Search

Grace Y Lee,1 Calvin CK Yip,2 Edwin CS Yu,3 David WK Man4 1Occupational Therapy Department, Kwai Chung Hospital, 2CY Functional Recovery Services, 3Psychogeriatric Team, Kwai Chung Hospital, 4Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hong Kong, People’s Republic of China Background: Improving the situation in older adults with cognitive decline and evidence of cognitive rehabilitation is considered crucial in long-term care of the elderly. The objective of this study was to implement a computerized errorless learning-based memory training program (CELP) for persons with early Alzheimer’s disease, and to compare the training outcomes of a CELP group with those of a therapist-led errorless learning program (TELP) group and a waiting-list control group. Methods: A randomized controlled trial with a single-blind research design was used in the study. Chinese patients with early Alzheimer’s disease screened by the Clinical Dementia Rating (score of 1) were recruited. The subjects were randomly assigned to CELP (n = 6), TELP (n = 6), and waiting-list control (n = 7) groups. Evaluation of subjects before and after testing, and at three-month follow-up was achieved using primary outcomes on the Chinese Mini-Mental State Examination, Chinese Dementia Rating Scale, Hong Kong List Learning Test, and the Brief Assessment of Prospective Memory-Short Form. Secondary outcomes were the Modified Barthel Index, Hong Kong Lawton Instrumental Activities of Daily Living Scale, and Geriatric Depression Scale-Short Form. The data were analyzed using Friedman's test for time effect and the Kruskal-Wallis test for treatment effect. Results: Positive treatment effects on cognition were found in two errorless learning-based memory groups (ie, computer-assisted and therapist-led). Remarkable changes were shown in cognitive function for subjects receiving CELP and emotional/daily functions in those receiving TELP. Conclusion: Positive changes in the cognitive function of Chinese patients with early Alzheimer's disease were initially found after errorless training through CELP. Further enhancement of the training program is recommended. Keywords: Alzheimer’s disease, memory training, errorless learning, computerized, early dementia

Chiral photonic-band structure provides technical benefits in the form of a self-assembled helical structure and further functional wavelength tunability that exploits helical deformation according to pitch changes. The stopband wavelength control of the chiral photonic-band structure can be obtained by individual electrical methods or mechanical stretching deformation approaches. However, research on combined electric control of stretchable chiral photonic-band wavelength control while ensuring optical stability during the tuning process has remained limited till now. In this study, using the hybrid structure of elastomeric mesogenic chiral photonic gels (CPGs) with an electrically controlled dielectric soft actuator, we report the first observation of electrically stretchable CPGs and their electro-mechano-optical behaviors. The reliable wavelength tuning of a CPG to a broadband wavelength of ∼171 nm changed with high optical stability and repeated wavelength transitions of up to 100 times. Accordingly, for the first time, electrical wavelength tuning method of stretchable chiral liquid crystal photonicband structure was investigated.

Aluminum flakes, inorganic filler, and Acrylonitrile–butadiene–styrene (ABS) polymer were mixed to form noble aluminum-pigmented metallic polymers. The effects of inorganic filler on weld- and flow-line visibility were investigated using field-emission scanning electron microscopy and energy-dispersive X-ray spectroscopy. The aluminum flakes were poorly oriented and not uniformly distributed at both hole and gate locations. Addition of inorganic filler improved flake orientation and distribution quality. Traditional flakes have relatively flat surfaces and high surface areas that reflect light in a highly angular manner, which results in a metallic appearance which varies with viewing angle. Comparatively, light reflected from polymers containing both aluminum flakes and specific filler pigments exhibits much less angular dependence, i.e., the flop effect of traditional aluminum pigments is minimized. The loading, size, and shape of the inorganic filler particles affected weld and flow line visibility. Adding a spherical filler with narrow particle size distribution can better stabilize the orientation of aluminum flakes in flow- and weld-line regions compared with irregularly shaped filler particles. The choice of inorganic pigment type and its optimum loading strongly affect the visibility of flow and weld lines.

This study aims to evaluate and analyse how a renovation impacts occupant satisfaction through a pre-and post-occupancy evaluation with physical measurements and occupant satisfaction survey. The study was performed for the HVAC renovation of a research institute in Korea. Online occupant survey was conducted in 2021 winter before renovation and in 2022 summer after renovation. Both surveys were performed by using Korean Building Occupant Survey System (K-BOSS) which is integrated building open data including spatial information. The physical measurements through sensors were conducted simultaneously with surveys. In terms of sensor measurement, representative IEQ factors such as temperature, relative humidity, CO2 concentration, and illuminance were measured. The surveys included three main indoor environmental quality categories such as thermal comfort, air quality, lighting environment. The measured results were analysed via T-test. As a result, the study found a statistically significant improvement with HVAC renovation about relative humidity in physical measurements and thermal comfort, air quality, overall occupant satisfaction in the survey. The results are displayed in the 3D (three dimensional) indoor map to help intuitively view gap between pre- and post-occupancy evaluation. Overall, the pre- and post-occupation evaluation survey analyses supported the beneficial effects of IEQ in the renovated building. In conclusion, the study provides a thorough examination of the effect on occupant satisfaction with IEQ of the data-driven changes collected from pre- and post-occupancy evaluation surveys.

Objectives: There is currently a lack of evidence regarding the optimal revascularization method for Takayasu arteritis (TA). This study compares outcomes between endovascular treatment and surgical therapy in TA patients requiring revascularization. Method: From September 1994 to January 2011, 235 patients were diagnosed with TA according to the diagnostic criteria of the 1990 American College of Rheumatology, and of these, arterial revascularizations were performed in 65 (27.7%). Symptomatic or angiographic recurrence and peri-operative use of immunosuppressive drugs were investigated by retrospectively reviewing medical records. Results: A total of 111 arterial lesions in the 65 (27.7%) patients were revascularized during the follow-up period (median 3.2 years, range 0.01-12.7 years). At the 2-year follow-up, the symptomatic recurrence rate was significantly higher in the endovascular treatment group (32.3% vs. 11.5%, p = 0.016), as was the incidence of angiographic recurrence (32.1% vs. 11.1%, p = 0.026). The symptomatic recurrence rate was not influenced by the need for peri-operative immunosuppressive drugs (20% vs. 34.1%, p = 0.34). Conclusions: In TA patients, surgical revascularization seems to be superior to endovascular treatment with regard to patency. Further investigation to identify novel and optimal arterial revascularization methods for TA patients should be undertaken. [ABSTRACT FROM AUTHOR]

In this study, a water-to-air type hollow-fiber membrane humidifier was built, and its humidification characteristics were experimentally investigated under various test conditions. A humidification module made of a porous hollow-fiber membrane in which hydrophilic and polymeric raw materials are mixed was used. Using the selected material, shell-and-tube structured hollow-fiber membrane module was fabricated and tested under various operating conditions. The experimental data showed that the proposed membrane modules exhibited 74.5%–91.7% humidification effectiveness and moisture transfer of 2.5–15.8 g/kg under various operating conditions; furthermore, the modules could provide humidifier performance with few temperature changes. The results of the parametric analysis indicated that the inlet water temperature was a critical factor affecting the humidification heating performance of the proposed system but did not show a clear effect of the water flow rate.

Objectives: To evaluate the MR-based outcome predictors of lumbar transforaminal epidural steroid injection (ESI) for lumbar radiculopathy caused by herniated intervertebral disc (HIVD).Methods: A total of 149 patients (male/female 75:74; mean age 51.5 years) with the very worst (87 patients) or the very best outcome (62 patients) after ESI were enrolled in this study. They were selected from 1,881 patients who underwent lumbar transforaminal ESI for lumbar radiculopathy caused by HIVD from January 2007 to December 2008. Two radiologists reviewed MR in consensus. Chi-square test and Fisher's exact test were used to evaluate the difference between the two groups.Results: HIVD in the foraminal-extraforaminal zone were significantly more common in the very best outcome group (16/24, 66.6 %) than HIVD in the central-subarticular zone (46/125, 36.8 %) (P = 0.012). Other factors such as HIVD zone, T2-high signal, relation to nerve root, corner change, Modic change, disc height loss, grade of disc degeneration, and osteophyte were not statistically significant.Conclusion: HIVD in the foraminal or extraforaminal zone is the only good MR-based outcome predictor of lumbar transforamial ESI for lumbar radiculopathy. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this study is to analyze implant survival in patients who received radiotherapy treatment for oral malignancies and in patients who had suffered mandibular osteoradionecrosis. MATERIALS AND METHODS: We reviewed retrospectively 225 implants placed in 30 patients who had received radiotherapy as part of the oncologic treatment. Radiation doses ranged between 50 and 70 Gy. 39 implants were placed after a combined treatment of radiotherapy and chemotherapy. Data referred to tumour type and reconstruction, presence of osteoradionecrosis, region of implant installation and type of prostheses were recorded. Survival rates were calculated with cumulative Kaplan-Meier survival curves and compared between different groups with a log-rank test. RESULTS: 152 osseointegrated implants were placed in patients who presented previous reconstruction procedure. Five patients developed osteorradionecrosis as a complication of the radiotherapy treatment. Once osteoradionecrosis had healed in these patients, 41 implants were installed. The overall 5 year survival rate in irradiated patients was 92.6%. Irradiated patients had a marginally significantly higher implant loss than non-irradiated patients. (p = 0.063). The 5 year survival rate in the osteoradionecrosis group was of 48.3% and in the non-osteoradionecrosis group 92.3%, with a statistically significant difference between both groups. (p = 0.002). CONCLUSION: Osseointegrated implants enhance oral rehabilitation in most irradiated patients, even being an acceptable option for patients who had suffered osteoradionecrosis. Totally implantsupported prostheses are recommended after irradiation providing functional, stable and aesthetically satisfactory rehabilitation. [ABSTRACT FROM AUTHOR]

Lymph node metastasis is an important prognostic factor in oral squamous cell carcinoma. However, the lack of significant biomarkers for lymph node metastasis can cause patients to be inappropriately treated and produce a poor prognosis. Therefore, there is a need to identify gene sets that are associated with lymph node metastasis. In this study, we used three expression datasets obtained from a public database and selected candidate gene sets that were related with lymph node metastasis from two datasets and a combined dataset. We evaluated the selected gene set using OOB error rates in a validation dataset. The gene set detected from the combined dataset classified the lymph node status more accurately in the validation dataset and clear expression patterns classifying the lymph node status based on chromosomal location were observed. The combined dataset holds promise for use as a more accurate candidate gene set for the diagnosis of lymph node metastasis and the selected gene set could be used for biological validation in further studies. [ABSTRACT FROM AUTHOR]

Objective: Peroxisome proliferator-activated receptor (PPAR)-α/γ dual agonists have been developed to alleviate metabolic disorders. However, several PPARα/γ dual agonists are accompanied with unwanted side effects, including body weight gain, edema, and tissue failure. This study investigated the effects of a novel PPARα/γ dual agonist, CG301269, on metabolic disorders both in vitro and in vivo.Research Design and Methods: Function of CG301269 as a PPARα/γ dual agonist was assessed in vitro by luciferase reporter assay, mammalian one-hybrid assay, and analyses of PPAR target genes. In vitro profiles on fatty acid oxidation and inflammatory responses were acquired by fatty acid oxidation assay and quantitative (q)RT-PCR of proinflammatory genes. In vivo effect of CG301269 was examined in db/db mice. Total body weight and various tissue weights were measured, and hepatic lipid profiles were analyzed. Systemic glucose and insulin tolerance were measured, and the in vivo effect of CG301269 on metabolic genes and proinflammatory genes was examined by qRT-PCR.Results: CG301269 selectively stimulated the transcriptional activities of PPARα and PPARγ. CG301269 enhanced fatty acid oxidation in vitro and ameliorated insulin resistance and hyperlipidemia in vivo. In db/db mice, CG301269 reduced inflammatory responses and fatty liver, without body weight gain.Conclusions: We demonstrate that CG301269 exhibits beneficial effects on glucose and lipid metabolism by simultaneous activation of both PPARα and PPARγ. Our data suggest that CG301269 would be a potential lead compound against obesity and related metabolic disorders. [ABSTRACT FROM AUTHOR]

If we want to analyze the motion of a body in fluid, we should use rigid-body dynamics and fluid dynamics together. Even if the rigid-body and fluid dynamics are each self-consistent, there arises the problem of self-similar structure in the equation of motion when the two dynamics are coupled with each other. When the added mass is greater than the mass of a body, the calculated motion is divergent because of its self-similar structure. This study showed that the above problem is an inherent problem. This problem of self-similar structure may arise in the equation of motion in which the fluid dynamic forces are treated as external forces on the right hand side of the equation. A reconfiguration technique for the equation of motion using pseudo-added-mass was proposed to resolve the self-similar structure problem; specifically for the case when the fluid force is expressed by integration of the fluid pressure.

In this study, the inertial properties of fully filled liquid in a tank were studied based on the potential theory. The analytic solution was obtained for the rectangular tank, and the numerical solutions using Green’s 2nd identity were obtained for other shapes. The inertia of liquid behaves like solid in recti-linear acceleration. But under rotational acceleration, the moment of inertia of liquid becomes small compared to that of solid. The shapes of tank investigated in this study were ellipse, rectangle, hexagon, and octagon with various aspect ratios. The numerical solu¬tions were compared with analytic solution, and an ad hoc semi-analytical approximate formula is proposed herein and this formula gives very good predictions for the moment of inertia of the liquid in a tank of several different geometrical shapes. The results of this study will be useful in analyzing of the motion of LNG/LPG tanker, liquid cargo ship, and damaged ship.

Paul D. Choy was born on February 26th. 1896. He spent his childhood in Japan and America, and he returned to Korea when he turned twenty one years old. He graduated from Severance Union Medical College in 1921. After graduating the college, he went to Peking Union Medical College to study parasitology. He came back to Korea after one year as the first parasitologist in Korea. On returning, he took the charge of the clinical laboratory of Severance Hospital. Before long he made another journey for study to Canada. He spent two years in Toronto University studying pathology. After studying pathology, he challenged a new field of medicine. It was medical jurisprudence. He stayed two years in Japan in order to earn his doctorate in medical jurisprudence in Tohoku Imperial College. This time he returned as the first specialist in medical jurisprudence in Korea. His field of study was not confined to medical field. He had deep interest in current situation in Manchuria and Mongol, and wrote a book on this matter. His interest also extended to the history of ancient Korean people. He made extensive studies on this subject, which resulted in publishing a huge work on the origin of Korean people and its ancient history. He was a true pioneer of medicine in Korea and his life was characterized by endless quest for learning.

The exhaustion of fossil fuel and the greenhouse gas emission are one of the most significant energy and environmental issues, respectively. Photovoltaic (PV) generators and battery energy storage systems (BESSs) have been significantly increased for recent years. The BESSs are mainly used for smoothing active power fluctuation of the PV. In this paper, PV–BESSs integration of two DC/DC converters and one AC/DC converter is investigated and DC-link voltage control to compensate the AC voltage deviation is proposed for the PV‒BESS system in low-voltage (LV) networks.

Abstract Ethylene glycol (EG)-based zinc oxide (ZnO) nanofluids containing no surfactant have been manufactured by one-step pulsed wire evaporation (PWE) method. Round-robin tests on thermal conductivity measurements of three samples of EG-based ZnO nanofluids have been conducted by five participating labs, four using accurate measurement apparatuses developed in house and one using a commercial device. The results have been compared with several theoretical bounds on the effective thermal conductivity of heterogeneous systems. This study convincingly demonstrates that the large enhancements in the thermal conductivities of EG-based ZnO nanofluids tested are beyond the lower and upper bounds calculated using the models of the Maxwell and Nan et al. with and without the interfacial thermal resistance.

Abstract Background This study evaluated the clinical accuracy and analytical sensitivity of the NanoSign® Influenza A/B antigen kit in detecting 2009 pandemic influenza A/H1N1 viruses. The kit is one of the most popular rapid diagnostic tests for detecting influenza in Republic of Korea. Results The NanoSign® Influenza A/B kit resulted in 79.4% sensitivity and 97.2% specificity compared to RT-PCR in the detection of the viruses from 1,023 specimens. In addition, the kit was able to detect two strains of novel influenza viruses, Influenza A/California/12/2009(H1N1) and clinically isolated wild-type novel influenza A/H1N1, both of which are spreading epidemically throughout the world. In addition, the correlation between NanoSign® Influenza A/B test and conventional RT-PCR was approximately 94%, indicating a high concordance rate. Analytical sensitivity of the kit was approximately 73 ± 3.65 ng/mL of the purified viral proteins and 1.13 ± 0.11 hemagglutination units for the cultured virus. Conclusions As the NanoSign® Influenza A/B kit showed relatively high sensitivity and specificity and the good correlation with RT-PCR, it will be very useful in the early control of influenza infection and in helping physicians in making early treatment decisions.

Abstract Background Serum-containing medium (SCM), which has a number of poorly defined components with varying concentrations, hampers standardization of lymphocyte cultures. In order to develop a serum-free medium (SFM) for the expansion of human lymphocytes from peripheral blood mononuclear cells (PBMCs), a statistical optimization approach based on a fractional factorial method and a response surface method was adopted. A basal medium was prepared by supplementing RPMI1640 medium with insulin, albumin, ferric citrate, ethanolamine, fatty acids, glutamine, sodium pyruvate, 2-mercaptoethanol, 1-thioglycerol, nonessential amino acids, and vitamins. We identified additional positive determinants and their optimal concentrations for cell growth through a statistical analysis. Results From a statistical analysis using the fractional factorial method, cholesterol and polyamine supplement were identified as positive determinants for cell growth. Their optimal concentrations were determined by the response surface method. The maximum viable cell concentration in the developed SFM was enhanced by more than 1.5-fold when compared to that in RPMI1640 supplemented with 10% fetal bovine serum (FBS). Furthermore, a cytotoxicity assay and an enzyme-linked immunospot assay revealed that the effector function of cytotoxic T lymphocytes generated from PBMCs grown in SFM, by stimulation of peptide-presenting dendritic cells, was retained or even better than that in SCM. Conclusions The use of a developed SFM with cholesterol and polyamine supplement for human lymphocyte culture resulted in better growth without loss of cellular function when compared to SCM.

Abstract Human astroviruses (HAstVs) are among the major causes of gastroenteritis in South Korea. In this study, the partial regions of the open reading frame (ORF) 1a and ORF2 genes of HAstVs from gastroenteritis patients in nine hospitals were sequenced, and the molecular characterization of the viruses was revealed. 89 partial nucleotide sequences of ORF1a and 88 partial nucleotide sequences of ORF2 were amplified from 120 stool specimens. Phylogenetic analysis showed that most of the nucleotide sequences of ORF1a and ORF2 were grouped with HAstV type 1 but had evolutionary genetic distance compared with the reference sequences, such as the HAstV-1 prototype, Dresden strain, and Oxford strain. According to the phylogenetic analysis, some nucleotide sequences including SE0506041, SE0506043, and SE0506058, showed the discrepancy of the genotypes, but there was no proof of recombination among the HAstV types. In conclusion, this study showed that the dominant HAstV isolated from the Seoul metropolitan area in 2004-2005 was HAstV type 1, and that Korean HAstV-1 had the genetic distance in evolution compared with the reference sequences of HAstVs. Lots of nucleotide sequences of the ORF1a and ORF2 genes of HAstV will be useful for studying for the control and prevention of HAstV gastroenteritis in South Korea.

Abstract Background Slowness is a well-recognized feature of movements in aging. One of the possible reasons for slowness suggested by previous research is production of corrective submovements that compensate for shortened primary submovement to the target. Here, we re-examine this traditional interpretation and argue that the majority of submovements in older adults may be a consequence rather than the cause of slowness. Methods Pointing movements in young and older adults were recorded. Conditions for submovement emergence were manipulated by using small and large targets and three movement modes: discrete (required stopping on the target), reciprocal (required reversal on the target), and passing (required crossing the target and stopping after that). Movements were parsed into a primary and secondary submovement based on zero-crossings of velocity (type 1 submovements), acceleration (type 2 submovements), and jerk (type 3 submovements). In the passing mode, secondary submovements were analyzed only after crossing the target to exclude that they were accuracy adjustments. Results Consistent with previous research, the primary submovement was shortened and total secondary submovement incidence was increased in older adults. However, comparisons across conditions suggested that many submovements were non-corrective in both groups. Type 1 submovements were non-corrective because they were more frequent for large than small targets. They predominantly emerged due to arm stabilization and energy dissipation during motion termination in the discrete and passing mode. Although type 2 and 3 submovements were more frequent for small than large targets, this trend was also observed in the passing mode, suggesting that many of these submovements were non-corrective. Rather, they could have been velocity fluctuations associated predominantly with low speed of movements to small targets. Conclusion The results question the traditional interpretation of frequent submovements in older adults as corrective adjustments. Rather, the increased incidence of submovements in older adults is directly related to low movement speed observed in aging, whereas the relationship between submovement incidence and target size is a result of speed-accuracy trade-off. Aging-related declines in muscular control that may contribute to the disproportional increases in submovement incidence during slow movements of older adults are discussed.

Background/objectives: There are scant established data on the cause, distribution, treatment options, and recurrence rate of pediatric keloids in Asian populations. We characterized clinical features by comprehensively categorizing pediatric keloid patients into prepubertal and postpubertal groups at a single tertiary center., Methods: We searched the database of Kangbuk Samsung Hospital for pediatric patients (< 18 years) with clinically proven keloids who underwent outpatient-based treatment from 2007 to 2021. Clinical features, including demographics, distribution, underlying cause, treatment modality, and recurrence, were analyzed., Results: Of the 93 patients (total 110 keloids), 42 females (45.2%) and 51 males (54.8%), with a mean age of 14.5 ± 4.1 years (range, 1-18 years), were retrospectively analyzed. The mean length of follow-up was 22.0 ± 14.2 months (range, 6-63). Of the 100 keloids with assessable causes, piercing (22%) and acne (19%) were the most common. In the prepubertal group, the lower and upper limbs (n = 7, 28%; n = 6, 24%) were the two most common locations, suggesting that post-traumatic keloids are common during this developmental period. In the postpubertal group, the ear (n = 25, 29.4%) was the most common site, which corresponds to the frequency of cosmetic piercing at this age. No differences were found between the effects of treatment methods on relapse rate., Conclusions: Understanding the clinical features of pediatric keloids is important in the therapeutic considerations for pediatric keloids. Future studies should analyze a larger number of children with keloids over longer observation periods., (© 2024 Wiley Periodicals LLC.)

Background: Livestock-associated Staphylococcus aureus (LA-SA) has gained global attention because of its ability to colonize farm animals and transmit to the environment and humans, leading to symptomatic infections and the spread of antimicrobial resistance (AMR). In the last decade, numerous studies have reported a high prevalence of S. aureus clonal complex (CC) 398 in pig farms., Results: In this study, 163 S. aureus isolates were collected from healthy pigs (n = 110), farm environments (n = 42), and farm workers (n = 11), and their AMR profiles and epidemiological characteristics were analyzed. We identified 51 (31.3%) methicillin-resistant S. aureus (MRSA) and 112 (68.7%) methicillin-susceptible S. aureus (MSSA), with 161 (98.8%) isolates belonging to the CC398 lineage. The highest prevalence of spa type t571 was observed among the CC398 isolates. All 47 sequence type (ST) 398 MRSA isolates carried staphylococcal cassette chromosome mec (SCCmec) V, while four ST541 isolates carried SCCmec IV. High levels of resistance to commonly used antibiotics, including phenicols, quinolones, lincosamides, macrolides, aminoglycosides, and tetracyclines, have been observed on Korean pig farms. Notably, 21 cfr-positive CC398 isolates (four ST541-SCCmec IV MRSA and 17 ST398 MSSA) displaying increased resistance to linezolid were identified in healthy pigs., Conclusions: In summary, these findings suggest that the multidrug-resistant CC398 S. aureus lineage predominantly colonizes healthy pigs and farm environments in Korea. The emergence of cfr-positive S. aureus at human-animal interfaces presents a significant threat to food safety and public health., (© 2024. The Author(s).)

Slim cameras are essential in state-of-the-art consumer electronics such as smartphones or augmented/virtual reality devices. However, reducing the camera thickness faces challenges primarily due to the thick lens systems. Current lens systems, composed of stacked refractive lenses, are fundamentally constrained from becoming thinner due to the presence of empty spaces between lenses and the excessive volume of each lens. Here, we present a lens system using metasurface folded optics to overcome these pervasive issues. In our design, metasurfaces are arranged horizontally on a glass wafer and direct light along multifolded paths inside the substrate. This approach achieves an ultra-slim lens system with a thickness of 0.7 millimeters and 2× thinner relative to the EFL, thereby overcoming the inherent limitations of conventional optical platforms. It delivers quasi-diffraction-limited imaging quality with a 10° field of view and an f number of 4 at an operational wavelength of 852 nanometers. Our findings provide a compelling platform for compact cameras using folded nano-optics.

Background and Purpose: To train and validate a deep learning (DL)-based segmentation model for cerebral microbleeds (CMB) on susceptibility-weighted MRI; and to find associations between CMB, cognitive impairment, and vascular risk factors., Materials and Methods: Participants in this single-institution retrospective study underwent brain MRI to evaluate cognitive impairment between January-September 2023. For training the DL model, the nnU-Net framework was used without modifications. The DL model's performance was evaluated on independent internal and external validation datasets. Linear regression analysis was used to find associations between log-transformed CMB numbers, cognitive function (mini-mental status examination [MMSE]), white matter hyperintensity (WMH) burden, and clinical vascular risk factors (age, sex, hypertension, diabetes, lipid profiles, and body mass index)., Results: Training of the DL model (n = 287) resulted in a robust segmentation performance with an average dice score of 0.73 (95% CI, 0.67-0.79) in an internal validation set, (n = 67) and modest performance in an external validation set (dice score = 0.46, 95% CI, 0.33-0.59, n = 68). In a temporally independent clinical dataset (n = 448), older age, hypertension, and WMH burden were significantly associated with CMB numbers in all distributions (total, lobar, deep, and cerebellar; all P <.01). MMSE was significantly associated with hyperlipidemia (β = 1.88, 95% CI, 0.96-2.81, P <.001), WMH burden (β = -0.17 per 1% WMH burden, 95% CI, -0.27-0.08, P <.001), and total CMB number (β = -0.01 per 1 CMB, 95% CI, -0.02-0.001, P = .04) after adjusting for age and sex., Conclusions: The DL model showed a robust segmentation performance for CMB. In all distributions, CMB had significant positive associations with WMH burden. Increased WMH burden and CMB numbers were associated with decreased cognitive function., Abbreviations: CMB = cerebral microbleed; DL = deep learning, DSC = dice similarity coefficient; MMSE = mini-mental status examination; SVD = small vessel disease; SWI = susceptibility-weighted image; WMH = white matter hyperintensity., Competing Interests: The authors declare no conflicts of interest related to the content of this article, (© 2024 by American Journal of Neuroradiology.)

Background/objectives: We investigated the effects of ultraprocessed food (UPF) consumption on metabolic disorders (e.g., adiposity, metabolic associated steatotic liver disease [MASLD], and insulin resistance) in children and adolescents with obesity to improve dietary guidelines and public health strategies., Methods: The dietary intake of 149 participants (aged 8-17 years) was assessed with food diaries. The NOVA classification system was used to classify food according to the degree of processing. Metabolic outcomes, including the fat mass index (FMI), hepatic fat percentage, and insulin resistance, were measured via dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging proton density fat fraction (MRI-PDFF), and biochemical analysis, respectively., Results: Greater UPF consumption from baseline to the 6-month follow-up was significantly associated with increased insulin and decreased total cholesterol and LDL-cholesterol. UPF consumption was positively associated with the prevalence of MASLD (liver MRI-PDFF ≥ 5%; odds ratio T3 vs. T1 = 1.75; 95% confidence interval [CI] 1.03, 3.00), moderate-to-severe MASLD (liver MRI-PDFF ≥ 10%; OR T3 vs. T1 = 4.19; 95% CI 1.72, 10.22), and insulin resistance (OR T3 vs. T1 = 2.44; 95% CI 1.33, 4.48), after adjusting for covariates. A linear dose-response relationship was observed between UPF consumption and the odds of moderate-to-severe MASLD and insulin resistance., Conclusions: Greater UPF consumption was strongly associated with MASLD and insulin resistance in children and adolescents with obesity, underscoring the importance of reducing UPF consumption through dietary guidelines and public health interventions to mitigate the risk of obesity-related metabolic conditions in young populations., Competing Interests: The authors declare no conflicts of interest.

In this study, the nutrients, phytochemicals (including isoflavone and ginsenoside derivatives), and antioxidant activities of cheonggukjang with different ratios (0%, 2.5%, 5%, and 10%) of mountain-cultivated ginseng (MCG) were compared and analyzed using microorganisms isolated from traditional cheonggukjang . The IDCK 30 and IDCK 40 strains were confirmed as Bacillus licheniformis and Bacillus subtilis , respectively, based on morphological, biological, biochemical, and molecular genetic identification, as well as cell wall fatty acid composition. The contents of amino acids and fatty acids showed no significant difference in relation to the ratio of MCG. After fermentation, isoflavone glycoside (such as daidzin, glycitin, and genistin) contents decreased, while aglycone (daidzein, glycitein, and genistein) contents increased. However, total ginsenoside contents were higher according to the ratio of MCG. After fermentation, ginsenoside Rg2, F2, and protopanaxadiol contents of cheonggukjang decreased. Conversely, ginsenoside Rg3 (2.5%: 56.51 → 89.43 μg/g, 5.0%: 65.56 → 94.71 μg/g, and 10%: 96.05 → 166.90 μg/g) and compound K (2.5%: 28.54 → 69.43 μg/g, 5.0%: 41.63 → 150.72 μg/g, and 10%: 96.23 → 231.33 μg/g) increased. The total phenolic and total flavonoid contents were higher with increasing ratios of MCG and fermentation (fermented cheonggukjang with 10% MCG: 13.60 GAE and 1.87 RE mg/g). Additionally, radical scavenging activities and ferric reducing/antioxidant power were significantly increased in fermented cheonggukjang . This study demonstrates that the quality of cheonggukjang improved, and cheonggukjang with MCG as natural antioxidants may be useful in food and pharmaceutical applications.

Background: Previous randomized controlled trials had established the efficacy of dupilumab among patients with chronic obstructive pulmonary disease (COPD) treated with triple therapy over 52 weeks of follow-up., Objective: This population-based cohort study aimed to explore the long-term clinical effectiveness of dupilumab in COPD patients., Methods: This population-based cohort study included U.S. patients with COPD between April 2017 and August 2024. Patients initiating dupilumab and therapies that incorporated long-acting β2-agonists (LABA) inhalers were included. Patients with asthma or lung cancer were excluded. The risk of outcomes after the initiation of dupilumab versus LABA-containing therapies was measured. For detailed Methods, please see the Methods section in this article's Online Repository at www.jacionline.org., Results: A total of 1,521 dupilumab initiators and 1,521 propensity score-matched patients receiving LABA-based therapies were included. Dupilumab recipients were associated with lower all-cause mortality (HR:0.53, 95% CI:0.43-0.65), emergency visits (HR:0.78, 95% CI:0.69-0.89), and acute exacerbation (AE) rates (HR:0.59, 95% CI:0.53-0.65). Dupilumab was also associated with reductions in the requirement of short-acting β2-agonists (HR:0.48, 95% CI:0.43-0.52), short-acting muscarinic antagonists (HR:0.43, 95% CI:0.37-0.49) for symptoms control. Additionally, dupilumab decreased subsequent pneumonia (HR:0.65, 95% CI:0.50-0.86), and COPD-relevant comorbidities including new-onset heart failure (HR:0.69, 95% CI:0.53-0.90) and new-onset anxiety (HR:0.70, 95% CI:0.53-0.93)., Conclusions: Dupilumab was associated with a lower rate of mortality, emergency visits, reduced risk of AEs, respiratory symptoms, and respiratory infections in COPD patients. More studies are required to validate the effectiveness of dupilumab among patients with COPD across various severities., (Copyright © 2024. Published by Elsevier Inc.)

The clonal transmission of fluconazole-resistant Candida glabrata isolates within hospitals has seldom been analyzed by whole-genome sequencing (WGS). We performed WGS on 79 C . glabrata isolates, comprising 31 isolates from three premature infants with persistent C. glabrata bloodstream infection despite antifungal treatment in the same neonatal intensive care unit (NICU) in 2022 and 48 (27 fluconazole-resistant and 21 fluconazole-susceptible dose-dependent) bloodstream isolates from 48 patients in 15 South Korean hospitals from 2010 to 2022. Phylogenetic analysis based on WGS single-nucleotide polymorphisms (SNPs) distinguished the 79 isolates according to multilocus sequence typing (MLST) (17 sequence type [ST]3, 13 ST7, two ST22, 41 ST26, four ST55, and two ST59 isolates) and unveiled two possible clusters of nosocomial transmission among ST26 isolates. One cluster from two premature infants with overlapping NICU hospitalizations in 2022 encompassed 15 fluconazole-resistant isolates harboring pleiotropic drug-resistance transcription factor (Pdr1p) P258L (13 isolates) or N1086I (two isolates), together with 10 fluconazole-susceptible dose-dependent isolates lacking Pdr1p SNPs. The other cluster indicated unforeseen clonal transmission of fluconazole-resistant bloodstream isolates among five patients (four post-lung transplantation and one with diffuse interstitial lung disease) in the same hospital over 8 months. Among these five isolates, four obtained after exposure to azole antifungals harbored distinct Pdr1p SNPs (N1091D, E388Q, K365E, and R376Q). The findings reveal the transmission patterns of clonal bloodstream isolates of C. glabrata among patients undergoing antifungal treatment, exhibiting different levels of fluconazole susceptibility or distinct Pdr1p SNP profiles., Importance: The prevalence of fluconazole-resistant bloodstream infections caused by Candida glabrata is increasing globally, but the transmission of these resistant strains within hospitals has rarely been documented. Through whole-genome sequencing and epidemiological analyses, this study identified two potential clusters of C. glabrata bloodstream infections within the same hospital, revealing the transmission of clonal C. glabrata strains with different levels of fluconazole susceptibility or distinct transcription factor pleiotropic drug resistance protein 1 (Pdr1p) single-nucleotide polymorphism profiles among patients receiving antifungal therapy., Competing Interests: The authors declare no conflict of interest.

Early-life experiences play a crucial role in the development of the fronto-limbic regions, influencing both macro- and microstructural changes in the brain. These alterations profoundly impact cognitive, social-emotional functions. Recently, early limbic structural alterations have been associated with numerous neurological and psychiatric morbidities. Although identifying normative developmental trajectories is essential for determining brain alterations, only a few studies have focused on examining the normative trajectories in the fronto-limbic regions during preschool-aged children. The aim of this study was to investigate the structural-developmental trajectory of the fronto-limbic regions using the cortical thickness, volume, and subcortical volume in 57 healthy and typical preschool-aged children between 1 and 5 years and examined the early lateralization patterns during the development of the fronto-limbic regions. Regarding brain lateralization, remarkable asymmetry was detected in the volume of thalamus and the cortical regions excluding the lateral orbitofrontal cortex in the fronto-limbic regions. This study of preschool-aged children may fill the knowledge gaps regarding the developmental patterns and hemispheric asymmetries of the fronto-limbic regions between newborns and adolescents., 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., (© 2024 Lee, Youn, Jang, Kim, Lee, Lee, Jung and Lee.)

Ischemic stroke segmentation at an acute stage is vital in assessing the severity of patients' impairment and guiding therapeutic decision-making for reperfusion. Although many deep learning studies have shown attractive performance in medical segmentation, it is difficult to use these models trained on public data with private hospitals' datasets. Here, we demonstrate an ensemble model that employs two different multimodal approaches for generalization, a more effective way to perform on external datasets. First, after we jointly train a segmentation model on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) MR modalities, the model is inferred on the DWI images. Second, a channel-wise segmentation model is trained by concatenating the DWI and ADC images as input, and then is inferred using both MR modalities. Before training with ischemic stroke data, we utilized BraTS 2021, a public brain tumor dataset, for transfer learning. An extensive ablation study evaluates which strategy learns better representations for ischemic stroke segmentation. In our study, nnU-Net well-known for robustness is selected as our baseline model. Our proposed method is evaluated on three different datasets: the Asan Medical Center (AMC) I and II, and the 2022 Ischemic Stroke Lesion Segmentation (ISLES). Our experiments are widely validated over a large, multi-center, and multi-scanner dataset with a huge amount of 846 scans. Not only stroke lesion models can benefit from transfer learning using brain tumor data, but combining the MR modalities using different training schemes also highly improves segmentation performance. The method achieved a top-1 ranking in the ongoing ISLES'22 challenge and performed particularly well on lesion-wise metrics of interest to neuroradiologists, achieving a Dice coefficient of 78.69% and a lesion-wise F1 score of 82.46%. Also, the method was relatively robust on the AMC I (Dice, 60.35%; lesion-wise F1, 68.30%) and II (Dice; 74.12%; lesion-wise F1, 67.53%) datasets in different settings. The high segmentation accuracy of our proposed method could improve radiologists' ability to detect ischemic stroke lesions in MRI images. Our model weights and inference code are available on https://github.com/MDOpx/ISLES22-model-inference ., (© 2024. The Author(s) under exclusive licence to Society for Imaging Informatics in Medicine.)

Dendritic cells (DCs) undergo glycolytic reprogramming, a metabolic conversion process essential for their activation. Vitamin D has been reported to affect the function of DCs, but studies in metabolic diseases are insufficient. This study investigates the effects of in vitro 1,25-dihydroxyvitamin D3 (1,25(OH) 2 D 3 ) treatment on glycolytic reprogramming of bone marrow-derived dendritic cells (BMDCs) from control, obese, and atherosclerosis mice. Six-week-old male C57BL/6J mice were fed a control diet (CON) or a Western diet (WD), and B6.129S7-Ldlr tm1Her /J mice were fed a Western diet (LDLR -/- ) for 16 weeks. BMDCs were cultured in a medium containing 1,25(OH) 2 D 3 (10 nM) for 7 days and stimulated with lipopolysaccharide (LPS, 50 ng/mL) for 24 h. In mature BMDCs, 1,25(OH) 2 D 3 treatment decreased basal and compensatory glycolytic proton efflux rates (glycoPER), the expression of surface markers related to immune function of DCs (MHC class II, CD80, and CD86), and IL-12p70 production. In addition, mTORC1 activation and nitric oxide (NO) production were suppressed by 1,25(OH) 2 D 3 treatment in mature BMDCs. The effect of 1,25(OH) 2 D 3 treatment on IL-12p70 production and mTORC1 activity in the LDLR -/- group was greater than in the CON group. These findings suggest that vitamin D can affect the metabolic environment of BMDCs by regulating glycolytic reprogramming as well as by inducing tolerogenic phenotypes of DCs., Competing Interests: Declaration of competing interest The authors declare no conflict of interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background : Distal bile duct cancer is an aggressive malignancy. Tumor-infiltrating immune cells (TIICs) in the tumor microenvironment are crucial for predicting prognosis in various cancers. In this study, we analyzed TIICs based on CD11b, CD163, and CD8 expression, and evaluated their association with clinicopathologic factors and prognosis in distal bile duct cancer. Methods: A total of 90 patients who underwent curative resection for distal bile duct cancer were enrolled. We analyzed CD11b+ tumor-infiltrating myeloid cells (TIMs), CD163+ tumor-infiltrating macrophages (TAMs), and CD8+ tumor-infiltrating lymphocytes (TILs) using immunohistochemistry and tissue microarrays. The correlation between TIICs and clinicopathologic characteristics was assessed. Results: Low levels of CD11b+ TIMs ( p < 0.001) and high levels of CD8+ TILs ( p = 0.003) were significantly associated with improved overall survival (OS). A combined low level of CD11b+ TIMs and high level of CD8+ TILs was identified as an independent favorable prognostic factor (hazard ratio, 0.159; confidence interval, 0.061-0.410; p < 0.001). Conclusions: CD11b+ TIMs play a crucial role in the tumor microenvironment and the prognosis of distal bile duct cancer. The combined analysis of CD11b+ TIMs and CD8+ TILs can predict survival in patients with distal bile duct cancer., Competing Interests: The authors declare no conflicts of interest.

Background: Emergency departments (EDs) are often the front door for urgent mental health care, especially when demand exceeds capacity. Long waits in EDs exert strain on hospital resources and worsen distress for individuals experiencing a mental health crisis. We used as a test case the Australian Capital Territory (ACT), with a population surge of over 27% across 2011-2021 and a lagging increase in mental health care capacity, to evaluate population-based approaches to reduce mental health-related ED presentations., Methods: We developed a system dynamics model for the ACT region using a participatory approach involving local stakeholders, including health planners, health providers and young people with lived experience of mental health disorders. Outcomes were projected over 2023-2032 for youth (aged 15-24) and for the general population., Results: Improving the overall mental health care system through strategies such as doubling the annual capacity growth rate of mental health services or leveraging digital technologies for triage and care coordination is projected to decrease youth mental health-related ED visits by 4.3% and 4.8% respectively. Implementation of mobile crisis response teams (consisting of a mental health nurse accompanying police or ambulance officers) is projected to reduce youth mental health-related ED visits by 10.2% by de-escalating some emergency situations and directly transferring selected individuals to community mental health centres. Other effective interventions include limiting re-presentations to ED by screening for suicide risk and following up with calls post-discharge (6.4% reduction), and limiting presentations of frequent users of ED by providing psychosocial education to families of people with schizophrenia (5.1% reduction). Finally, combining these five approaches is projected to reduce youth mental health-related ED presentations by 26.6% by the end of 2032., Conclusions: Policies to decrease youth mental health-related ED presentations should not be limited to increasing mental health care capacity, but also include structural reforms., (© 2024. The Author(s).)