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Abstract Plant pathogens secrete nuclear effectors into the host nuclei to modulate the host immune system. Although several nuclear effectors of fungal pathogens have been recently reported, the molecular mechanism of NLS-associated transport vehicles of nuclear effectors and the roles of NLS in transcriptional reprogramming of host immunity genes remain enigmatic. We previously reported the MoHTR1, a nuclear effector of the rice blast fungus, Magnaporthe oryzae. MoHTR1 is translocated to rice nuclei but not in fungal nuclei. Here, we identify the core NLS (RxKK) responsible for MoHTR1’s nuclear localization. MoHTR1 is translocated in the host nucleus through interaction with rice importin α. MoHTR1 NLS empowers it to translocate the cytoplasmic effectors of M. oryzae into rice nuclei. Furthermore, other nuclear effector candidates of the blast pathogen and rice proteins which have RxKK also exhibit nuclear localization, highlighting the crucial role of RxKK in this process. We also unveil the importance of SUMOylation in the stability of MoHTR1 and translocation of MoHTR1 to host nuclei. Moreover, MoHTR1 NLS is essential for the pathogenicity of M. oryzae by reprogramming immunity-associated genes in the host. Our findings provide insights into the significance of plant-specific NLS on fungal nuclear effectors and its role in plant-pathogen interactions.

Purpose Acetaminophen overdose accounts for the largest proportion of pediatric poisoning reported in South Korea. We investigated the characteristics and prognosis of pediatric acetaminophen overdose. Methods We retrospectively reviewed medical records of patients younger than 19 years with acetaminophen overdose who visited the emergency department (ED) of Pusan National University Children’s Hospital from January 2009 through December 2022. We investigated age, sex, dose, clinical findings, and treatment, and compared the differences in the variables according to the intentionality of ingestion and the presence of hepatotoxicity. Results Among the 132,691 pediatric patients who visited the ED during the period, 555 did for drug intoxication, of whom 51 with acetaminophen overdose were included in this study. The overdose was intentional in 43 patients (the intentional group; median age, 15.4 years [interquartile range, 13.9-16.8]) and accidental in 8 patients (the accidental group; 7.7 years [2.3-15.4]). The mean ingested dose was higher in the intentional group than in the accidental group (170.3 ± 129.0 vs. 105.3 ± 37.5 mg/kg; P = 0.016). Hospitalization tended to be implemented more frequently in the intentional group (53.5% vs. 12.5%; P = 0.081). All patients with hepatotoxicity (n = 10) belonged to the same group, and showed a higher or longer median age (15.9 [14.6-17.1] vs. 13.8 years [13.7-16.4]; P = 0.030), mean ingested dose (13,230.0 ± 10,544.8 vs. 7,654.0 ± 6,752.3 mg; P = 0.043), mean time from ingestion to arrival at the ED (22.6 ± 23.4 vs. 5.5 ± 6.4 hours; P = 0.048), and frequency of hospitalization (80.0% vs. 39.0%; P = 0.048). Conclusion It is necessary to track the occurrence of hepatotoxicity in patients who intentionally ingest acetaminophen.

Heavy-chain deposition disease (HCDD) is a rare disorder characterized by the deposition of monoclonal immunoglobulin. Due to the disease's rarity and diagnostic challenges, its prognosis is generally poor. Herein, we report a case of successful treatment of HCDD coexisting with multiple myeloma. A 56-year-old man presented at an outpatient clinic with complaints of whole-body pain, edema, and dyspnea that had persisted for 2 weeks. Diagnostic tests confirmed nephrotic syndrome, hematuria, and progressive renal failure. Serum immunofixation electrophoresis identified the presence of IgG kappa paraprotein. A diagnosis of multiple myeloma was established following a bone marrow biopsy. A renal biopsy revealed antibodies specific to the heavy chains of IgG on immunofluorescence, and electron microscopy showed diffuse electron-dense "powdery" densities in the glomerular basement membrane. Based on these findings, the patient was diagnosed with both HCDD and multiple myeloma. Following the diagnosis, the patient immediately began anti-plasma cell therapy using bortezomib, lenalidomide, and dexamethasone. Intermittent hemodialysis was initiated due to persistent azotemia during the diagnostic process; however, renal function improved significantly after only 1 month of therapy, allowing the discontinuation of dialysis. Early intervention with anti-plasma cell therapy, such as bortezomib, is known to improve prognosis in the early stages of the disease. This case report is presented to enhance understanding of HCDD and underscore the importance of prompt diagnosis and treatment in managing this rare condition.

ABSTRACT 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.IMPORTANCEThe 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.

Abstract Background Overweight, often known as obesity, is the abnormal and excessive accumulation of fat that exposes the health of a person at risk by increasing the likelihood that they may experience many chronic conditions. Consequently, obesity has become a global health threat, presenting serious health issues, and attracting a lot of attention in the healthcare profession and the scientific community. Method This study aims to explore the anti-adipogenic properties of 7-MEGA™ in an attempt to address obesity, using both in vitro and in vivo research. The effects of 7MEGA™ at three distinct concentrations were investigated in obese mice who were given a high-fat diet (HFD) and 3T3-L1 adipocytes. Results 7MEGA™ decreased the total fat mass, overall body weight, and the perirenal and subcutaneous white adipose tissue (PWAT and SWAT) contents in HFD mice. Additionally, 7MEGA™ showed promise in improving the metabolic health of individuals with obesity and regulate the levels of insulin hormone, pro-inflammatory cytokines and adipokines. Furthermore, Peroxisome proliferator-activated receptors (PPAR) α and γ, Uncoupling Protein 1 (UCP-1), Sterol Regulatory Element-Binding Protein 1 (SREBP-1), Fatty Acid-Binding Protein 4 (FABP4), Fatty Acid Synthase (FAS), Acetyl-CoA Carboxylase (ACC), Stearoyl-CoA Desaturase-1 (SCD-1) and CCAAT/Enhancer-Binding Protein (C/EBPα) were among the adipogenic regulators that 7MEGA™ could regulate. Conclusion In summary, this study uncovered that 7MEGA™ demonstrates anti-adipogenic and anti-obesity effects, suggesting its potential in combating obesity.

This study aims to analyze the motivations and participation and continuity factors of voluntary activities among retired government employees and, thus, offer theoretical and policy recommendations to encourage and retain their involvement. A total of 337 retired government employees in South Korea were surveyed in this study. First, this study found that the most important motivations for volunteering among retired government employees are other-oriented (altruistic) (67.5%) rather than self-oriented (egoistic) (29.2%). Second, personal difficulties in participating in volunteer activities for retired employees were lack of expertise, health problems, and economic burden. Third, the main characteristics of retired employees participating in volunteer activities were retirees who have volunteering experience while working in the past, are women, are active participants in religious activities, and have a high level of education. Finally, retired employees who continued to volunteer after retirement had the following characteristics: a relatively long post-retirement period, volunteer experience while in office, good economic conditions, self-recognized poor health conditions, and high overall life satisfaction.

Abstract Background Glycemic control is crucial in peritoneal dialysis (PD) patients with diabetes. Although fasting blood glucose (FBG) is the most commonly used index to measure blood glucose levels, there is currently no evidence supporting the association between FBG level and mortality risk in PD patients. Methods A total of 3548 diabetic PD patients between 2002 and 2018 were enrolled from the National Health Insurance Service database of Korea. We investigated the association between FBG levels and the risk of all‐cause and cause‐specific mortality. Results Patients with FBG levels 80–99 mg/dL exhibited the highest survival rates, whereas those with FBG levels ≥180 mg/dL had the lowest survival rates. Compared with FBG levels 80–99 mg/dL, the adjusted hazard ratios and 95% confidence interval for all‐cause mortality significantly increased as follows: 1.02 (0.87–1.21), 1.41 (1.17–1.70), 1.44 (1.18–2.75), and 2.05 (1.73–2.42) for patients with FBG 100–124 mg/dL, FBG 125–149 mg/dL, FBG 150–179 mg/dL, and FBG ≥180 mg/dL, respectively. The risk for all‐cause mortality also showed an increasing pattern in patients with FBG levels

Background Despite the widespread impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019, COVID-19) and vaccination in South Korea, our understanding of kidney diseases following these events remains limited. We aimed to address this gap by investigating the characteristics of glomerular diseases following the COVID-19 infection and vaccination in South Korea. Methods Data from multiple centers were used to identify de novo glomerulonephritis (GN) cases with suspected onset following COVID-19 infection or vaccination. Retrospective surveys were used to determine the COVID-19–related histories of patients who were initially not implicated. Bayesian structural time series and autoregressive integrated moving average models were used to determine causality. Results Glomerular diseases occurred shortly after the infection or vaccination. The most prevalent postinfection GN was podocytopathy (42.9%), comprising primary focal segmental glomerulosclerosis and minimal change disease, whereas postvaccination GN mainly included immunoglobulin A nephropathy (IgAN; 57.9%) and Henoch-Schönlein purpura nephritis (HSP; 15.8%). No patient progressed to end-stage kidney disease. Among the patients who were initially not implicated, nine patients with IgAN/HSP were recently vaccinated against COVID-19. The proportion of glomerular diseases changed during the pandemic in South Korea, with an increase in acute interstitial nephritis and a decrease in pauci-immune crescentic GN. Conclusion This study showed the characteristics of GNs following COVID-19 infection or vaccination in South Korea. Understanding these associations is crucial for developing effective patient management and vaccination strategies. Further investigation is required to fully comprehend COVID-19’s impact on GN.

Abstract Background Clinical practice guidelines on limitation of life-sustaining treatments (LST) in the intensive care unit (ICU), in the form of withholding or withdrawal of LST, state that there is no ethical difference between the two. Such statements are not uniformly accepted worldwide, and there are few studies on LST limitation in Asia. This study aimed to evaluate the predictors and outcomes of withholding and withdrawal of LST in Singapore, focusing on the similarities and differences between the two approaches. Methods This was a multicentre observational study of patients admitted to 21 adult ICUs across 9 public hospitals in Singapore over an average of three months per year from 2014 to 2019. The primary outcome measures were withholding and withdrawal of LST (cardiopulmonary resuscitation, invasive mechanical ventilation, and vasopressors/inotropes). The secondary outcome measure was hospital mortality. Multivariable generalised mixed model analysis was used to identify independent predictors for withdrawal and withholding of LST and if LST limitation predicts hospital mortality. Results There were 8907 patients and 9723 admissions. Of the former, 80.8% had no limitation of LST, 13.0% had LST withheld, and 6.2% had LST withdrawn. Common independent predictors for withholding and withdrawal were increasing age, absence of chronic kidney dialysis, greater dependence in activities of daily living, cardiopulmonary resuscitation before ICU admission, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, and higher level of care in the first 24 h of ICU admission. Additional predictors for withholding included being of Chinese race, the religions of Hinduism and Islam, malignancy, and chronic liver failure. The additional predictor for withdrawal was lower hospital paying class (with greater government subsidy for hospital bills). Hospital mortality in patients without LST limitation, with LST withholding, and with LST withdrawal was 10.6%, 82.1%, and 91.8%, respectively (p

Abstract There is a substantial rise in the global incidence of obesity. Brown rice contains metabolic substances that can help minimize the prevalence of obesity. This study evaluated nine brown rice varieties using probiotic fermentation using Pediococcus acidilacti MNL5 to enhance bioactive metabolites and their efficacy. Among the nine varieties, FBR-1741 had the highest pancreatic lipase inhibitory efficacy (87.6 ± 1.51%), DPPH assay (358.5 ± 2.80 mg Trolox equiv./100 g, DW), and ABTS assay (362.5 ± 2.32 mg Trolox equiv./100 g, DW). Compared to other fermented brown rice and FBR-1741 varieties, UHPLC-Q-TOF-MS/MS demonstrated significant untargeted metabolite alterations. The 17 most abundant polyphenolic metabolites in the FBR-1741 variety and 132 putative targets were assessed for obesity-related target proteins, and protein interaction networks were constructed using the Cystoscope software. Network pharmacology analysis validated FBR-1741 with active metabolites in the C. elegans obesity-induced model. Administration of FBR-1741 with ferulic acid improved lifespan decreased triglycerides, and suppressed the expression of fat-related genes. The enhanced anti-obesity properties of FBR-1741 suggest its implementation in obesity-functional food.

This article describes a complete control method that uses Laguerre exponentially weighted model predictive control (LEMPC) to help four-wheel independent drive electric vehicles stay stable and follow their paths. The proposed method incorporates an enhanced direct yaw moment control using a robust non-singular terminal sliding mode control framework. We evaluated traditional, Laguerre, and exponentially weighted model predictive control methodologies (TMPC, LMPC, and LEMPC), respectively, with comparisons of reduced computational load and complexity while maintaining path tracking. The weighted Laguerre model predictive control exhibits improved robustness and reduced computational time and load. The suggested strong non-singular terminal sliding mode control (NTSMC) combined with LEMPC improved control and stability in a wide range of maneuvering situations and levels of uncertainty. The synergistic impact of NTMSC with LEMPC was examined to improve path tracking efficacy and dynamic stability under diverse road conditions and disturbances. The effectiveness of the control strategy in handling and stability of vehicle at high speed while maintaining efficient path tracking was validated by simulation conducted in MATLAB/Simulink along with high-fidelity co-Simulink Carsim environment.

Thin-film-transistor-liquid crystal displays (TFT-LCDs) still dominate most of the display markets due to a big leap in image quality while keeping low cost and superior reliability, and its evolution is continuing to compete with emerging emissive displays. In this paper, recent progress in liquid crystal technologies mainly focusing on fringe-field switching (FFS) and polymer-stabilized vertical alignment (PS-VA) modes and materials for improving electro-optic performances is reviewed.

Studies on organotellurium compounds have not been extensively conducted due to a lack of tolerable synthetic methods, difficult isolation processes, and their chemical instabilities. Overcoming these hurdles, we developed an efficient and mild method for the selective synthesis of symmetrical diorganyl tellurides 1, a representative class of organotellurium compounds, using a proper reducing reagent. The reaction condition was optimized for the selective formation of 1 by forming the telluride dianion (Te2−) using a reducing reagent, sodium borohydride (NaBH4), and then followed by the addition of organyl halides. The optimized reaction condition was as follows: (1) Te (1.0 eq), NaBH4 (2.5 eq) in DMF for 1 h at 80 °C; (2) organyl halides (2.0 eq) for 3–5 h at 25–153 °C. Using this condition, 18 various diorganyl tellurides 1 were selectively and efficiently synthesized in reasonable yields (37–93%). The reaction pathways for the formation of diorganyl tellurides 1 were also investigated. Consequently, we established a practical and efficient method for the selective synthesis of diorganyl tellurides 1 as a representative class of organotellurium compounds.

Background: Single-injection adductor canal block (SACB) is one of the multimodal pain managements in total knee arthroplasty. The effect of an intrathecal local anesthetic is prolonged with an intraoperative dexmedetomidine infusion. Currently, SACB’s effect along with the prolonged spinal anesthesia effect by dexmedetomidine has not been studied elsewhere. Methods: Seventy-eight patients were randomized to either the SACB group (n = 39) or the control group (n = 39). Spinal anesthesia and continuous infusion of dexmedetomidine were performed intraoperatively. The SACB was performed using 15 mL of either 0.5% ropivacaine or normal saline in postanesthesia care unit postoperatively. Primary endpoint examined the average numerical rating scale (NRS) pain scores at 2, 6, 12, and 24 hours after SACB while resting or moving. The secondary outcomes were the morphine equivalent, postoperative nausea and vomiting score, quadriceps strength, and overall satisfaction score. Results: The SACB group showed a lower average NRS pain score until 24 hours than the control group (2.4 vs 3.3 resting, 3.4 vs 4.1 moving). Resting and moving NRS scores at 6 and 12 hours were significantly lower in the SACB group, whereas no difference was found at 2, 24, and 48 hours, regardless of movement. The satisfaction score was higher in the SACB group than in the control group (9 [7.3-10.0] vs 7 [5.3-8.8]), and morphine equivalent at 2 hours was lower in the SACB group (2 [1-3]) than in the control group (2.9 [1.6-4]). Conclusions: SACB provided an additional analgesic effect in patients undergoing total knee arthroplasty under spinal anesthesia with continuous dexmedetomidine intravenous infusion.

Background: Fruit bats are natural carriers of Nipah virus (NiV). The primary objective of this study is to identify potential reservoir species in a selected geographic regions. It is necessary to determine an accurate species identification of the associated reservoir bat species distributed in a specific region. Results: In this study, we collected 20 different bat specimens from the NiV-prone area of the Kushtia district. Among these, 14 were tissue samples (BT-1–14) and six were fecal samples (BF-1–6). We used the mitochondrial gene cytochrome b, one of the most abundant and frequently used genetic markers, for polymerase chain reaction amplification and sequencing. Out of the 20 samples, 12 tissue samples and 2 fecal samples were successfully amplified and sequenced. However, two tissue samples and four fecal samples yielded chimeric sequences, rendering them unsuitable for annotation. The sequences of the successfully amplified samples were compared to those deposited in the National Center for Biotechnology Information database using basic local alignment search tool to identify the bat specimen collected. The study identified six different bat species using both morphological and genetic data, which may carriers of the NiV. Conclusions: Our results suggest that additional research should be conducted to gather more information on fruit bats from different localities across the country. The study contributes to the establishment of appropriate measures for NiV carrying disease control and management.

An increase in the volume of endoscopic procedures performed in recent times has led to increasing detection rates of asymptomatic gastrointestinal subepithelial tumors. However, accurate diagnosis and risk assessment of these tumors preoperatively is challenging. A 70-year-old man patient visited the emergency department for evaluation of melena. Emergency endoscopy revealed an ulcerated subepithelial tumor (8 cm in size) in the gastric cardia and fundus. Computed tomography and upper endoscopy performed at another hospital 6 months earlier were reviewed; the mass showed a significant increase in size (from 2 cm to 8 cm). The patient underwent surgical resection of the mass and was diagnosed with a high-risk gastrointestinal stromal tumor (GIST). In this article, we describe a rare case of a rapidly growing GIST at a rate significantly greater than commonly reported rates.

Background: The compression therapy, which is the standard treatment for lymphedema patients, may be difficult to implement and contraindicated to some patients depending on their health condition. Objects: The purpose of this study is to investigate whether kinesiology taping (KT) can be used effectively and safely in the management of lymphedema as an alternative treatment through systematic review and meta-analysis. Methods: In February 2023, the literature was systematically collected through eight search engines with a combination of terms, ‘lymphedema’ and ‘kinesiology taping.’ We qualitatively analyzed the differences and safety of KT methods, and quantitatively meta-analyzed the effects of volume reduction in edema, range of motion (ROM), and pain improvement using Review Manager ver. 5. 4. To assess the risk of bias in the randomized controlled trial (RCT) studies, Risk of Bias was used. Results: A total of 616 articles searched and 20 studies were selected, including 12 RCTs and eight case studies. KT intervention could not replace multilayer compression bandage (MLB), but it demonstrated similar or better results compared to compression garment (CG), with reduced pain and improved intervention comfort. Studies reported skin adverse events ranging from 2.5% to 20.68%, with a total adverse event incidence of 7.7%. There was no significant difference in the application method of KT. As a result of the meta-analysis from the 8 RCTs, the KT intervention showed a mean difference (MD) of –7.18 with a 95% confidence interval (CI) [–12.64 to –1.72] in the volume change of lymphedema, while the pain difference was MD 0.82 with CI 95% [0.50 to 1.15], in comparison to the MLB and CG intervention. Conclusion: KT therapy led to a reduction in edema size, volume, pain, and improved ROM and quality of life. KT may be a viable option for lymphedema patients who have trouble applying traditional compression therapies.

Background/Aims We investigated the effect of rituximab on systemic bone metabolism in patients with seropositive rheumatoid arthritis (RA). Methods Twenty seropositive patients with RA were enrolled and administered one cycle of rituximab. If RA became active for > 6 months after the first rituximab cycle, a second cycle was initiated; otherwise, no additional treatment was administered. Patients were divided into two groups according to the number of rituximab treatment cycles. Results In patients treated with a second cycle, the total hip bone mineral density (BMD) was clinically low, whereas the serum levels of receptor activator of nuclear factor kappa-B ligand (RANKL) were increased at 12 months. BMD in patients treated with one cycle did not change at 12 months, whereas serum RANKL levels decreased at all time points. DAS28 activity improved in both groups from baseline to 4 months; however, from 4 to 12 months, DAS28 activity worsened in the group with the second cycle but remained stable in the group with one cycle. Conclusions Systemic inflammation, reflected by increased disease activity, may be responsible for the increase in RANKL levels, which causes systemic bone loss in rituximab-treated patients with RA. Although rituximab affects inflammation, it does not seem to alter systemic bone metabolism in RA.

Abstract Background Myalgic encephalitis/chronic fatigue syndrome (ME/CFS) is a long-term disabling illness without a medically explained cause. Recently during COVID-19 pandemic, many studies have confirmed the symptoms similar to ME/CFS in the recovered individuals. To investigate the virus-related etiopathogenesis of ME/CFS, we conducted a systematic assessment of viral infection frequency in ME/CFS patients. Methods We conducted a comprehensive search of PubMed and the Cochrane Library from their inception through December 31, 2022, using selection criteria of viral infection prevalence in ME/CFS patients and controls. Subsequently, we performed a meta-analysis to assess the extent of viral infections' contribution to ME/CFS by comparing the odds ratio between ME/CFS patients and controls (healthy and/or diseased). Results Finally, 64 studies met our eligibility criteria regarding 18 species of viruses, including a total of 4971 ME/CFS patients and 9221 control subjects. The participants included healthy subjects and individuals with one of 10 diseases, such as multiple sclerosis or fibromyalgia. Two DNA viruses (human herpes virus (HHV)-7 and parvovirus B19, including their co-infection) and 3 RNA viruses (borna disease virus (BDV), enterovirus and coxsackie B virus) showed odds ratios greater than 2.0 compared with healthy and/or diseased subjects. Specifically, BDV exceeded the cutoff with an odds ratio of ≥ 3.47 (indicating a "moderate association" by Cohen’s d test) compared to both healthy and diseased controls. Conclusion This study comprehensively evaluated the risk of viral infections associated with ME/CFS, and identified BDV. These results provide valuable reference data for future studies investigating the role of viruses in the causation of ME/CFS.

Abstract This retrospective cross-sectional study assessed older adults aged between 40 and 80 years, registered in the Korean National Health Insurance Service database from 2002 to 2019 to investigate the association between vestibular loss and the risk of dementia. The population was divided into three groups (general, vestibular loss, and hearing loss). The hazard ratios (HRs) of dementia in the vestibular and hearing loss groups were calculated using national population data. In total, 2,347,610 individuals were identified (general: 2,145,609, vestibular loss: 60,525, hearing loss: 141,476). Mean ages were 53.29 years, 58.26 years, and 58.52 years, respectively. Dementia occurred in 127,081 (IR = 4.91 per 1000 person-years), 7705 (IR = 10.79 per 1000 person-years), and 16,116 (IR = 9.63 per 1000 person-years) patients. The vestibular and hearing loss groups had hazard ratios for dementia of 1.084 (95% CI, 1.059–1.110) and 1.074 (95% CI, 1.056–1.092), respectively, compared with the general group. The results of the current study suggest that vestibular loss increases the risk of developing dementia. Therefore, similar to hearing loss, vestibular loss should be considered a risk factor for dementia, and treatments such as adequate vestibular rehabilitation may reduce this risk.

Temporary immersion system (TIS) cultures are reported to be superior when compared to semi-solid (SS) and liquid (LQ) cultures for the in vitro plant regeneration of many plant species. In the present study, we used a TIS for plant regeneration of Gerbera jemesonii “Shy Pink” and compared the results with that of SS and LQ cultures. The number of shoots regenerated in the SS, LQ, and TIS cultures was 6.93, 3.13, and 3.03, respectively. The shoots regenerated with the SS and LQ cultures demonstrated 3.33 and 4.22% hyperhydricity, whereas the shoots regenerated with the TIS were healthy even though the number of shoots regenerated was less. The plantlets regenerated with the TIS demonstrated higher values for the number of roots, root length, biomass of the plantlets, leaf length/width, and area compared to the SS and LQ cultures. When the G. jemesonii “Shy Pink” plants were regenerated using the TIS, their levels of photosynthetic pigments were highest. The number of stomata on the abaxial surface of their leaves was 11.40, and the frequency of closed stomata was 59% for the plants regenerated with the TIS. The number of stomata was 21.4 and 14.5 for the plants regenerated with the SS and LQ cultures, respectively. Meanwhile, the frequency of closed stomata was 13% and 15% for the plants regenerated with SS and LQ cultures. Furthermore, G. jemesonii “Shy Pink” showed the highest survival of plants when regenerated in the TIS compared to SS and LQ cultures. The TIS was found to be the most suitable culture system for plant regeneration of G. jemesonii “Shy Pink” compared to SS and LQ cultures.

Abstract This study investigated whether histopathological classification and histologic lesion scores could significantly and independently predict the progression to end-stage kidney disease (ESKD) in Korean patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis-glomerulonephritis (AAV-GN). This study included 113 patients with AAV-GN confirmed by kidney biopsy. The glomerular, tubulointerstitial, and vascular lesions were systematically assessed using a scoring system. The scoring system was adopted from the Banff scoring system but also the Oxford study and the revision of the ISN/RPS. For comparison, the scores were classified into two groups; the low, and the high, and the difference was investigated between ESKD and non-ESKD groups using Cox proportional analysis. At diagnosis, the median age was 59.0 years and 33.6% were males. Of 113 patients, 44.2% had ESKD progression during follow-up. There were significant differences in several kidney-, inflammation-, and AAV-pathogenesis-related variables between AAV-GN patients with ESKD and those without. The sclerotic class exhibited the worst renal prognosis among the four histopathological classes. Among histopathological features, high interstitial fibrosis, tubular atrophy and global glomerulitis scores were significantly associated with ESKD progression. Whereas multivariable Cox analysis revealed only a high global glomerulitis score which means global endocapillary hypercellularity in a larger number of glomeruli is an independent predictor of ESKD progression. Moreover, among clinical and histopathological features, a high global glomerulitis score could also predict ESKD progression in addition to serum blood urea nitrogen and creatinine. This study demonstrated the worst renal prognosis for the sclerotic class and first discovered that a high global glomerulitis score was an independent predictor of ESKD in patients with AAV-GN.

Purpose This study aimed to examine pediatric hospital nurses' perceptions and performance of family-centered care. Methods A descriptive study design was used. This study surveyed 162 nurses who worked at a single tertiary children's hospital in South Korea. The modified Family-Centered Care Scale was used to assess nurses' perceptions and performance of family-centered care. Barriers to the implementation of family-centered care were described in an open-ended format. Results Pediatric hospital nurses had a higher score for perceptions (mean score=4.07) than for performance (mean score=3.77). The collaboration subscale had the lowest scores for both perceptions and performance. The perceptions of family-centered care differed significantly according to the nurses’ clinical career in the pediatric unit and familiarity with family-centered care, while performance differed according to clinical career only. Perceptions and performance were positively correlated (r=.594, p

Human organotypic bone models are an emerging technology that replicate bone physiology and mechanobiology for comprehensive in vitro experimentation over prolonged periods of time. Recently, we introduced a mineralized bone model based on 3D bioprinted cell-laden alginate-gelatin-graphene oxide hydrogels cultured under dynamic loading using commercially available human mesenchymal stem cells. In the present study, we created cell-laden scaffolds from primary human osteoblasts isolated from surgical waste material and investigated the effects of a previously reported optimal cell printing density (5 × 106 cells/mL bioink) vs. a higher physiological cell density (10 × 106 cells/mL bioink). We studied mineral formation, scaffold stiffness, and cell morphology over a 10-week period to determine culture conditions for primary human bone cells in this microenvironment. For analysis, the human bone-derived cell-laden scaffolds underwent multiscale assessment at specific timepoints. High cell viability was observed in both groups after bioprinting (>90%) and after 2 weeks of daily mechanical loading (>85%). Bioprinting at a higher cell density resulted in faster mineral formation rates, higher mineral densities and remarkably a 10-fold increase in stiffness compared to a modest 2-fold increase in the lower printing density group. In addition, physiological cell bioprinting densities positively impacted cell spreading and formation of dendritic interconnections. We conclude that our methodology of processing patient-specific human bone cells, subsequent biofabrication and dynamic culturing reliably affords mineralized cell-laden scaffolds. In the future, in vitro systems based on patient-derived cells could be applied to study the individual phenotype of bone disorders such as osteogenesis imperfecta and aid clinical decision making.

Foods that contain components known for their health-promoting qualities, beyond just their nutritional value, are called functional foods. These particular components are referred to as functional food ingredients. Mainly, the bioactive peptides purified from food materials, including animal sources, have been identified as such functional food ingredients. In this review, we discuss the purification process of bioactive peptides from duck meat, egg and processing by-products. Additionally, we highlight the technologies currently used to purify bioactive peptides from sources other than duck, including modern computational techniques like insilico methodology or bioinformatics as well as and methods to enhance the purification process. These techniques can be applied in the future to purify bioactive peptides from duck in order to boost the efficacy of bioactive peptide purification. Furthermore, we summarize the bio-functional activities of bioactive peptides, purified from duck, which help to protect the body against various diseases, thereby proving their potential to be functional food ingredients.

Abstract A neoadjuvant immunotherapy platform clinical trial allows for rapid evaluation of treatment-related changes in tumors and identifying targets to optimize treatment responses. We enrolled patients with resectable pancreatic adenocarcinoma into such a platform trial (NCT02451982) to receive pancreatic cancer GVAX vaccine with low-dose cyclophosphamide alone (Arm A; n = 16), with anti-PD-1 antibody nivolumab (Arm B; n = 14), and with both nivolumab and anti-CD137 agonist antibody urelumab (Arm C; n = 10), respectively. The primary endpoint for Arms A/B - treatment-related change in IL17A expression in vaccine-induced lymphoid aggregates - was previously published. Here, we report the primary endpoint for Arms B/C: treatment-related change in intratumoral CD8+ CD137+ cells and the secondary outcomes including safety, disease-free and overall survivals for all Arms. Treatment with GVAX+nivolumab+urelumab meets the primary endpoint by significantly increasing intratumoral CD8+ CD137+ cells (p = 0.003) compared to GVAX+Nivolumab. All treatments are well-tolerated. Median disease-free and overall survivals, respectively, are 13.90/14.98/33.51 and 23.59/27.01/35.55 months for Arms A/B/C. GVAX+nivolumab+urelumab demonstrates numerically-improved disease-free survival (HR = 0.55, p = 0.242; HR = 0.51, p = 0.173) and overall survival (HR = 0.59, p = 0.377; HR = 0.53, p = 0.279) compared to GVAX and GVAX+nivolumab, respectively, although not statistically significant due to small sample size. Therefore, neoadjuvant and adjuvant GVAX with PD-1 blockade and CD137 agonist antibody therapy is safe, increases intratumoral activated, cytotoxic T cells, and demonstrates a potentially promising efficacy signal in resectable pancreatic adenocarcinoma that warrants further study.

Introduction: Epidemiological studies have reported an association between exposures to ambient air pollution and respiratory diseases, including chronic obstructive pulmonary disease (COPD). Pneumonitis is a critical driving factor of COPD and exposure to air pollutants (e.g., acrolein) is associated with increased incidence of pneumonitis. Objectives: Currently available anti-inflammatory therapies provide little benefit against respiratory diseases. To this end, we investigated the preventive role of curcumin against air pollutant-associated pneumonitis and its underlying mechanism. Methods: A total of 40 subjects was recruited from Chengdu, China which is among the top three cities in terms of respiratory mortality related to air pollution. The participants were randomly provided either placebo or curcumin supplements for 2 weeks and blood samples were collected at the baseline and at the end of the intervention to monitor systemic markers. In our follow up mechanistic study, C57BL/6 mice (n = 40) were randomly allocated into 4 groups: Control group (saline + no acrolein), Curcumin only group (curcumin + no acrolein), Acrolein only group (saline + acrolein), and Acrolein + Curcumin group (curcumin + acrolein). Curcumin was orally administered at 100 mg/kg body weight once a day for 10 days, and then the mice were subjected to nasal instillation of acrolein (5 mg/kg body weight). Twelve hours after single acrolein exposure, all mice were euthanized. Results: Curcumin supplementation, with no noticeable adverse responses, reduced circulating pro-inflammatory cytokines in association with clinical pneumonitis as positive predictive while improving those of anti-inflammatory cytokines. In the pre-clinical study, curcumin reduced pneumonitis manifestations by suppression of intrinsic and extrinsic apoptotic signaling, which is attributed to enhanced redox sensing of Nrf2 and thus sensitized synthesis and restoration of GSH, at least in part, through curcumin-Keap1 conjugation. Conclusions: Our study collectively suggests that curcumin could provide an effective preventive measure against air pollutant-enhanced pneumonitis and thus COPD.

In atmospheric chemistry, the Henry’s law constant (HLC) is crucial for understanding the distribution of organic compounds across gas, particle, and aqueous phases. Quantitative structure–property relationship (QSPR) models described in scientific research are generally tailored to specific groups or categories of substances and are often developed using a limited set of experimental data. This study developed a machine learning model using an extensive dataset of experimental HLCs for approximately 1100 organic compounds. Molecular descriptors calculated using alvaDesc software (v 2.0) were used to train the models. A hybrid approach was adopted for feature selection, ensuring alignment with the domain knowledge. Based on the root mean squared error (RMSE) of the training and test data after cross-validation, Gradient Boosting (GB) was selected as a model for predicting HLC. The hyperparameters of the selected model were optimized using the automated hyperparameter optimization framework Optuna. The impact of features on the target variable was assessed using the SHapley Additive exPlanations (SHAP). The optimized model demonstrated strong performance across the training, evaluation, and test datasets, achieving coefficients of determination (R2) of 0.96, 0.78, and 0.74, respectively. The developed model was used to estimate the HLC of compounds associated with carbon capture and storage (CCS) emissions and secondary organic aerosols.

The edible flowers of marigold (Tagetes spp.) are cultivated for their aesthetic appeal and high utility as functional health food ingredients. Carotenoid and flavonoid contents in marigold petals highlight the importance of selecting the appropriate cultivar and its processing methods for their industrial applications. The comparative understanding of the effects of dry processing on functional components across different marigold cultivars is still lacking. Therefore, this study investigated functional compound changes in the dry processing effect on four marigold cultivars with distinct flower shapes (Durango, Inca) and colors (yellow, orange). The petals in hot air drying (HAD) with 30, 60, and 90 °C applications were analyzed for the measurement of their individual secondary metabolite contents, total phenolic and flavonoid contents, and antioxidant activities. In freeze drying (FD), the lutein content varied significantly based on flower color, exhibiting higher levels in cultivars with orange petals. Otherwise, the levels of quercetin derivatives displayed distinct differences based on varieties other than color, with Inca cultivars demonstrating higher levels of quercetin 7-O-glucoside (Q7G) than Durango cultivars. In HAD, the lutein levels show a tendency to increase above 60 °C regardless of the cultivar. The content of quercetin glycosides decreased, while the aglycone increased in HAD treatments, regardless of the temperatures. Correlation and PCA results highlighted the impact of phenol compounds on antioxidant activity. Overall, these findings underscore the significance of variety and color in determining the chemical composition and antioxidant properties of marigold flowers.

Inverted organic light-emitting devices (OLEDs) have been aggressively developed because of their superiorities such as their high stability, low driving voltage, and low drop of brightness in display applications. The injection of electrons is a critical issue in inverted OLEDs because the ITO cathode has an overly high work function in injecting electrons into the emission layer from the cathode. We synthesized hexagonal wurtzite ZnO nanoparticles using different oxidizing agents for an efficient injection of electrons in the inverted OLEDs. Potassium hydroxide (KOH) and tetramethylammonium hydroxide pentahydrate (TMAH) were used as oxidizing agents for synthesizing ZnO nanoparticles. The band gap, surface defects, surface morphology, surface roughness, and electrical resistivity of the nanoparticles were investigated. The inverted devices with phosphorescent molecules were prepared using the synthesized nanoparticles. The inverted devices with ZnO nanoparticles using TMAH exhibited a lower driving voltage, lower leakage current, and higher maximum external quantum efficiency. The devices with TMAH-based ZnO nanoparticles exhibited the maximum external quantum efficiency of 19.1%.

The goal of this study was to examine the factorial structure, internal consistency, test-retest reliability, criterion validity, convergent validity, and discriminant validity of the Brief Strengths Scale-12 (BSS-12) in Korean population. The Korean sample comprised 288 college students (68.1% were female), ranging in age 19 to 30 years (mean age = 21.65 years, SD = 1.98). Results showed that a three-factor model with exploratory structural equation modeling provided a better model fit than the other competing models. Indices of internal consistency reliability, criterion validity, convergent validity, and discriminant validity of the BSS-12 were acceptable. These results suggest that the BSS-12 can be used as an effective tool for measuring character strengths in Korean population.

Habitat-specific and movement-related behavioral studies are essential for the development of sustainable biodiversity management practices. Although the number of studies on sika deer is increasing, habitat utilization distribution (UD)-related studies remain limited. In this study, we investigated the habitat UD behavior of sika deer (Cervus nippon) using a literature survey and an experimental study on Suncheon Bonghwasan Mountain, South Korea. We reviewed home range-related literature on sika deer published between 1982 and 2019 in order to assess their estimation methods, study region, and research background. We observed that the number of studies on sika deer has increased. The minimum convex polygon (MCP) has been utilized the most to estimate habitat UD, followed by the kernel density (KD), the Brownian bridge model, and a combination of these methods. The average home ranges (95 % utilization distribution) of sika deer from the literature survey were 236.99 ha and 1183.96 ha using the minimum convex polygon and kernel density approaches, respectively. The five female deer in our experimental study on Suncheon Bonghwasan Mountain had a mean home range of 66.831 ± 15.241 ha using the MCP approach and 78.324 ± 20.82 ha using the KD approach. The UD behavior of sika deer explored in this research is expected to benefit future scholars and policymakers when formulating deer management and wildlife conservation strategies.

The National Institutes of Health (NIH) lupus nephritis activity and chronicity indices, which comprise six activity scores and four chronicity scores, have a long development history. The 2018 revised International Society of Nephrology/Renal Pathology Society classification for lupus nephritis adopted the most recent NIH indices to replace subclasses A, C, and A/C. Although an evidence-based approach should further evaluate the clinical significance of the modified NIH indices, recent validation studies demonstrated that the modified chronicity indices have a strong correlation with kidney outcome of lupus nephritis.

Background: The precise underlying mechanism of antioxidant effects of dexmedetomidine-induced neuroprotection against cerebral ischemia has not yet been fully elucidated. Activation of Nuclear factor erythroid 2-related factor (Nrf2) and Heme Oxygenase-1 (HO-1) represents a major antioxidant-defense mechanism. Therefore, we determined whether dexmedetomidine increases Nrf2/HO-1 expression after global transient cerebral ischemia and assessed the involvement of Protein Kinase C (PKC) in the dexmedetomidine-related antioxidant mechanism. Methods: Thirty-eight rats were randomly assigned to five groups: sham (n...=...6), ischemic (n...=...8), chelerythrine (a PKC inhibitor; 5...mg.kg-1 IV administered 30...min before cerebral ischemia) (n...=...8), dexmedetomidine (100.....g.kg-1 IP administered 30...min before cerebral ischemia (n...=...8), and dexmedetomidine...+...chelerythrine (n...=...8). Global transient cerebral ischemia (10...min) was applied in all groups, except the sham group; histopathologic changes and levels of nuclear Nrf2 and cytoplasmic HO-1 were examined 24...hours after ischemia insult. Results: We found fewer necrotic and apoptotic cells in the dexmedetomidine group relative to the ischemic group (p...

Study Design Cadaveric biomechanics study. Purpose This study investigated the effects of unilateral sacroiliac joint (SIJ) fixation for fusion with/without L5–S1 fixation on contralateral SIJ range of motion (ROM). Overview of Literature SIJ fusion raises concerns that unilateral SIJ stabilization for fusion may increase contralateral SIJ mobility, leading to accelerated SIJ degeneration. Also, prior lumbosacral fixation may lead to accelerated SIJ degeneration, due to adjacent level effects. SIJ fixation biomechanics have been evaluated, showing a reduced-ROM, but SIJ fixation effects on contralateral nonfixated SIJ remain unknown. Methods Seven human lumbopelvic spines were used, each affixed to six-degrees-of-freedom testing apparatus; 8.5-Nm pure unconstrained bending moments applied in flexion-extension, lateral bending, and axial rotation. The ROM of left and right SIJ was measured using a motion analysis system. Each specimen tested as (1) intact, (2) injury (left), (3) L5–S1 fixation, (4) unilateral stabilization (left), (5) unilateral stabilization+L5–S1 fixation, (6) bilateral stabilization, and (7) bilateral stabilization+L5–S1 fixation. Both left-sided iliosacral and posterior ligaments were cut for injury condition to model SIJ instability before surgery. Results There were no statistical differences between fixated and contralateral nonfixated SIJ ROM following unilateral stabilization with/without L5–S1 fixation for all loading directions (p>0.930). Injured condition and L5–S1 fixation provided the largest motion increases across both joints; no significant differences were recorded between SIJs in any loading direction (p>0.850). Unilateral and bilateral stabilization with/without L5–S1 fixation reduced ROM compared with the injured condition for both SIJs, with bilateral stabilization providing maximum stability. Conclusions In the cadaveric model, unilateral SIJ stabilization with/without lumbosacral fixation did not lead to significant contralateral SIJ hypermobility; long-term changes and in vivo response may differ.

Abstract Burnout is a form of negative emotional and physical response to job stress. This study aimed to investigate the prevalence of burnout among healthcare workers responding to the coronavirus disease 2019 (COVID-19) outbreak in Korea and to explore correlates of burnout among healthcare workers. A nationwide questionnaire-based survey was conducted from December 1, 2020, to January 29, 2021 on 1425 healthcare workers who worked in one of the 16 healthcare facilities designated for COVID-19 care, in public health centers, or as paramedics in Korea. Burnout was assessed using 16 Korean-adapted items based on the Oldenburg Burnout Inventory (OLBI). Data were collected using a structured questionnaire and analyzed using the R version 4.1.1 software program. OLBI results indicate clinically exhaustion in 84.5% (1204/1425) and clinically disengagement in 91.1% (1298/1425), and 77.3% (1102/1425) met the score criteria for both the exhaustion and disengagement subscales for burnout. Burnout rate was significantly increased in the group with chronic fatigue symptoms (Fatigue Severity Scale ≥ 3.22) after the outbreak of COVID-19 (OR, 3.94; 95% CI 2.80–5.56), in the female group (OR, 2.05; 95% CI 1.46–2.86), in the group with physical symptoms (Patient Health Questionnaire-15 ≥ 10) after the outbreak of COVID-19 (OR, 2.03; 95% CI 1.14–3.60), in the group with a higher Global Assessment of Recent Stress scale (OR, 1.71; 95% CI 1.46–2.01), in the group with post-traumatic stress symptoms (Primary Care Post-Traumatic Stress Disorder-5 ≥ 2) (OR, 1.47; 95% CI 1.08–2.01), and in the younger age group(OR, 1.45; 95% CI 1.22–1.72). The chronic fatigue symptoms were correlated with cumulative days of care (OR, 1.18; 95% CI 1.02–1.37). The physical symptoms were correlated with average contact hours with COVID-19 patients per day (OR, 1.34; 95% CI 1.17–1.54), and cumulative days of care (OR, 1.21; 95% CI 1.06–1.38). Most Korean healthcare workers suffered from burnout related to excessive workload during the COVID-19 pandemic. During a widespread health crisis like COVID-19, it is necessary to regularly check the burnout status in healthcare workers and reduce their excessive workload by supplementing the workforce and providing appropriate working hours sufficient rest hours.

Abstract Background The popular statistics-based Genome-wide association studies (GWAS) have provided deep insights into the field of complex disorder genetics. However, its clinical applicability to predict disease/trait outcomes remains unclear as statistical models are not designed to make predictions. This study employs statistics-free machine-learning (ML)-optimized polygenic risk score (PRS) to complement existing GWAS and bring the prediction of disease/trait outcomes closer to clinical application. Rheumatoid Arthritis (RA) was selected as a model disease to demonstrate the robustness of ML in disease prediction as RA is a prevalent chronic inflammatory joint disease with high mortality rates, affecting adults at the economic prime. Early identification of at-risk individuals may facilitate measures to mitigate the effects of the disease. Methods This study employs a robust ML feature selection algorithm to identify single nucleotide polymorphisms (SNPs) that can predict RA from a set of training data comprising RA patients and population control samples. Thereafter, selected SNPs were evaluated for their predictive performances across 3 independent, unseen test datasets. The selected SNPs were subsequently used to generate PRS which was also evaluated for its predictive capacity as a sole feature. Results Through robust ML feature selection, 9 SNPs were found to be the minimum number of features for excellent predictive performance (AUC > 0.9) in 3 independent, unseen test datasets. PRS based on these 9 SNPs was significantly associated with (P 0.9) of RA in the 3 unseen datasets. A RA ML-PRS calculator of these 9 SNPs was developed ( https://xistance.shinyapps.io/prs-ra/ ) to facilitate individualized clinical applicability. The majority of the predictive SNPs are protective, reside in non-coding regions, and are either predicted to be potentially functional SNPs (pfSNPs) or in high linkage disequilibrium (r2 > 0.8) with un-interrogated pfSNPs. Conclusions These findings highlight the promise of this ML strategy to identify useful genetic features that can robustly predict disease and amenable to translation for clinical application.