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Yujin Choi,1,* Byunwoo Son,2,* Woo-Chul Shin,3,4 Seong-uk Nam,5 Jaehong Lee,6 Jinwoong Lim,3,7 Sungha Kim,1 Changsop Yang,1 Hyeonhoon Lee8– 10 1KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; 2Combined Dispensary, 7th Corps, Republic of Korea Army, Icheon, Republic of Korea; 3Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea; 4Medical Company, 1st Airborne Special Forces Brigade, Republic of Korea Army, Seoul, Republic of Korea; 5 28th Division, Republic of Korea Army, Yangju-si, Republic of Korea; 6Medical Corps, The Capital Defense Command, Seoul, Republic of Korea; 7Department of Acupuncture and Moxibustion, Wonkwang University Gwangju Korean Medicine Hospital, Gwangju, Republic of Korea; 8Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea; 9Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; 10 9th Division, Republic of Korea Army, Goyang, Republic of Korea*These authors contributed equally to this workCorrespondence: Changsop Yang, KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon, 34054, Republic of Korea, Tel +82-42-869-2705, Fax +82-42-868-9395, Email yangunja@kiom.re.kr Hyeonhoon Lee, Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea, Tel +82-2-2072-0505, Fax +82-2-747-5639, Email hhoon@snu.ac.krPurpose: Sleep quality among military service members is important for enhancing their capabilities and preventing psychiatric problems. We aimed to explore the association of dietary behaviors with poor sleep quality and increased risk of obstructive sleep apnea (OSA) in military men on active duty.Patients and Methods: A large-scale multi-site cross-sectional survey was conducted in five units of the Republic of Korea’s army. Poor sleep quality and increased risk of OSA were defined using the Pittsburgh sleep quality index (PSQI) and Berlin Questionnaire, respectively. Information on dietary behaviors, including the frequency of skipping breakfast, eating snacks, consuming a night meal, and overeating, were collected.Results: From August 2021 to September 2021, 4389 male respondents, mean age (20.8 ± 1.3 years), completed the survey; 2579 (58.8%) were assessed as having poor sleep quality, and 614 (14.0%) increased risk of OSA. After adjusting for lifestyle and occupational covariates, skipping breakfast 1– 2 times weekly was associated with an increased likelihood of experiencing poor sleep quality, compared with not skipping breakfast (odds ratio: 1.23 [95% CI 1.02– 1.47]). Eating night meals 5– 6 times weekly was also associated with poor sleep quality (odds ratio: 5.54 [95% CI 2.49– 14.18]). In addition, skipping breakfast daily (odds ratio: 2.28 [95% CI 1.27– 4.03]) and eating night meals daily (odds ratio: 2.30 [95% CI 1.21– 4.22]) were related to an increased risk of OSA.Conclusion: Dietary behaviors appear to be related to poor sleep quality and a high risk of OSA. To improve sleep quality, dietary factors could be considered when promoting health programs for military personnel in further research.Keywords: sleep, dietary behavior, insomnia, obstructive sleep apnea, military

Objective: The aim of this study was to examine the effect of acupuncture on obesity-related parameters with regard to metabolomics. Methods: This two-arm parallel, patient- and assessor-blind, sham-controlled randomized clinical trial included 120 obese participants. Participants were randomized into two groups. The treatment group received a combined intervention of manual acupuncture (MA) plus electroacupuncture (EA), while the control group received a combination of sham acupuncture interventions consisting of sham MA plus sham EA for 6 weeks. The serum lipid levels were measured as the primary outcome measure and anthropometric parameters and serum metabolic profiles including amino acids and carnitines were measured as secondary outcome measures. Results: The serum lipid levels and anthropometric measurements did not significantly differ between groups, while body weight, body mass index (BMI), and waist circumference were improved within each group and the level of high-density lipoprotein cholesterol increased over time in the treatment group. There were no significant differences in amino acid levels between groups, while certain carnitine (C2, C4, C6, and l-carnitine) levels were significantly increased ( p Conclusion: In summary, 6 weeks of acupuncture treatment did not affect anthropometric and serum metabolic parameters, with the exception of certain carnitines, when compared to sham acupuncture. The observation of increased carnitine levels in the acupuncture group could result in potential long-term benefits to obese individuals. Additional studies are needed to investigate the long-term effects of acupuncture on lipid metabolism and the underlying mechanism of action. Trial registration number: This study is registered at ClinicalTrials.gov (NCT02066090).

Cellulose nanocrystal (CNC)-based hydrogels are considered attractive biomaterials for tissue engineering due to their excellent physicochemical properties. Hydrogels of alginate and gelatin were prepared with or without CNCs and printed using a CELLINK® BIOX 3D bio-printer. The 3D-printed scaffolds were characterized by Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy, transmission electron microscopy (TEM), and scanning electron microscopy (SEM). Improved mechanical strength was observed in the composite scaffolds compared to the pure polymer scaffolds. Fabricated scaffolds exhibited superior swelling potential; this property is profoundly affected by the CNC content of hydrogels. Biocompatibility of the fabricated scaffolds was monitored in the presence of human bone marrow-derived mesenchymal stem cells (hBMSCs) using the WST-1 assay. Notably, better cell viability was observed in the composite scaffolds than in the control, indicating improved biocompatibility of composites. Cells were healthy and adhered appropriately to the surface of the scaffolds. Mineralization potential of the prepared scaffolds was evaluated by the alizarin red S (ARS) staining technique in the presence of hBMSCs after 7 and 14 days of treatment. Enhanced mineral deposition was observed in the composite scaffolds compared to the control, indicating superior composite mineralization potential. Upregulation of osteogenic-associated genes was observed in the scaffold-treated groups relative to the control, showing superior scaffold osteogenic potential. These results demonstrate that 3D-printed scaffolds are potential candidates for bone tissue engineering applications.

Naturally derived polymer hydrogels are extensively used in tissue engineering applications due to their excellent biocompatibility, electroconductivity, and biodegradability. The conductive hydrogels have great applications in the fields of biosensing, drug delivery, and skin-tissue regeneration, behavior that can be easily tuned by the external stimuli. Collagen-containing electronic skin has the potential to regenerate the skin surrounding the wound site with minimum secondary infection. However, this area is still unexplored due to limited information as well as applications. Herein, we elaborate the biomedical as well as agroecosystem applications of bioprinted hydrogels by considering some common examples. In addition, the source and nature of the different biopolymers used in this field are also discussed.

Cellulose nanocrystals (CNCs) have received a significant amount of attention from the researchers. It is used as a nanomaterial for various applications due to its excellent physiochemical properties for the last few decades. Self-assembly is a phenomenon where autonomous reorganization of randomly oriented species occurs elegantly. Self-assembly is responsible for the formation of the hierarchical cholesteric structure of CNCs. This process is highly influenced by several factors, such as the surface chemistry of the nanoparticles, intermolecular forces, and the fundamental laws of thermodynamics. Various conventional experimental designs and molecular dynamics (MD) studies have been applied to determine the possible mechanism of self-assembly in CNCs. Different external factors, like pH, temperature, magnetic/electric fields, vacuum, also influence the self-assembly process in CNCs. Notably, better responses have been observed in CNCs-grafted polymer nanocomposites. These functionalized CNCs with stimuli-responsive self-assembly have immense practical applications in modern biotechnology and medicine. Herein, we have concisely discussed the mechanism of the self-assembled CNCs in the presence of different external factors such as pH, temperature, electric/magnetic fields, and their biomedical applications.

Background Sciatica is a relatively frequent illness that easily becomes a chronic and relapsing condition. Although numerous systematic reviews have analyzed various therapies for sciatica, the validity of their included studies is limited. Considering the limitations of conventional treatment options for sciatica, acupuncture is a possible option; however, evidence supporting its efficacy and mechanism in patients with sciatica is lacking. The aim of this proposed protocol is to investigate the effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica. Methods/design This study is a randomized, patient-assessor blind, two-arm, parallel, non-penetrating, sham-controlled clinical trial. Eligible participants will include adults (aged 19–70 years old) with a clinical diagnosis of chronic sciatica (40 mm or more of a 100-mm visual analog scale (VAS) for bothersomeness) blinded to the treatment received. Patients will be randomly allocated into the acupuncture treatment group (manual acupuncture plus electroacupuncture (EA), n = 34) or the sham acupuncture control group (sham acupuncture plus placebo EA without electrical stimulation, n = 34). Groups will receive treatment twice a week for a total of eight sessions over 4 weeks. Functional magnetic resonance imaging will be implemented at baseline and endpoint to investigate the mechanism of acupuncture. The primary outcome measure is the VAS for bothersomeness and secondary outcomes include the VAS for pain intensity, Oswestry Disability Index, EuroQol 5-Dimension, Coping Strategy Questionnaire, Beck’s Depression Inventory, and State-Trait Anxiety Inventory. Adverse events will be assessed at every visit. Discussion The results of this trial (which will be available in 2020) should provide important clinical evidence for the effect of acupuncture and demonstrate how acupuncture can be helpful for the treatment of chronic sciatica. Trial registration ClinicalTrials.gov, ID: NCT03350789. Registered on 15 November 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3164-8) contains supplementary material, which is available to authorized users.

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) Checklist. (DOC 138 kb)

Beta-glucan (β-glucan) is a macromolecule structure where glucose unit has bonded through β-glycosidic bond at 1 and 3 positions. It is well known as a natural immunomodulator without exhibiting any side effects via enhancing immunity. Mushroom contains a large amount of β-glucan and it has anticancerous and antioxidant efficacy. Structure and physical properties of β-glucan are highly influenced by the types of mushroom. In particular, Grifola frondosa has β-1, 3 and β-1, 6 bonds in their structure. It has been noted that β-glucan content also depends upon the size of mushroom particles. The exact content of β-glucan and their immunological activity by a particle size of G. frondosa have yet to be fully elucidated. Herein, β-glucan contents were analyzed according to the particle size of leaf mushroom followed by cell activation and immunoactivity analysis. The highest β-glucan content was observed at a particle size of 20-30 μm (27.65 ± 0.30 w/w). All samples showed ~ 103% cell activation compared to the control and greater cell activity was observed at higher concentration. The significant increase in cytokines secretion was observed in the presence of 20-30 μm particle size of G. frondosa compared to the control. This study suggested that 20-30 μm size is the suitable size of G. frondosa that can be used as a health supplement and food additive to act as an immune booster, hypotensive agent, and hypoglycemic agent.

Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). (DOC 55 kb)

Because of impact on the underwater light field, CDOM can influence the accuracy of global satellite-based measurement of ocean chlorophyll and primary productivity. So we investigated the distribution and seasonal variation of CDOM in the East Sea during summer 2009 and 2011. Among them we report two distinctively different summer cases between 2009 and 2011 year, in which showed the different main sources for CDOM. Regulating factors and sources of CDOM in the East Sea were examined. Comparison between in situ and satellite derived Chl a and CDOM were made to find an influence of CDOM on measurement of satellite derived Chl a. Similar pattern and matching of MODIS Chl a with in situ Chl a 2009 was comparable, but significant discrepancy between MODIS Chl a and in situ Chl a was found, when CDOM was high in summer of 2011. GOCI data showed better matching with in situ data for both Chl a and CDOM, compared to MODIS data in summer of 2011. The presence of high CDOM at the surface layer supplied by vertical mixing seems to affect on the overestimation of Chl a by satellite data.

Stimulation degree, biomechanical force, and de qi sensation are the three major components of needle manipulation. To date, it has been difficult to measure all three components quantitatively.To (1) measure and compare biomechanical forces of six human acupoints in vivo during haptic manipulation, (2) develop phantom acupoints with biomechanical forces similar to those of human acupoints, and (3) validate the newly developed phantom acupoints based on assessment by doctors of Korean medicine.The biomechanical force and needle grasp sensation (i.e., the practitioner's de qi sensation) of six human acupoints (LI4, LI11, LR3, ST36, ST25, and BL25) were assessed in 16 participants upon stimulation with the twisting manipulation technique. On the basis of biomechanical data from these human acupoints, phantom acupoints that generated similar biomechanical forces were developed by using 1%-7% agarose gel.In humans, the mean torque amplitudes of the six acupoints differed significantly. In the phantom, the biomechanical force was dose-dependently greater in higher-concentration agarose gel phantom acupoints. Biomechanical force and the needle grasp sensation were significantly correlated in both human and phantom acupoints. Importantly, practitioners could not discriminate between human and phantom acupoints, suggesting that the validity and credibility of the phantom acupoints are sufficient for applications in education and research.Application of force-validated phantom acupoints based on human data will be a helpful tool for training and will contribute to a more comprehensive understanding of the characteristics of acupuncture manipulation.

This paper reports the design, analysis, and experimental results of a miniature spindle using magnetic bearings for very high-speed micromachining. To ensure stable high-speed rotation, the shaft was designed such that the first flexible natural frequency was higher than 9 kHz. Four-pole radial magnetic bearings with a permanent magnet bias were located in front of and behind the spindle, and axial air bearings at the spindle covers were used to hold the shaft in the axial direction. Additionally, to ensure small tools were clamped effectively, a clamping mechanism with a shape memory alloy was added at the nose of the shaft. The designed miniature spindle has an outer diameter of 62 mm and a total length of 94 mm, including the housing. The spindle was controlled with a digital signal processor (DSP)-based control system and rotated at up to 200,000 rpm using a built-in air turbine. The stability and ability of the spindle to control the tool orbit to generate micro-features was evaluated.

The lightshelf system reduces intense illumination levels of indoor from direct sun light and reflect to lead diffused light into indoor deeply. This study aims to design acurved-lightshelf by a ray tracing method and evaluate the daylighting performance of window integrated with the curved-lightshelf by computer simulations. For this purpose, evaluation test model was designed for the experiments to validate the simulation model, and the curved-lightshelf was designed by the ray tracing method using Ecotect. After the office model was designed using 3D simulation, the average indoor illuminance, luminance and distribution of illuminance were evaluated by simulation which has a algorithm of Radiosity and Ray-Tracing method under four different cases(case1;no lightshelf, case2; Flat board, case3; tilted at angle, case4; the curved-lightshelf). As results, it turns out that case1 showed higher average illuminance and case4 was more uniformly distributed than case2 and case3, In addition average luminance of case1 was also lower. indicating that the curved-lightshelf would reduce the possibility of the glare, while maintaining the sufficient daylight level.

Background Excessive mucus production is typical in various upper airway diseases. In sinusitis, the expression of MUC5AC, a major respiratory mucin gene, increases. However, the mechanisms leading to mucus hypersecretion in sinusitis have not been characterized. Hypoxia due to occlusion of the sinus ostium is one of the major pathologic mechanisms of sinusitis, but there have been no reports regarding the mechanism of hypoxia-induced mucus hypersecretion. Methods and Findings This study aims to identify whether hypoxia may induce mucus hypersecretion and elucidate its mechanism. Normal human nasal epithelial (NHNE) cells and human lung mucoepidermoid carcinoma cell line (NCI-H292) were used. Sinus mucosa from patients was also tested. Anoxic condition was in an anaerobic chamber with a 95% N2/5% CO2 atmosphere. The regulatory mechanism of MUC5AC by anoxia was investigated using RT-PCR, real-time PCR, western blot, ChIP, electrophoretic mobility shift, and luciferase assay. We show that levels of MUC5AC mRNA and the corresponding secreted protein increase in anoxic cultured NHNE cells. The major transcription factor for hypoxia-related signaling, HIF-1α, is induced during hypoxia, and transfection of a mammalian expression vector encoding HIF-1α results in increased MUC5AC mRNA levels under normoxic conditions. Moreover, hypoxia-induced expression of MUC5AC mRNA is down-regulated by transfected HIF-1α siRNA. We found increased MUC5AC promoter activity under anoxic conditions, as indicated by a luciferase reporter assay, and mutation of the putative hypoxia-response element in MUC5AC promoter attenuated this activity. Binding of over-expressed HIF-1α to the hypoxia-response element in the MUC5AC promoter was confirmed. In human sinusitis mucosa, which is supposed to be hypoxic, expression of MUC5AC and HIF-1α is higher than in control mucosa. Conclusion The results indicate that anoxia up-regulates MUC5AC by the HIF-1α signaling pathway in human nasal epithelia and suggest that hypoxia might be a pathogenic mechanism of mucus hypersecretion in sinusitis.

Dorsal soft-tissue defects of the foot and ankle are difficult to cover adequately, particularly in children, although multiple options for reconstruction are available. This study reports the long-term clinical outcomes of the use of distally based adipofascial flaps for these injuries in children. Fourteen children, all younger than 9 years, had relatively homogenous local lesions on the dorsum of the foot and ankle or on the distal lower leg. All 14 defects were covered with distally based adipofascial flaps, either lateral supramalleolar flaps (11 cases) or sural flaps (3 cases), after thorough wound debridement. The minimum follow-up interval was 5 years. The appearance of the reconstructed feet aesthetically and functionally satisfied the patients and their parents. Some patients exhibited a growth mismatch between grafted skin and the recipient site, resulting in mild extension contracture of the metatarsophalangeal joints; however, motion of the ankle joints was excellent.

The sensitivity of sulfate and nitrate deposition during a spring storm in the eastern United States to changes in SO x and NO x emissions is evaluated by performing simulations with the STEM-II acid deposition model. The proportionality between emission reductions and deposition is found to vary from the dry and wet processes. Dry deposition of sulfate and nitrate is proportional to SO x and NO x emissions, respectively. Liquid-phase production of sulfate is nonproportional to SO x and NO x emissions

Acid deposition in the eastern U.S. during a spring frontal storm from 1 to 5 May 1985 is analysed using the STEM-II acid deposition model. Nitrate formation is dominated by gas-phase production processes, with wet and dry deposition contributing equally to the total domain nitrate deposition. In-cloud sulfate production accounts for 60% of the total sulfate production, while wet deposition dominates the total sulfate deposition. Oxidation of S(IV) by hydrogen peroxide is the most important sulfate formation pathway. Hydrogen peroxide is found to exist in excess of S(IV) in cloud and rainwater in the storm front and at altitudes above 2 km. Production rates of sulfate in the high sulfur source regions are significantly lower (up to an order of magnitude) than in the moderate or low source regions. Model predictions are shown to capture the major features of the observed deposition.

Purpose The midfacial degloving approach (MFDA) is the primary option for the removal of benign and malignant sinonasal tumours. However, the classic MFDA does not compensate for the fact that most benign and malignant paranasal sinus (PNS) tumours are unilateral and the incisions may lead to some unnecessary complications?. Surgical exposure is limited to the upper and deep part of the PNS. Modifications of the classical MFDA that minimize complications and improve surgical field exposure are warranted. Patients The medical records of 27 consecutive patients who had undergone surgery using a modified MFDA for treatment of unilateral benign or malignant tumours from 2000 to 2006, were reviewed. Results We developed and performed a modified MFDA utilizing a hemigingivobuccal incision, a transfixion incision, mucosal detachment of the pyriform aperture and separation of the upper lateral cartilage from the nasal bone in 27 patients with unilateral benign (85%) or malignant (15%) PNS neoplasms. Adequate surgical exposure was achieved in all cases. No technical problems and no intraoperative complications related to the surgical ?procedure were encountered. Conclusion Our modified MFDA provides sufficient surgical exposure for the removal of unilateral malignant or benign PNS tumours with few surgical or cosmetic complications.

Utilisation d'un modele mathematique pour evaluer l'effet de la reduction des emissions de NO x , de SO x et d'hydrocarbures differents du methane sur les teneurs des polluants au sol mesurees tout au long de la distance s'etendant de la zone urbaine de Tokyo a la region centrale montagneuse du Japon

Many tumors, including hepatocellular carcinomas (HCCs), resist Fas-mediated cell death, which is one of the effector mechanisms in the host's anti-tumor response; however, this resistance can be abolished by interferon-gamma (IFN-gamma). IFN-gamma may sensitize Fas-mediated cell death in several ways, but the exact mechanism in HCCs is uncertain. In this study, we thoroughly investigated the effect of IFN-gamma on the susceptibility of one human normal liver cell line and 12 HCC cell lines to Fas-mediated cell death. We also investigated the effect of IFN-gamma on the expression of various apoptosis-related genes such as the Fas/TNF-related genes, the bcl-2 family, and the caspase family of genes. Although most cell lines showed considerable constitutive expression of Fas, all tested cell lines resisted Fas-mediated cell death without IFN-gamma. When cells were pretreated with IFN-gamma, only three cell lines were made significantly susceptible to Fas-mediated cell death (SNU-354, SNU-387 and SNU-423); the other 10 cell lines were not affected. IFN-gamma increased the mRNA expression of Fas, TRAIL and caspase-1, and surface Fas was also increased. The strongly sensitized cell lines (SNU-354, SNU-387 and SNU-423) showed a particularly potent increment in surface Fas after IFN-gamma treatment (increase in surface Fas1.7-fold). This result enabled us to conclude that a potent increment of surface Fas expression is a major sensitizing mechanism of IFN-gamma. We conclude that IFN-gamma cannot play a sensitizing role in most HCC cell lines and that IFN-gamma makes HCC cells susceptible to Fas-mediated cell death through a marked up-regulation of surface Fas in some HCC cells.