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Chai Young Lee,1,&ast; Sun Hye Shin,1,&ast; Hye Sook Choi,2 Yunjoo Im,1 Bo-Guen Kim,1 Ju Yeun Song,1 Daegeun Lee,1 Hye Yun Park,1 Jun Hyeok Lim3 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea; 3Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea&ast;These authors contributed equally to this workCorrespondence: Hye Yun Park, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea, Tel +82-2-3410-3429, Fax +82-2-3410-3849, Email hyeyunpark@skku.edu Jun Hyeok Lim, Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea, Tel +82-32-890-1038, Fax +82-32-890-3099, Email jhl@Inha.ac.krPurpose: Vitamin D insufficiency or deficiency is prevalent in patients with chronic obstructive pulmonary disease (COPD). However, the association between vitamin D levels and respiratory symptoms in patients with stable COPD has not been fully investigated. This study evaluated the association between vitamin D levels and respiratory symptoms in patients with stable COPD.Patients and Methods: Patients with COPD who had their serum 25-hydroxyvitamin D (25-OH vitamin D) level measured within 6 months of spirometry between January 2016 and April 2020 were retrospectively included. Respiratory symptoms were assessed using the modified Medical Research Council (mMRC) scale and COPD assessment test (CAT) score.Results: Of the 329 included patients, 193, 88, and 48 were categorized as having vitamin D deficiency (< 20 ng/mL), insufficiency (20– 29 ng/mL), and sufficiency (≥ 30 ng/mL), respectively. The mean serum 25-OH vitamin D level of each group was 13.45 ng/mL, 24.61 ng/mL, and 38.90 ng/mL, respectively. Patients with vitamin D insufficiency/deficiency showed higher CAT scores than those with vitamin D sufficiency (p = 0.004). In multivariable adjusted models, vitamin D insufficiency/deficiency was significantly associated with a CAT score of 10 or more (adjusted odds ratio [aOR] = 2.41, 95% confidence interval [CI] = 1.20– 4.82, p = 0.013) and mMRC ≥ 2 (aOR = 2.39, 95% CI = 1.08– 5.32, p = 0.032). Among CAT items, the amount of phlegm (p = 0.008), chest tightness (p = 0.030), breathlessness walking upstairs (p < 0.001), home activity limitations (p = 0.002), and lack of energy (p = 0.003) were significantly associated with vitamin D insufficiency/deficiency after adjustment for age, sex, body mass index, smoking history, Charlson comorbidity index, post-bronchodilator forced expiratory volume in 1 second, and season of blood draw.Conclusion: Vitamin D insufficiency/deficiency were associated with worse respiratory symptoms in patients with stable COPD.Keywords: chronic obstructive pulmonary disease, vitamin D, respiratory symptoms, COPD assessment test, modified Medical Research Council

Hyun-Il Gil,1,* Sungmin Zo,2,* Paul W Jones,3,4 Bo-Guen Kim,2 Noeul Kang,2 Yeonseok Choi,5 Hyun Kyu Cho,6 Danbee Kang,7 Juhee Cho,7 Hye Yun Park,2 Sun Hye Shin2 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; 3Institute For Infection and Immunity, St George’s University of London, London, UK; 4Value Evidence and Outcomes, Global Medical R&D, GlaxoSmithKline, Uxbridge, UK; 5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea; 6Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea; 7Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea*These authors contributed equally to this workCorrespondence: Sun Hye Shin; Hye Yun ParkDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaTel +82-2-3410-3429Fax +82-2-3410-3849Email freshsunhye@gmail.com; hyeyunpark@skku.eduPurpose: The chronic obstructive pulmonary disease (COPD) assessment test (CAT) is widely used to assess the impact of COPD symptoms on health status. Whilst the CAT consists of eight different items, details on the distribution of each item are limited. This study aimed to investigate the distribution and clinical implication of each CAT item, stratified by CAT severity group, in stable COPD patients.Patients and Methods: This was a cross-sectional study at a single referral hospital in South Korea. Spirometry confirmed COPD patients with CAT measured at the first clinical visit were retrospectively identified. Patients were categorized into three groups: low (0 ≤ CAT < 10), medium (10 ≤ CAT < 20), and high (20 ≤ CAT ≤ 40) impact group. For the purpose of this analysis, the first four items (cough, sputum, chest tightness, and dyspnea) and the remaining four items (activities, confidence, sleep and energy) were also grouped as “pulmonary” and “extra-pulmonary”, respectively.Results: A total of 815 patients were included, and mean (SD) forced expiratory volume in 1 s (FEV1) was 62.8 (17.4) % pred. Among them, 300 patients (36.8%) were in the high impact group and had a greater exacerbation history and lower lung function. The proportion of “extra-pulmonary” items score was greater in patients with higher total CAT scores, with the activity and confidence items showing higher scores.Conclusion: In our study, in addition to dyspnea, activity limitation is a particular problem in individual patients with higher CAT total scores, for which physicians need to pay more attention. Our study suggests that whilst CAT total score captures the overall impact of COPD, each item of the CAT contains potentially useful information in understanding the patient’s symptom burden.Keywords: COPD, COPD assessment test, patient reported outcome, symptom

Hwa-young Lee,1 Bong-Min Yang,1 Ji-min Hong,1 Tae-Jin Lee,1 Byoung-Gie Kim,2 Jae-Weon Kim,3 Young-Tae Kim,4 Yong-Man Kim,5 Sokbom Kang61Graduate School of Public Health, Seoul National University, Seoul, South Korea; 2Department of Obstetrics and Gynecology, Samsung Medical Center, Seoul, South Korea; 3Department of Obstetrics and Gynecology, Seoul National University, Seoul, South Korea; 4Department of Obstetrics and Gynecology, Yonsei University, Seoul, South Korea; 5Department of Obstetrics and Gynecology, University of Ulsan, Ulsan, South Korea; 6Department of Obstetrics and Gynecology, National Cancer Center, Kyeonggi-do, South KoreaObjective: We performed a cost–utility analysis to assess the cost-effectiveness of a chemotherapy sequence including a combination of polyethylene glycolated liposomal doxorubicin (PLD)/carboplatin versus paclitaxel/carboplatin as a second-line treatment in women with platinum-sensitive ovarian cancer.Methods: A Markov model was constructed with a 10-year time horizon. The treatment sequence consisted of first- to sixth-line chemotherapies and best supportive care (BSC) before death. Cycle length, a time interval for efficacy evaluation of chemotherapy, was 9 weeks. The model consisted of four health states: responsive, progressive, clinical remission, and death. At any given time, a patient may have remained on a current therapy or made a transition to the next therapy or death. Median time to progressions and overall survivals data were obtained through a systematic literature review and were pooled using a meta-analytical approach. If unavailable, this was elicited from an expert panel (eg, BSC). These outcomes were converted to transition probabilities using an appropriate formula. Direct costs included drug-acquisition costs for chemotherapies, premedication, adverse-event treatment and monitoring, efficacy evaluation, BSC, drug administration, and follow-up tests during remission. Indirect costs were transportation expenses. Utilities were also derived from the literature. Costs and utilities were discounted at an annual rate of 5% per cycle.Results: PLD/carboplatin combination as the second line in the sequence is more effective and costly than paclitaxel/carboplatin combination, showing an additional US$21,658 per quality-adjusted life years. This result was robust in a deterministic sensitivity analysis except when median time to progression of second-line therapies and administration cost of PLD/carboplatin per administration cycle were varied. The probability of cost-effectiveness for PLD/carboplatin combination was 49.4% at a willingness to pay $20,000.Conclusion: A PLD/carboplatin combination is an economically valuable option as second-line chemotherapy for the treatment of platinum-sensitive ovarian cancer in South Korea.Keywords: cost, utility, Markov modeling, ovarian cancer, chemotherapy

Thi Hoan Le1,2, Ellinor Ottosson3, Thi Kim Chuc Nguyen4, Bao Giang Kim5, Peter Allebeck11Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden; 2Department of Environmental Health, Hanoi Medical University, Hanoi, Vietnam; 3Department of Medicine, Gothenburg University, Gothenburg, Sweden; 4Department of Family Medicine, Hanoi Medical University, Hanoi, Vietnam; 5Department of Health Education, Hanoi Medical University, Hanoi, VietnamAims: To explore the knowledge, attitudes, and behaviors of parents in their use of drugs for respiratory illness or diarrhea among children under 5 years of age, and to understand factors influencing self-medication.Methods: A qualitative study was conducted, using in-depth interviews with two drug sellers and three health care providers, and four focus-group discussions with mothers of children under 5 years of age. Verbatim transcriptions were analyzed, and emerging themes and categories identified, using content analysis.Results: Use of a number of different drugs was reported, including broad-spectrum antibiotics and corticosteroids. There was poor awareness of side-effects, antibiotic resistance, and drug efficacy. Factors influencing self-medication were perceptions of the illness in the child, waiting time, and convenience, the attitudes of public health medical staff, insufficient drug supply in public health facilities, and poor control of prescribed drugs on the market.Conclusion: Misuse and misconceptions regarding drug use gave rise to considerable problems. Mothers' knowledge and attitudes to illness and health care services played an important role in determining the nature of self-medication. Financial barriers were not the only obstacle to adequate treatment. Health services should be more accessible and responsive to the needs of the population.Keywords: health services, parental attitudes, education

We present a hybrid method for spectral reflectivity recovery, using 3D extrapolation as a supplemental method for 3D interpolation. The proposed 3D extrapolation is an extended version of 3D interpolation based on the barycentric algorithm. It is faster and more accurate than the conventional spectral-recovery techniques of principal-component analysis and nonnegative matrix transformation. Four different extrapolation techniques (based on nearest neighbors, circumcenters, in-centers, and centroids) are formulated and applied to recover spectral reflectivity. Under the standard conditions of a D65 illuminant and 1964 10° observer, all reflectivity data from 1269 Munsell color chips are successfully reconstructed. The superiority of the proposed method is demonstrated using statistical data to compare coefficients of correlation and determination. The proposed hybrid method can be applied for fast and accurate spectral reflectivity recovery in image processing.

Background/aims: Although access to [18F]2-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography and computed axial tomography (PET/CT) for patients with malignancy has increased, little information is available on the suitability of PET/CT for diagnosis of advanced colonic neoplasms in oncology patients and on the clinical significance of incidental 18F-FDG focal uptake confined to the left-sided colon.Methods: Patients who underwent 18F-FDG PET/CT followed, within 90 days, by colonoscopy were identified. Case-control analysis was undertaken to determine whether focal 18F-FDG uptake confined to the left-sided colon was associated with advanced neoplasms in the right-sided colon.Results: One hundred ninety-five patients with colonic 18F-FDG uptake and 561 without colonic (18)F-FDG uptake were identified. Of the 195 patients with focal colonic 18F-FDG activity, 103 patients (52.8%) had 145 advanced colonic neoplasms, including 58 colon cancers and 11 metastatic cancers. In the detection of advanced colonic neoplasms, the sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT were 54.4, 82.4, 46.9, and 86.3%, respectively. Overall accuracy was 76.2%. Ten (8.0%) of the 125 patients with focal 18F-FDG uptake confined to the left-sided colon had three colon cancers and seven advanced adenomas in the right-sided colon. Case-control analysis revealed that focal 18F-FDG uptake confined to the left-sided colon was associated with an advanced neoplasms in the right-sided colon (OR, 3.02; 95% CI, 1.12-8.13; P = 0.023).Conclusions: Colonic focal (18)F-FDG uptake by oncology patients warrants endoscopic verification. Complete colon evaluation by colonoscopy is required, even for patients with focal 18F-FDG uptake confined to the left-sided colon. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: Both sequestrated nucleus pulposus (SNP) and the remaining nucleus pulposus (RNP) were studied from the discs of the same patient to evaluate apoptosis using immunohistochemical staining. OBJECTIVE.: To compare apoptosis of the SNP and the RNP in the disc of the same patient. SUMMARY OF BACKGROUND DATA.: Many studies have been conducted on the natural history and apoptosis of the herniated nucleus pulposus; however, apoptosis of the remaining nucleus cells, after removal of the sequestrated disc, in the same patient, has not been reported. MATERIALS AND METHODS.: Eight samples of SNP and RNP from the disc of the same patient were obtained. The TUNEL stain was performed to confirm the occurrence of apoptosis in disc cells. Immunohistochemistry staining and Western blot analysis were performed to determine the presence of proteins, including caspase-3,-8,-9, and Bid. RESULTS.: TUNEL-positive chondrocytes were identified in all of the SNP and RNP samples; the apoptotic index was 5.8 ± 1.9% and 5.9 ± 1.2%, respectively (P = 0.60). Caspase-3,-8,-9, and Bid were expressed in the SNP and the RNP of the cytoplasm and the nucleus by the immunohistochemical staining. The expression of active caspase-3,-8,-9, and Bid in the RNP of the disc and the SNP was different in each patient. CONCLUSION.: The frequency of chondrocyte apoptosis in the SNP and the RNP was not different in the disc. The pathways involved in chondrocyte apoptosis of the SNP and the RNP differed among individuals and included intrinsic and/or extrinsic pathways. [ABSTRACT FROM AUTHOR]

This study investigates changes in autonomic nervous function through Qi-training. The power spectrum of heart rate variability (HRV) was examined in 20 sedentary healthy subjects and 20 Qi-trainees. It was found that Qi-training in healthy young subjects during controlled respiration increases the high frequency (HF) power and decreases the low frequency/high frequency (LF/HF) power ratio of HRV. These results support the hypothesis that Qi-training increases cardiac parasympathetic tone. In addition, Qi-trainees were found to have higher parasympathetic heart modulation compared with their age-matched, sedentary counterparts. This augmented HRV in Qi-trainees provides further support for long-term Qi-training as a possible non-pharmacological cardio-protective maneuver. In conclusion, Qi-training may stabilize the autonomic nervous system by modulating the parasympathetic nervous system. [ABSTRACT FROM AUTHOR]

The prediction of response to treatment would be valuable for managing cervical carcinoma with neoadjuvant chemotherapy.~Background~Background~To this end, the expression of VEGF was analyzed by immunohistochemistry using paraffin-embedded pre-treatment cervical biopsy tissues. This study included 29 patients with bulky IB to IIA cervical squamous cell carcinoma treated with neoadjuvant chemotherapy.~Methods~Methods~Fifteen (51.7%) of 29 patients were scored as VEGF-positive. Response to chemotherapy (complete response or residual tumor with less than 3 mm stromal invasion) was observed in eight patients (27.6%), and it was negatively associated with VEGF expression (P = 0.009). With logistic regression analysis, VEGF positivity continued to be an independent predictor for poor response (P = 0.032). In addition, the progression-free survival rate was significantly lower in patients with VEGF-positive tumors (P = 0.033).~Results~Results~Pretreatment assessment of VEGF expression may provide additional information for identification of patients with cervical cancer who had a low likelihood of response to neoadjuvant chemotherapy and an unfavorable prognosis.~Conclusion~Conclusions [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate and analyse the costs for providing the expanded programme on immunization (EPI) in a rural community in the north of Viet Nam in 2005. METHODS: An ingredient approach was used to collect cost data from the perspective of the service providers. FINDINGS: The total annual cost of EPI in Bavi district was US$58,460 [purchasing power parity (PPP) 282,076]. Vaccines and supplies were the largest cost category (33%), followed by personnel costs (30.2%). The largest share of the total cost was due to activities at commune level (38%). The average cost per fully vaccinated child (FVC) was US$4.81 (PPP 23.21), much lower than the figure of US$15 that is generally accepted as the cost-effective threshold for EPI in developing countries. CONCLUSION: This empirical study indicates that EPI has been implemented efficiently in rural Viet Nam, but that opportunities exist to make it even more efficient. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the incidence, clinical characteristics, and risk factors of pelvic insufficiency fracture (PIF) after pelvic radiotherapy (RT) in cervical cancer.Methods and Materials: Medical records and imaging studies, including bone scintigraphy, CT, and MRI of 557 patients with cervical cancer who received whole-pelvic RT between January 1998 and August 2005 were reviewed.Results: Eighty-three patients were diagnosed as having PIF after pelvic RT. The 5-year cumulative incidence of PIF was 19.7%. The most commonly involved site was the sacroiliac joint. Pelvic pain developed in 48 patients (57.8%) at diagnosis. Eleven patients (13.3%) needed admission or narcotics because of severe pain, and others had good relief of symptoms with conservative management. In univariate analysis, age>or=55 years (p<0.001), anteroposterior/posteroanterior parallel opposing technique (p=0.001), curative treatment (p<0.001), and radiation dose>or=50.4 Gy (p=0.005) were the predisposing factors for development of PIF. Concurrent chemotherapy (p=0.78) was not significant. Multivariate analysis showed that age>or=55 years (p<0.001), body weight<55 kg (p=0.02), curative treatment (p=0.03), and radiation dose>or=50.4 Gy (p=0.04) were significant predisposing factors for development of PIF.Conclusion: The development of PIF is not rare after pelvic RT. The use of multibeam arrangements to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture, especially in elderly women with low body weight. [ABSTRACT FROM AUTHOR]

Developing countries struggle with water quality management owing to poor infrastructure, limited expertise, and financial constraints. Traditional water testing, relying on periodic site visits and manual sampling, is impractical for continuous wide-area monitoring and fails to detect sudden heavy metal contamination. To address this, plant-inspired robots capable of fully autonomous water quality monitoring are proposed. Constructed from paper, the robot absorbs surrounding water through its roots. This paper robot is controlled by paper-based microfluidic logic that sends absorbed water to petal-shaped actuators only when the water is polluted by heavy metals. This triggers the actuators to swell and bend like a blooming flower, visually signaling contamination to local residents. In tests with copper-contaminated water, the robotic flower's diameter increased from 4.69 cm to 14.89 cm, a more than threefold expansion (217.25 %). This significant blooming movement serves as a highly visible and easily recognizable indicator of water pollution, even for the public. Furthermore, the paper robot can be mass-produced at a low cost (∼$0.2 per unit) and deployed over large areas. Once installed, the paper robot operates autonomously using surrounding water as a power source, eliminating the need for external electrical infrastructure and expert intervention. Therefore, this autonomous robot offers a new approach to water quality monitoring suitable for resource-limited environments, such as Sub-Saharan Africa., 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 B.V. All rights reserved.)

Piezo1 is a mechanosensitive, nonselective Ca2+ channel which is broadly expressed in CD4+ T cells. Using lineage-specific Piezo1 knockout mice (Piezo1cKO), we show that loss of Piezo1 in CD4+ T cells significantly increased IFNγ and IL-17 production in vitro under TH1 and TH17 polarizing conditions, respectively. Despite their intrinsic proinflammatory phenotype, Piezo1cKO T cells are incapable of establishing disease in vivo in three separate adoptive transfer (AT) T cell-mediated inflammatory mouse models, including experimental autoimmune encephalomyelitis, inflammatory bowel disease (IBD), and graft versus-host disease. These phenomena coincided with a decreased effector memory (CD44hiCD62Llo) CD4+ T cell pool derived from donor Piezo1cKO T cells, an observation that is related to intrinsic T-cell fitness, as co-transfer IBD mouse model revealed a deficiency in the CD4+ effector memory population derived only from the naïve Piezo1cKO but not co-infused Piezo1WT CD4+ T cell source. Taken together, our results support Piezo1 as restraining proinflammatory T cell differentiation while contributing to the generation and persistence of the effector memory pool during CD4+ T cell-mediated immunopathology., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Leukocyte Biology.)

Objective: The objectives were to validate a previously published equation for estimating basal endogenous losses (BEL) of crude protein (CP) in pigs fed nitrogen-free diets and to develop prediction equations for BEL of CP and amino acids (AA)., Methods: A total of 139 observations from 123 experiments in 117 papers that determined the BEL of CP and AA in pigs were collected. For the validation of the previous equation for the BEL of CP, 94 observations that were not used for developing the previous equation were used. All observations were used to develop novel equations for estimating BEL of CP in pigs based on the initial body weight (IBW)., Results: The validation study indicated that the slope for BEL of CP, representing a linear bias, was less than zero (-0.56; standard error [SE] = 0.130; p<0.001). The intercept for BEL of CP, representing a mean bias, was less than zero (-3.21; SE = 0.488; p<0.001). The models for estimating BEL of CP (g/kg dry matter intake) in pigs fed a nitrogen-free diet were developed: 20.36-0.077×IBW with R2 = 0.11 and p<0.001 and 20.80×e(-0.00475×IBW) with R2 = 0.12 and p<0.001. Novel linear models for estimating BEL of AA were developed using BEL of CP as the independent variable., Conclusion: The accuracy of the previous equation for estimating BEL of CP in pigs has been improved by reflecting additional data from recent publications. In the novel linear models for estimating BEL of AA of pigs, BEL of CP was used as an independent variable.

This work aimed to determine the effects of dietary full-fat or defatted black soldier fly larvae (BSFL) to replace protein sources on growth performance, blood parameters, intestinal morphology, and intestinal microbiota in nursery pigs and to investigate the effects of dietary defatted BSFL at up to 30% at the expense of protein sources on growth performance in nursery pigs. In Exp. 1, a total of 36 barrows with an initial body weight of 7.0 kg (standard deviation = 0.8) were allotted to 3 dietary treatments in a randomized complete block design with 4 replicate pens per treatment and 3 barrows per pen. A corn-soybean meal (SBM)-whey-based control diet was prepared with soy protein concentrate and fish meal as additional protein supplements. Two additional diets were prepared to include 20% full-fat BSFL or 20% defatted BSFL to replace soy protein concentrate and fish meal to maintain the same energy and nutrient concentrations in all diets. In the 28-day feeding trial, pigs fed the diet containing defatted BSFL tended to consume more feeds (P < 0.10) than other groups during days 14 to 28 and the overall period. On day 28, the serum blood urea nitrogen in pigs fed the control diet was less (P < 0.05) than that fed the full-fat or defatted BSFL, but fecal score and jejunal morphology did not differ among the treatment groups. Relative abundance of Mycoplasma in the ileal digesta was less (P < 0.05) in the pigs fed the diet containing full-fat or defatted BSFL compared with the control group. In Exp. 2, a total of 192 pigs with an initial body weight of 7.8 (standard deviation = 1.2 kg) were randomly allotted to one of 4 dietary treatments in a randomized complete block design with 6 replicate pens per treatment and 4 barrows and 4 gilts per pen. A control diet was mainly based on corn, SBM, fermented SBM, fish meal, and spray-dried plasma protein. Three additional diets were prepared to contain 10%, 20%, and 30% defatted BSFL to replace SBM, fermented SBM, fish meal, and spray-dried plasma protein to maintain for the same energy and nutrient concentrations. Average daily gain, average daily feed intake, gain:feed, and fecal score were not affected by increasing dietary defatted BSFL. Overall, dietary black soldier fly larvae did not compromise growth performance or intestinal health in nursery pigs. Black soldier fly larvae can be used in nursery pig diets to replace other protein sources without negative effects., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This study systematically reviews the effects of muscle strength exercises on muscle mass and strength in stroke patients by analyzing randomized controlled trials. Ten studies, involving a total of 378 stroke patients, were included in the meta-analysis. The standardized mean difference (SMD) and confidence intervals (CIs) were calculated using a random effects model. The results indicated that strength exercises had a medium effect on increasing muscle strength in stroke patients (SMD, 0.6; 95% CI, 0.47-0.72; I 2 =51%; P <0.05). Specifically, strength exercises were found to be particularly effective in chronic stroke patients, showing a medium effect on muscle strength (SMD, 0.68; 95% CI, 0.55-0.81; I 2 =45%; P <0.05). The study also compared the effects based on repetition maximum (RM) settings, revealing that strength increased significantly regardless of whether RM was used, with studies showing medium effects (with RM: SMD, 0.52; 95% CI, 0.4-0.64; I 2 =0%; P <0.05; without RM: SMD, 0.65; 95% CI, 0.4-0.91; I 2 =72%; P <0.05). The study concludes that strength exercises are beneficial for improving muscle strength in chronic stroke patients, but the use of RM to set exercise intensity is not strictly necessary., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2024 Korean Society of Exercise Rehabilitation.)

Background and Objectives : Sarcopenia is a significant concern in stroke rehabilitation, with a high prevalence reported in acute stroke patients. This study examines the effect of sarcopenia on rehabilitation outcomes in acute stroke patients. Materials and Methods : This study was conducted with acute stroke patients admitted within 90 days of onset to the rehabilitation hospital. Participants were divided into a stroke with sarcopenia group and a stroke without sarcopenia group. Evaluations were conducted at baseline, 4 weeks, and 8 weeks, including the following assessments: manual muscle testing (MMT), Berg Balance Scale (BBS), functional ambulation category (FAC), and Modified Barthel Index (MBI). Both groups received an identical rehabilitation program for 8 weeks. Results : Significant within-group improvements were observed in both groups across all measures ( p < 0.05). However, the stroke with sarcopenia group showed significantly less improvement in MMT, BBS, FAC, and MBI compared to the stroke without sarcopenia group at both 4 and 8 weeks ( p < 0.05). Conclusions : These results underscore the significant impact of sarcopenia on functional recovery in stroke patients, despite both groups receiving identical rehabilitation programs. The presence of sarcopenia was a critical predictor of poorer outcomes in muscle strength, balance, ambulation, and activities of daily living. Given these findings, specific rehabilitation strategies targeting sarcopenia are needed to improve recovery in stroke patients. Future research should include larger sample sizes, longer follow-ups, and sarcopenic patient-specific rehabilitation programs.

The flavonoid diosmin (diosmetin 7- O -rutinoside) is used as a therapeutic agent for disorders of the blood vessels such as hemorrhoids and varicose veins. Diosmin is commercially produced using semi-synthetic methods involving the oxidation of hesperidin, the most abundant flavonoid in citrus fruits. However, this method produces byproducts that are toxic to the environment, and new sustainable methods to produce diosmin are required. Here, we used a synthetic biology approach to produce diosmin without generating toxic byproducts through reconstitution of the diosmin biosynthetic pathway in Nicotiana benthamiana . We first established that N. benthamiana leaves co-infiltrated with all seven genes in the flavonoid biosynthesis pathway produced high levels of luteolin, a precursor of diosmetin. We then compared the activity of modification enzymes such as methyltransferases, glucosyltransferases, and rhamnosyltransferases in Escherichia coli and in planta and selected genes encoding enzymes with the highest activity for producing diosmetin, diosmetin 7- O -glucoside, and diosmin, respectively. Finally, we reconstructed the entire diosmin biosynthetic pathway using three constructs containing ten genes encoding enzymes in this pathway, from phenylalanine ammonia lyase to rhamnosyltransferase. N. benthamiana leaves transiently co-expressing all these genes yielded 37.7 µg diosmin per gram fresh weight. To our knowledge, this is the first report of diosmin production in a heterologous plant system without the supply of a precursor. Successful production of diosmin in N. benthamiana opens new avenues for producing other commercially important flavonoids using similar platforms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lee, Park, Lee, Song, Kim and Kim.)

Background : Rheumatoid arthritis (RA) is associated with diverse extra-articular manifestations, including interstitial lung disease (ILD). No previous studies have examined the bidirectional relationship between RA and ILD using the Mendelian randomization (MR) analyses. Therefore, we aimed to investigate this subject using a two-sample bidirectional MR method. Methods : We performed bidirectional two-sample MR using summary statistics from genome-wide association studies (GWASs). The data are publicly available, de-identified, and from European (EUR) and East Asian (EAS) ancestries. Results : A total of 474,450 EUR participants and 351,653 EAS participants were included for either forward or reverse MR analysis. In our primary analysis, we found significant evidence of an increased risk of ILD associated with RA among individuals of EUR ancestry (OR MR-cML = 1.08; 95% confidence interval [CI] = 1.03-1.14; p = 0.003) and EAS ancestry (OR MR-cML = 1.37; 95% CI = 1.23-1.54; p < 0.001). Additionally, the reverse MR showed significant evidence of an increased risk of RA associated with ILD among those of EUR ancestry (OR MR-cML = 1.12; 95% CI = 1.05-1.19; p < 0.001). However, only one instrumental variable was selected in the EAS ILD GWAS, and there was no increased risk of RA associated with ILD in those of EAS ancestry (OR MR-cML = 1.02; 95% CI = 0.91-1.14; p = 0.740). Conclusions : Our findings indicate that RA and ILD have a bidirectional causal inference when using the MR analysis of GWAS datasets. The findings are only relevant for genetic predisposition; thus, further research is needed to determine the impact of non-genetic predispositions.

This work describes a self-powered wireless temperature sensor platform that can be used for foot ulceration monitoring for diabetic patients. The proposed self-powered sensor platform consists of a piezoelectric bimorph, a power conditioning circuit, a temperature sensor readout circuit, and a wireless module. The piezoelectric bimorph mounted inside the shoe effectively converts the foot movement into electric energy that can power the entire sensor platform. Furthermore, a sensor platform was designed, considering the energy requirement of 4.826 mJ for transmitting one data packet of 18 bytes. The self-powered sensor platform prototype was evaluated with five test subjects with different weights and foot shapes; the test results show the subjects had to walk an average of 119.6 s to transmit the first data packet and an additional average of 71.2 s to transmit the subsequent data packet. The temperature sensor showed a resolution of 0.1 °C and a sensitivity of 56.7 mV/°C with a power conditioning circuit efficiency of 74.5%.

Background: Environmental exposure to metal mixtures is common and may be associated with increased risk for neurodegenerative disorders including Alzheimer's disease. This study examined associations of mixed metal exposures with medial temporal lobe (MTL) MRI structural metrics and neuropsychological performance., Methods: Metal exposure history, whole blood metal, MRI R1 (1/T1) and R2* (1/T2*) metrics (estimates of brain Mn and Fe, respectively), and neuropsychological tests were obtained from subjects with/without a history of mixed metal exposure from welding fumes (42 exposed subjects; 31 controls). MTL structures (hippocampus, entorhinal and parahippocampal cortices) were assessed by morphologic (volume or cortical thickness) and diffusion tensor imaging [mean (MD), axial (AxD), radial diffusivity (RD), and fractional anisotropy (FA)] metrics. In exposed subjects, effects of mixed metal exposure on MTL structural and neuropsychological metrics were examined., Results: Compared to controls, exposed subjects displayed higher MD, AxD, and RD throughout all MTL ROIs (p's<0.001) with no morphological differences. They also had poorer performance in processing/psychomotor speed, executive, and visuospatial domains (p's<0.046). Long-term mixed metal exposure history indirectly predicted lower processing speed performance via lower parahippocampal FA (p's<0.023). Higher entorhinal R1 and whole blood Mn and Cu levels predicted higher entorhinal diffusivity (p's<0.043) and lower Delayed Story Recall performance (p=0.007)., Discussion: Mixed metal exposure predicted certain MTL structural and neuropsychological features that are similar to those detected in Alzheimer's disease at-risk populations. These data warrant follow-up as they may illuminate a potential path for environmental exposure to brain changes associated with Alzheimer's disease-related health outcomes., 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 B.V. All rights reserved.)

The Korean Gynecologic Oncology Group (KGOG) was established in 2002 and is the only organization in Korea conducting multi-center clinical trials for gynecologic cancers. Since its re-establishment as a non-profit organization in 2021, KGOG has grown significantly, now including 207 gynecologic oncology specialists from 76 hospitals. This growth is a testament to the dedication and hard work of all those involved in the organization. KGOG is committed to maximizing the activation of multi-center clinical research through policies that support patients with rare diseases and gynecologic cancer research, focusing on strengthening institutional capacity, equalizing participation opportunities, and enhancing information sharing. A significant milestone for KGOG was becoming a member of the US Gynecologic Oncology Group (GOG) in 2005, allowing participation in GOG clinical trials. KGOG later joined the Gynecologic Cancer InterGroup (GCIG) and strengthened its capabilities by hosting the first Endometrial Cancer Consensus Conference-Clinical Research (ECCC-CR) in 2023. KGOG holds biannual meetings and symposia, as well as 224 operating committee meetings annually to review the discussions of the Tumor Site Committee. KGOG has conducted 156 investigator-initiated trial (IIT) or sponsor-initiated trial (SIT) studies as KGOG-led or participated in research. Currently, 18 studies are registered, and 10 are in preparation. To date, 68 papers have been published. KGOG conducts six national projects and collaborates with external organizations such as the NRG Oncology Foundation, Gynecologic Oncology Group Partners (GOG-P), GCIG, East Asian Gynecologic Oncology Trial group (EAGOT), and the Japanese Gynecologic Oncology Group (JGOG). Through collaboration with renowned international research institutions, KGOG has significantly expanded the scope of its research, achieving noteworthy clinical outcomes. This report not only introduces the history and recent status of KGOG but also presents the exciting future direction of the organization, filled with potential breakthroughs and advancements in gynecologic oncology research.

Background: It remains uncertain how long pure ground-glass nodules (pGGNs) detected on low-dose CT (LDCT) imaging should be followed up. Further studies with longer follow-up periods are needed to determine the optimal follow-up duration for pGGNs., Research Question: What is the percentage of enlarging nodules among pGGNs that have remained stable for 10 years?, Study Design and Methods: This was a retrospective cohort study originating from participants with pGGNs detected on LDCT scans between 1997 and 2006 whose natural courses were reported in 2013. We re-analyzed all the follow-up data until July 2022. The study participants were followed up per our institutional guidelines until they were no longer a candidate for definitive treatment. The growth of the pGGNs was defined as an increase in the diameter of the entire nodule by ≥ 2 mm or the appearance of new solid portions within the nodules., Results: A total of 89 patients with 135 pGGNs were followed up for a median of 193 months. Of 135 pGGNs, 23 (17.0%) increased in size, and the median time to the first detection of a size change was 71 months. Of the 23 growing pGGNs, 122 were detected on the first LDCT scan and 13 were newly detected on the follow-up CT scan. An increase in size was observed within 5 years in 8 nodules (34.8%), between 5 and 10 years in 12 nodules (52.2%), and following 10 years in 3 nodules (13.0%). Fifteen nodules were histologically confirmed as adenocarcinoma by surgery. Among the 76 pGGNs stable for 10 years, 3 (3.9%) increased in size., Interpretation: Among pGGNs that remained stable for 10 years, 3.9% eventually grew, indicating that some pGGNs can grow even following a long period of stability. We suggest that pGGNs may need to be followed up for > 10 years to confirm growth., Competing Interests: Financial/Nonfinancial Disclosures None declared., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Photovoltaic power generation is influenced not only by variable environmental factors, such as solar radiation, temperature, and humidity, but also by the condition of equipment, including solar modules and inverters. In order to preserve energy production, it is essential to maintain and operate the equipment in optimal condition, which makes it crucial to determine the condition of the equipment in advance. This paper proposes a method of determining a degradation of efficiency by focusing on photovoltaic equipment, especially inverters, using LSTM (Long Short-Term Memory) for maintenance. The deterioration in the efficiency of the inverter is set based on the power generation predicted through the LSTM model. To this end, a correlation analysis and a linear analysis were performed between the power generation data collected at the power plant to learn the power generation prediction model and the data collected by the environmental sensor. With this analysis, a model was trained using solar radiation data and power data that are highly correlated with power generation. The results of the evaluation of the model's performance show that it achieves a MAPE of 7.36, an RMSE of 27.91, a MAE of 18.43, and an R2 of 0.97. The verified model is applied to the power generation data of the selected inverters for the years 2020, 2021, and 2022. Through statistical analysis, it was determined that the error rate in 2022, the third year of its operation, increased by 159.55W on average from the error rate of the power generation forecast in 2020, the first year of operation. This indicates a 0.75% decrease in the inverter's efficiency compared to the inverter's power generation capacity. Therefore, it is judged that it can be applied effectively to analyses of inverter efficiency in the operation of photovoltaic plants.

Objective: The present study aimed to measure fecal and urinary phosphorus (P) excretion from pigs and to develop prediction models for P excretion of pigs., Methods: A total of 96 values for P excretions were obtained from pigs of 15 to 93 kg body weight (BW) fed 12 diets in four experiments and were used to develop the prediction models. All experimental diets contained exogenous phytase at 500 phytase units per kg. Body weight of pigs and dietary P concentrations were used as independent variables in the prediction models., Results: The BW, feed intake, and P intake were positively correlated with total (fecal plus urinary) P excretions (r = 0.80, 0.91, and 0.94, respectively; p<0.001). The models for estimating P excretion were: fecal P excretion (g/d) = -0.654-0.000618×BW2+0.273×BW ×dietary P concentration (R2 = 0.83; p<0.001); urinary P excretion (g/d) = 0.045+ 0.00781×BW×dietary P concentration (R2 = 0.15; p<0.001); total P excretion (g/d) = -0.598-0.000613×BW2+0.280×BW×dietary P concentration (R2 = 0.86; p<0.001) where the BW of pigs and dietary P concentration are expressed as kg and % (as-fed basis), respectively. Based on the developed prediction models, the estimated annual fecal, urinary, and total P excretion for a market pig was 1.24, 0.09, and 1.33 kg/yr, respectively., Conclusion: The P excretions in market pigs can be estimated using BW of pigs and dietary P concentration. In the present model, a market pig excretes 1.24 kg of fecal P and 0.09 kg of urinary P per year.

The generation of an oligodendrocyte primary culture model encompassing the diverse stages of the lineage is essential for the in vitro research of oligodendrocyte physiology and pathophysiology. Here, we provide a protocol for generating oligodendrocytes from the neonatal rodent brain. We describe steps for isolating oligodendrocyte progenitor cells (OPCs) through differential centrifugation, their subsequent expansion, passaging, and differentiation. For complete details on the use and execution of this protocol, please refer to Kim et al. 1 ., Competing Interests: Declaration of interests The authors have applied for a patent in the Republic of Korea for the culture method related to this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Welding fumes contain various metals. Past studies, however, mainly focused on Manganese (Mn)-related neurotoxicity. This study investigated welding-related mixed metal exposure effects on MRI metrics in the basal ganglia (BG) and their dose-response relationship. Subjects with (N = 23) and without (N = 24) a welding exposure history were examined. Metal exposure was estimated with exposure history questionnaire and whole blood metal levels. T1 (weighted-intensity and relaxation time; estimates of brain Mn accumulation), diffusion tensor imaging [Axial (AD), mean (MD), radial diffusivity (RD), and fractional anisotropy (FA); estimates of microstructural differences] metrics in BG [caudate nucleus, putamen, and globus pallidus (GP)] and voxel-based morphometry (for volume) were examined and related with metal exposure measures. Compared to controls, welders showed higher GP R1 (1/T1; p = 0.034) but no differences in blood metal and T1-weighted (T1W) values in any ROIs (p's > 0.120). They also had higher AD and MD values in the GP (p's < 0.033) but lower FA values in the putamen (p = 0.039) with no morphologic differences. In welders, higher blood Mn and Vanadium (V) levels predicted higher BG R1 and T1W values (p's < 0.015). There also were significant overall metal mixture effects on GP T1W and R1 values. Moreover, GP AD and MD values showed non-linear associations with BG T1W values: They increased with increasing T1W values only above certain threshold of T1 values. The current findings suggest that Mn and V individually but also metal mixtures jointly predict GP T1 signals that may in turn contribute to altered DTI metrics in the BG after certain exposure threshold levels., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The objectives of this study were to determine the apparent ileal digestibility and standardized ileal digestibility (SID) of crude protein (CP) and amino acids (AA) in feed ingredients, compare the ileal digestibility of CP and AA between commercial crossbred pigs and mini-Jeju Island native pigs (JINP), and develop models for estimating SID of CP and AA for commercial pigs using mini-JINP data. The study involved five crossbred commercial pigs (31.5 ± 1.6 kg of body weight and 11 weeks of age; Landrace × Yorkshire) and five mini-JINP (31.0 ± 3.2 kg body weight and 20 weeks of age). The pigs were surgically equipped with a T-cannula at the end of ileum. Each pig breed was assigned to 5 dietary treatments in a 5 × 10 incomplete Latin square design with 10 periods. Four experimental diets were formulated to contain each of soybean meal, corn gluten feed, copra meal, and sesame expellers as the sole source of nitrogen. A nitrogen-free diet was also prepared to determine basal endogenous losses of CP and AA. No interaction between breed and feed ingredient was observed for the digestibility of CP and all indispensable AA. The SID of CP and all indispensable AA, except Arg, His, and Lys, did not differ between the two breeds of pigs. Prediction equations were developed for SID of CP and AA of commercial pigs using the SID values of mini-JINP: SID of CP (%) = (1.02 × SID of CP in mini-JINP) - 5.20 with r 2 = 0.97 and p < 0.05; SID of Lys (%) = (1.12 × SID of Lys in mini-JINP) - 9.10 with r 2 = 0.98 and p < 0.05; and SID of Met (%) = (1.08 × SID of Met in mini-JINP) - 4.27 with r 2 = 0.96 and p < 0.05. The digestibility for most AA in feedstuffs for commercial pigs can be estimated using data from mini-JINP.

Background: The Global Initiative for Chronic Obstructive Lung Disease 2023 revision proposed that chronic obstructive pulmonary disease (COPD) has various etiologies including infections (COPD-I), such as tuberculosis and human immunodeficiency virus. While nontuberculous mycobacterial pulmonary disease (NTM-PD) and pulmonary tuberculosis share similar clinical manifestations, research on COPD development during longitudinal follow-up in patients with NTM-PD is limited. In this study, we aimed to evaluate the incidence and risk of COPD development in patients with NTM-PD., Methods: We retrospectively enrolled patients with NTM-PD with normal lung function and 1:4 age-, sex-, body mass index-, and smoking status-matched controls between November 1994 and January 2022. We compared the risks of spirometry-defined COPD between the NTM-PD and control groups (study 1). A nationwide cohort study using the health insurance claims database was conducted to validate the findings (study 2)., Results: In study 1, during a mean follow-up of 3.3 years, COPD occurred in 14.0% (241/1,715) and 4.3% (293/6,860) of individuals in the NTM-PD and matched control cohorts, respectively. The NTM-PD cohort exhibited a higher risk of incident COPD (adjusted hazard ratio [aHR], 2.57; 95% CI, 2.15-3.09) compared to matched controls. In study 2, COPD occurred in 6.2% (24/386) and 2.5% (28/1,133) of individuals with and without NTM-PD, respectively. The NTM-PD cohort had a higher risk of incident COPD (aHR, 2.04; 95% CI, 1.21-3.42) compared to matched controls., Conclusion: These findings suggest that NTM-PD could be considered a new etiotype of COPD-I and emphasize the importance of monitoring lung function in individuals with NTM-PD., (© 2024. The Author(s).)