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Abstract Electrocardiogram (ECG) changes after primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients are associated with prognosis. This study investigated the feasibility of predicting left ventricular (LV) dysfunction in STEMI patients using an artificial intelligence (AI)-enabled ECG algorithm developed to diagnose STEMI. Serial ECGs from 637 STEMI patients were analyzed with the AI algorithm, which quantified the probability of STEMI at various time points. The time points included pre-PCI, immediately post-PCI, 6 h post-PCI, 24 h post-PCI, at discharge, and one-month post-PCI. The prevalence of LV dysfunction was significantly associated with the AI-derived probability index. A high probability index was an independent predictor of LV dysfunction, with higher cardiac death and heart failure hospitalization rates observed in patients with higher indices. The study demonstrates that the AI-enabled ECG index effectively quantifies ECG changes post-PCI and serves as a digital biomarker capable of predicting post-STEMI LV dysfunction, heart failure, and mortality. These findings suggest that AI-enabled ECG analysis can be a valuable tool in the early identification of high-risk patients, enabling timely and targeted interventions to improve clinical outcomes in STEMI patients.

Extracellular microRNAs (miRNAs) can be detected in body fluids and hold great potential as cancer biomarkers. Extracellular miRNAs are protected from degradation by binding various proteins and through their packaging into extracellular vesicles (EVs). There is evidence that the diagnostic performance of cancer-associated extracellular miRNAs can be improved by assaying EV-miRNA instead of total cell-free miRNA, but several challenges have hampered the advancement of EV-miRNA in liquid biopsy. Because almost all types of cells release EVs, cancer cell-derived EVs might constitute only a minor fraction of EVs in body fluids of cancer patients with low volume disease. Furthermore, a given cell type can release several subpopulations of EVs that vary in their cargo, and there is evidence that the majority of EVs contain low copy numbers of miRNAs. In this mini-review, we discuss the potential of several candidate EV membrane proteins such as CD147 to define cancer cell-derived EVs, and approaches by which subpopulations of miRNA-rich EVs in body fluids might be identified. By integrating these insights, we discuss strategies by which EVs that are both cancer cell-derived and miRNA-rich could be isolated to enhance the diagnostic performance of extracellular miRNAs.

Abstract Infectious pathogens can be transmitted through textiles. Therefore, additional efforts are needed to develop functional fabrics containing antimicrobial substances to prevent the growth of antibiotic-resistant bacteria and their biofilms. Here, we developed a cotton fabric coated with reduced graphene oxide (rGO) and copper nanoparticles (Cu NPs), which possessed hydrophobic, antimicrobial, and anti-biofilm properties. Once the graphene oxide was dip-coated on a cellulose cotton fabric, Cu NPs were synthesized using a chemical reduction method to fabricate an rGO/Cu fabric, which was analyzed through FE-SEM, EDS, and ICP-MS. The results of our colony-forming unit assays indicated that the rGO/Cu fabric possessed high antibacterial and anti-biofilm properties against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus epidermidis, Corynebacterium xerosis, and Micrococcus luteus. Particularly, the fabric could inhibit the growth of E. coli, C. xerosis, and M. luteus with a 99% efficiency. Furthermore, our findings confirmed that the same concentrations of rGO/Cu had no cytotoxic effects against CCD-986Sk and Human Dermal Fibroblast (HDF), human skin cells, and NIH/3T3, a mouse skin cell. The developed rGO/Cu fabric thus exhibited promising applicability as a cotton material that can maintain hygienic conditions by preventing the propagation of various bacteria and sufficiently suppressing biofilm formation while also being harmless to the human body.

Abstract Cell-to-cell propagation of protein aggregates has been implicated in the progression of neurodegenerative diseases. However, the underlying mechanism and modulators of this process are not fully understood. Here, we screened a small-molecule library in a search for agents that suppress the propagation of α-synuclein and mutant huntingtin (mHtt). These screens yielded several molecules, some of which were effective against both α-synuclein and mHtt. Among these molecules, we focused on simvastatin and pravastatin. Simvastatin administration in a transgenic model of synucleinopathy effectively ameliorated behavioral deficits and α-synuclein accumulation, whereas pravastatin had no effect. Because only simvastatin enters the brain effectively, these results suggest that inhibition of brain cholesterol synthesis is important in simvastatin effects. In cultured cells, accumulation of intracellular cholesterol, induced by genetic ablation of the NPC1 gene or by pharmacological treatment with U18666A, increased α-synuclein aggregation and secretion. In contrast, lowering cholesterol using methyl-β-cyclodextrin or statins reversed α-synuclein aggregation and secretion in NPC1-knockout cells. Consistent with these observations, feeding a high-fat diet aggravated α-synuclein pathology and behavioral deficits in the preformed fibril-injected mouse model, an effect that was also reversed by simvastatin administration. These results suggest that statins suppress propagation of protein aggregates by lowering cholesterol in the brain.

BackgroundWhile conventional electrocardiogram monitoring devices are useful for detecting atrial fibrillation, they have considerable drawbacks, including a short monitoring duration and invasive device implantation. The use of patch-type devices circumvents these drawbacks and has shown comparable diagnostic capability for the early detection of atrial fibrillation. ObjectiveWe aimed to determine whether a patch-type device (AT-Patch) applied to patients with a high risk of new-onset atrial fibrillation defined by the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex scale (CHA2DS2-VASc) score had increased detection rates. MethodsIn this nonrandomized multicenter prospective cohort study, we enrolled 320 adults aged ≥19 years who had never experienced atrial fibrillation and whose CHA2DS2-VASc score was ≥2. The AT-Patch was attached to each individual for 11 days, and the data were analyzed for arrhythmic events by 2 independent cardiologists. ResultsAtrial fibrillation was detected by the AT-Patch in 3.4% (11/320) of patients, as diagnosed by both cardiologists. Interestingly, when participants with or without atrial fibrillation were compared, a previous history of heart failure was significantly more common in the atrial fibrillation group (n=4/11, 36.4% vs n=16/309, 5.2%, respectively; P=.003). When a CHA2DS2-VASc score ≥4 was combined with previous heart failure, the detection rate was significantly increased to 24.4%. Comparison of the recorded electrocardiogram data revealed that supraventricular and ventricular ectopic rhythms were significantly more frequent in the new-onset atrial fibrillation group compared with nonatrial fibrillation group (3.4% vs 0.4%; P=.001 and 5.2% vs 1.2%; P

Abstract Background Emerging artificial intelligence (AI) technologies have diverse applications in medicine. As AI tools advance towards clinical implementation, skills in how to use and interpret AI in a healthcare setting could become integral for physicians. This study examines undergraduate medical students’ perceptions of AI, educational opportunities about of AI in medicine, and the desired medium for AI curriculum delivery. Methods A 32 question survey for undergraduate medical students was distributed from May–October 2021 to students to all 17 Canadian medical schools. The survey assessed the currently available learning opportunities about AI, the perceived need for learning opportunities about AI, and barriers to educating about AI in medicine. Interviews were conducted with participants to provide narrative context to survey responses. Likert scale survey questions were scored from 1 (disagree) to 5 (agree). Interview transcripts were analyzed using qualitative thematic analysis. Results We received 486 responses from 17 of 17 medical schools (roughly 5% of Canadian undergraduate medical students). The mean age of respondents was 25.34, with 45% being in their first year of medical school, 27% in their 2nd year, 15% in their 3rd year, and 10% in their 4th year. Respondents agreed that AI applications in medicine would become common in the future (94% agree) and would improve medicine (84% agree Further, respondents agreed that they would need to use and understand AI during their medical careers (73% agree; 68% agree), and that AI should be formally taught in medical education (67% agree). In contrast, a significant number of participants indicated that they did not have any formal educational opportunities about AI (85% disagree) and that AI-related learning opportunities were inadequate (74% disagree). Interviews with 18 students were conducted. Emerging themes from the interviews were a lack of formal education opportunities and non-AI content taking priority in the curriculum. Conclusion A lack of educational opportunities about AI in medicine were identified across Canada in the participating students. As AI tools are currently progressing towards clinical implementation and there is currently a lack of educational opportunities about AI in medicine, AI should be considered for inclusion in formal medical curriculum.

The omentum contains immune cell structures called milky spots that are niches for transcoelomic metastasis. It is difficult to remove the omentum completely, and there are no effective strategies to minimize the risk of colonization of preserved omental tissues by cancer cells that circulate in the peritoneal fluid. Normal saline is commonly administered into the peritoneal cavity for diagnostic and intraoperative lavage. Here we show that normal saline, when administered into the peritoneal cavity of mice, is prominently absorbed by the omentum, exfoliates its mesothelium, and induces expression of CX3CL1, the ligand for CX3CR1, within and surrounding the omental vasculature. Studies using CX3CR1-competent and CX3CR1-deficient mice showed that the predominant response in the omentum following saline administration is an accumulation of CX3CR1+ monocytes/macrophages that expand milky spots and promote neoangiogenesis within these niches. Moreover, saline administration promoted the implantation of cancer cells of ovarian and colorectal origin onto the omentum. By contrast, these deleterious effects were not observed following i.p. administration of lactated Ringer’s solution. Our findings suggest that normal saline stimulates the receptivity of the omentum for cancer cells and that the risk of colonization can be minimized by using a biocompatible crystalloid for lavage procedures.

Abstract Extracellular vesicles (EVs) are ideal for liquid biopsy, but distinguishing cancer cell‐derived EVs and subpopulations of biomarker‐containing EVs in body fluids has been challenging. Here, we identified that the glycoproteins CD147 and CD98 define subpopulations of EVs that are distinct from classical tetraspanin+ EVs in their biogenesis. Notably, we identified that CD147+ EVs have substantially higher microRNA (miRNA) content than tetraspanin+ EVs and are selectively enriched in miRNA through the interaction of CD147 with heterogeneous nuclear ribonucleoprotein A2/B1. Studies using mouse xenograft models showed that CD147+ EVs predominantly derive from cancer cells, whereas the majority of tetraspanin+ EVs are not of cancer cell origin. Circulating CD147+ EVs, but not tetraspanin+ EVs, were significantly increased in prevalence in patients with ovarian and renal cancers as compared to healthy individuals and patients with benign conditions. Furthermore, we found that isolating miRNAs from body fluids by CD147 immunocapture increases the sensitivity of detecting cancer cell‐specific miRNAs, and that circulating miRNAs isolated by CD147 immunocapture more closely reflect the tumor miRNA signature than circulating miRNAs isolated by conventional methods. Collectively, our findings reveal that CD147 defines miRNA‐enriched, cancer cell‐derived EVs, and that CD147 immunocapture could be an effective approach to isolate cancer‐derived miRNAs for liquid biopsy.

Abstract Background and Aims Although many angiotensin receptor blockers (ARBs) are widely used, comparative data regarding their impact on clinical outcomes are limited. We aimed to compare the clinical effectiveness of seven ARBs on long‐term cardiovascular outcomes in Korean patients with hypertension. Methods Using the Korean National Health Insurance Service database, the data of 780,785 patients with hypertension without cardiovascular disease (CVD) who initiated ARB treatment (candesartan, fimasartan, irbesartan, losartan, olmesartan, telmisartan, or valsartan) in 2014 and underwent this treatment for more than 6 months, were analyzed. Cox‐regression analysis was performed using Losartan as a comparator, as it was the most widely used drug, by adjusting age, sex, diabetes, dyslipidemia, smoking, alcohol drinking, exercise, body mass index, systolic blood pressure, albuminuria, estimated glomerular filtration rate, and concomitant medications. The occurrence of mortality and the rate of major adverse cardiovascular events (MACEs) of the six ARBs was compared with that of losartan. Results The median follow‐up duration was 5.94 (interquartile range, 5.87–5.97) years. In the crude analysis of all‐cause mortality and MACEs, fimasartan exhibited the lowest event rates. In the Cox‐regression analysis with adjustment, there was no significant difference in all‐cause mortality among ARBs. The risk of MACEs with ARBs was similar to that with losartan, although the risks with irbesartan (hazard ratio [HR], 1.079; 95% confidence interval [CI], 1.033–1.127; p = 0.007) and candesartan (HR: 1.066; 95% CI, 1.028–1.106; p = 0.015) were slightly higher. Conclusion In a Korean population of patients with hypertension without CVD, six different ARBs showed similar efficacy to losartan in terms of long‐term mortality and MACEs. Further well‐designed prospective studies are required to confirm our findings.

Abstract Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death and morbidity worldwide. This randomized controlled, single-center, open-label trial tested the impact of a mobile health (mHealth) service tool optimized for ASCVD patient care. Patients with clinical ASCVD were enrolled and randomly assigned to the intervention or control group. Participants in the intervention group were provided with a smartphone application named HEART4U, while a dedicated interface integrated into the electronic healthcare record system was provided to the treating physicians. A total of 666 patients with ASCVD were enrolled, with 333 patients in each group. The estimated baseline 10-year risk of cardiovascular disease was 9.5% and 10.8% in the intervention and control groups, respectively, as assessed by the pooled cohort risk equations. The primary study endpoint was the change in the estimated risk at six months. The estimated risk increased by 1.3% and 1.1%, respectively, which did not differ significantly (P = 0.821). None of the secondary study endpoints showed significant differences between the groups. A post-hoc subgroup analysis showed the benefit was greater if a participant in the intervention group accessed the application more frequently. The present study demonstrated no significant benefits associated with the use of the mHealth tool in terms of the predefined study endpoints in stable patients with ASCVD. However, it also suggested that motivating patients to use the mHealth tool more frequently may lead to greater clinical benefit. Better design with a positive user experience needs to be considered for developing future mHealth tools for ASCVD patient care. Trial Registration: ClinicalTrials.gov NCT03392259

Purpose The purpose of this study was to compare the efficacy of low-dose steroid, high-dose steroid, and low-dose steroid combined with hyaluronidase with respect to intra-articular injection therapy for adhesive capsulitis (AC) of the shoulder. Methods Thirty patients with primary AC in the initial stage were randomly assigned into three groups to receive ultrasound-guided intra-articular injections with 20 mg of triamcinolone acetonide (group A, n=10), 40 mg of triamcinolone acetonide (group B, n=10) and 20 mg of triamcinolone acetonide combined with hyaluronidase (group C, n=10). The outcome measures included a visual analogue scale (VAS), the Shoulder Disability Questionnaire (SDQ), abduction and external rotation range of motion, and intra-sheath fluid (ISF) before treatment and at 2, 4, 8, and 16 weeks after treatment. Results Among the 30 patients, one participant in group B dropped out; therefore, a total of 29 patients completed this study and were successfully injected. After the injection, the VAS, SDQ, range of flexion and external rotation, and ISF improved in all groups compared with the pre-injection status, regardless of treatment or time point. In the comparison between groups, the SDQ and ISF showed significantly greater improvements in groups B and C than in group A. Conclusion The therapeutic efficacy of combined low-dose corticosteroid and hyaluronidase is superior to that of low-dose corticosteroid and equivalent to that of high-dose corticosteroid in early AC.

BackgroundAcute myocardial infarction may be associated with new-onset arrhythmias. Patients with myocardial infarction may manifest serious arrhythmias such as ventricular tachyarrhythmias or atrial fibrillation. Frequent, prolonged electrocardiogram (ECG) monitoring can prevent devastating outcomes caused by these arrhythmias. ObjectiveWe aimed to investigate the incidence of arrhythmias in patients following myocardial infarction using a patch-type device—AT-Patch (ATP-C120; ATsens). MethodsThis study is a nonrandomized, single-center, prospective cohort study. We evaluated 71 patients who had had a myocardial infarction and had been admitted to our hospital. The ATP-C120 device was attached to the patient for 11 days and analyzed by 2 cardiologists for new-onset arrhythmic events. ResultsOne participant was concordantly diagnosed with atrial fibrillation. The cardiologists diagnosed atrial premature beats in 65 (92%) and 60 (85%) of 71 participants, and ventricular premature beats in 38 (54%) and 44 (62%) participants, respectively. Interestingly, 40 (56%) patients showed less than 2 minutes of sustained paroxysmal atrial tachycardia confirmed by both cardiologists. Among participants with atrial tachycardia, the use of β-blockers was significantly lower compared with patients without tachycardia (70% vs 90%, P=.04). However, different dosages of β-blockers did not make a significant difference. ConclusionsWearable ECG monitoring patch devices are easy to apply and can correlate symptoms and ECG rhythm disturbances in patients following myocardial infarction. Further study is necessary regarding clinical implications and appropriate therapies for arrhythmias detected early after myocardial infarction to prevent adverse outcomes.

The need for effective leadership by physicians is clear, yet the design/delivery of curricula, and assessment of leadership competencies, in Undergraduate Medical Education (UGME) continues to need work. In reappraising their UGME assessment strategies, the Medical Council of Canada (MCC) invited position papers across diverse lenses, including the CanMEDS Intrinsic Roles. This article is foundational work derived from the report on leadership assessment to the MCC. Using Kern’s Model of Curriculum development as a guide, we reviewed the landscape of Canadian UGME leadership education through an environmental scan of the published and grey literature, Canadian leadership frameworks and resources, and consultation with learner and faculty leadership. Leadership education across programs was highly variable and learners were often unaware of available opportunities. In response, we have suggested processes for curricular development, including strategies for key content, teaching and assessment, and program evaluation considerations. Leadership education cannot remain another checkbox on a list of UGME experiences. Such training necessitates focused attention and investment to foster ongoing identity formation toward becoming a good doctor.

AimA link between low muscle mass and arterial stiffness is not always consistent. In this study, we aimed to evaluate the clinical significance of low skeletal muscle mass in relation to arterial stiffness measured by the cardio-ankle vascular index (CAVI).MethodsA total of 2,561 asymptomatic Korean subjects who underwent bioelectrical impedance analysis (BIA) and CAVI were included for analysis. Using appendicular skeletal muscle mass (ASM), classes I and II sarcopenia were defined as ASM% greater than 1 standard deviation (SD) and 2 SDs below the gender-specific mean of healthy young Korean adults.ResultsCompared to normal, CAVI was significantly higher, but the number of patients with a low ankle-brachial index (ABI) was not significantly different (p < 0.001 for CAVI, p = 0.078 for ABI). Classes I and II sarcopenia showed an independent and significant association with CAVI (estimate 0.148, standard error (SE) 0.043, p < 0.001 and estimate 0.304, SE 0.073, p < 0.001 for classes I and II sarcopenia, respectively, adjusted for age groups, gender, body mass index (BMI) ≥25, hypertension, diabetes, hypercholesterolemia, and smoking).ConclusionLow muscle mass is independently and significantly associated with increased CAVI, and should be considered when managing asymptomatic subjects to assess the risk of atherosclerosis.

A new scoring system based on information technology (IT) is an innovative way to judge matches fairly. However, there are reliability and expertise problems due to sophisticated differences in human-machine judging criteria. Taekwondo, a traditional Korean sport, uses an IT-based protector and scoring system. The system records the player’s movement data through its sensors, but it has a limitation in that it cannot detect anomalous kicks. Because anomalous kicks are executed with minimal strength outside the typical form of kick patterns, it interrupts fair judgment of the scoring system and reduces the liveliness of Taekwondo matches. To minimize the dispute by anomalous kicks, we aim to detect the anomalous kicks in Taekwondo matches. We construct a kick dataset and propose an attention-based deep learning model. The proposed model has the advantage of simultaneously handling the spatial and temporal features of the kick dataset because it is a model that combines a convolutional neural network (CNN) and bidirectional long-short term memory (BiLSTM) with an attention mechanism. The experimental results showed that the accuracy of the attention-based CNN-BiLSTM is 95.67%, and the false-positive rate is 0.086. We open our dataset and it is freely available on https://github.com/daanVeer/Taekwondo_dataset.

The present study analyzes the determinants and patterns of the regional, local, and differential plant diversity of two different sites with similar climatic but varied edaphic factors. This research was undertaken to study the plant diversity and population structure as a consequence of variation in the soil quality between two biotopes: Guru Ghasidas Vishwavidyalaya in Koni (site-I) and National Thermal Power Corporation in Sipat (site-II). The soil of site-I was found to be fertile and showed rich vegetation. On the other hand, the soil of site II was found to be contaminated with heavy metals, which impacts the flora of the region. The ecology of both sites was studied, and their quantitative and qualitative aspects were compared and contrasted. The abundance, density, and richness of the plants in site II were fairly lower than in site-I, which was confirmed by utilizing Simpson’s and Shannon’s diversity indices. Many of the species collected from site II were heavy metal accumulators and could also serve as indicators of heavy metal toxicity.

The rise of domestic fringe groups within the United States has been well documented, threatening political and social stability. The QAnon conspiracy theory has developed as one such destructive group, though it remains a largely misunderstood movement. Through a mixed-methods analysis of over 3.5 million messages on Telegram from three politically extreme communities - QAnon, far-right, and far-left - we studied how QAnon fits within the larger non-mainstream political ecosystem. Our analysis provides insights into how this new political movement is dissimilar to the far-right or the far-left but shares offline interests with the far-right. The topics discussed within QAnon communities were unique to the movement and the least reactive to news cycles. Links shared by QAnon, particularly from YouTube and Twitter, were often from traditional conservative sources and individuals, whereas the far-left and far-right relied on less mainstream sources. Finally, though QAnon may be distinct from the other communities, it coalesces with the far-right during particular political events where the former United States President Trump is a major player. Our findings highlight how fringe groups react to major political events and navigate conversations online.

Biological treatment methods for the biodegradation of anthropogenic toxic pollutants are eco-friendly in nature and are powered by a variety of microbial enzymes. Green chemistry and enzymes play a crucial role in catalyzing the biodegradation of organic and inorganic pollutants including azo dyes; polyaromatic hydrocarbons; lead; organic cyanides; aromatic amines; mono-, di-, and polyphenols; polymers; and mercury. Laccases form a prospective group of multifunctional oxidoreductase enzymes with great potential for oxidizing different categories of organic and inorganic pollutants and their diversified functions, such as pigment formation, lignin degradation, and detoxification of industrial wastes including xenobiotics mainly from the pharmaceutical, paper textile, and petrochemical industries. Therefore, it is very important to study laccases as green and environmentally friendly alternatives for the degradation of xenobiotics. This review article will cover comprehensive information about the functions and properties of bacterial laccases for a deep understanding of their scope and applications for effective bioremediation of recalcitrant xenobiotics.

Abstract Background Adults with unoperated congenitally corrected transposition of the great arteries are rare but form a distinct group among adults with congenital heart disease. Patients with congenitally corrected transposition of the great arteries often have one or more associated cardiac anomalies that dictate the need for, and timing of, surgical intervention in childhood. However, in a proportion of patients, the hemodynamics does not require surgical attention during childhood, and, in some patients, a correct diagnosis is not established until adulthood. Here we report an adult case of unoperated congenitally corrected transposition of the great arteries with a large ventricular septal defect and probable pulmonary arterial hypertension. Case presentation Our patient was a 46-year-old Korean man. Transthoracic echocardiography and cardiac catheterization demonstrated hemodynamically balanced ventricles with a non-regurgitant systemic atrioventricular valve, normal pulmonary arterial pressure, and a reasonable difference between the oxygen saturation values of the aorta and pulmonary trunk, even with the presence of a large ventricular septal defect. Further morphological assessments using cardiac computed tomography and three-dimensional modeling/printing of his heart revealed that the mitral valve was straddling over the posteriorly positioned ventricular septal defect, which could explain the functional and anatomical subvalvular pulmonary stenosis and a small amount of shunt flow through the large ventricular septal defect. We interpreted this combination of cardiac defects as able to sustain his stable cardiac function. Thus, we decided to maintain his unoperated status. Conclusion A detailed anatomical understanding based on transthoracic echocardiography, cardiac computed tomography, and three-dimensional printing can justify a decision to not operate in cases of congenitally corrected transposition of the great arteries with hemodynamically balanced pulmonary stenosis and a ventricular septal defect, as observed in the present case.

Abstract Background We conducted a randomized controlled trial to investigate whether an additional platelet inhibition with tirofiban would reduce the extent of myocardial damage and prevent periprocedural myonecrosis in patients with Non-ST-elevation acute coronary syndrome (NSTE-ACS) with a high residual platelet activity (HPR). Methods Patients with an HPR, defined as P2Y12 reaction unit (PRU) > 230, were randomly assigned to group A (tirofiban treatment, n = 30) or C1 (n = 30) and patients without an HPR to C2 (n = 78). Periprocedural myocardial damage was assessed using the area under the curve (AUC) of serial cardiac enzyme levels from the time of the procedure to post-36 h. Periprocedural myonecrosis incidence was evaluated. Results The troponin I AUC was not different between the groups (197.2 [41.5395.7], 37.9 [8.9313.9], 121.3 [43.7481.8] h∙ng/mL; p = 0.088). The results did not change when the baseline levels were adjusted (365.3 [279.5, 451.1], 293.0 [207.1, 379.0], and 298.0 [244.7, 351.3] h∙ng/mL; p = 0.487). The rate of periprocedural myonecrosis was also not different between the groups (53.0% vs. 50.0% vs. 33.3%, p = 0.092). The CK-MB isoenzyme analysis showed similar results. No difference in complications was noted. Conclusion Additional tirofiban administration was not beneficial to patients with NSTE-ACS even with an HPR. Trial registration Clinical trial no. NCT03114995, registered 11 April, 2017, retrospectively.

Abstract In a paper manufacturing system, it is substantially important to detect machine failure before it occurs and take necessary maintenance actions to prevent an unexpected breakdown of the system. Multiple sensor data collected from a machine provides useful information on the system's health condition. However, it is hard to predict the system condition ahead of time due to the lack of clear ominous signs for future failures, a rare occurrence of failure events, and a wide range of sensor signals which might be correlated with each other. We present two versions of feature extraction techniques based on the nearest neighbor combined with machine learning algorithms to detect a failure of the paper manufacturing machinery earlier than its occurrence from the multistream system monitoring data. First, for each sensor stream, the time series data is transformed into the binary form by extracting the class label of the nearest neighbor. We feed these transformed features into the decision tree classifier for the failure classification. Second, expanding the idea, the relative distance to the local nearest neighbor has been measured, results in the real‐valued feature, and the support vector machine is used as a classifier. Our proposed algorithms are applied to the dataset provided by Institute of Industrial and Systems Engineers 2019 data competition, and the results show better performance than other state‐of‐the‐art machine learning techniques.

Even with increasing awareness of sex-related differences in atherosclerotic cardiovascular disease (ASCVD), it remains unclear whether the progression of coronary atherosclerosis differs between women and men. We sought to compare coronary artery calcium (CAC) progression between women and men. From a retrospective, multicentre registry of consecutive asymptomatic individuals who underwent CAC scoring, we identified 9,675 men and 1,709 women with follow-up CAC scoring. At baseline, men were more likely to have a CAC score >0 than were women (47.8% vs. 28.6%). The probability of CAC progression at 5 years, defined as [√CAC score (follow-up)-√CAC score (baseline)] ≥2.5, was 47.4% in men and 29.7% in women (p

The social standing of an artist provides a reliable proxy for the value of the artist's product and reduces uncertainty about the quality of the product. While there are several different types of social standing, we focus on reputation among professional artists within the same genre, as they are best able to identify the artistic value of a product within that genre. To reveal the underlying means of attaining high social standing within the professional group, we examined two quantifiable properties that are closely associated with social standing, musical identity and the social position of the artist. We analyzed the playlist data of electronic dance music DJ/producers, DJs who also compose their own music. We crawled 98,332 tracks from 3,164 playlists by 815 DJs, who played at nine notable international music festivals. Information from the DJs' tracks, including genre, beats per minute, and musical keys, was used to quantify musical identity, and playlists were transformed into network data to measure social positions among the DJs. We found that DJs with a distinct genre identity as well as network positions combining brokerage and cohesion tend to place higher in success and social standing.

Cell-cell interactions influence all aspects of development, homeostasis, and disease. In cancer, interactions between cancer cells and stromal cells play a major role in nearly every step of carcinogenesis. Thus, the ability to record cell-cell interactions would facilitate mechanistic delineation of the role of the cancer microenvironment. Here, we describe GFP-based Touching Nexus (G-baToN) which relies upon nanobody-directed fluorescent protein transfer to enable sensitive and specific labeling of cells after cell-cell interactions. G-baToN is a generalizable system that enables physical contact-based labeling between various human and mouse cell types, including endothelial cell-pericyte, neuron-astrocyte, and diverse cancer-stromal cell pairs. A suite of orthogonal baToN tools enables reciprocal cell-cell labeling, interaction-dependent cargo transfer, and the identification of higher order cell-cell interactions across a wide range of cell types. The ability to track physically interacting cells with these simple and sensitive systems will greatly accelerate our understanding of the outputs of cell-cell interactions in cancer as well as across many biological processes.

(1) Background: Progression of chronic obstructive pulmonary disease (COPD) leads to irreversible lung damage and inflammatory responses; however, biomarker discovery for monitoring of COPD progression remains challenging. (2) Methods: This study evaluated the metabolic mechanisms and potential biomarkers of COPD through the integrated analysis and receiver operating characteristic (ROC) analysis of metabolic changes in lung, plasma, and urine, and changes in morphological characteristics and pulmonary function in a model of PPE/LPS-induced COPD exacerbation. (3) Results: Metabolic changes in the lungs were evaluated as metabolic reprogramming to counteract the changes caused by the onset of COPD. In plasma, several combinations of phenylalanine, 3-methylhistidine, and polyunsaturated fatty acids have been proposed as potential biomarkers; the α-aminobutyric acid/histidine ratio has also been reported, which is a novel candidate biomarker for COPD. In urine, a combination of succinic acid, isocitric acid, and pyruvic acid has been proposed as a potential biomarker. (4) Conclusions: This study proposed potential biomarkers in plasma and urine that reflect altered lung metabolism in COPD, concurrently with the evaluation of the COPD exacerbation model induced by PPE plus LPS administration. Therefore, understanding these integrative mechanisms provides new insights into the diagnosis, treatment, and severity assessment of COPD.

The structural integrity of butt fusion (BF) joints in thermoplastic pressure piping systems is critical to their long-term safe use. The tapered waist tensile (TWT) specimen was developed to alleviate issues associated with ISO 13953 waisted tensile (WT) specimen for evaluating BF joints. Experimental and finite element analyses were performed to obtain optimum TWT specimen designs for the BF joint destructive test. For TWT specimens, depending on the pipe size, the displacement at onset necking was reduced by 30~100%, and the tested BF area increased by 60~80% compared to the WT specimen. In addition, the transverse specimen deflection was lower thus providing better experimental stability. Furthermore, it showed the same BF displacement at the maximum force local to the BF bead, indicating that the tapered waist geometry provides equivalent deformation constraint and BF failure mode designed for the BF joint in the WT specimens. Therefore, TWT specimens offer simplicity, adaptability, stability, and accuracy in specimen preparation, testing, and analysis compared to WT specimens.

A survey conducted over South Korean adults (N=513) reveals that emotions, specifically anger, contribute to the broader spread of misinformation on COVID-19 by leading angry individuals to consider false claims to be “scientifically credible.” This pattern is more evident among conservatives than liberals.

The aim of this study is to diagnose and optimize a closed multistage gold ore flotation circuit in an operational industrial plant. Linear circuit analysis (LCA), a partition-based model, and a mass balance model using flotation first-order kinetics are employed to diagnose the current process. The result shows that the current circuit operates with high recovery but the gold grade of the final concentrate is low owing to the low buoyancy ratio. Hence, several alternative circuits with different streamlines and cell arrangements are proposed and simulated using LCA and a mass balance model. The result suggests that if the current process is changed to an alternative circuit in which the floated product stream of the rougher bank is changed, then the gold grade of the concentrate can be improved by 128%. Finally, the current circuit is optimized by changing it to an alternative circuit. This study provides a methodology for adapting the simulation of optimization for the flotation circuit of an industrial plant via LCA and mass balance simulation.

Ginkgonis Semen (GS) is the seed of Ginkgo biloba Linné and a valuable material for herbal medicines and functional foods in China, Japan and Korea. The main bio-compounds of GS are GA, GB and GC like the leaves. There are many studies for the analysis of ginkgolides in the leaves or leaves extract of G. biloba because the leaves extract is a valuable material in pharmaceutical industries. However, there is no efficient analytical method for the quality control of GS based on the quantitation of ginkgolides because of matrix effect induced by different chemical composition. So, there are no content criteria of GS in Pharmacopoeia of Korea, Japan and China until now. This study aimed to develop HPLC method using ginkgolides based on the quantitation of GA, GB and GC for the quality control of GS with the optimization of sample preparation to enhance the analytical sensitivity and reproducibility. At first, defatting process using petroleum ether and liquid–liquid extraction were applied for sample preparation to remove matrix effect. The HPLC-ELSD method was developed with the mobile phase of a 0.5% aqueous acetic acid and methanol–acetonitrile solution (1:1 ratio) under gradient conditions. GA, GB and GC contents in GS were different between Korea and China. The mean quantity of Korean samples was 4.85 ± 2.33 μg/g GA, 48.38 ± 5.10 μg/g GB, and 37.83 ± 7.64 μg/g GC. Those contents of Chinese samples were higher than Korean samples as 9.39 ± 2.51 μg/g GA, 123.59 ± 26.24 μg/g GB and 53.39 ± 4.97 μg/g GC. It indicated that the discrimination of GS between Korea and China could be achieved by marker compound contents. Furthermore, the geographical discrimination of GS between Korea and China was confirmed by PCA using the quantitative data of marker compounds. By statistical analysis, the calculated content criteria of GS by regression method were 2.35 μg/g of GA, 29.20 μg/g of GB, and 27.75 μg/g of GC, based on dry weight. Thus, our HPLC method shows potential toward the development of a universal quality control methodology to quantify GS quality and origin.

Objective We aimed to describe electrocardiographic (ECG) findings in spontaneous pneumothorax patients before and after closed thoracostomy. Methods This is a retrospective study which included patients with spontaneous pneumothorax who presented to an emergency department of a tertiary urban hospital from February 2005 to March 2015. The primary outcome was a difference in ECG findings between before and after closed thoracostomy. We specifically investigated the following ECG elements: PR, QRS, QTc, axis, ST segments, and R waves in each lead. The secondary outcomes were change in ST segment in any lead and change in axis after closed thoracostomy. Results There were two ECG elements which showed statistically significant difference after thoracostomy. With right pneumothorax volume of greater than 80%, QTc and the R waves in aVF and V5 significantly changed after thoracostomy. With left pneumothorax volume between 31% and 80%, the ST segment in V2 and the R wave in V1 significantly changed after thoracostomy. However, majority of ECG elements did not show statistically significant alteration after thoracostomy. Conclusion We found only minor changes in ECG after closed thoracostomy in spontaneous pneumothorax patients.

Ovarian clear cell carcinoma (OCCC) is a rare subtype of gynecological cancer for which well-characterized and authenticated model systems are scarce. We provide an extensive characterization of ‘105C’, a cell line generated from an adenocarcinoma of the clear cell histotype using targeted next-generation sequencing, cytogenetic microarrays, along with analyses of AKT/mTOR signaling. We report that that the 105C cell line is a bona fide OCCC cell line, carrying PIK3CA, PTEN, and ARID1A gene mutations, consistent with OCCC, yet maintain a stable genome as reflected by low copy number variation. Unlike KOC-7c, TOV-21G, and RMG-V OCCC lines also mutated for the above genes, the 105C cells do not carry mutations in mismatch repair genes. Importantly, we show that 105C cells exhibit greater resistance to mTOR inhibition and carboplatin treatment compared to 9 other OCCC cell lines in 3D spheroid cultures. This resistance may be attributed to 105C cells remaining dormant in suspension culture which surprisingly, contrasts with several other OCCC lines which continue to proliferate in long-term suspension culture. 105C cells survive xenotransplantation but do not proliferate and metastasize. Collectively, we show that the 105C OCCC cell line exhibits unique properties useful for the pre-clinical investigation of OCCC pathobiology.

In neurodegenerative diseases like AD, tau forms neurofibrillary tangles, composed of tau protein. In the AD brain, activated caspases cleave tau at the 421th Asp, generating a caspase-cleaved form of tau, TauC3. Although TauC3 is known to assemble rapidly into filaments in vitro, a role of TauC3 in vivo remains unclear. Here, we generated a transgenic mouse expressing human TauC3 using a neuron-specific promoter. In this mouse, we found that human TauC3 was expressed in the hippocampus and cortex. Interestingly, TauC3 mice showed drastic learning and spatial memory deficits and reduced synaptic density at a young age (2–3 months). Notably, tau oligomers as well as tau aggregates were found in TauC3 mice showing memory deficits. Further, i.p. or i.c.v. injection with methylene blue or Congo red, inhibitors of tau aggregation in vitro, and i.p. injection with rapamycin significantly reduced the amounts of tau oligomers in the hippocampus, rescued spine density, and attenuated memory impairment in TauC3 mice. Together, these results suggest that TauC3 facilitates early memory impairment in transgenic mice accompanied with tau oligomer formation, providing insight into the role of TauC3 in the AD pathogenesis associated with tau oligomers and a useful AD model to test drug candidates.

The quality of life for people in urban regions can be improved by predicting urban human mobility and adjusting urban planning accordingly. In this study, we compared several possible variables to verify whether a gravity model (a human mobility prediction model borrowed from Newtonian mechanics) worked as well in inner-city regions as it did in intra-city regions. We reviewed the resident population, the number of employees, and the number of SNS posts as variables for generating mass values for an urban traffic gravity model. We also compared the straight-line distance, travel distance, and the impact of time as possible distance values. We defined the functions of urban regions on the basis of public records and SNS data to reflect the diverse social factors in urban regions. In this process, we conducted a dimension reduction method for the public record data and used a machine learning-based clustering algorithm for the SNS data. In doing so, we found that functional distance could be defined as the Euclidean distance between social function vectors in urban regions. Finally, we examined whether the functional distance was a variable that had a significant impact on urban human mobility.

Lichens are considered a great bio-resource because they produce large numbers of secondary metabolites with many biological activities; however, they have not been cultivated under artificial conditions to date. As a result, lichen substances from natural sources are limited and have not been widely utilized in commercial applications. Accordingly, interest in lichen-associated fungi, especially endogenic fungi, has increased. Ultraviolet (UV) radiation in sunlight is harmful to human health, resulting in demand for effective UV filtering agents for use in sunscreen. In this study, we purified (3R)-5-hydroxymellein, which has UVA absorption activity, from the secondary metabolites of an endolichenic fungus (ELF000039). The antioxidant properties were then assessed by in vitro tests. The antioxidant activity of (3R)-5-hydroxymellein was high when compared to the recognized antioxidants ascorbic acid (ASA) and butyl hydroxyl anisole (BHA). Moreover, the compound exhibited no cytotoxicity toward mouse melanoma cell lines, B16F1 and B16F10, or the normal cell line, HaCaT. Furthermore, (3R)-5-hydroxymellein recovered the damage caused by UVB irradiation and inhibited melanin synthesis. Taken together, these results suggest that (3R)-5-hydroxymellein could have an interesting and vital profile to go further development as a multifunctional skin UV protectant.