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Introduction SB17 is a biosimilar to reference ustekinumab (UST). We compared the efficacy, safety, and immunogenicity of SB17 to UST up to Week 52, including switching from UST to SB17.Methods Subjects were randomized to receive 45 mg of SB17 or UST subcutaneously up to Week 40. At Week 28, subjects from the UST treatment group were re-randomized to either switch to SB17 or continue UST. Efficacy, safety, and immunogenicity were assessed up to Week 52.Results Among baseline randomized 503 subjects, 481 subjects were re-randomized at Week 28; continuing SB17 (SB17 + SB17, n = 237), switching from UST to SB17 (UST+SB17, n = 122) or continuing UST (UST+UST, n = 122). The percent change from baseline in Psoriasis Area and Severity Index (PASI) was comparable between treatment groups up to Week 52 (SB17 + SB17: 95.8%, UST+SB17: 95.6%, UST+UST: 94.5% at Week 52). Other efficacy endpoints were also comparable. The incidence of treatment-emergent adverse events (SB17 + SB17: 16.5%, UST+SB17: 13.9%, UST+UST: 23.8%) and the overall incidence of anti-drug antibodies occurring after transition were comparable between treatment groups (SB17 + SB17: 5.6%, UST+SB17: 5.1%, and UST+UST: 6.7%).Conclusion SB17 demonstrated clinical biosimilarity to UST after switching from UST, and maintained long-term comparable efficacy and safety with UST up to Week 52.

Owing to the hyper-connectivity of convergence environments, the Internet of Blended Environments (IoBE) has emerged As a result, the environments and architectures in which cyber-security threats can occur have steadily diversified leading to an increase in security incidents. However, existing detection systems lack correlation analysis and thus cannot detect the corresponding diverse attack paths and attack chains effectively. In this paper, we propose a data prediction technique in which knowledge graph embedding technology is applied to predict blended threats in complex environments such as the IoBE. We also verify the performance of the proposed technique.

The demand for face masks is increasing exponentially due to the coronavirus pandemic and the particulate matter (PM) in the atmosphere. As a result, an enormous number of disposable mask filters have been produced and discarded, contributing to plastic waste. Underprivileged people who cannot afford to purchase commercial face masks have started making fabric masks with waste clothing; however, this material does not effectively filter viruses or PM. Therefore, in this study, a chitosan coating was applied to clothing fabrics to increase their effectiveness as face masks. The improvement in the PM removal efficiency owing to the chitosan polymer was observed for stocking, innerwear, and bamboo materials, but not for cotton. Furthermore, chitosan prepared in the form of a nanowhisker (CsW) achieved a PM 2.5 removal efficiency of 96% in a five-layer cotton fabric. In addition, a commercial biodegradable poly(lactic acid) filter was coated with CsW, which increased the PM 2.5 removal efficiency from 67% to 83%. Additionally, microbial growth was significantly suppressed in the chitosan-coated fabrics, and the degree to which it was suppressed depended on the coating concentration. The study will aid in the utilization of face mask filters that are more sustainable, efficient, and widely accessible.

Abstract Among plastic items, single‐use straws are particularly detrimental to marine ecosystems because such straws, including those made of poly(lactic acid) (PLA), are sharp and extremely slowly degradable in the ocean. While paper straws are promising alternatives, they exhibit hydration‐induced swelling even when coated with a non‐degradable plastic coating and promote effervescence (fizzing) in soft drinks owing to their surface heterogeneities. In this study, upgraded paper straw is coated with poly(butylene succinate) cellulose nanocrystal (PBS/CNC) composites. CNC increases adhesion to paper owing to their similar chemical structures, optimizes crystalline PBS spherulites through effective nucleation, and reinforces the matrix through its anisotropic and rigid features. The straws are not only anti‐fizzing when used with soft drinks owing to their homogeneous and seamless surface coatings, but also highly water‐resistant and tough owing to their watertight surfaces. All degradable components effectively decompose under aerobic composting and in the marine environment. This technology contributes to United Nations Sustainable Development Goal 14 (Life Below Water).

Abstract Background A heterogeneous radiological response is frequently observed in cancer patients and could reflect tumor heterogeneity. We investigated the prognostic impact of heterogeneous radiological responses in patients with advanced non‐small‐cell lung cancer (NSCLC) who received platinum‐based chemotherapy. Methods The treatment response according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria was evaluated in 212 patients with advanced NSCLC who received platinum‐based chemotherapy. Patients with partial response (PR) or stable disease (SD) were classified into “PR homo,” “PR hetero,” “SD homo,” and “SD hetero” by the presence of a heterogeneous radiological response, and survival was compared between groups. We also compared survival based on the presence of metabolic responses in lesions with heterogeneous radiological responses. Results Fifty‐two patients (24.5%) were classified as PR, 112 patients (52.8%) as SD, and 48 patients (22.7%) as progressive disease (PD). There was no significant difference in progression‐free survival (PFS) and overall survival (OS) between the PR homo and PR hetero groups. The SD homo group had a longer PFS and OS than the SD hetero group. In the SD hetero group, patients with increased maximum standardized uptake value (SUVmax) in lesions with heterogeneous radiological responses had a shorter PFS than those with a stable SUVmax. Conclusions The presence of lesions with radiological heterogeneity was associated with disease progression and poor prognosis in the SD group. Patients with heterogeneous radiological responses require careful monitoring.

Abstract Background Abdominal lymph node metastasis (ALNM) is common in patients with metastatic non‐small‐cell lung cancer (NSCLC). However, its mechanism of spread remains to be elucidated. We investigated whether thoracic duct has the role as a pathway for ALNM in NSCLC using clinical data. Methods We classified ALNM into subgroups by their location and evaluated its prevalence and association with clinical characteristics in 892 patients with metastatic NSCLC. The abdominal lymph nodes were classified into direct or indirect groups depending on whether they drain directly into the trunk (intestinal trunk or lumbar trunks) connected to the cisterna chyli. Results One hundred‐five patients (11.8%) had ALNM. The paraaortic lymph node was most commonly involved, followed by the aortocaval, left gastric, paracaval, and celiac lymph nodes. After grouping the patients by location of ALNM, 56 patients (53.3%) with ALNM were in the “direct only” group, only seven patients (6.7%) were in the “indirect only” group, and 42 patients (40.0%) were in “both” groups. In patients whose intrathoracic lesions were limited to the right thorax, there was a significantly lower prevalence of ALNM (3.4% vs. 14.3%, p

Abstract Background The purpose of this study was to investigate factors influencing eating performance in older adults with dementia (OAWDs) in long-term care (LTC) facilities. Methods This cross-sectional study examined risk factors for compromised eating performance by comparing both independent and dependent older adults with dementia. The study participants were 117 OAWDs in LTC facilities in South Korea. Measurements included (a) general characteristics, (b) activities of daily living (ADL) including eating performance, (c) cognitive function, (d) physical capability, (e) grip strength, (f) Behavioral Psychological Symptoms of Dementia (BPSD), and (g) depression. Data were analyzed by the percentage, mean and standard deviation, Chi-square test, t-test, and logistic regression. Results The eating independent group had more comorbidities than the dependent group (t = 2.793, p

This study’s purpose is to examine the effect of employee experience on job satisfaction, psychological well-being, and organizational commitment among corporate employees, with a specific focus on three factors: physical, technological, and cultural experiences. Given the growing importance of mental health management for employees, the study investigates the relationship between employee experience and mental toughness. A structural equation modeling research model was designed, and data were collected through a survey of 534 Korean employees. The analysis results show that cultural and physical experiences have a significant impact on organizational commitment, while technological experience does not have a significant impact. Furthermore, the study identifies that employee experience positively effects organizational commitment through job satisfaction and psychological well-being as mediators. It also reveals that the effect of employee experience on organizational commitment varies depending on the level of mental toughness. The findings suggest that managing employee experience can increase organizational commitment by improving job satisfaction and psychological well-being. Therefore, it is essential to be aware of individual mental toughness and its development. Hence this study highlights the importance of considering the physical, technological, and cultural experiences of employees in enhancing their well-being and commitment to the organization.

This study aims to examine the impact of mental toughness of employees on their psychological well-being, job satisfaction, and organizational commitment. A research model based on structural equation modeling ‘ developed, and a survey was conducted with 534 office workers in Korean companies to gather the data. The findings indicate that mental toughness has a significant effect on psychological well-being and positively (+) affects organizational commitment and job satisfaction through psychological well-being. The study also reveals that mental toughness has a greater influence on organizational commitment than on job satisfaction. However, the positive effect of job satisfaction was found to increase when psychological well-being was mediated. Consequently, this study recommends that employees’ mental toughness be managed effectively to improve their job satisfaction and organizational commitment, leading to enhanced job competency, and reduced turnover intention. These findings are of practical significance to organizational practitioners, as they underscore the importance of fostering mental toughness among employees to promote their well-being and commitment to their work.

To enhance the life satisfaction of the elderly with multimorbidity, it is necessary to investigate the relevant factors and to examine the differences in factors according to gender. The aim of this study was to identify factors affecting life satisfaction of the elderly with multimorbidity in the community by gender in Korea. We analyzed data from 2140 participants with multimorbidity who were aged 65 or older and participated in the Korean Longitudinal Study of Ageing (KLoSA) in 2016. A multivariate linear regression analysis was conducted to examine the factors affecting life satisfaction among male and female older participants with multimorbidity. The most common pattern of multimorbidity of women was hypertension and arthritis/rheumatism, while that of men was hypertension and diabetes mellitus. Some factors, such as depression, exercise, and number of chronic diseases, affected both male and female participants, but others related to life satisfaction varied by gender. Therefore, it is necessary to consider the characteristics of multiple chronic diseases, and policy support should be provided in consideration of gender differences to improve the life satisfaction of the elderly.

Self-healing materials strive to emulate curable and resilient biological tissue but their performance is often insufficient for commercial applications because self-healing and toughening are mutually exclusive properties. Here, the authors report a tough and strong carbonate-type thermoplastic polyurethane elastomer that self-heals at ambient temperature.

Abstract Background The look-back period is needed to define baseline population for estimating incidence. However, short look-back period is known to overestimate incidence of diseases misclassifying prevalent cases to incident cases. The purpose of this study is to evaluate the impact of the various length of look-back period on the observed incidences of uterine leiomyoma, endometriosis and adenomyosis, and to estimate true incidences considering the misclassification errors in the longitudinal administrative data in Korea. Methods A total of 319,608 women between 15 to 54 years of age in 2002 were selected from Korea National Health Insurance Services (KNHIS) cohort database. In order to minimize misclassification bias incurred when applying various length of look-back period, we used 11 years of claim data to estimate the incidence by equally setting the look-back period to 11 years for each year using prediction model. The association between the year of diagnosis and the number of prevalent cases with the misclassification rates by each look-back period was investigated. Based on the findings, prediction models on the proportion of misclassified incident cases were developed using multiple linear regression. Results The proportion of misclassified incident cases of uterine leiomyoma, endometriosis and adenomyosis were 32.8, 10.4 and 13.6% respectively for the one-year look-back period in 2003. These numbers decreased to 6.3% in uterine leiomyoma and − 0.8% in both endometriosis and adenomyosis using all available look-back periods (11 years) in 2013. Conclusion This study demonstrates approaches for estimating incidences considering the different proportion of misclassified cases for various length of look-back period. Although the prediction model used for estimation showed strong R-squared values, follow-up studies are required for validation of the study results.

This study examines how shop managers’ attitudes toward customers are transferred to sales employees, and thus affect customer performance. We surveyed shop managers, sales employees, and customers in five department stores in Seoul, South Korea, in June 2021 to determine the relationships among service orientation, customer orientation, customers’ perceptions of sales employees’ authenticity, and customer performance. We found that sales managers’ service orientation positively influences sales employees’ service and customer orientation. Furthermore, this orientation positively correlates with customers’ perceptions of sales employees’ authenticity, thereby improving service performance and customer loyalty. Few studies have examined how institutional-level capacity and attitudes influence employees within organizations and how this, in turn, affects service performance. Thus, this study theoretically and empirically explores how sales managers’ attitudes and sales behaviors are transferred to sales employees and how this affects customer performance. The research findings fill a gap in the current understanding of customer performance in the service industry.

Abstract The demand for face masks is increasing exponentially due to the coronavirus pandemic and issues associated with airborne particulate matter (PM). However, both conventional electrostatic‐ and nanosieve‐based mask filters are single‐use and are not degradable or recyclable, which creates serious waste problems. In addition, the former loses function under humid conditions, while the latter operates with a significant air‐pressure drop and suffers from relatively fast pore blockage. Herein, a biodegradable, moisture‐resistant, highly breathable, and high‐performance fibrous mask filter is developed. Briefly, two biodegradable microfiber and nanofiber mats are integrated into a Janus membrane filter and then coated by cationically charged chitosan nanowhiskers. This filter is as efficient as the commercial N95 filter and removes 98.3% of 2.5 µm PM. The nanofiber physically sieves fine PM and the microfiber provides a low pressure differential of 59 Pa, which is comfortable for human breathing. In contrast to the dramatic performance decline of the commercial N95 filter when exposed to moisture, this filter exhibits negligible performance loss and is therefore multi‐usable because the permanent dipoles of the chitosan adsorb ultrafine PM (e.g., nitrogen and sulfur oxides). Importantly, this filter completely decomposes within 4 weeks in composting soil.

To address environmental concerns related to the large volume of plastics currently used, high-performance, sustainable, and satisfactorily performing bioplastics can be a solution. Isosorbide (ISB)-based amorphous poly(arylene ether sulfone)s (PAESs) derived from biomass feedstocks instead of harmful aromatic petrochemicals, such as bisphenol-A (BPA), are promising novel materials. To expand the range of eco-friendly products, ISB-PAES microfibers (ISU) along with BPA-PAES-based microfibers (PSU) have been fabricated through dry-jet wet spinning. ISU is mechanically 2.3 times stronger (247 MPa) than PSU (106 MPa), which may be ascribed to the compact and homogeneous structure of ISU compared to the porous structure of PSU. This structural superiority is due to the polar ISB moiety, which improves the phase stability of the ISU spinning dope in water (a role of the coagulant). For potential wig applications, the diameter, strength, and moduli of ISU are well matched to those of human hair. In addition, ISU is easily colored and endures high temperatures better than current wig filaments. It survives at high temperatures without breaking down during hair iron treatment (200 °C).

Abstract Synthesis of morphologically well-defined crystals of metalloporphyrin by direct crystallization based on conventional anti-solvent crystallization method without using any additives has been rarely reported. Herein, we demonstrate an unconventional and additive-free synthetic method named reverse anti-solvent crystallization method to achieve well-defined zinc-porphyrin cube crystals by reversing the order of the addition of solvents. The extended first solvation shell effect mechanism is therefore suggested to support the synthetic process by providing a novel kinetic route for reaching the local supersaturation environment depending on the order of addition of solvents, which turned out to be critical to achieve clean cube morphology of the crystal. We believe that our work not only extends fundamental knowledge about the kinetic process in binary solvent systems, but also enables great opportunities for shape-directing crystallization of various organic and organometallic compounds.

Introduction: The aim of this study was to determine the diagnostic value of single-photon emission computed tomography/computed tomography (SPECT/CT) in prediction of avascular necrosis (AVN) after femoral neck fracture and to evaluate whether photon defect in femoral head as seen in SPECT/CT can be an index for choice of surgical method. Methods: This study was based on 97 patients who took SPECT/CT after femoral neck fracture from November 2012 to November 2017, with 64 patients with femoral intertrochanteric fracture in which chances of AVN is rare as a comparison group. Among 97 patients with femoral neck fracture, osteosynthesis was conducted in 7 patients with less than 15% of photon defect in damaged femoral head and 7 patients who wanted osteosynthesis, despite photon defect more than 15%, and 83 patients with photon defect more than 25% had arthroplasty. Patient with osteosynthesis was followed up with AVN by conducting magnetic resonance imaging (MRI) in 1 year after the surgery. Results: Quantitative analysis of SPECT/CT in 14 patients who had femoral neck osteosynthesis showed that 7 patients with femoral neck fracture showed photon defect of 15% or more, but less than 25% and 3 patients in these were diagnosed with AVN after 1-year follow-up by MRI. Sensitivity and specificity of SPECT/CT in predicting AVN was 100% and 63.6%, respectively, with prediction accuracy of 71.4%. Among 14 patients with femoral neck fracture who had osteosynthesis, photon defect in 3 patients diagnosed with AVN was 19.6% ± 5.2%, but photon defect in 11 patients who was not diagnosed with AVN was 10.7% ± 5.2%, showing statistically significant difference between 2 groups ( P = .001). Conclusion: Single-photon emission computed tomography/CT in patients with femoral neck fracture is considered to have diagnostic value in predicting occurrence of AVN, and percentage of photon defect is considered to be an useful index in determining the operative method.

ObjectivesThe purpose of this study was to examine the function, health status, and efficacy effects of a combined exercise program using an iPad among older women in Korea, a tech-savvy country.MethodsThe study employed a pretest and posttest experimental design with a control group. The experimental group of subjects comprised 16 female older adults and the control group comprised 10 who were aged 65 years or older. The experimental group participated in a supervised group-based exercise program and an individualized home-based exercise program that involved the use of an iPad. The combined group and home-based exercise program consisted of group exercise, which took place in a senior center for 30 minutes weekly, and a home-based iPad exercise program, which the subjects followed at least 3 times a week. The collected data were analyzed using the Statistical Analysis System (SAS ver. 9.3 TS Level 1M0) program, which utilized a chi-square test, a Fisher exact test, a t-test, and a repeated-measures ANOVA.ResultsThe results showed that cognitive status changed significantly over time, and there was an interaction between group and time. Further, self-efficacy for exercise and outcome expectations for exercise changed significantly over time.ConclusionsExercise programs using iPad interventions may be useful for the management of cognitive functioning and the integration of functional physical abilities in older adults.

Patients with hormone receptor-positive breast cancer typically show favorable survival. However, identifying individuals at high risk of recurrence among these patients is a crucial issue. We tested the hypothesis that [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans can help predict prognosis in patients with hormone receptor-positive breast cancer.Between April 2004 and December 2008, 305 patients with hormone receptor-positive breast cancer who underwent FGD-PET were enrolled. Patients with luminal B subtype were identified by positivity for human epidermal growth factor receptor-2 (HER2) or high Ki67 (≥14%) according to criteria recently recommended by the St. Gallen panelists. The cut-off value of SUVmax was defined using the time-dependent receiver operator characteristic curve for recurrence-free survival (RFS).At a median follow up of 6.23 years, continuous SUVmax was a significant prognostic factor with a hazard ratio (HR) of 1.21 (p = 0.021). The cut-off value of SUVmax was defined as 4. Patients with luminal B subtype (n = 82) or high SUVmax (n = 107) showed a reduced RFS (p = 0.031 and 0.002, respectively). In multivariate analysis for RFS, SUVmax carried independent prognostic significance (p = 0.012) whereas classification with immunohistochemical markers did not (p = 0.274). The Harell c-index was 0.729. High SUVmax was significantly associated with larger tumor size, positive nodes, HER2 positivity, high Ki67 (≥14%), high tumor grade, and luminal B subtype.Among patients with hormone receptor-positive breast cancer, FDG-PET can help discriminate patients at high risk of tumor relapse.