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Chanwoo Joo,1,2,* Kun Hyung Kim,3,* Bo-Hyoung Jang,4 Ching-Wen Huang,4 Jung Won Kang,2,5 Jae-Dong Lee,2,5 Suji Lee,2 Seunghoon Lee2,5 1Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea; 2Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; 3Department of Acupuncture and Moxibustion Medicine, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea; 4Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea; 5Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea*These authors contributed equally to this workCorrespondence: Seunghoon Lee, Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, 23 Kyunghee dae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea, Tel +82 2 958 1724, Fax +82 2 966 9366, Email kmdoctorlee@gmail.comPurpose: Routine overprescribing of postoperative opioid analgesics may induce side effects and correlate with chronic opioid use following surgery. This review aims to evaluate the effectiveness and safety of acupuncture for opioid-sparing effects in patients who underwent abdominal surgery.Methods: Eleven databases in different languages, including English (Ovid MEDLINE, CENTRAL, EMBASE, CINAHL), Chinese, Korean, and Japanese, will be searched. Randomized controlled trials using acupuncture for postoperative pain control in adult patients undergoing abdominal surgery will be screened. All randomized controlled trials comparing acupuncture with no treatment, sham acupuncture, and conventional treatments will be included. The Cochrane risk of bias tool will be used to assess the risk of bias. The primary outcome will consist of a cumulative opioid consumption. Additionally, the number of cumulative opioid analgesic demands/requests, the time to initial opioid analgesic usage, postoperative pain, opioid-related side effects, and adverse events of acupuncture will be assessed. The mean differences or risk ratios with a 95% confidence interval will be calculated to estimate the pooled effect of acupuncture when it is possible to conduct a meta-analysis.Results: This study could confirm the effect of opioid-sparing on acupuncture after abdominal surgery.Conclusion: This study would evaluate the evidence on the effectiveness of acupuncture after abdominal surgery with a focus on opioid intake. It provides evidence to support decision-making on applying acupuncture for postoperative management.Registration Number: CRD42022311155.Keywords: acupuncture, abdominal surgery, opioid-sparing effect, systematic review, meta-analysis, protocol

Hyo Jung Shin,1,2,* Ka Young Lee,1,3,* Joon Won Kang,4,5 Seung Gyu Choi,1,5 Dong Woon Kim,1,2,4,* Yoon Young Yi6,* 1Department of Anatomy and Cell Biology, Chungnam National University, Daejeon, Republic of Korea; 2Brain Research Institute, Chungnam National University, Daejeon, Republic of Korea; 3Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 4Department of Medical Science, Chungnam National University, Daejeon, Republic of Korea; 5Department of Pediatrics, Chungnam National Hospital, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; 6Department of Pediatrics, College of Medicine, Hallym University and Gangdong Sacred Heart Hospital, Seoul, Republic of Korea*These authors contributed equally to this workCorrespondence: Dong Woon Kim; Yoon Young Yi, Tel +82-42-580-8207 ; +82-2-2224-2251, Email visnu528@cnu.ac.kr; 070133@kdh.or.krPurpose: Ischemic stroke is a leading cause of death and disability worldwide. Additionally, neonatal ischemia is a common cause of neonatal brain injury, resulting in cerebral palsy with subsequent learning disabilities and epilepsy. However, there is currently a lack of effective treatments available for patients with perinatal ischemic stroke. In this study, we investigated the effect of perampanel (PER)-loaded poly lactic-co-glycolic acid (PLGA) by targeting microglia in perinatal stroke.Methods: After formation of focal ischemic stroke by photothrombosis in P7 rats, PER-loaded PLGA was injected intrathecally. Proinflammatory markers (TNF-α, IL-1β, IL-6, COX2, and iNOS) and M2 polarization markers (Ym1 and Arg1) were evaluated. We investigated whether PER increased M2 microglial polarization in vitro.Results: PER-loaded PLGA nanoparticles decreased the pro-inflammatory cytokines compared to the control group. Furthermore, they increased M2 polarization.Conclusion: PER-loaded PLGA nanoparticles decreased the size of the infarct and increased motor function in a perinatal ischemic stroke rat model. Pro-inflammatory cytokines were also reduced compared to the control group. Finally, this development of a drug delivery system targeting microglia confirms the potential to develop new therapeutic agents for perinatal ischemic stroke.Graphical Abstract: Keywords: ischemic stroke, neonate, poly lactic-co-glycolic acid, PLGA, nanoparticle, perampanel, microglial polarization

Elevated atmospheric CO2 (eCO2) concentration initially enhances photosynthesis, growth and ecosystem productivity, but the excessive use of nitrogen due to the increased productivity causes uncertainty in long-term ecosystem responses. We exposed Korean red pine, Chinese ash, and Korean mountain ash to current atmospheric CO2 concentration (aCO2), 1.4 times higher CO2 concentration (eCO21.4), and 1.8 times higher CO2 concentration (eCO21.8) in an Open-Top Chamber (OTC) experiment for eight years (2010-2017) to investigate the effect on the morphological and physiological properties of trees. We also assessed whether nitrogen limitation occurred with time by comparing leaf and soil nitrogen concentration. CO2 fertilization effect was observed on tree growth for the first two years (p < 0.05), but there was no difference thereafter. For photosynthetic properties, CO2 effects were species-specific; no effects on Korean red pine and Chinese ash vs. significant effect on Korean mountain ash. However, maximum photosynthetic and carboxylation rates significantly decreased by 24.3% and 31.3% from 2013 to 2017, respectively. Leaf nitrogen significantly decreased by 21.0 % at eCO21.4 and 18.5 % at eCO21.8 compared with aCO2 treatment. This study showed the decline of leaf nitrogen and species-specific responses to long-term high CO2 concentration, which will effect on species competition and ecosystem succession.

Syndecan-1 (SDC-1), a transmembrane heparin sulphate proteoglycan predominantly expressed on epithelial cells, also exists in a soluble form through ectodomain shedding. SDC-1 expression and shedding may be modulated in the inflammatory milieu of primary Sjögren's syndrome (SS). We investigated SDC-1 expression in minor salivary glands (MSGs) and analysed the association between salivary or plasma levels of SDC-1 and clinical parameters in SS. We measured salivary and plasma SDC-1 levels via an enzyme-linked immunosorbent assay and assessed the salivary flow rates (SFRs) in 70 patients with SS and 35 healthy subjects. Disease activity indices, serological markers, salivary gland scintigraphy, and MSG biopsy were evaluated in patients with SS. SDC-1 expression was upregulated on ductal epithelial cells in inflamed salivary glands. Salivary SDC-1 levels in patients significantly exceeded those in healthy subjects [median (interquartile range) 49.0 (20.7–79.1) vs 3.7 (1.7–6.3) ng/mL, p < 0.001] and inversely correlated with SFRs (r = −0.358, p = 0.032) and ejection fractions of the parotid (r = −0.363, p = 0.027) and submandibular (r = −0.485, p = 0.002) glands in salivary gland scintigraphy. Plasma SDC-1 levels were significantly correlated with the EULAR Sjögren's Syndrome Disease Activity Index (r = 0.507, p < 0.001) and EULAR Sjögren's Syndrome Patient Reported Index (r = 0.267, p = 0.033). Focus scores were correlated with salivary SDC-1 levels (r = 0.551, p = 0.004). Salivary and plasma SDC-1 levels may constitute potential biomarkers for salivary gland function and disease activity, respectively, in SS. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the evidence for or against the effectiveness of moxibustion as a treatment option for pain. Fourteen electronic databases were searched. Randomized clinical trials (RCTs) testing moxibustion in human patients with pain of any type were considered. Trials using direct or indirect moxibustion were included. Studies comparing moxibustion with other treatments of unproven effectiveness, studies testing moxibustion together with other treatments of unproven efficacy and trials where pain was not a central symptom of the condition were all excluded. The selection of studies, data extraction, and validation were performed independently by two reviewers. Four RCTs met all the inclusion criteria. Others were of poor methodological quality. Two RCTs suggested significant pain reductions for indirect moxibustion in osteoarthritis as compared with drug therapy (n = 200, RR, 1.11; 95% CI of 1.02 to 1.21, p = 0.02, heterogeneity: χ2 = 1.03, p = 0.31, I2 = 3%). The other two RCTs suggested positive effects of indirect or direct moxibustion on pain in scleroma or herpes zoster compared to drug therapy, respectively. We conclude that few RCTs are available that test the effectiveness of moxibustion in the management of pain, and most of the existing trials have a high risk of bias. Therefore, more rigorous studies are required before the effectiveness of moxibustion for the treatment of pain can be determined. [ABSTRACT FROM AUTHOR]

Objectives: This trial assessed diagnostic accuracy of contrast-enhanced magnetic resonance angiography (MRA) with meglumine gadoterate (Gd-DOTA) at 3 Tesla (T) over unenhanced MRA at 3 T in non-coronary arterial diseases by comparing their accuracy with that of the gold standard, x-ray angiography.Methods: Ninety-two patients with suspected non-coronary arterial disease underwent in fixed sequence unenhanced time-of flight (TOF) MRA, contrast-enhanced MRA using a Gd-DOTA bolus (intravenous bolus 0.1 mmol/kg) and x-ray angiography.Results: Eighty-four patients (71 male, 13 female; median age 64.5 years) were included in an intent-to-treat efficacy analysis. Targeted vascular areas were aorto-iliac, calf, carotid, femoral, popliteal and renal. Within-patient accuracy was significantly higher with contrast-enhanced MRA using Gd-DOTA than with unenhanced MRA (p = 0.0003). There was 84.4 +/- 17.5% agreement between contrast-enhanced MRA (Gd-DOTA) and x-ray angiography, compared with 76.8 +/- 20.4% between non-enhanced MRA and x-ray angiography. Sensitivity and specificity were also better with Gd-DOTA compared with non-enhanced MRA at the segment level. Duration of the MRA procedure was 3.5 times shorter with Gd-DOTA compared with non-enhanced MRA. Six patients reported six mild or moderate adverse events. No serious adverse events occurred.Conclusions: Contrast-enhanced MRA using Gd-DOTA at 3 T was superior to unenhanced TOF MRA in the vascular territories investigated. [ABSTRACT FROM AUTHOR]

To assess the signal pattern in T2-weighted images (T2WI) and determine its relation to persistent microvascular obstruction (PMO) and intramyocardial hemorrhage in a porcine model with reperfused acute myocardial infarction. Left anterior descending artery was occluded (90 or 180 min) and reperfused (90 min). T2WI and delayed-enhanced magnetic resonance images (DE-MRI) were acquired. The T2WI signal pattern, T2WI contrast ratio, PMO, and intramyocardial hemorrhage were evaluated, and their interrelationships were analyzed. The infarct area on T2WI was recorded as a homogeneous high-intensity signal or as low- or iso-intensity signals. The contrast ratio of the T2WI in the cases with PMO was significantly lower than that in those without PMO (1.38 +/- 0.25 vs. 1.89 +/- 0.31, P < 0.05), and it showed significant inverse correlation with the extent of PMO observed in DE-MRI images (r =-0.8, P < 0.05). The extent of PMO correlated strongly with that of intramyocardial hemorrhage (r = 0.97, P < 0.05). The abnormal signal area in the T2WI was larger than the infarct area in the DE-MRI images (47.0 +/- 9.9% vs. 37.8 +/- 9.9%, P < 0.05) and the infarct area observed after TTC staining (47.0 +/- 9.9% vs. 37.4 +/- 8.4%, P < 0.05). We observed variable T2WI signal patterns for the infarcted myocardium. Lower T2WI contrast ratios significantly correlated with the extent of PMO in DE-MRI and intramyocardial hemorrhage in the gross specimen. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Interview-based measures of cognition may serve as potential coprimary measures in clinical trials of cognitive-enhancing drugs for schizophrenia. However, there is no such valid scale available. Interviews of patients and their clinicians are not valid in that they are unrelated to patients' levels of cognitive impairment as assessed by cognitive performance tests. This study describes the reliability and validity of a new interview-based assessment of cognition, the Schizophrenia Cognition Rating Scale (SCoRS), that involves interviews with patients and informants. METHOD: Sixty patients with schizophrenia were assessed with the SCoRS and three potential validators of an interview-based measure of cognition: cognitive performance, as measured by the Brief Assessment of Cognition in Schizophrenia (BACS); real-world functioning, as measured by the Independent Living Skills Inventory; and functional capacity, as measured by the University of California, San Diego, Performance-Based Skills Assessment (UPSA). RESULTS: The SCoRS global ratings were significantly correlated with composite scores of cognitive performance and functional capacity and with ratings of real-world functioning. Multiple regression analyses suggested that SCoRS global ratings predicted unique variance in real-world functioning beyond that predicted by the performance measures. CONCLUSIONS: An interview-based measure of cognition that included informant reports was related to cognitive performance as well as real-world functioning. Interview-based measures of cognition, such as the SCoRS, may be valid coprimary measures for clinical trials assessing cognitive change and may also aid clinicians desiring to assess patients' level of cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the hemodynamic and anatomic factors associated with sinus thrombosis following transcatheter aortic valve replacement (TAVR), integrating in vivo patient data analysis and in vitro experiments., Methods and Results: Postprocedural, 4-dimensional, multiphase computed tomography data from 211 patients enrolled in the ADAPT-TAVR (Anticoagulation Versus Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization After Transcatheter Aortic Valve Replacement) study were analyzed. The prevalence of native sinus thrombosis was examined in relation to valve type, implant depth, and anatomic features. In vitro experiments used particle image velocimetry to observe changes in sinus flow based on the transcatheter heart valves (23-mm SAPIEN3, Edwards Lifesciences; and 29-mm CoreValve, Medtronic) height and coronary artery flow. Native sinus thrombosis was more common in self-expanding valves (39.1% versus 14.9%, P =0.004). In per-cusp analysis of in vivo patient data, adjusted transcatheter heart valve implant depth (odds ratio, 1.2 [95% CI, 1.1-1.3]; P <0.001), noncoronary sinus of Valsalva (odds ratio, 4.0 [95% CI, 2.0-7.8]; P <0.001), sinus inflow diameter (odds ratio, 0.8 [95% CI, 0.6-0.9]; P =0.008), and implanted valve size (odds ratio, 0.8 [95% CI, 0.7-1.0]; P =0.025) were significant factors associated with native sinus thrombosis. In the in vitro experiments, CoreValve showed noticeable flow stasis compared with SAPIEN3. High-positioned SAPIEN3 was linked to reduced velocity within the native sinus of Valsalva. Coronary artery flow led to higher sinus velocity and improved particle washout, reducing sinus thrombosis risk., Conclusions: This study provides insights into the relationship between transcatheter heart valve deployment and native sinus thrombosis, emphasizing the role of anatomic factors in relation to the risk of sinus thrombosis.

Objectives: The aims of this study were to characterize the electrodiagnostic findings of radial neuropathy using motor segmental conduction study and to determine the utility of subsequent inching test in precise lesion localization., Design: Twenty-three patients with radial neuropathy were evaluated using radial neuropathy using motor segmental conduction study with three-point stimulation. The pathomechanism of the lesions according to the radial neuropathy using motor segmental conduction study was classified into three groups: conduction block, mixed lesion (combination of conduction block and axonal degeneration), and axonal degeneration. Inching test was performed in patients with conduction block to localize the lesion site, and needle electromyography identified the most proximal radial nerve-innervated muscles affected., Results: Out of 23 cases, the radial neuropathy using motor segmental conduction study demonstrated probable partial conduction block in 10, mixed lesions in 2, and axonal degeneration in 10. One case could not be categorized with radial neuropathy using motor segmental conduction study alone. As determined by radial neuropathy using motor segmental conduction study and inching test, the most common cause of conduction block was compression, while the most common cause of axonal degeneration was iatrogenic. In the conduction block group, the lesion locations identified by radial neuropathy using motor segmental conduction study and inching test were consistent with needle electromyography localization., Conclusions: The combined radial neuropathy using motor segmental conduction study and inching test technique can precisely localize radial motor nerve injuries and provide detailed information on electrodiagnostic characteristics of radial mononeuropathy., Competing Interests: All authors declare that they have no conflict of interest. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Multiple studies over the last decade have established that Alzheimer's disease and related dementias (ADRD) are associated with changes in the gut microbiome. These alterations in organismal composition result in changes in the abundances of functions encoded by the microbial community, including metabolic capabilities, which likely impact host disease mechanisms. Gut microbes access dietary components and other molecules made by the host and produce metabolites that can enter circulation and cross the blood-brain barrier (BBB). In recent years, several microbial metabolites have been associated with or have been shown to influence host pathways relevant to ADRD pathology. These include short chain fatty acids, secondary bile acids, tryptophan derivatives (such as kynurenine, serotonin, tryptamine, and indoles), and trimethylamine/trimethylamine N-oxide. Notably, some of these metabolites cross the BBB and can have various effects on the brain, including modulating the release of neurotransmitters and neuronal function, inducing oxidative stress and inflammation, and impacting synaptic function. Microbial metabolites can also impact the central nervous system through immune, enteroendocrine, and enteric nervous system pathways, these perturbations in turn impact the gut barrier function and peripheral immune responses, as well as the BBB integrity, neuronal homeostasis and neurogenesis, and glial cell maturation and activation. This review examines the evidence supporting the notion that ADRD is influenced by gut microbiota and its metabolites. The potential therapeutic advantages of microbial metabolites for preventing and treating ADRD are also discussed, highlighting their potential role in developing new treatments., 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 © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Dyslipidemia and statin use are associated with an increased risk of various cancers. However, the association in head and neck cancer (HNC) remains unclear. Therefore, this study aimed to investigate the impact of dyslipidemia and statin use on the development of HNC., Methods: Using data from the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2019, we compared two groups HNC patients (n = 1006) and matched control participants (n = 4024) after propensity score overlap weighted balancing. The odds ratios (ORs) for HNC development according to dyslipidemia and statin use duration were assessed using propensity score overlap-weighted multivariable logistic regression., Results: Individuals with untreated dyslipidemia had significantly lower odds of developing HNC than those of normal participants (OR 0.70, 95% confidence interval [CI] 0.59-0.82). Conversely, patients with dyslipidemia who received statin therapy (< 60 days) showed a nearly two-fold increase in the odds of HNC (OR 1.94, 95% CI 1.29-2.90). Long-term statin use (≥ 60 days) aligned the odds with those of normal participants (OR 0.89, 95% CI 0.76-1.04)., Conclusions: The adverse effect of short-term statin use on HNC development requires further study, and long-term statin use for dyslipidemia treatment does not increase the odds of HNC., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: We aimed to compare computed tomography (CT)-derived myocardial strain between patients with constrictive pericarditis (CP) and a matched healthy control group and to identify factors associated with clinical outcomes after pericardiectomy., Methods: This retrospective study included 65 patients with CP (mean age: 58.9 ​± ​8.0 years) and 65 healthy individuals (mean age: 58.0 ​± ​6.5 years) who underwent multiphase cardiac CT. The type of CP was classified as calcified CP or fibrotic CP. CT-derived strains from four cardiac chambers were compared between the CP and control groups, as well as between different types of CP. Clinical and CT-derived factors associated with adverse outcomes were identified using Cox regression analysis., Results: Compared with the control group, the CP group showed significantly lower values of left atrium (LA) reservoir strain (15.7 ​% vs. 27.4 ​%), right atrium (RA) reservoir strain (15.1 ​% vs. 27.0 ​%), left ventricle (LV) global longitudinal strain (GLS) (-17.0 ​% vs. -19.5 ​%), and right ventricle free wall longitudinal strain (-21.1 ​% vs. -25.9 ​%) (all p ​< ​0.001). Biatrial reservoir strains and LV GLS were significantly lower in those with calcified CP compared to those with fibrotic CP. LA reservoir strain (hazard ratio, 0.91-95 ​% confidence interval, 0.86-0.96- p ​= ​0.001) was an independent prognostic factor for adverse events in patients with CP., Conclusion: Cardiac strain differences in CP were predominantly observed in the LA and RA compared to the healthy control group. Biatrial reservoir strains were specifically impaired in those with calcified CP than in those with fibrotic CP. LA reservoir strain was associated with prognosis in patients with CP following pericardiectomy., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Background: The pragmatic role of dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) needs to be evaluated and compared across distinct lymphatic disorders. We aimed to evaluate the performance of DCMRL for identifying the underlying causes of lymphatic disorders and to define the potential benefit of DCMRL for planning lymphatic interventions., Methods: Patients who underwent DCMRL between August 2017 and July 2022 were included in this retrospective analysis. DCMRL was performed with intranodal injection of a gadolinium-based contrast medium through inguinal lymph nodes under local anesthesia. Technical success of DCMRL and feasibility of percutaneous embolization were assessed based on the lymphatic anatomy visualized by DCMRL. Based on the underlying causes, clinical outcomes were evaluated and compared., Results: Seventy consecutive patients were included. The indications were traumatic chylothorax (n = 42), traumatic chylous ascites (n = 11), and nontraumatic lymphatic leak (n = 17). The technical success rate of DCMRL was the highest in association with nontraumatic lymphatic disorders (94.1% [16/17]), followed by traumatic chylothorax (92.9% [39/42]) and traumatic chylous ascites (81.8% [9/11]). Thirty-one (47.7%) patients among 65 patients who underwent technically successful DCMRL had feasible anatomy for intervention. Clinical success was achieved in 90.3% (28/31) of patients with feasible anatomy for radiologic intervention, while 62.5% (10/16) of patients with anatomical challenges showed improvement. Most patients with traumatic chylothorax showed improvement (92.9% [39/42]), whereas only 23.5% (4/17) of patients with nontraumatic lymphatic disorders showed clinical improvement., Conclusion: DCMRL can help identify the underlying causes of lymphatic disorders. The performance of DCMRL and clinical outcomes vary based on the underlying cause. The feasibility of lymphatic intervention can be determined using DCMRL, which can help in predicting clinical outcomes., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2024 The Korean Academy of Medical Sciences.)

Water contamination with pharmaceuticals has become an evident environmental challenge. Treatment processes such as electrochemical oxidation (EO) and adsorption have limitations in the simultaneous removal of pharmaceuticals from water. Therefore, this study examined the potential of coupled process (EO followed by adsorption) in binary pharmaceuticals (acetaminophen (ACM) + ciprofloxacin (CIP)) removal from water, with an emphasis on coupled process optimization. Consequently, optimized coupled process conditions including current density (22 mA/cm 2 ), pH (5.5), EO time (40 min), adsorbent dose (0.1 g/L) and adsorption time (60 min) were obtained. Under optimal conditions, removal efficiencies of 94.6% (ACM)+92% (CIP), 94.07% (ACM)+91.15% (CIP), and > 99.8% (ACM + CIP) were recorded for 20 mg/L (ACM + CIP) removal in EO, adsorption and EO + adsorption, respectively. Further, the coupled process was employed in multiple pharmaceuticals (20 mg/L of ACM + CIP + ATN (atenolol) + AMX (amoxicillin)) removal from water and removal of > 97.56% (ACM + CIP + ATN + AMX) was achieved. Removal efficiencies of ACM (83.35%) + CIP (73.1%) + ATN (68.52%) + AMX (63.05%) and ACM (80.37%) + CIP (66.5%) + ATN (73.07%) + AMX (60.5%) were obtained in EO and adsorption, respectively. The noted lower removal efficiencies in EO and adsorption are associated with the diverse nature of the pharmaceuticals, limited adsorbent active sites, and the shared utilization of reactive oxygen species (ROS) among the pharmaceuticals in EO. The total organic carbon (TOC) removal of 40.24%, and 99% and chemical oxygen demand (COD) removal of 72.45%, and 99.6% were obtained under optimal conditions of EO, and coupled process, respectively. These findings indicate that the pharmaceuticals are only partially mineralized in EO and the subsequent adsorption effectively eliminated the remaining target pharmaceuticals, and degradation by-products from water. Additionally, integrating EO with adsorption reduced the electrical energy consumption of the EO process from 31.6 kWh/m³ to 6 kWh/m³ under optimal conditions. Overall, coupling EO with adsorption offers the utmost advantages when removing multiple pharmaceuticals from complex water matrices., 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 © 2024 Elsevier Ltd. All rights reserved.)

Objective: Residual aortic dissection (AD) following DeBakey type I AD repair is associated with a high rate of adverse events that need additional intervention or surgery. This study aimed to identify clinical and early post-operative computed tomography angiography (CTA) imaging factors associated with adverse events in patients with type I AD after ascending aorta replacement., Methods: This single centre, retrospective cohort study included consecutive patients with type I AD who underwent ascending aorta replacement from January 2011 to December 2017 and post-operative CTA within three months. The primary outcome was AD related adverse events, defined as AD related death and re-operation due to aortic aneurysm or impending rupture. The location and size of the primary intimal tears, aortic diameter, and false lumen status were evaluated. Regression analyses were performed to identify factors associated with AD related adverse events. A decision tree model was used to classify patients as high or low risk., Results: Of 103 participants (55.43 ± 13.94 years; 49.5% male), 24 (23.3%) experienced AD related adverse events. In multivariable Cox regression analysis, connective tissue disease (hazard ratio [HR] 15.33; p < .001), maximum aortic diameter ≥ 40 mm (HR 4.90; p < .001), and multiple (three or more) intimal tears (HR 7.12; p < .001) were associated with AD related adverse events. The three year cumulative survival free from AD related events was lower in the high risk group with aortic diameter ≥ 40 mm and multiple intimal tears (41.7% vs. 90.9%; p < .001)., Conclusion: Early post-operative CTA findings indicating a maximum aortic diameter ≥ 40 mm and multiple intimal tears may predict a higher risk of adverse events. These findings suggest the need for careful monitoring and more vigilant management approaches in these cases., (Copyright © 2024 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)

Memory plays a crucial role in cognitive health. Social isolation (SI) and loneliness (LON) are recognized risk factors for global cognition, although their combined effects on memory have been understudied in the literature. This study used three waves of data over six years from the Canadian Longitudinal Study on Aging to examine whether SI and LON are individually and jointly associated with memory in community-dwelling middle-aged and older adults (n = 14,208). LON was assessed with the question: "In the last week, how often did you feel lonely?". SI was measured using an index based on marital/cohabiting status, retirement status, social activity participation, and social network contacts. Memory was evaluated with combined z-scores from two administrations of the Rey Auditory Verbal Learning Test (immediate-recall, delayed-recall). We conducted our analyses using all available data across the three timepoints and retained participants with missing covariate data. Linear mixed models were used to regress combined memory scores onto SI and LON, adjusting for sociodemographic, health, functional ability, and lifestyle variables. Experiencing both SI and LON had the greatest inverse effect on memory (least-squares mean: -0.80 [95 % confidence-interval: -1.22, -0.39]), followed by LON alone (-0.73 [-1.13, -0.34]), then SI alone (-0.69 [-1.09, -0.29]), and lastly by being neither lonely nor isolated (-0.65 [-1.05, -0.25]). Sensitivity analyses confirmed this hierarchy of effects. Policies developed to enhance memory in middle-aged and older adults might achieve greater benefits when targeting the alleviation of both SI and LON rather than one or the other individually., 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 © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Infections of Coronavirus Disease-2019 (COVID-19) can cause long-term effects known as long COVID. This pilot study aimed to evaluate the feasibility of a clinical study as well as the efficacy and safety of traditional East Asian herbal medicines in alleviating fatigue and cognitive dysfunction in patients with long COVID., Methods: This prospective pilot study investigated the use of three types of herbal medicines, Bojungikgi-tang (BIT), Kyungok-go (KOG), and Cheonwangbosim-dan (CBD), for a 12-week period as potential treatments for fatigue and cognitive dysfunction in patients with long COVID. Forty-five patients with long COVID were recruited, and one of three drugs was given based on the patient's symptoms and pattern identification. The effect of herbal medications on fatigue and cognitive function outcomes was assessed over a 36-week period, with patient adherence closely monitored., Results: After 12 weeks of herbal drug administration, fatigue symptoms improved significantly across all groups, with treatment success rates of 80 %, 53.33 %, and 46.67 % in the BIT, KOG, and CBD groups, respectively. However, cognitive dysfunction symptoms showed less improvement, with treatment success rates of 40 %, 46.67 %, and 13.33 % in the BIT, KOG, and CBD groups, respectively. All adverse events reported were mild and unrelated to the medication. The study design was found to be feasible with high medication adherence., Conclusions: This study demonstrated the feasibility of conducting a clinical trial with three herbal medicines to treat long COVID symptoms like fatigue and cognitive dysfunction., Competing Interests: 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., (© 2024 The Authors.)

Objective : The size of T4 tumor could vary in oropharyngeal squamous cell carcinoma (OPSCC). Using the Surveillance, Epidemiology, and End Results (SEER) database, this study aimed to investigate the role of tumor size in the prognosis of patients with T4 OPSCC. Study Design: Retrospective cross-sectional. Setting: SEER-Medicare-linked database. Methods: This study enrolled 1153 patients diagnosed with T4 OPSCC from the SEER registry between 2010 and 2016. The primary study variables were tumor size, human papillomavirus (HPV) infection, and disease-specific survival (DSS). Primary tumor size and clinicopathological variables according to HPV status were analyzed using Kaplan-Meier survival curves and Cox proportional hazards regression. Results: The 5-year DSS of patients with HPV-negative T4 OPSCC tumors ≤1 cm was worse than that of patients with tumors >1 cm ( P < .001). The results were consistent even after propensity score matching ( P = .002). Tumors ≤1 cm had a hazard ratio (HR) as high as that of distant metastasis (HR 2.8 vs HR 2.6, P = .006). A decreased DSS of ≤ 1 cm tumors was observed in HPV-negative T4 OPSCC, but not in HPV-positive T4 OPSCC ( P < .001 vs P = .96). Conclusion: A tumor diameter ≤1 cm was associated with poor prognosis in patients with HPV-negative T4 OPSCC. Tumor diameter ≤1 cm could be a predictive factor for poor outcomes in HPV-negative T4 OPSCC., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The gut microbiome is a potentially modifiable factor in Alzheimer's disease (AD); however, understanding of its composition and function regarding AD pathology is limited., Methods: Shallow-shotgun metagenomic data was used to analyze fecal microbiome from participants enrolled in the Wisconsin Microbiome in Alzheimer's Risk Study, leveraging clinical data and cerebrospinal fluid (CSF) biomarkers. Differential abundance and ordinary least squares regression analyses were performed to find differentially abundant gut microbiome features and their associations with CSF biomarkers of AD and related pathologies., Results: Gut microbiome composition and function differed between people with AD and cognitively unimpaired individuals. The compositional difference was replicated in an independent cohort. Differentially abundant gut microbiome features were associated with CSF biomarkers of AD and related pathologies., Discussion: These findings enhance our understanding of alterations in gut microbial composition and function in AD, and suggest that gut microbes and their pathways are linked to AD pathology., Competing Interests: Dr. Kaddurah-Daouk in an inventor on a series of patents on use of metabolomics for the diagnosis and treatment of CNS diseases and holds equity in Metabolon Inc., Chymia LLC and PsyProtix. Dr. Rob Knight is a scientific advisory board member, and consultant for BiomeSense, Inc., has equity and receives income. He is a scientific advisory board member and has equity in GenCirq. He is a consultant for DayTwo, and receives income. He has equity in and acts as a consultant for Cybele. He is a co-founder of Biota, Inc., and has equity. He is a cofounder of Micronoma, and has equity and is a scientific advisory board member. The terms of these arrangements have been reviewed and approved by the University of California, San Diego in accordance with its conflict of interest policies. Dr. Zetterberg has served at scientific advisory boards and/or as a consultant for Abbvie, Acumen, Alector, Alzinova, ALZPath, Amylyx, Annexon, Apellis, Artery Therapeutics, AZTherapies, Cognito Therapeutics, CogRx, Denali, Eisai, LabCorp, Merry Life, Nervgen, Novo Nordisk, Optoceutics, Passage Bio, Pinteon Therapeutics, Prothena, Red Abbey Labs, reMYND, Roche, Samumed, Siemens Healthineers, Triplet Therapeutics, and Wave, has given lectures in symposia sponsored by Alzecure, Biogen, Cellectricon, Fujirebio, Lilly, Novo Nordisk, and Roche, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program (outside submitted work). Daniel McDonald is a consultant for, and has equity in, BiomeSence, Inc. The terms of this arrangement has been reviewed and approved by the University of California, San Diego in accordance with its conflict of interest polices.

Importance: Despite advancements in herd management, feeding, and pharmaceutical interventions, neonatal calf diarrhea (NCD) remains a major global health concern. Bacteria, viruses, and parasites are the major contributors to NCD. Although several pathogens have been identified in the Republic of Korea (ROK), the etiological agents of numerous NCD cases have not been identified., Objective: To identify, for the first time, the prevalence and impact of Boosepivirus (BooV) on calf diarrhea in the ROK., Methods: Here, the unknown cause of calf diarrhea was determined using metagenomics We then explored the prevalence of certain pathogens, including BooV, that cause NCD. Seventy diarrheal fecal samples from Hanwoo ( Bos taurus coreanae ) calves were analyzed using reverse transcriptase and quantitative real-time polymerase chain reaction for pathogen detection and BooV isolate sequencing., Results: The complete genome of BooV was detected from unknown causes of calf diarrhea. And also, BooV was the most frequently detected pathogen (35.7%) among 8 pathogens in 70 diarrheic feces from Hanwoo calves. Co-infection analyses indicated that most BooV-positive samples were solely infected with BooV, indicating its significance in NCD in the ROK. All isolates were classified as BooV B in phylogenetic analysis., Conclusions and Relevance: This is the first study to determine the prevalence and molecular characteristics of BooV in calf diarrhea in the ROK, highlighting the potential importance of BooV as a causative agent of calf diarrhea and highlighting the need for further research on its epidemiology and pathogenicity., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Korean Society of Veterinary Science.)

The performance and scalability of perovskite solar cells (PSCs) based on 3D formamidinium lead triiodide (FAPbI 3 ) absorber are often hindered by defects at the surface and grain boundaries of the perovskite. To address this, the study demonstrates the use of pyrrolidinium iodide for the in situ formation of an energetically aligned 1D pyrrolidinium lead triiodide (PyPbI 3 ) capping layer over the 3D FAbI 3 perovskite. The thermodynamically stable PyPbI 3 perovskitoids, formed through cation exchange reactions, effectively reduce surface and grain boundary defects in the FAPbI 3 perovskite. In addition to improved phase stability, the resulting 1D/3D perovskite film forms a cascade energy band alignment with the other functional layers in PSCs, enabling a barrier-free interfacial charge transport. With a maximum power conversion efficiency (PCE) of ≈23.1% and ≈20.7% at active areas of 0.09 and 1.05 cm 2 , respectively, the 1D/3D PSCs demonstrate excellent performance and scalability. Leveraging this improved scalability, the study has successfully developed a mechanically-scribed 1D/3D perovskite mini-module with an unprecedentedly high PCE of ≈20.6% and a total power output of ≈270 mW at an active area of ≈13.0 cm 2 . The 1D/3D multi-dimensional perovskite film developed herein holds great promise for producing low-cost, high-performance perovskite photovoltaics at both the cell and module levels., (© 2024 The Author(s). Small Methods published by Wiley‐VCH GmbH.)

Optical fiber probe-based Raman spectroscopy systems are widely used for in situ measurements ranging from material characterization to biomedical applications. However, small Raman cross sections necessitate the use of high-power lasers or long exposure times that limit Raman's larger application to multiple research fields. This limitation can be overcome by collecting more Raman photons through additional collection fibers with taller detectors. This system configuration requires replacement of the detector and modification of the spectrograph to incorporate larger optical components, making it a costly and cumbersome option. In probe-based Raman systems, a typical detector image shows stacked collection fibers on the vertical axis and Raman spectra on the horizontal axis. While the vertical pixels are fully packed with multiple collection fibers, horizontal pixels have broad silent regions due to the narrow bandwidth of Raman peaks, potentially wasting valuable detector pixels. Here, we propose a new approach utilizing horizontally shifted collection fibers rather than vertically stacked ones. We designed and fabricated a novel collection fiber bundle that has horizontally shifted optical fibers in two vertical lines at the spectrograph entrance. This custom-made fiber bundle was incorporated into the imaging spectrograph to provide multiple horizontally shifted spectra on the detector. Through deconvolution, the original spectra can be recovered with an improved detection limit from greater photon collection. We demonstrate an enhanced limit of detection on various bioanalytes, such as glucose, urea, and lactate. Further, we applied the probe to measure tissue Raman spectra and successfully decomposed them into basis spectra, demonstrating the potential application of high-throughput in vivo tissue diagnosis. Our approach provides a simple, cost-effective, and universal method to increase the throughput without modifying existing Raman spectrometers.

Objective: Segmenting the aorta into zones based on anatomical landmarks is a current trend to better understand interventions for aortic dissection or aneurysm. However, comprehensive reference values for aortic zones are lacking. The aim of this study was to establish reference values for aortic size using a fully automated deep learning based segmentation method., Methods: This retrospective study included 704 healthy adults (mean age 50.6 ± 7.5 years; 407;57.8%] males) who underwent contrast enhanced chest computed tomography (CT) for health screening. A convolutional neural network (CNN) was trained and applied on 3D CT images for automatic segmentation of the aorta based on the Society for Vascular Surgery and Society of Thoracic Surgeons classification. The CNN generated masks were reviewed and corrected by expert cardiac radiologists., Results: Aortic size was significantly larger in males than in females across all zones (zones 0 - 8, all p < .001). The aortic size in each zone increased with age, by approximately 1 mm per 10 years of age, e.g., 25.4, 26.7, 27.5, 28.8, and 29.8 mm at zone 2 in men in the age ranges of 30 - 39, 40 - 49, 50 - 59, 60 - 69, and ≥ 70 years, respectively (all p < .001)., Conclusion: The deep learning algorithm provided reliable values for aortic size in each zone, with automatic masks comparable to manually corrected ones. Aortic size was larger in males and increased with age. These findings have clinical implications for the detection of aortic aneurysms and other aortic diseases., (Copyright © 2024 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)