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Ji Eun Song,1 Eunjeong Ji,2 Nak-Hyun Kim,1,3 Jung Hun Ohn,1,3 Yejee Lim,1,3 Jongchan Lee,1,3 Hye Won Kim,1,3 Sun-Wook Kim,1,3 Jiwon Ryu,1,3 Hee-Sun Park,1,3 Eun Sun Kim1,3 1Hospital Medicine Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 2Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of KoreaCorrespondence: Eun Sun Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea, Email apolio3700@gmail.comPurpose: Older patients have a higher risk of aspiration pneumonia and mortality if they are hospitalized. We aimed to assess the effectiveness of an aspiration prevention quality improvement (QI) program that utilizes the Gugging Swallowing Screen (GUSS) in older patients.Patients and Methods: This retrospective cohort study was conducted in an acute medical care unit of a tertiary hospital in South Korea. The study used one-to-one propensity matching and included 96 patients who received the QI program and 96 who did not. All patients were aged 65 years or older and had risk factors for aspiration, including neurological and non-neurological disorders, neuromuscular disorders, impaired airway defenses, and dysphagia due to esophageal or gastrointestinal disorders. The primary outcomes included the duration of the fasting period during hospitalization, changes in nutritional status before admission and at discharge, in-hospital mortality, and readmission due to pneumonia within 90 days.Results: Fasting period, changes in weight and albumin levels upon discharge after hospitalization, and length of stay did not differ significantly between patients in the GUSS and non-GUSS groups. However, the risk of readmission within 90 days was significantly lower in patients who underwent the GUSS than in those who did not (hazard ratio, 0.085; 95% confidence interval, 0.025– 0.290; p = 0.001).Conclusion: The GUSS aspiration prevention program effectively prevented readmission due to pneumonia within 90 days in older patients with acute illnesses. This implies that the adoption of efficient aspiration prevention methods in older patients with acute illnesses could play a pivotal role by enhancing patient outcomes and potentially mitigating the healthcare costs linked to readmissions.Keywords: aspiration pneumonia, older patients, gugging swallowing screen, prevention, quality improvement

Woo-Youn Kim,1,2 Anna Baek,1 Yoonhee Kim,1 Yewon Suh,1,2 Eunsook Lee,1 Eunkyung Euni Lee,1,2 Ju-Yeun Lee,1,2 Jongchan Lee,3– 5 Hee Sun Park,3– 5 Eun Sun Kim,3– 5 Yejee Lim,3– 5 Nak-Hyun Kim,3– 5 Jung Hun Ohn,3– 5 Sun-wook Kim,3– 5 Jiwon Ryu,3– 5 Hye Won Kim3– 5 1Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, South Korea; 2College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea; 3Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; 4Hospital Medicine Center, Seoul National University Bundang Hospital, Seongnam, South Korea; 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaCorrespondence: Hye Won Kim, Email kimhwhw@gmail.comBackground: Transitional medication safety is crucial, as miscommunication about medication changes can lead to significant risks. Unclear or incomplete documentation during care transitions can result in outdated or incorrect medication lists at discharge, potentially causing medication errors, adverse drug events, and inadequate patient education. These issues are exacerbated by extended hospital stays and multiple care events, making accurate medication recall challenging at discharge.Objective: Thus, we aimed to investigate how real-time documentation of in-hospital medication changes prevents undocumented medication changes at discharge and improves physician-pharmacist communication.Methods: We conducted a retrospective cohort study in a tertiary hospital. Two pharmacists reviewed medical records of patients admitted to the acute medical unit from April to June 2020. In-hospital medication discrepancies were determined by comparing preadmission and hospitalization medication lists and it was verified whether the physician’s intent of medication changes was clarified by documentation. By a documentation rate of medication changes of 100% and < 100%, respectively, fully documented (FD) and partially documented (PD) groups were defined. Any undocumented medication changes at discharge were considered a “documentation error at discharge”. Pharmacists’ survey was conducted to assess the impact of appropriate documentation on the pharmacists.Results: After reviewing 400 medication records, patients were categorized into FD (61.3%) and PD (38.8%) groups. Documentation errors at discharge were significantly higher in the PD than in the FD group. Factors associated with documentation errors at discharge included belonging to the PD group, discharge from a non-hospitalist-managed ward, and having three or more intentional discrepancies. Pharmacists showed favorable attitudes towards physician’s documentation.Conclusion: Appropriate documentation of in-hospital medication changes, facilitated by free-text communication, significantly decreased documentation errors at discharge. This analysis underlines the importance of communication between pharmacists and hospitalists in improving patient safety during transitions of care.Plain language summary: During transitions of care, communication failures among healthcare professionals can lead to medication errors. Therefore, effective sharing of information is essential, especially when intentional changes in prescription orders are made. Documenting medication changes facilitates real-time communication, potentially improving medication reconciliation and reducing discrepancies. However, inadequate documentation of medication changes is common in clinical practice. This retrospective cohort study underlines the importance of real-time documentation of in-hospital medication changes. There was a significant reduction in documentation errors at discharge in fully documented group, where real-time documentation of medication changes was more prevalent. Pharmacists showed favorable attitudes toward the physician’s real-time documenting of medication changes because it provided valuable information on understanding the physician’s intent and improving communication and also saved time for pharmacists. This study concludes that physicians’ documentation on medication changes may reduce documentation errors at discharge, meaning that proper documentation of medication changes could enhance patient safety through effective communication.Keywords: medication reconciliation, medication safety, transitions in care, hospital information systems, hospital discharge, quality audit

Nack Hwan Kim,1 Youngki Hong,2 Sang-Heon Lee3 1Biomedical Research Center, Korea University Anam Hospital, Seoul, Republic of Korea; 2Department of Sports Medicine, Cheongju University, Cheongju, Republic of Korea; 3Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Republic of Korea Purpose: To report on the 2-year clinical outcomes of focal ablation using a navigable plasma disc decompression device in patients with lumbar herniated nucleus pulposus (HNP).Patients and methods: This was a prospective, single-cohort study conducted in a clinical center. A total of 170 patients with lumbar HNP were assessed for pain intensity using the visual analog scale (VAS), for disability level using the Oswestry Disability Questionnaire (ODI), for health-related quality of life using the short form-36 version 2 of the bodily pain scale (SF-36 BP), and for the angles of passive straight leg raise (SLR) test. The herniated portions of the target discs were ablated using a navigable catheter under a well-instructed protocol with informed consent. Outcome data were prospectively collected before the procedure: 1 week after the procedure: and then 1, 3, 6, 12, and 24 months postoperatively. For statistical analysis, repeated-measures analysis of variance was performed.Results: Two years after the procedure, the mean VAS decreased from 7.1±1.7 to 2.1±1.9, the mean ODI decreased from 50.9±17.2 to 20.3% ± 14.6%, and the mean SF-36 BP increased from 38.8±8.4 to 45.8±9.4 (P

Purified and crude proteases have been broadly applied to obtain hydrolysates from soy protein isolate (SPI) with the improved functional and biological properties. However, the use of fruit juices containing native proteases to produce SPI hydrolysates with better bioactivities receives less attention. The present study attempted to investigate the ability of papaya ( Carica papaya ) and cantaloupe ( Cucumis melo ) juices in the hydrolysis of SPI and assess the antioxidant, anti-tyrosinase, and wound-healing activities of obtained hydrolysates. Our analysis showed that SPI was hydrolysed by papaya juice, at the juice to substrate ratio of 2.5:2 ( v/ w), with a degree of hydrolysis (DH) of approximately 11% after 4 h of treatment at 55ºC. A higher DH (about 26%) was obtained by the hydrolysis with cantaloupe juice at the same juice to substrate ratio and treatment conditions. Papain used at the enzyme to substrate ratio of 0.625:2 ( w/w ) broke down SPI in a similar DH as papaya juice at the juice to substrate ratio of 2.5:2 ( v/w ). The ABTS •+ -scavenging, • OH-scavenging and tyrosinase inhibitory capacities of SPI were lower than those of hydrolysates obtained by the treatment with papaya juice (IC 50 of 2.39, 7.17, and 32.07 μg/mL, respectively) and cantaloupe juice (IC 50 of 2.46, 6.93, and 30.49 μg/mL, respectively). An enhancement in ABTS •+ -scavenging, • OH-scavenging and anti-tyrosinase activities was also observed in the hydrolysate obtained by papain (IC 50 of 2.75, 17.85, and 117.80 μg/mL, respectively) compared to SPI. However, the increased level of the • OH-scavenging capacity of the hydrolysate obtained by papain was lower than that of the fruit juice-treated samples. Remarkably, the hydrolysates prepared from the hydrolysis with fruit juices accelerated the wound closure in human fibroblasts by estimately 1.5 times after 24 h of treatment while this property was not observed in the hydrolysate by papain. Our study data suggest the potential of SPI hydrolysates obtained by papaya and cantaloupe juices in the preparation of healthy food products.

Enzymatic hydrolysis of edible bird's nest (EBN) has attracted great interest in both scientific and commercial fields due to the enhancement of solubility and nutraceutical values. The present study attempted to investigate the hydrolysis of EBN with papaya (Carica papaya L.), pineapple (Ananas comosus (L.) Merr.), and cantaloupe (Cucumis melo L.) juices as well as two commercial enzymes papain and bromelain. Our analysis revealed that EBN hydrolysis with pineapple juice and bromelain produced a degree of hydrolysis (DH) value of approximately 27 % while it was about 25 % for the hydrolysis with cantaloupe juice and 22 % for the hydrolysis with papaya juice and papain after 4 h of treatment. When EBN was digested by fruit juices and enzymes, the protein solubility and free sialic acid content were increased and the highest values were achieved for EBN hydrolysis with pineapple juice and bromelain (estimately 11 mg/mL of soluble protein and 18 g/kg of free sialic acid). The ABTS•+-scavenging, •OH-scavenging, and anti-tyrosinase capacities were higher in the EBN hydrolysates by papaya juice (IC50 of 0.034, 0.108, and 0.419 mg/mL, respectively), pineapple juice (IC50 of 0.025, 0.045, and 0.190 mg/mL, respectively), and cantaloupe juice (IC50 of 0.031 mg/mL, 0.056, and 0.339 mg/mL, respectively) than in the hydrolysates by unhydrolyzed EBN (IC50 of 0.094, 0.366, and 1.611 mg/mL, respectively). An improvement in ABTS•+-scavenging, •OH-scavenging, and anti-tyrosinase abilities was also observed for the hydrolysates by papain (IC50 of 0.041, 0.129, and 0.417 mg/mL, respectively) and bromelain (IC50 of 0.025, 0.069, and 0.336 mg/mL, respectively) but in a lesser extent as compared to the hydrolysates by respective papaya and pineapple juices. Noticeably, the EBN hydrolysates by fruit juices remarkably enhanced the wound closure in human fibroblasts by about 1.4–1.8 times after 24 h of treatment whereas this property was insignificant in the hydrolysates by enzymes. As papaya, pineapple, and cantaloupe juices are easily obtainable and have pleasant flavors, our results provide a possible method to hydrolyze EBN and apply the resultant hydrolysates in functional food products.

The study assessed the variations in nine agro-morphological characters among and within the black glutinous rice (Oryza sativa) population from Chau Thanh District, Tra Vinh Province. The nine quantitative agromorphological characters that were measured include culm length, leaf length, leaf width, number of panicles, panicle length, grain length, grain width, number of firm grain, and number of grain per panicle. The unweighted pair group method with arithmetic mean method and principal coordinate analysis by the NTSYS program were applied in this study to classify the nine agro-morphological characters. In addition, to compare the variations in quantitative characters between O. sativa populations, one-way analysis of variance (ANOVA) was used. The results showed significant differences between the black glutinous rice populations for all quantitative agro-morphological characters. Moreover, some agro-morphological characters showed positive correlations to each other. The dendrogram generated from the analysis process of the agromorphological data divided the O. sativa populations into two groups with unfamiliar features. However, the O. sativa populations assessed exhibited a wide range of variations in morphological characteristics, both within the same population and among other populations with the same strains.

The purpose of this study is to investigate the impact of customer immersive experience on attitude and adoption intention toward mobile augmented reality applications (MAR apps). This paper also examines the moderating role of technology anxiety on the relationship between immersive experience on attitude and adoption intention toward MAR apps. A dataset of 322 customers and the partial least square structural equation model (PLS-SEM) with the SmartPLS 3.2.8 statistical software were used to test the proposed hypotheses. The results show that immersive experience significantly affects attitude and adoption intention toward MAR apps. In addition, the vital role of technology anxiety in moderating the relationship between customer immersive experience and their responses toward MAR apps is revealed.

Abstract Background African rice, Oryza glaberrima, is an invaluable resource for rice cultivation and for the improvement of biotic and abiotic resistance properties. Since its domestication in the inner Niger delta ca. 2500 years BP, African rice has colonized a variety of ecologically and climatically diverse regions. However, little is known about the genetic basis of quantitative traits and adaptive variation of agricultural interest for this species. Results Using a reference set of 163 fully re-sequenced accessions, we report the results of a Genome Wide Association Study carried out for African rice. We investigated a diverse panel of traits, including flowering date, panicle architecture and resistance to Rice yellow mottle virus. For this, we devised a pipeline using complementary statistical association methods. First, using flowering time as a target trait, we found several association peaks, one of which co-localised with a well described gene in the Asian rice flowering pathway, OsGi, and identified new genomic regions that would deserve more study. Then we applied our pipeline to panicle- and resistance-related traits, highlighting some interesting genomic regions and candidate genes. Lastly, using a high-resolution climate database, we performed an association analysis based on climatic variables, searching for genomic regions that might be involved in adaptation to climatic variations. Conclusion Our results collectively provide insights into the extent to which adaptive variation is governed by sequence diversity within the O. glaberrima genome, paving the way for in-depth studies of the genetic basis of traits of interest that might be useful to the rice breeding community.

Abstract Genetic transformation is one of the most important technologies for revealing or modulating gene function. It is used widely in both functional genomics and molecular breeding of rice. Demands on its use in wild Oryza species is increasing because of their high genetic diversity. Given the difficulties in genetic crosses between distantly related species, genetic transformation offers a way to alter or transfer genetic traits in wild rice accessions. However, transformation of wild Oryza accessions by conventional methods using calli induced from scutellum tissue of embryos in mature seeds often fails. Here, we report methods using immature embryos for the genetic transformation of a broad range of Oryza species. First, we investigated the ability of callus induction and regeneration from immature embryos of 192 accessions in 20 species under several culture conditions. We regenerated plants from immature embryos of 90 accessions in 16 species. Next, we optimized the conditions of Agrobacterium infection using a vector carrying the GFP gene driven by the maize ubiquitin promoter. GFP signals were observed in 51 accessions in 11 species. We analyzed the growth and seed set of transgenic plants of O. barthii, O. glumaepatula, O. rufipogon, and O. brachyantha. The plants grew to maturity and set seeds normally. Southern blot analyses using DNA from T0 plants showed that all GFP plants were derived from independent transformation events. We confirmed that the T-DNAs were transmitted to the next generation through the segregation of GFP signals in the T1 generation. These results show that many Oryza species can be transformed by using modified immature-embryo methods. This will accelerate the use of wild Oryza accessions in molecular genetic analyses and molecular breeding.

Identification of molecular-based signatures is one of the critical steps toward finding therapeutic targets in cancer. In this paper, we propose methods to discover prognostic gene signatures under a causal structure learning framework across the whole genome. The causal structures are represented by directed acyclic graphs (DAGs), wherein we construct gene-specific network modules that constitute a gene and its corresponding regulators. The modules are then subsequently used to correlate with survival times, thus, allowing for a network-oriented approach to gene selection to adjust for potential confounders, as opposed to univariate (gene-by-gene) approaches. Our methods are motivated by and applied to a clear cell renal cell carcinoma (ccRCC) study from The Cancer Genome Atlas (TCGA) where we find several prognostic genes associated with cancer progression - some of which are novel while others confirm existing findings. [ABSTRACT FROM AUTHOR]

Abstract Context Yield improvement is an important issue for rice breeding. Panicle architecture is one of the key components of rice yield and exhibits a large diversity. To identify the morphological and genetic determinants of panicle architecture, we performed a detailed phenotypic analysis and a genome-wide association study (GWAS) using an original panel of Vietnamese landraces. Results Using a newly developed image analysis tool, morphological traits of the panicles were scored over two years: rachis length; primary, secondary and tertiary branch number; average length of primary and secondary branches; average length of internode on rachis and primary branch. We observed a high contribution of spikelet number and secondary branch number per panicle to the overall phenotypic diversity in the dataset. Twenty-nine stable QTLs associated with seven traits were detected through GWAS over the two years. Some of these QTLs were associated with genes already implicated in panicle development. Importantly, the present study revealed the existence of new QTLs associated with the spikelet number, secondary branch number and primary branch number traits. Conclusions Our phenotypic analysis of panicle architecture variation suggests that with the panel of samples used, morphological diversity depends largely on the balance between indeterminate vs. determinate axillary meristem fate on primary branches, supporting the notion of differences in axillary meristem fate between rachis and primary branches. Our genome-wide association study led to the identification of numerous genomic sites covering all the traits studied and will be of interest for breeding programs aimed at improving yield. The new QTLs detected in this study provide a basis for the identification of new genes controlling panicle development and yield in rice.

Contents In humans, regulatory T (T reg) cells are known to play a critical role in both the regulation of immune homoeostasis and the progression of cancer. However, there is little information about the identification, characterization and the function of T reg cells in canine tumours. We identified T reg cells in 28 canine seminoma samples using a Forkhead box P3 (Foxp3) antibody and investigated the relationship between T reg cell infiltration and histopathological features of classical and spermatocytic seminomas (SE and SS, respectively). The Foxp3 protein showed nuclear immunostaining in infiltrating lymphocytes, and Foxp3+ cells were diffused or focally distributed in seminoma tissues. Foxp3+ cells were frequently present in the SS histotype, in seminomas that showed no evidence of tumour cell invasion into the vessels and in seminomas showing a diffuse growth pattern with three cell types. Neither the SE/SS histotype nor the histopathological features of the tumour correlated with Foxp3+ cell counts. These results indicate that Foxp3+ T reg cells may be associated with a less malignant histological phenotype or may not play a critical role in the immune response of canine seminomas. Moreover, Foxp3+ T reg cells may be associated with SS seminoma, but further studies, involving a larger number of samples, are required to better understand whether these cells play a critical role in the immune response in canine seminomas. This is the first report to demonstrate the characteristics of T reg cell infiltration in canine seminoma. [ABSTRACT FROM AUTHOR]

Contents Precisely detecting oestrus is important for artificial insemination. The aims of this study were to identify oestrus-specific sow mucus proteins to determine the optimal time for artificial insemination. The proestrous- and oestrous-stage mucus proteins were purified and analysed with proteomic tools such as two-dimensional gel electrophoresis and matrix-assisted laser desorption/ionization-time-of-flight analyses. Among the differentially expressed proteins, the dimethylarginine dimethylaminohydrolase 2 (DDAH2) protein showed a 3.6-fold increase during the proestrous stage compared to that during the oestrous stage. A western immunoblot study revealed that two of three sow mucus samples clearly showed negative anti-DDAH2 antibody activity during the oestrous stage. This study demonstrated that the pig DDAH2 mucus protein exists during the proestrous stage, but not during the oestrous stage, suggesting that mucus DDAH2 could be useful as an oestrus detection marker. [ABSTRACT FROM AUTHOR]