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Abstract Interfacial magnetic interactions between different elements are the origin of various spin-transport phenomena in multi-elemental magnetic systems. We investigate the coupling between the magnetic moments of the rare-earth, transition-metal, and heavy-metal elements across the interface in a GdFeCo/Pt thin film, an archetype system to investigate ferrimagnetic spintronics. The Pt magnetic moments induced by the antiferromagnetically aligned FeCo and Gd moments are measured using element-resolved x-ray measurements. It is revealed that the proximity-induced Pt magnetic moments are always aligned parallel to the FeCo magnetic moments, even below the ferrimagnetic compensation temperature where FeCo has a smaller moment than Gd. This is understood by a theoretical model showing distinct effects of the rare-earth Gd 4f and transition-metal FeCo 3d magnetic moments on the Pt electronic states. In particular, the Gd and FeCo work in-phase to align the Pt moment in the same direction, despite their antiferromagnetic configuration. The unexpected additive roles of the two antiferromagnetically coupled elements exemplify the importance of detailed interactions among the constituent elements in understanding magnetic and spintronic properties of thin film systems.

Abstract We investigate the voltage control of magnetism in a van der Waals (vdW) heterostructure device consisting of two distinct vdW materials, the ferromagnetic Fe3-x GeTe2 and the ferroelectric In2Se3. It is observed that gate voltages applied to the Fe3-x GeTe2/In2Se3 heterostructure device modulate the magnetic properties of Fe3-x GeTe2 with significant decrease in coercive field for both positive and negative voltages. Raman spectroscopy on the heterostructure device shows voltage-dependent increase in the in-plane In2Se3 and Fe3-x GeTe2 lattice constants for both voltage polarities. Thus, the voltage-dependent decrease in the Fe3-x GeTe2 coercive field, regardless of the gate voltage polarity, can be attributed to the presence of in-plane tensile strain. This is supported by density functional theory calculations showing tensile-strain-induced reduction of the magnetocrystalline anisotropy, which in turn decreases the coercive field. Our results demonstrate an effective method to realize low-power voltage-controlled vdW spintronic devices utilizing the magnetoelectric effect in vdW ferromagnetic/ferroelectric heterostructures.

Abstract The interplay between ferromagnetism and the non-trivial topology has unveiled intriguing phases in the transport of charges and spins. For example, it is consistently observed the so-called topological Hall effect (THE) featuring a hump structure in the curve of the Hall resistance (R xy ) vs. a magnetic field (H) of a heterostructure consisting of a ferromagnet (FM) and a topological insulator (TI). The origin of the hump structure is still controversial between the topological Hall effect model and the multi-component anomalous Hall effect (AHE) model. In this work, we have investigated a heterostructure consisting of BixSb2−xTeySe3−y (BSTS) and Cr2Te3 (CT), which are well-known TI and two-dimensional FM, respectively. By using the so-called “minor-loop measurement”, we have found that the hump structure observed in the CT/BSTS is more likely to originate from two AHE channels. Moreover, by analyzing the scaling behavior of each amplitude of two AHE with the longitudinal resistivities of CT and BSTS, we have found that one AHE is attributed to the extrinsic contribution of CT while the other is due to the intrinsic contribution of BSTS. It implies that the proximity-induced ferromagnetic layer inside BSTS serves as a source of the intrinsic AHE, resulting in the hump structure explained by the two AHE model. Graphical abstract

Abstract Transition metal dichalcogenides have attracted renewed interest for use as thermoelectric materials owing to their tunable bandgap, moderate Seebeck coefficient, and low thermal conductivity. However, their thermoelectric parameters such as Seebeck coefficient, electrical conductivity, and thermal conductivity are interdependent, which is a drawback. Therefore, it is necessary to find a way to adjust one of these parameters without affecting the other parameters. In this study, we investigated the effect of helium ion irradiation on MoSe2 thin films with the objective of controlling the Seebeck coefficient and electrical conductivity. At the optimal irradiation dose of 1015 cm−2, we observed multiple enhancements of the power factor resulting from an increase in the electrical conductivity, with slight suppression of the Seebeck coefficient. Raman spectroscopy, X-ray diffraction, and transmission electron microscopy analyses revealed that irradiation-induced selenium vacancies played an important role in changing the thermoelectric properties of MoSe2 thin films. These results suggest that helium ion irradiation is a promising method to significantly improve the thermoelectric properties of two-dimensional transition metal dichalcogenides. Graphical Abstract Effect of He+ irradiation on thermoelectric properties of MoSe2 thin films.

Abstract We report on a thickness-dependent wetting property of WS2/Al2O3 and WS2/SiO2/Si structures. We prepared WS2 films with gradient thickness by annealing thickness-controlled WO3 films at 800 °C in sulfur atmosphere. Raman spectroscopy measurements showed step-like variation in the thickness of WS2 over substrates several centimeters in dimension. On fresh surfaces, we observed a significant change in the water contact angle depending on film thickness and substrate. Transmission electron microscopy analysis showed that differences in the surface roughness of WS2 films can account for the contrasting wetting properties between WS2/Al2O3 and WS2/SiO2/Si. The thickness dependence of water contact angle persisted for longer than 2 weeks, which demonstrates the stability of these wetting properties when exposed to air contamination.

Abstract Laser lift-off (LLO) of ultrathin polyimide (PI) films is important in the manufacturing of ultrathin displays. However, conventional LLO technologies face challenges in separating the ultrathin PI films without causing mechanical and electrical damage to integrated devices. Here, we propose a graphene-enabled laser lift-off (GLLO) method to address the challenges. The GLLO method is developed by integrating chemical vapor deposition (CVD)-grown graphene at the interface between a transparent carrier and an ultrathin PI film, exhibiting improved processability and lift-off quality. In particular, the GLLO method significantly mitigates plastic deformation of the PI film and minimizes carbonaceous residues remaining on the carrier. The role of graphene is attributed to three factors: enhancement of interfacial UV absorption, lateral heat diffusion, and adhesion reduction, and experimentations and numerical simulations verify the mechanism. Finally, it is demonstrated that the GLLO method separates ultrathin organic light-emitting diode (OLED) devices without compromising performance. We believe that this work will pave the way for utilizing CVD graphene in various laser-based manufacturing applications.

Elevated blood cholesterol and triglyceride levels induced by secondary causes are frequently observed. The identification and appropriate handling of these causes are essential for secondary dyslipidemia treatment. Major secondary causes of hypercholesterolemia and hypertriglyceridemia include an unhealthy diet, diseases and metabolic conditions affecting lipid levels, and therapeutic side effects. It is imperative to correct secondary causes prior to initiating conventional lipid-lowering therapy. Guideline-based lipid therapy can then be administered based on the subsequent lipid levels.

Abstract This paper presents experimental results of combined cyclic load testing on a reinforced concrete (RC) column that was retrofitted with newly designed steel rods. The steel rods were installed around the column longitudinally and then anchored. The proposed steel rods utilize simple components and installation to enhance both the strength and ductility of RC columns. Cyclic lateral load tests were conducted on three specimens: one unreinforced specimen as reference, one specimen with the entire length of the column retrofitted, and one specimen with only the plastic hinge region of the column retrofitted. All specimens were tested under eccentric constant axial load and incrementally increasing lateral loading cycles with eccentricity. The implementation of steel rods resulted in significant improvement in ductility and an up to 60% increase in ultimate loading capacity.

Background/Aims Sedation has become a standard practice for patients undergoing gastrointestinal (GI) endoscopy. However, considering the serious cardiopulmonary adverse events associated with sedatives, it is important to identify patients at high risk. Machine learning can generate reasonable prediction for a wide range of medical conditions. This study aimed to evaluate the risk factors associated with sedation during GI endoscopy and develop a predictive model for hypoxia during endoscopy under sedation. Methods This prospective observational study enrolled 446 patients who underwent sedative endoscopy at the Korea University Ansan Hospital. Clinical data were used as predictor variables to construct predictive models using the random forest method that is a machine learning algorithm. Results Seventy-two of the 446 patients (16.1%) experienced life-threatening hypoxia requiring immediate medical intervention. Patients who developed hypoxia had higher body weight, body mass index (BMI), neck circumference, and Mallampati scores. Propofol alone and higher initial and total dose of propofol were significantly associated with hypoxia during sedative endoscopy. Among these variables, high BMI, neck circumference, and Mallampati score were independent risk factors for hypoxia. The area under the receiver operating characteristic curve for the random forest-based predictive model for hypoxia during sedative endoscopy was 0.82 (95% confidence interval, 0.79–0.86) and displayed a moderate discriminatory power. Conclusions High BMI, neck circumference, and Mallampati score were independently associated with hypoxia during sedative endoscopy. We constructed a model with acceptable performance for predicting hypoxia during sedative endoscopy.

Identifying the primary site of origin of metastatic cancer is vital for guiding treatment decisions, especially for patients with cancer of unknown primary (CUP). Despite advanced diagnostic techniques, CUP remains difficult to pinpoint and is responsible for a considerable number of cancer-related fatalities. Understanding its origin is crucial for effective management and potentially improving patient outcomes. This study introduces a machine learning framework, ONCOfind-AI, that leverages transcriptome-based gene set features to enhance the accuracy of predicting the origin of metastatic cancers. We demonstrate its potential to facilitate the integration of RNA sequencing and microarray data by using gene set scores for characterization of transcriptome profiles generated from different platforms. Integrating data from different platforms resulted in improved accuracy of machine learning models for predicting cancer origins. We validated our method using external data from clinical samples collected through the Kangbuk Samsung Medical Center and Gene Expression Omnibus. The external validation results demonstrate a top-1 accuracy ranging from 0.80 to 0.86, with a top-2 accuracy of 0.90. This study highlights that incorporating biological knowledge through curated gene sets can help to merge gene expression data from different platforms, thereby enhancing the compatibility needed to develop more effective machine learning prediction models.

Abstract Clade 2.3.4.4b highly pathogenic avian influenza (HPAI) H5N1 virus was detected in the South American sea lions found dead in Santa Catarina, Brazil, in October 2023. Whole genome sequencing and comparative phylogenetic analysis were conducted to investigate the origin, genetic diversity, and zoonotic potentials of the H5N1 viruses. The H5N1 viruses belonged to the genotype B3.2 of clade 2.3.4.4b H5N1 virus, which was identified in North America and disseminated to South America. They have acquired new amino acid substitutions related to mammalian host affinity. Our study provides insights into the genetic landscape of HPAI H5N1 viruses in Brazil, highlighting the continuous evolutionary processes contributing to their possible adaptation to mammalian hosts.

The aircraft maintenance personnel qualification systems and trainings in Korea are constantly striving to meet the standards of the International Civil Aviation Organization (ICAO). However, Korean aircraft maintenance licenses are not recognized in most foreign countries. The reason for this is that the educational standards of the Korean maintenance training curriculum do not meet international standards such as those set by ICAO. Therefore, this study aims to examine the changing trend of The Korean aircraft maintenance qualification system and the current status of maintenance training through the study of international literature on ICAO, European Aviation Safety Agency, Federal Aviation Administration and previous studies in Korea. It will diagnose the problems and provide some suggestions on how to secure the international status of The Korean aircraft maintenance qualification system and the current status of maintenance training, and provide practical suggestions for fostering the aircraft maintenance technician.

Nivolumab plus chemotherapy in the first-line setting has demonstrated clinical efficacy in patients with human epidermal growth factor receptor 2–negative advanced or metastatic gastric cancer, and is currently indicated as a standard treatment. Programmed death-ligand 1 (PD-L1) expression is an important biomarker for predicting response to anti–programmed death 1/PD-L1 agents in several solid tumors, including gastric cancer. In the CheckMate-649 trial, significant clinical improvements were observed in patients with PD-L1 combined positive score (CPS) ≥ 5, determined using the 28-8 pharmDx assay. Accordingly, an accurate interpretation of PD-L1 CPS, especially at a cutoff of 5, is important. The CPS method evaluates both immune and tumor cells and provides a comprehensive assessment of PD-L1 expression in the tumor microenvironment of gastric cancer. However, CPS evaluation has several limitations, one of which is poor interobserver concordance among pathologists. Despite these limitations, clinical indications relying on PD-L1 CPS are increasing. In response, Korean gastrointestinal pathologists held a consensus meeting for the interpretation of PD-L1 CPS in gastric cancer. Eleven pathologists reviewed 20 PD-L1 slides with a CPS cutoff close to 5, stained with the 28-8 pharmDx assay, and determined the consensus scores. The issues observed in discrepant cases were discussed. In this review, we present cases of gastric cancer with consensus PD-L1 CPS. In addition, we briefly touch upon current practices and clinical issues associated with assays used for the assessment of PD-L1 expression in gastric cancer.

Ship heave effects in the swell-prevalent Southern Ocean induce frequent false overturns in density profiles, and conventional Thorpe scale analysis leads to unrealistically large diapycnal diffusivities. Another critical factor causing large positive biases in Thorpe scale analysis concerns the Ozmidov to Thorpe scales ratio α often considered constant and equal to 0.8. A revised Thorpe scale analysis is proposed with an innovative segment-by-segment approach to circumvent heave-induced false overturns together with best-fitting α functions to Diapycnal and Isopycnal Mixing Experiment in the Southern Ocean (DIMES) data, which yields realistic diffusivities in the Drake Passage region. The revised Thorpe scale method applied to a finely-resolved CTD section across the Drake Passage yields typical diffusivities of O (10-5-10-3 m2 s-1), with the largest values being preferentially concentrated close to the bottom at major circumpolar fronts, consistent with nearby DIMES microstructure observations. In the southern Drake Passage the method highlights a middepth (500-1500 m) mixing maximum of 10-4-10-3 m2 s-1 in the Lower Circumpolar Deep Water (LCDW) layer due to large intrusions of Warm Deep Water (a cold/fresh variety of LCDW) of Weddell Gyre origin. The inferred middepth mixing maximum in intrusive regions, which is associated with isopycnal eddy stirring rather than caused by internal waves or double diffusive mixing, supports the short-circuiting paradigm of meridional overturning circulation in the southwestern Scotia Sea region and has important climatic implications in a warming climate.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Abstract Sarcopenia, the progressive decline in skeletal muscle mass and function, is observed in various conditions, including cancer and aging. The complex molecular biology of sarcopenia has posed challenges for the development of FDA-approved medications, which have mainly focused on dietary supplementation. Targeting a single gene may not be sufficient to address the broad range of processes involved in muscle loss. This study analyzed the gene expression signatures associated with cancer formation and 5-FU chemotherapy-induced muscle wasting. Our findings suggest that dimenhydrinate, a combination of 8-chlorotheophylline and diphenhydramine, is a potential therapeutic for sarcopenia. In vitro experiments demonstrated that dimenhydrinate promotes muscle progenitor cell proliferation through the phosphorylation of Nrf2 by 8-chlorotheophylline and promotes myotube formation through diphenhydramine-induced autophagy. Furthermore, in various in vivo sarcopenia models, dimenhydrinate induced rapid muscle tissue regeneration. It improved muscle regeneration in animals with Duchenne muscular dystrophy (DMD) and facilitated muscle and fat recovery in animals with chemotherapy-induced sarcopenia. As an FDA-approved drug, dimenhydrinate could be applied for sarcopenia treatment after a relatively short development period, providing hope for individuals suffering from this debilitating condition.

Abstract Background Petersen’s hernia, which occurs after Billroth-II (B-II) or Roux-en-Y (REY) anastomosis, can be reduced by defect closure. This study aims to compare the incidence of bowel obstruction above Clavien–Dindo classification grade III due to Petersen’s hernia between the mesenteric fixation method and the conventional methods after laparoscopic or robotic gastrectomy. Methods This study was designed as prospective, single-blind, non-inferiority randomized controlled multicenter trial in Korea. Patients with histologically diagnosed gastric cancer of clinical stages I, II, or III who underwent B-II or REY anastomosis after laparoscopic or robotic gastrectomy are enrolled in this study. Participants who meet the inclusion criteria are randomly assigned to two groups: a CLOSURE group that underwent conventional Petersen’s defect closure method and a MEFIX group that underwent the mesenteric fixation method. The primary endpoint is the number of patients who underwent surgery for bowel obstruction caused by Petersen’s hernia within 3 years after laparoscopic or robotic gastrectomy. Discussion This trial is expected to provide high-level evidence showing that the MEFIX method can quickly and easily close Petersen’s defect without increased postoperative complications compared to the conventional method. Trial registration ClinicalTrials.gov NCT05105360. Registered on November 3, 2021.

Abstract Background Parthanatos represents a critical molecular aspect of Parkinson's disease, wherein AIMP2 aberrantly activates PARP-1 through direct physical interaction. Although AIMP2 ought to be a therapeutic target for the disease, regrettably, it is deemed undruggable due to its non-enzymatic nature and predominant localization within the tRNA synthetase multi-complex. Instead, AIMP2 possesses an antagonistic splice variant, designated DX2, which counteracts AIMP2-induced apoptosis in the p53 or inflammatory pathway. Consequently, we examined whether DX2 competes with AIMP2 for PARP-1 activation and is therapeutically effective in Parkinson’s disease. Methods The binding affinity of AIMP2 and DX2 to PARP-1 was contrasted through immunoprecipitation. The efficacy of DX2 in neuronal cell death was assessed under 6-OHDA and H2O2 in vitro conditions. Additionally, endosomal and exosomal activity of synaptic vesicles was gauged in AIMP2 or DX2 overexpressed hippocampal primary neurons utilizing optical live imaging with VAMP-vGlut1 probes. To ascertain the role of DX2 in vivo, rotenone-induced behavioral alterations were compared between wild-type and DX2 transgenic animals. A DX2-encoding self-complementary adeno-associated virus (scAAV) was intracranially injected into 6-OHDA induced in vivo animal models, and their mobility was examined. Subsequently, the isolated brain tissues were analyzed. Results DX2 translocates into the nucleus upon ROS stress more rapidly than AIMP2. The binding affinity of DX2 to PARP-1 appeared to be more robust compared to that of AIMP2, resulting in the inhibition of PARP-1 induced neuronal cell death. DX2 transgenic animals exhibited neuroprotective behavior in rotenone-induced neuronal damage conditions. Following a single intracranial injection of AAV-DX2, both behavior and mobility were consistently ameliorated in neurodegenerative animal models induced by 6-OHDA. Conclusion AIMP2 and DX2 are proposed to engage in bidirectional regulation of parthanatos. They physically interact with PARP-1. Notably, DX2's cell survival properties manifest exclusively in the context of abnormal AIMP2 accumulation, devoid of any tumorigenic effects. This suggests that DX2 could represent a distinctive therapeutic target for addressing Parkinson's disease in patients.

Abstract Background The increased expression of the nicotinic acetylcholine receptor (nAChR) in muscle denervation is thought to be associated with electrophysiological acetylcholine supersensitivity after nerve injury. Hence, we investigated the utility of the 18F-ASEM alpha7-nAChR targeting radiotracer as a new diagnostic method by visualizing skeletal muscle denervation in mouse models of sciatic nerve injury. Methods Ten-week-old C57BL/6 male mice were utilized. The mice were anesthetized, and the left sciatic nerve was resected after splitting the gluteal muscle. One week (n = 11) and three weeks (n = 6) after the denervation, 18F-ASEM positron emission tomography/magnetic resonance imaging (PET/MRI) was acquired. Maximum standardized uptake values (SUVmax) of the tibialis anterior muscle were measured for the denervated side and the control side. Autoradiographic evaluation was performed to measure the mean counts of the denervated and control tibialis anterior muscles at one week. In addition, immunohistochemistry was used to identify alpha7-nAChR-positive areas in denervated and control tibialis anterior muscles at one week (n = 6). Furthermore, a blocking study was conducted with methyllycaconitine (MLA, n = 5). Results 18F-ASEM PET/MRI showed significantly increased 18F-ASEM uptake in the denervated tibialis anterior muscle relative to the control side one week and three weeks post-denervation. SUVmax of the denervated muscles at one week and three weeks showed significantly higher uptake than the control (P = 0.0033 and 0.0277, respectively). The relative uptake by autoradiography for the denervated muscle was significantly higher than in the control, and immunohistochemistry revealed significantly greater alpha7-nAChR expression in the denervated muscle (P = 0.0277). In addition, the blocking study showed no significant 18F-ASEM uptake in the denervated side when compared to the control (P = 0.0796). Conclusions Our results suggest that nAChR imaging with 18F-ASEM has potential as a noninvasive diagnostic method for peripheral nervous system disorders.

Abstract Background Neurodegenerative diseases, including Parkinson's disease, Amyotropic Lateral Sclerosis (ALS) and Alzheimer's disease, present significant challenges for therapeutic development due to drug delivery restrictions and toxicity concerns. Prevailing strategies often employ adeno-associated viral (AAV) vectors to deliver neuroprotective survival genes directly into the central nervous system (CNS). However, these methods have been limited by triggering immunogenic responses and risk of tumorigenicity, resulting from overexpression of survival genes in peripheral blood mononuclear cells (PBMC), thereby increasing the risk of tumorigenicity in specific immune cells. Thus, by coding selectively suppressive microRNA (miRNA) target sequences in AAV genome, we designed CNS-targeted neuroprotective gene expression vector system without leakage to blood cells. Methods To minimize the potential for transgene contamination in the blood, we designed a CNS-specific AAV system. Our system utilized a self-complementary AAV (scAAV), encoding a quadruple repeated target sequence of the hematopoietic cell-specific miR142-3p at the 3' untranslated region (UTR). As a representative therapeutic survival gene for Parkinson’s disease treatment, we integrated DX2, an antagonistic splice variant of the apoptotic gene AIMP2, known to be implicated in Parkinson's disease, into the vector. Results This configuration ensured that transgene expression was stringently localized to the CNS, even if the vector found its way into the blood cells. A single injection of scAAV-DX2 demonstrated marked improvement in behavior and motor activity in animal models of Parkinson’s disease induced by either Rotenone or 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Importantly, comprehensive preclinical data adhering to Good Laboratory Practice (GLP) standards revealed no adverse effects in the treated animals. Conclusions Our CNS-specific vector system, which encodes a survival transgene DX2, signifies a promising avenue for safe gene therapy, avoiding unintended expression of survival gene in blood cells, applicable to various neurodegenerative diseases.

Abstract Aerosol jet printing (AJP) is a new non-contact direct writing technique designed to achieve precise and intricate patterns on various substrates. Specifically, the pneumatic AJP process breaks down the ink into fine particles, significantly reducing the risk of nozzle clogging and rendering it highly advantageous for industrial applications. This paper focuses on the optimization of the line electrode formation process using soluble silver clusters as the conductive ink, along with the aerosol formation procedure. The main parameters of the AJP process, namely sheath flow rate, atomizer flow rate, and dispensing speed, were identified and examined for their influence on line width and resistivity. Through this analysis, an operability window, including optimized conditions for printing high-quality lines using the AJP process, was established, along with a regression equation enabling the statistical estimation of line width. In summary, the outcomes of this investigation underscore the feasibility of an integrated printing system capable of precision control over line width, achieved through the optimization of AJP process parameters. Furthermore, it was established that pneumatic AJP offers robust process stability. The practical applicability of the proposed optimization techniques was assessed, highlighting their potential utilization in electrode formation processes within the electronic and display industry.

Granulomatous gastritis (GG) is a rare condition, with incidence between 0.08 and 0.35% in gastric biopsies. Various infectious and non-infectious aetiologies can be considered to cause granulomatous gastritis. Foreign bodies are a rare aetiology of GG and may result from foods, suture materials, or medications. We report a 59-year-old woman who had eaten large amounts of peanuts for more than 10 years and presented with epigastric discomfort. Esophagogastroduodenoscopy revealed multiple nodular lesions with ulcer scars at the stomach, which was diagnosed as GG probably caused by chronic peanut ingestion on endoscopic mucosal resection.

Objectives Adenosine triphosphate-binding cassette subfamily G member 2 (ABCG2) and CD133 are recognized stem cell markers of gastric cancer. Extensive research has examined the significance of these markers in different types of cancers and their impact on prognoses, linking them to unfavorable clinical outcomes in various tumors. However, the prognostic value of these markers for gastric cancer remains unclear. We investigated the expression of ABCG2 and CD133 and their relationship with clinical outcomes in gastric cancer. Methods ABCG2 and CD133 expression levels were analyzed, using immunohistochemistry and tissue microarrays, in tumor samples from 459 patients who underwent surgical resections due to gastric cancer. ABCG2 and CD133 expression levels were defined by intensity and dichotomized as medians. The associations among the expression levels of these markers, disease severity, and patient survival were also determined. Results In the 411 patients for whom we analyzed the expression levels of these markers, 74.9% and 80.5% were found to have high levels of ABCG2 and CD133, respectively. High expression levels of ABCG2 and CD133 were more commonly observed in well-differentiated (p

Hepatic graft-versus-host disease (GVHD) significantly impacts morbidity and mortality among allogeneic hematopoietic stem cell transplant recipients. However, the relationship between clinical and immunopathological phenotypes and their influence on clinical outcomes in hepatic GVHD is not well understood. In this study, we aimed to study the implications of portal T-cell infiltration on the clinical outcomes in hepatic GHVD and its similarities to autoimmune liver disease. We analyzed 78 patients with biopsy-confirmed hepatic GVHD (n = 38) or autoimmune liver disease (n = 40) between 2016 and 2021. The cholestatic variant was defined by an R-value < 2.0, based on the ratio of alanine aminotransferase to alkaline phosphatase. The primary outcome was the biochemical response at 4 (early) and 8–12 (late) weeks after corticosteroid treatment. In hepatic GVHD patients, the hepatitic variant (n = 19) showed greater CD3+ T-cell infiltration than the cholestatic variant (n = 19; p < 0.001). No significant differences were observed in the infiltration of CD20+, CD38+, or CD68+ cells. The hepatitic variant had significantly better early and late responses and higher liver-related event-free survival than the cholestatic variants (p < 0.05). Concerning autoimmune liver diseases, the autoimmune hepatitis (AIH) group had significantly more portal T-cell infiltration and better treatment responses than the primary biliary cholangitis (PBC) group. In conclusion, higher portal T-cell infiltration may be associated with better clinical outcomes in patients with hepatic GVHD. Additionally, this study highlights similarities in portal T-cell infiltration and treatment response patterns between AIH and the hepatitic variant, as well as PBC and the cholestatic variant.

An air-sea interaction field campaign was conducted in September of 2017 within the warm and cold eddy region of the western Northwest Pacific (WNP) (17.5˚-20.5˚N, 127.5˚E-133.5˚E). Both near-surface oceanic and atmospheric conditions in addition to ocean heat content (OHC) were examined to better understand the mechanisms governing high heat flux magnitudes responsible for rapidly intensifying tropical cyclones. Observations from this experiment indicate that the latent heat flux (LHF) under modest wind conditions reached 400 W m-2 within the vicinity of a warm eddy, with OHC higher than 100 kJ cm-2 of warm eddy region being 2~3 times as large as that of cold eddy region. These high OHC and a resultant high LHF in the warm eddy, comparable to the magnitude of LHF in the North Equatorial Current, may explain the mechanism of why tropical cyclones over a warm eddy in eddy-rich zones often rapidly intensify in the WNP. A month later typhoon Lan rapidly intensified into a super typhoon, while passing over the boundary region of warm and cold eddies during the observation period. Results from this study illustrate that both the wind-normalized LHF and the difference (Qs-Qa) between the specific humidity at air (Qa) and at the sea surface (Qs), closely correlate with OHC patterns, which suggests that the ocean looks likely to control the spatial pattern of LHF. Overall, both the ocean and weather conditions govern the pattern of specific humidity difference between the air-sea interface, with large OHC over the warm eddy controlling higher Qs and the pattern of Qa depending on the pattern of wind direction. Qa as a factor impacting LHF magnitude is strongly linked to wind direction in the experimental area, that is, the drier northwesterly flow and southeasterly moist wind, resulting in the enhanced contrast of specific humidity at cold eddy region.

Abstract Objective The aim of this study is to assess the value of using videofluoroscopic swallowing study (VFSS) for assessing vocal fold paralysis. Methods This was a retrospective study of patients who underwent VFSS with a vocal fold testing maneuver from June 2020 to February 2022, and who had undergone laryngoscopy within 2 weeks before or after VFSS. The vocal fold testing maneuver consisted of making an ‘e’ sound for about 2–3 seconds during VFSS anterior–posterior (AP) view. The diagnostic value of the VFSS was evaluated by a trained reviewer, who assessed the presence and laterality of vocal fold paralysis by examining videos of the patients performing the vocal fold testing maneuver. Intra‐rater reliability was determined by evaluation of the videos by the same reviewer 2 weeks later, and inter‐rater reliability was determined by evaluation by a second reviewer. Results Seventy patients were enrolled in the study. The positive predictive value was 91.43% and the intra‐rater and inter‐rater reliabilities, as determined by Cohen's kappa value, were 0.746 and 0.824 respectively. Conclusions The presence and laterality of vocal fold paralysis were identified accurately and reliably by the reviewers, showing that VFSS can be used to assess vocal fold paralysis. Level of evidence 2.

Abstract Patients with ampulla of Vater adenocarcinoma exhibit diverse outcomes, likely since these malignancies can originate from any of the three converging epithelia at this site. Such variability presents difficulties in clinical decision-making processes and in devising therapeutic approaches. In this study, the potential clinical value of histomolecular phenotypes was determined by integrating histopathological analysis with protein expression (MUC1, CDX2, CK20, and MUC2), in a cohort of 87 patients diagnosed with stage IB to III ampulla of Vater adenocarcinoma who underwent curative surgical resection. Of the 87 patients, 54 were classified as pancreato-biliary (PB) subtype and 33 as intestinal subtype. The median follow-up time for all patients was 32.8 months (95% CI, 25.3–49.2). Patients with a histomolecular PB phenotype (CDX2 negative, MUC1 positive, MUC2 negative, and irrespective of the CK20 results) were associated with poor prognostic outcomes in both disease-free survival (DFS) (HR = 1.81; 95% CI, 1.04–3.17; p = 0.054) and overall survival (OS) (HR = 2.01; 95% CI, 1.11–3.66; p = 0.039) compared to those with histomolecular intestinal carcinomas. Patients with the PB subtype were more likely to have local recurrence alone (11 of 37, 29.7%) compared to those with the intestinal subtype (1 of 15, 6.7%). In the context of systemic disease, a notably greater proportion of patients exhibiting elevated carbohydrate antigen 19–9 levels were observed in the PB subtype compared to the intestinal subtype (p = 0.024). In the cohort of 38 patients who received first-line palliative chemotherapy, a diminished median overall survival (OS) was observed in the PB group compared to the intestinal group (10.3 vs. 28.3 months, HR = 2.47; 95% CI, 1.23–4.95; p = 0.025). By integrating histopathologic and molecular criteria, we can identify distinct and clinically relevant histomolecular phenotypes in adenocarcinomas of the ampulla of Vater, which could have considerable impact on existing therapeutic approaches.

PURPOSE This study aims to provide empirical foundational data for the development of a new profit model in Korean professional baseball. It does so by examining the influence of professional baseball NFT product attributes on customer perceptions of value, satisfaction, and purchase intention. METHODS Data were collected from consumers who have experience purchasing KBOLLECT. A total of 363 samples were collected for analysis. Surveys were utilized for data collection, encompassing 39 items that measured product characteristics, perceived value, satisfaction, purchase intention, and demographic information. Using the collected data, various statistical analyses were conducted including descriptive statistics, exploratory factor analysis, reliability analysis, correlation analysis and multiple regression using SPSS version 21. The ensuing results from the correlation analysis and multiple regression analysis are as follows. RESULTS Product features, including aesthetics, symbolism, and scarcity, had a positive impact on consumer’s perceived emotional value. Moreover, product features, encompassing aesthetics, symbolism, scarcity, and creativity played a significant role in enhancing consumer’s perceived economic value. Furthermore, product attributes such as aesthetics, symbolism, and creativity positively contributed to consumer’s perceived social value. Similarly, product features comprising aesthetics, scarcity, creativity, and symbolism positively affected consumer’s perceived intellectual value. Additionally, the research revealed that product features related to aesthetics, symbolism, creativity, and scarcity were instrumental in bolstering consumer. Importantly, these very attributes, including aesthetics, symbolism, scarcity, and creativity, exhibited a positive influence on consumers’ purchase intentions. CONCLUSIONS In conclusion, this study underscores the substantial impact of professional baseball NFT product characteristics on consumers’ perceptions, satisfaction, and purchase intentions. To maintain enduring relationships with consumers who engage with professional baseball NFT products, it is essential to fortify these product attributes and offer diverse services utilizing them.

This study introduces one specimen each of the genera Gymnopilus, Marasmius, and Mycena as an unrecorded species found in the Hwasun Gotjawal and Jeju Gotjawal Provincial Park of the Hangyeong-Andeok terrain, South Korea. Morphological analyses of macroscopic and microscopic features, and molecular analysis of the nuclear ribosomal internal transcribed spacer region were conducted to identify the specimens. Our results indicated that the newly identified specimens were Gymnopilus dilepis, Marasmius tenuissimus, and Mycena seminau. Here, we describe these newly identified mushroom species and provide baseline data on their diversity in Gotjawal, South Korea.

Background Dysphagia is a common problem with potentially serious consequences including malnutrition, dehydration, pneumonia, and death. However, there are challenges in screening for dysphagia in older adults. We assessed the feasibility of using the Clinical Frailty Scale (CFS) as a risk assessment tool for dysphagia. Methods This cross-sectional study was conducted at a tertiary teaching hospital from November 2021 to May 2022 and included 131 older patients (age ≥65 years) admitted to acute wards. We used the Eating Assessment Tool-10 (EAT-10), which is a simple measure for identifying individuals at risk of dysphagia, to assess the relationship between EAT-10 score and frailty status as measured using the CFS. Results The mean age of the participants was 74.3±6.7 years, and 44.3% were male. Twenty-nine (22.1%) participants had an EAT-10 score ≥3. The CFS was significantly associated with an EAT-10 score ≥3 after adjusting for age and sex (odds ratio=1.48; 95% confidence interval [CI], 1.09–2.02). The CFS was able to classify the presence of an EAT-10 score ≥3 (area under the receiver operating characteristic [ROC] curve=0.650; 95% CI, 0. 544–0.756). The cutoff point for predicting an EAT-10 score ≥3 was a CFS of 5 according to the highest Youden index, with a sensitivity of 82.8% and a specificity of 46.1%. The positive and negative predictive values were 30.4% and 90.4%, respectively. Conclusion The CFS can be used as a tool to screen for the risk of swallowing difficulty in older inpatients to determine clinical management encompassing drug administration routes, nutritional support, prevention of dehydration, and further evaluation of dysphagia.

Abstract Ramp lesions, commonly observed in patients with anterior cruciate ligament (ACL) injuries, have been previously defined as longitudinal tears around the meniscocapsular junction. However, the definitions and interpretations of ramp lesions have varied, emphasizing the need to confirm their presence before surgery and the importance of direct visualization using arthroscopy. Recent histological studies have reported new findings on ramp lesions, shedding light on their attachment mechanisms. The anatomical structures around the ramp lesion, such as the posterior horn of medial meniscus (PHMM), semimembranosus (SM), posteromedial (PM) capsule, and meniscotibial ligament (MTL), were assessed regarding how these structures could be attached to each other. The studies of ramp lesions have also contributed to the progression of biomechanical studies explaining the cause and effects of ramp lesions. Ramp lesion has been proven to stabilize the anteroposterior (AP) instability of ACL. In addition, various laboratory studies have demonstrated the relationship between rotational instability of the knee joint and ramp lesions. The analysis of risk factors of ramp lesion helped to understand the injury mechanism of the lesion. Many authors have evaluated the prevalence of ramp lesions in patients with ACL injuries. The development of arthroscopy techniques has influenced the outcomes of ACL reconstruction with the easy detection of ramp lesions. This review article aims to analyze the past findings and recent advancements in anatomical, biomechanical, and epidemiological studies of ramp lesions in patients who underwent ACL reconstruction, and provide various perspectives ramp lesions in patients with ACL reconstruction.

The use of naturally sourced organic materials with chirality, such as the M13 bacteriophage, holds intriguing implications, especially in the field of nanotechnology. The chirality properties of bacteriophages have been demonstrated through numerous studies, particularly in the analysis of liquid crystal phase transitions, developing specific applications. However, exploring the utilization of the M13 bacteriophage as a template for creating chiral nanostructures for optics and sensor applications comes with significant challenges. In this study, the chirality of the M13 bacteriophage was leveraged as a valuable tool for generating helical hybrid structures by combining it with nanoparticles through an evaporation-induced three-dimensional (3D) printing process. Utilizing on the self-assembly property of the M13 bacteriophage, metal nanoparticles were organized into a helical chain under the influence of the M13 bacteriophage at the meniscus interface. External parameters, including nanoparticle shape, the ratio between the bacteriophage and nanoparticles, and pulling speed, were demonstrated as crucial factors affecting the fabrication of helical nanostructures. This study aimed to explore the potential of chiral nanostructure fabrication by utilizing the chirality of the M13 bacteriophage and manipulating external parameters to control the properties of the resulting hybrid structures.

It is most effective to reduce floor impact noise as close to the sound source as possible. In apartments, there are multiple layers in the floor system, from floor finishing to the structural concrete slab. Apart from the floor finishing, mortar lies at the top layer of the floor system, followed by autoclaved lightweight concrete, insulation, and the concrete slab. The present study aims to identify the reduction characteristics of light and heavy floor impact noises by changing the glass transition temperature of an SBR (styrene–butadiene rubber) latex mortar. To achieve this, structural tests were undertaken to find the appropriate mix proportions of SBR latex in the mortar, meeting the glass transition temperature based on the physical test results regarding the latex mortar. As seen in the study method and process, because this study aimed to both increase and decrease the strength compared to general mortar, a 7% mixture ratio of Tg 4 °C SBR latex was decided upon for the strength increase, while a 5% mixture ratio of Tg −16 °C SBR latex was chosen for the strength reduction. A mock-up specimen was created using the SBR latex-modified mortar according to the identified mix proportions, and the characteristics of light- and heavy-weight floor impact noises of the SBR latex-modified mortar were then examined. Comprehensive analysis of the reduction performance of the floor impact noise revealed that the Tg −16 °C SBR latex-mixed mortar showed a reduction effect of about 2–5 dB for light-weight impact noise and about 7–10 dB for heavy-weight impact noise.

Tone-mapping algorithms aim to compress a wide dynamic range image into a narrower dynamic range image suitable for display on imaging devices. A representative tone-mapping algorithm, Retinex theory, reflects color constancy based on the human visual system and performs dynamic range compression. However, it may induce halo artifacts in some areas or degrade chroma and detail. Thus, this paper proposes a Retinex jointed multiscale contrast limited adaptive histogram equalization method. The proposed algorithm reduces localized halo artifacts and detail loss while maintaining the tone-compression effect via high-scale Retinex processing. A performance comparison of the experimental results between the proposed and existing methods confirms that the proposed method effectively reduces the existing problems and displays better image quality.

Recently, heavy rains caused by climate change have resulted in dam failures due to overtopping. This study presents a design method aiming to prevent overtopping failures by applying gabion retaining walls at the dam crest. Simulations, experiments, and measurements were conducted to evaluate the effectiveness of this design. The design framework aims to establish a system in which gabion retaining walls prevent overtopping when water levels exceed the crest of the dam, efficiently draining seepage water into the dam body through vertical filters. Research findings indicate that implementing dam crest core and geomembrane design effectively prevents seepage and saturation of the downstream slope during overtopping events. Notably, the reservoir dam operates in a stable manner, as seepage water passing through the dam body is directed solely to the toe drain. Overall, this design approach suggests its potential as a practical solution by significantly reducing hazards resulting from heavy rainfall.

Background The metastatic brain tumor is the most common brain tumor. The aim of this study was to demonstrate the clinicopathological and molecular pathologic features of brain metastases (BM). Methods A total of 269 patients were diagnosed with BM through surgical resection at Seoul St. Mary’s Hospital from January 2010 to March 2020. We reviewed the clinicopathological features and molecular status of primary and metastatic brain tissues using immunohistochemistry and molecular pathology results. Results Among 269 patients, 139 males and 130 females were included. The median age of primary tumor was 58 years (range, 13 to 87 years) and 86 patients (32.0%) had BM at initial presentation. Median BM free interval was 28.0 months (range, 1 to 286 months). The most frequent primary site was lung 46.5% (125/269), and followed by breast 15.6% (42/269), colorectum 10.0% (27/269). Epidermal growth factor receptor (EGFR) mutation was found in 50.8% (32/63) and 58.0% (40/69) of lung primary and BM, respectively. In both breast primary and breast cancer with BM, luminal B was the most frequent subtype at 37.9% (11/29) and 42.9% (18/42), respectively, followed by human epidermal growth factor receptor 2 with 31.0% (9/29) and 33.3% (14/42). Triple-negative was 20.7% (6/29) and 16.7% (7/42), and luminal A was 10.3% (3/29) and 7.1% (3/42) of breast primary and BM, respectively. In colorectal primary and colorectal cancer with BM, KRAS mutation was found in 76.9% (10/13) and 66.7% (2/3), respectively. Conclusions We report the clinicopathological and molecular pathologic features of BM that can provide useful information for understanding the pathogenesis of metastasis and for clinical trials based on the tumor’s molecular pathology.

We isolated 5 highly pathogenic avian influenza A(H5N1) clade 2.3.4.4.b viruses from wild waterfowl feces in South Korea during November 2022. Whole-genome sequencing and phylogenetic analysis revealed novel genotypes produced by reassortment with Eurasian low pathogenicity avian influenza viruses. Enhanced surveillance will be required to improve prevention and control strategies.

Background This study presents a novel technical tip for intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip for totally laparoscopic distal gastrectomy in patients with middle-third gastric cancer and describes the short-term results of its application. Methods In total, 42 patients with middle-third gastric cancer who underwent intraoperative tumor localization using a titanium ring strip and determination of the proximal resection line through intraoperative radiography between January 2020 and December 2021 were enrolled in this study. We retrospectively analyzed patients’ prospectively collected clinical, pathological, and surgical data. Results Twenty-six men and 16 women with a mean age of 58.3±12.5 years were enrolled. The mean operation time and estimated blood loss were 212.6±43.0 minutes and 122.4±77.6 mL, respectively. The lengths of the proximal and distal resection margin were 2.0±0.4 cm (range, 0.8–3.7 cm) and 10.5±4.1 cm (range, 0.4–20.4 cm), respectively. Roux-en-Y anastomosis was performed in 30 patients, while Billroth II with Braun anastomosis was performed in 12 patients. There were no procedure-related complications, and the mean postoperative hospital stay was 7.2±1.9 days. For all patients, the negative proximal resection margin was confirmed by postoperative pathological examinations. Conclusions Intraoperative tumor localization and determination of the proximal resection line using a titanium ring strip is a useful alternative method that can be easily and safely performed. This method is especially useful for patients with middle-third gastric cancer requiring an appropriate proximal resection margin.

Abstract Background The effects of inspiratory muscle training (IMT) with pulmonary rehabilitation (PR) on patients with non‐small cell lung cancer (NSCLC) receiving radiotherapy (RT) have not previously been reported. This pilot study aimed to determine the effectiveness of IMT with PR on respiratory muscles and exercise capacity of NSCLC patients receiving RT. Methods We retrospectively analyzed 20 patients who underwent RT for NSCLC. The rehabilitation included IMT, stretching, strengthening, and aerobic exercises three times a week for 4 weeks with concurrent RT. IMT training lasted 10 min, consisting of one cycle of 30 breaths using the Powerbreathe KH1 device in the hospital by a physical therapist. Patients underwent two IMT sessions at home daily at an intensity of approximately 30%–50% of the participant's maximum inspiratory muscle pressure (MIP) using the threshold IMT tool. We analyzed the results from the respiratory muscle strength test, pulmonary function test, 6‐min walk test (6MWT), cardiopulmonary function test, cycle endurance test (CET), Inbody test, grip measurement, knee extensor/flexor strength measurement, Cancer Core Quality of Life Questionnaire (EORTCQ‐C30), and NSCLC 13 (EORTC‐LC13). Results There were no adverse events during evaluation and IMT with PR. MIP (60.1 ± 25.1 vs. 72.5 ± 31.9, p = 0.005), 6MWT (439.2 ± 97.1 vs. 60.7 ± 97.8, p = 0.002), CET (181.39 ± 193.12 vs. 123.6 ± 87.6, p = 0.001), knee extensor (14.4 ± 5.3 vs. 17.4 ± 5, p = 0.012), and knee flexor (14.0 ± 5.2 vs. 16.9 ± 5.5, p = 0.004) significantly improved after IMT with PR. Conclusion IMT with PR appears effective on respiratory muscles and exercise capacity without adverse events in NSCLC patients who underwent RT.

The invention of Light Emitting Diode (LED) revolutionized energy-efficient illumination, but concerns persist regarding the potential harm of blue light to our eyes. In this study, we scrutinized the impact of LED light characteristics on eyes using two cell types: M-1 (rich in mitochondria) and CD-1 (neuronal). Variations in color rendering index (CRI) and correlated color temperature (CCT) were investigated, alongside exposure durations ranging from 0 to 24 hours. The findings illuminated the potential benefits of high-quality LED lighting, characterized by a high CRI and low CCT, which emits a greater proportion of red light. This form of lighting was associated with enhanced cell proliferation, elevated ATP levels, and reduced oxidative stress. In contrast, LEDs with low CRI and high CCT exhibited adverse effects, diminishing cell viability and increasing oxidative stress. These results suggest that high-quality LED lighting may have neuroprotective potential as a treatment option, such as for retinal ganglion cells.

The Nakdong River underwent water impoundment after eight weirs were constructed as part of South Korea's Four Major River Restoration Project from 2009 to 2012. In this study, we aimed to confirm whether the assemblage of phytoplankton based on phytoplankton functional groups (PFGs), could indicate environmental changes in the weir section (WS) and non-weir section (NWS) of the lower Nakdong River after the construction of the weir. Thus, we examined the relationships between PFGs and gradients in environmental drivers, such as physicochemical, meteorological, and hydrological variables. Environmental gradients were observed between the WS and NWS in dissolved oxygen (DO), electric conductivity (EC), biochemical oxygen demand (BOD), chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP), dissolved total nitrogen (DTN), dissolved total phosphorus (DTP), ammonia nitrogen (NH3–N), nitrate nitrogen (NO3–N), and phosphorus (PO4–P), which were relatively higher in the WS. Seventeen PFGs were identified (A, B, C, D, E, F, G, H1, J, LM, LO, MP, P, T, W1, X1, and X2).Additionally, the LM and P groups, preferring an enriched lentic system more than other groups, were found to be the dominant PFGs that led the succession of assemblages. Traditional nutrients (N, P) and organic pollutants (BOD, COD) primarily affected the autochthonous growth of the most dominant PFGs in the WS as HRT (hydraulic retention time) increased. Furthermore, the hydrological variables associated with meteorological conditions have a synergistic effect on the composition of the major PFGs and chemical and physical variables in the WS. In other words, the WS may be a new source of inoculum that primarily determines the occurrence and maintenance of phytoplankton in the immediate downstream region (NWS). In particular, group LM (mainly potentially toxic Microcystis) developing in the upper weir impoundment is transported downstream, resulting in a high inoculation effect on further growth in the NWS during the summer monsoon season.

Abstract Machine learning (ML) provides temporal advantage and performance improvement in practical electronic device design by adaptive learning. Herein, Bayesian optimization (BO) is successfully applied to the design of optimal dual‐layer oxide semiconductor thin film transistors (OS TFTs). This approach effectively manages the complex correlation and interdependency between two oxide semiconductor layers, resulting in the efficient design of experiment (DoE) and reducing the trial‐and‐error. Considering field effect mobility (𝜇) and threshold voltage (Vth) simultaneously, the dual‐layer structure designed by the BO model allows to produce OS TFTs with remarkable electrical performance while significantly saving an amount of experimental trial (only 15 data sets are required). The optimized dual‐layer OS TFTs achieve the enhanced field effect mobility of 36.1 cm2 V−1 s−1 and show good stability under bias stress with negligible difference in its threshold voltage compared to conventional IGZO TFTs. Moreover, the BO algorithm is successfully customized to the individual preferences by applying the weight factors assigned to both field effect mobility (𝜇) and threshold voltage (Vth).

Abstract The prognostic role of soluble PD-L1 (sPD-L1) and exosomal PD-L1 (exoPD-L1) in patients with gastric cancer (GC) receiving systemic chemotherapy remains unelucidated. Thus, we examined their prognostic significance in patients with advanced GC. Blood samples were obtained from 99 patients with advanced GC receiving first-line chemotherapy. Serum-derived exosomes were isolated by centrifugation and polymer precipitation. The correlation between serum-derived exoPD-L1, plasma sPD-L1, immune-related markers, and circulating immune cells was evaluated. Patients were divided into two groups according to pretreatment sPD-L1 and exoPD-L1 levels: low sPD-L1 and high sPD-L1 groups, low exoPD-L1 and high exoPD-L1 groups. Patients with low sPD-L1 level before treatment (

Abstract Background During general anesthesia, the surgical pleth index (SPI) monitors nociception. The evidence of SPI in the elderly remains scarce. We aimed to investigate whether there is a difference in perioperative outcomes following intraoperative opioid administration according to the surgical pleth index (SPI) value versus hemodynamic parameters (heart rate or blood pressure) in elderly patients. Methods Patients aged 65–90 years who underwent laparoscopic colorectal cancer surgery under sevoflurane/remifentanil anesthesia were randomized to receive remifentanil guided by SPI (SPI group) or conventional clinical judgment based on hemodynamic parameters (conventional group). The primary endpoint was intraoperative remifentanil consumption. Secondary endpoints were intraoperative hemodynamic instability, pain score, fentanyl consumption and delirium in the post-anesthesia care unit (PACU), and perioperative changes in interleukin-6 and natural killer (NK) cell activity. Results Seventy-five patients (38, SPI; 37, conventional) were included in the study. The SPI group consumed significantly more remifentanil intraoperatively than the conventional group (mean ± SD, 0.13 ± 0.05 vs. 0.06 ± 0.04 μg/kg/min, P

Background and objective: Chronic respiratory diseases in children deteriorate their daily life due to dyspnea and reduced lung function. We aimed to evaluate the feasibility of home-based pulmonary rehabilitation in pediatric chronic respiratory diseases. Methods: This prospective, single-arm, cohort study included children with chronic lung disease. They were instructed to perform home-based pulmonary rehabilitation 30 min/session, three sessions/week for three months. Pulmonary function test (PFT) using spirometry, respiratory muscle strength (RMT), cardiopulmonary exercise test (CPET), 6 min walk test (6MWT), dyspnea questionnaires, speech evaluation, and pediatric quality of life inventory (PedsQL) were assessed pre- and post-pulmonary rehabilitation. Compliance and satisfaction of the program were also evaluated. Results: Twenty children (mean age: 11.2 ± 3.1 years) with chronic respiratory diseases without cardiopulmonary instability participated. The overall compliance was 71.1% with no related adverse events. After pulmonary rehabilitation, forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), RMT, 6MWT, dyspnea questionnaire, speech rate, and PedsQL (child) significantly improved (p < 0.05), particularly better in the FEV1 < 60% group than in the FEV1 ≥ 60% group and in the high-compliance group (compliance ≥ 50%) than in the low-compliance group (compliance < 50%). Conclusions: Home-based pulmonary rehabilitation for children with chronic lung disease was feasible with high compliance and effective in terms of objective functions, subjective dyspnea symptom, and quality of life.

This paper aimed to develop a method for generating sand–dust removal and dehazed images utilizing CycleGAN, facilitating object identification on roads under adverse weather conditions such as heavy dust or haze, which severely impair visibility. Initially, the study addressed the scarcity of paired image sets for training by employing unpaired CycleGAN training. The CycleGAN training module incorporates hierarchical single-scale Retinex (SSR) images with varying sigma sizes, facilitating multiple-scaled trainings. Refining the training data into detailed hierarchical layers for virtual paired training enhances the performance of CycleGAN training. Conventional sand–dust removal or dehazing algorithms, alongside deep learning methods, encounter challenges in simultaneously addressing sand–dust removal and dehazing with a singular algorithm. Such algorithms often necessitate resetting hyperparameters to process images from both scenarios. To overcome this limitation, we proposed a unified approach for removing sand–dust and haze phenomena using a single model, leveraging images processed hierarchically with SSR. The image quality and image sharpness metrics of the proposed method were BRIQUE, PIQE, CEIQ, MCMA, LPC-SI, and S3. In sand–dust environments, the proposed method achieved the highest scores, with an average of 21.52 in BRISQUE, 0.724 in MCMA, and 0.968 in LPC-SI compared to conventional methods. For haze images, the proposed method outperformed conventional methods with an average of 3.458 in CEIQ, 0.967 in LPC-SI, and 0.243 in S3. The images generated via this proposed method demonstrated superior performance in image quality and sharpness evaluation compared to conventional algorithms. The outcomes of this study hold particular relevance for camera images utilized in automobiles, especially in the context of self-driving cars or CCTV surveillance systems.

The previous research introduced an innovative retrofitting technique for reinforced concrete beams using modularized steel plates. This technique enhances structural performance, offering a lightweight solution compared to conventional retrofitting methods using steel plates, and accommodates construction errors. However, a challenge arises due to the lack of integrity between unit steel plates. To address this, this study proposes a novel method of connecting each steel plate with bolts. The experimental results show that retrofitted beams achieved a maximum load of 311.9 kN, roughly 1.6 times that of non-retrofitted specimens, with the ductility of retrofitted beams being 3.3 times that of the non-retrofitted beams. Additionally, there was a 25% increase in load capacity for beams retrofitted with interconnected steel plates compared to those without connections between unit steel plates.

In South Korea, Agriculture, Forestry, and Other Land Use (AFOLU) collates greenhouse gas (GHG) inventories. However, the settlement category lacks a clear definition of land use and activity data. This study proposed a method for examining the settlement spatial extent and constructing activity data to estimate GHG emissions and absorption as a pilot calculation, as well as to provide data for land use classification. Utilizing cadastral maps (CDMs), settlement spatial extents were determined, with settlements occupying approximately 11% of the total land area in 2019, or 9% excluding overlaps. Activity data for settlements were established through a sampling method and analysis of aerial orthoimages from 2000 and 2019. After removing overlaps with digital forest type maps and smart farm maps, settlement activity data covered approximately 18.47% based on CDMs, or 12.66% excluding overlaps. In 2019, CO2 emissions and absorptions were estimated at 622.16 ktCO2yr−1 based on CDMs and 242.16 ktCO2yr−1, excluding overlaps. To enhance GHG inventory calculation consistency and compliance with TACCC principles, clear spatial extents for settlements must be established. This entails constructing activity data and assessing GHG inventories accordingly. GHG inventory statistics should also inform future nationally determined contributions.