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Background/Aims: A few studies have suggested the association between Helicobacter pylori (HP) infection and ischemic stroke. However, the impact of HP eradication on stroke risk has not been well evaluated. This study aimed to assess the influence of HP eradication on the incidence of ischemic stroke, considering the potential effect of sex. Methods: This prospective observational cohort study was conducted at Seoul National University Bundang Hospital, from May 2003 to February 2023, and involved gastroscopy-based HP testing. Propensity score (PS) matching was employed to ensure balanced groups by matching patients in the HP eradicated group (n=2,803) in a 3:1 ratio with patients in the HP non-eradicated group (n=960). Cox proportional hazard regression analysis was used to evaluate the risk of ischemic stroke. Results: Among 6,664 patients, multivariate analysis after PS matching indicated that HP eradication did not significantly alter the risk of ischemic stroke (hazard ratio, 0.531; 95% confidence interval, 0.221 to 1.270; p=0.157). Sex-specific subgroup analyses, both univariate and multivariate, did not yield statistically significant differences. However, Kaplan-Meier analysis revealed a potential trend: the females in the HP eradicated group exhibited a lower incidence of ischemic stroke than those in the HP non-eradicated group, although this did not reach statistical significance (p=0.057). Conclusion : s: This finding suggests that HP eradication might not impact the risk of ischemic stroke. However, there was a trend showing that females potentially had a lower risk of ischemic stroke following HP eradication, though further investigation is required to establish definitive evidence.

BackgroundOrganizational readiness for change, defined as the collective preparedness of organization members to enact changes, remains understudied in implementing sepsis survivor transition-in-care protocols. Effective implementation relies on collaboration between hospital and post-acute care informants, including those who are leaders and staff. Therefore, our cross-sectional study compared organizational readiness for change among hospital and post-acute care informants.MethodsWe invited informants from 16 hospitals and five affiliated HHC agencies involved in implementing a sepsis survivor transition-in-care protocol to complete a pre-implementation survey, where organizational readiness for change was measured via the Organizational Readiness to Implement Change (ORIC) scale (range 12–60). We also collected their demographic and job area information. Mann-Whitney U-tests and linear regressions, adjusting for leadership status, were used to compare organizational readiness of change between hospital and post-acute care informants.ResultsEighty-four informants, 51 from hospitals and 33 from post-acute care, completed the survey. Hospital and post-acute care informants had a median ORIC score of 52 and 57 respectively. Post-acute care informants had a mean 4.39-unit higher ORIC score compared to hospital informants (p = 0.03).ConclusionsPost-acute care informants had higher organizational readiness of change than hospital informants, potentially attributed to differences in health policies, expertise, organizational structure, and priorities. These findings and potential inferences may inform sepsis survivor transition-in-care protocol implementation. Future research should confirm, expand, and examine underlying factors related to these findings with a larger and more diverse sample. Additional studies may assess the predictive validity of ORIC towards implementation success.

Abstract Coronary artery fistula (CAF) is characterized as a congenital or acquired abnormal communication between a coronary artery and any of the four chambers of the heart (coronary–cameral fistula) or great vessels (coronary arteriovenous fistula) bypassing the capillaries within myocardium. CAF is a rare disease, challenging to diagnose and treat depending on the anatomical location and type of the fistula and accompanying diseases. This study aims to report a case with multiple coronary artery to coronary sinus (CS) fistulas with giant left circumflex artery and multivalvular infective endocarditis.

Abstract Glehnia littoralis, a medicinal herb employed in traditional practices for alleviating fatigue, cough, and a dry throat, is recognized for its beneficial properties due to a diverse array of active compounds found in its extracts. For example, the G. littoralis roots (Radix Glehniae) mainly contain coumarins and phenolic acids, serving as the primary focus of this study. Despite the widespread use of the tools in various industries and the development of multiple analytical methods for their examination, the edible aerial parts have industrial potential, and there is currently no analytical method available to identify their key components. In this study, a high-performance liquid chromatography method combined with diode array detection (HPLC–DAD) was developed to simultaneously detect 16 phenolic compounds previously reported to be present in the edible aerial parts of G. littoralis. The proposed approach included using gradient elution to change the solvent system from water/acetonitrile to water/methanol. Furthermore, the method validation was conducted, assessing its linearity, limit of detection, limit of quantification, precision, accuracy, and recovery, all of which demonstrated satisfactory results. Subsequently, the developed method was applied to quantify the phenolic compounds in various G. littoralis samples obtained from different organs, solvent extraction processes, and processing methods. Moreover, the online HPLC-ABTS (2,2ʹ-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) assay was used to evaluate the antioxidant capacities of individual constituents, identifying four important antioxidants and estimate the overall antioxidant capacity of the G. littoralis extract.

Understanding the molecular redox state is crucial for investigating chemical activities involving electron exchange, particularly in optical electrochemistry. Methyl viologen (MV) is commonly employed as a redox mediator and electron acceptor, exhibiting three distinct redox states (MV0, MV+, and MV2+), each characterized by a unique molecular structure and Raman spectrum. Utilizing surface-enhanced Raman spectroscopy (SERS), we explore the discrete molecular redox states of MV on shell-isolated nanoparticles (SHINs), which are gold nanoparticles (AuNPs) coated with silica shells of varying thicknesses, ranging from 1 to 10 nm. Our study, employing 532 nm excitation, reveals that all three redox forms of MV are sporadically observed on the metallic surfaces of AuNPs. However, the radical cation (MV+) state is predominantly detected on the silica surfaces of the SHINs, irrespective of the shell thickness. This consistency across different shell thicknesses suggests that electromagnetic (EM) effect predominantly contributes to the Raman enhancement in shell-isolated nanoparticle-enhanced Raman spectroscopy (SHINERS), rather than enhancement via electron transfer. If electron transfer were induced by laser excitation, varying redox species would likely appear dependent on shell thickness. Given the absence of external perturbation such as applied potential or reducing agents, we believe our findings can provide a crucial reference for future studies using MV as a redox state-sensing probe. Furthermore, our results demonstrate the efficacy of SHINs as a robust nano-sensing platform that efficiently prevents direct contact with the metallic surface and unwanted reactions.

Abstract Signal transducers are crucial in bioassay platforms for converting target detection into recordable signals. Commonly used color development for immunoassays involves enzymes and colorimetric substrates. However, due to cost and environmental issues, practical point‐of‐care testing requires alternative signal transducers. Growth‐induced extinction (absorption and scattering) of gold nanoclusters (AuNCs) is proposed as a novel approach for quantitative immunoassays. AuNCs devoid of localized surface plasmon resonance (LSPR) are used as seeds for growth reactions. Through reactions with a growth solution comprised of gold precursor and mild reductant, AuNCs of varying concentrations underwent controlled growth, resulting in nanoparticles of different sizes exhibiting distinct LSPR‐mediated extinction bands. Notably, the seed concentration exhibited a robust correlation with the resulting extinction of the grown particles on a small scale of 110 µL for a 96‐well microplate platform. To demonstrate this signal transduction mechanism, immunosorbent assays are performed using the conjugates of AuNC and detection antibody. The sandwich‐type assay successfully quantified a model antigen, human immunoglobulin G (hIgG), by monitoring LSPR wavelength and absorbance. This assay demonstrated a working range of 0.001–1 µg mL−1 and limit of detection of 1.19 ng mL−1. Signal transducers using the growth of AuNCs offer new alternative candidates for immunoassay platforms.

Introduction and Objectives: Acute kidney injury (AKI) is prevalent and has deleterious effects on postoperative outcomes following liver transplantation (LT). The impact of nonselective beta-blockers (NSBBs) in patients with liver cirrhosis remains controversial. This study investigated the association between preoperative NSBB use and AKI after living donor LT (LDLT). Patients and Methods: We evaluated 2,972 adult LDLT recipients between January 2012 and July 2022. The patients were divided into two groups based on the preoperative NSBB use. Propensity score matched (PSM) and inverse probability of treatment weighting (IPTW) analyses were performed to evaluate the association between preoperative NSBB use and postoperative AKI. Multiple logistic regression analyses were also used to identify the risk factors for AKI. Results: The overall incidence of AKI was 1,721 (57.9%) cases. The NSBB group showed a higher incidence of AKI than the non-NSBB group (62.4% vs. 56.7%; P = 0.011). After PSM and IPTW analyses, no significant difference in the incidence of AKI was found between the two groups (Odds ratio, OR 1.13, 95% confidence interval, CI 0.93–1.37, P = 0.230, PSM analysis; OR 1.20, 95% CI 0.99–1.44, P = 0.059, IPTW analysis). In addition, preoperative NSBB use was not associated with AKI after multivariate logistic regression analysis (OR 1.16, 95% CI 0.96–1.40, P = 0.118). Conclusions: Preoperative NSBB use was not associated with AKI after LDLT. Further studies are needed to validate our results.

In this paper, a solid state circuit breaker(SSCB) for a low voltage direct current (LVDC) system is presented. The LVDC distribution system such as a household distribution, require a DC input source, DC loads, and a DC circuit breaker. The major problems in the DC distribution system are the arc problem of disconnecting power from loads and a fast acting circuit breaker for the existing power converter. Therefore, a fast acting and high-voltage-withstanding circuit breaker such as the SSCB is required. The SSCB is composed of wide-band gap power semiconductor switch, such as a SiC MOSFET. It can operate in a very short time and contain the energy-absorbing or bypass circuit to protect itself and other components in the LVDC distribution system under a short circuit fault. In this paper, an SSCB using a SiC MOSFET for LVDC applications is presented. It contains a parallel bypass circuit to reduce the fault energy. The circuit of the SSCB was simulated using PSIM and validated experimentally using a prototype.

Synchronous renal malignancies are seldom encountered or diagnosed post-renal resection. A combination of renal cell carcinoma (RCC) and urothelial carcinoma (UC) is most commonly reported. Typically, the RCC subtype is clear-cell RCC; however, a combination of collecting duct carcinoma (CDC) and UC has rarely been reported in the existing literature. Here, we present two cases of synchronous renal malignancy, specifically a combination of CDC and UC, in the ipsilateral kidney.

Abstract Background Intravenous (IV) medication is commonly administered and closely associated with patient safety. Although nurses dedicate considerable time and effort to rate the control of IV medications, many medication errors have been linked to the wrong rate of IV medication. Further, there is a lack of comprehensive studies examining the literature on rate control of IV medications. This study aimed to identify the attributes of errors, facilitators, and barriers related to rate control of IV medications by summarizing and synthesizing the existing literature. Methods This scoping review was conducted using the framework proposed by Arksey and O’Malley and PRISMA-ScR. Overall, four databases—PubMed, Web of Science, EMBASE, and CINAHL—were employed to search for studies published in English before January 2023. We also manually searched reference lists, related journals, and Google Scholar. Results A total of 1211 studies were retrieved from the database searches and 23 studies were identified from manual searches, after which 22 studies were selected for the analysis. Among the nine project or experiment studies, two interventions were effective in decreasing errors related to rate control of IV medications. One of them was prospective, continuous incident reporting followed by prevention strategies, and the other encompassed six interventions to mitigate interruptions in medication verification and administration. Facilitators and barriers related to rate control of IV medications were classified as human, design, and system-related contributing factors. The sub-categories of human factors were classified as knowledge deficit, performance deficit, and incorrect dosage or infusion rate. The sub-category of design factor was device. The system-related contributing factors were classified as frequent interruptions and distractions, training, assignment or placement of healthcare providers (HCPs) or inexperienced personnel, policies and procedures, and communication systems between HCPs. Conclusions Further research is needed to develop effective interventions to improve IV rate control. Considering the rapid growth of technology in medical settings, interventions and policy changes regarding education and the work environment are necessary. Additionally, each key group such as HCPs, healthcare administrators, and engineers specializing in IV medication infusion devices should perform its role and cooperate for appropriate IV rate control within a structured system.

Abstract Background Various renal abnormalities, including hydronephrosis, polycystic kidney disease, and hydroureter, have been reported, and these abnormalities are present in DiGeorge syndrome, renal dysplasia, and acute kidney failure. Previous studies have shown that various genes are associated with renal abnormalities. However, the major target genes of nonobstructive hydronephrosis have not yet been elucidated. Results We examined neuroblast differentiation-associated protein Ahnak localization and analyzed morphogenesis in developing kidney and ureter. To investigated function of Ahnak, RNA-sequencing and calcium imaging were performed in wild type and Ahnak knockout (KO) mice. Ahnak localization was confirmed in the developing mouse kidneys and ureter. An imbalance of calcium homeostasis and hydronephrosis, which involves an expanded renal pelvis and hydroureter, was observed in Ahnak KO mice. Gene Ontology enrichment analysis on RNA-seq results indicated that ‘Channel Activity’, ‘Passive Transmembrane Transporter Activity’ and ‘Cellular Calcium Ion Homeostasis’ were downregulated in Ahnak KO kidney. ‘Muscle Tissue Development’, ‘Muscle Contraction’, and ‘Cellular Calcium Ion Homeostasis’ were downregulated in Ahnak KO ureter. Moreover, peristaltic movement of smooth muscle in the ureter was reduced in Ahnak KO mice. Conclusions Abnormal calcium homeostasis causes renal disease and is regulated by calcium channels. In this study, we focused on Ahnak, which regulates calcium homeostasis in several organs. Our results indicate that Ahnak plays a pivotal role in kidney and ureter development, and in maintaining the function of the urinary system.

Electrophotography is a digital, on-demand, dry, and page printing technique that operates based on toner particles of electronic materials using an electrostatic force and generates an electrical circuit via distribution of the toner particles. We developed a 10 μm linewidth resolution with various electronic materials, including conductors, semiconductors, and insulators, without any chemical pretreatments on the substrate films, while a 5 μm resolution was also possible for limited materials. The electrical resistivity of the printed Ag–Ni after an intense pulse light sintering was comparable to that of commercial indium tin oxide transparent films.

A colony of subterranean termites contains different castes such as workers and soldiers that perform various tasks. Foraging activity is vital among many tasks of a colony and ~20% of the worker population in a colony of Coptotermes formosanus engage in foraging. Although flexibility in task allocation plays a crucial role in maintaining colony function in fluctuating environments, such flexibility is barely understood in subterranean termites. Here, we investigated regulations of foraging task allocation in response to different soil types at the nest and the foraging site. At the nest and foraging site, either nitrogen-rich organic soil or nitrogen-poor sand, which differed in carbon and nitrogen ratio, was provided and the proportions of workers and soldiers at the foraging site were determined. Our results showed that the foraging worker proportion and per-capita wood consumption significantly differed depending on the soil type at the nest but not the soil type at the foraging site. When the colony had access to organic soil at the nest, the proportion of workers at the foraging site and per-capita wood consumption was much smaller than those with sand at the nest. Conversely, the proportion of soldiers at the foraging site remained the same regardless of the soil type at the nest and the foraging site. In brief, the current study showed flexible regulation of foraging task allocation in C. formosanus and demonstrated that perturbation of soil type alters the allocation of workers, but not soldiers, in the colony.

Abstract Elaborate task allocation is key to the ecological success of eusocial insects. Termite colonies are known for exhibiting age polyethism, with older instars more likely to depart the reproductive center to access food. However, it remains unknown how termites retain this spatial structure against external disturbances. Here we show that a subterranean termite Coptotermes formosanus Shiraki combines age polyethism and behavioral flexibility to maintain a constant worker proportion at the food area. Since this termite inhabits multiple wood pieces by connecting them through underground tunnels, disastrous colony splitting events can result in the loss of colony members. We simulated this via weekly removal of all individuals at the food area. Our results showed that termites maintained a worker proportion of ~ 20% at the food area regardless of changes in total colony size and demographic composition, where younger workers replaced food acquisition functions to maintain a constant worker proportion at the food area. Food consumption analysis revealed that the per-capita food consumption rate decreased with younger workers, but the colony did not compensate for the deficiency by increasing the proportion of workers at the feeding site. These results suggest that termite colonies prioritize risk management of colony fragmentation while maintaining suitable food acquisition efficiency with the next available workers in the colony, highlighting the importance of task allocation for colony resiliency under fluctuating environments.