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Abstract Dyskalemia is a common electrolyte abnormality. Since dyskalemia can cause fatal arrhythmias and cardiac arrest in severe cases, it is crucial to monitor serum potassium (K+) levels on time. We developed deep learning models to detect hyperkalemia (K+ ≥ 5.5 mEq/L) and hypokalemia (K+

Abstract Aims This study evaluated how well serial pulse pressure (PP) and PP adjusted by the vasoactive inotropic score (VIS) predicted venoarterial extracorporeal membrane oxygenation (VA‐ECMO) weaning success and clinical outcomes in acute myocardial infarction complicated by cardiogenic shock (AMI‐CS) patients. Methods and results A total of 213 patients with AMI‐CS who received VA‐ECMO between January 2010 and August 2021 were enrolled in the institutional ECMO registry. Serial PP and VIS were measured immediately, 12, 24, and 48 h after VA‐ECMO insertion. PP adjusted by VIS was defined as PP/√VIS. The primary outcome was successful VA‐ECMO weaning. Successful weaning from VA‐ECMO was observed in 151 patients (70.9%). Immediately after VA‐ECMO insertion, PP [successful vs. failed weaning, 26.0 (15.5–46.0) vs. 21.0 (12.5–33.0), P = 0.386] and PP/√VIS [11.1 (5.1–25.0) vs. 6.0 (3.1–14.2), P = 0.118] did not differ between the successful and failed weaning groups. Serial PP and PP adjusted by VIS at 12, 24, and 48 h after VA‐ECMO insertion were significantly higher in patients with successful weaning than those with failed weaning [successful vs. failed weaning, 24.0 (4.0–38.0) vs. 12.5 (6.0–25.5), P = 0.007 for 12 h PP, and 10.1 (5.7–22.0) vs. 2.9 (1.7–5.9), P 7). Conclusions PP adjusted by VIS taken 12 h following VA‐ECMO initiation can predict weaning from VA‐ECMO more successfully than PP alone, and its low value was associated with a higher risk of mortality in AMI‐CS patients.

The complete mitochondrial genome of Leptychaster arcticus, deep-sea inhabited asteroid, was examined in this study. The complete mitogenome of L. arcticus is 16,253 bp in length and contains 13 protein-coding genes, 22 transfer RNA genes, and two ribosomal RNA genes. No gene rearrangements or deletions were observed in compared to other Paxillosida. The ND4L and ND3 genes have ‘ATT’ as its start codon, which is a feature that has been found in previous echinoderm mitochondrial studies. In the ML tree analysis based on the superorder Valvatacea, it was difficult to establish the molecular phylogenetic relationship at lower taxonomic levels, such as order and family, due to the lack of asteroid molecular data available. Therefore, we expect to contribute to the expansion of the data and determine the phylogenetic positioning in future studies.

Although percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been increasing in recent years, CTO PCI is still one of the most challenging procedures with relatively higher rates of procedural complications and adverse clinical events after PCI. Due to the innate limitations of invasive coronary angiography, intravascular imaging (IVI) has been used as an adjunctive tool to complement PCI, especially in complex coronary artery disease. Considering the complexity of CTO lesions, the role of IVI is particularly important in CTO intervention. IVI has been a useful adjunctive tool in every step of CTO PCI including assisted wire crossing, confirmation of wire location within CTO segment, and stent optimization. The meticulous use of IVI has been one of the greatest contributors to recent progress of CTO PCI. Nevertheless, studies evaluating the role of IVI during CTO PCI are limited. The current review provides a comprehensive overview of the mechanistic advantages of IVI in CTO PCI, summarizes previous studies and trials, and presents future perspective of IVI in CTO PCI.

Abstract Background Concomitant use of clopidogrel and proton pump inhibitor (PPI) is common, but PPI may reduce the antiplatelet effects of clopidogrel in patients undergoing percutaneous coronary intervention (PCI). We evaluated the impact of PPI use on clinical outcomes in post-PCI patients, by incorporating P2Y12 reaction unit (PRU) and CYP2C19 genotyping results. Methods From a multicenter registry of patients who underwent PCI with drug-eluting stent implantation and received clopidogrel-based dual antiplatelet therapy (DAPT), patients who were prescribed a PPI at the time of PCI (PPI users) were compared to those who were not (non-users). The primary outcome included all-cause death, myocardial infarction, stent thrombosis, or cerebrovascular accident at 12 months. Major bleeding (Bleeding Academic Research Consortium [BARC] types 3–5) and gastrointestinal (GI) bleeding (BARC types 3–5) were important secondary outcomes. The adjusted outcomes were compared using a 1:1 propensity-score (PS) matching and competing risk analysis. Results Of 13,160 patients, 2,235 (17.0%) were prescribed PPI, with an average age of 65.4 years. PPI users had higher on-treatment PRU levels than non-users. After PS matching, the primary outcome occurred in 51 patients who were PPI users (cumulative incidence, 4.7%) and 41 patients who were non-users (cumulative incidence, 3.7%; log-rank p = 0.27). In carriers of both CYP2C19 loss-of-function alleles, PPI use was linked to an increased risk of the primary outcome (hazard ratio, 3.22; 95% confidence interval, 1.18–8.78). The incidence of major bleeding and GI bleeding (BARC types 3–5) was comparable between PPI users and non-users in the PS-matched cohort. Conclusions In post-PCI patients receiving clopidogrel-based DAPT, PPI use was not linked to an increased risk of adverse cardiac and cerebrovascular events, but there was a small but significant increase in on-treatment PRU. Future research using a more individualized approach would further elucidate these interactions and guide evidence-based clinical practices.

Abstract We investigated the long-term patterns and effects of transfusion on the clinical outcome of patients undergoing percutaneous coronary intervention (PCI) using a nationwide registry. Five-year clinical outcome of all Koreans undergoing PCI using stent in year 2011 (n = 48,786) was investigated. Primary outcome was the incidence density of transfusion. The association of transfusion with major adverse clinical event (MACE) consisting all-cause death, revascularization, critically ill cardiovascular status, or stroke was assessed after adjusting the propensity of each patient for transfusion. The 5-year incidence density of transfusion was 4.74 (95% confidence interval [CI] 4.70–4.79) per 100 person-year. Patients who received transfusion were older and had higher frequency of clinical risk factors (p

Abstract Background Age-dependent immune responses to coronavirus disease 2019 (COVID-19) vaccinations and breakthrough infections (BIs) in young and middle-aged individuals are unclear. Methods This nationwide multicenter prospective cohort study analyzed immune responses in participants of the ChAdOx1 (ChAd)-ChAd-mRNA vaccine group using cytometry by time-of-flight, anti-spike protein antibody (Sab) and anti-nucleocapsid antibody (Nab) titers, plaque reduction neutralization tests (PRNTs), and interferon-gamma (IFN-γ) release assays at various time points. Results We evaluated 347 participants with an average age of 38.9 ± 9.4 years (range: 21–63). There was a significant inverse correlation between age and Sab levels after the second dose (slope − 14.96, P = 0.032), and this was more pronounced after the third dose (slope − 208.9, P

Abstract The bioinspired camera, comprising a single lens and a curved image sensor—a photodiode array on a curved surface—, was born of flexible electronics. Its economical build lends itself well to space-constrained machine vision applications. The curved sensor, much akin to the retina, helps image focusing, but the curvature also creates a problem of image distortion, which can undermine machine vision tasks such as object recognition. Here we report an anti-distortion single-lens camera, where 4096 silicon photodiodes arrayed on a curved surface in a nonuniform pattern assimilated to the distorting optics are the key to anti-distortion engineering. That is, the photo-pixel distribution pattern itself is warped in the same manner as images are warped, which correctively reverses distortion. Acquired images feature no appreciable distortion across a 120° horizontal view, as confirmed by their neural-network recognition accuracies. This distortion correction via photo-pixel array reconfiguration is a form of in-sensor computing.

Abstract Background We investigated the association between exercise habits before or after thyroidectomy and incident type 2 diabetes mellitus (T2DM) in patients with thyroid cancer. Methods An observational cohort study of 69,526 thyroid cancer patients who underwent thyroidectomy for the treatment of thyroid cancer between 2010 and 2016 was performed using the Korean National Health Information Database. Regular exercise was defined as mid-term or vigorous exercise at least 1 day in a week based on a self-reported questionnaire. Patients were divided into four groups according to exercise habits before and after thyroidectomy: persistent non-exercisers, new exercisers, exercise dropouts, and exercise maintainers. Results During a median follow-up of 4.5 years, 2,720 (3.91%) patients developed T2DM. The incidence of T2DM per 1,000 person years was lower in patients who performed regular exercise before or after thyroidectomy than in persistent non-exercisers (10.77 in persistent non-exerciser group, 8.28 in new exerciser group, 8.59 in exercise dropout group, and 7.61 in exercise maintainer group). Compared with the persistent non-exerciser group, the new exerciser group (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.78–0.97), the exercise dropout group (HR 0.81, 95% CI 0.72–0.91), and the exercise maintainer group (HR 0.84, 95% CI 0.76–0.93) had lower risks of incident T2DM. Exercising

Background: As the group at high risk for sepsis is increasing with the aging of the population, physical activity (PA), which has beneficial effects on various diseases, needs to be considered as a personalized prevention strategy for sepsis without direct anti-sepsis drug. Purpose: To examine the association between the amount of PA (based on intensity, duration, and frequency) and the incidence rates of sepsis and mortality after sepsis. Methods: This was a large-scale, retrospective, longitudinal cohort study using data from the Korean National Health Insurance Service and the biennial general health screening program. The amount of PA self-reported at the time of the health screening was categorized as non-PA, mild (

Abstract Carbon nanotubes (CNTs), owing to their superior electrical and mechanical properties, are a promising alternative to nonmetallic electrically conducting materials. In practice, cellulose as a low‐cost sustainable matrix has been used to prepare the aqueous dispersion of cellulose‐CNT (C‐CNT) nanocomposites. However, the compatibility with conventional solution‐processing and structural rearrangement for improving conductivity has yet to be determined. Herein, a straightforward route to prepare a conductive composite material from single‐walled CNTs (SWCNTs) and natural pulp is reported. High‐power shaking realizes the self‐alignment of individual SWCNTs in a cellulose matrix, resulting from the structural change in molecular orientations owing to countless collisions of zirconia beads in the aqueous mixture. The structural analysis of the dried C‐CNT films confirms that the entanglement and dispersion of C‐CNT nanowires determine the mechanical and electrical properties. Moreover, the rheological behavior of C‐CNT inks explains their coating and printing characteristics. By controlling shaking time, the electrical conductivity of the C‐CNT films with only 9 wt.% of SWCNTs from 0.9 to 102.4 S cm−1 are adjusted. the optimized C‐CNT ink is highly compatible with the conventional coating and printing processes on diverse substrates, thus finding potential applications in eco‐friendly, highly flexible, and stretchable electrodes is also demonstrated.

Background: Survival rates following percutaneous coronary intervention (PCI) show variability across studies, particularly regarding sex-specific outcomes. Relative survival analysis, which considers survival patterns in sex- and age-matched general populations, could help explain this variability. Methods: In a 2011 nationwide South Korean PCI cohort study with 48,783 patients, all-cause death was assessed as the primary outcome over 5 years. Observed and relative survival rates at 5 years conditional on surviving 0 days, 30 days, 1 year, and 2 years were assessed. Sex-specific differences in clinical characteristics were adjusted using propensity score-matching. Results: In the unadjusted analyses, 15,710 females had more cardiovascular risk factors than 33,073 males. Both observed survival (HR 1.28; 95% CI [1.22–1.34]) and relative survival (HR 1.21; 95% CI [1.16–1.27]) were lower in females than males (all p

Abstract When implementing optoelectronic devices through the stacking of heterogeneous materials, considering the bandgap offset is crucial for achieving efficient carrier dynamics. In this study, the bandgap offset characteristics are investigated when n‐type gallium nitride nanowires (n‐GaN NWs) are used as electron transport layers in methylammonium lead iodide (MAPbI3)‐based optoelectronic devices. n‐GaN NWs are grown on indium‐tin‐oxide (ITO)‐coated glass via the plasma‐assisted molecular beam epitaxy (PA‐MBE) process to form the “GaN NWs‐on‐glass” platform. A MAPbI3 thin film is then spin‐coated on the GaN NWs‐on‐glass. X‐ray photoelectron spectroscopy (XPS) shows that the valence and conduction band offsets in the MAPbI3/n‐GaN heterostructure are 2.19 and 0.40 eV, respectively, indicating a type‐II band alignment ideal for optoelectronic applications. Prototype photovoltaic devices stacking perovskite on GaN NWs‐on‐glass show excellent interfacial charge‐transfer ability, photon recycling, and carrier extraction efficiency. As a pioneering step in exploiting the diverse potential of the GaN‐on‐glass, it is demonstrated that the junction characteristics of MAPbI3/n‐GaN NW heterostructures can lead to a variety of optoelectronic device applications.

Abstract The exploration of novel hosts with the ability to assimilate formic acid, a C1 substrate that can be produced from renewable electrons and CO2, is of great relevance for developing novel and sustainable biomanufacturing platforms. Formatotrophs can use formic acid or formate as a carbon and/or reducing power source. Formatotrophy has typically been studied in neutrophilic microorganisms because formic acid toxicity increases in acidic environments below the pKa of 3.75 (25°C). Because of this toxicity challenge, utilization of formic acid as either a carbon or energy source has been largely unexplored in thermoacidophiles, species that possess the ability to produce a variety of metabolites and enzymes of high biotechnological relevance. Here we investigate the capacity of several thermoacidophilic archaea species from the Sulfolobales order to tolerate and metabolize formic acid. Metallosphaera prunae, Sulfolobus metallicus and Sulfolobus acidocaldarium were found to metabolize and grow with 1–2 mM of formic acid in batch cultivations. Formic acid was co‐utilized by this species alongside physiological electron donors, including ferrous iron. To enhance formic acid utilization while maintaining aqueous concentrations below the toxicity threshold, we developed a bioreactor culturing method based on a sequential formic acid feeding strategy. By dosing small amounts of formic acid sequentially and feeding H2 as co‐substrate, M. prunae could utilize a total of 16.3 mM of formic acid and grow to higher cell densities than when H2 was supplied as a sole electron donor. These results demonstrate the viability of culturing thermoacidophilic species with formic acid as an auxiliary substrate in bioreactors to obtain higher cell densities than those yielded by conventional autotrophic conditions. Our work underscores the significance of formic acid metabolism in extreme habitats and holds promise for biotechnological applications in the realm of sustainable energy production and environmental remediation.

Middle aged women are exposed to high levels of psychologic distress due to various factors including health problems of family members, their own declining health, negative outlook towards menopause, loss of significant supportive relationships, and uncertainties regarding the future. The purpose of this study was to identify the factors associated with psychologic distress of middle-aged Korean women in the Seoul metropolitan area. Methods: The data were collected from 277 community-dwelling women between the ages of 40 and 60 years without any known severe illnesses from May 6, 2004 to May 31, 2004. The researcher or two research assistants visited the participants in person, handed out copies of the questionnaire after receiving study permission, and answered if they had any questions. Results: Hierarchical multiple regression analysis found that women with low scores of health promoting behaviors for self-actualization, nutrition, and interpersonal relation reported high levels of psychologic distress. In addition, women with low scores of marital satisfaction reported high psychologic distress. Conclusion: The study found cultural characteristics of middle-aged Korean women in psychologic distress. Health care providers should consider marital satisfaction, self-actualization, nutrition, and interpersonal relations, in particular, among Korean middle-aged women.

Ground-penetrating radars (GPR) based on a variety of techniques have been proposed to improve the performance of buried target (e.g., landmines, threat devices) detection. However, the small radar cross section (RCS) of small electronic devices poses difficulties for target detection, especially when they are buried in lossy and inhomogeneous media. This paper presents a novel buried nonlinear target detection method based on the decomposition of the time-reversal operator (DORT) that uses a multistatic system to overcome the limitations of conventional GPR. Using harmonic radar, which detects the harmonic responses scattered from electronic devices, and DORT processing, which enables focusing/imaging of the detected target, the detection performance is verified by conducting simulation and measurements. The overall results demonstrate that the proposed method achieves accurate detection of buried targets with small RCS.

Introduction: The combination of atezolizumab/bevacizumab has emerged as an effective first-line treatment for advanced hepatocellular carcinoma (HCC). However, this therapy is potentially associated with bleeding complications, warranting a comprehensive analysis of their incidence and severity. This meta-analysis aims to synthesize available evidence from clinical trials and observational studies to quantify the prevalence of bleeding following atezolizumab/bevacizumab administration. Methods: This meta-analysis focused on HCC treatment using atezolizumab/bevacizumab, particularly examining bleeding complications. It determined the prevalence of bleeding post-administration and compared the risk ratio with tyrosine kinase inhibitors (sorafenib or lenvatinib). Risk factors for bleeding complications were also evaluated. Results: From 28 studies involving 3,895 patients, the pooled prevalence of bleeding side effects was 8.42% (95% CI: 5.72–11.54). Grade III or IV bleeding occurred in 4.42% (95% CI: 2.64–6.10) of patients, with grade V bleeding observed in 2.06% (95% CI: 0.56–4.22). Gastrointestinal bleeding, predominantly variceal, was the most common, with a prevalence of 5.48% (95% CI: 3.98–7.17). Subgroup analysis indicated variability in bleeding rates based on study design and geographical location. Atezolizumab/bevacizumab treatment exhibited a 2.11 times higher prevalence of bleeding compared to tyrosine kinase inhibitors (95% CI: 1.21–3.66). Meta-regression identified high body mass index (BMI) and higher proportion of albumin-bilirubin (ALBI) grade 3 as significant risk factors for bleeding complications. Conclusion: Atezolizumab/bevacizumab therapy for advanced HCC carries a heightened risk of gastrointestinal bleeding, exceeding that of tyrosine kinase inhibitors. High BMI and higher ALBI grade are key predictors of bleeding complications, emphasizing the need for cautious patient selection and monitoring.

Abstract This study evaluated the association of atherogenic index of plasma (AIP) with platelet reactivity and clinical outcomes according to acute myocardial infarction (AMI). The composite of 3-year adverse outcomes of all-cause death, myocardial infarction, and cerebrovascular accident was evaluated in 10,735 patients after successful percutaneous coronary intervention with drug-eluting stents. AIP was defined as the base 10 logarithm of the ratio of triglyceride to high-density lipoprotein cholesterol concentration. High platelet reactivity (HPR) was defined as ≥ 252 P2Y12 reactivity unit. An increase of AIP (per-0.1 unit) was related to the decreased risk of HPR [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.96–0.99; P = 0.001] in non-AMI patients, not in AMI patients (OR 0.98, 95% CI 0.96–1.01; P = 0.138). The HPR was associated with the increased risk of composite outcomes in both non-AMI and AMI patients (all-P

Background The predictive factors for lateral neck lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC) remain undetermined. This study investigated the clinicopathological characteristics, transcriptomes, and tumor microenvironment in PTMC according to the LLNM status. We aimed to identify the biomarkers associated with LLNM development. Methods We retrospectively reviewed the medical records of patients with PTMC from two independent institutions between 2018 and 2022 (n=597 and n=467). We compared clinicopathological features between patients without lymph node metastasis (N0) and those with LLNM (N1b). Additionally, laser capture microdissection and RNA sequencing were performed on primary tumors from both groups, including metastatic lymph nodes from the N1b group (n=30; 20 primary tumors and 10 paired LLNMs). We corroborated the findings using RNA sequencing data from 16 BRAF-like PTMCs from The Cancer Genome Atlas. Transcriptomic analyses were validated by immunohistochemical staining. Results Clinicopathological characteristics, such as male sex, multifocality, extrathyroidal extension, lymphatic invasion, and central node metastasis showed associations with LLNM in PTMCs. Transcriptomic profiles between the N0 and N1b PTMC groups were similar. However, tumor microenvironment deconvolution from RNA sequencing and immunohistochemistry revealed an increased abundance of tumor-associated macrophages, particularly M2 macrophages, in the N1b group. Conclusion Patients with PTMC who have a male sex, multifocality, extrathyroidal extension, lymphatic invasion, and central node metastasis exhibited an elevated risk for LLNM. Furthermore, infiltration of M2 macrophages in the tumor microenvironment potentially supports tumor progression and LLNM in PTMCs.

Background Current research has not investigated the effect of thyroid-stimulating hormone suppression therapy with levothyroxine on the risk for developing subsequent primary cancers (SPCs). This study aimed to investigate the association between levothyroxine dosage and the risk for SPCs in thyroid cancer patients. Methods We conducted a nationwide population-based retrospective cohort study form Korean National Health Insurance database. This cohort included 342,920 thyroid cancer patients between 2004 and 2018. Patients were divided into the non-levothyroxine and the levothyroxine groups, the latter consisting of four dosage subgroups according to quartiles. Cox proportional hazard models were performed to evaluate the risk for SPCs by adjusting for variables including cumulative doses of radioactive iodine (RAI) therapy. Results A total of 17,410 SPC cases were observed over a median 7.3 years of follow-up. The high-dose levothyroxine subgroups (Q3 and Q4) had a higher risk for SPC (adjusted hazard ratio [HR], 1.14 and 1.27; 95% confidence interval [CI], 1.05–1.24 and 1.17– 1.37; respectively) compared to the non-levothyroxine group. In particular, the adjusted HR of stomach (1.31), colorectal (1.60), liver and biliary tract (1.95), and pancreatic (2.48) cancers were increased in the Q4 subgroup. We consistently observed a positive association between high levothyroxine dosage per body weight and risk of SPCs, even after adjusting for various confounding variables. Moreover, similar results were identified in the stratified analyses according to thyroidectomy type and RAI therapy, as well as in a subgroup analysis of patients with good adherence. Conclusion High-dose levothyroxine use was associated with increased risk of SPCs among thyroid cancer patients regardless of RAI therapy.

In this study, we explore the potential of leveraging machine learning techniques, specifically auto-encoders (AE), for the decoding of linear block codes. Our findings suggest that this approach can outperform the conventional ordered statistics decoding (OSD) method, especially in a Rayleigh fading channel environment. We have rigorously trained the AE under both additive white Gaussian noise and Rayleigh fading channel conditions to ensure robustness in its performance. The output of the AE is combined with the received vector in a suitable manner to perform OSD. Through our experiments, we demonstrate that this proposed decoding approach yields better results than the conventional OSD method in Rayleigh fading channel when we used (23,12) Golay code.

Korea Pathfinder Lunar Orbiter (KPLO) is South Korea’s first space exploration mission, developed by the Korea Aerospace Research Institute. It aims to develop technologies for lunar exploration, explore lunar science, and test new technologies. KPLO was launched on August 5, 2022, by a Falcon-9 launch vehicle from cape canaveral space force station (CCSFS) in the United States and placed on a ballistic lunar transfer (BLT) trajectory. A total of four trajectory correction maneuvers were performed during the approximately 4.5-month trans-lunar cruise phase to reach the Moon. Starting with the first lunar orbit insertion (LOI) maneuver on December 16, the spacecraft performed a total of three maneuvers before arriving at the lunar mission orbit, at an altitude of 100 kilometers, on December 27, 2022. After entering lunar orbit, the commissioning phase validated the operation of the mission mode, in which the payload is oriented toward the center of the Moon. After completing about one month of commissioning, normal mission operations began, and each payload successfully performed its planned mission. All of the spacecraft operations that KPLO performs from launch to normal operations were designed through the system operations design process. This includes operations that are automatically initiated post-separation from the launch vehicle, as well as those in lunar transfer orbit and lunar mission orbit. Key operational procedures such as the spacecraft’s initial checkout, trajectory correction maneuvers, LOI, and commissioning were developed during the early operation preparation phase. These procedures were executed effectively during both the early and normal operation phases. The successful execution of these operations confirms the robust verification of the system operation.

Anthropogenic methane emissions are a leading cause of the increase in global average temperatures, often referred to as global warming. Flooded soils play a significant role in methane production, where the anaerobic conditions promote the production of methane by methanogenic microorganisms. Rice fields contribute a considerable portion of agricultural methane emissions, as rice plants provide both factors that enhance and limit methane production. Rice plants harbor both methane- producing and methane-oxidizing microorganisms. Exudates from rice roots provide source for methane production, while oxygen delivered from the root aerenchyma enhances methane oxidation. Studies have shown that the diversity of these microorganisms depends on rice cultivars with some genes characterized as harboring specific groups of microorganisms related to methane emissions. However, there is still a need for research to determine the balance between methane production and oxidation, as rice plants possess the ability to regulate net methane production. Various agronomical practices, such as fertilizer and water management, have been employed to mitigate methane emissions. Nevertheless, studies correlating agronomic and chemical management of methane with productivity are limited. Moreover, evidences for breeding low-methane-emitting rice varieties are scattered largely due to the absence of coordinated breeding programs. Research has indicated that phenotypic characteristics, such as root biomass, shoot architecture, and aerenchyma, are highly correlated with methane emissions. This review discusses available studies that involve the correlation between plant characteristics and methane emissions. It emphasizes the necessity and importance of breeding low-methane-emitting rice varieties in addition to existing agronomic, biological, and chemical practices. The review also delves into the ideal phenotypic and physiological characteristics of low-methane-emitting rice and potential breeding techniques, drawing from studies conducted with diverse varieties, mutants, and transgenic plants.

Immune checkpoint inhibitors (ICIs) are highly effective in cancer treatment. However, the risks associated with the treatment must be carefully balanced against the therapeutic benefits. Immune-related adverse events (irAEs) are generally unpredictable and may persist over an extended period. In this review, we analyzed common irAEs reported in highly cited original articles and systematic reviews. The prevalent adverse reactions include fatigue, pyrexia, rash, pruritus, diarrhea, decreased appetite, nausea, abdominal pain, constipation, hepatitis, and hypothyroidism. Therefore, it is crucial to conduct evaluations not only of gastrointestinal organs but also of cardiac, neurologic, endocrine (including the frequently affected thyroid), and ophthalmic systems before commencing ICIs. This review further explores commonly reported types of irAEs, specific irAEs associated with each ICI agent, rare yet potentially fatal irAEs, and available treatment options for managing them.

Photodynamic therapy (PDT) activates intracellular oxygen using a photosensitizer activated by light of a specific wavelength and is a potential means of treating wound infections caused by antibiotic-resistant bacteria. Pseudomonas aeruginosa (P. aeruginosa) is typically non-pathogenic in healthy individuals but can induce severe illnesses like sepsis in the immunocompromised. Antibiotics have been conventionally used to treat P. aeruginosa infections, but increasing antibiotic resistance caused by drug misuse poses a growing challenge to the management of these infections. This study aimed to investigate the ability of PDT using photosensitizers (PhotoMed, Methyl pheophorbide A, or RadachlorinⓇ) and a diode laser to inhibit P. aeruginosa. Suspensions of P. aeruginosa and a photosensitizer were inoculated into Petri dishes and incubated for 30 minutes. Samples were then irradiated with the laser at 3 J/cm2, and after incubation, colony areas were measured. P. aeruginosa killing rates were 79.65% for PhotoMed, 47.36% for Methyl pheophorbide A, and 40.91% for RadachlorinⓇ. This study shows that PDT using a diode laser and a photosensitizer constitutes an effective practical therapeutic approach for inhibiting P. aeruginosa.

Background The classification of nodal peripheral T-cell lymphoma (PTCL) has evolved according to histology, cell-of-origin, and genetic alterations. However, the comprehensive expression pattern of follicular helper T-cell (Tfh) markers, T-cell factor-1 (TCF1), and Th1-and Th2-like molecules in nodal PTCL is unclear. Methods Eighty-two cases of nodal PTCL were classified into 53 angioimmunoblastic T-cell lymphomas (AITLs)/nodal T-follicular helper cell lymphoma (nTFHL)-AI, 18 PTCLs-Tfh/nTFHL–not otherwise specified (NOS), and 11 PTCLs-NOS according to the revised 4th/5th World Health Organization classifications. Immunohistochemistry for TCF1, TBX21, CXCR3, GATA3, and CCR4 was performed. Results TCF1 was highly expressed in up to 68% of patients with nTFHL but also in 44% of patients with PTCL-NOS (p > .05). CXCR3 expression was higher in AITLs than in non-AITLs (p = .035), whereas GATA3 expression was higher in non-AITL than in AITL (p = .007) and in PTCL-Tfh compared to AITL (p = .010). Of the cases, 70% of AITL, 44% of PTCLTfh/nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the TBX21 subtype; and 15% of AITL, 38% of PTCL-Tfh/nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the GATA3 subtype. The others were an unclassified subtype. CCR4 expression was associated with poor progression-free survival (PFS) in patients with PTCL-Tfh (p < .001) and nTFHL (p = .023). The GATA3 subtype showed poor overall survival in PTCL-NOS compared to TBX21 (p = .046) and tended to be associated with poor PFS in patients with non-AITL (p = .054). Conclusions The TBX21 subtype was more prevalent than the GATA3 subtype in AITL. The GATA3 subtype was associated with poor prognosis in patients with non-AITL and PTCL-NOS.

Abstract The clinical impact of different polymer technologies in newer-generation drug-eluting stents (DESs) for patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) remains poorly understood. We investigated the efficacy and safety of durable polymer DESs (DP-DESs) compared with biodegradable polymer DESs (BP-DESs). A total of 620 patients who underwent percutaneous coronary intervention with newer-generation DESs for AMI complicated by CS was divided into two groups based on polymer technology: the DP-DES group (n = 374) and the BP-DES group (n = 246). The primary outcome was target vessel failure (TVF) during a 12-month follow-up, defined as a composite of cardiac death, myocardial infarction, or target vessel revascularization. Both the DP-DES and BP-DES groups exhibited low stent thrombosis rates (1.3% vs. 1.6%, p = 0.660). The risk of TVF did not significantly differ between the two groups (34.2% vs. 28.5%, hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.69–1.29, p = 0.721). This finding remained consistent after adjustment with inverse probability of treatment weighting (28.1% vs. 25.1%, HR 0.98, 95% CI 0.77–1.27, p = 0.899). In AMI patients complicated by CS, the risk of a composite of cardiac death, myocardial infarction, or target vessel revascularization was not significantly different between those treated with DP-DESs and those treated with BP-DESs. Trial registration: RESCUE registry, https://clinicaltrials.gov/ct2/show/NCT02985008 , NCT02985008.

Abstract Bioresorbable neural implants based on emerging classes of biodegradable materials offer a promising solution to the challenges of secondary surgeries for removal of implanted devices required for existing neural implants. In this study, we introduce a fully bioresorbable flexible hybrid opto-electronic system for simultaneous electrophysiological recording and optogenetic stimulation. The flexible and soft device, composed of biodegradable materials, has a direct optical and electrical interface with the curved cerebral cortex surface while exhibiting excellent biocompatibility. Optimized to minimize light transmission losses and photoelectric artifact interference, the device was chronically implanted in the brain of transgenic mice and performed to photo-stimulate the somatosensory area while recording local field potentials. Thus, the presented hybrid neural implant system, comprising biodegradable materials, promises to provide monitoring and therapy modalities for versatile applications in biomedicine.

AbstractIn the realm of optical technologies, the integration of nature’s designs and modern engineering has paved the way for groundbreaking innovations. Bio-inspired tunable optics and photonics, drawing from the intricate mechanisms found in biological systems, offer a new frontier in adaptive and efficient light management. Here, this review presents a comprehensive examination of the principles, advancements, and applications of natural light-manipulation and adaptation mechanisms, highlighting their translation into artificial tunable optics and photonic structures. Emphasizing the remarkable potential of bio-inspired systems, particularly those emulating the tunable optical functionalities of biological eyes and skins, it explores the current state of bio-inspired tunable optics and photonic devices. Our review categorizes these tunable bio-inspired systems into two foundational mechanisms: light-manipulation and light-adaptation, illustrating their wide-ranging implications from consumer electronics to next-generation technologies. This review also highlights the challenges and prospects of bio-inspired tunable optics and photonics. It emphasizes their role in promoting tunable optical properties for multifunctional devices, providing revolutionary opportunities across various sectors, including the military and everyday life, thus surpassing current cutting-edge optical technologies.

Introduction There is a lack of evidence to support the effectiveness of prolonged β-blocker therapy after stabilisation of patients with acute myocardial infarction (AMI) without heart failure (HF) or left ventricular systolic dysfunction.Methods and analysis The SMart Angioplasty Research Team: DEcision on Medical Therapy in Patients with Coronary Artery DIsease or Structural Heart Disease Undergoing InterventiON (SMART-DECISION) trial is a multicentre, prospective, open-label, randomised, non-inferiority trial designed to determine whether discontinuing β-blocker therapy after ≥1 year of maintenance in stabilised patients after AMI is non-inferior to continuing it. Patients eligible for participation are those without HF or left ventricular systolic dysfunction (ejection fraction >40%) who have been continuing β-blocker therapy for ≥1 year after AMI. A total of 2540 patients will be randomised 1:1 to continuation of β-blocker therapy or not. Randomisation will be stratified according to the type of AMI (ie, ST-segment-elevation MI or non-ST-segment-elevation MI), type of β-blocker (carvedilol, bisoprolol, nebivolol or other) and participating centre. The primary study endpoint is a composite of all-cause death, MI and hospitalisation for HF over a median follow-up period of 3.5 years (minimum, 2.5 years; maximum, 4.5 years). Adverse effects related to β-blocker therapy, the occurrence of atrial fibrillation, medical costs and Patient-reported Outcomes Measurement Information system-29 questionnaire responses will also be collected as secondary endpoints.Ethics and dissemination Ethics approval for this study was granted by the Institutional Review Board of Samsung Medical Center (no. 2020-10-176). Informed consent is obtained from every participant before randomisation. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conferences.Trial registration number ClinicalTrials.gov, NCT04769362.

Carbon-based fibers have attracted attention in various field owing to their exceptional properties, including high tensile strength, thermal stability, and electrical conductivity. In particular, graphene-based high-strength fibers are promising materials in aerospace, automotive, and marine sectors. Recently, the hybrid fiber, consisting of carbon nanotubes (CNTs) and graphene with enhanced toughness was reported by deflecting cracks and enabling high deformation. However, complex synthesis and structural optimization of composite fiber with two different materials make challenge for mass production. Here, we introduce a novel graphene composite fiber, consisting of reduced graphene oxide (rGO) and scrolled rGO (SrGO), showing remarkable toughness. A multidimensional-state solution with 2D rGO and 1D SrGO was obtained by using a simple sonication technique. Mass production of high-toughness composite fibers was achieved via wet-spinning, with enhanced toughness attributed to microstructure optimization by controlling the SrGO ratio. Additionally, the use of poly(vinyl alcohol) (PVA) as the matrix facilitated high deformation, resulting in a remarkable 90.7 % increase in mechanical toughness without complex composite material synthesis.

Tobacco (Nicotiana tabacum) is known for its psychoactive alkaloid nicotine, which presents significant public health challenges. Recent research has linked the final stages of nicotine biosynthesis with the BBL and A622 genes, yet this part of the biosynthetic pathway remains largely unexplored, representing a 'black box' in our understanding. In our study, we employed a multi-target CRISPR/Cas9 system to target homologous genes of BBL and A622 in commercial tobacco varieties Virginia, creating various mutants. This led to significant variations in plant development and alkaloid content. Notably, mutant lines a622a-38–5 and a622l-3–9 with exon-intron boundary deletions exhibited significantly decreased plant height and leaf number, along with a substantial reduction in alkaloids, including nicotine. Particularly, double mutants in the A622 family displayed more severe effects than sextuple BBL mutants, emphasizing the distinctive role of A622 in nicotine synthesis and plant development. Our findings demonstrate that mutations in A622 and BBL genes can drastically reduce nicotine and anatabine content, with some cases showing reductions up to 99.6%. These results underscore the potential of genome editing in developing tobacco varieties with significantly lower nicotine levels. This study not only enhances our understanding of nicotine biosynthesis but also contributes to public health efforts by providing a pathway to develop less addictive tobacco products.

Abstract Adaptive multicolor filters have emerged as key components for ensuring color accuracy and resolution in outdoor visual devices. However, the current state of this technology is still in its infancy and largely reliant on liquid crystal devices that require high voltage and bulky structural designs. Here, we present a multicolor nanofilter consisting of multilayered ‘active’ plasmonic nanocomposites, wherein metallic nanoparticles are embedded within a conductive polymer nanofilm. These nanocomposites are fabricated with a total thickness below 100 nm using a ‘lithography-free’ method at the wafer level, and they inherently exhibit three prominent optical modes, accompanying scattering phenomena that produce distinct dichroic reflection and transmission colors. Here, a pivotal achievement is that all these colors are electrically manipulated with an applied external voltage of less than 1 V with 3.5 s of switching speed, encompassing the entire visible spectrum. Furthermore, this electrically programmable multicolor function enables the effective and dynamic modulation of the color temperature of white light across the warm-to-cool spectrum (3250 K–6250 K). This transformative capability is exceptionally valuable for enhancing the performance of outdoor optical devices that are independent of factors such as the sun’s elevation and prevailing weather conditions.

Abstract Fusion-positive rhabdomyosarcoma (FP-RMS) is an aggressive pediatric sarcoma driven primarily by the PAX3-FOXO1 fusion oncogene, for which therapies targeting PAX3-FOXO1 are lacking. Here, we screen 62,643 compounds using an engineered cell line that monitors PAX3-FOXO1 transcriptional activity identifying a hitherto uncharacterized compound, P3FI-63. RNA-seq, ATAC-seq, and docking analyses implicate histone lysine demethylases (KDMs) as its targets. Enzymatic assays confirm the inhibition of multiple KDMs with the highest selectivity for KDM3B. Structural similarity search of P3FI-63 identifies P3FI-90 with improved solubility and potency. Biophysical binding of P3FI-90 to KDM3B is demonstrated using NMR and SPR. P3FI-90 suppresses the growth of FP-RMS in vitro and in vivo through downregulating PAX3-FOXO1 activity, and combined knockdown of KDM3B and KDM1A phenocopies P3FI-90 effects. Thus, we report KDM inhibitors P3FI-63 and P3FI-90 with the highest specificity for KDM3B. Their potent suppression of PAX3-FOXO1 activity indicates a possible therapeutic approach for FP-RMS and other transcriptionally addicted cancers.

The indolent nature and favorable outcomes associated with papillary thyroid microcarcinoma have prompted numerous prospective studies on active surveillance (AS) and its adoption as an alternative to immediate surgery in managing low-risk thyroid cancer. This article reviews the current status of AS, as outlined in various international practice guidelines. AS is typically recommended for tumors that measure 1 cm or less in diameter and do not exhibit aggressive subtypes on cytology, extrathyroidal extension, lymph node metastasis, or distant metastasis. To determine the most appropriate candidates for AS, factors such as tumor size, location, multiplicity, and ultrasound findings are considered, along with patient characteristics like medical condition, age, and family history. Moreover, shared decision-making, which includes patient-reported outcomes such as quality of life and cost-effectiveness, is essential. During AS, patients undergo regular ultrasound examinations to monitor for signs of disease progression, including tumor growth, extrathyroidal extension, or lymph node metastasis. In conclusion, while AS is a feasible and reliable approach for managing low-risk thyroid cancer, it requires careful patient selection, effective communication for shared decision-making, standardized follow-up protocols, and a clear definition of disease progression.

Background: This study was designed to determine changes in risk factors on the prognosis of patients during each period of the bloodstream infection (BSI) timeline. Methods: Through an integrated study of multivariable regressions with machine learning techniques, the risk factors for mortality during each period of BSI were analyzed. Results: A total of 302,303 inpatients who underwent blood cultures during 2011–2021 were enrolled. More than 8 % of BSI cases progressed to subsequent BSI, and risk factors were identified as gut colonization with vancomycin-resistant enterococci (aOR 1.82; 95 % CI 1.47–2.24), intensive care unit admission (aOR 3.37; 95 % CI 3.35–4.28), and current cancer chemotherapy (aOR 1.54; 95 % CI 1.36–1.74). The mean SOFA score of the deceased patients during the first 7 days was 10.6 (SD 4.3), which was significantly higher than those on days 8–30 (7.0 ± 4.2) and after Day 30 (4.0 ± 3.5). BSIs caused by Acinetobacter baumannii and Candida albicans were more likely to result in deaths of patients for all time periods (all, P

For improving thermal characteristics and on-current ( $I_{\mathrm {ON}}$ ) in vertically stacked nanosheet field-effect transistor (NSFET), the effect of parasitic channel height ( $H_{\mathrm {parasitic}}$ ) on thermal and electrical characteristics has been investigated. By increasing $H_{\mathrm {parasitic}}$ , it has been demonstrated that the maximum lattice temperature ( $T_{\max }$ ) could be improved from 428 K to 416 K, and thermal resistance ( $R_{\mathrm {TH}}$ ) could be improved by 9.3 %. This thermal improvement has been achieved since the increased parasitic channel height could lead to the formation of effective heat sink. The relationship between $H_{\mathrm {parasitic}}$ and the thermal characteristics of the device has rarely been addressed in previous studies, and we have explored this with a novel approach. In addition, regarding $I_{\mathrm {ON}}$ , it has been demonstrated that the proposed device structure could have 19.7 % higher $I_{\mathrm {ON}}$ , due to the increased fringing field effect. The origin and benefits of these thermal and electrical improvement have been thoroughly investigated through Synopsys Sentaurus three-dimensional (3D) technology computer-aided design (TCAD) simulation tool. The proposed NSFET structure is expected to be very strategic for the next-generation IC chip design with increased performance (from $I_{\mathrm {ON}}$ improvement) and enhanced reliability (from thermal improvement), at the same time.

Abstract Stent thrombosis (ST) is a fatal complication after percutaneous coronary intervention (PCI). The association between P2Y12 reaction unit (PRU) level and stent thrombosis occurrence remains unclear. Based on the multicenter, observational PTRG-DES (Platelet function and genoType-Related long-term proGnosis in DES-treated patients) registry of patients with drug-eluting stents (DES) implantation, a total of 11,714 patients with PRU values were analyzed. We sought to identify the predictors of early stent thrombosis (EST) and compared the primary outcome, a composite of cardiac death, myocardial infarction, and revascularization, between EST and non-EST groups. EST, defined as definite ST within 1 month after index PCI, occurred in 51 patients. PRU values were significantly higher in the EST group (263.5 ± 70.8 vs. 217.5 ± 78.7, p

Purpose: Understanding the native posterior tibial slope (PTS) is important especially in cruciate ligament retaining total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA). This study investigated the efficacy of PTS with lateral knee radiograph (radiographic PTS) by comparing it with PTS of medial and lateral tibial condyles (MPTS and LPTS) by computed tomography (CT). Methods: In patients who underwent TKA and UKA on varus knee osteoarthritis, radiographic PTS, MPTS, and LPTS were measured. Spearman's correlation was used to compare the radiographic PTS and PTS on CT. More than 3° delta PTS (CT PTS - radiographic PTS) were defined as positive outliers. Results: Three-hundred and twenty-six osteoarthritic knees (278 TKAs and 48 UKAs) were evaluated. The mean radiographic PTS, MPTS, LPTS was 8.0 ​± ​2.9°, 10.2 ​± ​4.2°, and 8.3 ​± ​3.3°, respectively. Plain radiograph tended to underestimate steep MPTS, and its correlations to LPTS (ρ ​= ​0.65, p ​

Artificial antireflective nanostructured surfaces, inspired by moth eyes, effectively reduce optical losses at interfaces, offering significant advantages in enhancing optical performance in various optoelectronic applications, including solar cells, light-emitting diodes, and cameras. However, their limited flexibility and low surface hardness constrain their broader use. In this study, we introduce a universal antireflective film by integrating nanostructures on both sides of a thin polycarbonate film. One side was thinly coated with Al2O3 for its high hardness, enhancing surface durability while maintaining flexibility. The opposite side was coated with SiO2 to optimize antireflective properties, making the film suitable for diverse environments (i.e., air, water, and adhesives). This dual-coating strategy resulted in a mechanically robust and flexible antireflective film with superior optical properties in various conditions. We demonstrated the universal capabilities of our antireflective film via optical simulations and experiments with the fabricated film in different environments.

Background: Ricin, a toxin extracted from the seeds of Ricinus communis, is classified as a ribosome-inactivating protein. The A-subunit of ricin shows RNA N-glycosidase activity that cleaves ribosomal RNA (rRNA) and exhibits toxicity by inhibiting protein synthesis and inducing vascular leak syndrome. Methods: In this study, we created a truncated version of the previously developed R51 ricin vaccine (RTA 1-194 D75C Y80C) through in silico analysis. Results: The resulting R51-3 vaccine showed a more-than-six-fold increase in soluble protein expression when compared to R51, with over 85% solubility. In a pilot toxicity test, no toxicity was observed in hematological and biochemical parameters in BALB/c mice and New Zealand white rabbits following five repeated administrations of R51-3. Furthermore, R51-3 successfully protected mice and rabbits from a 20 × LD50 ricin challenge after three intramuscular injections spaced 2 weeks apart. Similarly, monkeys that received three injections of R51-3 survived a 60 µg/kg ricin challenge. Conclusions: These findings support R51-3 as a promising candidate antigen for ricin vaccine development.

Photodynamic therapy (PDT) is an innovative cancer treatment that utilizes light. When light irradiates, purpurin-18-N-propylimide methyl ester (P18 N PI ME) generates reactive oxygen species that destroy cancer cells. The hydrophobic nature of P18 N PI ME presents challenges regarding its aggregation in the body, which can affect its effectiveness. This study aimed to enhance the bioavailability and effectiveness of cancer treatment by synthesizing P18 N PI ME and formulating P18 N PI ME-loaded solid lipid nanoparticles (SLNs). The efficacy of PDT was estimated using the 1,3-diphenylisobenzofuran (DPBF) assay and photocytotoxicity tests on the HeLa (human cervical carcinoma) and A549 (human lung carcinoma) cell lines. The P18 N PI ME-loaded SLNs demonstrated particle sizes in the range of 158.59 nm to 248.43 nm and zeta potentials in the range of –15.97 mV to –28.73 mV. These SLNs exhibited sustained release of P18 N PI ME. DPBF analysis revealed enhanced PDT effects with SLNs containing P18 N PI ME compared with standalone P18 N PI MEs. Photocytotoxicity assays indicated toxicity under light irradiation but no toxicity in the dark. Furthermore, the smallest-sized formulation exhibited the most effective photodynamic activity. These findings indicate the potential of P18 N PI ME-loaded SLNs as promising strategies for PDT in cancer therapy.

Background Carriers of CYP2C19 loss‐of‐function alleles have increased adverse events after percutaneous coronary intervention, but limited data are available for older patients. We aimed to evaluate the prognostic impact of CYP2C19 genotypes on clinical outcomes in older patients after percutaneous coronary intervention. Methods and Results The study included 1201 older patients (aged ≥75 years) who underwent percutaneous coronary intervention and received clopidogrel‐based dual antiplatelet therapy in South Korea. Patients were grouped on the basis of CYP2C19 genotypes. The primary outcome was 3‐year major adverse cardiac events, defined as a composite of cardiac death, myocardial infarction, and stent thrombosis. Older patients were grouped into 3 groups: normal metabolizer (36.6%), intermediate metabolizer (48.1%), and poor metabolizer (15.2%). The occurrence of the primary outcome was significantly different among the groups (3.1, 7.0, and 6.2% in the normal metabolizer, intermediate metabolizer, and poor metabolizer groups, respectively; P=0.02). The incidence rate of all‐cause death at 3 years was greater in the intermediate metabolizer and poor metabolizer groups (8.1% and 9.2%, respectively) compared with that in the normal metabolizer group (3.5%, P=0.03) without significant differences in major bleeding. In the multivariable analysis, the intermediate metabolizer and poor metabolizer groups were independent predictors of 3‐year clinical outcomes. Conclusions In older patients, the presence of any CYP2C19 loss‐of‐function allele was found to be predictive of a higher incidence of major adverse cardiac events within 3 years following percutaneous coronary intervention. This finding suggests a need for further investigation into an optimal antiplatelet strategy for older patients. Registration URL: https://clinicaltrials.gov. Identifier: NCT04734028.

Background Although age and body mass index (BMI) significantly affect platelet reactivity units and clinical outcomes after percutaneous coronary intervention, there are limited data on the relationship between high on‐treatment platelet reactivity (HPR) and clinical outcomes on age and BMI differences. Thus, we investigated the association of HPR with clinical outcomes according to age and BMI. Methods and Results The study analyzed 11 714 patients who underwent platelet function tests after percutaneous coronary intervention. The primary end point was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs), whereas the secondary end point was major bleeding. HPR was defined as platelet reactivity units ≥252. Patients were categorized by age (22.6 kg/m2). Patients 22.6 kg/m2 had increases in MACCEs (adjusted HR, 1.387 [95% CI, 1.140–1.688]; P=0.001). No differences were shown in major bleeding. Conclusions HPR was linked to an increase in MACCEs or a decrease in major bleeding in patients after percutaneous coronary intervention, depending on age and BMI. This study is the first to observe that clinical outcomes in patients with HPR after percutaneous coronary intervention may vary based on age and BMI. Because the study is observational, the results should be viewed as hypothesis generating and emphasize the need for randomized clinical trials.

Recent experimental studies have shown lanthanum-doped hafnium oxide (La:HfO2) possessing ferroelectric properties. This material is of special interest since it is based on lead-free, simple binary oxide of HfO2, and has excellent endurance property (1 × 109 field cycles without fatigue. There exists substantial information about the material aspects of La:HfO2 but it lacks proven application potential for CMOS-compatible low-power memory design. In this work, 10 % La metal cation fraction of HfO2 (La:HfO2) is proposed as the gate stack material in tunnel FET (TFET) for its potential as a memory device. 2D device simulations are carried out to show that the proposed ferroelectric TFET (FeTFET) provides the largest memory window (MW) as compared to present perovskite ferroelectric materials such as PZT, SBT (SrBi2Ta2O9) and silicon doped (4.6 % Si in HfO2) hafnium oxide (Si:HfO2). The larger window is attributed to greater polarization, and the calculation of MW is quantified by the shift in threshold voltage (Vth). The simulations carried out in this work suggest that La:HfO2 can be adopted as a potential ferroelectric material to target low-power FeTFET design at significantly reduced ferroelectric layer thickness.

Abstract This study estimated global climate change signals at different latitudes for four main Shared Socioeconomic Pathways (SSPs). Five evaluation metrics were integrated using the Technique for Order of Preference by Similarity to Ideal Solution to quantify the historical reproducibility of 25 CMIP6 General Circulation Models (GCMs) with Global Precipitation Climatology Centre precipitation and Climatic Research Unit temperature as the reference. The most suitable GCMs for simulating climate over different latitudes, selected based on evaluation metrics, were used to prepare a multimodel ensemble and project the future annual and seasonal precipitation and temperature in the near (2031–2065) and far future (2066–2100). The results showed that GCMs estimated the historical mean temperature efficiently but underestimated the monthly precipitation compared to the reference data. The changes in precipitation and temperature at mid‐latitudes (N45.5°–60°) showed the highest variability for all scenarios. The maximum increases in both climate variables for SSP5‐8.5 were 80.5% and 4.8% at N45.5°–60°, respectively. In contrast, the temperature and precipitation at S30.5°–45° revealed a decreasing pattern. Mid‐latitude winter (S30.5°–45°) would be drier in the future than in the base period (1980–2014). This study showed that precipitation variability and the mean temperature in the northern hemisphere would be larger for SSPs with higher radiative forcing. Therefore, the results of this study help improve knowledge of global future climate change by latitudes.

Electrochemically powered carbon nanotube (CNT) yarn muscles are of increasing interest because of their advantageous features as artificial muscles. They are light, and have high electrical properties, mechanical strength, and chemical stability. Twist-based CNT yarn muscles show superior actuation performance: 30 times the work capacity and 85 times the power density of natural muscles. Despite achieving these high performances, there is still potential for performance improvement because their twisted structure is not fully utilized. In particular, designing a cross-sectional structure that allows ions to freely enter and exit the twisted structure of the yarn muscle is necessary. Here, we propose highly enhanced artificial muscles with high chemical stability that consist of only nanocarbon materials of carbon nanoscroll (CNS) and twisted CNT yarns. The CNS/CNT yarn muscles (CCYM) can improve the ion accessibility and utilization of the twist structure. The maximum contractile stroke, work capacity, power density, and energy conversion efficiency of the CCYM were 20.11%, 2.26 J g−1, 0.53 W g−1, and 3.39%, which are 1.4-, 1.4-, 4.8, and 4.3 times that of the pristine CNT yarn muscles, respectively. The effects of CNS on CCYM were confirmed by experimental and theoretical analyses. Additionally, in a solid electrolyte, which opens up new application possibilities, the CCYM demonstrates high actuation performance (16.38%) with very low input energy.

Background: Carbapenemase-producing Enterobacterales (CPE) are global concerns in infection control, and the number of CPE outbreaks in hospitals is increasing despite the strengthening of contact precautions. This study aimed to confirm the prevalence and transition rate of CPE infection from stool surveillance culture and to identify the acquisition pathway of CPE. Methods: This is a longitudinal review of patients with stool surveillance cultures at a tertiary center in Seoul, South Korea, from July 2018 to June 2020. Pulsed-field gel electrophoresis, multi-locus sequence typing, and whole genome sequencing were performed for carbapenemase-producing Klebsiella pneumoniae and Escherichia coli strains. Results: Among 1620 patients who had undergone stool CPE surveillance cultures, only 7.1% of active surveillance at the Emergency Room (ER) and 4.4% of universal surveillance in the Intensive Care Unit (ICU) were stool CPE positive. The transition rates from stool carriers to clinical CPE infections were 29.4% in the ER and 31.3% in the ICU. However, it was significantly high (55.0%) in the initial stool CPE-negative ICU patients. Among the initial stool CPE-positive patients, hypertension (61% vs. 92.3%, P = 0.004), malignancy (28.8% vs. 53.8%, P = 0.027), and mechanical ventilation (25.4% vs. 53.8%, P = 0.011) were significant risk factors for clinical CPE infection. Molecular typing revealed that sequence type (ST) 307 and ST 395 were dominant in K. pneumoniae, and ST 410 was dominant in E. coli isolates. Conclusions: Active surveillance showed a higher detection rate than universal stool CPE screening, and one-third of positive stool CPE specimens ultimately developed subsquent clinical CPE infection. According to the molecular typing of the identified CPE strains, in-hospital spread prevailed over external inflow, and the transition rate to clinical CPE was particularly high in the ICU. Therefore, in order to control CPE propagation, not only active surveillance to block inflow from outside, but also continuous ICU monitoring within the hospital is necessary.