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The electrochemical reduction of CO2 (eCO2RR) holds promise in mitigating atmospheric greenhouse gas levels but is hindered by low reaction kinetics, high energy barriers, and poor selectivity. To address these challenges, we developed a novel series of cost‐effective AgCu‐containing metal‐aerogel catalysts with high electrochemical surface areas (ECSA) using a top‐down reduction approach. The Ag85Cu15 aerogel, with an ECSA of 27.41 cm2, achieved a Faraday efficiency (FE%) of 89.3 % for CO production at −0.9 V vs. RHE. Increasing the Cu content to over 50 % in the aerogel matrix produced small amounts of C2H4, with a maximum FE% of 12.9 % at −1.0 V vs. RHE. To further enhance CO2 reduction efficiency, multi‐walled carbon nanotubes (CNT) were incorporated into the Ag85Cu15 alloy aerogel via a hydrothermal treatment. The highly dispersed CNTs within the aerogel matrix increased the ECSA to 57.00 cm2 by forming a well‐defined porous structure through van‐der Waals interactions, improving CO selectivity, and achieving a FE% of 98.6 % at −0.7 V vs. RHE and a partial current density of 9.6 mA/cm2 in an H‐cell. 86 % of the initial FECO% was maintained during an 18 h test with continuous electrolysis. [ABSTRACT FROM AUTHOR]

The prediction of protein 3D structure from amino acid sequence is a computational grand challenge in biophysics and plays a key role in robust protein structure prediction algorithms, from drug discovery to genome interpretation. The advent of AI models, such as AlphaFold, is revolutionizing applications that depend on robust protein structure prediction algorithms. To maximize the impact, and ease the usability, of these AI tools we introduce APACE, AlphaFold2 and advanced computing as a service, a computational framework that effectively handles this AI model and its TB-size database to conduct accelerated protein structure prediction analyses in modern supercomputing environments. We deployed APACE in the Delta and Polaris supercomputers and quantified its performance for accurate protein structure predictions using four exemplar proteins: 6AWO, 6OAN, 7MEZ, and 6D6U. Using up to 300 ensembles, distributed across 200 NVIDIA A100 GPUs, we found that APACE is up to two orders of magnitude faster than off-the-self AlphaFold2 implementations, reducing time-to-solution from weeks to minutes. This computational approach may be readily linked with robotics laboratories to automate and accelerate scientific discovery. [ABSTRACT FROM AUTHOR]

Purpose: Three-month gonadotropin-releasing hormone agonists (GnRHas) are expected to achieve better compliance in patients with central precocious puberty (CPP) compared to the monthly formulation. However, 1-month depot remains the dominant choice for conventional treatment worldwide. Our study aimed to investigate the long-term efficacy of a 3-month GnRHa for CPP treatment. Methods: In this retrospective study, 69 Korean girls with CPP were prescribed either triptorelin pamoate (TP) 3-month depot (n=29) or triptorelin acetate (TA) 1-month depot (n=40) and were followed for 1 year after the end of treatment. Auxological, radiological, and biochemical data were collected every 6 months. Results: Baseline characteristics were similar between the 2 groups. In the TP 3-month depot group, 27 of 29 patients (93.1%) exhibited suppressed luteinizing hormone level (below 2.5 IU/L) after 6 months of treatment, and this suppression level was reserved until the final injection. The degree of bone age advancement in the TP 3-month depot group decreased from 1.8±0.4 years at the start of treatment to 0.6±0.5 years at 1-year posttreatment. The gain in predicted adult height (PAH) 1 year after the end of treatment was similar between the TP 3-month and TA 1-month depot groups (5.2±3.1 and 5.3±2.4 cm, respectively; P=0.875). Conclusion: A 3-month depot of triptorelin effectively inhibited gonadal and sex hormones, suppressed bone maturation, and increased PAH. For patient convenience, we suggest a 3-month GnRHa regimen as a promising CPP treatment option. [ABSTRACT FROM AUTHOR]

Purpose: To unravel the mechanism regulating the phosphorylation of glycogen synthase kinase 3 (GSK3) and the correlation between the inhibitory phosphorylation of GSK3α and sperm motility in human. Materials and Methods: The phosphorylation and priming phosphorylated substrate-specific kinase activity of GSK3 were examined in human spermatozoa with various motility conditions. Results: In human spermatozoa, GSK3α/β was localized in the head, midpiece, and principal piece of tail and p-GSK3α(Ser21) was enriched in the midpiece. The ratio of p-GSK3α(Ser21)/GSK3α was positively coupled with normal sperm motility criteria of World Health Organization. In high-motility spermatozoa, p-GSK3α(Ser21) phosphotyrosine (p-Tyr) proteins but p-GSK3α(Tyr279) markedly increased together with decreased kinase activity of GSK3 after incubation in Ca2+ containing medium. In high-motility spermatozoa, p-GSK3α(Ser21) levels were negatively coupled with kinase activity of GSK3, and which was deregulated in low-motility spermatozoa. In high-motility spermatozoa, 6-bromo-indirubin-3’-oxime, an inhibitor of kinase activity of GSK3 increased p-GSK3α(Ser21) and p-Tyr proteins. p-GSK3α(Ser21) and p-Tyr protein levels were decreased by inhibition of PKA and Akt. Calyculin A, a protein phosphatase-1/2A inhibitor, markedly increased the p-GSK3α(Ser21) and p-Tyr proteins, and significantly increased the motility of low-motility human spermatozoa. Conclusions: Down regulation of kinase activity of GSK3α by inhibitory phosphorylation was positively coupled with human sperm motility, and which was regulated by Ca2+, PKA, Akt, and PP1. Small-molecule inhibitors of GSK3 and PP1 can be considered to potentiate human sperm motility. [ABSTRACT FROM AUTHOR]

Purpose: Complex traumatic upper extremity injuries often require microvascular free tissue transfer for adequate soft tissue coverage or functional reconstruction. The need for rapid coverage is acknowledged, but the optimal timing for reconstruction remains a subject of debate. Methods: A retrospective review was conducted of patients who underwent free flap reconstruction for upper extremity injuries after trauma from March 2012 to August 2018 in South Korea at a facility specializing in extremity trauma. Surgical timing was categorized according to the classification of Godina into early (within 72 hours after injury) and delayed (from 72 hours to 3 months after injury) reconstruction. Patients' demographic characteristics, methods of free tissue transfer, flap failure rates, postoperative infections, total hospital stays, and the number of operations required were analyzed. Results: In total, 80 free tissue transfers were conducted on 76 patients. The demographics and characteristics of patients in the early and delayed reconstruction groups showed no significant differences. Early reconstruction was associated with a significantly lower infection rate, shorter average hospital stay, and a lower average number of operations, without showing a significant difference in the flap failure rate. Conclusion: The results of this study indicate that early reconstruction within 72 hours after trauma significantly reduces infection rates, the length of hospital stays, and the number of required operations. This study underscores the importance of timely intervention in upper extremity free flap reconstruction for optimal patient outcomes. [ABSTRACT FROM AUTHOR]

In 2018, the South Korean government denied refugee status to all but two of the almost 500 Yemenis who, fleeing civil war in their home country, had arrived earlier in the year on the resort island of Jeju. This decision was made in the context of a short-lived but intense public backlash, even though the overall number of refugees has remained consistently low. Three years later, nearly 400 Afghans were evacuated to South Korea with government support and little controversy. What explains these different patterns of refugee politicization in South Korea? I argue that the 2018 episode of anti-refugee activism in South Korea does not follow the typical script in immigration politics which pits "natives" against "outsiders"; rather, it is a reflection of internal political divisions. In this article, I focus on political framing contests involving governmental and non-governmental actors that draw upon prior rhetorical frames of political mobilization which had developed in a broader context of state-building, development, and democratization. The 2018 Jeju "crisis" was partially a reaction against state-led multiculturalism (damunhwa), which had gained momentum since the 2000s. It also signalled a political backlash against previous decades of social and political movements that framed labour rights, migrant workers' rights, and other minority rights as a necessary expansion of human rights befitting a responsible "advanced nation." At the same time, the varied responses to the arrival of Yemenis in 2018 and Afghans in 2021 show that the coherence and resonance of competing political frames during key moments can help explain the type and degree of political mobilization on refugee policy. Furthermore, these comparative case studies show that South Korean attitudes toward refugees have not settled into stable political-economic coalitions and remain contested and in flux. [ABSTRACT FROM AUTHOR]

Purpose Recently, we developed allele-discriminating priming system (ADPS) technology. This method increases the sensitivity of conventional quantitative polymerase chain reaction up to 100 folds, with limit of detection, 0.01%, with reinforced specificity. This prospective study aimed to develop and validate the accuracy of ADPS epidermal growth factor receptor (EGFR) Mutation Test Kit using clinical specimens. Materials and Methods In total 189 formalin-fixed paraffin-embedded tumor tissues resected from patients with non-small cell lung cancer were used to perform a comparative evaluation of the ADPS EGFR Mutation Test Kit versus the cobas EGFR Mutation Test v2, which is the current gold standard. When the two methods had inconsistent results, next-generation sequencing-based CancerSCAN was utilized as a referee. Results The overall agreement of the two methods was 97.4% (93.9%-99.1%); the positive percent agreement, 95.0% (88.7%-98.4%); and the negative percent agreement, 100.0% (95.9%-100.0%). EGFR mutations were detected at a frequency of 50.3% using the ADPS EGFR Mutation Test Kit and 52.9% using the cobas EGFR Mutation Test v2. There were 10 discrepant mutation calls between the two methods. CancerSCAN reproduced eight ADPS results. In two cases, mutant allele fraction was ultra-low at 0.02% and 0.06%, which are significantly below the limit of detection of the cobas assay and CancerSCAN. Based on the EGFR genotyping by ADPS, the treatment options could be switched in five patients. Conclusion The highly sensitive and specific ADPS EGFR Mutation Test Kit would be useful in detecting the patients who have lung cancer with EGFR mutation, and can benefit from the EGFR targeted therapy. [ABSTRACT FROM AUTHOR]

This article explores the impact of the COVID-19 pandemic on asthmatic children and their risk for metabolic syndrome (MS) and pulmonary dysfunction. The study reveals that the pandemic, with school closures and reduced physical activity, has contributed to increased obesity in children, which is a significant risk factor for MS. The researchers conducted a cross-sectional study and found that asthmatic children with MS had higher triglyceride levels and lower high-density lipoprotein cholesterol levels compared to those without MS. Additionally, asthmatic children with MS had higher forced expiratory volume and forced vital capacity levels, but a lower FEV1/FVC ratio. The study suggests a potential relationship between obesity, MS, and pulmonary dysfunction in asthmatic children. The article emphasizes the need for prevention strategies for MS in asthmatic children, particularly in light of the pandemic's impact on physical activity and obesity rates. [Extracted from the article]

Malignant lymphoma typically presents with homogeneous enhancement of enlarged lymph nodes without internal necrotic or cystic changes on multiphasic CT, which can be suspected without invasive diagnostic methods. However, some subtypes of malignant lymphoma show atypical imaging features, which makes diagnosis challenging for radiologists. Moreover, there are several lymphomamimicking diseases in current clinical practice, including leukemia, viral infections in immunocompromised patients, and primary or metastatic cancer. The ability of diagnostic processes to distinguish malignant lymphoma from mimicking diseases is necessary to establish effective management strategies for initial radiological examinations. Therefore, this study aimed to discuss the typical and atypical imaging features of malignant lymphoma as well as mimicking diseases and discuss important diagnostic clues that can help narrow down the differential diagnosis. [ABSTRACT FROM AUTHOR]

Background: Severe burns cause pathophysiological processes that result in mortality. A laboratory biomarker, red cell distribution width (RDW), is known as a predictor of mortality in critically-ill patients. We examined the association between RDW and postoperative mortality in severe burn patients. Methods: We retrospectively analyzed medical data of 731 severely burned patients who underwent surgery under general anesthesia. We evaluated whether preoperative RDW value can predict 3-month mortality after burn surgery using receiver operating characteristic (ROC) curve analysis, logistic regression, and Cox proportional-hazards regression analysis. Mortality was also analyzed according to preoperative RDW values and incidence of postoperative acute kidney injury (AKI). Results: The 3-month mortality rate after burn surgery was 27.1% (198/731). The area under the ROC curve of preoperative RDW to predict mortality after burn surgery was 0.701 (95% confidence interval [CI], 0.667–0.734; P < 0.001) with a cut-off point of 12.9. The adjusted hazard ratio in patients with RDW > 12.9 was 1.238 (95% CI, 1.138–1.347; P < 0.001). Subgroup analysis showed that the survival rate was 88.8% for the non-AKI group with RDW ≤ 12.9 and 17.6% for the AKI group with RDW > 12.9. Preoperative RDW was considered an independent risk factor for mortality (odds ratio, 1.679; 95% CI, 1.378– 2.046; P < 0.001). Conclusions: Preoperative RDW may predict 3-month postoperative mortality in patients with severe burns, while preoperative RDW > 12.9 and postoperative AKI may further increase mortality after burn surgery. [ABSTRACT FROM AUTHOR]

Quaternary stereogenic centers are of great importance because of their prevalence in a series of bioactive natural products and pharmaceuticals. Although the catalytic asymmetric construction of these highly congested centers poses a formidable challenge, this field has been extensively explored in the past few decades, and several elegant strategies, such as the asymmetric conjugate addition to β,β‐disubstituted nitroalkenes, have been developed. The resultant β‐nitro quaternary stereocenters can be conveniently transformed into the corresponding β‐amino quaternary stereocenters commonly found in bioactive compounds. This review summarizes the recent advances in the construction of all‐carbon quaternary or hetero‐carbon quaternary stereocenters via metal‐catalyzed and organocatalyzed asymmetric conjugate addition to β,β‐disubstituted nitroalkenes, focusing on the scope, applications, and mechanisms of these reactions. [ABSTRACT FROM AUTHOR]

Post-burn scar contracture associated with deep second-degree or higher burns in the joint area can lead to joint immobility and may cause chronic ulcers, substantially impacting patients' quality of life. Surgical intervention is necessary, with local flaps or skin grafts being the first option. In extreme cases, free flap transfer may be required to address large defects that occur after contracture release. This study presents a successful case of reconstruction using free flap transfer in a patient with severe postburn scar contracture, which resulted in a club-like deformed ankle with a nonfunctional joint. Despite the extreme deformity and nonfunctioning joint, we utilized a thoracodorsal artery perforator flap to stably cover the newly fused joint in a neutral position. After reconstruction, the patient was able to wear shoes and ambulate. This case highlights the potential of free flap transfer even in the most challenging situations where joint function is severely compromised. [ABSTRACT FROM AUTHOR]

Plant cells can reprogram their fate. The combinatorial actions of auxin and cytokinin dedifferentiate somatic cells to regenerate organs, which can develop into individual plants. As transgenic plants can be generated from genetically modified somatic cells through these processes, cell fate transition is an unavoidable step in crop genetic engineering. However, regeneration capacity closely depends on the genotype, and the molecular events underlying these variances remain elusive. In the present study, we demonstrated that WUSCHEL (WUS)--a homeodomain transcription factor--determines regeneration capacity in different potato (Solanum tuberosum) genotypes. Comparative analysis of shoot regeneration efficiency and expression of genes related to cell fate transition revealed that WUS expression coincided with regeneration rate in different potato genotypes. Moreover, in a high-efficiency genotype, WUS silencing suppressed shoot regeneration. Meanwhile, in a low-efficiency genotype, regeneration could be enhanced through the supplementation of a different type of cytokinin that promoted WUS expression. Computational modeling of cytokinin receptor-ligand interactions suggested that the docking pose of cytokinins mediated by hydrogen bonding with the core residues may be pivotal for WUS expression and shoot regeneration in potatoes. Furthermore, our whole-genome sequencing analysis revealed core sequence variations in the WUS promoters that differentiate low- and high-efficiency genotypes. The present study revealed that cytokinin responses, particularly WUS expression, determine shoot regeneration efficiency in different potato genotypes. [ABSTRACT FROM AUTHOR]

Follicular unit excision is widely used for hair transplantation because it lacks a donor scar and is associated with less postoperative pain. Obtaining high-quality grafts and minimizing hair follicle damage during graft harvesting are key. This review elaborates on the types and dynamics of punches used in follicular unit extraction. We also describe the utility and advantages of a new "Multi-Wave Punch," a new type of punch designed to optimize graft extraction and reduce follicular injury. This multi-wave punch is composed of three different parts. The cutting edge at the end is blunt-angled. Adjacent is the leading edge, which is characterized by several horizontally oriented multi-wave shapes. Most proximal is the main body, which is decagonal in shape. Because of the multi-wave and decagonal structure, the punch easily enters the outer layers of the scalp. The wave energy is transmitted to the surrounding tissue, separating hair follicles from adjacent tissue, facilitating extraction, reducing follicular damage, and ensuring higher quality grafts. [ABSTRACT FROM AUTHOR]

Lifestyle is formed by the daily habits of a personal, and depending on the behavior, health problems, or premature death are affected. Efforts and research to maintain and improve healthy lifestyles in public health continue. This study tried to develop a tool that can be quantitatively evaluated through the Activity, Interest, and Opinion (AIO) technique and to verify the validity of the tool to understand the lifestyle based on personal values at a microscopic point. Lifestyle evaluation tool was developed through Delphi surveys. The development items consisted of three categories (activity, interest, opinion) that can understand contextual factors such as individual values, opinions, and interests, and items with 24 concepts. The Delphi survey consisted of a panel of 17 experts in the field of health-care for the elderly, and convergence and consensus were confirmed in two rounds. The average content validity ratio of the final Delphi survey was 0.89, stability 0.16, convergence 0.42, and consensus 0.76, which were high. The developed tool is expected to be used in empirical research to identify the lifestyle reflecting the values of the elderly and to promote health. [ABSTRACT FROM AUTHOR]

Purpose: Although chylous ascites is a frequent complication of radical gastrectomy for gastric cancer, proper diagnostic criteria and optimal treatment strategies have not been established. This study aimed to identify the clinical features of chylous ascites and evaluate the treatment outcomes. Materials and Methods: We retrospectively analyzed the data of patients who underwent radical gastrectomy between 2013 and 2019. Diagnosis was made when milky fluid or elevated triglyceride levels (≥100 mg/dL) appeared in the drains without a preceding infection. The clinical features, risk factors, and treatment outcomes were assessed according to the initial treatment modalities for fasting and non-fasting groups. Results: Among the 7,388 patients who underwent radical gastrectomy for gastric cancer, 156 (2.1%) experienced chylous ascites. The median length of hospital stay was longer in patients with chylous ascites than in those without (median [interquartile range]: 8.0 [6.0–12.0] vs. 6.0 [5.0–8.0], P<0.001). Low body mass index (adjusted odds ratio [aOR]=0.9; P<0.001), advanced gastric cancer (aOR=1.51, P=0.024), open surgery (reference: laparoscopic surgery; aOR=1.87, P=0.003), and extent of surgical resection (reference: subtotal gastrectomy, total gastrectomy, aOR=1.5, P=0.029; proximal gastrectomy, aOR=2.93, P=0.002) were associated with the occurrence of chylous ascites. The fasting group (n=12) was hospitalized for a longer period than the non-fasting group (n=144) (15.0 [12.5–19.5] vs. 8.0 [6.0–10.0], P<0.001). There was no difference in grade III complication rate (16.7% vs. 4.2%, P=0.117) or readmission rate (16.7% vs. 11.1%, P=0.632) between the groups. Conclusions: A fat-controlled diet and medication without fasting provided adequate initial treatment for chylous ascites after radical gastrectomy for gastric cancer. [ABSTRACT FROM AUTHOR]

Background: Complex orbital fractures are impure orbital fractures because they involve the orbital walls and mid-facial bones. The author reported an orbital wall restoration technique in which the primary orbital wall fragments were restored to their prior position in complex orbital fractures in 2020. As a follow-up to a previous preliminary study, this study retrospectively reviewed the surgical results of complex orbital wall fractures over a 4-year period and compared the surgical outcomes by dividing them into groups with and without balloon restoration. Methods: Data of 939 patients with facial bone fractures between August 2018 and August 2022 were reviewed. Of these, 154 had complex orbital fractures. Among them, 44 and 110 underwent reduction with and without the balloon technique respectively. Pre- and postoperative Naugle exophthalmometer (Good-Lite Co.) scales were evaluated. The orbital volume and orbital volume ratio were calculated from preoperative and 6 months postoperative computed tomography images. Results: Among 154 patients with complex orbital fractures, 44 patients underwent restoration with the balloon technique, and 110 patients underwent restoration without it. The Naugle scale did not differ significantly between the two groups, but the orbital volume ratio significantly decreased by 3.32% and 2.39% in groups with and without the balloon technique and the difference in OVR was significantly greater in patients in the balloon restoration group compared with the control group. Postoperative balloon rupture occurred in six out of 44 cases (13.64%). None of the six patients with balloon rupture showed significant enophthalmos at 6 months of follow-up. Conclusion: The balloon rupture rate was 13.64% (6/44 cases) with marginal screw fixation, blunt screws, and extra protection with a resorbable foam dressing. Furthermore, we restored the orbital wall with primary orbital fragments using balloon support in complex orbital wall fractures. [ABSTRACT FROM AUTHOR]

Lifestyle is formed by the daily habits of a personal, and depending on the behavior, health problems, or premature death are affected. Efforts and research to maintain and improve healthy lifestyles in public health continue. This study tried to develop a tool that can be quantitatively evaluated through the Activity, Interest, and Opinion (AIO) technique and to verify the validity of the tool to understand the lifestyle based on personal values at a microscopic point. Lifestyle evaluation tool was developed through Delphi surveys. The development items consisted of three categories (activity, interest, opinion) that can understand contextual factors such as individual values, opinions, and interests, and items with 24 concepts. The Delphi survey consisted of a panel of 17 experts in the field of health-care for the elderly, and convergence and consensus were confirmed in two rounds. The average content validity ratio of the final Delphi survey was 0.89, stability 0.16, convergence 0.42, and consensus 0.76, which were high. The developed tool is expected to be used in empirical research to identify the lifestyle reflecting the values of the elderly and to promote health. [ABSTRACT FROM AUTHOR]

Background/Aims: Efficacy of proton pump inhibitors is limited in patients with nonerosive reflux disease (NERD). The aim of this study was to comparatively evaluate the efficacy and safety of esomeprazole with sodium bicarbonate and esomeprazole alone. Methods: This was a multicenter, randomized, double-blind, active-controlled, noninferiority comparative study. A total of 379 patients with NERD were randomly allocated to receive either EsoduoⓇ (esomeprazole 20 mg with sodium bicarbonate 800 mg) or NexiumⓇ (esomeprazole 20 mg) once daily for 4 weeks from January 2019 to December 2019. The patients had a history of heartburn for at least 2 days in the week before randomization as well as in the last 3 months and no esophageal mucosal breaks on endoscopy. The primary endpoint was a complete cure of heartburn at week 4. The secondary and exploratory endpoints as well as the safety profiles were compared in the groups at weeks 2 and 4. Results: A total of 355 patients completed the study (180 in the EsoduoⓇ group and 175 in the NexiumⓇ group). The proportions of patients without heartburn in the entire 4th week of treatment were not different between the two groups (33.33% in the EsoduoⓇ group and 35% in the NexiumⓇ group, p=0.737). There were no significant differences in most of the secondary and exploratory endpoints as well as the safety profiles. Conclusions: EsoduoⓇ is as effective and safe as NexiumⓇ for managing typical symptoms in patients with NERD (ClinicalTrial.gov identifier: NCT03928470). [ABSTRACT FROM AUTHOR]

Adipose tissue (AT) inflammation is strongly associated with obesity-induced insulin resistance. When subjected to metabolic stress, adipocytes become inflamed and secrete a plethora of cytokines and chemokines, which recruit circulating immune cells to AT. Although sirtuin 6 (Sirt6) is known to control genomic stabilization, aging, and cellular metabolism, it is now understood to also play a pivotal role in the regulation of AT inflammation. Sirt6 protein levels are reduced in the AT of obese humans and animals and increased by weight loss. In this review, we summarize the potential mechanism of AT inflammation caused by impaired action of Sirt6 from the immune cells’ point of view. We first describe the properties and functions of immune cells in obese AT, with an emphasis on discrete macrophage subpopulations which are central to AT inflammation. We then highlight data that links Sirt6 to functional phenotypes of AT inflammation. Importantly, we discuss in detail the effects of Sirt6 deficiency in adipocytes, macrophages, and eosinophils on insulin resistance or AT browning. In our closing perspectives, we discuss emerging issues in this field that require further investigation. [ABSTRACT FROM AUTHOR]

Background: Sugammadex is a widely used medication for the reversal of aminosteroid neuromuscular blockades. Although sugammadex is generally regarded to be safe, concerns about the risk of serious complications have emerged. Case: A 57-year-old man without a history of coronary disease was scheduled for general anesthesia to undergo cardiac radiofrequency catheter ablation due to symptomatic persistent atrial fibrillation and flutter. At the end of the procedure, he was given 400 mg of sugammadex. A little later, the electrocardiogram showed a sudden ST elevation on the inferior leads, followed by cardiac arrest. The urgent coronary angiography demonstrated total collapse of the right coronary artery. After two injections of intra-coronary nitroglycerin, the vasospasm of the right coronary artery was completely resolved. The patient recovered without sequelae and was discharged on postoperative day 5. Conclusions: Clinicians should pay close attention to the potential risk of coronary vasospasm, even cardiac arrest, after sugammadex administration. [ABSTRACT FROM AUTHOR]

Because of their small size, small bowel malignancies are often easily missed when radiologists read CT images, which can lead to errors in the normal small bowel due to their similar enhancement to the small bowel or non-specific enhancement. In addition, small bowel malignancies are sometimes mistaken for masses of other origins, such as the uterus, rectum, or omentum. In this article, we describe various small-bowel malignancies, their mimicking lesions and the typical and atypical features on CT imaging along with their clinical manifestations. [ABSTRACT FROM AUTHOR]

Purpose: To clarify (phospho-) glycogen synthase kinase-3 (GSK3) isoform variants in the germline and soma of human testes and spermatozoa. Materials and Methods: GSK3 isoform variants in normospermatogenic and Sertoli cell-only (SCO) testicular biopsies and spermatozoa were examined. Results: In normospermatogenic testes, GSK3α and GSK3β variants 1 and 2 different in low complexity region (LCR) were expressed and their levels were decreased in SCO testes. GSK3β variant 3 was only expressed in SCO testes. GSK3β as well as GSK3α, the dominant isoforms in testes were decreased in SCO testes. In normospermatogenic testes, GSK3β were found in spermatogonia and markedly decreased in meiotic germ cells in which GSK3α was dominant. p-GSK3α/β were marginal in spermatogonia and early spermatocytes. In SCO testes, GSK3α/β immunoreactivity in seminiferous epithelia was weaker than those of normospermatogenic testes whereas p-GSK3α/β(Ser) immunoreactivity was visibly increased in Sertoli cells. GSK3α was dominant in ejaculated spermatozoa in which GSK3α and p-GSK3α(Ser) were found in the head, midpiece, and tail. In acrosome-reacted spermatozoa, GSK3α was found in the equatorial region of head, midpiece, and tail, and p-GSK3α(Ser) was only found in midpiece. During sperm capacitation, p-GSK3α(Ser) was significantly increased together with phosphotyrosine proteins and motility. Conclusions: In human male germ cells, GSK3 isoforms different in LCRs switch from GSK3β to GSK3α during meiotic entry, suggesting the isoform-specific roles of GSK3α and GSK3β in meiosis and stemness or proliferation of spermatogonia, respectively. In dormant Sertoli cells of SCO testes kinase activity of GSK3 might be downregulated via inhibitory phosphorylation. In spermatozoa, inhibitory phosphorylation of GSK3α might be coupled with activation of motility during capacitation. [ABSTRACT FROM AUTHOR]

Background/Aims Video capsule endoscopy is rarely used to diagnose Crohn’s disease in patients with negative ileocolonoscopy or cross-sectional image findings. We evaluated clinical characteristics and long-term outcomes of these rare cases. Methods This multicenter study included patients with Crohn’s disease from three tertiary hospitals from January 2007 to October 2022. Patients with normal findings on ileocolonoscopy and CT/MR enterography but had ulcerations at the small bowel detected by video capsule endoscopy were included. The controls were patients with abnormal findings on endoscopy or CT/MR enterography. Controls were case-matched in a ratio of 3:1 for sex, calendar year of diagnosis, and age at diagnosis. Results Among 3,752 patients, 24 (0.6%) were diagnosed with Crohn’s disease using video capsule endoscopy findings. The disease location (p<0.001) and behavior at diagnosis (p=0.013) of the cases significantly differed from that of controls. The perianal fistula modifier (25.0% vs. 33.3%, p=0.446) did not differ significantly between the two groups. Initial disease activity and C-reactive protein and fecal calprotectin levels were significantly lower in cases versus controls. The median Lewis score was 838 [interquartile range 393 –1803]. Over 10 years of follow-up, the cases showed significantly lower cumulative risk of complicated behavior, biologics use, Crohn’s disease-related hospitalization, and surgeries (log-rank test p<0.05). Conclusion Patients with Crohn’s disease whose lesions were observed only by video capsule endoscopy were rare and exhibit different clinical characteristics and a more favorable long-term disease course compared to those who were conventionally diagnosed. [ABSTRACT FROM AUTHOR]

Background/Aims EUS-guided antegrade intervention (EUS-AI) has emerged as a therapeutic option for benign bilioenteric anastomotic stricture (BAS). However, it has not been standardized yet and data on long-term outcomes are limited. This study aimed to assess the long-term outcomes of a two-staged EUS-AI with transmural/transanastomotic stenting (TAS) in patients with BAS. Methods Consecutive patients with BAS undergoing a two-stage EUS-AI after failed deep enteroscopy between January 2016 and June 2023 were retrospectively analyzed. In the first session, EUS-guided hepaticogastrostomy (HGS) with a transmural covered metal stent was performed to create the fistula. Four weeks later, the second session involved stent removal and antegrade intervention (balloon dilation, stone removal, and TAS) through HGS tract based on the protocol (Figure1). TAS was performed using one or two double 7Fr pigtail plastic stents, with the intent of long-term indwelling for refractory or recurrent BAS or on-demand reintervention. The primary outcome was the time to reintervention (TR) after TAS. Secondary outcomes were technical success of antegrade intervention, endoscopic reintervention rate (IR), and stricture recurrence rate after TAS removal. Results Thirty-eight patients underwent two-stage EUS-AI, with a median follow-up of 36.5 months (range 6.2 – 101). Antegrade intervention was successful in 34 patients (89.5%), of whom 28 (73.7%) proceeded to TAS. The median TR after TAS was 691 days (95% CI, 564 – NA). The IR was 49.9% (12/28, 8 in scheduled intervention and 4 in unscheduled intervention). Endoscopic reintervention was successful in 83.3% of cases, while percutaneous intervention was required in 16.7%. TAS removal was performed in 12 patients (42.9%) after a median stent maintenance time of 647 days, with no stricture recurrence requiring endoscopic reinterventions during a median follow-up period of 422 days. Conclusion Two-stage EUS-AI with TAS for patients with BAS showed promising long-term clinical outcomes in terms of stricture recurrence [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine correlates of comorbidities in adult female Korean cancer survivors. SAMPLE & SETTING: This cross-sectional study used data from the 2017-2019 Korea National Health and Nutrition Examination Survey. The study sample consisted of adult female Korean cancer survivors (N = 609) aged 19 years or older. METHODS & VARIABLES: Comorbidities were assessed using an adapted Charlson Comorbidity Index (CCI). Bivariate and multivariate linear regression analyses were conducted to identify correlates of comorbidities. Data were collected on sociodemographic characteristics, cancer-related characteristics, and comorbidities. RESULTS: The mean adapted CCI score was 2.4. Type of cancer and years since diagnosis were significant correlates of comorbidity. Other significant correlates included high body mass index, physical inactivity, low income, having less than a college education, being a former or current smoker, and having never smoked. IMPLICATIONS FOR NURSING: Many correlates of comorbidities in adult female Korean cancer survivors are consistent with those reported in other countries, including in the United States. Nurses can assess and educate cancer survivors on modifiable risk factors to prevent health comorbidities in cancer survivorship care. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) can be diagnosed noninvasively on multiphasic CT and MRI based on its distinctive imaging findings. These features include arterial phase hyperenhancement and washout on portal or delayed phase images. However, radiologists face significant diagnostic challenges because some HCCs exhibit atypical imaging characteristics. In addition to many HCC-mimicking lesions, such as arterioportal shunts, combined HCC-cholangiocarcinoma, intrahepatic cholangiocarcinoma, and hemangioma present a challenge for radiologists in actual clinical practice. The ability to distinguish HCCs from mimickers on initial imaging examinations is crucial for appropriate management and treatment decisions. Therefore, this pictorial review presents the imaging findings of atypical HCCs and HCCs mimicking malignant and benign lesions and discusses important clues that may help narrow down the differential diagnosis. [ABSTRACT FROM AUTHOR]

Applications of component-based models have gained much attention as a means of accompanying dimension reduction in the regression setting and have been successfully implemented to model a univariate outcome in the behavioral and social sciences. Despite the prevalence of correlated ordinal outcome data in the fields, however, most of the extant component-based models have been extended to address the multivariate ordinal issue with a simplified but unrealistic assumption of independence, which may lead to biased statistical inferences. Thus, we propose a Bayesian methodology for a component-based model that accounts for unstructured residual covariances, while regressing multivariate ordinal outcomes on pre-defined sets of predictors. The proposed Bayesian multivariate ordinal logistic model re-expresses ordinal outcomes of interest with a set of latent continuous variables based on an approximate multivariate t-distribution. This contributes not only to developing an efficient Gibbs sampler, a Markov Chain Monte Carlo algorithm, but also to facilitating the interpretation of regression coefficients as log-transformed odds ratio. The empirical utility of the proposed method is demonstrated through analyzing a subset of data, extracted from the 2009 to 2010 Health Behavior in School-Aged Children study that investigates risk factors of four different forms of bullying perpetration and victimization: physical, social, racial, and cyber. [ABSTRACT FROM AUTHOR]

Purpose To evaluate changing trends in relation to the sexual debut age and socioeconomic status (SES) in Korea. Materials and Methods The Korean Internet Sexuality Survey (KISS) was conducted for in 2004, 2006, 2014, and 2016. We sent emails and surveyed people registered at an Internet survey agency. To determine the changing trends in sexual debut age, we collected and compared the responses of females in their 20s in 2004 (n=253) and 2014 (n=131) and collected and compared the responses of males in their 20s in 2006 (n=87) and 2016 (n=200). Results In females, SES factors such as occupation, income, and academic background were not related to early sexual debut age. In the 2006 male study, early sexual debut age was associated with occupation, income, and academic background. However, in the 2016 male study, participants' academic background was the only significant factor about early sexual debut age. In both the male and female studies, early sexual debut age was related to a higher number of sexual partners in life. Also, in both female cohorts (2004 and 2014), the number of pregnancies and the incidents of sexual abuse experienced were higher in the early sexual debut groups. Conclusions Factors influencing early sexual debut were different in time and between men and women. And there was no significant association between SES factors and early sexual debut age in women. However, early sexual debut caused multiple problems, especially in young women. Thus, we need to create some suitable strategies to address these problems. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to investigate the appropriate indications for intra-articular injection of hyaluronic acid in ankle osteoarthritis, its efficacy at each stage of osteoarthritis and to compare the efficacy related differences at each stage. Materials and Methods: A retrospective study was conducted from January 2016 to September 2019 on 43 patients (50 cases) diagnosed with ankle arthritis and given intra-articular injection of hyaluronic acid. Patients were classified according to the modified Takakura ankle osteoarthritis stages. Stage 2 comprised 24 cases; stage 3A, 15 cases; stage 3B, 8 cases; and stage 4, 3 cases. The clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). The patients' satisfaction with the injection was evaluated at 1 year after injection. A radiographic evaluation was performed to gauge the progression of osteoarthritis before and after the injection. Results: The VAS, AOFAS score, and FAOS at 3 months and 1 year after injection showed statistically significant improvements compared to those before the injection. There was a significant difference in the VAS for each stage over time; however, this was not the case with the AOFAS score and the FAOS. A significant improvement of the VAS after injection was seen only in stage 3A when compared with the other stages. The overall satisfaction rate with the injection was 90%. There were no ankle osteoarthritic stage changes in the serial follow-up radiograph. Conclusion: Intra-articular injection of hyaluronic acid resulted in a significant clinical improvement up to 1 year after the injection. Therefore, the intra-articular injection of hyaluronic acid could be a treatment option for ankle osteoarthritis. [ABSTRACT FROM AUTHOR]

Among efforts made to improve thermoelectric efficiency, the use of structurally modified graphene nanomaterials as thermoelectric matter are one of the promising strategies owing to their fascinating physical and electrical properties, and these materials are anticipated to be less thermally conductive than regular graphene structures, as a result of an additional phonon scattering introduced at the modified surfaces. In this study, we explore the thermal conductivity behaviors of strain-induced rippled graphene sheets by varying the ripple amplitude, periodicity, and dimensions of the structure. We introduce a technique which enables creation of a graphene sheet with evenly distributed ripples in molecular dynamics simulation, and the Green-Kubo linear response theory is used to calculate the thermal conductivity of the structures of interest. The results reveal the reduction of thermal conductivity with the greater degree of strain, the smaller system dimension, and the shorter ripple wavelength, which, in turn, could lead to the thermoelectric efficiency enhancement. This work has significance in that it presents the capability of generating repeated and controllable patterns in molecular dynamics, and so, it enables the atomic-level transport study in the regularly patterned two-dimensional surface or in any structures with a specified degree of strain. [ABSTRACT FROM AUTHOR]

Background: Advanced hemostatic devices (AHDs) have been widely used in gynecologic minimally invasive surgeries. These AHDs using ultrasonic energy or bipolar thermal energy are effective in sealing vessels up to 7 mm in diameter in previous studies. Vi-Sealer is a reusable AHD with an interchangeable blade. This device uses bipolar energy to coagulate and seal blood vessels and a built-in blade to divide the vessels simultaneously. This study aims to evaluate the efficacy and safety of Vi-Sealer by comparing it with other AHDs. Methods: This multi-centered, open-labeled, non-inferiority, randomized control study compares Vi-Sealer with other AHDs in total laparoscopic hysterectomy (TLH) for benign gynecologic disease. This study excludes patients who have a larger than gestational 16 week-sized uterus, stage 3 to 4 endometriosis, cervical or intraligamentary fibroids, suspicious malignancies in the uterus and adnexa, implantable cardioverter defibrillators or pacemakers contraindicated for energy devices, or history of 3 or more pelvic surgeries. The patients are stratified into two cohorts according to whether operating surgeons (or participating institutes) are familiar with the use of AHD and use one kind of AHD. We assign the patients in a 1:1 ratio to undergo TLH with Vi-sealer or other AHD. The total sample size is calculated as 280 with 140 in each cohort. The primary endpoints are operation time and estimated blood loss. The secondary endpoints are medical cost, operating surgeons' score of device function, and adverse events. This study will investigate the efficacy, safety, and cost-effectiveness of the reusable AHD, Vi-Sealer, in TLH compared with the standard AHDs. [ABSTRACT FROM AUTHOR]

Objective: The International Federation of Gynecology and Obstetrics (FIGO) committee modified the endometrial cancer staging system based on the histopathological feature and molecular profile. The aim is to evaluate the clinical implications of the new 2023 system compared with the previous 2009 system. Methods: We retrospectively identified 161 patients with endometrial cancer who underwent primary surgical treatment between 2014 and 2018 at Seoul National University Hospital. The droplet-digital polymerase chain reaction for POLE mutations and immunohistochemistry for MLH1, PMS2, MS2, MSH6, and p53 were performed using tissues from formalin-fixed, paraffinembedded blocks. All patients were categorized according to the 2009 and 2023 FIGO staging systems. Results: The median follow-up period was 62.9 months (range, 0.3-110.9), and the median age was 57.2 years old (range, 28.0-85.9). The 5-year progression-free survival (PFS) for the 2023 system with molecular classification was 80.3% for stage I, 75.2% for stage II, 61.2% for stage III, and 22.2% for stage IV (p<0.001). Patients with the 2009 stage I and II disease were restaged using the 2023 system. In contrast, patients with stage III and IV disease were fixed in the 2009 and 2023 systems. Molecular classification downstaged 10 patients (71.4%) to IAmPOLEmut and upstaged 6 patients (37.5%) to IICmp53abn. The 2023 system with molecular classification was associated with PFS and overall survival (p<0.001 and p=0.038, respectively). Conclusion: The 2023 FIGO staging system for endometrial cancer subdivided stages I and II compared to the 2009 system. The 2023 FIGO staging system with molecular classification is a good predictor of survival. [ABSTRACT FROM AUTHOR]

The article presents a study which explores about parallel functional subnetworks embedded in the macaque face patch system. It mentions that findings of the study challenge prevailing views about functional segregation in the cortex and underscore the importance of naturalistic paradigms for cognitive neuroscience.

Purpose: Osteosynthesis has been recommended for treatment of Pauwels type III femoral neck fractures in young patients. However, no implant of choice has been reported so far. This study was conducted in order to compare the fixation stability of two conventional fixation methods with three different novel fixed angle devices in this type of fracture. Materials and Methods: A total of 25 composite femurs (4th Generation Saw bone; Pacific Research Laboratories, USA) corresponding to human bone were used. Pauwels type III fracture type was uniformly reproduced. Specimens were fixed with a cannulated screw, cannulated screw with cable, and Intertan nail, dynamic hip screw, and IKEY nail. Measurement of failure loads and the rotational change of the femoral head fragment was performed for evaluation of fixation stability. Results: All implants were compared with cannulated screw and dynmaic hip screw. No meaningful improvement was observed for the cannulated screw with cable compared with the cannulated screw and dynamic hip screw. Meaningful improvement in load-to-failure and y-rotation and z-rotation was observed for both the Intertan nail and IKEY nail compared with the cannulated screw. However, compared with the dynamic hip screw, only the IKEY nail showed improvement in the same profile but the Intertan nail did not. Conclusion: Among novel fixed angle devices, meaningful improvement was observed for the IKEY nail compared with conventional implants. Strengths of this implant include biomechanical stability and simplicity of surgical technique, indicating that it may be another good option for osteosynthesis of Pauwels type III femoral neck fractures. [ABSTRACT FROM AUTHOR]

Background In addition to vascular endothelial cells, vascular smooth muscle cells (VSMCs) are subject to continuous shear stress because of blood circulation. The angiogenic properties of VSMCs in extracranial arteriovenous malformations (AVMs) may exceed those of normal blood vessels if the body responds more sensitively to mechanical stimuli. This study was performed to investigate the hypothesis that rapid angiogenesis may be achieved by mechanical shear stress. Methods VSMCs were obtained from six patients who had AVMs and six normal controls. The target genes were set to angiopoietin-2 (AGP2), aquaporin-1 (AQP1), and transforming growth factor-beta receptor 1 (TGFBR1). Reverse-transcriptase polymerase chain reaction (RT-PCR) and real-time PCR were implemented to identify the expression levels for target genes. Immunofluorescence was also conducted. Results Under the shear stress condition, mean relative quantity values of AGP2, AQP1, and TGFBR1 in AVM tissues were 1.927±0.528, 1.291±0.031, and 2.284±1.461 when compared with neutral conditions. The expression levels of all three genes in AVMs were higher than those in normal tissue except for AQP1 under shear stress conditions. Immunofluorescence also revealed increased staining of shear stress-induced genes in the normal tissue and in AVM tissue. Conclusions Shear stress made the VSMCs of AVMs more sensitive. Although the pathogenesis of AVMs remains unclear, our study showed that biomechanical stimulation imposed by shear stress may aggravate angiogenesis in AVMs. [ABSTRACT FROM AUTHOR]

Objective: The present study was conducted to assess the effect of urease inhibitor (hydroquinone [HQ]) and nitrification inhibitor (dicyandiamide [DCD]) on nitrogen (N) use efficiency of pig slurry for perennial ryegrass regrowth yield and its environmental impacts. Methods: A micro-plot experiment was conducted using pig slurry-urea 15N treated with HQ and/or DCD and applied at a rate of 200 kg N/ha. The flows of N derived from the pig slurry urea to herbage regrowth and soils as well as soil N mineralization were estimated by tracing pig slurry-urea 15N, and the N losses via ammonia (NH3), nitrous oxide (N2O) emission, and nitrate (NO3 -) leaching were quantified for a 56 d regrowth of perennial ryegrass (Lolium perenne) sward. Results: Herbage dry matter at the final regrowth at 56 d was significantly higher in the HQ and/or DCD applied plots, with a 24.5% to 42.2% increase in 15N recovery by herbage compared with the control. Significant increases in soil 15N recovery were also observed in the plots applied with the inhibitors, accompanied by the increased N content converted to soil inorganic N (NH4 ++NO3 -) (17.3% to 28.8% higher than that of the control). The estimated loss, which was not accounted for in the herbage-soil system, was lower in the plots applied with the inhibitors (25.6% on average) than that of control (38.0%). Positive effects of urease and/or nitrification inhibitors on reducing N losses to the environment were observed at the final regrowth (56 d), at which cumulative NH3 emission was reduced by 26.8% (on average 3 inhibitor treatments), N2O emission by 50.2% and NO3 - leaching by 10.6% compared to those of the control. Conclusion: The proper application of urease and nitrification inhibitors would be an efficient strategy to improve the N use efficiency of pig slurry while mitigating hazardous environmental impacts. [ABSTRACT FROM AUTHOR]

A fire during manned space exploration can cause serious casualties and disrupt the mission if the initial response is delayed. Therefore, measurement technology that can detect fire in the early stage of ignition is important. There have been a number of works that investigate the smoke behaviors in microgravity as the foundation for a reliable method for sensing a fire during spaceflight. For space missions to the outer planets, however, a strategy of detecting smoke as an indicator of fire should be adjusted to cover the fire scenario that can be greatly affected by changes in gravity (microgravity, lunar, Mars, and Earth gravity). Therefore, as a preliminary study on fire detectors of the manned pressurized module, the present study examined the smoke particle behavior and detection characteristics with respect to changes in gravity using numerical analysis. In particular, the effects of the combination of buoyancy and ventilation flow on the smoke particle movement pattern was investigated to further improve the understanding of the fire detection characteristics of the smoke detector, assuming that a fire occurred in different gravity environments inside the pressurized module. To this end, we modeled the internal shape of Destiny and performed a series of numerical analysis using the Fire Dynamics Simulator (FDS). The findings of this study can provide basic data for the design of a fire detection system for manned space exploration modules. [ABSTRACT FROM AUTHOR]

Malignant nodular hidradenoma (MNH) is an infrequent, highly malignant tumor derived from eccrine sweat glands. MNH usually occurs on the scalp, trunk, and proximal extremities, and rarely on the hand. A 55-year-old male patient visited clinics with a gradually enlarging painless mass at fingertip. It begins a year ago. Recently, it has grown rapidly and starts ulceration, and bleeding over the past 3 weeks. According to the biopsy report, it has focal necrosis, atypia, atypical mitoses, and nuclear pleomorphism suggested that the mass was MNH. After histological diagnosis, tiny bone erosion was observed in the re-read radiographic finding. For the oncologic evaluation, the patient was transferred to the cancer center. Radical amputation was performed to the residual tumor that might remain based on re-reading of radiographs. MNH of the finger is especially difficult to the diagnosis given its rarity and variable histology. When ulcerative skin lesion and radiographic bone erosion are observed, one should suspect malignancy and makes out a proper therapeutic plan after histologic biopsy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate osteoarthritis after treatment of bony mallet finger using the extension block method. Methods: A single institutional retrospective review identified 163 patients with bony mallet between January 2012 and July 2020 and received surgical treatment using extension block method. The radiographic examination showed that the fracture line disappeared and a bridging callus was formed and bone union was confirmed. Fractures were classified according to the Tubiana classification method. Demographic data, fracture pattern, postoperative X-ray, and late complications were analyzed. Clinical outcomes were analyzed using Crawford's criteria. Results: Surgical treatment was performed within an average of 8.8 days after injury, and the average follow-up period was 11.6 weeks. Osteoarthritis findings were confirmed by joint space narrowing and osteophytes on radiographic examination of 32 out of 163 patients. Age, sex, occupation, location of trauma, operation time, and type of fracture did not affect the osteoarthritis after extension block. Invasion of Kirschner wire (K-wire) to the fracture surface, family history of osteoarthritis, and operation time turned out to have a statistically significant effect on osteoarthritis (p<0.05). Conclusion: Fracture surface invasion of K-wire and family history of osteoarthritis affect osteoarthritis after treatment of bony mallet. [ABSTRACT FROM AUTHOR]

Objective: Red ginseng (RG) exerts anti-inflammatory, anti-proliferative, and immunomodulatory effects on endometriosis through the regulation of microRNA (miRNA) expression. It may also ameliorate endometriosis by affecting the expression of multiple miRNAs simultaneously, rather than acting on a single miRNA at a given time. Since studies on the overall effects of RG on endometriosis via the regulation of miRNA expression are lacking, the current study aimed to explore the global effect of RG on miRNA expression in a mouse model of endometriosis. Methods: To establish the mouse model, the uterine horn of donor mice was implanted into the lateral side of the recipients'peritoneum, followed by vehicle or RG treatment for 8 weeks. Results: To confirm the effects of RG on the established mouse model, the size of the implanted uterus was measured; it was found to be lower in mice from the RG group than in mice from the control group. miRNA expression profiles in the implanted uterus of the mouse model of endometriosis after vehicle or RG administration were analyzed using microarray technology. Thereafter, seven candidate miRNAs and 125 candidate genes (miRNA targets) were identified through a bioinformatics analysis. Conclusion: The present findings suggest that RG regulates the expression of multiple miRNAs and mRNAs, thereby alleviating endometriosis in a mouse model of the disease. [ABSTRACT FROM AUTHOR]

Physical debilitation and other health risks such as cardiovascular disease and osteoporosis often accompany decreased estrogen production in postmenopausal women. Phytoestrogens, natural compounds that functionally mimic estrogens, have emerged as a potential treatment method for hormonal dysregulation during menopause. Among these, chaga (Inonotus obliquus) extract has gained attention for its various health benefits, including anti-cancer and antioxidant properties. The aim of this study was to investigate the bone metabolic efficacy of lactic acid bacteria derived from I. obliquus in ovariectomized C57BL/6J female mice. The results demonstrated the estrogenic activity of probiotics derived from I. obliquus and its potential to alleviate osteoporosis symptoms by improving bone microstructure and density. Furthermore, probiotics derived from I. obliquus favored biochemical markers associated with a reduction in bone resorption. Additionally, effects on brain neurotransmitters and serum estradiol levels suggested its regulatory role in estrogen mimicry. These findings underscore the therapeutic potential of probiotics derived from I. obliquus in managing menopausal symptoms and thus warrant potential human investigation in improving bone health in postmenopausal women. [ABSTRACT FROM AUTHOR]

Purpose: Although laparoscopic distal gastrectomy has rapidly replaced open distal gastrectomy, laparoscopic total gastrectomy (LTG) is less frequently performed owing to technical difficulties. Robotic surgery could be an appropriate minimally invasive alternative to LTG because it alleviates the technical challenges posed by laparoscopic procedures. However, few studies have compared the oncological safety of robotic total gastrectomy (RTG) with that of LTG, especially for advanced gastric cancer (AGC). Herein, we aimed to assess the oncological outcomes of RTG for AGC and compare them with those of LTG. Materials and Methods: We retrospectively reviewed 147 and 204 patients who underwent RTG and LTG for AGC, respectively, between 2007 and 2020. Long-term outcomes were compared using inverse probability of treatment weighting (IPTW). Results: After IPTW, the 2 groups exhibited similar clinicopathological features. The 5-year overall survival was comparable between the 2 groups (88.5% [95% confidence interval {CI}, 79.4%–93.7%] after RTG and 87.3% [95% CI, 80.1%–92.0%]) after LTG; log-rank P=0.544). The hazard ratio (HR) for death after RTG compared with that after LTG was 0.73 (95% CI, 0.40–1.33; P=0.304). The 5-year relapse-free survival was also similar between the 2 groups (75.7% [95% CI, 65.2%–83.4%] after RTG and 76.4% [95% CI, 67.9%–83.0%] after LTG; logrank P=0.850). The HR for recurrence after RTG compared with that after LTG was 0.93 (95% CI, 0.60–1.46; P=0.753). Conclusions: Our findings revealed that RTG and LTG for AGC had similar long-term outcomes. RTG is an oncologically safe alternative to LTG and has technical advantages [ABSTRACT FROM AUTHOR]

Purpose: Deep learning–based image enhancement has significant potential in the field of ultrasound image processing, as it can accurately model complicated nonlinear artifacts and noise, such as ultrasonic speckle patterns. However, training deep learning networks to acquire reference images that are clean and free of noise presents significant challenges. This study introduces an unsupervised deep learning framework, termed speckle-to-speckle (S2S), designed for speckle and noise suppression. This framework can complete its training without the need for clean (speckle-free) reference images. Methods: The proposed network leverages statistical reasoning for the mutual training of two in vivo images, each with distinct speckle patterns and noise. It then infers speckle- and noise-free images without needing clean reference images. This approach significantly reduces the time, cost, and effort experts need to invest in annotating reference images manually. Results: The experimental results demonstrated that the proposed approach outperformed existing techniques in terms of the signal-to-noise ratio, contrast-to-noise ratio, structural similarity index, edge preservation index, and processing time (up to 86 times faster). It also performed excellently on images obtained from ultrasound scanners other than the ones used in this work. Conclusion: S2S demonstrates the potential of employing an unsupervised learning-based technique in medical imaging applications, where acquiring a ground truth reference is challenging. [ABSTRACT FROM AUTHOR]

Lateral spinal artery (LSA) aneurysms are extremely rare lesions that can rupture and cause subarachnoid hemorrhage (SAH) even though the spinal arteries communicate directly with the subarachnoid space. To date, six cases of LSA aneurysms have been reported in the literature. Herein, three such cases are reported. All patients presented to the emergency department with headaches. The patients in the first two cases were confirmed to have SAH and LSA aneurysms on a brain computed tomography (CT) angiography performed at the hospital. Two patients had prior instances of cerebral infarction and coronary disease, respectively, and were undergoing antiplatelet therapy. The antiplatelet medication was stopped for 2 weeks and 1 week, respectively, while conservative care was provided. Subsequently, a suboccipital craniectomy was performed, followed by aneurysm clipping. Following the surgery, both patients were discharged without any significant neurological deficits. Regarding the third patient, no aneurysm was found on brain CT angiography, and cerebral angiography was performed during the patient’s hospital stay. She was hospitalized, where she received medication and conservative care, and was discharged with an improvement in bleeding without neurological symptoms. Subsequently, a LSA aneurysm was identified on a brain CT angiography performed at an outpatient clinic; however, the patient was transferred because she wanted to be treated at another hospital. LSA aneurysms are difficult to visualize using CT angiography; therefore, careful angiographic studies are required. Surgical clipping is the treatment of choice if the aneurysm is inaccessible by the endovascular treatment. [ABSTRACT FROM AUTHOR]

Changes in light quality caused by the presence of neighbor proximity regulate many growth and development processes of plants. PHYTOCHROME INTERACTING FACTOR 7 (PIF7), whose subcellular localization, DNA-binding properties, and protein abundance are regulated in a photoreversible manner, plays a central role in linking shade light perception and growth responses. How PIF7 activity is regulated during shade avoidance responses has been well studied, and many factors involved in this process have been identified. However, the detailed molecular mechanism by which shade light regulates the PIF7 protein level is still largely unknown. Here, we show that the PIF7 protein level regulation is important for shade-induced growth. Two ubiquitin-specific proteases, UBP12 and UBP13, were identified as positive regulators in shade avoidance responses by increasing the PIF7 protein level. The ubp12-2w/13-3 double mutant displayed significantly impaired sensitivity to shade-induced cell elongation and reproduction acceleration. Our genetic and biochemical analysis showed that UBP12 and UBP13 act downstream of phyB and directly interact with PIF7 to maintain PIF7 stability and abundance through deubiquitination. [ABSTRACT FROM AUTHOR]

Background: We estimated the effect of obesity on the incidence of cardiovascular disease (CVD) and mortality in women according to menopausal status. Methods: Women aged 40 to 69 years under routine health check-ups provided by the National Health Insurance Service in 2009 were followed up till 2018 (n=2,208,559). Results: In premenopausal women, a significant increment of mortality rate was found in underweight and obesity class II (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.31 to 1.67; and HR, 1.25; 95% CI, 1.12 to 1.39) compared to normal body mass index (BMI); overweight and obesity class I did not affect mortality rate. In postmenopausal women, obesity as well as overweight status reduced the risk of mortality compared to normal BMI (HR, 0.86; 95% CI, 0.83 to 0.88; and HR, 0.84; 95% CI, 0.82 to 0.86). By contrast, there was a linear association between CVD and BMI above the normal range irrespective of menopausal status, which was attenuated in diabetic women. Conclusion: The current study replicated the J-shaped relationship between BMI and mortality, being more prominent in the postmenopausal group. The risk of CVD was linearly increased as BMI was increased above the normal range irrespective of menopausal status. [ABSTRACT FROM AUTHOR]