consisted of 20 active volunteers. The Ear-IMU sensor measured the head angle, while a 3D motion analysis system simultaneously measured the angles of the head, trunk, pelvis, hips, and knees during workouts. Comparison with the head angle measured using the 3D motion analysis system indicated that the validity of the Ear-IMU sensor was very strong or moderate in the sagittal and frontal planes. In addition, the trunk angle in the frontal plane showed a fair correlation with the head angle determined with the Ear-IMU sensor during a single-leg squat, reverse lunge, and standing hip abduction; the correlation was poor in the sagittal plane. Our results indicated that the Ear-IMU sensor can be used to directly estimate head motion and indirectly estimate trunk motion.

Waldenström macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is a non-Hodgkin-type B cell lymphoma. Here, the authors identify two risk loci for WM/LPL in a two-stage GWAS involving a family-oversampling approach and provide evidence for a functional role of the non-coding SNP rs116446171.

The enhancement of recombinant therapeutic protein production in mammalian cell culture has been regarded as an important issue in the biopharmaceutical industry. Previous studies have reported that the addition of the recombinant 30Kc19 protein, a silkworm-derived plasma protein with simultaneous cell-penetrating and mitochondrial enzyme-stabilizing properties, can enhance the recombinant protein expression in Chinese hamster ovary (CHO) cell culture. Here, we produced an α-helix N-terminal domain of 30Kc19, called (30Kc19α), and investigated its effects on the production of human erythropoietin (EPO), a widely used therapeutic protein for the treatment of anemia, in recombinant CHO cell culture. Similar to the full-length 30Kc19, 30Kc19α was able to be mass-produced in a form of recombinant protein through an Escherichia coli expression system and delivered into EPO-producing CHO (EPO–CHO) cells. Supplementing the medium of EPO–CHO cell culture with 30Kc19α increased the intracellular NADPH/NADP+ ratio related to the flux of metabolic reducing power for protein biosynthesis, subsequently enhancing EPO production in serum-free culture. 30Kc19α is considered to have certain advantages in the downstream purification process of therapeutic protein production when it is used as a medium supplement due to its small size and low isoelectric point compared to the full-length 30Kc19. These results suggest that 30Kc19α has potential use for manufacturing biopharmaceutical proteins.

(1) Background: Household humidifier disinfectant (HD) brands containing polyhexamethylene guanidine (PHMG) have been found to cause the most HD-associated lung injuries (HDLIs) in the Republic of Korea. Nevertheless, no study has attempted to characterize the potential association of the health effects, including HDLI, with the physicochemical properties of PHMG dissolved in different HD brands. This study aimed to characterize the molecular weight (MW) distribution, the number-average molecular weight (Mn), the weight-average molecular weight (Mw), and the structural types of PHMG used in HD products. (2) Methods: Quantitative measurements were made using matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS). The Mn, Mw, and MW distributions were compared among various HD products. (3) Results: The mean Mn and Mw were 542.4 g/mol (range: 403.0–692.2 g/mol) and 560.7 g/mol (range: 424.0–714.70 g/mol), respectively. The degree of PHMG oligomerization ranged from 3 to 7. The MW distribution of PHMG indicated oligomeric compounds regardless of the HD brands. (4) Conclusions: Based on the molecular weight distribution, the average molecular weight of PHMG, and the degree of polymerization, the PHMG collected from HDLI victims could be regarded as an oligomer. PHMG, as used in household humidifiers, should not be exempted from toxic chemical registration as a polymer. Further study is necessary to examine the association of PHMG oligomeric compounds and respiratory health effects, including HDLI.

A new type of cyclotron orbit combining surface Fermi arcs and bulk states in topological semimetals has recently been proposed as Weyl orbit. Here, Zhang et al. report the evolution of Shubnikov-de Haas oscillations in Dirac semimetal Cd3As2 nanoplates along with a quantum Hall state possibly arising from such Weyl orbit.

Chronic lymphocytic leukemia is a highly inheritable cancer. Here the authors conduct a metaanalysis of four genome-wide association studies and identify three novel loci located near EOMES, SERPINB6 and LPPassociated with risk of this disease.

This study aimed to quantify both chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) dissolved in different product brands and to characterize the exposure to these chemicals among humidifier disinfectant-associated lung injury (HDLI) patients. Both CMIT and MIT dissolved in different humidifier disinfectant (HD) products were quantified using gas chromatography–mass spectrometry. The inhalation level of CMIT and MIT was estimated based on HD-associated factors as reported by HDLI patients. A total of eleven HD products marketed until the end of 2011 were found to contain CMIT and/or MIT. The level of combined CMIT and/or MIT dissolved in these HD products ranged from 12 to 353 ppm. The level varied among HD products and the year of manufacture. The average inhalation levels were estimated to be 7.5, 4.1, and 3.2 μg/m3 for the definite, probable, and possible groups, respectively. If probable and possible groups were collapsed together, the inhalation level of the collapsed group was significantly different from that of the definite group (p < 0.001). All HDLI patients responded as having used HD not only while sleeping, but also as having a humidifier treated with HD within close proximity every day in insufficiently ventilated spaces. These HD use characteristics of patients may be directly/indirectly linked to the HDLI development.

The use of humidifier disinfectant (HD) has been determined to be associated with lung injuries (HDLI) in Korea. Although HD brands containing polyhexamethylene guanidine (PHMG) oligomers have been found to cause more HDLI compared to brands containing other disinfectants, the physicochemical properties of PHMG have been poorly defined. We aimed to quantify the PHMG dissolved in HD brands, characterize the number-average (Mn) and weight-average (Mw) molecular masses, and identify the polymerization degree of PHMG. Analysis of the PHMG oligomers was performed using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS) operated in positive-ion reflectron mode. Eight brands of HD containing PHMG were identified. The PHMG concentrations in these brands ranged from 160 to 37,200 ppm (mean = 3100.9 ppm). Concentration was a significant variable among and within HD brands. The degree of PHMG oligomerization fell within the range of two to four. The averages of Mn and Mw were 517.2 g/mol (range: 422–613 g/mol) and 537.3 g/mol (range: 441.0–678.0 g/mol), respectively. Based on the average molecular weight and the degree of polymerization, the PHMG examined here could be regarded as oligomers, which may be associated with the highest proportion of HDLI being caused by PHMG.

The purpose of this study was to compare the efficacy of botulinum toxin (BoNT) in masseter muscle reduction depending on the amount of chin deviation. Exploring distinctive effects of BoNT relative to the characteristics of facial asymmetry will aid in planning and predicting treatment outcomes. Sixteen adult volunteers were classified into two groups according to the degree of menton deviation observed in posteroanterior cephalograms. Eight had a menton deviation of 3 mm or more and the other eight had less than 3 mm. A total of 25 Units of BoNT was injected into the unilateral masseter muscle of the prominent side for each participant. Changes in the volume and bulkiest height of the lower face on each side were measured with a 3D laser scan at four time points: before and 4, 8, and 12 weeks after the injection. Two-way mixed ANOVA was employed for analyses. The volume and bulkiest height of the injected side decreased over time in both types of asymmetry, with significant differences at each time point. The reductions in the volume and bulkiest height were significantly greater in subjects without chin deviation. The reductions in the volume and bulkiest height of the lower face using BoNT are more effective for subjects without chin deviation.

Recent heritability analyses have indicated that genome-wide association studies (GWAS) have the potential to improve genetic risk prediction for complex diseases based on polygenic risk score (PRS), a simple modelling technique that can be implemented using summary-level data from the discovery samples. We herein propose modifications to improve the performance of PRS. We introduce threshold-dependent winner's-curse adjustments for marginal association coefficients that are used to weight the single-nucleotide polymorphisms (SNPs) in PRS. Further, as a way to incorporate external functional/annotation knowledge that could identify subsets of SNPs highly enriched for associations, we propose variable thresholds for SNPs selection. We applied our methods to GWAS summary-level data of 14 complex diseases. Across all diseases, a simple winner's curse correction uniformly led to enhancement of performance of the models, whereas incorporation of functional SNPs was beneficial only for selected diseases. Compared to the standard PRS algorithm, the proposed methods in combination led to notable gain in efficiency (25-50% increase in the prediction R2) for 5 of 14 diseases. As an example, for GWAS of type 2 diabetes, winner's curse correction improved prediction R2 from 2.29% based on the standard PRS to 3.10% (P = 0.0017) and incorporating functional annotation data further improved R2 to 3.53% (P = 2×10-5). Our simulation studies illustrate why differential treatment of certain categories of functional SNPs, even when shown to be highly enriched for GWAS-heritability, does not lead to proportionate improvement in genetic risk-prediction because of non-uniform linkage disequilibrium structure.