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Jeong Bae Ko,1,* Kwang Bok Kim,1,* Young Sub Shin,1 Hun Han,1 Sang Kuy Han,2 Duk Young Jung,3 Jae Soo Hong1 1Digital Health Care R&D Department, Korea Institute of Industrial Technology, Cheonan, Chuncheongnam-do, South Korea; 2Robotics R&D Department, Korea Institute of Industrial Technology, Ansan, Gyeonggi-do, South Korea; 3Seongnam Senior Experience Complex, Eulji University, Seongnam, Gyeonggi-do, South Korea*These authors contributed equally to this workCorrespondence: Jae Soo HongDigital Health Care R&D Department, Korea Institute of Industrial Technology, Cheonan, Chuncheongnam-do, South KoreaTel +82 41-589-8412Fax +82 41-589-8413Email jshong94@kitech.re.krDuk Young JungSeongnam Senior Experience Complex, Eulji University, Seongnam, Gyeonggi-do, South KoreaTel +82 41-589-8412Email dyjung@eulji.ac.krPurpose: Sarcopenia is a symptom in which muscle mass decreases due to decreasing in the number of muscle fibers and muscle cross-sectional area as aging. This study aimed to develop a machine learning classification model for predicting sarcopenia through a inertial measurement unit (IMU)-based physical performance measurement data of female elderly.Patients and Methods: Seventy-eight female subjects from an elderly population (aged: 78.8± 5.7 years) volunteered to participate in this study. To evaluate the physical performance of the elderly, the experiment conducted timed-up-and-go test (TUG) and 6-minute walk test (6mWT) with worn a single IMU. Based on literature review, 132 features were extracted from collected data. Feature selection was performed through the Kruskal–Wallis test, and features datasets were constructed according to feature selection. Three major machine learning-based classification algorithms classified the sarcopenia group in each dataset, and the performance of classification models was compared.Results: As a result of comparing the classification model performance for sarcopenia prediction, the k-nearest neighborhood algorithm (kNN) classification model using 40 major features of TUG and 6mWT showed the best performance at 88%.Conclusion: This study can be used as a basic research for the development of self-monitoring technology for sarcopenia.Keywords: sarcopenia, physical activity, machine learning, inertial measurement unit

Dohyung Lim,1 ChoongYeon Kim,2 HoHyun Jung,1 Dukyoung Jung,3 Keyoung Jin Chun21Department of Mechanical Engineering, Sejong University, Seoul, Republic of Korea; 2Advanced Biomedical Engineering Lab, Korea Institute of Industrial Technology, Cheonan, Republic of Korea; 3R&D Team, Senior Products Industrial Center, Busan, Republic of KoreaAbstract: The risk of falling increases significantly in the elderly because of deterioration of the neural musculature regulatory mechanisms. Several studies have investigated methods of preventing falling using real-time systems to evaluate balance; however, it is difficult to monitor the results of such characterizations in real time. Herein, we describe the use of Microsoft’s Kinect depth sensor system to evaluate balance in real time. Six healthy male adults (25.5±1.8 years, 173.9±6.4 cm, 71.4±6.5 kg, and 23.6±2.4 kg/m2), with normal balance abilities and with no musculoskeletal disorders, were selected to participate in the experiment. Movements of the participants were induced by controlling the base plane of the balance training equipment in various directions. The dynamic motion of the subjects was measured using two Kinect depth sensor systems and a three-dimensional motion capture system with eight infrared cameras. The two systems yielded similar results for changes in the center of body mass (P>0.05) with a large Pearson’s correlation coefficient of γ>0.60. The results for the two systems showed similarity in the mean lower-limb joint angle with flexion–extension movements, and these values were highly correlated (hip joint: within approximately 4.6°; knee joint: within approximately 8.4°) (0.400.05). Large differences with a low correlation were, however, observed for the lower-limb joint angle in relation to abduction–adduction and internal–external rotation motion (γ

Objective: To determine the mechanisms by which blockade of adenosine A(2B) receptors (A(2B)Rs) reduces insulin resistance.Research Design and Methods: We investigated the effects of deleting or blocking the A(2B)R on insulin sensitivity using glucose tolerance tests (GTTs) and hyperinsulinemic-euglycemic clamps in mouse models of type 2 diabetes. The effects of diabetes on A(2B)R transcription and signaling were measured in human and mouse macrophages and mouse endothelial cells. In addition, tag single nucleotide polymorphisms (SNPs) in ~42 kb encompassing the A(2B)R gene, ADORA2B, were evaluated for associations with markers of diabetes and inflammation.Results: Treatment of mice with the nonselective adenosine receptor agonist 5'-N-ethylcarboxamidoadensoine (NECA) increased fasting blood glucose and slowed glucose disposal during GTTs. These responses were inhibited by A(2B)R deletion or blockade and minimally affected by deletion of A(1)Rs or A(2A)Rs. During hyperinsulinemic-euglycemic clamp of diabetic KKA(Y) mice, A(2B)R antagonism increased glucose infusion rate, reduced hepatic glucose production, and increased glucose uptake into skeletal muscle and brown adipose tissue. Diabetes caused a four- to sixfold increase in A(2B)R mRNA in endothelial cells and macrophages and resulted in enhanced interleukin (IL)-6 production in response to NECA due to activation of protein kinases A and C. Five consecutive tag SNPs in ADORA2B were highly correlated with IL-6 and C-reactive protein (CRP). Diabetes had a highly significant independent effect on variation in inflammatory markers. The strength of associations between several ADORA2B SNPs and inflammatory markers was increased when accounting for diabetes status.Conclusions: Diabetes affects the production of adenosine and the expression of A(2B)Rs that stimulate IL-6 and CRP production, insulin resistance, and the association between ADORA2B SNPs and inflammatory markers. We hypothesize that increased A(2B)R signaling in diabetes increases insulin resistance in part by elevating proinflammatory mediators. Selective A(2B)R blockers may be useful to treat insulin resistance. [ABSTRACT FROM AUTHOR]

Objective: Liver-specific inactivation of carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) by a dominant-negative transgene (l-SACC1 mice) impaired insulin clearance, caused insulin resistance, and increased hepatic lipogenesis. To discern whether this phenotype reflects a physiological function of CEACAM1 rather than the effect of the dominant-negative transgene, we characterized the metabolic phenotype of mice with null mutation of the Ceacam1 gene (Cc1(-/-)).Research Design and Methods: Mice were originally generated on a mixed C57BL/6x129sv genetic background and then backcrossed 12 times onto the C57BL/6 background. More than 70 male mice of each of the Cc1(-/-) and wild-type Cc1(+/+) groups were subjected to metabolic analyses, including insulin tolerance, hyperinsulinemic-euglycemic clamp studies, insulin secretion in response to glucose, and determination of fasting serum insulin, C-peptide, triglyceride, and free fatty acid levels.Results: Like l-SACC1, Cc1(-/-) mice exhibited impairment of insulin clearance and hyperinsulinemia, which caused insulin resistance beginning at 2 months of age, when the mutation was maintained on a mixed C57BL/6x129sv background, but not until 5-6 months of age on a homogeneous inbred C57BL/6 genetic background. Hyperinsulinemic-euglycemic clamp studies revealed that the inbred Cc1(-/-) mice developed insulin resistance primarily in liver. Despite substantial expression of CEACAM1 in pancreatic beta-cells, insulin secretion in response to glucose in vivo and in isolated islets was normal in Cc1(-/-) mice (inbred and outbred strains).Conclusions: Intact insulin secretion in response to glucose and impairment of insulin clearance in l-SACC1 and Cc1(-/-) mice suggest that the principal role of CEACAM1 in insulin action is to mediate insulin clearance in liver. [ABSTRACT FROM AUTHOR]

This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program. [ABSTRACT FROM AUTHOR]

Nanostructures are critical for improving the contact area with an electrolyte and catalytic efficiency for the CO 2 reduction reaction (CO 2 RR). However, their hydrophobicity conflicts with the intended increase in the contact area and complicates the determination of the active contact area. Here, bismuth-nickel (BiNi) micro-nano hierarchical catalysts for the CO 2 RR were studied to understand the effects of electrolyte-catalyst contact area variation with the immersion duration in an aqueous electrolyte. The immersed BiNi samples showed about 13.4-fold higher formate production compared to the pristine BiNi sample. The 2-day pre-immersed BiNi sample exhibited faradaic efficiencies (FE%) of ∼80.1% for formate and ∼10% for H 2 with a current density of 10.2 mA cm -2 at -1.5 V vs. Ag/AgCl. In contrast, the pristine BiNi catalysts exhibited an FE% of ∼12.9% for formate and ∼76.3% for H 2 with a current density of 5.38 mA cm -2 . Our experimental results reveal that the improved contact between the electrolyte and the catalyst surface through pre-immersion can lead to enhanced CO 2 RR efficiency for formate production using hierarchical BiNi catalysts.

Objectives: Depression and anxiety are emotional difficulties that are common among adolescents. Adolescents suffering from depression and anxiety can exhibit problems such as antisocial behavior, aggression, and academic slump. This study aimed to explore the factors influencing adolescents' depression and anxiety during the coronavirus disease 2019 (COVID-19) pandemic., Methods: This study examined the data from an online student health survey conducted by the Ministry of Education in 2022. The survey participants were 131194 students ranging from the first grade of middle school to the third grade of high school. The influence of each variable on depression and anxiety was examined., Results: Factors that predicted depression and anxiety were sex (female), grade level (higher), financial difficulties (existing or unknown), physical activity (higher), sleep time (shorter), media usage time (higher), family/friends relationship (worse), and change in the health status of family, friends, and oneself due to COVID-19 (worse)., Conclusion: These results may help identify patterns of depression and anxiety among adolescents caused by COVID-19 and maximize the intervention effect., Competing Interests: Conflicts of Interest The authors have no potential conflicts of interest to disclose., (Copyright © 2024 Korean Academy of Child and Adolescent Psychiatry.)

Background: Hyperuricemia could be a risk for various chronic diseases, and it could be largely corrected by diet control. This study was a nationwide cross-sectional study to investigate the association between serum uric acid level and dietary fiber intake., Methods: This study analyzed data based on the Korean National Health and Nutrition Examination Survey conducted from 2016 to 2018. Adults over 20 years of age with normal renal function, defined as an estimated glomerular filtration rate (eGFR) over 30mL/min/1.73m 2 , were included. The criteria for hyperuricemia were ≥ 7 mg/dL in men and ≥ 6 mg/dL in women. Data regarding dietary intake were obtained using the 24-hour recall method., Results: A total of 15,278 subjects (6,455 males/8,823 females) were analyzed. The prevalence of hyperuricemia was 19.3% in men and 6.8% in women. There were significant, negative associations between serum uric acid and total fiber intake in both men and women. Consuming more than 27.9 g of dietary fiber in men and 20.7 g in women reduced the risk of hyperuricemia by approximately 30% with odds ratios of 0.72 (0.62-0.83) and 0.71 (0.56-0.88) in men and women, respectively. With regard to the risk reduction by the type of dietary fiber, cereal fiber was significantly identified in both men and women, while fruit fiber was only significant in men. In the subgroup analysis, this association remained significantly in young and metabolically healthy populations with normal weight., Conclusions: Dietary fiber intake was inversely associated with serum uric acid levels. This relationship was particularly significant in metabolically healthy young adults., (© 2024. The Author(s).)

Digital PCR (dPCR) is a technique for absolute quantification of nucleic acid molecules. To develop a dPCR technique that enables more accurate nucleic acid detection and quantification, we established a novel dPCR apparatus known as centrifugal force real-time dPCR (crdPCR). This system is efficient than other systems with only 2.14% liquid loss by dispensing samples using centrifugal force. Moreover, we applied a technique for analyzing the real-time graph of the each micro-wells and distinguishing true/false positives using artificial intelligence to mitigate the rain, a persistent issue with dPCR. The limits of detection and quantification were 1.38 and 4.19 copies/μL, respectively, showing a two-fold higher sensitivity than that of other comparable devices. With the integration of this new technology, crdPCR will significantly contribute to research on next-generation PCR targeting absolute micro-analysis., (© 2024. The Author(s).)

Background: Common hyperkeratotic palmar skin lesions include chronic hand eczema (CHE), hyperkeratotic hand eczema (HHE), palmar psoriasis (PP). However, clinically differentiating these disorders is often challenging., Objectives: To compare the expressions of keratin (K) 5, K9, K14 and involucrin in palmar hyperkeratotic lesions (HHE, CHE and PP)., Materials and Methods: Immunohistochemical staining was performed on skin biopsy specimens obtained from the palms of patients clinically diagnosed with CHE, HHE and PP (n = 21, 24 and 18, respectively)., Results: K5 and K14 expression levels were higher in the spinous and granular layers of PP and HHE compared to CHE. Involucrin was expressed in the basal layer of PP and HHE but not in CHE. K9 expression was decreased in PP and HHE compared to CHE., Conclusion: Keratin and involucrin expression in the epidermis are markers of keratinocyte differentiation. Expression levels of keratin and involucrin were similar between the HHE and PP groups, suggesting that HHE shares pathogenesis with PP rather than CHE., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Tracheal collapse (TC), a common disease in dogs, is characterized by cough; however, little is known about the serum biomarkers that can objectively evaluate the severity of cough in canine TC. Furthermore, studies elucidating the relationship of fluoroscopic characteristics with the severity of cough are lacking. Therefore, this study aimed to evaluate the relationship between cough severity and clinical characteristics, fluoroscopic images, and new serum biomarkers in canine TC., Results: Fifty-one client-owned dogs diagnosed with TC based on fluoroscopic and clinical signs were enrolled in this study and divided into three groups according to the severity of cough (grade of cough: 0, 1, and 2). Signalments, comorbidities, and fluoroscopic characteristics were compared among the groups retrospectively. The serum matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), surfactant protein-A (SP-A), and syndecan-1 (SDC-1) levels were measured in all groups. No significant differences in age, breed, sex, or clinical history were observed among the groups. Concomitant pharyngeal collapse increased significantly with the severity of cough (p = .031). Based on the fluoroscopic characteristics, the TC grade of the carinal region increased significantly and consistently with the grade of cough (p = .03). The serum MMP-9 level was significantly higher in the grade 2 group than that in the grade 0 group (p = .014). The serum IL-6 level was significantly lower in the grade 1 group than that in the grade 0 group (p = .020). The serum SP-A and SDC-1 levels did not differ significantly among the groups., Conclusions: The severity of cough with the progression of TC can be predicted with the fluoroscopic TC grade at the carinal region. MMP-9 may be used as an objective serum biomarker that represents cough severity to understand the pathogenesis., (© 2024. The Author(s).)

Although goat meat has several health benefits than other red meats but comsumers reluctant it due to its unpleasant flavor. This study aimed to investigate the odorant of goat meat as well as compare the quality traits of meat regarding sex status. The loin meats [non-castrated male (NCM), castrated male (CM), and female (FM)] were collected and stored at 4°C in a laboratory refrigerator and analyzed on the 1 st , 5 th , and 8 th consecutive days. The moisture content was the lowest and the protein content was highest in FM (p<0.05). Fat and ash content in NCM and FM were similar while lowest in CM. The CIE L* was significantly higher in NCM, but there were no significant differences of CIE a* and CIE b* within groups at initial day. The color intensity increased on the 5 th storage day and decreased again after the 8 th storage day, except in NCM. NCM displayed the highest thiobarbituric acid reactive substances value (p<0.05), whereas CM displayed a higher pH value than other groups throughout the storage period. Indole levels were the highest in NCM (0.031 mg/kg); however, skatole levels were not significant differences across all treatments (p>0.05). No significant difference was observed in the fatty acid composition between NCM and CM (p>0.05), whereas a significant difference was observed in FM (p<0.05). Most of the water-soluble metabolites showed significant differences between sexes. Overall, sex status effects on quality properties of meat and castration can improve the overall sensory acceptance by reducing goaty flavor of Korean native black goat meat., Competing Interests: The authors declare no potential conflicts of interest., (© Korean Society for Food Science of Animal Resources.)

Objective: Many scientists have investigated solutions to reduce microbiological risks in dry-aged meat after the dry-aging technology was revived for high quality and value-added premium meat product in the market. This study aimed to investigate the effect of scoria powder in onggi (Korean earthenware) on the meat quality of pork loins during 21 days of dry aging and to elucidate its mechanism of action., Methods: The pork loins were randomly divided into three groups: aged in vacuum-packaging, onggi containing red clay only (OR), and onggi containing 30% red clay and 70% scoria powder (OS). Microbial analyses (total plate count and Lactobacillus spp.) and physicochemical analyses (pH, shear force, volatile basic nitrogen [VBN], water activity, 2-thiobarbituric acid reactive substances, water content, water holding capacity, cooking loss, and color analysis) of aged meat were conducted. Far-infrared ray emission, quantification of immobilized L. sakei and microstructure of onggi were investigated to understand the mechanism., Results: On day 21, the meat aged in OS exhibited lower pH, shear force, VBN, and water activity than those aged in OR, along with an increase in the number of Lactobacillus spp. OS had a smaller pore diameter than OR, implying lower gas permeability, which could promote the growth of L. sakei., Conclusion: OS improved the microbiological safety and storage stability of pork loin during dry aging by increasing number of Lactobacillus spp. possibly due to low permeability of OS.

Background: Hallux valgus (HV) is a common toe deformity with various contributory factors. The interactions between intrinsic risk factors of HV, such as arch height, sex, age, and body mass index (BMI) should be considered. The present study aimed to establish a predictive model for HV using intrinsic factors, such as sex, age, BMI, and arch height based on decision tree (DT) model., Methods: This is retrospective study. The study data were based on the fifth Size Korea survey, of the Korea Technology Standard Institute. Among 5,185 patients, 645 were excluded due to unsuitable age or missing data, and 4,540 (males = 2,236 and females = 2,304) were selected for inclusion in the study. Seven variables (i.e., sex, age, BMI, and four normalized arch height variables) were used to develop the prediction model for the presence of HV using a DT model., Results: The DT model correctly classified 68.79% (95% confidence interval [CI] = 67.25-70.29%) of the training data set (3,633 cases). The predicted presence of HV based on the DT was verified against the testing data set (907 cases) and showed an accuracy of 69.57% (95% CI = 66.46-72.55%)., Conclusions: The DT model predicted the presence of HV on the basis of sex, age, and normalized arch height. According to our model, women aged over 50 years and those with lower normalized arch height were at high risk of HV., (© 2023. The Author(s).)

Avocado (Persea americana) contains a variety of physiological active substances such as polyphenol, which has excellent antioxidant properties. This study investigated the radioprotective effect of avocado peel extract on congenital malformations and on the behavior of Sprague-Dawley (SD) rats. Experimental animals were randomly classified into four groups: NC Group, normal control; PA Group, oral administration with avocado peel extract (200 mg/kg/day); IR Group, irradiation; and PA+IR Group, irradiation after orally administered with avocado peel extract. For irradiation, 2 Gy of 6 MV X-ray was used once for the whole body. After that, congenital malformations, histopathological evaluation of the brain, and behavioral evaluation were performed in the obtained offspring. Although the body weight of the offspring was decreased by radiation exposure, it was confirmed that the decrease in weight was smaller when treated with PA. As the congenital malformations, hydrocephalus, loss of eyes, and abnormal rat tail occurred, and the result for the PA+IR Group was significantly lower than that of IR Group. Histopathologically, the length of the cerebral cortex of the PA+IR Group was similar to that of the non-radiation group. It was confirmed that emotional and behavioral disorders such as anxiety and depression were improved in the open field test (OFT) and elevated plus maze (EPM) test. And proved that working memory and cognitive ability were enhanced in the novel object recognition (NOR) test and spontaneous alternation Y-maze (SAY) test. Therefore, it was concluded that avocado peel extract can reduce the incidence of congenital malformations and improve growth disorders, memory and cognitive abilities. In the future, based on these results, we will conduct research on the hippocampus and amygdala, which are major regions of the brain, and additional research on cell biology., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Restrictions on daily life and changes in economic structure due to coronavirus disease 2019 (COVID-19) likely would have affected men and women differently. However, there is still a lack of research on the difference between men and women in the amount of change in depression during COVID-19 compared to before COVID-19. Therefore, the researchers investigated gender differences in the magnitude of increase in the prevalence of depression with its severity and individual symptoms during COVID-19 compared with pre-pandemic levels., Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018 were used to assess depression levels pre-pandemic and the KNHANES 2020 for pandemic depression levels. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). To analyze the differences between men and women in the magnitude of the mental health impact of COVID-19, the researchers analyzed the weighted differences in depression prevalence, severity, and individual symptoms during the COVID-19 pandemic compared to before COVID-19 stratified by gender., Results: In men, there were significant increases in weighted prevalence for depression (1.2% percentage point; 95% confidence interval [CI], 0.0-2.3) and severe symptoms of depression (2.6-fold; 95% CI, 1.2-5.7). Among the individual symptoms of depression, significant increases during the pandemic compared to before were: little interest or pleasure in doing things, 1.26-fold; feeling tired or having little energy, 2.2-fold; and suicidal thoughts, 1.7-fold. However, there was no significant difference in prevalence, symptoms severity, and any symptom before and during COVID-19 in women., Conclusions: Because the pandemic is likely to increase mental problems of the affected over time due to such problems as financial stress and joblessness or post-infection health issues, the researchers anticipate an increase in the prevalence of some mental illnesses. In particular, since the suicide rate of men is higher than that of women, from a public health perspective, active interventions are needed to prevent an increase in the suicide rate due to COVID-19. It is also necessary to establish national policies to overcome the psychological, social, and economic losses resulting from COVID-19., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2023 The Korean Academy of Medical Sciences.)

Background: It remains unclear whether a combination of glycemic variability and glycated hemoglobin (HbA1c) status leads to a higher incidence of cardiovascular disease (CVD). Therefore, to investigate CVD risk according to the glucose control status during early diabetes, we examined visit-to-visit HbA1c variability among patients with type 2 diabetes (T2DM)., Methods: In this 9-year retrospective study, we measured HbA1c levels at each visit and tracked the change in HbA1c levels for 3 years after the first presentation (observation window) in newly diagnosed T2DM patients. We later assessed the occurrence of CVD in the last 3 years (target outcome window) of the study period after allowing a 3-year buffering window. The HbA1c variability score (HVS; divided into quartiles, HVS&#95;Q1-4) was used to determine visit-to-visit HbA1c variability., Results: Among 4,817 enrolled T2DM patients, the mean HbA1c level was < 7% for the first 3 years. The group with the lowest HVS had the lowest rate of CVD (9.4%; 104/1,109 patients). The highest incidence of CVD of 26.7% (8/30 patients) was found in HVS [≥ 9.0%]&#95;Q3, which was significantly higher than that in HVS [6.0-6.9%]&#95;Q1 ( P = 0.006), HVS [6.0-6.9%]&#95;Q2 ( P = 0.013), HVS [6.0-6.9%]&#95;Q3 ( P = 0.018), and HVS [7.0-7.9%]&#95;Q3 ( P = 0.040)., Conclusion: To our knowledge, this is the first long-term study to analyze the importance of both HbA1c change and visit-to-visit HbA1c variability during outpatient visits within the first 3 years. Lowering glucose levels during early diabetes may be more critical than reducing visit-to-visit HbA1c variability., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2023 The Korean Academy of Medical Sciences.)

This research evaluated the potentiality of oyster mushroom powder (OMP) as a phosphate alternative by improving emulsion stability of emulsion-type sausage. Sausage without phosphate (NC), with 0.2% sodium triphosphate (PC), and with 1 and 2% OMP (M1 and M2) were prepared. The OMP addition improved the physicochemical properties of sausage, effectively prevented lipid oxidation, and delayed the growth of aerobic bacteria during 28 days of cold storage compared to NC. The M1 and M2 improved the emulsion stability similar to PC. M2 had the highest water holding capacity and apparent viscosity and the lowest cooking loss (P < 0.05). The addition of OMP resulted in different textural characteristics from that of phosphate due to the formation of emulsion structures randomly entrapped by filament-like components, which were derived from polysaccharides or the conjugates between polysaccharides and proteins. According to the results of this study, emulsion stability promoted by OMP was mainly due to the polysaccharides, which are involved in enhancing viscosity and steric hindrance., Competing Interests: Declaration of Competing Interest The authors declare that there is no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Fresh food products can be contaminated with pathogenic bacteria in various agricultural environments. Potting soil is sterilized by heat sterilization and then reused. This study evaluated the effects of three sterilization methods (non-sterilized, pasteurized, and sterilized) on the survival of pathogenic bacteria in potting soil during storage for 60 days at 5, 15, 25, and 35 °C. The reduction in Escherichia coli O157:H7, Salmonella Typhimurium, and Staphylococcus aureus in potting soil was higher at higher temperatures (25 and 35 °C) than at lower temperatures (5 and 15 °C). The population of pathogenic bacteria in pasteurized and sterilized potting soil was reduced below the detectable levels within 30 days at 35 °C. In contrast, the population of Bacillus cereus did not change in potting soil during storage for 60 days at all temperatures. These results indicate that sterilization and storage temperature of potting soil are critical factors influencing the survival of pathogenic bacteria., Competing Interests: Conflict of interestThe authors declare no conflicts of interest., (© The Author(s) 2022.)

Background: We evaluated patients visiting a tertiary university hospital due to a diagnosis of diabetes with a goal of achieving blood glucose control and evaluated blood glucose persistence over 7 years according to the change in blood glucose evident at 3 months after the first visit., Methods: Patients treated from 2009 to 2013 were categorized into four groups according to the change in HbA1c levels during the first 3 months of follow-up (Best&#95;group, ≥ 1.6% decrease; Better&#95;group, 0.5-1.5% decrease; Neutral&#95;group, maintained at -0.4% to +0.4%; Worse&#95;group, ≥ 0.5% increase). Each patient's blood glucose control status was then monitored for 7 years. The incidence of stroke and acute coronary syndrome during this period was confirmed., Results: Overall, 9,776 patients were included. HbA1c values were lower in the Best&#95;group than in the other groups at all time points (all P < 0.001). The rate of reaching targets of < 6.5% or < 7.0% HbA1c decreased over time; the rate at which the estimated glomerular filtration rate decreased to < 30 or < 60 mL/min/1.73m² increased over time (all trends, P < 0.01)., Conclusion: Blood glucose control status in the first 3 months after initiating hospital care enabled estimation of the patient's glycemic control status for the next 7 years. In cases with poor initial blood glucose control, a new or more active method of blood glucose control should be sought., Competing Interests: No potential conflict of interest relevant to this article is reported., (© 2022 The Korean Academy of Medical Sciences.)

Background: In the euthyroid state, the risk of developing diabetes according to changes in thyroid-stimulating hormone (TSH) levels remains controversial. Additionally, the correlation of various body indices affecting blood glucose levels according to changes in TSH levels over a certain period is not well known., Methods: Patients who underwent health check-ups twice at a 2 year interval at a tertiary university hospital between 2009 and 2018 were included. By dividing baseline TSH levels into quartiles (TSH&#95;Q1, Q2, Q3, and Q4), various variables were compared, and their changes after 2 years (∆TSH&#95;Q1, Q2, Q3, and Q4) were confirmed., Results: Among 15 557 patients, the incidence of diabetes mellitus after 2 years was 2.4% (377/15 557 patients). There was no statistically significant difference in the incidence of diabetes according to TSH&#95;Q (p = 0.243) or ∆TSH&#95;Q (p = 0.131). However, as TSH levels increased, skeletal muscle mass decreased (p < 0.001), and body fat mass and percent body fat significantly increased (p < 0.001). As ∆TSH increased, ∆fasting blood glucose and ∆body mass index also significantly increased (all p < 0.001). The incidence of diabetes decreased significantly as skeletal muscle mass increased (odds ratio 0.734, p < 0.001)., Conclusions: Owing to the short study period, it was not possible to prove a statistical relationship between the incidence of diabetes mellitus and TSH levels in the euthyroid state. Significant decreases in skeletal muscle mass and increases in body mass index and body fat mass according to baseline TSH levels were demonstrated. Therefore, a focus on improving physical functions, such as increasing muscle mass and decreasing fat, is required in this case., (© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.)

The objective of the present study was to compare the breast meat quality and metabolomic characteristics from broilers that were raised in conventional (conventional farm reared-broilers; CB, n = 20) and legally approved animal welfare farms (welfare farm reared-broilers; WB, n = 20) in aerobic cold storage (1, 3, 5, and 7 d). Compared to CB chickens, the WB chickens had a larger floor size as well as lower stocking density, atmospheric ammonia, and nipple-shared chicken counts. The results demonstrated significantly higher pH, L ⁎ - and b ⁎ -value, and lower shear force in CB compared to WB during cold storage. Using 1 H NMR analysis, 25 compounds were identified in the chicken breast meat. Partial least square-discriminant analysis (PLS-DA) was performed based on the identified metabolites. The content of 15 metabolites (1 di-peptide, 9 free amino acids, 2 glycolytic potential-related products, 2 nucleotide-related products, and 1 organic acid) was significantly different due to the rearing environment (CB vs. WB). Among them, all free amino acids were higher in CB than in WB. Six free amino acids (glycine, isoleucine, leucine, phenylalanine, valine, and β-alanine) had variable importance in projection (VIP) score >1, regardless of the number of cold storage days. Therefore, these compounds in the breast meat may be used as potential markers to determine the rearing environment of broilers. Also, this result might be an indication of stress-related meat quality changes in broilers., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: Increasing brown adipocytes activity and inducting browning of white adipocytes are potential therapeutic targets for the treatment of obesity. In the present study, we investigated the effects of Tanshinone 1 (Tan 1), a major compound from Salvia miltiorrhiza Bunge, on the activation of brown adipocytes and browning of white adipocytes in vivo and in vitro., Materials and Methods: Expression of genes associated with brown adipocyte function including thermogenesis, mitochondria biogenesis and fatty acid oxidation was examined in brown adipose tissue (BAT) and white adipose tissue (WAT) of high fat diet (HFD)-fed obese mice administrated with Tan 1 or in immortalized brown adipocytes (iBAs) and 3T3-L1 adipocytes treated with Tan 1. Mitochondria DNA (mtDNA) content, lipolysis and phosphorylated AMP-activated protein kinase (AMPK) were further assessed in Tan 1 treated-iBAs and 3T3-L1 adipocytes., Key Findings: The administration of Tan 1 protected against HFD-induced obesity in mice, which was associated with enhanced expression of brown adipocyte function-related genes in BAT and WAT. Tan 1 treatment also upregulated brown adipocyte function-related genes in iBA and induced beige adipocytes genes in 3T3-L1 adipocytes, resulting in increased mtDNA content and lipolysis. Tan 1 activated AMPK in BAT and WAT of HFD-fed obese mice as well as in iBAs and 3T3-L1 adipocytes. Inhibition of AMPK by compound C prevented Tan 1-induced expression of beige adipocytes genes., Significance: These results indicate that Tan 1 activates brown adipocytes and induces browning of white adipocytes, which may contribute to anti-obesity activity of Tan 1., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Despite growing interest from consumers in meat products from animal-friendly raising environments, the influence of environmental conditions on chicken meat quality remains unclear. This study investigated the effects of legally approved animal-friendly raising environments on the physicochemical quality and storage stability of chicken thigh muscle using nuclear magnetic resonance-based metabolic analysis. One-day-old Cobb chicks were raised for 35 days under conventional or animal-friendly farms in an indoor system. Chicken thigh meat from conventional farms (CB) and chicken thigh meat from legally approved animal-friendly farms (AFB) were stored for 7 days and the metabolomic profiles and characteristics of meat were analyzed. Two chicken groups were clearly separated by partial least squares-discriminant analysis based on their metabolomic profiles. Glycolysis-related products (glucose and lactic acid) were more abundant in AFB, whereas inosine, hypoxanthine, and free amino acid contents were higher in CB. An animal-friendly raising environment resulted in the differential regulation of metabolic pathways and physicochemical quality of AFB, which presented a lower pH and water holding capacity and higher shear force compared with CB. However, both chicken groups maintained their storage stability in terms of microbial quality, lipid oxidation, volatile basic nitrogen, and fatty acid profiles. These results suggest that an animal-friendly raising environment could lead to differences in meat quality via metabolic changes, which subsequently alter the physicochemical quality of chicken thigh meat., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: The present study translated the Vocal Tract Discomfort Scale (VTDS) into Korean (K-VTDS) and evaluated its reliability and validity., Study Design: This was a prospective study., Methods: The VTDS was first translated into Korean and validated. One hundred and fifty-nine patients with voice disorders were divided into three different diagnostic groups (functional, structural, and neurologic voice disorder) and 131 vocally healthy adults were also included. All participants completed the K-VTDS and the Korean version of the Voice Handicap Index (K-VHI) and Korean versions of the Voice-Related Quality of Life (K-VRQOL). The internal consistency of the K-VTDS was analyzed through Cronbach's α coefficient. The VTDS score differences related to the diagnostic groups were assessed with t test and analysis of variance. We assessed the correlation between the K-VTDS, the K-VHI, and the K-VRQOL using Pearson's correlation analysis., Results: High internal consistency and the test-retest reliability of the K-VTDS were found. The voice disorder group had significantly higher K-VTDS scores for the subscales and total scores than those in the healthy group (P < 0.001). The K-VTDS scores for the subscale of frequency and total scores were highest in the functional voice disorder group. We found a significant difference in frequency and total score of the K-VTDS between the functional voice disorder group and the structural voice disorder group (P < 0.05). We observed a strong positive correlation among the scores for the subscales of frequency and severity, and total scores in the K-VTDS. The K-VTDS showed moderate correlation with the K-VHI and the K-VRQOL., Conclusion: The K-VTDS is a reliable and valid instrument for voice assessment for voice disorders in Korean-speaking patients., (Copyright © 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Air pollution may influence prenatal maternal stress, but research evidence is scarce. Using data from a prospective cohort study conducted on pregnant women (n = 2153), we explored the association between air pollution and perceived stress, which was assessed using the 14-item Perceived Stress Scale (PSS), among pregnant women. Average exposures to particulate matter with an aerodynamic diameter of < 2.5 µm (PM 2.5 ) or < 10 µm (PM 10 ), nitrogen dioxide (NO 2 ), and ozone (O 3 ) for each trimester and the entire pregnancy were estimated at maternal residential addresses using land-use regression models. Linear regression models were applied to estimate associations between PSS scores and exposures to each air pollutant. After adjustment for potential confounders, interquartile-range (IQR) increases in whole pregnancy exposures to PM 2.5 , PM 10 , and O 3 in the third trimester were associated with 0.37 (95% confidence interval [CI] 0.01, 0.74), 0.54 (95% CI 0.11, 0.97), and 0.30 (95% CI 0.07, 0.54) point increases in prenatal PSS scores, respectively. Furthermore, these associations were more evident in women with child-bearing age and a lower level of education. Also, the association between PSS scores and PM 10 was stronger in the spring. Our findings support the relationship between air pollution and prenatal maternal stress., (© 2021. The Author(s).)

Objective: The aims of this study were to describe the unilateral biportal endoscopic (UBE) technique for decompression of extraforaminal stenosis at L5-S1 and evaluate 1-year clinical outcomes. Especially, we evaluated compression factors of extraforaminal stenosis at L5-S1 and described the surgical technique for decompression in detail., Methods: Thirty-five patients who underwent UBE decompression for extraforaminal stenosis at L5-S1 between March 2018 and February 2019 were enrolled. Clinical results were analyzed using the MacNab criteria, the visual analogue scale (VAS) for back and leg pain, and the Oswestry Disability Index (ODI). Compression factors evaluated pseudoarthrosis within the transverse process of L5 and ala of sacrum, disc bulging with or without osteophytes, and the thickened lumbosacral and extraforaminal ligament., Results: The mean back VAS was 3.7 ± 1.8 before surgery, which dropped to 2.3 ± 0.8 at 1-year postoperative follow-up (p < 0.001). There was a significant drop in postoperative mean VAS for leg pain from 7.2 ± 1.1 to 2.3 ± 1.2 at 1 year (p < 0.001). The ODI was 61.5 before surgery and 28.6 (p < 0.001). Pseudoarthrosis between the transverse process and the ala was noted in all cases (35 of 35, 100%). Pure disc bulging was seen in 12 patients (34.3%), and disc bulging with osteophytes was demonstrated in 23 patients. The thickened lumbosacral and extraforaminal ligament were identified in 19 cases (51.4%). No complications occurred in any of the patients., Conclusion: In the current study, good surgical outcomes without complications were achieved after UBE decompression for extraforaminal stenosis at L5-S1.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. While the development of NAFLD is correlated with aberrant histone methylation, modifiers of histone methylation involved in this event remain poorly understood. Here, we studied the functional role of the histone demethylase KDM7A in the development of hepatic steatosis. KDM7A overexpression in AML12 cells upregulated diacylglycerol acyltransferase 2 (DGAT2) expression and resulted in increased intracellular triglyceride (TG) accumulation. Conversely, KDM7A knockdown reduced DGAT2 expression and TG accumulation, and significantly reversed free fatty acids-induced TG accumulation. Additionally, adenovirus-mediated overexpression of KDM7A in mice resulted in hepatic steatosis, which was accompanied by increased expression of hepatic DGAT2. Furthermore, KDM7A overexpression decreased the enrichment of di-methylation of histone H3 lysine 9 (H3K9me2) and H3 lysine 27 (H3K27me2) on the promoter of DGAT2. Taken together, these results indicate that KDM7A overexpression induces hepatic steatosis through upregulation of DGAT2 by erasing H3K9me2 and H3K27me2 on the promoter.

Background: Air pollution is associated with depressive and anxiety symptoms in the general population. However, this relationship among pregnant women remains largely unknown., Objective: To evaluate the association between pregnancy air pollution exposure and maternal depressive and anxiety symptoms during the third trimester assessed using the Center for Epidemiologic Studies-Depression and State-Trait Anxiety Inventory scales, respectively., Methods: We analyzed 1481 pregnant women from a cohort study in Seoul. Maternal exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM 2.5 ) and <10 μm (PM 10 ), as well as to nitrogen dioxide (NO 2 ) and ozone (O 3 ) for each trimester and the entire pregnancy was assessed at participant's residential address by land use regression models. We estimated the relative risk (RR) and corresponding confidence interval (CI) of the depressive and anxiety symptoms associated with an interquartile range (IQR) increase in PM 2.5 , PM 10 , NO 2 , and O 3 using modified Poisson regression., Results: In single-pollutant models, an IQR increase in PM 2.5 , PM 10 , and NO 2 during the second trimester was associated with an increased risk of depressive symptoms (PM 2.5 RR = 1.15, 95% CI: 1.04, 1.27; PM 10 RR = 1.13, 95% CI: 1.04, 1.23; NO 2 RR = 1.15, 95% CI: 1.03, 1.29) after adjusting for relevant covariates. Similarly, an IQR increase in O 3 during the third trimester was associated with an increased risk of depressive symptoms (RR = 1.09, 95% CI: 1.01, 1.18), while the IQR increase in O 3 during the first trimester was associated with a decreased risk (RR = 0.89, 95% CI: 0.82, 0.96). Exposure to PM 2.5 , PM 10 , and NO 2 during the second trimester was significantly associated with anxiety symptoms. The associations with PM 2.5 and O 3 in single-and multi-pollutant models were consistent., Conclusions: Our findings indicate that increased levels of particulate matter, NO 2 , and O 3 during pregnancy may elevate the risk of depression or anxiety in pregnant women., (Copyright © 2021 The Authors. Published by Elsevier GmbH.. All rights reserved.)

This study investigated freeze- or oven-dried winter mushroom powder (FDP or ODP, respectively) as an alternative to phosphate in beef patties. The beef patties were prepared with four treatments: no addition of phosphate and winter mushroom (control), addition of 0.3% sodium pyrophosphate (BP), addition of 1% FDP (BFW), and addition of 1% ODP (BOW). The pH of FDP and ODP was 6.73, and 7.00, respectively. FDP and ODP contained phenolic compound at a level of 3.50 and 5.45 g gallic acid equivalent/kg, respectively. The cooking loss of beef patties was the highest in the control and lowest in BP (p<0.05). BFW had lower cooking loss than the control (p<0.05), and BOW showed similar cooking loss as that of the control (p>0.05). Inhibition of lipid oxidation was found in BP and BOW as compared with control (p<0.05). BFW was similar to the control in terms of the degree of lipid oxidation (p>0.05). BOW showed lower L* and higher a* values than those of the control, BP and BFW (p<0.05). Texture properties such as hardness, springiness, cohesiveness, gumminess, and chewiness were the highest in BP (p<0.05). A slight increase in hardness and springiness was observed in BOW compared to those of the control (p<0.05). The results showed that FDP and ODP did not exhibit all the properties of phosphate in beef patties. Therefore, FDP and ODP can be used for partial substitution of phosphate in beef patties., Competing Interests: The authors declare no potential conflicts of interest., (© Korean Society for Food Science of Animal Resources.)

Silicon oxide-coated lithium aluminum layered double hydroxide (Li x Al 2 -LDH@SiO 2 ) nanocrystals (NCs) are investigated to selectively separate lithium cations in aqueous lithium resources. We directly synthesized Li x Al 2 -LDH NC arrays by oxidation of aluminum foil substrate under a urea and lithium solution. Various lithium salts, including Cl - , CO 3 2- , NO 3 - , and SO 4 2- , were applied in aqueous solution to confirm the anion effect on the captured and released lithium quantity of the Li x Al 2 -LDH NCs. In a 5% solution of sulfate ions mix with lithium chloride, the Li x Al 2 -LDH NCs separated a larger quantity of lithium than in other anion conditions. To enhance regeneration stability and lithium selectivity, thin layers of SiO 2 were coated onto the Li x Al 2 -LDH nanostructure arrays for inhibition of nanostructure destruction after desorption of lithium cations in hot water. The Li x Al 2 -LDH@SiO 2 nanostructures showed enhanced properties for lithium adsorption, including increase of stable regeneration cycles from three to five cycles, and they showed high lithium selectivity in the Mg 2+ , Na + , and K + cation mixed aqueous resource. Our nanostructured LDH lithium adsorbents would provide a facile and efficient application for cost-efficient and large-scale lithium production., (© 2021 Wiley-VCH GmbH.)

Background: Diabetic nephropathy (DN) is one of the most important medical complications of diabetes mellitus. Autophagy is an important mediator of pathological response and plays a critical role in inflammation during the progression of diabetic nephropathy. Interleukin (IL)-17A favorably modulates inflammatory disorders including DN. In this study, we examined whether IL-17A deficiency affected the autophagy process in the kidneys of mice with streptozotocin (STZ)-induced DN., Methods: The autophagic response of IL-17A to STZ-induced nephrotoxicity was evaluated by analyzing STZ-induced functional and histological renal injury in IL-17A knockout (KO) mice., Results: IL-17A KO STZ-treated mice developed more severe nephropathy than STZ-treated wild-type (WT) mice, with increased glomerular damage and renal interstitial fibrosis at 12 weeks. IL-17A deficiency also increased the up-regulation of proinflammatory cytokines and fibrotic gene expression after STZ treatment. Meanwhile, autophagy-associated proteins were induced in STZ-treated WT mice. However, IL-17A KO STZ-treated mice displayed a significant decrease in protein expression. Especially, the levels of LC3 and ATG7, which play crucial roles in autophagosome formation, were notably decreased in the IL-17A KO STZ-treated mice compared with their WT counterparts., Conclusions: IL-17 deficiency aggravates of STZ-induced DN via attenuation of autophagic response. Our study demonstrated that IL-17A mediates STZ-induced renal damage and represents a potential therapeutic target in DN.

Background: Stretching and length test of hamstring muscles have been performed commonly to manage lower back pain (LBP) in sports rehabilitation. Previous literatures addressed that stretching techniques and length test of hamstring muscles should be performed with the pelvic maintained in an anterior tilt position. However, there is no study to determine the effectiveness of pressure biofeedback unit (PBU) to maintain in anterior pelvic tilting (APT) on length test and stretching of hamstring muscles., Objective: To determine the effectiveness of hamstring muscles stretching using a PBU., Methods: Forty participants with shortness of hamstrings randomized into two groups. Participants performed the active knee extension (AKE) stretching without (control group) or with PBU (intervention group) for four weeks. AKE tests without and with PBU were administered three times before and after hamstrings stretching by each group., Results: The AKE test without PBU showed a significant main effect of time ( p < 0 . 01 ) but not of group ( p = 0 . 55 ) on the AKE angle. The AKE test with PBU showed a significant increase in the AKE angle in the post-intervention compared to the pre-intervention assessments in both groups ( p < 0 . 01 ). The difference of AKE angle between the pre- and post-intervention results was significantly greater in the intervention group than in the control group ( p < 0 . 01 )., Conclusion: We recommend the use of a PBU to maintain the pelvic anterior tilting position when performing the AKE test or AKE stretching., Competing Interests: The authors declare that there is no conflict of interest., (© 2020, Hong Kong Physiotherapy Association.)

Ligand-activated liver X receptor α (LXRα) upregulates the expression of hepatic lipogenic genes, which leads to triglyceride (TG) accumulation, resulting in nonalcoholic fatty liver disease (NAFLD). Thus, LXRα regulation may provide a novel therapeutic target against NAFLD. However, histone methylation-mediated epigenetic regulation involved in LXRα-dependent lipogenesis is poorly understood. In this study, we investigated the functional role of the histone demethylase Jumonji domain-containing protein 2B (JMJD2B) in LXRα-dependent lipogenesis. JMJD2B expression level was upregulated in HepG2 cells treated with LXRα agonist T0901317 or palmitate and the liver of mice administered with T0901317 or fed a high-fat diet. Knockdown of JMJD2B using siRNA abrogated T0901317-induced LXRα-dependent lipogenic gene expression and lowered intracellular TG accumulation. Conversely, overexpression of JMJD2B in HepG2 cells upregulated the expression of LXRα-dependent lipogenic genes, in line with increased intracellular TG levels. JMJD2B overexpression or T0901317 treatment induced the recruitment of JMJD2B and LXRα to LXR response elements (LXRE) in the promoter region of LXRα-target gene and reduced the enrichment of H3K9me2 and H3K9me3 in the vicinity of the LXRE. Furthermore, JMJD2B enhanced T0901317 or LXRα-induced transcriptional activities of reporters containing LXRE. A co-immunoprecipitation assay revealed that JMJD2B interacted with activated LXRα. Moreover, overexpression of JMJD2B in mice resulted in upregulation of hepatic LXRα-dependent lipogenic genes, consistent with development of hepatic steatosis. Taken together, these results indicate that JMJD2B plays a role in LXRα-mediated lipogenesis via removing the repressive histone marks, H3K9me2 and H3K9me3, at LXRE, which might contribute to hepatic steatosis.

Benign prostatic hyperplasia (BPH) is a progressive pathological condition associated with proliferation of prostatic tissues, prostate enlargement, and lower-urinary tract symptoms. However, the mechanism underlying the pathogenesis of BPH is unclear. The aim of this study was to investigate the protective effects of a combination of Stauntonia hexaphylla and Cornus officinalis (SC extract) on a testosterone propionate (TP)-induced BPH model. The effect of SC extract was examined in a TP-induced human prostate adenocarcinoma cell line. Male Sprague-Dawley rats were randomly divided into 5 groups (n = 6) for in vivo experiments. To induce BPH, all rats, except those in the control group, were administered daily with subcutaneous injections of TP (5 mg/kg) and orally treated with appropriate phosphate buffered saline/drugs (finasteride/saw palmetto/SC extract) for 4 consecutive weeks. SC extract significantly downregulated the androgen receptor (AR), prostate specific antigen (PSA), and 5α-reductase type 2 in TP-induced BPH in vitro. In in vivo experiments, SC extract significantly reduced prostate weight, size, serum testosterone, and dihydrotestosterone (DHT) levels. Histologically, SC extract markedly recovered TP-induced abnormalities and reduced prostatic hyperplasia, thereby improving the histo-architecture of TP-induced BPH rats. SC extract also significantly downregulated AR and PSA expression, as assayed using immunoblotting. Immunostaining revealed that SC extract markedly reduced the 5α-reductase type 2 and significantly downregulated the expression of proliferating cell nuclear antigen. In addition, immunoblotting of B-cell lymphoma 2 (Bcl-2) family proteins indicated that SC extract significantly downregulated anti-apoptotic Bcl-2 and markedly upregulated pro-apoptotic B cell lymphoma-associated X (Bax) expression. Furthermore, SC treatment significantly decreased the Bcl-2/Bax ratio, indicating induced prostate cell apoptosis in TP-induced BPH rats. Thus, our findings demonstrated that SC extract protects against BPH by inhibiting 5α-reductase type 2 and inducing prostate cell apoptosis. Therefore, SC extract might be useful in the clinical treatment of BPH., Competing Interests: The authors have declared that no competing interests exist.

Background: Detecting bacteremia among surgical in-patients is more obscure than other patients due to the inflammatory condition caused by the surgery. The previous criteria such as systemic inflammatory response syndrome or Sepsis-3 are not available for use in general wards, and thus, many clinicians usually rely on practical senses to diagnose postoperative infection., Objective: This study aims to evaluate the performance of continuous monitoring with a deep learning model for early detection of bacteremia for surgical in-patients in the general ward and the intensive care unit (ICU)., Methods: In this retrospective cohort study, we included 36,023 consecutive patients who underwent general surgery between October and December 2017 at a tertiary referral hospital in South Korea. The primary outcome was the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC) for detecting bacteremia by the deep learning model, and the secondary outcome was the feature explainability of the model by occlusion analysis., Results: Out of the 36,023 patients in the data set, 720 cases of bacteremia were included. Our deep learning-based model showed an AUROC of 0.97 (95% CI 0.974-0.981) and an AUPRC of 0.17 (95% CI 0.147-0.203) for detecting bacteremia in surgical in-patients. For predicting bacteremia within the previous 24-hour period, the AUROC and AUPRC values were 0.93 and 0.15, respectively. Occlusion analysis showed that vital signs and laboratory measurements (eg, kidney function test and white blood cell group) were the most important variables for detecting bacteremia., Conclusions: A deep learning model based on time series electronic health records data had a high detective ability for bacteremia for surgical in-patients in the general ward and the ICU. The model may be able to assist clinicians in evaluating infection among in-patients, ordering blood cultures, and prescribing antibiotics with real-time monitoring., (©Hyung Jun Park, Dae Yon Jung, Wonjun Ji, Chang-Min Choi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.08.2020.)

Ethnopharmacological Relevance: Panax ginseng C.A. Mey. (Korean ginseng) has been widely used in traditional medicine to treat diabetes mellitus for thousands of years. It also plays a key role in health maintenance owing to its anti-oxidant and anti-fatigue properties, and is quite popular as a dietary supplement., Aim of the Study: This study was designed to offer a complementary and alternative medicine to manage the diabetic kidney disease (DKD), which causes long-term damage to the renal structure. We also investigated the regulation of the autophagy mechanism, which is the underlying the pathogenesis of DKD., Materials and Methods: The effect of Korean red ginseng (KRG) on DKD was evaluated using human kidney proximal tubular cells and streptozotocin (STZ)-treated Sprague-Dawley rat models. In vitro experiments were conducted to evaluate the proteins related to fibrosis and autophagy. This was followed by in vivo experiments involving rats treated with single intraperitoneal administration of STZ (60 mg/kg) and then with KRG solution orally for 4 weeks. Proteins related to renal injury, fibrosis, and autophagy were determined by immunoblotting. Hematoxylin and eosin (H&E), Periodic acid-Schiff (PAS), Sirius red, and immunostaining were processed for histological studies., Results: KRG diminished the levels of metabolic measurements and blood parameters. Western blotting showed a decreased expression of proteins, such as TGF-β1, KIM1, and AGE, which are responsible for renal inflammation, injury, and fibrosis. Histological studies also supported these results and revealed that the KRG-treated groups recovered from renal injury and fibrosis. Furthermore, the autophagy marker, LC3, was upregulated, whereas p62 was downregulated. The levels of proteins related to the autophagy mechanism, such as ATG7, increased, while mammalian target of rapamycin (mTOR) decreased with the KRG treatment and exhibited accelerated autophagy compared to the STZ alone group., Conclusions: KRG can suppress renal inflammation, injury, and fibrosis by blocking TGF-β1 activation and can induce cellular autophagy. Therefore, this study strongly suggests that KRG exhibits a renoprotective effect against the STZ-induced DKD., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Tanshinone I (Tan I) is a diterpenoid isolated from Salvia miltiorrhiza Bunge and exhibits antitumor effects in several cancers. However, the anti-obesity properties of Tan I remain unexplored. Here, we evaluated the anti-obesity effects of Tan I in high-fat-diet (HFD)-induced obese mice and investigated the underlying molecular mechanisms in 3T3-L1 cells. HFD-induced obese mice were orally administrated Tan I for eight weeks, and body weight, weight gain, hematoxylin and eosin staining and serum biological parameters were examined. The adipogenesis of 3T3-L1 preadipocytes was assessed using Oil Red O staining and measurement of intracellular triglyceride (TG) levels, and mitotic clonal expansion (MCE) and its related signal molecules were analyzed during early adipogenesis of 3T3-L1 cells. The administration of Tan I significantly reduced body weight, weight gain, and white adipocyte size, and improved obesity-induced serum levels of glucose, free fatty acid, total TG, and total cholesterol in vivo in HFD-induced obese mice. Furthermore, Tan I-administered mice demonstrated improvement of glucose metabolism and insulin sensitivity. Treatment with Tan I inhibited the adipogenesis of 3T3-L1 preadipocytes in vitro, with this inhibition mainly occurring at an early phase of adipogenesis through the attenuation of MCE via cell cycle arrest at the G1/S phase transition. Tan I inhibited the phosphorylation of p38, extracellular signal-regulated kinase (ERK), and Akt during the process of MCE, while it stimulated the phosphorylation of AMP-activated protein kinase. Furthermore, Tan I repressed the expression of CCAAT-enhancer-binding protein β ( C/EBPβ ), histone H3K9 demethylase JMJD2B , and subsequently cell cycle genes. Moreover, Tan I regulated the expression of early adipogenic transcription factors including GATAs and Kruppel-like factor family factors. These results indicate that Tan I prevents HFD-induced obesity via the inhibition of early adipogenesis, and thus improves glucose metabolism and insulin sensitivity. This suggests that Tan I possesses therapeutic potential for the treatment of obesity and obesity-related diseases., Competing Interests: The authors declare no conflict of interest.

The Baeg-nyong cave is a limestone cave which has been nominated as the first critical zone observatory (CZO) in South Korea. Moonmilk is a well-known speleothem composed of various carbonate minerals. To characterize moonmilk from the Baeg-nyong cave, we performed mineralogical analyses and applied high-throughput 16S rRNA gene sequencing to analyze the microbial communities, including bacteria and fungi, of dry and wet moonmilk samples. The results showed that the dry and wet moonmilk samples had different and atypical crystal structures, although they were predominantly composed of CaCO 3 . Furthermore, metagenomic data revealed that the dry and wet moonmilk samples collected from an oligotrophic environment had completely different bacterial communities when compared to the outside soil, and there was a difference in bacterial communities even between dry and wet moonmilk specimens. Fungal communities, however, did not differ significantly between dry and wet moonmilk samples. This study is the first metagenomic analysis of two different types of moonmilk with different physical properties and the first report on the microbial diversity of moonmilk from a cave in the first CZO in South Korea., (Copyright © 2020 Park, Cho, Jung, Jo, Lee and Lee.)

Ethnopharmacological Relevance: Stauntonia hexaphylla (Lardizabalaceae, S. hexaphylla) is traditionally used as a folk remedy for alleviating fever and for its anti- inflammatory and analgesic properties. In Korea and China, S. hexaphylla has been used as a traditional medicine that acts as diuretic and analgesic. S. hexaphylla has also been reported to inhibit osteoporosis and aldose reductase activity., Aim of the Study: The study aimed to evaluate the therapeutic effects of an extract of S. hexaphylla on testosterone induced benign prostate hyperplasia (BPH) models and to observe its mechanism of action., Materials and Methods: To induce a BPH model in vitro and in vivo, a testosterone-treated LNCaP cell line and Sprague Dawley (SD) rats were used, respectively. Androgen receptors (ARs) and prostate-specific antigens (PSA), which are typical BPH-related proteins, were evaluated using western blotting. Prostate weights and dihydrotestosterone (DHT) levels were measured in vivo, and histopathology of the prostate examined using hematoxylin and eosin staining. Proliferating cell nuclear antigen (PCNA) and 5α-reductase type 2 were also evaluated via immunohistochemistry (IHC). In addition, TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) staining and LC3 staining of IHC were performed to evaluate apoptosis and autophagy., Results: S. hexaphylla reduced prostates weights and the thickness of prostate epithelial cells. In vivo and in vitro, PSA and ARs were downregulated following S. hexaphylla treatment. The S. hexaphylla extracts also reduced DHT and 5α-reductase type 2 expression. In addition, the expression of PCNA was reduced, and in the TUNEL staining and IHC of LC3, the number of positive cells was increased in the groups treated with S. hexaphylla., Conclusions: It was observed that extracts of S. hexaphylla inhibited both 5α -reductase type 2 and ARs. The results indicate that the use of S. hexaphylla extract in BPH is probably beneficial through 5α-reductase inhibition and α-adrenergic receptor blockade. In addition, apoptosis and autophagy were induced, and PCNA was downregulated after S. hexaphylla treatment. Therefore, it can be concluded that S. hexaphylla has a therapeutic effect on BPH., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Two-dimensional (2D) materials have attracted significant attention because of their outstanding electrical, mechanical, and optical characteristics. Because all of the conducting (graphene), semiconducting (molybdenum disulfide, MoS 2 ), and insulating (hexagonal boron nitride, h-BN) components can be constructed from 2D materials, thin-film transistors based on 2D materials (2D TFTs) have been developed. However, scaling-up is necessary for these technologies to go beyond their initial implementation using the mechanical exfoliation method. Furthermore, it would be beneficial to find a method to realize high flexibility and/or transparency to their full potential. In this study, large-scale, flexible, and transparent 2D TFTs are developed and demonstrated as a backplane in active-matrix organic light-emitting diodes (AMOLEDs). With the optical chemical vapor deposition of the 2D materials, flexible (bending radius < 1 mm) and transparent (transmittance > 70%) TFTs with high electrical performances (mobility ≈ 10 cm 2 V -1 s -1 , on/off current ratio > 10 6 ) can be achieved. Furthermore, 2D TFTs are integrated into OLEDs by connecting the source electrode of the TFT to the anode of the OLED via a single graphene film, thus demonstrating pixel-by-pixel driving through a 2D TFT array in an active-matrix configuration.

Study Design: Randomized control trial., Introduction: During weight-bearing wrist movement, potential stabilizing forces caused by carpal stabilizing taping (CST) may restrict movement of the carpal bones, allowing greater wrist joint extension., Purpose of the Study: The purpose of study was to investigate the effect of CST during weight-bearing wrist movement on pain intensity and range of motion (ROM) of wrist extension in subjects with dorsal wrist pain., Methods: Thirty participants with dorsal wrist pain when weight bearing through the hand were randomly allocated into 2 groups: (1) a CST group using rigid tape and (2) placebo taping (PT) group using elastic tape. Subjects performed weight-bearing wrist movements with CST or PT in 6 sessions for 1 week. Active and passive ROM (AROM and PROM), and the visual analog scale (VAS) were assessed at baseline and after the intervention., Results: The AROM and PROM of wrist extension increased significantly in both groups compared with preintervention values (P < .01). Comparing the PT and CST groups, the differences between preintervention and postintervention AROM (mean difference [MD] = +8.6°) and PROM (MD = +6.8°) were significantly greater in the CST group than in the PT group (P < .01). The CST group also showed greater improvement in VAS compared with the PT group (MD = -18 mm) (P < .01)., Conclusion: We recommend CST during weight-bearing wrist movement as an effective intervention for both increasing wrist extension ROM and decreasing pain in patients with dorsal wrist pain during weight bearing through the hand., (Copyright © 2019 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

Background: Weakness of the trapezius and serratus anterior (SA) muscle may be a risk factor for unilateral neck pain., Objective: This study examined the trapezius (upper, middle, and lower) and SA muscle strength ipsilateral and contralateral to the painful side in violinists with unilateral neck pain., Method: Twenty-six female violinists with unilateral neck pain participated in this study. Participants reported the pain intensity and duration and completed the Neck Disability Index (NDI). The strengths of the upper (UT), middle (MT), and lower (LT) trapezius and SA muscles were measured using a handheld dynamometer. Paired t-test was used to compare the strength of the muscles between ipsilateral and contralateral to the painful side within subjects. The relationship between pain intensity, pain duration, and neck disability and strength deficit of the muscle was demonstrated by Pearson's correlation and Spearman's rank correlation., Results: The strengths of the UT, MT, LT, and SA muscles were significantly decreased on the painful side compared with the contralateral side (P< 0.05). Except for correlations between pain intensity and percent strength deficit of the UT and between pain duration and percent strength deficit of the MT (P< 0.05), there were no significant associations between pain intensity, pain duration, or NDI and the percent strength deficit of the UT, MT, LT and SA muscles (P> 0.05)., Conclusions: These results suggest that decreased UT, MT, LT, and SA muscle strength on the side of the pain should be considered in the rehabilitation of violinists with unilateral neck pain.

Cryptotanshinone (CT), a diterpene that is isolated from Salvia miltiorrhiza Bunge, exhibits anti-cancer, anti-oxidative, anti-fibrosis, and anti-inflammatory properties. Here, we examined whether CT administration possess a hepatoprotective effect on chronic ethanol-induced liver injury. We established a chronic alcohol feeding mouse model while using C57BL/6 mice, and examined the liver sections with hematoxylin-eosin (H&E) and Oil Red O (ORO) staining. Further, we analyzed the lipogenesis, fatty acid oxidation, oxidative stress, and inflammation genes by using quantitative polymerase chain reaction (qPCR) and immunoblotting in in vivo, and in vitro while using HepG2 and AML-12 cells. CT treatment significantly ameliorated ethanol-promoted hepatic steatosis, which was consistent with the decreased hepatic triglyceride levels. Interestingly, CT activated the phosphorylation of AMP-activated protein kinase ( AMPK ), sirtuin 1 ( SIRT1 ), and nuclear factor E2-related factor 2 ( Nrf2 ) proteins. Importantly, compound C ( AMPK inhibitor) significantly blocked the CT-mediated reduction in TG accumulation, but not Ex52735 ( SIRT1 inhibitor), which suggested that CT countering ethanol-promoted hepatic steatosis is mediated by AMPK activation. Furthermore, CT significantly inhibited cytochrome P450 2E1 ( CYP2E1 ) and enhanced both the expression of antioxidant genes and hepatic glutathione levels. Finally, CT inhibited the ethanol-induced inflammation in ethanol-fed mice and HepG2 cells. Overall, CT exhibits a hepatoprotective effect against ethanol-induced liver injury by the inhibition of lipogenesis, oxidative stress, and inflammation through the activation of AMPK/SIRT1 and Nrf2 and the inhibition of CYP2E1 . Therefore, CT could be an effective therapeutic agent for treating ethanol-induced liver injury.

Ducks are potential carriers of pathogenic bacteria, which are capable of transmitting zoonotic diseases to humans. The global spread of Enterobacteriaceae carrying extended-spectrum β-lactamase (ESBL) genes is a public health concern. This study investigated the prevalence of antimicrobial resistance in Escherichia coli isolated from ducks in Korea and described the molecular characteristics of the ESBLs they produced. A total of 146 E. coli isolates from 404 duck fecal and carcass samples in 85 duck farms were tested for antimicrobial resistance using the broth dilution method and were further characterized using molecular methods. We observed high resistance rates to tetracycline, trimethoprim/sulfamethoxazole, nalidixic acid, ampicillin, and ciprofloxacin. In total, six ceftiofur-resistant isolates (4.1%) were observed, which produced CTX-M-55 ( n  = 3) or CTX-M-65 β-lactamase ( n  = 3). All CTX-M-producing E. coli isolates were also resistant to ciprofloxacin, with mutations in the quinolone resistance determining region of GyrA (S83L with or without D87N) and ParC (S80I), and three CTX-M-producing E. coli isolates carried plasmid-mediated quinolone resistance (PMQR) genes, qepA ( n  = 1), qnrS , and acc ( 6' ) -Ib-cr ( n  = 2). The transfer of bla CTX-M genes was observed in one isolate mediated by IncF-family plasmids but not in the co-resistant isolates carrying both bla CTX-M and PMQR genes. Pulsed-field gel electrophoresis and multilocus sequence typing demonstrated that CTX-M-producing isolates were heterogeneous; however, identical isolates were found in different farms and slaughterhouses. This study presents baseline data on antimicrobial resistance of E. coli derived from duck samples and is the first report of CTX-M-55 and CTX-M-65 β-lactamase-producing E. coli isolated from ducks in Korea. The dissemination of ESBL-producing E. coli poses a potential risk to public health and therefore should be monitored.

We report a case of a 73-year-old woman who developed pancreatic adenocarcinoma and presented with a colonic obstruction due to isolated metastasis to the colon, the primary lesion being diagnosed subsequently on imaging. The histopathological findings of the pancreatic mass exhibited a morphology and immunohistochemical profile consistent with a pancreatic adenocarcinoma and led to further analysis of the colonic pathology which ultimately confirmed the lesion was a pancreatic metastases rather than a primary colonic carcinoma. As the pancreatic cancer had metastasised to the colon, it was inoperable. The patient continued on palliative chemotherapy and passed 7 months after presentation for evaluation of her pancreatic mass due to progression of the pancreatic cancer. This report demonstrates a rare presentation of pancreatic cancer with colonic obstruction due to isolated metastatic disease and illustrated the importance of careful evaluation of histopathological findings., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Poria cocos Wolf (PCW) is an edible, pharmaceutical mushroom with remarkable biological properties including anti-tumor, anti-inflammation, anti-oxidation, anti-ageing, and anti-diabetic effects. In the current study, we investigated the effects of PCW extract on hepatic steatosis under in vitro and in vivo conditions, and elucidated the underlying mechanisms. In this study, a mixture of HepG2 cells treated with free fatty acid (FFA)-palmitic and oleic acid-and high-fat diet (HFD)-fed obese mice were used; in this background, the triglyceride (TG) levels in HepG2 cells and mice liver were measured, and the expression levels of genes associated with lipogenesis, fatty acid oxidation, endoplasmic reticulum (ER) stress, and autophagy were determined. Treatment of HepG2 cells with FFA enhanced intracellular TG levels in HepG2 cells, but co-treatment with PCW significantly attenuated the TG levels. Notably, PCW significantly enhanced the phosphorylation of AMP-activated protein kinase (AMPK), acetyl-CoA carboxylase (ACC), and sterol regulatory element-binding protein-1c (SREBP-1c) in FFA-treated HepG2 cells. PCW downregulated the expression of lipogenesis-related genes, but upregulated the expression of genes associated with fatty acid oxidation. Further, PCW inhibited FFA-induced expression of ER stress markers and induced autophagy proteins. However, inhibition of AMPK significantly attenuated the beneficial effects of PCW in HepG2 cells. Moreover, PCW efficiently decreased HFD-induced hepatic TG accumulation in vivo and increased the phosphorylation of hepatic AMPK. Three compounds present in PCW including poricoic acid, pachymic acid, and ergosterol, significantly decreased FFA-induced increase in intracellular TG levels, consistent with increased AMPK phosphorylation, suggesting that poricoic acid, pachymic acid, and ergosterol are responsible for PCW-mediated amelioration of hepatic steatosis. Taken together, these results demonstrated that PCW ameliorates hepatic steatosis through the regulation of lipid metabolism, inhibition of ER stress, and activation of autophagy in an AMPK-dependent manner. This suggested that PCW can be potentially used for the treatment of hepatic steatosis.