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Abstract Distinguishing between pathologic complete response and residual cancer after neoadjuvant chemotherapy (NAC) is crucial for treatment decisions, but the current imaging methods face challenges. To address this, we developed deep-learning models using post-NAC dynamic contrast-enhanced MRI and clinical data. A total of 852 women with human epidermal growth factor receptor 2 (HER2)-positive or triple-negative breast cancer were randomly divided into a training set (n = 724) and a validation set (n = 128). A 3D convolutional neural network model was trained on the training set and validated independently. The main models were developed using cropped MRI images, but models using uncropped whole images were also explored. The delayed-phase model demonstrated superior performance compared to the early-phase model (area under the receiver operating characteristic curve [AUC] = 0.74 vs. 0.69, P = 0.013) and the combined model integrating multiple dynamic phases and clinical data (AUC = 0.74 vs. 0.70, P = 0.022). Deep-learning models using uncropped whole images exhibited inferior performance, with AUCs ranging from 0.45 to 0.54. Further refinement and external validation are necessary for enhanced accuracy.

Tire particles leach 1,3-diphenylguanidine (DPG) into aquatic environments, raising concern about the chemical, and ecological impact. This study investigated the acute and multigenerational chronic effects of DPG on freshwater water fleas (Moina macrocopa), focusing on toxicity, reproductive and growth implications, antioxidant responses and oxidative stress biomarkers. Acute exposure revealed dose-dependent mortality increase with a significant reduction in Chronic exposure to a sub-lethal concentration of 0.5 mg/L DPG across four generations (P0, F1, F2, and F3) demonstrated substantial declines in reproductive output and growth metrics, alongside increased reactive oxygen species (ROS)activity and suppressed antioxidant enzyme activities, including, superoxide dismutase (SOD), catalase (CAT). Glutathione levels (GSH and GSSG) were reduced, with elevated GSH/GSSG ratios suggesting disrupted redox homeostasis. Pearson correlation analysis highlighted significant relationships between DPG presence and physiological and biochemical parameters, indicating a potential cascade of adverse effects stemming from oxidative stress. These findings underscore the ecological risk of DPG exposure, warranting further investigation into its toxicological pathways to protect aquatic ecosystems.

Background: Emerging research has suggested a link between ambient temperature and mental and neurological conditions such as depression and dementia. This systematic review aims to summarize the epidemiological evidence on the effects of ambient temperature on mental and neurological conditions in older adults, who may be more vulnerable to temperature-related health effects compared to younger individuals. Methods: A systematic search was conducted in PubMed, Ovid/Embase, Web of Science, and Ovid/PsycINFO on July 17, 2023, and updated on July 31, 2024. We included epidemiological studies investigating the association between ambient temperature exposures and numerous mental and neurological conditions in populations aged 60 years and older. Exclusions were made for studies on indoor or controlled exposure, suicide, substance abuse, those not published as peer-reviewed journal articles, or those not written in English. The risk of bias of included studies was assessed using a tool developed by the World Health Organization (WHO). Qualitative synthesis was performed on all eligible studies, and random-effects meta-analyses were conducted on groups of at least four studies sharing similar study design, exposure metric, and health outcome. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework modified by the WHO. Results: From 16,786 screened articles, 76 studies were deemed eligible, primarily from mainland China and North America. There was notable heterogeneity in study variables and methodologies. The most commonly used exposure metrics were daily absolute temperature and heat waves, and time-series and case-crossover analyses were the most frequently employed study designs. Meta-analysis of four studies on the effect of a 1 °C increase in temperature on hospital admissions/visits for mental disorders showed a pooled risk ratio (RR) of 1.014 (95 % Confidence Interval, CI: 1.001, 1.026). Comparing heat wave days to non-heat wave days, pooled effect estimates showed increased risk in hospital admissions/visits (RR: 1.269; 95 % CI: 1.030, 1.564; six studies) and mortality related to mental disorders (RR: 1.266; 95 % CI: 0.956, 1.678; four studies). Despite the limited number of studies on cold exposures, they consistently reported that lower temperatures were associated with an increased risk of various mental and neurological conditions. Conclusions: This review presents epidemiological evidence of the adverse impacts of ambient temperature exposures, such as high temperatures and heat waves, on mental and neurological conditions among the older adult population, with overall moderate certainty. The findings highlight the need for greater attention to the mental and neurological health of older adults in the context of climate change and population aging.Registration number (PROSPERO ID): CRD42023428137.

Background/Objectives: The aim of this study was to investigate the effect of a custom neck collar with negative sensory feedback for the treatment of torticollis that was previously unresponsive to conservative or surgical treatment. Methods: Twenty-four children diagnosed with unresponsive or intractable torticollis were enrolled in this two-stage, single-arm study. The ipsilateral aspect of the orthosis is adjustable in height and designed to provide support between the clavicle and the mandibular angle on the tilted side. In stage 1 (the adjustment period), the orthosis with a smooth surface was applied for 2 h per day for 3 months. In stage 2, a rough surface with a hook-and-loop fastener (Velcro©) was attached to the collar, and it was worn for a further 2 h a day for 3 months. Twenty children (mean age 63.95 ± 13.44 months) were included in the analysis. Results: The mean torticollis angle was 17.60 ± 5.65° (mean ± SD) at baseline; 14.15 ± 3.62° directly after stage 1; and 6.00 ± 3.67° directly after stage 2 (X2 = 36.685, df = 19, p = 0.000). Conclusions: This study demonstrated the feasibility, therapeutic effect, and safety of a novel tactile feedback orthosis for the treatment of children with torticollis. The use of a custom neck collar with negative sensory feedback may be a viable therapeutic option for the treatment of unresolved or intractable torticollis.

Abstract We investigated the correlation between standardized uptake value (SUV) of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) and conductivity parameters in breast cancer and explored the feasibility of conductivity as an imaging biomarker. Both SUV and conductivity have the potential to reflect the tumors’ heterogeneous characteristics, but their correlations have not been investigated until now. Forty four women diagnosed with breast cancer who underwent breast MRI and 18F-FDG PET/CT at the time of diagnosis were included. Among them, 17 women received neoadjuvant chemotherapy followed by surgery and 27 women underwent upfront surgery. For conductivity parameters, maximum and mean values of the tumor region-of-interests were examined. For SUV parameters, SUVmax, SUVmean, and SUVpeak of the tumor region-of-interests were examined. Correlations between conductivity and SUV were evaluated, and among them, the highest correlation was observed between mean conductivity and SUVpeak (Spearman’s correlation coefficient = 0.381). In a subgroup analysis for 27 women with upfront surgery, tumors with lymphovascular invasion (LVI) showed higher mean conductivity than those without LVI (median: 0.49 S/m vs 0.06 S/m, p

Purpose This study aimed to evaluate the role of Doppler ultrasound (US) and elastography to identify residual breast cancer for patients showing near complete response following chemotherapy on magnetic resonance imaging (MRI). Methods Between September 2016 and January 2018, 40 breast cancer patients who showed near complete response (either tumor size ≤0.5 cm or lesion-to-background parenchymal signal enhancement ratio ≤1.6) on MRI following neoadjuvant chemotherapy were prospectively enrolled. After excluding seven women who did not undergo Doppler US and elastography, 33 women (median age, 49 years; range, 32 to 67 years) were analyzed. On the day of surgery, women underwent Doppler US and elastography for tumor bed prior to US-guided core needle biopsy. Histopathologic results of biopsy and surgery were evaluated. Negative predictive value (NPV) and false negative rate (FNR) of biopsy and the combined Doppler US and elastography were analyzed, respectively. Results After surgery, nine women had residual cancers and 24 women had pathologic complete response. The NPV and FNR of biopsy were 92% (24 of 26) and 22% (2 of 9), respectively. The NPV and FNR of combined Doppler US and elastography were 100% (14 of 14) and 0% (0 of 9), respectively. All of nine women with residual cancers had positive vascularity or elasticity. Two women with false-negative biopsy results, having 0.3 cm or 2.5 cm ductal carcinoma in situ at surgery, showed positive vascularity or elasticity. Conclusion Tumor bed showing positive vascularity or elasticity indicates residual breast cancer for patients showing near complete response on MRI following chemotherapy.

Since February 2022, the Ukrainian refugee crisis has been highlighting mental health problems associated with trauma and distress. This study aimed to evaluate the mental health status of twenty-seven refugee minors (10 to 18 years old) who fled Ukraine and temporarily settled in the Republic of Korea (ROK). This cross-sectional survey study aimed to evaluate the mental health status of ethnic Korean Ukrainian refugee minors. The Child and Adolescent Trauma Screen—Youth Report (CATS), generalized anxiety disorder seven-item scale (GAD-7), and subjective unit of distress scale (SUDs) were used for assessment. A preliminary analysis indicated that 77% Ukrainian refugee minors were exposed to and experienced war-related trauma. They are at a relatively low risk of trauma symptoms, anxiety, and distress due to stable family and visa status and a comparably better environment in the ROK. Meanwhile, refugee teenagers showed higher rates of psychological distress compared with refugee children. This finding suggests that an early psychological interventions in a host country may be beneficial to prevent mental health issues in refugee minors.

Objective To analyze the correlation between standardized language assessment batteries of toddlers and developmental language delays. Methods A total of 319 children with suspected language developmental delays were enrolled in this study retrospectively. They underwent the Receptive and Expressive Vocabulary Test (REVT) for vocabulary development assessment and at least one of two language assessment batteries: The Sequenced Language Scale for Infants (SELSI) or the Preschool Receptive-Expressive Language Scale (PRES) for language development assessment. The correlation of the results for receptive and expressive language between the scales were analyzed. Results The participants were divided into two groups: SELSI and REVT (n=45) and PRES and REVT (n=273). When the children’s results were classified into groups (average, mild delay, and delay), receptive and expressive scores were significantly correlated with each other in both SELSI-REVT and PRES-REVT groups. In addition, the correlation of mean developmental age between tests are analyzed. In the SELSI-REVT group, there was weak correlation of mean developmental age between tests for receptive and expressive language. In the PRES-REVT group, there was a strong positive correlation of mean developmental age for receptive and expressive language in children aged >36 months. Attention deficits during the test was found to be the statistically significant factor affecting the differences between the tests. The odds ratios for receptive and expressive language were 2.60 (95% confidence interval,1.15–5.84) and 1.94 (95% confidence interval, 1.15–3.27), respectively. Conclusion This study examined the correlations and influencing factors between language development evaluation tools for toddlers. An integrated interpretation of comprehensive language and vocabulary evaluation tools may be possible in children older than 3 years of language developmental age.

Abstract An input‐series quasi‐resonant (QR) flyback high‐voltage switching mode power supply (SMPS) based on an integrated transformer has been designed and analysed. It is capable of converting a high DC input voltage to lower DC voltage to power the control components of high‐power converters in a DC microgrid. An integrated transformer, combined with identical duty cycle control, is adopted to achieve automatic equalization of the series modules effectively even without employing any voltage or current equalization control strategy, of which effect is analysed theoretically. The design of the control system, based on QR flyback SMPS is given, which is implemented by peak current control, and a DCM small‐signal model for the designed SMPS is established, which indicates that the system has high stability and accuracy to ensure normal operation across a broad range of input voltages. Finally, the validity of the theoretical analysis and the proposed method is demonstrated by the development of a 48 W SMPS experimental prototype, which is composed of three input‐series modules. The overall efficiency of the prototype has been improved due to the adoption of QR. The proposed design and analysis methods can be extended to other input‐series isolated DC/DC topologies.

As biochar improves soil fertility and crop productivity, there is a growing interest in it as a resource for sustainable agriculture. Miscanthus sacchariflorus has promising applications in various industries because it has a large amount of biomass. However, research on the agricultural utilization of Miscanthus-derived biochar is insufficient. The aim of this study was to demonstrate the effects of Miscanthus biochar on the soil environment and soybean growth. First, Miscanthus biochar was amended at different levels (3 or 10 tons/ha) in upland soil, after which the soil properties, root development, and yield of soybeans were compared with the control (without biochar). In the soil amended with 10 tons/ha of biochar (BC10), organic matter (OM) and available phosphate increased 1.6 and 2.0 times, respectively, compared with that in the control soil (CON). In addition, the soil dehydrogenase activity increased by 70% in BC10, and 16S rRNA gene sequence analysis revealed that the structure of the microbial community changed after amendment with biochar. The bacterial phyla that differed between CON and BC10 were Acidobacteria and Chloroflexi, which are known to be involved in carbon cycling. Owing to these changes in soil properties, the root dry weight and number of nodules in soybeans increased by 23% and 27%, respectively, and the seed yield increased 1.5-fold in BC10. In conclusion, Miscanthus biochar increased the fertility of soybean-growing soil and consequently increased seed yield. This study is valuable for the practical application of biochar for sustainable agriculture.

Abstract Background Schizophrenia requires a community-based intervention approach combined with standard treatment to prevent relapses. A literature review is required to understand the effectiveness of community-based interventions and to enhance quality in countries where they have not been fully established. This is a protocol for a systematic review of the effectiveness of community-based interventions for patients with schizophrenia spectrum disorders. Methods We will search (from inception to January 2021) PubMed/MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, and Research Information Sharing Service/Korean databases. Randomized controlled trials on community-based interventions for patients with schizophrenia spectrum disorders will be eligible. The comparison groups will include patients with schizophrenia spectrum disorders who are only receiving the usual care and those who also receive community-based interventions. The schizophrenia spectrum disorders referred to in this study are defined according to the DSM-5: delusional disorders, schizophrenic disorders, and schizoaffective disorder will be included. Relapse/re-hospitalization rates (primary outcome) and quality of life (secondary outcome) will be identified for each group. Two reviewers will independently screen study titles, abstract data, and full-text articles and perform the data extraction process. Potential conflicts will be resolved through discussion. The study risk of bias will be appraised using the Cochrane Risk of Bias 2.0 tool. Results will be descriptively synthesized and will be structured according to patients’ characteristics, intervention type and exposure, and outcome type. If feasible and appropriate, outcome data will be used to perform random effects meta-analyses. Discrete variables will be calculated via odds ratio, and continuous variables will be calculated via standardized mean difference using RevMan 5.3 software. Discussion We will provide a summary of the available evidence on the effectiveness of community-based interventions and specific guidelines to improve their outcomes. Systematic review registration PROSPERO ( CRD42019145660 ).

Background The effect of a forest therapy in a natural environment noted that the forest therapy induced a state of relaxation among workers, thereby decreasing cortisol levels and work-related stress. Objective The primary objective of this study is to determine the effects of the forest therapy for employees in the manufacturing industry on psychological stress responds, stress hormone and heart rate variability (HRV). The secondary objective is to determine the effects of the forest therapy for employees in the manufacturing industry on cytotoxic activity of natural killer (NK) cells, health-related quality of life and mood states compare to urban untreated and remained in urban environment. Methods Forty-two employees were recruited from a single workplace located in Incheon city, Republic of Korea. Participants were allocated to either an experimental group (n= 21), wherein they participated in the forest therapy and or a control group (n= 21), wherein they were given no treatment. Participants were assigned to these groups on a randomized, open-label basis. Pre and post-test measures of natural killer (NK) cell activity, salivary cortisol, heart rate variability (HRV), health-related quality of life, stress response, and mood states were taken for both groups. Results The results showed that participants who took part in the forest therapy showed greater physiological improvement when compared to those in the control group, as indicated by a significant increase in some HRV measures. The forest therapy also contributed to a significantly greater decrease in work-related stress symptoms and a significantly greater improvement in health-related quality of life and mood states compared to participants in the control group. Conclusions These results may suggest that the forest therapy could be an effective means of relaxation technique, reducing stress and leads to an increase in positive mood for employees in the manufacturing industry.

OBJECTIVES The purpose of this study is to investigate the relationship between the habits of physical activities in several intensities, drinking, and smoking of the general public who live in the S city and diabetes, high blood pressure, high-density lipoprotein cholesterol, plasma triglyceride, and waist circumference of them. METHODS For research, residents of 2,438,370 in S city were selected by using the big data of health checkups sheets that were conducted by the National Health Insurance Corporation in 2017. Physical activities were classified into three groups by intensity. The part of drinking was divided into three groups of non-alcohol, low, and high-drinking people. There were four groups in smoking of non-smoking, the group that smoke lower than the half pack of cigarettes per day, the half to one pack, and more than one pack. Metabolic syndrome frequency analysis and logistic regression analysis were used for this research. RESULTS Compared to the low-intensity physical activity group, the high-intensity group had 0.992, 0.954, 0.871, 0.83, and 0.878 times of lower risk in fasting plasma glucose, blood pressure, high density lipoprotein (HDL-C), plasma triglycerides, and abnormal waist circumference. High drinking group had more risk of fasting plasma glucose, blood pressure, HDL-C, plasma triglyceride, and abnormal waist circumference by 1.326, 1.894, 1.334, 2.125 and 1.263 times than non-drinking group. The group who smoked more than one pack a day had more risk of fasting plasma glucose, blood pressure, HDL-C, plasma triglyceride, and abnormal waist circumference by 1.971, 1.225, 3.229, 2.871, and 1.522 times than the group of non-smoking. CONCLUSION The subjects who did not have risk factors for metabolic syndrome were 29.7%. The average of patients with metabolic syndrome was 25.2%, of which males were 30.3%, and females were 20.1% of them. Metabolic syndrome factors were proved statistically valid. In the physical activity group, the high-intensity physical activity group had a lower risk of metabolic syndrome factors than the low and medium-intensity physical activity groups. The high-drinking group had a higher risk of metabolic syndrome in triglycerides, and the smoking group who smoked more than one pack per day had a higher risk of metabolic syndrome in high-density lipoprotein cholesterol.

Tumour necrosis is associated with tumour aggressiveness and poor outcomes in patients with glioblastomas, but the underlying mechanisms remain poorly understood. Here, the authors show that in a xenograft mouse model of glioblastoma, tumour-infiltrating neutrophils amplify necrosis by promoting myeloperoxidase-induced tumour cell ferroptosis.

Abstract Background Traditional Korean medicine (TKM) has been employed for the treatment of children with cerebral palsy in Korea; however, the addition of TKM to usual rehabilitation (UR) treatment is hindered by insufficient evidence of clinical improvement with TKM in patients with cerebral palsy. In this study, we will evaluate the effectiveness and safety of integrative medicine rehabilitation (IMR) for cerebral palsy through a randomized controlled clinical study. Methods Eighty children (2–6 years old) diagnosed with cerebral palsy will be recruited and randomly divided into groups A and B. Patients in group A will receive IMR with UR, while those in group B will receive only UR during weeks 1–12 of the study. IMR includes acupuncture treatment (head and limb acupuncture) three times a week and the administration of herbal medicine (Yukgunza-tang and Yukmijihwang-tang extracts) twice a day in parallel with UR. Evaluations will be conducted at the beginning of the study and at 12 and 24 weeks (follow-up). The primary outcome is the Gross Motor Function Measure-88 score, and the secondary outcomes are the scores for the Goal Attainment Scale, Korean Bayley Scales of Infant Development III, and the Pediatric Quality of Life Inventory, and adverse events. Discussion This will be the first pragmatic randomized controlled trial to evaluate the efficacy and safety of IMR in children with cerebral palsy in Korea. The results will help to demonstrate if IMR is an effective therapeutic approach for cerebral palsy. Trial registration Ministry of Food and Drug Safety 31361 ( http://www.mfds.go.kr ). Registered on 29 June 2017. Clinical Research Information Service KCT0002620 ( https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=9819 ). Registered on 29 December 2017.

Abstract Background Attachment in the parent-infant dyads is fundamental for growth and development of children born prematurely. However, the natural process of attachment is interrupted just after preterm birth, and emotional and physical detachment, limited social interaction, and a traumatic, technologically heavy environment in a neonatal intensive care unit (NICU) may result in impaired attachment or bonding. To our knowledge, few studies have evaluated the effectiveness of interventions aimed at enhancing attachment, bonding, and relationships between parents and their preterm infants during the infant’s hospitalization in the NICU. This study aims to perform a comprehensive systematic review and a meta-analysis survey of the effects of attachment- and relationship-based interventions in the NICU. Method A comprehensive literature review will be conducted in the following databases: MEDLINE, CINAHL, PubMed, EMBASE (OVID), Scopus, PsycINFO (OVID), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science. Selected studies will be published in English, in the last 20 years, from 1999 onwards. All studies of randomized controlled trials (e.g., parallel groups, cluster) will be included. We will consider studies evaluating attachment- and relationship-based interventions (e.g., skin-to-skin contact, parental involvement in infant care) versus a comparator (standard of care). The primary outcome will be maternal attachment. Secondary outcomes will include infants’ growth and development, family health, and parenting experience. Data extraction from eligible studies will be conducted independently by two experts who will compare their data. The Cochrane risk of bias tool will be applied to the selected studies. If data permits, we will conduct random effects meta-analysis where appropriate. Subgroup and additional analyses will be conducted to explore the potential sources of heterogeneity considering gender of parents, infants’ sex, and gestational age. Data synthesis will be carried out using the RevMan 5.3 software. Publication bias will be assessed with the graphical funnel plot method and the Egger test. The quality of the evidence will be rated using the methods of the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. Discussion The results of this systematic review will discuss the types of attachment- or relationship-based interventions that are effective for facilitating family health outcomes and the babies’ growth and development and will contribute to establishing new evidence in neonatal and family-centered care by providing scientific guidance for clinical practice and further research. Systematic review registration PROSPERO CRD42019145834

This review examined recently published (July 2014 to June 2017), randomized controlled trials (RCTs) which investigated the safety and effectiveness of combined Korean medicine/complementary alternative medicine (CAM) and Western medicine, to indicate the direction for integrative medical practice. The Korean Medicine Convergence Research Information Center evidence-based medicine database (KMCRIC EBM DB) was used to retrieve relevant RCTs indexed in the last 3 years. Study design, country, sample size, disease/condition with the Korean Standard Classification of Diseases code, interventions, direction of outcomes, and adverse events were extracted and summarized. A total of 93 RCTs were included in this review. Acupuncture/moxibustion was the most commonly used intervention (n = 47; 51%), and 19% (n = 18) of the studies treated musculoskeletal disorders, followed by circulatory disorders (n = 16; 17%), and mental and behavioral disorders (n = 9; 10%). Integrative treatment was reported as more effective than monotherapy in approximately 83% of these studies. Adverse events were poorly reported in most studies. This review suggests that integrative treatments are feasible, effective, and safe for various diseases/conditions, based on the evidence from recently published RCTs. Future studies on integrative healthcare are warranted.

Objective To investigate longitudinal changes in language function in left-hemispheric ischemic stroke patients as well as factors that influence language recovery until 1 year after stroke onset. Methods We analyzed data from 235 patients with first-ever left-hemispheric ischemic stroke. All patients completed the Korean version of the Frenchay Aphasia Screening Test (K-FAST) at 7 days (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after stroke onset. Repeated measures analysis of variance (ANOVA) was used to investigate changes in language function between time points. Subgroup analysis was performed according to the K-FAST scores at T1. Stroke lesion volume was assessed using diffusion tensor images, and involvement of language-related brain regions was examined. Multiple regression analysis was used to analyze factors influencing improvement of K-FAST score. Results The K-FAST scores at T1, T2, T3, and T4 differed significantly (p

We herein report the microstructure, optical and electrothermal properties of a series of reduced graphene oxide (RGO) thin films, which are manufactured by spin-coating (1 and 3 layers) of graphene oxide (GO) dispersion on a quartz substrate and thermal reduction at different temperatures of 800–1000 °C. The energy dispersive X-ray spectra reveal that the relative carbon content of RGO films increases from 84.3 at% to 93.5 at% with increasing the thermal reduction temperature from 800 °C and 1000 °C, whereas the oxygen content decreases from 15.7 at% to 6.5 at%. The optical transmittance of RGO1 (1 spin-coating layer) and RGO3 (3 spin-coating layers) films at 550 nm is characterized 32.7–40.8% and 6.3–12.4%, respectively, although it decreases with increasing the thermal reduction temperature. The sheet resistance of RGO1 films decreases from 5160 Ω/sq to 1220 Ω/sq with the increment of the thermal reduction temperature, whereas the sheet resistance of RGO3 films decreased from 1080 Ω/sq to 350 Ω/sq. The decreases in optical transparency and sheet resistance values of RGO thin films are due to the successful reduction of GO films with oxygen-related functional groups to electrically conductive graphene films during the thermal treatment. The RGO thin films are characterized to exhibit high performance electrothermal behavior in terms of uniform temperature distribution, controllable steady-state saturated temperatures, rapid temperature responsiveness, and electric power efficiency at input power densities.

Assessment of functional independence and residual disability is very important for measuring treatment outcome after stroke. The modified Rankin Scale (mRS) and the modified Barthel Index (MBI) are commonly used scales to measure disability or dependence in activities of daily living (ADL) of stroke survivors. Lack of consensus regarding MBI score categories has caused confusion in interpreting stroke outcomes. The purpose of this study was to identify the optimal corresponding MBI and modified Rankin scale (mRS) grades for categorization of MBI. The Korean versions of the MBI (K-MBI) and mRS were collected from 5,759 stroke patients at 3 months after onset of stroke. The sensitivity and specificity were calculated at K-MBI score cutoffs for each mRS grade to obtain optimally corresponding K-MBI scores and mRS grades. We also plotted receiver operating characteristic (ROC) curves of sensitivity and specificity and determined the area under the curve (AUC). The K-MBI cutoff points with the highest sum of sensitivity and specificity were 100 (sensitivity 0.940; specificity 0.612), 98 (sensitivity 0.904; specificity 0.838), 94 (sensitivity 0.885; specificity 0.937), 78 (sensitivity 0.946; specificity, 0.973), and 55 (sensitivity 937; specificity 0.986) for mRS grades 0, 1, 2, 3, and 4, respectively. From this result, the K-MBI cutoff score range for each mRS grade can be obtained. For mRS grade 0, the K-MBI cutoff score is 100, indicating no associated score range. For mRS grades 1, 2, 3, 4, and 5, the K-MBI score ranges is from 99 to 98, 97 to 94, 93 to 78, 77 to 55, and under 54, respectively.The AUC for the ROC curve was 0.791 for mRS grade 0, 0.919 for mRS grade 1, 0.970 for mRS grade 2, 0.0 for mRS grade 3, and 0.991 for mRS grade 4. The K-MBI cutoff score ranges for representing mRS grades were variable; mRS grades 0, 1, and 2 had narrow K-MBI score ranges, while mRS grades 3, 4, and 5 exhibited broad K-MBI score ranges. mRS grade seemed to sensitively differentiate mild residual disability of stroke survivors, whereas K-MBI provided more specific information of the functional status of stroke survivors with moderate to severe residual impairment.

The scientific community has increasingly focused on forming transformation products (TPs) from environmental organic pollutants. However, there is still a lot of discussion over how these TPs are generated and how harmful they are to living terrestrial or aquatic organisms. Potential transformation pathways, TP toxicity, and their mechanisms require more investigation. Non-target screening (NTS) via high-resolution mass spectrometry (HRMS) in model organisms to identify TPs and the formation mechanism on various organisms is the focus of this review. Furthermore, uptake, accumulation process, and potential toxicity with their detrimental consequences are summarized in various organisms. Finally, challenges and future research initiatives, such as performing NTS in a model organism, characterizing and quantifying TPs, and evaluating future toxicity studies on TPs, are also included in this review.

Abstract Background To provide effective interventions for spasticity, accurate and reliable spasticity assessment is essential. For the assessment, the Modified Tardieu Scale (MTS) has been widely used owing to its simplicity and convenience. However, it has poor or moderate accuracy and reliability. Methods We proposed a novel inertial measurement unit (IMU)-based MTS assessment system to improve the accuracy and reliability of the MTS itself. The proposed system consists of a joint angle calculation algorithm, a function to detect abnormal muscle reaction (a catch and clonus), and a visual biofeedback mechanism. Through spastic knee and ankle joint assessment, the proposed IMU-based MTS assessment system was compared with the conventional MTS assessment system in 28 children with cerebral palsy by two raters. Results The results showed that the proposed system has good accuracy (root mean square error 0.8), while the conventional MTS system has poor or moderate reliability. Moreover, we found that the deteriorated reliability of the conventional MTS system comes from its goniometric measurement as well as from irregular passive stretch velocity. Conclusions The proposed system, which is clinically relevant, can significantly improve the accuracy and reliability of the MTS in lower limbs for children with cerebral palsy.

ObjectiveTo investigate the current status of pharmacotherapy prescribed by physiatrists in Korea for cognitive-behavioral disorder.MethodsA cross-sectional study was performed by mailing questionnaires to 289 physiatrists working at teaching hospitals. Items on the questionnaire evaluated prescribing patterns of 16 drugs related to cognitive-behavioral therapy, the status of combination pharmacotherapy, and tools for assessing target symptoms.ResultsFifty physiatrists (17.3%) including 24 (48%) specializing in neurorehabilitation completed the questionnaires. The most common target symptom was attention deficit (29.5%). Donepezil and methylphenidate (96.0%) were the most frequently prescribed drugs for cognitive-behavioral improvement. Mostly, a combination of two drugs was prescribed (38.0%), and the most common combination therapy included donepezil plus methylphenidate (19.1%). Pharmacotherapy for cognitive-behavioral disorder after brain injury was typically initiated within 2 months (69.5%). A follow-up assessment was usually performed at 1 month after treatment initiation (31.0%). The most common reason for treatment discontinuation was improvement of target symptoms (37.8%). The duration of pharmacotherapy was 3–12 months (57.7%), 1–2 years (17.9%), or 1–2 months (13.6%).ConclusionAccording to the survey, combination pharmacotherapy is preferred to monotherapy for the treatment of cognitive-behavioral disorder in patients with brain injury. Physiatrists expressed diverse views on the definition of target symptoms, prescribing patterns, and the status of drug combination therapy. Guidelines are needed for cognitive-behavioral pharmacotherapy. Further research should investigate drug costs and aim to reduce polypharmacy and adverse drug reactions.

In a previous report, 3-aminopropyl functionalized magnesium phyllosilicate (aminoclay) improved adenovirus transduction efficiency by shielding the negative surface charges of adenovirus particles. The present study analyzed the physicochemical characterization of the electrostatic complex of adenoviruses with aminoclay and explored whether it could be utilized for enhancing tumor suppressive activity in the bladder. As a result of aminoclay-adenovirus nanobiohybridization, its transduction was enhanced in a dose-dependent manner, increasing transgene expression in bladder cancer cells and in in vivo animal models. Physicochemical studies demonstrated that positively charged aminoclay led to the neutralization of negative surface charges of adenoviruses, protection of adenoviruses from neutralizing antibodies and lowered transepithelial electrical resistance (TEER). As expected from the physicochemical properties, the aminoclay enabled tumor-targeting adenoviruses to be more potent in killing bladder cancer cells and suppressing tumor growth in orthotopic bladder tumors, suggesting that aminoclay would be an efficient, versatile and biocompatible delivery carrier for intravesical instillation of adenoviruses.

In this study, an artificial stream mesocosm consisting of a head tank, faster-flowing riffle section, gravel section, pool section, lower-run section, and tail tank was installed to simulate a chemical spill in a river. The responses of freshwater periphyton algae, crustacea (Moina macrocopa), freshwater worm (Limnodrilus hoffmeisteri), benthic midge (Glyptotendipes tokunagai), and fish (Zacco platypus and Aphyocypris chinensis) were observed after exposure to benzyl chloride (classified as an accident preparedness substance, APS) at concentrations of 1, 2, and 4 µL/L for 22.5 h. Higher concentrations increased the inhibition (photosynthetic efficiency decrease) of periphyton algae and the mortality of M. macrocopa, whereas the reproduction of the female cladoceran decreased in the 4 µL/L treatment. Mortality of fish did not occur or was lower (≤20%) at all concentrations; however, toxic symptoms were observed for some time after chemical exposure termination and later, symptoms receded. G. tokunagai mortality increased at all concentrations except the control after seven days, and no significant toxic effects were observed in L. hoffmeisteri. The hazardous concentration of benzyl chloride was calculated as 94 µg/L. This study showed the different sensitivities of each species to benzyl chloride. The findings can assist in environmental risk assessment of APSs after chemical spills to protect Korean aquatic species.

PURPOSE The purpose of this study was to compare and analyze the effects of Taekwondo training including 8-week inspiratory muscle training on physical fitness, CRP, pulmonary function and isokinetic muscle function of middle-aged male smokers. METHODS 21 middle-aged male smokers were divided into 3 groups: inspiratory muscle training+Taekwondo training group (n=7), Taekwondo training group (n=7) and control group (n=7). Measurement variables were physical fitness (Body composition, muscular strength, muscular endurance, flexibility, cardiorespiratory function, balance), CRP, pulmonary function (FVC, FEV1, FEV1/FVC), and isokinetic muscle function (peak torque %BW, average power %BW). The repeated measure ANOVA was conducted to analyze the differences and interactions between groups and periods. In the case of any difference, t-test was conducted to perform post hoc test between pre and post treatment and the contrast was conducted to perform post hoc test between groups. One-way analysis of variance (ANOVA) was used between groups, and repeated measures t-test was used between groups. All significance levels were verified at .05. RESULTS As a result, the combined exercise group also showed statistically significant changes in the physical fitness (Body composition, muscular strength, muscular endurance, flexibility, cardiorespiratory function), pulmonary function (FEV1, FEV1/FVC), and isokinetic muscle function (peak torque %BW). CONCLUSIONS Consequently, it shows that 8 weeks Taekwondo training including inspiratory muscle training made a positive effect on fat content, muscular strength, muscular endurance, cardio respiratory fitness, R-extension in peak torque %BW in middle-aged male smokers.

Studies have shown that insertion of oleic acid into lipid bilayers can modulate the membrane properties of liposomes so as to improve their function as drug carriers. Considering that 2-hydroxyoleic acid (2OHOA), a potential antitumor agent currently undergoing clinical trials, is a derivative of oleic acid, we explored the possibility of developing 2OHOA-inserted liposomes as a multifunctional carrier of antitumor drugs in the present study. The insertion of 2OHOA into lipid bilayers was confirmed by surface charge determination and differential scanning calorimetry. 2OHOA insertion greatly decreased the order of dimyristoylphosphatidylcholine packing, produced a nanosized (

Objective To investigate the rate of return to work and identify key factors associated with return to work between 3 months and 2 years after stroke.Design Prospective cohort study.Setting The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) in Korea.Participants A total of 193 persons with first-ever stroke who reported working status at 3 months after stroke.Outcome measures Data on baseline characteristics were collected from medical records. Functional assessments were performed using the National Institutes of Health Stroke Scale, the modified Rankin Scale, the Fugl-Meyer Assessment, the Functional Ambulatory Category, the Korean Mini-Mental State Examination, the Korean version of the Frenchay Aphasia Screening Test, the American Speech-Language-Hearing Association National Outcomes Measurement System, the Korean-Modified Barthel Index, the Geriatric Depression Scale-Short Form and the EuroQol-5 dimensions. An enumeration survey included the Reintegration to Normal Living Index, the Psychosocial Well-being Index-Short Form , the Family Support Index and the Caregivers Burden Index.Results Overall, 145 (75.1%) patients who had a stroke in the Continuously-Employed group and 48 (24.9%) in the Employed-Unemployed group returned to work between 3 months and 2 years after stroke. Multivariate logistic analysis demonstrated that in patients who had a stroke, characteristics such as age, PWI-SF Score, and caregiver characteristics, including age, sex (female) and living arrangements, were significantly associated with return to work between 3 months and 2 years after stroke.Conclusion Age and PWI-SF Score of patients who had a stroke, as well as the age, sex and living arrangements of caregivers, are key factors influencing the return to work after stroke.Trial registration number NCT03402451.

We studied the effect of derrone (DR), one of the major compounds of unripe fruits of Cudrania tricuspidata, on cancer cell death. DR inhibited cell growth of various cancer cells, and that was partially associated with apoptosis in A549 cells. DR showed the autophagic features, such as the conversion of LC3-I to LC3-II, the formation of autophagosome and the downregulation of SQSTM1/p62 (p62). The treatment of autophagy inhibitor reversed DR-mediated cell death, suggesting that DR induces autophagic cell death. The increase of cytoplasmic Ca2+ and ROS by DR treatment significantly influences the formation of autophagosomes; however, only ROS scavengers significantly rescued the reduced cell viability. Additional results revealed that treatment of DR induces sustained phosphorylation of ERK and the inhibition of ERK phosphorylation using U0126 (ERK inhibitor) markedly attenuated DR-induced cell death. Overall, these results suggest that DR induces autophagic cell death through intracellular ROS and sustained ERK phosphorylation in A549 cells.

Breast cancer is the second most common malignancy among Korean women. The incidence of breast cancer has increased since 1999, which is when the national screening program involving mammography started. Until now, the benefits of screening mammography have been emphasized, but information about its benefits and harms should be provided in a comprehensive fashion, in order to guide people toward making informed decisions. Although the main benefit of screening is reduction of breast cancer mortality, harms such as overdiagnosis, overtreatment, false positive and false negative diagnoses, and radiation-induced breast cancer, can all occur as a result of screening. The 2015 Korean guideline for breast cancer screening recommends biennial screening mammography for asymptomatic women aged 40 to 69 years. This review discusses the benefits and harms of screening mammography in light of evidence-based approaches obtained from randomized trials, meta-analysis, and guidelines.

This study reviewed new concept waterproofing performance gradation to respond to the limit of unified single standard performance standard used in each country from the past until now. This study was carried out using the standard test data from 34 products tested and evaluated by Korea’s national quality test institution for 2 years (2018~2019) based on national standard specification (KS F 4934, Self-Adhesive Rubberized Asphalt Sheet). Major proposal contents utilized the result values of 9 waterproofing performance evaluation criteria included in the national standard specification. Major study contents and results are as follows. Existing widely used domestic and overseas standard grading (Stanine, Sten Scores, Grade 5 Scale, energy consumption efficiency, and other grading) theories were investigated and analyzed. Based on the analysis contents, standard Grade 5 Scale system suitable for waterproofing material performance grading was selected and applied. Grade sections were set according to the application ratio for each grade section of Grade 5 Scale (grade 1 with 10%, grade 2 with 20%, grade 3 with 40%, grade 4 with 20% and grade 5 with 10%). According to the set sections, performance grades were derived for 9 test criteria of 34 products. Section setting standard for grade section was derived centered on the performance result values of 9 criteria. As a result, average value of waterproofing performance of each of 9 test criteria for 34 products was verified to have 1.2 times to 7.52 times higher performance value than the minimum quality standard (based on grade 5). Such results sufficiently showed the limit of the current unified single standard performance application. Also, as a solution for waterproofing quality degradation problem, possibility to apply the waterproofing performance grading of this study was verified. Therefore, through this study, it is decided that new concept quality standard to pursue future waterproofing industry development can be set, quality reinforcement is possible by performance grading for each product and sustainable waterproofing performance maintaining effect at the waterproofing construction site can be expected with the use of such gradation.

Despite enormous investment in air-quality regulations, there are only a few studies about the health effects of the air-quality regulations. By applying synthetic control methods to controlled-interrupted time-series analysis, this study aimed to test whether air-quality regulations implemented in Seoul metropolitan area since 2005 had reduced cardiovascular mortality rate in Seoul and Incheon. Each synthetic control for Seoul and Incheon was constructed to predict the counterfactual cardiovascular mortality rate through synthetic control methods. By using a synthetic control as a control group in controlled-interrupted time-series analysis, we tested whether the air-quality regulations had changed the trend of cardiovascular mortality rate in Seoul and Incheon after the intervention. The results showed a significant slope change in cardiovascular mortality rate in Seoul (coefficient: −0.001, 95% confidence interval (CI): −0.0015, −0.0004) and Incheon (coefficient: −0.0006, 95% CI: −0.0012, 0). This study suggests additional evidence that air-quality regulations implemented in the Seoul metropolitan areas since 2005 had beneficial effects on cardiovascular mortality rate in Seoul and Incheon.

Background and objectives: Aquatic exercises have demonstrated several advantages over land-based exercise, but only a few studies have compared the workout intensities and efficiencies in a stage-specific manner. This study aimed to investigate workout intensity during aquatic and land-based running, based on the rating of perceived exertion (RPE). Materials and Methods: Twenty healthy young male subjects underwent a land-based running test (LRT) and an aquatic running test (ART), in the form of a cardiopulmonary exercise treadmill test and a shallow-water running test. The seven stages of the ART were composed of 3 minutes each of the Bruce protocol performed during the LRT. In the ART, the participants were instructed to run in a swimming pool with matching RPE to that obtained at each stage of the LRT. Results: Heart rate (HR) during both LRT and ART exhibited a linear relationship (r = 0.997 and 0.996, respectively; p < 0.001). During the initial and middle period, HR was higher in the ART than in the LRT. However, in the final period, HR was higher in the LRT than in the ART. Conclusions: In aquatic exercises based on the RPE obtained from the LRT, HR exhibited a linear relationship in both the ART and the LRT. The ART appears to increase cardiac loading more efficiently in the initial period and does not increase cardiac loading abruptly at a later period. Although there is no precise, objective, controlled parameter to compare the ART and the LRT, the RPE may be used as a convenient measurement for workout intensity in aquatic running.

This retrospective study aimed to evaluate whether ultrasound texture analysis is useful to predict lymph node metastasis in patients with papillary thyroid microcarcinoma (PTMC). This study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. Between May and July 2013, 361 patients (mean age, 43.8 ± 11.3 years; range, 16-72 years) who underwent staging ultrasound (US) and subsequent thyroidectomy for conventional PTMC ≤ 10 mm between May and July 2013 were included. Each PTMC was manually segmented and its histogram parameters (Mean, Standard deviation, Skewness, Kurtosis, and Entropy) were extracted with Matlab software. The mean values of histogram parameters and clinical and US features were compared according to lymph node metastasis using the independent t-test and Chi-square test. Multivariate logistic regression analysis was performed to identify the independent factors associated with lymph node metastasis. Tumors with lymph node metastasis (n = 117) had significantly higher entropy compared to those without lymph node metastasis (n = 244) (mean±standard deviation, 6.268±0.407 vs. 6.171±.0.405; P = .035). No additional histogram parameters showed differences in mean values according to lymph node metastasis. Entropy was not independently associated with lymph node metastasis on multivariate logistic regression analysis (Odds ratio, 0.977 [95% confidence interval (CI), 0.482-1.980]; P = .949). Younger age (Odds ratio, 0.962 [95% CI, 0.940-0.984]; P = .001) and lymph node metastasis on US (Odds ratio, 7.325 [95% CI, 3.573-15.020]; P < .001) were independently associated with lymph node metastasis. Texture analysis was not useful in predicting lymph node metastasis in patients with PTMC.

Leakage in below-grade concrete structures are repaired using various types of grout-injection materials, but the selection of optimal material types with a consideration of the environmental degradation factors are not conducted. Different degradation factors can act on the waterproofing membranes or grout-injection materials simultaneously. Especially in the early stages of installation, the injected grout materials in the cracks for leakage repair or for reforming damaged waterproofing layers are subject to complex forms of degradation factors. In such cases, physical property changes to the materials can reduce the waterproofing performance of the grout-injection materials. In this study, a technical evaluation regime is proposed for selecting the optimal repair material to be used in underground concrete structure leakage cracks. In this study, six environmental degradation factors (thermal stress, chemical corrosion, erosion due to ground water flow, hydrostatic pressure, substrate movement, and humidity on concrete surface) are identified. Corresponding evaluation methods based on the ISO TS 16774 test method series were used for each factor to assess the performance evaluation of four different types of grout-injection materials (acrylic resin, epoxy resin, polyurethane foam, and synthetic polymerized rubber gel). Based on the test results, a new comprehensive evaluation regime is presented that allows a quantitative performance comparison between each type of grout-injection material.

Objective : Sjogren's Syndrome is a chronic inflamatory disorder characterized by lymphocytic infiltration of lacrimal and salivary gland. It may be associated with renal disease such as tubulonephritis or glomerulonephritis. Proteinuria is a kidney disorder resulting in an abnormally high amount of protein in the urine. When the glomeruli are damaged, proteins of various sizes pass through them and are excreted in the urine. This report is a case of proteinuria with Sjogren's Syndrome. Methods : The patient was diagnosed as kidney yang deficiency syndrome and treated with Woogyu-eum, Sa-am acupuncture therapy and bee venom acupuncture therapy. Visual Analog Scale was used to estimate the clinical symptoms. Results : Clinical symptoms and proteinuria were improved without steroid therapy. Conclusion Therefore, we concluded that oriental medical therapy may be useful to treat proteinuria with Sjogren's Syndrome.

Objectives : Hand paresthesia is common syndrome and the cause is more unknown than known reason. The Purpose of this study were investigated the effects of Myofacial Pain Syndrome theory to make diagnosis and treatment by Pharmacopuncture for the patients of hand paresthesia. Method : This study was carried out to established the clinical criteria of hand parethesia. The patients who had past history of diabeics, neuropathy induced by alcohol or drug were excluded, and 86 patients who had hand paresthesia related with unknown-reason was selected by the interview process. And the effects of Pharmacopuncture theory were analyzed using VAS score before and after treatment. Results and conclusions : 56.9% of unknown-reason patients are positive at diagnosis by MPS theory. While positive group decrease from 62.81±14.27 to 25.28±15.97, negative group decrease from 55.88±10.92 to 48.28±14.01 by VAS scores. Positive group was accordingly more effective than negative group. So diagnosis and treatment for hand numbness patients by MPS theory was useful in clinical.

There are no existing standard test methods at home and abroad that can verify the performance of water leakage repair materials, and it is thus very difficult to perform quality control checks in the field of water leakage repair. This study determined that the key factors that have the greatest impact on the water leakage repair materials are the micro-behaviors of cracks, and proposed an artificial-crack-behavior test method for the performance verification of the repair materials. The performance of the 15 kinds of repair materials that are currently being used in the field of water leakage repair was evaluated by applying the proposed test method. The main aim of such a test method is to determine if there is water leakage by injecting water leakage repair materials into a crack behavior test specimen with an artificial 5-mm crack width, applying a 2.5 mm vertical behavior load at 100 cycles, and applying 0.3 N/mm2 constant water pressure. The test results showed that of the 15 kinds of repair materials, only two effectively sealed the crack and thus stopped the water leakage. The findings of this study confirmed the effectiveness of the proposed artificial-crack-behavior test method and suggest that it can be used as a performance verification method for checking the responsiveness of the repair materials being used in the field of water leakage repair to the repetitive water leakage behaviors that occur in concrete structures. The study findings further suggest that the use of the proposed test method makes it possible to quantify the water leakage repair quality control in the field.

To examine inflammatory tissue, an initial and common symptom of various types of pathogenesis, we designed inflammation-targeted T 1 contrast agents prepared by bioconjugation of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) with anti-intercellular adhesion molecule 1 (ICAM-1) antibody. The anti-ICAM-1 antibody was coupled with DTPA and was then conjugated with Gd. The specific binding of the Gd-DTPA-anti-ICAM-1 antibody complex to the ICAM-1-expressing cells was examined in the cultured endothelial cells where ICAM-1 expression was stimulated. Inflammation-specific T 1 imaging was then assessed using a mouse abscess model with the 1.5-Tesla module. The Gd-DTPA-anti-ICAM-1 antibody displayed increased r1, which was two times higher than that of Gd-DTPA and showed predominant binding to cultured endothelial cells, which expressed a high level of ICAM-1. Moreover, the inflammation-specific T 1 enhancement was imaged with the Gd-DTPA-anti-ICAM-1 antibody in the mouse acute inflammation model. The Gd-DTPA-anti-ICAM-1 antibody showed significantly increased vascular circulation time, which thereby offered a greater chance for its binding to the target cells. The Gd-DTPA-anti-ICAM-1 antibody displays a potential targeted T 1 contrast agent specific to the inflammatory tissue that expresses ICAM-1.

Background: Malnutrition is a well-known risk factor for mortality and morbidity. We investigated whether preoperative malnutrition, diagnosed using an objective nutritional index, was associated with postoperative mortality in patients undergoing liver transplantation (LT). Methods: This retrospective cohort observational study assessed the preoperative nutritional status of 440 patients who underwent LT, using the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score. We evaluated the association between preoperative malnutrition and 3-year postoperative mortality using the Kaplan–Meier curve and log-rank test. In addition, we identified prognostic factors for mortality using Cox proportional hazard analysis. Results: Malnutrition was identified in 72.7% (n = 320), 66.1% (n = 291), and 97.3% (n = 428) of patients as assessed by the NRI, PNI, and CONUT score, respectively. The Kaplan–Meier survival curve demonstrated that mortality increased with the presence and severity of malnutrition risk, as assessed by the NRI and PNI, respectively; however, NRI was the only index identified as an independent risk factor for mortality, along with preoperative renal replacement therapy, platelet count, and C-reactive protein. After adjustment, lower NRI was associated with a higher risk of mortality (hazard ratio 0.97, 95% confidence interval 0.95–0.99, P = 0.009). The malnutrition group (NRI ≤ 100) had a significantly greater incidence of postoperative acute kidney injury than that of the normal group. Conclusions: Preoperative NRI is an independent risk factor for mortality after LT, and therefore it would be a helpful tool for mortality risk stratification in patients undergoing LT. [ABSTRACT FROM AUTHOR]

Background: The relationship between early life factors and childhood pulmonary function and structure in preterm infants remains unclear. Purpose: This study investigated the impact of bronchopulmonary dysplasia (BPD) and perinatal factors on childhood pulmonary function and structure. Methods: This longitudinal cohort study included preterm participants aged ≥5 years born between 2005 and 2015. The children were grouped byBPD severity according to National Institutes of Health criteria. Pulmonary function tests (PFTs) were performed using spirometry. Chest computed tomography (CT) scans were obtained and scored for hyperaeration or parenchymal lesions. PFT results and chest CT scores were analyzed with perinatal factors. Results: A total 150 children (66 females) aged 7.7 years (6.4–9.9 years) were categorized into non/mild BPD (n=68), moderate BPD (n=39), and severe BPD (n=43) groups. The median z score for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced midexpiratory flow (FEF25%–75%) were significantly lower in the severe versus non/mild BPD group (-1.24 vs. -0.18, -0.22 vs. 0.41, -1.80 vs. -1.12, and -1.88 vs. -1.00, respectively; all P<0.05). The median z scores of FEV1, FEV1/ FVC, and FEF25%–75% among asymptomatic patients were also significantly lower in the severe versus non/mild BPD group (-0.82 vs. 0.09, -1.68 vs. -0.87, -1.59 vs. -0.61, respectively; all P<0.05). The severe BPD group had a higher median (range) CT score than the non/mild BPD group (6 [0–12] vs. 1 [0–10], P<0.001). Prenatal oligohydramnios was strongly associated with both low pulmonary function (FEV1/FVC

This case study examines the use of corticosteroids in treating Pneumocystis jirovecii pneumonia (PCP) in an infant with severe combined immunodeficiency (SCID). The effectiveness of corticosteroids in preventing immune reconstitution inflammatory syndrome (IRIS) in non-HIV patients with PCP is a topic of debate. However, in this particular case, the infant experienced a paradoxical reaction during PCP treatment, which improved with the addition of corticosteroids. The study emphasizes the need for further research on the use of corticosteroids in individuals with compromised immune systems. [Extracted from the article]