Search

Background: We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB). Methods: This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy. Results: Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P<0.003) included solid composition, irregular margins, microcalcifications, and high suspicion on the US risk stratification system. Conclusion: Repeat biopsy of nodules diagnosed with IIIB on CNB did not increase the detection of malignancy but can potentially reduce unnecessary surgery. Repeat biopsy should be performed selectively, with US features guiding the choice between repeat biopsy and diagnostic surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND Previous studies have shown that systemic tranexamic acid reduces bleeding during soft tissue surgeries and reduces postoperative ecchymosis and edema experienced by surgical patients. OBJECTIVE To evaluate the effect of postoperative tranexamic acid administration on the reduction of ecchymosis and edema after lipoma surgery. MATERIALS AND METHODS A total of 40 patients who underwent lipoma excision were included in the comparative analysis. In the tranexamic acid group (n 5 20), 1 g of tranexamic acid was administered daily for 5 consecutive postoperative days. Tranexamic acid was not administered to the control group (n 5 20). The severity of ecchymosis and edema at the first visit after surgery was rated on a 4-point scale by 2 blinded dermatologists. RESULTS The mean interval of the initial visit after surgery was 1.1 6 0.5 (range: 1–4) days. Mean ecchymosis scores were significantly lower in the tranexamic acid group (0.560.8) than in the control group (1.261.0) (p,.05). No statistical difference was seen in mean edema scores between groups (0.5 6 0.6 in tranexamic acid vs 0.7 6 0.8 in control). CONCLUSION We observed that postoperative administration of tranexamic acid significantly decreased ecchymosis in lipoma excision. [ABSTRACT FROM AUTHOR]

Kähler-Einstein metrics for polarized families (f : X → S,λX/S) of Calabi-Yau manifolds define a natural hermitian metric on the relative canonical bundle KX/S. The computation of the curvature form being equal to the pullback of the Weil-Petersson form up to a numerical constant is used for the construction of a Kähler form on X, whose restriction to the fibers is Ricci at. [ABSTRACT FROM AUTHOR]

Objectives: Radiological extranodal extension (rENE) upon CT is obtained before concurrent chemoradiation therapy (CCRT) for head and neck squamous cell carcinoma (HNSCC). We evaluated the prognostic value of rENE, rather than pathologically proven ENE, in patients who received CCRT for HNSCC. Materials and methods: We reviewed 117 patients. We divided the patients into rENE(+) and rENE(-) groups and evaluated overall survival (OS) and disease-specific survival (DSS), and factors affecting these outcomes. Results: Median follow-up was 37.4 months; 31 patients (26.2%) died and 26 (22.2%) had recurrence. Thirty patients were rENE(+) and these had worse 5-year OS (74% vs. 94%, p < .01) and DSS (42% vs. 84%, p < .01) rates compared with the rENE(-) group (n = 87). rENE (hazard ratio [HR] 3.57, p < .05) and complete response (HR 3.55, p < .05) affected OS. Clinical T stage (HR 2.86, p < .05), rENE (HR 2.88, p < .05), and complete response (HR 7.03, p < .01) affected DSS. rENE(+) increased risk of incomplete response (IR) compared with the rENE(-) group (p < .05). Conclusions: CT findings suggesting ENE predicts treatment response to CCRT and prognosis, and could be used to determine the treatment modality for HNSCC. [ABSTRACT FROM AUTHOR]

Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control. However, FNB leads to quadriceps muscle weakness, which impairs early mobilization and increases the risk of postoperative falls. In this context, emerging evidence suggests that adductor canal block (ACB) facilitates postoperative rehabilitation compared with FNB because it primarily provides a sensory nerve block with sparing of quadriceps strength. However, whether ACB is more appropriate for contemporary pain management after TKA remains controversial. The objective of this study was to review and summarize recent studies regarding practical issues for ACB and comparisons of analgesic efficacy and functional recovery between ACB and FNB in patients who have undergone TKA. [ABSTRACT FROM AUTHOR]

Ultrasound (US) elastography has been introduced as a noninvasive imaging technique for evaluating cervical lymph nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic lymph nodes demonstrate higher stiffness than benign lymph nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant cervical lymph nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the diagnostic role of fine-needle aspiration cytology (FNAC) and analyze factors associated with false-negative FNAC results in patients with parathyroid incidentaloma who were referred for ultrasonography (US)-guided fine-needle aspiration (FNA) of thyroid nodules. Methods: In this study, 121 patients with suspected parathyroid lesions were enrolled. The patients underwent US-guided FNAC with measurements of washout parathyroid hormone (PTH) between January 2015 and May 2020. The diagnostic performance of FNAC for the diagnosis of parathyroid lesions was assessed using surgical results and elevated washout PTH as a reference standard. The clinical and radiologic features associated with false-negative results on FNAC for the diagnosis of parathyroid lesions were evaluated. Results: Among the 121 nodules assessed, 38 were parathyroid lesions (31.4%), and 83 were non-parathyroid lesions (68.6%). The diagnostic performance of FNAC for parathyroid incidentaloma showed a sensitivity of 31.6% (12/38), specificity of 100% (83/83), positive predictive values of 100% (12/12), negative predictive values of 76.1% (83/109), and accuracy of 78.5% (95/121). The FNAC results of non-parathyroid lesions included thyroid nodules, lymph nodes, neurogenic tumors, and fat tissue. True-positive results on FNAC were significantly associated with performing FNA twice (58.3% vs. 23.1%, P=0.043). Conclusion: Considering the low sensitivity of FNAC, measuring washout PTH in addition to FNAC may help accurately diagnose parathyroid incidentaloma on thyroid US. Further, the falsenegative rate for FNAC can be reduced by obtaining two or more FNA samples. [ABSTRACT FROM AUTHOR]

Context. Near-Earth asteroid 162173 (1999 JU3) is a potential target of two asteroid sample return missions, not only because of its accessibility but also because of the first C-type asteroid for exploration missions. The lightcurve-related physical properties of this object were investigated during the 2011-2012 apparition. Aims. We aim to confirm the physical parameters useful for JAXA's Hayabusa 2 mission, such as rotational period, absolute magnitude, and phase function. Our data complement previous studies that did not cover low phase angles. Methods. With optical imagers and 1-2 m class telescopes, we acquired the photometric data at different phase angles. We independently derived the rotational lightcurve and the phase curve of the asteroid. Results. We have analyzed the lightcurve of 162173 (1999 JU3), and derived a synodic rotational period of 7.625 ± 0.003 h, the axis ratio a/b = 1.12. The absolute magnitude HR = 18.69 ± 0.07 mag and the phase slope of G = -0.09 ± 0.03 were also obtained based on the observations made during the 2011-2012 apparition. These physical properties are in good agreement with the previous results obtained during the 2007-2008 apparition. [ABSTRACT FROM AUTHOR]

Background: Developing intervention strategies for the control of parasitic nematodes continues to be a significant challenge. Genomic and post-genomic approaches play an increasingly important role for providing fundamental molecular information about these parasites, thus enhancing basic as well as translational research. Here we report a comprehensive genome-wide survey of the developmental transcriptome of the human filarial parasite Brugia malayi. Methodology/Principal Findings: Using deep sequencing, we profiled the transcriptome of eggs and embryos, immature (≤3 days of age) and mature microfilariae (MF), third- and fourth-stage larvae (L3 and L4), and adult male and female worms. Comparative analysis across these stages provided a detailed overview of the molecular repertoires that define and differentiate distinct lifecycle stages of the parasite. Genome-wide assessment of the overall transcriptional variability indicated that the cuticle collagen family and those implicated in molting exhibit noticeably dynamic stage-dependent patterns. Of particular interest was the identification of genes displaying sex-biased or germline-enriched profiles due to their potential involvement in reproductive processes. The study also revealed discrete transcriptional changes during larval development, namely those accompanying the maturation of MF and the L3 to L4 transition that are vital in establishing successful infection in mosquito vectors and vertebrate hosts, respectively. Conclusions/Significance: Characterization of the transcriptional program of the parasite's lifecycle is an important step toward understanding the developmental processes required for the infectious cycle. We find that the transcriptional program has a number of stage-specific pathways activated during worm development. In addition to advancing our understanding of transcriptome dynamics, these data will aid in the study of genome structure and organization by facilitating the identification of novel transcribed elements and splice variants. [ABSTRACT FROM AUTHOR]

Old-age income security has become one of the most important social policy issues in two East Asian emerging welfare states, South Korea and Taiwan, as they transform at a remarkable pace into societies with a representation of older people approaching that of western countries. During the last two decades, the two countries have developed different forms of social protection for older people. South Korea has expanded social insurance pensions with means-tested benefits, whereas Taiwan has introduced flat-rate old-age allowance programmes that exclude the rich rather than target the poor. much has been written about these programmes, but their actual performance in reducing old-age poverty has not been thoroughly examined. This paper analyses the anti-poverty effect of these programmes, firstly by describing recent developments in the two countries, and secondly by examining headcount poverty rates and the size and incidence of the 'poverty gap' using nationally-representative micro-household datasets. We argue that while the programmes have increasingly reduced old-age income security, the different policy choices have resulted in distinctive welfare outcomes in the two countries. In the final section of the article, we discuss the long-term implications of the recent policy reforms. [ABSTRACT FROM AUTHOR]

This article studies the space A-∞(Ω), the function algebra of holomorphic functions on a domain Ω with C1 boundary in n with polynomial growth. In particular, we present an explicit construction of countable subset that is weakly sufficient. [ABSTRACT FROM AUTHOR]

Alkene monooxygenase from Xanthobacter autotrophicus Py2 (XAMO) catalyses the asymmetric epoxidation of a broad range of alkenes. As well as the electron transfer components (a NADH-oxidoreductase and a Rieske-type ferredoxin) and the terminal oxygenase containing the binuclear non-haem iron active site, it requires a small catalytic coupling/effector protein, AamD. The effect of changing AamD stoichiometry and substitution with effector protein homologues on the regioselectivity of toluene hydroxylation and stereoselectivity of styrene epoxidation has been studied. At sub-optimal stoichiometries, there was a marked change in regioselectivity, but no significant change in epoxidation stereoselectivity. Recombinant coupling proteins from a number of phylogenetically related oxygenases were investigated for their ability to functionally replace AamD. Substitution of AamD with IsoD, the coupling protein from the closely related isoprene monooxygenase, changed the regioselectivity of toluene hydroxylation and stereoselectivity of styrene epoxidation, although this was accompanied by a high level of uncoupling. This indicates the importance of coupling protein interaction in controlling the catalytic specificity. Sequence analysis suggests that interaction between Asn34 and Arg57 is important for complementation specificity of the coupling proteins, providing a candidate for site-directed mutagenesis studies. [ABSTRACT FROM AUTHOR]

The South Korean National Pension scheme was instituted in 1988 and now covers all private-sector employees and the self-employed. Since the financial crisis of 1997, however, it has become controversial and is under considerable pressure, not least because of the perceived financial implications of the country's rapidly ageing population. Predictions of financial shortfalls or ‘unsustainabiity’ have prompted calls for severe ‘downsizing’ of the scheme. The debate on the reform of the scheme has been dominated by the need to respond to demographic change in ways that assist the national economy, invariably by reducing social expenditure. The debate, however, has given little attention to the social or welfare functions of the pension scheme, though the material insecurity of older people has been exacerbated by major changes in the labour market and the family. This paper details recent socio-demographic changes in Korea and discusses their implications for old-age security and pension reform. It argues that public-pension schemes should be developed to strengthen social protection against the insecurities of old-age, that intra-generational redistribution should be at the core of the reformed arrangements, and that the introduction of a comprehensive non-contributory pension scheme should be seriously considered. [ABSTRACT FROM AUTHOR]

Wounding, as during excision and preparation of lettuce (Lactuca sativa L.) leaf tissue for salads, induces the synthesis and accumulation of phenolic compounds that participate in subsequent reactions that cause tissue browning. Exposure of excised 5-mm mid-rib segments of romaine lettuce leaf tissue to vapors of mono-carboxylic acids or aqueous solutions of mono-carboxylic acids or their salts inhibited wound-induced phenolic accumulation (WIPA) and subsequent tissue browning. The decline in phenolic content followed a quadratic curve with increasing concentration, reaching a maximum inhibition after 60 min of 74 ± 8% for 50 m M sodium acetate (2 carbons, C2) and 91 ± 4% for 20 m M sodium decanoate (capric acid, C10). Respiration (i.e. carbon dioxide production) was unaffected by concentrations of formic, acetic, or propionic acids that reduced wound-induced phenolic content or that increase ion leakage from the tissue into an isotonic mannitol solution. However, WIPA was suppressed up to 70% at concentrations (20 m M acetate) that did not increase ion leakage over that of water controls. Various acetate salts (i.e. ammonium, calcium, magnesium, and sodium) all produced the same level of inhibition. The effectiveness of the compounds increased with increasing number of carbons in the molecule from 1 to 10, and was unaffected by whether the carbons were a straight chain or branched or whether the treatment was delayed by up to 6 h. The effectiveness of butyrate (C4) in reducing WIPA (27% reduction at 20 m M) was less than that predicted from the response of the two adjacent mono-carboxylates similarly applied: propionate (C3) (62%) and valerate (C5) (73%). It appears that, unlike the n-alcohols, mono-carboxylates are not interfering with the synthesis or propagation of a wound signal but are interfering with subsequent steps in the production and accumulation of wound-induced phenolic compounds. [ABSTRACT FROM AUTHOR]

In plant tissue, a wound signal is produced at the site of injury and propagates or migrates into adjacent tissue where it induces increased phenylalanine ammonia lyase (PAL, EC 4.3.1.5) activity and phenylpropanoid metabolism. We used excised mid‐rib leaf tissue from Romaine lettuce (Lactuca sativa L., Longifolia) as a model system to examine the involvement of components of the phospholipid‐signaling pathway in wound‐induced phenolic metabolism. Exposure to 1‐butanol vapors or solutions inhibited wound‐induced increase in PAL activity and phenolic metabolism. Phospholipases D (EC 3.1.4.4), an enzyme involved in the phospholipid‐signaling pathway is specifically inhibited by 1‐butanol. Re‐wounding tissue, in which an effective 1‐butanol concentration had declined below active levels by evaporation, did not elicit the normal wound response. It appears the 1‐butanol‐treated tissue developed resistance to wound‐induced increases in phenylpropanoid metabolism that persisted even when active levels of 1‐butanol were no longer present. However, a metabolic product of 1‐butanol, rather than 1‐butanol itself, may be the active compound eliciting persistence resistance. Inhibiting a subsequent enzyme in the phospholipid‐signaling pathway, lipoxygenase (LOX; EC 1.13.11.12) with 1‐phenyl‐3‐pyrazolidinone (1P3P) or reducing the product of LOX activity with diethyldithio‐carbamic acid (DIECA) also inhibited wound‐induced PAL activity and phenolic accumulation. The effectiveness of 1‐butanol, DIECA, and 1P3P declined as the beginning of the 1‐h immersion period was delayed from 0 to 4 h after excision. This decline in effectiveness is consistent with involvement of the inhibitors in the production or propagation of a wound signal. The wound signal in lettuce moves into adjacent tissue at 0.5 cm h−1, so delaying application would allow the signal to move into and induce the wound response in adjacent tissue before the delayed application inhibited synthesis of the signal. Salicylic acid (SA) inhibits allene oxide synthase (AOS, EC 4.2.1.92), another enzyme in the phospholipid‐signaling pathway. Exposure to 1 or 10 mM SA for 60 min reduced wound‐induced phenolic accumulation by 26 or 56%, respectively. However, 1 mM SA lost its effectiveness if applied 3 h after excision, while 10 mM SA remained effective even when applied 4 h after excision. At 1 mM, SA may be perturbing the wound signal through inhibition of AOS, while at 10 mM it appears to have some generally inhibitory effect on subsequent phenolic metabolism. These data further implicate the phospholipid‐signaling pathway in the generation of a wound signal that induces phenolic metabolism in wounded leaf tissue. [ABSTRACT FROM AUTHOR]

This article studies the impact of the death of geographical distance brought about by e-marketplaces on market equilibrium and social welfare. A partial equilibrium model for an economy with and without e-marketplaces is developed. It is shown that e-marketplaces lower the price level and improve consumers’ welfare, thus generating a sufficient condition under which e-marketplaces improve social welfare. An optimal rate of sales tax on transactions through e-marketplaces is derived. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the clinical and ultrasonographic (US) findings of suture granulomas and recurrent tumors, and aimed to identify specific characteristics of suture granulomas through an experimental study. Methods: This retrospective study included 20 pathologically confirmed suture granulomas and 40 recurrent tumors between January 2010 and December 2020. The clinical findings included suture material, surgery, and initial TNM stage. The US findings included shape, size, margin, echogenicity, heterogeneity, vascularity, and internal echogenic foci. The distribution, paired appearance, and "knot-and-ear" appearance of internal echogenic foci were assessed. An experiment using pork meat investigated the US configuration of suture knots. Results: Eighteen patients with 20 suture granulomas (15 women; mean age, 52±13 years) and 37 patients with 40 recurrent tumors (24 women; 54±18 years) were included. Patients with suture granulomas exhibited earlier initial T and N stages than those with recurrent tumors. The knot-and-ear appearance, defined as an echogenic dot accompanied by two adjacent echogenic dots or lines based on experimental findings, was observed in 50% of suture granulomas, but not in recurrent tumors (P<0.001). Central internal echogenic foci (68.8%, P=0.023) and paired appearance (75.0%, P<0.001) were more frequent in suture granulomas. During follow-up, 94.1% of suture granulomas shrunk. Conclusion: The knot-and-ear appearance is a potential pathognomonic finding of suture granuloma, and central internal echogenic foci with paired appearance were typical US features. Clinically, suture granulomas showed early T and N stages and size reduction during follow-up. Understanding these features can prevent unnecessary biopsy or diagnostic surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND Recently, a new cryotherapy device that precisely controls skin temperature was developed. Precision cryotherapy (PC) can be a safe and alternative treatment modality for immune-related skin diseases that are difficult to treat by conventional cryotherapy because of serious adverse events. OBJECTIVE To evaluate the efficacy and safety of PC in scalp seborrheic dermatitis (SD). METHODS A single-arm, prospective trial was designed. Twenty-four patients with SD underwent 3 PC interventions 2 weeks apart. At the baseline, Week 6, and Week 8, overall improvements in Physician Global Assessment (PGA) and clinical severity scores were assessed. At each visit, the erythema index (EI) and transepidermal water loss were evaluated. The patients scored 9 subjective symptoms using a visual analog scale (VAS). RESULTS The itch VAS score decreased by 50.4% at Week 8. Blinded investigators reported improvement of PGA scores from 2.86 ± 0.62 to 1.66 ± 0.61 and clinical severity scores from 4.55 ± 1.30 to 2.45 ± 1.37. The average EI decreased by 19.6% at Week 8 (p < .05). CONCLUSION This study not only demonstrated the efficacy and safety of PC in scalp SD but it also revealed insights for PC being a promising treatment modality in immune-related skin diseases. [ABSTRACT FROM AUTHOR]

To understand grain size evolution on the lunar surface in detail, we analyze the distribution of the average grain size for the lunar near side obtained by Jeong et al. Furthermore, we analyze the polarimetric properties of the regolith simulants SiC and JSC-1A in a laboratory. We find two characteristics of grain size evolution on the Moon. First, the lunar regolith has evolved on a specific evolutionary pathway in space. Here, Φ is defined as the ratio of the perpendicular () and parallel () components of the reflectance. Second, we also find that the evolutionary pathway depends on the FeO abundance and selenographic latitude of the surface. The dependence on the FeO content seems to result from the different resistance to comminution of regolith materials, and the dependence on the latitude seems to result from differences in the resurfacing environment. We present the probable causes of these characteristics of grain size evolution on the lunar surface. [ABSTRACT FROM AUTHOR]

Doppler ultrasonography (US) is widely used for the differential diagnosis of thyroid nodules, metastatic cervical lymph nodes in patients with thyroid cancer, and diffuse parenchymal disease, as well as for guidance in various US-guided procedures, including biopsy and ablation. However, controversies remain regarding the appropriate use and interpretation of Doppler US. Therefore, the Korean Society of Thyroid Radiology organized a taskforce to develop a consensus statement on the clinical use of Doppler US for thyroid disease. The review and recommendations in this article are based on a comprehensive analysis of the current literature and the consensus of experts. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the technical feasibility, efficacy, and safety of anterolateral hydrodissection (ALHD) in radiofrequency ablation (RFA) for benign thyroid nodules. Methods: Between November 2019 and April 2020, 39 patients underwent 41 sessions of RFA with the ALHD technique to treat benign thyroid nodules. ALHD was performed with cold (0°C-4°C) 5% dextrose solution during RFA to minimize pain and secure sufficient safety margins from critical neck structures. The initial ablation ratio (IAR) was measured to assess the technique's efficiency. Ultrasound examinations, symptoms, and cosmetic scores were evaluated pre-procedure and at 6 and 12 months post-procedure. Procedure-related pain during RFA and complications were recorded. Results: The mean index nodule volume was 20.5±21.6 mL. ALHD was technically feasible in all patients. The mean IAR was 90.7%±8.3%, and significant reductions in mean nodule volume were noted at 6- and 12-month follow-ups (P<0.001, 63.9%±19.0%, and 76.3%±18.9%, respectively). Symptom and cosmetic scores showed significant improvements at 6- and 12-month follow-ups (P<0.001). Pain during the procedure was well-controlled with ALHD in all patients. After the initial use of 5-10 mL of lidocaine at the start of the procedure, no further lidocaine injection was given to any patient. Transient voice change was observed in one patient, but the patient recovered spontaneously within 30 minutes. Conclusion: The ALHD technique was technically feasible and effective in all patients, achieving a mean IAR of 90.7%. The ALHD technique also had a pain-relieving effect, resulting in only low amounts of lidocaine administration being required during the procedure. [ABSTRACT FROM AUTHOR]

In order to understand the regolith characteristics of the Reiner Gamma swirl, one of the most prominent lunar swirls, we analyze the correlation between the linear polarization fluxQand the intensity I of the swirl. We present comparisons between the phase function (the intensity variation with the phase angle) of the swirl and the phase functions of its neighbors using polarimetric data. We find that the swirl has unusually large Q values for given I values. We also show that the phase function of the swirl is relatively shallow compared to its neighbors. We suggest that the microstructure of the regolith on the Reiner Gamma swirl has been disrupted. [ABSTRACT FROM AUTHOR]

Although differentiated thyroid cancer has an excellent prognosis and low mortality, its recurrence rate has been reported to be very high. While surgery is recommended as the standard treatment for recurrent thyroid cancer, reoperation may increase the incidence of complications due to fibrosis and anatomical distortion. In patients with high surgical risk or those who refuse repeated surgery, ultrasonography-guided ablation techniques including radiofrequency ablation, ethanol ablation, and laser ablation are suggested as alternative treatments. In this manuscript, we introduce an anatomy-based management concept for radiofrequency ablation for recurrent thyroid cancer, and present a review of the relevant literature, including indications, basic techniques, clinical outcomes, and complications. [ABSTRACT FROM AUTHOR]

Background: Immunoglobulin G4 (IgG4)-related disease is an entity that can involve the thyroid gland. The spectrum of IgG4-related thyroid disease (IgG4-RTD) includes Hashimoto thyroiditis (HT) and its fibrotic variant, Riedel thyroiditis, as well as Graves’ disease. The early diagnosis of IgG4-RTD is important because it is a medically treatable disease, and a delay in the diagnosis might result in unnecessary surgery. We present a case series of IgG4-RTD with a review of the literature. Methods: We retrospectively reviewed the clinical presentation and the radiological and pathological findings of patients diagnosed with IgG4-RTD between 2017 and 2021 at a tertiary medical center in Korea. We also conducted a literature review of IgG4-RTD. Results: Five patients were diagnosed with IgG4-RTD during the study period. The patients’ age ranged from 31 to 76 years, and three patients were men. Most patients visited the clinic for a neck mass, and hypoechogenic nodular lesions were observed on neck ultrasonography. Three patients had IgG4 HT, and two patients had IgG4 Riedel thyroiditis. All patients developed hypothyroidism that necessitated L-thyroxine replacement. The diagnosis of IgG4-RTD was confirmed after a pathological examination of the surgical specimen in the first two cases. However, the early diagnosis was possible after a core needle biopsy in three clinically suspected patients. Conclusion: The diagnosis of IgG4-RTD requires clinical suspicion combined with serology and histological analyses using IgG4 immunostaining. The early diagnosis of IgG4-RTD is difficult; thus, biopsy with IgG4 immunostaining and serum IgG4 measurements will help diagnose patients suspected of having IgG4-RTD. [ABSTRACT FROM AUTHOR]

Background: To assess the effects of radiofrequency ablation (RFA) using an internally-cooled wet (ICW) electrode in ex vivo bovine liver and evaluate the feasibility of the ICW electrode for benign thyroid nodules. Methods: We developed an 18-gauge ICW electrode with a microhole at the distal tip for tissue infusion of chilled (0 − 4 °C) isotonic saline (rate = 1.5 ml/min). RFA using ICW and IC electrodes were performed in bovine livers (40 pairs, 1-cm active tip, 50 W, 1-min). We compared the morphological characteristics of ablation zones and presence of carbonization. Twenty patients with benign thyroid nodules larger than 5 ml were prospectively enrolled in a clinical study and underwent ultrasound-guided RFA with ICW electrodes. Ultrasound examinations, laboratory data, and symptom and cosmetic scores were evaluated preprocedure and 1 and 6 months after the procedure. Results: In the ex vivo study, the ICW achieved significantly larger ablation zones than the IC (p<.001). In the clinical study, ICW electrodes were tolerable in all patients. At last follow-up, nodule volume had decreased from 15.6 ± 12.1 ml to 4.1 ± 4.3 ml (p<.001), and the mean volume reduction ratio (VRR) was 73.3 ± 13.7% at 6.0 months follow-up. Cosmetic and symptom scores were reduced from 3.52 ± 1.03 to 2.65 ± 0.88 and 3.10 ± 2.17 to 0.85 ± 0.99 (both p<.001), respectively. After RFA, thyroid function was well preserved in all patients, and mean thyroglobulin level decreased from 36.6 ± 52.1 ng/ml to 26.9 ± 62.2 ng/ml. One patient experienced a temporary voice change that recovered within a week. Conclusions: We developed a thyroid-dedicated ICW electrode that we showed to be feasible and effective in patients with benign thyroid nodules. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the use of three criteria to determine the need for additional treatment of cystic thyroid nodules after their recurrence following ethanol ablation (EA). Methods: In total, 154 patients (male:female=30:124; mean age, 53.4 years; range, 23 to 79 years) with 154 thyroid nodules (49 cystic and 105 predominantly cystic nodules) who presented between January 2014 and August 2017 were enrolled. All patients underwent follow-up ultrasonography (US) 1 month after EA, and were divided into therapeutic success and failure groups. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (=50%) with improvement of nodule-related symptoms. The therapeutic failure was defined according to three previously suggested criteria for recommending additional treatment: nodules with =1 mL of remnant fluid (criterion 1), volume reduction <50% (criterion 2), and demonstration of a solid component with vascularity (criterion 3). Results: Thyroid nodules treated by EA showed significant volume reduction (18.4±21.6 mL to 4.2±6.5 mL [1-month follow-up] to 1.9±3.3 mL [final follow-up], P<0.001) and improvement in clinical problems. Therapeutic failure were 26 patients according to criteria 1, 14 patients according to criteria 2, and 35 patients according to criteria 3. Additional treatment was unnecessary in 81.3%, 70.0%, and 77.8% of patients deemed to need it according to criteria 1, 2, and 3, respectively. Conclusion: The choice to perform additional treatment after EA should be made according to a combination of clinical problems and US features. Understanding this concept will be useful in planning further treatment following US-guided EA. [ABSTRACT FROM AUTHOR]

This report describes the isolation and identification of a potent acetylcholinesterase (AChE) inhibitor-producing yeasts. Of 731 species of yeast strain, the S-3 strain was selected as a potent producer of AChE inhibitor. The selected S-3 strain was investigated for its microbiological characteristics. The S-3 strain was found to be short-oval yeast that did not form an ascospore. The strain formed a pseudomycelium and grew in yeast malt medium containing 50% glucose and 10% ethanol. Finally, the S-3 strain was identified by its physiological characteristics and 26S ribosomal DNA sequences as Yarrowia lipolytica S-3. [ABSTRACT FROM AUTHOR]

Background: The Anopheles gambiae salivary glands play a major role in malaria transmission and express a variety of bioactive components that facilitate blood-feeding by preventing platelet aggregation, blood clotting, vasodilatation, and inflammatory and other reactions at the probing site on the vertebrate host. Results: We have performed a global transcriptome analysis of the A. gambiae salivary gland response to bloodfeeding, to identify candidate genes that are involved in hematophagy. A total of 4,978 genes were found to be transcribed in this tissue. A comparison of salivary gland transcriptomes prior to and after blood-feeding identified 52 and 41 transcripts that were significantly up-regulated and down-regulated, respectively. Ten genes were further selected to assess their role in the blood-feeding process using RNAi-mediated gene silencing methodology. Depletion of the salivary gland genes encoding D7L2, anophelin, peroxidase, the SG2 precursor, and a 5'nucleotidase gene significantly increased probing time of A. gambiae mosquitoes and thereby their capacity to blood-feed. Conclusions: The salivary gland transcriptome comprises approximately 38% of the total mosquito transcriptome and a small proportion of it is dynamically changing already at two hours in response to blood feeding. A better understanding of the salivary gland transcriptome and its function can contribute to the development of pathogen transmission control strategies and the identification of medically relevant bioactive compounds. [ABSTRACT FROM AUTHOR]

Introduction: Nasotracheal intubation (NTI) is preferred for general anesthesia in maxillofacial surgery. However, NTI is often traumatic or even unsuccessful, particularly in patients with a narrow nasal pathway. In this case report, we describe a less traumatic NTI approach using maxillary downfracture of Le Fort I osteotomy. Case presentation: A 19-year-old woman was admitted with a skeletal Class III malocclusion and scheduled to undergo bimaxillary orthognathic surgery. A preoperative evaluation revealed no other medical history and abnormal laboratory findings. Preoperative computed tomography showed nasal septal deviation, concha bullosa, and turbinate hypertrophy. A nasal Ring-Adair-Elwyn endotracheal tube and a tube exchanger could not be inserted via NTI because of her narrow nasal cavity. An oral intubation was performed temporarily and surgery was started. After a maxillary downfracture was performed, which made the nasal cavity wider than before, NTI was successfully conducted without difficulty. The patient was ventilated without any problems, and the operation was continued. Postoperatively, the patient had no further complications and her vital parameters were all stable. Conclusions: This case report suggests that NTI after maxillary downfracture of Le Fort I osteotomy can be a good alternative that can be successfully performed with less trauma in patients undergoing orthognathic surgery who are preoperatively evaluated as having a narrow nasal cavity. [ABSTRACT FROM AUTHOR]

Purpose: Thermal ablation is a novel treatment alternative for benign thyroid nodules, and one of the most promising thermal ablation techniques is radiofrequency ablation (RFA). Considering the increasing use of thyroid RFA, some scientific societies have proposed clinical practice guidelines. We systemically reviewed and compared these guidelines for thyroid RFA to identify a standard treatment strategy that represents the positions of most societies. Methods: We searched the MEDLINE and EMBASE databases for studies with human participants that were published in English between January 1, 2000 and August 2, 2019. Studies containing clinical practice guidelines for the RFA of benign thyroid nodules were included. We extracted data regarding indications, pre- and post-procedural evaluations, treatment techniques, and the need to obtain informed consent. Results: Of the 83 studies found, four studies were included, and one study was added after searching the bibliographies of those articles. The five included studies were guidelines developed by the Korean Society of Thyroid Radiology, a group of experts from Italian scientific societies, the Italian Working Group on Minimally Invasive Treatments of the Thyroid, the United Kingdom's National Institute for Health and Clinical Excellence, and a group of four professional Austrian thyroid associations. Indications, pre- and post-procedural evaluations, and techniques were similar across studies; however, differences in each of these categories were found. Conclusion: While the reviewed guidelines are similar with regard to major categories, international guidelines for the RFA of benign thyroid nodules should be established in the future. [ABSTRACT FROM AUTHOR]

Background: Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA. Methods: Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated. Results: Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage. Conclusion: Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions. [ABSTRACT FROM AUTHOR]

Background: Ultrasound-guided thermal ablations have become one of the main options for treating benign thyroid nodules. To determine efficacy of thermal ablation of benign thyroid nodules, we performed a meta-analysis of studies with long-term follow-up of more than 3 years. Methods: Databases were searched for studies published up to August 25, 2019, reporting patients with benign thyroid nodules treated with thermal ablation and with follow-up data of more than 3 years. Data extraction and quality assessment were performed according to PRISMA guidelines. The analysis yielded serial volume reduction rates (VRRs) of ablated nodules for up to 3 years or more, and adverse effect of ablation during follow-up. Radiofrequency ablation (RFA) and laser ablation (LA) were compared in a subgroup analysis. Results: The pooled VRRs for ablated nodules showed rapid volume reduction before 12 months, a plateau from 12 to 36 months, and more volume reduction appearing after 36 months, demonstrating long-term maintenance of treatment efficacy. Thermal ablation had an acceptable complication rate of 3.8%. Moreover, patients undergoing nodule ablation showed no unexpected delayed complications during the follow-up period. In the subgroup analysis, RFA was shown to be superior to LA in terms of the pooled VRR and the number of patients who underwent delayed surgery. Conclusion: Thermal ablations are safe and effective methods for treating benign thyroid nodules, as shown by a long follow-up analysis of more than 3 years. In addition, RFA showed superior VRRs compared with LA for the treatment of benign thyroid nodules, with less regrowth and less delayed surgery. [ABSTRACT FROM AUTHOR]

Background: To evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy. Methods: The data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis. Results: No atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001). Conclusion: RFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone. [ABSTRACT FROM AUTHOR]

Purpose: We compared the efficacy and safety of two ethanol ablation techniques-ethanol aspiration and ethanol retention-for benign cystic thyroid nodules. Methods: From October 2008 to September 2013, 113 patients who were treated using the ethanol aspiration technique (February 2008 to December 2010) and 108 patients who were treated using the ethanol retention technique (January 2011 to September 2013) were enrolled (male:female ratio, 53:168; mean age, 48.1 years; range, 18 to 80 years). The patient sample had 94 cystic and 127 predominantly cystic thyroid nodules. The volume reduction ratio (VRR) at the last follow-up, improvements in symptoms and cosmetic scores, vascularity, pain, and major complications were evaluated and compared between the ethanol aspiration group and ethanol retention group. We also performed a subgroup analysis according to the proportion of the solid component, in which VRR, symptom and cosmetic scores, and therapeutic success were compared. Results: No statistically significant difference in VRR was found between the ethanol retention group and the ethanol aspiration group (83.2%±32.8% vs. 86.1%±18.4%, P=0.416) while patients who underwent the retention technique were more likely to experience pain after treatment (P=0.001). VRR, symptom and cosmetic scores, and therapeutic success did not significantly differ between techniques in either group in the subgroup analysis. Conclusion: The ethanol aspiration technique may be preferable to the ethanol retention technique for treating benign cystic and predominantly cystic thyroid nodules, because a comparable VRR can be expected with less pain. [ABSTRACT FROM AUTHOR]

Background: To compare pain, tolerability, and complications associated with fine needle aspiration (FNA) versus core needle biopsy (CNB). Methods: FNAs were performed using 23-gauge needles and CNBs were performed using 18-gauge double-action spring-activated needles in 100 patients for each procedure. Patients were asked to record a pain score using a 10-cm visual analog scale and procedure tolerability. Complications and number of biopsies were recorded. Results: The median pain scores were similar for the FNA and CNB approaches during and 20 minutes after the biopsy procedures (3.7 vs. 3.6, P=0.454; 0.9 vs. 1.1, P=0.296, respectively). The procedure was tolerable in all 100 FNA patients and in 97 CNB patients (P=0.246). The mean number of biopsies was fewer in the CNB group (1.4 vs. 1.2, P=0.002). By subgroup analysis (staff vs. non-staff), no significant difference was detected in any parameter. There were no major complications in either group, but three patients who underwent CNB had minor complications (P=0.246). Conclusion: FNA and CNB show no significant differences for diagnosing thyroid nodules in terms of pain, tolerability, or complications. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate how the anisotropy and the static stretch stress of the cervical musculature influence the measured shear modulus in a tissue-mimicking phantom and in cervical lymph nodes in vivo by using shear wave elastography (SWE). Methods: SWE was performed on a phantom using a pig muscle and on the middle jugular cervical lymph nodes in six volunteers. Tissue elasticity was quantified using the shear modulus and a supersonic shear wave imaging technique. For the phantom study, first, the optimal depth for measurement was determined, and then, SWE was performed in parallel and perpendicular to the muscle fiber orientation with and without strain stress. For the in vivo study, SWE was performed on the cervical lymph nodes in parallel and perpendicular to the sternocleidomastoid muscle fiber direction with and without neck stretching. The mean values of the shear modulus (meanSM) were then analyzed. Results: In the phantom study, the measured depth significantly influenced the meanSM with a sharp decrease at the depth of 1.5 cm (P<0.001). Strain stress increased the meanSM, irrespective of the muscle fiber orientation (P<0.001). In the in vivo study, the meanSM values obtained in parallel to the muscle fiber orientation were greater than those obtained perpendicular to the fiber orientation, irrespective of the stretch stress (P<0.001). However, meanSM was affected significantly by the stretch stress parallel to the muscle fiber orientation (P<0.001). Conclusion: The anisotropic nature of the cervical musculature and the applied stretch stress explain the variability of the SWE measurements and should be identified before applying SWE for the interpretation of the measured shear modulus values. [ABSTRACT FROM AUTHOR]

An energy storage system (ESS) in a power system facilitates tasks such as renewable integration, peak shaving, and the use of ancillary services. Among the various functions of an ESS, this study focused on frequency regulation (or secondary reserve). This paper presents an optimal scheduling algorithm for frequency regulation by an ESS. This algorithm determines the bidding capacity and base point of an ESS in each operational period to achieve the maximum profit within a stable state-of-charge (SOC) range. However, the charging/discharging efficiency of an ESS causes SOC errors whenever the ESS performs frequency regulation. With an increase in SOC errors, the ESS cannot respond to an automatic generation control (AGC) signal. This situation results in low ESS performance scores, and finally, the ESS is disqualified from performing frequency regulation. This paper also presents a real-time SOC management algorithm aimed at solving the SOC error problem in real-time operations. This algorithm compensates for SOC errors by changing the base point of the ESS. The optimal scheduling algorithm is implemented in MATLAB by using the particle swarm optimization (PSO) method. In addition, changes in the SOC when the ESS performs frequency regulation in a real-time operation are confirmed using the PSCAD/EMTDC tool. The simulation results show that the optimal scheduling algorithm manages the SOC more efficiently than a commonly employed planning method. In addition, the proposed real-time SOC management algorithm is confirmed to be capable of performing SOC recovery. [ABSTRACT FROM AUTHOR]

OG2 is a modified antimicrobial peptide, that is, derived from the frog peptide Palustrin-OG1. It has high antimicrobial activity and low cytotoxicity, and it is therefore promising as a therapeutic agent. Both prokaryotic (Escherichia coli) and eukaryotic (Pichia pastoris) production host systems were used to produce OG2 in our previous study; however, it was difficult to achieve high expression yields and efficient purification. In this study, we achieved high-yield OG2 expression using the intein fusion system. The optimized OG2 gene was cloned into thepTWIN1 vector to generate pTWIN-OG2-intein2 (C-terminal fusion vector) andpTWINintein1-OG2 (N-terminal fusion vector). Nearly 70% of the expressed OG2-intein2 was soluble after the IPTG concentration and induction temperature were decreased, whereas only 42% of the expressed of intein1-OG2 was soluble. Up to 75 mg of OG2-intein2 was obtained from a 11 culture, and 85% of the protein was cleaved by 100 mM DTT. Intein1-OG2 was less amenable to cleavage due to the inhibition of cleavage by the N-terminal amino acid of OG2. The purified OG2 exhibited strong antimicrobial activity against E. coli K88. The intein system is the best currently available system for the cost-effective production of OG2. [ABSTRACT FROM AUTHOR]

BACKGROUND Surgical scars are a common cosmetic problem that occurs in various surgical fields including dermatology. Diverse trials have been made to prevent this annoying scar formation. Recently, 585- and 595-nm pulsed dye laser irradiation presented satisfactory cosmetic outcome for the treatment of surgical scars. Other fractionated lasers or light devices were also applied for scar treatment. OBJECTIVE To determine the effectiveness and safety of a newly developed 1,550-nm fractional erbium–glass laser in the prevention of scar formation after total thyroidectomy. MATERIALS AND METHODS Twenty-seven ethnic South Korean patients with linear surgical suture lines after total thyroidectomy operation were treated with a 1,550-nm fractional erbium–glass laser. The same surgeon performed all of the operations using the same surgical techniques. Each patient was treated four times at 1-month intervals using the same parameters (5- × 10-mm spot size, 10 mJ, 1,500 spot/cm2, static mode). Initiation of the first irradiation was made approximately 2 to 3 weeks after the thyroidectomy. The scar prevention effects were evaluated each month for 6 months after thyroidectomy. Two kinds of assessment methods were applied in this evaluation. First, the Vancouver Scar Scale (VSS) was used. Second, three independent physicians gave a global assessment valuation to the final cosmetic results: poor (1), fair (2), good (3), or excellent (4). These results were compared with the surgical scars of a control group (patients who denied laser treatments and had no other treatments during the 6 months after total thyroidectomy by the same surgeon). RESULTS The average VSS score was lower in the laser treatment group. The global assessment also presented better cosmetic outcomes in the treatment group than in the controls. CONCLUSION A new 1,550-nm fractional erbium–glass laser may efficiently repress the formation and hypertrophy of thyroidectomy scars on the neck, and it can be safely applied in relatively dark Asian skin without noticeable adverse effects. [ABSTRACT FROM AUTHOR]

PolCam, a wide-angle polarimetric camera, will be onboard the Korea Pathfinder Lunar Orbiter to investigate the lunar surface based on polarimetry. PolCam will construct a global lunar map of polarimetric parameters, such as maximal polarization (Pmax) and titanium distribution using three color bands centered at 320, 430, and 750 nm. PolCam's twin cameras are mounted at 45° tilt angles from the nadir across the orbital track in opposite directions. PolCam will obtain polarimetric measurements of sunlight scattered by the lunar surface at various phase angles up to ∼140° to achieve the scientific goals during the one-year mission. Since degree of linear polarization is a function of phase angle, it is essential to perform several measurements at various phase angles to properly retrieve, e.g., Pmax, Pmin, and the inversion angle, αinv. In this work, we show PolCam's phase-angle coverage as a function of selenographic longitudes from the equator to latitudes up to 70°N. Decreasing tilt angle to 25° and 0° limits the high end of phase-angle coverage, as well as the observational chances at high latitudes. [ABSTRACT FROM AUTHOR]

Polarimetry of the Moon reveals characteristics of the lunar regolith such as the size and composition of regolith grains, which are useful in understanding the surface properties and to determine landing sites for future lunar missions. As part of the Korea Pathfinder Lunar Orbiter (KPLO) mission, the wide-angle polarimetric camera (PolCam) will perform polarimetric measurements of the Moon for the first time from the lunar orbit. Because the degree of linear polarization is a function of the phase angle, it is necessary to observe the same region multiple times at various phase angles to construct the phase curve of polarization and derive the map of maximum polarization (Pmax). Any unexpected discontinuities of observing runs or an abrupt termination of the mission may cause the scientific goals of the PolCam to be unachievable. Here, we investigated how to recover the polarimetric phase curve when the observational data set is incomplete. Using ground-based polarimetry data, we explored the parameter space of the fitting formula of the phase curve and show that the formula can be reduced into a single parameter form. Assuming several cases of incomplete measurements, we constructed Pmax maps and investigated the allowable range of the phase-angle coverage. We show that Pmax can be estimated with a root-mean-square discrepancy less than 0.5%p when the maximum phase angle covered is greater than 90°. [ABSTRACT FROM AUTHOR]

We performed a monitoring observation of a Jupiter-family comet, 17P/Holmes, during its 2014 perihelion passage to investigate its secular change in activity. The comet has drawn the attention of astronomers since its historic outburst in 2007, and this occasion was its first perihelion passage since then. We analyzed the obtained data using an aperture photometry package and derived the parameter, a proxy for the dust-production rate. We found that showed asymmetric properties with respect to the perihelion passage: it increased moderately from 100 cm at the heliocentric distance of rh = 2.6–3.1 AU to a maximal value of 185 cm at rh = 2.2 AU (near the perihelion) during the inbound orbit, while dropping rapidly to 35 cm at rh = 3.2 AU during the outbound orbit. We applied a model for characterizing dust-production rates as a function of rh and found that the fractional active area of the cometary nucleus had dropped from 20%–40% in 2008–2011 (around the aphelion) to 0.1%–0.3% in 2014–2015 (around the perihelion). This result suggests that a dust mantle would have developed rapidly in only one orbital revolution around the Sun. Although a minor eruption was observed on UT 2015 January 26 at rh = 3.0 AU, the areas excavated by the 2007 outburst would be covered with a layer of dust (≲10 cm depth) which would be enough to insulate the subsurface ice and to keep the nucleus in a state of low activity. [ABSTRACT FROM AUTHOR]