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Abstract In lymphedema, proinflammatory cytokine-mediated progressive cascades always occur, leading to macroscopic fibrosis. However, no methods are practically available for measuring lymphedema-induced fibrosis before its deterioration. Technically, CT can visualize fibrosis in superficial and deep locations. For standardized measurement, verification of deep learning (DL)-based recognition was performed. A cross-sectional, observational cohort trial was conducted. After narrowing window width of the absorptive values in CT images, SegNet-based semantic segmentation model of every pixel into 5 classes (air, skin, muscle/water, fat, and fibrosis) was trained (65%), validated (15%), and tested (20%). Then, 4 indices were formulated and compared with the standardized circumference difference ratio (SCDR) and bioelectrical impedance (BEI) results. In total, 2138 CT images of 27 chronic unilateral lymphedema patients were analyzed. Regarding fibrosis segmentation, the mean boundary F1 score and accuracy were 0.868 and 0.776, respectively. Among 19 subindices of the 4 indices, 73.7% were correlated with the BEI (partial correlation coefficient: 0.420–0.875), and 13.2% were correlated with the SCDR (0.406–0.460). The mean subindex of Index 2 $$\left( {\frac{{P_{Fibrosis\, in\, Affected} - P_{Fibrosis\, in\, Unaffected} }}{{P_{Limb\, in\, Unaffected} }}} \right)$$ P F i b r o s i s i n A f f e c t e d - P F i b r o s i s i n U n a f f e c t e d P L i m b i n U n a f f e c t e d presented the highest correlation. DL has potential applications in CT image-based lymphedema-induced fibrosis recognition. The subtraction-type formula might be the most promising estimation method.

Inflammatory Bowel Disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC), requires a combination of procedures and tests in diagnosis and discrimination. This study aimed to delineate specific serum metabolomic biomarkers that diagnose IBD and differentiate IBD subgroups. Serum samples and clinical metadata of the participants, IBD patients and Normal Controls (NC), were collected. Untargeted and targeted metabolomic analyses by high-resolution mass spectrometry and multivariate statistical approaches were applied. Further, Receiver Operating Characteristic (ROC) curves, pathways, and network analyses were conducted. Distinct clustering separated IBD patients from the NC, although the CD and UC subgroups overlapped in the non-targeted profiling. Targeted metabolomics revealed elevated tryptophan and indole-3-acetic acid levels and reduced primary-to-secondary bile acid ratios in both CD and UC patients. The differences in specific tryptophan metabolites between CD and UC were identified. The ROC analysis underscored the discriminatory power of the biomarkers (AUC values: NC vs. CD = 0.9738; NC vs. UC = 0.9887; UC vs. CD = 0.7140). Pathway analysis revealed alterations in glycerolipid metabolism, markedly differentiating UC from CD. Network analysis correlated metabolomic markers with the clinical phenotypes of IBD. Serum metabolomic biomarkers can precisely identify IBD, discriminate IBD subtypes, and further reveal the phenotypes of IBD., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Bacillus velezensis strain DMB07, isolated from the traditional fermented Korean soybean meju, exhibits resistance to streptomycin [minimum inhibitory concentration (MIC) 128 mg/L]. To shed light on the genetic background behind this phenotype, this study determined the complete genome sequence of strain DMB07 and compared it with the genomes of two B. velezensis strains that are sensitive to streptomycin. Compared with the streptomycin-sensitive strains, in strain DMB07 there was a mutation of a nucleotide (C58T) of the 16 S rRNA (guanine 527 -N 7 )-methyltransferase gene (gidB) that leads to a change in the amino acid sequence of the protein (Arg20Cys). This sequence of gidB gene was previously linked with streptomycin resistance. To test the hypothesis that this change in the gidB gene sequence of strain DMB07 confers streptomycin resistance, a temperature-sensitive plasmid, pIMAY-tgidB T58C , was constructed for site-directed mutation (from thymine to cytosine) of nucleotide 58 of gidB in strain DMB07. The resulting strain, DMB07gidB T58C , showed the decreased MIC value (32 mg/L) against streptomycin. Furthermore, introduction of the wild-type gidB gene into strain DMB07gidB T58C resulted in recovery of the MIC for streptomycin to 128 mg/L. Thus, a single mutation of the nucleotide sequence of the gidB gene can confer resistance to streptomycin., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Speech emotion recognition has seen a surge in transformer models, which excel at understanding the overall message by analyzing long-term patterns in speech. However, these models come at a computational cost. In contrast, convolutional neural networks are faster but struggle with capturing these long-range relationships. Our proposed system, MemoCMT, tackles this challenge using a novel "cross-modal transformer" (CMT). This CMT can effectively analyze local and global speech features and their corresponding text. To boost efficiency, MemoCMT leverages recent advancements in pre-trained models: HuBERT extracts meaningful features from the audio, while BERT analyzes the text. The core innovation lies in how the CMT component utilizes and integrates these audio and text features. After this integration, different fusion techniques are applied before final emotion classification. Experiments show that MemoCMT achieves impressive performance, with the CMT using min aggregation achieving the highest unweighted accuracy (UW-Acc) of 81.33% and 91.93%, and weighted accuracy (W-Acc) of 81.85% and 91.84% respectively on benchmark IEMOCAP and ESD corpora. The results of our system demonstrate the generalization capacity and robustness for real-world industrial applications. Moreover, the implementation details of MemoCMT are publicly available at https://github.com/tpnam0901/MemoCMT/ for reproducibility purposes., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Individual differences in sleep duration have been reported, and genetic components of sleep duration have been identified showing various heritability. To identify genetic variants that contribute to sleep duration, we conducted a human genome-wide identification on sleep duration and performed confirmatory experiments using a Drosophila model. Genome-wide association study in human was analyzed to determine the association of the genetic variants with self-aware sleep duration from two community-based cohort, Ansan (cohort 1, n = 4635) and Ansung (cohort 2, n = 4205), recruited from the Korean Genome and Epidemiology Study. Individual single nucleotide variants (rs16948804 and rs4887991) in the WW domain containing oxidoreductase (WWOX) gene were associated with self-aware sleep duration in human (p-values, 1.11 × 10 - 7 and 2.05 × 10 - 7 , retrospectively). To examine the functional relevance of the WWOX gene identified in the genome-wide association study, we analyzed the sleep duration of Drosophila loss-of-function mutants. The deletion of Wwox in flies reduced sleep duration and quality with average bout length during daytime and increased night-time sleep duration (all of p-values < 0.01). Our findings suggested that WWOX expression is associated with sleep duration in both humans and Drosophila and genetic factors play a role in inter-individual variability in sleep characteristics., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Global evidence on the association between vaccines and renal adverse events (AEs) is inconclusive. This pharmacovigilance study analyzed a total of 120,715,116 reports from VigiBase collected between 1967 and 2022. We evaluated the global reporting of acute kidney injury (AKI), glomerulonephritis (GN), and tubulointerstitial nephritis (TIN) and assessed disproportionate signals between vaccines and renal AEs using reporting odds ratios (ROR) and the lower limit of the 95% confidence interval of the information component (IC 025 ) in comparison with the entire database. The number and proportion of reports on AKI, GN, and TIN gradually increased, with a substantial increase after 2020. Disproportionate reporting of AKI was significant for COVID-19 mRNA vaccines (ROR, 2.38; IC 025 , 1.09). Fourteen vaccines were significantly disproportionate for higher GN reporting, and the highest disproportionality for GN reporting was observed for COVID-19 mRNA (ROR, 13.41; IC 025 , 2.90) and hepatitis B vaccines (ROR, 11.35; IC 025 , 3.18). Disproportionate TIN reporting was significant for COVID-19 mRNA (ROR, 2.43; IC 025 , 0.99) and human papillomavirus (ROR, 1.75; IC 025 , 0.19) vaccines. Significant disproportionality in the reporting of AKI, GN, and TIN was observed in patients exposed to multiple vaccines, including COVID-19 mRNA vaccines, alongside increasing global reports of vaccine-associated renal AEs., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Interstitial lung disease (ILD) leads to worse outcomes in subjects with rheumatoid arthritis (RA). Few large-scale longitudinal studies have provided comprehensive data on the incidence and risk of ILD in RA compared with non-RA populations. We compare the risk of incident ILD in subjects with RA and matched controls, while also evaluating the impact of RA serologic status. Using the Korean National Health Insurance Service Data between 2010 and 2017, we identified 52,325 individuals with RA and 261,625 without RA. During a median follow-up period of 4.4 years, 3.7% of the RA cohort and 0.5% of the matched cohort developed ILD, with incidence rates of 8.30 and 1.01 per 1,000 person-years. Compared to controls, the risk of incident ILD was significantly higher in the RA cohort (adjusted hazard ratio [aHR] 7.84 [7.29-8.44]), and seropositive and seronegative RA exhibited aHRs of 9.00 (8.34-9.72) and 4.81 (4.25-5.44). Although the risk of ILD was higher in seropositive RA than seronegative RA, the risk of developing ILD was also higher in subjects with seronegative RA than in matched controls, suggesting that close monitoring for ILD should be performed in this population., Competing Interests: Declarations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Owing to limited data on the optimal timing of rotational atherectomy (RA), we sought to evaluate the clinical impact of the early application of the RA strategy. Consecutive patients with severe coronary artery calcification were enrolled, who underwent percutaneous coronary intervention (PCI) using RA between January 2010 and October 2019 at 9 tertiary centers. Direct RA was defined as the early application of RA before the balloon was expanded to a size more than or equal to 2.0 mm. The primary endpoint was the composite outcome of technical failure or severe coronary dissection (type D, E, or F) during entire procedure. Of 581 lesions, 360 (62.0%) lesions underwent direct RA. The technical success rate was higher in the direct RA group than in the indirect RA group (97.5% vs. 93.7%, p = 0.021). The primary endpoint was more frequently observed in the indirect RA group than in the direct RA group (24.4% vs. 11.9%, p < 0.001). Multivariate logistic regression analysis revealed that the risk of the primary endpoint was higher in the indirect RA group than in the direct RA group (odds ratio 2.512, 95% CI 1.547-4.078, p < 0.001). Early application of RA may reduce the incidences of in-hospital adverse events and procedure-related complications., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Advanced hepatocellular carcinoma (HCC) poses treatment challenges, especially where access to multi-kinase inhibitors and ICIs is limited by high costs and lack of insurance. This study evaluates the effectiveness of 5-fluorouracil (5-FU) plus platinum-based chemotherapy as an alternative systemic treatment for advanced HCC. A retrospective analysis of advanced HCC patients treated with 5-FU plus platinum-based chemotherapy was conducted. The Kaplan-Meier method determined median progression-free survival (PFS) and overall survival (OS). From April 2009 to October 2023, 48 patients with advanced HCC were included in the study. Nearly all patients (97.9%) had extrahepatic metastasis and stable liver function, with three-quarters previously treated with sorafenib. At a median follow-up of 7.8 months, the median PFS was 4.2 months (95% CI, 1.3-7.1), and the median OS was 8.2 months (95% CI, 2.5-13.9). A high pretreatment neutrophil-to-lymphocyte ratio (≥ 3.0) adversely affected both PFS (HR = 1.79; 95% CI, 0.99-3.25; p = 0.034) and OS (HR = 2.02; 95% CI, 1.10-3.69; p = 0.011). Hematologic toxicities related to the treatment were substantial, with 62.5% of patients experiencing grade 3 or 4 events, primarily neutropenia, which affected 60.4% of them. Our findings suggest that 5-FU combined with platinum-based chemotherapy is a viable, cost-effective alternative for advanced HCC treatment in resource-limited settings, particularly compared to ICIs and multi-kinase inhibitors, with significant implications for developing countries., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The study conformed to Korean regulations and the Declaration of Helsinki. Ethical approval for data acquisition was obtained from the Institutional Review Board (IRB) of The Catholic University of Korea (approval ID: KC23RCDI0316). Informed consent was waived due to the retrospective nature of the study, as approved by the ethics committee of The Catholic University of Korea. STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items., (© 2025. The Author(s).)

Electro-tactile stimulation (ETS) can be a promising aid in augmenting sensation for those with sensory deficits. Although applications of ETS have been explored, the impact of ETS on the underlying strategies of neuromuscular coordination remains largely unexplored. We investigated how ETS, alone or in the presence of mechano-tactile environment change, modulated the electromyogram (EMG) of individual muscles during force control and how the stimulation modulated the attributes of intermuscular coordination, assessed by muscle synergy analysis, in human upper extremities. ETS was applied to either the thumb or middle fingertip which had greater contact with the handle, grasped by the participant, and supported a target force match. EMGs were recorded from 11 arm muscles of 15 healthy participants during three-dimensional exploratory force control. EMGs were modeled as the linear combination of muscle co-activation patterns (the composition of muscle synergies) and their activation profiles. Individual arm muscle activation changed depending on the ETS location on the finger. The composition of muscle synergies was conserved, but synergy activation coefficients altered reflecting the effects of electro-tactile modulation. The mechano-tactile modulation tended to decrease the effects of ETS on the individual muscle activation and synergy activation magnitude. This study provides insights into sensory augmentation and its impact on intermuscular coordination in the human upper extremity., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: The demand for orthodontic treatment using clear aligners has been gradually increasing because of their superior esthetics compared with conventional fixed orthodontic therapy. This study aimed to evaluate and compare the compressive strength of three-dimensional direct printing aligners (3DPA) with that of conventional thermo-forming aligners (TFA) to determine their clinical applicability. In the experimental group, the 3DPA material TC-85 (TC-85 full) was used to create angular protrusions called rectangular pressure areas (RPA). A protrusion akin to the power ridge typically employed in conventional TFAs was created using glycol-modified polyethylene terephthalate (PETG; Control 1). RPA was created using the same TC-85 without filling the protrusions (TC-85 blank; Control 2). Compression cycle tests were conducted on an LTM 3 h electrodynamic testing machine (Zwick Roell, Germany), with 500 cycles and compression depths of 100, 300, 500, and 700 µm. Twenty specimens were tested for PETG, 17 for the TC-85 blank, and 19 for the TC-85 full., Results: Changes in the compressive force were assessed based on the material and thickness. The results indicated significantly higher and broader ranges of compressive strength for specimens fabricated with the 3DPA material TC-85 compared with those fabricated using PETG. Among the TC-85 specimens, TC-85 full demonstrated the highest statistically significant compressive strength ., Conclusions: 3DPA technology enables precise modifications in the shape and inner thickness at specific dental sites, including the creation of ridges in targeted areas, of aligners. These alterations enhance the biomechanical capability of aligners to exert selective forces necessary for desired tooth movement while reducing the number of attachments, thereby demonstrating the clinical potential of 3D-printed aligners in orthodontic treatment., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All human research procedures were followed in accordance with the ethical standards of the committee responsible for human experimentation (institutional and national), and with the Helsinki Declaration of 1975, as revised in 2013. This study was reviewed and approved by the Institutional Review Board (IRB) of Ajou University Hospital (IRB No: AJOUIRB-EX-2024-280)., (© 2025. The Author(s).)

Human cerebral organoids serve as a quintessential model for deciphering the complexities of brain development in a three-dimensional milieu. However, imaging these organoids, particularly when they exceed several millimeters in size, has been curtailed by the technical impediments such as phototoxicity, slow imaging speeds, and inadequate resolution and imaging depth. Addressing these pivotal challenges, our study has pioneered a high-speed scanning microscope, synergistically coupled with advanced computational image processing. This ensemble has empowered us to monitor the intricate dynamics of neuron and oligodendrocyte development within cerebral organoids across a trajectory of approximately two months. Line-shaped illumination mitigates photodamage and, alongside refined spatial gating, maximizes signal collection through integrating with computational processing. The integration of deconvolution and compressive sensing has improved image contrast by 6-fold, elucidating fine features of the neurites. Thus, noninvasive imaging enabled us to perform long-term tracking of neural and oligodendroglial development in the large-scale human cerebral organoid. Furthermore, our sophisticated volumetric segmentation algorithm has yielded a robust four-dimensional quantitative analysis, encapsulating both neuronal and oligodendroglial maturation. Collectively, these advances mark a significant advancement in the field of neurodevelopment, providing a powerful tool for in-depth study of complex brain organoid systems., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Peucedanum japonicum (PJ), a member of the Apiaceae family, is widely distributed and cultivated in East Asian countries for edible and functional foods. In this study, we compared the plastid genomes (plastomes) and 45S nuclear ribosomal DNA (45S nrDNA) simultaneously from 10 PJ collections. Plastome-based phylogenetic analysis showed that the PJ accessions were monophyletic within the genus Peucedanum. However, ten plastomes were classified into two different groups according to their length of inverted repeat (IR) block, the short-type (S-type) plastome group containing the 18.6 kbp of the original IR and the long-type (L-type) plastome group containing the 35.7 kbp of expanded IR by duplication of the 17.1 kbp of the large single copy region. A total of nine single nucleotide polymorphisms and eight insertions or deletions were identified among the five L-type plastomes, whereas large variations were identified among the five S-type plastomes. Calculation of synonymous substitution rates and divergence time estimation suggested that the 17 kbp IR expansion occurred recently. Molecular markers were developed and validated to classify the 55 PJ germplasm according to their plastome types. Our study would be useful for unraveling the dynamic evolution of plastomes in the Apiaceae family and for the molecular breeding of PJ., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

This study optimizes V T and ΔV T in amorphous indium-gallium-zinc-oxide (a-IGZO) field-effect transistors (FETs) by examining the influence of both channel length (L) and Ga composition. It was observed that as the ratio of In: Ga: Zn changed from 1:1:1 to 0.307:0.39:0.303 in the IGZO film, both V T and ΔV T decreased by 0.1 V at the shortest channel length (L = 0.5 μm). This reduction was attributed to the change in the oxygen concentration in IGZO due to the variation in Ga composition. In addition, as the channel length decreased from 10 μm to 0.5 μm, V T decreased by up to 0.7 V, and ΔV T decreased by up to 0.4 V. This observation was due to diffusion of oxygen vacancies (V O ) from the source and drain into the main channel. To provide a comprehensive understanding, we quantitatively modeled the doping concentration of IGZO and the trap density of gate insulator (GI) traps using TCAD simulation based on Ga composition and diffusion of V O . Using this approach, we propose a method to optimize the design of a-IGZO FETs with high V T and low ΔV T in short-channel devices by adjusting the Ga composition., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

pH sensing technology is pivotal for monitoring aquatic ecosystems and diagnosing human health conditions. Indium-gallium-zinc oxide electrolyte-gated thin-film transistors (IGZO EGTFTs) are highly regarded as ion-sensing devices due to the pH-dependent surface chemistry of their sensing membranes. However, applying EGTFT-based pH sensors in complex biofluids containing diverse charged species poses challenges due to ion interference and inherently low sensitivity constrained by the Nernst limit. Here, we propose a dual-biased (DB) EGTFT pH sensing platform, acquiring back-gate-assisted sensitivity enhancement and recyclable redox-coupled protonation at the semiconductor-biofluid interface. A solution-processed amorphous IGZO film, used as the proton-sensitive membrane, ensures scalable uniformity across a 6-inch wafer. These devices demonstrate exceptional pH resistivity over several hours when submerged in solutions with pH levels of 4 and 8. In-depth electrochemical investigations reveal that back-gate bias significantly enhances sensitivity beyond the Nernst limit, reaching 85 mV/pH. This improvement is due to additional charge accumulation in the channel, which expands the sensing window. As a proof of concept, we observe consistent variations in threshold voltage during repeated pH cycles, not only in standard solutions but also in physiological electrolytes such as phosphate-buffered saline (PBS) and artificial urine, confirming the potential for reliable operation in complex biological environments., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

This population-based cohort study aimed to evaluate the risk of osteoporosis and fractures associated with higher-potency statin use compared to lower-potency statin use in patients with stroke, using data from the Health Insurance and Review Assessment database of South Korea (2010-2019). Patients who received statin within 30 days after hospitalization for a new-onset stroke (n = 276,911) were divided into higher-potency (n = 212,215, 76.6%) or lower-potency (n = 64,696, 23.4%) statin initiation groups. The primary outcome was a composite of osteoporosis and osteoporotic fractures. Secondary outcomes were individual components of the primary outcome, including osteoporosis, vertebral fracture, hip fracture, and non-hip non-vertebral fracture. Cox proportional hazard models weighted by standardized morbidity ratios were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). The risk of the composite outcome (HR 0.95, 95% CI 0.93-0.97), osteoporosis (0.93, 0.90-0.96), vertebral fracture (0.95, 0.91-0.99), and hip fracture (0.89, 0.84-0.95) were significantly lower in higher-potency statin users, while the risk for non-hip non-vertebral fracture was not significant (0.98, 0.95-1.02). The use of higher-potency statins compared to lower-potency statins was associated with a lower risk of osteoporosis, vertebral fracture, and hip fracture in patients with stroke., Competing Interests: Declarations. Competing interests: JYS received grants from the Ministry of Food and Drug Safety, the Ministry of Health and Welfare, the National Research Foundation of Korea, the Government-wide R&D Fund for Infectious Disease Research, and pharmaceutical companies, including Daiichi Sankyo, GSK, and Pfizer, outside the submitted work. YN received grants from the Ministry of Health and Welfare, outside the submitted work. SWC is a CEO/founder of Cellus, inc., outside the submitted work. HK has received research funds from JW Pharmaceutical, outside the submitted work. JSJ, CYH, and YC declare no competing interests. No other relationships or activities that could have influenced the submitted work. Informed consent: Due to the retrospective nature of the study, the Institutional Review Board of Sungkyunkwan University waived the need of obtaining informed consent. Ethical approval: This study was approved by the Institutional Review Board of Sungkyunkwan University (No. SKKU 2020-12-002), which waived the requirement for informed consent as only de-identified data was used., (© 2024. The Author(s).)

Early detection of a premetabolic status that is at risk for metabolic syndrome (MetS) but not meeting the criteria is crucial. This study examined 27,623 participants aged 20-50 (mean: 40.7) years who underwent initial health screening at Kangbuk Samsung Hospital (2011-2019), focusing on individuals with one or two MetS components. Hierarchical agglomerative clustering was used to form MetS risk clusters based on initial and follow-up data, including age, resting heart rate (rHR), serum uric acid (UA), C-reactive protein (CRP), gamma-glutamyl transpeptidase, and ferritin levels, and nonalcoholic fatty liver disease (NAFLD), periodontal disease, and Helicobacter pylori infection duration. Kaplan-Meier and generalized additive models were used to present the restricted mean survival time (RMST) and identify onset contributors. Clusters with NAFLD and elevated UA levels had the highest MetS risk, whereas those with uniformly low biomarker levels revealed the lowest risk. During follow-up, a cluster initially comprising 60.2% moderate-risk patients exhibited high biomarker levels and had the worst MetS prognosis (RMST: 211 days). UA, CRP levels, and rHR contributed to the incidence of MetS in the fitted model. Machine learning can predict the premetabolic state at MetS risk in a population-based cohort., Competing Interests: Declarations. Competing interests: The authors declare no conflict of interest., (© 2024. The Author(s).)

In South Korea, there has been an increasing number of patients diagnosed with unruptured intracranial aneurysms (UIAs), requiring rigorous self-care to prevent rupture. This study aimed to identify predictors of self-care performance in patients with UIAs, focusing on illness perception and social support. A cross-sectional correlation design was employed. Data from 150 participants was analyzed. The Brief Illness Perception Questionnaire (B-IPQ), the Multidimensional Scale of Perceived Social Support (MSPSS), and a Self-Care Performance Tool were used for measurement. Pearson correlation was used to analyze the correlation among the participants' perceived illness perception, social support, and self-care performance. Differences in the level of self-care performance according to sociodemographic and clinical characteristics and correlations among continuous variables were identified using univariate statistics. Hierarchical multiple regression was used to identify predictors of self-care performance. The results showed that the self-care performance score was positively correlated with illness perception and social support. Regression analysis showed that being a non-smoker, not consuming alcohol, receiving social support from family, receiving social support from medical personnel, and strong illness perception positively affected the self-care performance score. Our findings should be considered when developing education and intervention programs to enhance self-care performance among patients with UIAs., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Consent for publication: As part of the informed consent process, permission was sought from the participants to be able to use the data collection in publication, with the participants remaining anonymous. Ethical approval and consent to participate: The present study was approved by the institutional review board of the authors’ affiliated university hospital (IRB no. AJOUIRB-SB-2022-376). Informed consent was obtained from all participants before their participation in this study., (© 2024. The Author(s).)

Gastroesophageal Reflux Disease (GERD) is characterized by the regurgitation of stomach contents. Recent research indicates that acid reflux may disrupt the homeostasis of the middle and inner ear through the Eustachian tube. Given this context, we hypothesized that an association between GERD and tinnitus may exist due to the imbalance of the middle and inner ear caused by acid reflux. To explore this connection, we conducted a retrospective cohort study involving 669,159 patients registered in the National Health Insurance Service-National Sample Cohort (2012-2019) in South Korea. Our data showed that GERD and tinnitus are highly associated. Nevertheless, the use of proton pump inhibitor medication in GERD patients did not show a significant decrease in the onset of tinnitus., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval: The retrospective cohort study was conducted under an informed consent waiver approved by the Institutional Review Board (IRB) at Ajou University Hospital (AJOUIRB-EX-2023–146)., (© 2024. The Author(s).)

Neurodegenerative diseases (NDDs) present significant challenges due to limited treatment options, ethical concerns surrounding traditional animal models, and the time-consuming and costly process of using human-induced pluripotent stem cells (iPSCs). We addressed these issues by developing a 3D culture protocol for differentiating SH-SY5Y cells into glutamatergic neurons, enhancing physiological relevance with a 3D microarray culture plate. Our protocol optimized serum concentration and incorporated retinoic acid (RA) to improve differentiation. We analyzed the proportions of N-type and S-type cells, observing that RA in the maturation stage not only reduced cell proliferation but also enhanced the expression of MAP2 and VGLUT1, indicating effective neuronal differentiation. Our approach demonstrates the strong expression of glutamatergic neuron phenotypes in 3D SH-SY5Y neural spheroids, offering a promising tool for high-throughput NDD modeling and advancing drug discovery and therapeutic development. This method overcomes limitations associated with conventional 2D cultures and animal models, providing a more effective platform for NDD research., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

This paper exhibits a proportional-type robust current controller for permanent magnet synchronous motors (PMSMs), incorporating the variable bandwidth technique driven by the proposed online auto-tuner and the disturbance observer (DOB) as the subsystems. There are two contributions: (a) the proposed online auto-tuner implements the variable bandwidth for the closed-loop system to boost the transient current tracking performance and (b) the combination of proportional-type feedback controller and DOB eliminates the requirement of the integral action, ensuring the steady-state error rejection property. Moreover, it is proved that the resultant feedback system recovers the target current tracking performance without steady-state errors. The experimental study is conducted to verify the efficacy of the proposed controller using a 700-W prototype PMSM., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

The effect of W and WO 3 electrodes on the ferroelectric characteristics of HZO (Zr-doped HfO 2 )-based MFM (metal-ferroelectric-metal) capacitors was investigated. During the deposition of tungsten, the W electrode was formed using only Ar gas, while the WO 3 electrode was formed using a mixture of Ar and O 2 gases. The W-based MFM capacitors exhibited superior remnant polarization (2P r of 107.9 µC/cm 2 at 700 o C) compared to the WO 3 -based capacitors; however, their endurance performance was degraded. In contrast, the WO 3 -based capacitors showed endurance performance enhanced by three orders of magnitude due to the oxygen-rich reservoir effect. The oxygen introduced during the deposition of WO 3 prevented the oxygen scavenging effect of tungsten. Consequently, excessive generation of oxygen vacancies in the HZO layer was suppressed, resulting in improved endurance performance. These results were quantitatively confirmed through TEM, XPS, and XRD analyses., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Existing evidence regarding the impact of continuity of care (COC) in asthma patients is limited, and its quality is low to moderate. This study aimed to investigate associations between relational COC within primary care and asthma-related hospitalizations in children using a robust methodology. This study is a population-based cohort study that utilized a national claims database in South Korea. The study comprised 136,296 individuals under 20 years old who were newly diagnosed with asthma between 2015 and 2016. These were classified into high, medium, and low continuity groups based on the continuity of care index (COCI). The primary outcome measure was the incidence of asthma-related hospitalizations. During a two-year follow-up period, 10,922 patients (8.01%) were hospitalized: 2520 (5.59%) in the high-continuity group, 3188 (6.98%) in the medium-continuity group, and 3867 (8.48%) in the low-continuity group. After adjusting for confounding covariates, patients in the low- and medium-continuity groups exhibited significantly higher risks of hospital admission (adjusted hazard ratio (aHR) = 1.30 [95% confidence interval = 1.24-1.37] and aHR = 1.14 [1.08-1.20], than those in the high-continuity group. Sensitivity and subgroup analyses findings were consistent. In a young population with asthma increased continuity of primary care was associated with less hospitalization., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

CNS Drug discovery has been challenging due to the lack of clarity on CNS diseases' basic biological and pathological mechanisms. Despite the difficulty, some CNS drugs have been developed based on phenotypic effects. Herein, we propose a phenotype-structure relationship model, which predicts an anti-neuroinflammatory potency based on 3D molecular structures of the phenotype-active or inactive compounds without specifying targets. For this chemo-centric study, a predictive model of the nitric oxide (NO) inhibitory potency in hyper-activated microglia is built from the 548 agents, which were collected from 95 research articles (28 substructures consisting of natural products and synthetic scaffolds) and doubly externally validated by the agents of 9 research articles as third set. 3D Structures (multi-conformer ensemble) of every agent were encoded into the E3FP molecular fingerprint of the Keiser group as a 3D molecular representation. The location information of the molecular fingerprints could be learned and validated to classify the inhibitory potency of compounds (IC 50 cut-off between the active and inactive: 37.1 µM): (1) multi-layer perceptron (MLP) (AUC- CV : 0.997, AUC- Test : 0.992), (2) recurrent neural network (RNN) (AUC- CV : 0.999, AUC- Test : 0.995), and (3) convolutional neural network (CNN) (AUC- CV : 0.998, AUC- Test : 0.994). The high performance of these models was compared with that of four classical machine classification models (Logistic, Ridge, Lasso, and Naïve Bayes). We named the binary classification models NO-Classifier. Independent test set validation and decision region analysis of the independent test set doubly demonstrated NO-Classifier effectively discerned the anti-inflammatory potency of testing compounds in inflammatory cell phenotype with the webserver in https://no-classifier.onrender.com., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

The involvement of the mechanistic targets of rapamycin (mTOR) pathway in lipid metabolism has been recently elucidated. However, its specific role in the Meibomian gland, where lipid metabolism is significant, remains not fully understood. We investigated the role of mTOR signaling system in the lipogenesis and differentiation of human meibomian gland epithelial cells (HMGECs). Treatment of HMGECs with rapamycin resulted in a reduction in lipid synthesis and the expression of PPARγ and SREBP-1, the major regulators of lipid synthesis. The phosphorylation of p70S6kinase and AKT, which are downstream signals of mTOR complexes 1 and 2, respectively, decreased following rapamycin treatment. In addition, when both mTOR complex 1 and 2 were suppressed using siRNA, there was a significant reduction in the expression of PPARγ and SREBP-1, along with a decrease in lipid synthesis in HMGECs. Our findings suggest that inhibiting the mTOR pathway diminishes the differentiation and adipogenesis of meibomian gland epithelial cells, and both mTOR complexes 1 and 2 appear to play a role in this activity., Competing Interests: Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

This study investigates the relationship between perceptions of inequality, feelings of loneliness, and societal fragmentation in South Korea, focusing on their interconnected dynamics. The research emphasizes the social contexts in which loneliness emerges and exerts its influence. In the first phase, path analysis is employed to examine how perceived inequality contributes to societal fragmentation-manifested through disbelief, exploitation, and indifference-with loneliness serving as a mediating factor. The findings reveal a significant link between perceived inequality and loneliness, which, in turn, undermines social cohesion. The second phase delves deeper into this relationship by analyzing each regression model, further substantiating the connection between perceived inequality and loneliness and its role in shaping perceptions of societal fragmentation. In an era marked by rising economic inequality and democratic erosion, loneliness extends beyond an individual concern, posing broader implications for societal emotional health. The study underscores the urgent need for interventions aimed at reducing economic inequality and addressing loneliness to promote more cohesive societies., (© 2024. The Author(s).)

Early and precise diagnosis of craniosynostosis (CSO), which involves premature fusion of cranial sutures in infants, is crucial for effective treatment. Although computed topography offers detailed imaging, its high radiation poses risks, especially to children. Therefore, we propose a deep-learning model for CSO and suture-line classification using 2D cranial X-rays that minimises radiation-exposure risks and offers reliable diagnoses. We used data comprising 1,047 normal and 277 CSO cases from 2006 to 2023. Our approach integrates X-ray-marker removal, head-pose standardisation, skull-cropping, and fine-tuning modules for CSO and suture-line classification using convolution neural networks (CNNs). It enhances the diagnostic accuracy and efficiency of identifying CSO from X-ray images, offering a promising alternative to traditional methods. Four CNN backbones exhibited robust performance, with F1-scores exceeding 0.96 and sensitivity and specificity exceeding 0.9, proving the potential for clinical applications. Additionally, preprocessing strategies further enhanced the accuracy, demonstrating the highest F1-scores, precision, and specificity. A qualitative analysis using gradient-weighted class activation mapping illustrated the focal points of the models. Furthermore, the suture-line classification model distinguishes five suture lines with an accuracy of > 0.9. Thus, the proposed approach can significantly reduce the time and labour required for CSO diagnosis, streamlining its management in clinical settings., (© 2024. The Author(s).)

This study presents a novel training technique, visual + electrotactile proprioception training (visual + EP training), which provides additional proprioceptive information via tactile channel during motor training to enhance the training effectiveness. In this study, electrotactile proprioception delivers finger aperture distance information in real-time, by mapping frequency of electrical stimulation to finger aperture distance. To test the effect of visual + EP training, twenty-four healthy subjects participated in the experiment of matching finger aperture distance with distance displayed on screen. Subjects were divided to three groups: the first group received visual training and the other two groups received visual + EP training with or without a post-training test with electrotactile proprioception. Finger aperture control error was measured before and after the training (baseline, 15-min post, 24-h post). Experimental data suggest that both training methods decreased finger aperture control error at 15-min post-training. However, at 24-h post-training, the training effect was fully retained only for the subjects who received visual + EP training, while it washed out for the subjects with visual training. Distribution analyses based on Bayesian inference suggest that the most likely mechanism of this long-term retention is proprioceptive recalibration. Such applications of artificially administered sense have the potential to improve motor control accuracy in a variety of applications., (© 2024. The Author(s).)

Guidelines encouraging social distancing, limited outings, and remote work due to COVID-19 have increased sedentary periods and reduced levels of physical activity. These habits increase the risk of metabolic diseases, obesity, cardiovascular disease, and diabetes mellitus. The World Health Organization recommends muscle-strengthening exercises as well as regular physical activity to promote overall health. This study investigates the effect of a wearable hip exoskeleton on muscle activity and heart rate during anaerobic exercise in 40 healthy adults (mean age of 40.00 ± 11.51 years; n = 20 females). Bot Fit, a wearable hip-type robotic exoskeleton, was developed by Samsung Electronics Co., Ltd. (Suwon, Republic of Korea) to enhance the effects of both aerobic and anaerobic exercise. All study participants performed a fitness exercise protocol, including knee-ups, good mornings, squats, mountain climbs, kick-backs, reverse lunges, and split jacks, with and without a Bot Fit. To evaluate the effect of anaerobic exercise with the Bot Fit, muscle activity and heart rate were measured during fitness exercises with and without a Bot Fit. Measured muscles were the rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), tibialis anterior (TA), gastrocnemius medialis (GCM), and gluteus maximus (GM). During anaerobic exercises with the Bot Fit, there was a significant increase in muscle activity compared to exercising without the Bot Fit. Muscle activity increased significantly in the RA, RF, VL, BF and TA muscles during knee-ups; in the ES, BF, and GM during good mornings; in the RF, VL, VM, BF, and GM during squats; in RA, RF, VL, VM, and GM during mountain climbs; in the RA and BF during kick-backs; in the RF, BF, and GCM during reverse lunges; and in the RF and VL during split jacks (p < 0.05). Heart rates showed a statistically significant increase during good mornings, mountain climbs, and reverse lunge exercises while wearing the Bot Fit (p < 0.05). This study demonstrated that anaerobic exercises by healthy adults using a Bot Fit led to enhanced activation of abdominal and lower-limb muscles as well as an improved heart rate, maximizing the effect of anaerobic exercise compared with the same exercise protocol without a Bot Fit. This suggests that use of a Bot Fit can increase the effectiveness of anaerobic exercise in healthy adults., (© 2024. The Author(s).)

This paper presents a novel single-layer, single-sided, dual-wideband linear-to-circular (LTC) polarsation converter. The unit cell of the polarisation converter comprises two identical diagonally oriented C-shaped metallic strips arranged symmetrically and integrated with four outwardly extending diagonal parasitic strips. The LTC polarisation converter is placed on the top side of an ultra-thin substrate layer with a profile size of 0.020 λ o at 11.9 GHz and 0.05 λ o at 30.7 GHz. The inclusion of parasitic strips in the unit cell design is pivotal, inducing a 90º phase shift between the orthogonal wave components, thus enhancing LTC polarisation conversion. The design achieved near-equal transmission amplitudes and maintained a stable phase difference of nearly 90° across two distinct frequency bands, enabling right-hand circular polarisation in the lower frequency band and left-hand circular polarisation in the higher frequency band. Numerical and experimental results showed that the polariser can realise a wideband LTC polarisation conversion for both x- and y-polarised electromagnetic wave incidences at two distinct frequency bands of 6.78-17.08 GHz (fractional bandwidth of 86.3%) and 25.09-36.40 GHz (36.8%). The converter maintained consistent polarisation conversion performance across a broad range of incidence angles and exhibited high and uniform total transmittance in both operational frequency bands., (© 2024. The Author(s).)

It remains unclear whether pulmonary fibrosis-like changes differ in patients with different SARS-CoV-2 variants. This study aimed to compare pulmonary fibrotic changes between two SARS-CoV-2 variant periods (delta vs. pre-delta) in critically ill patients with SARS-CoV-2 pneumonia. Clinical data and chest CT images of patients with SARS-CoV-2 pneumonia receiving mechanical ventilation were collected from 10 hospitals in South Korea over two periods: delta (July-December, 2021; n = 64) and pre-delta (February, 2020-June, 2021; n = 120). Fibrotic changes on chest CT were evaluated through visual assessment. Of 184 patients, the mean age was 64.6 years, and 60.5% were ale. Fibrosis-like changes on chest CT (median 51 days from enrollment to follow up CT scan, interquartile range 27-76 days) were identified in 75.3%. Delta group showed more fibrosis-like changes (≥ 2) (69.8% vs. 43.1%, P = 0.001) and more frequent reticulation and architectural distortion+/-parenchymal band than pre-delta group. Even after propensity score matching with clinical variables, delta group had more severe (≥ 2) fibrosis-like changes (71.4% vs. 38.8%, P = 0.001), and more frequent reticulation and architectural distortion+/-parenchymal band than pre-delta group. Our data suggest that critically ill patients with SARS-CoV-2 in delta period had more severe pulmonary fibrosis-like changes than those in pre-delta period., (© 2024. The Author(s).)

This study investigated the effect of various storage media on the physicochemical properties of plasma-treated 3-mol% yttria-stabilized tetragonal zirconia: air, vacuum, deionized water (DIW), and plasma-activated water (PAW). Each group was divided into five subgroups based on storage periods: immediately after NTP irradiation (T0), and after 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4). The control group (C) received no treatment. The storage groups were monitored weekly using various analytical techniques, including contact angle measurements, scanning electron microscopy (SEM), focused ion beam (FIB)-SEM, confocal laser scanning microscopy (CLSM), x-ray photoelectron spectroscopy (XPS), and x-ray diffraction (XRD). Our results demonstrate that plasma-treated zirconia surfaces stored in DIW retained or even increased their hydrophilicity due to the formation of hydrogen bonds and preservation of nitrogen functionalities. In contrast, surfaces stored in air exhibited significant hydrophobic recovery. FIB-SEM analysis showed no adverse internal structural changes regardless of storage medium. The roughness of the zirconia surface slightly increased after plasma treatment and was generally retained across all storage groups for 4 weeks, except for the air storage group. This study concludes that storage in DIW effectively preserves the enhanced surface properties of plasma-activated zirconia for up to 4 weeks., (© 2024. The Author(s).)

This study aims to analyze data from patients who received kidney transplantation from deceased donors to investigate the anesthetic factors influencing early and late graft outcomes, including the incidence of slow graft function (SGF), delayed graft function (DGF), and 3-year graft outcomes. We retrospectively analyzed 202 recipients who underwent deceased donor kidney transplantation from March 2010 to December 2020. Anesthetic monitoring data during the intraoperative period was analyzed at 5-minute intervals, and basic clinical parameters were evaluated. The mean recipient age was 46.6 ± 10.3 years, and the mean donor age was 41.7 ± 12.7 years. Anesthetic time averaged 285.8 ± 70.2 min, and operation time averaged 223.1 ± 44.0 min. The incidence of SGF was 11.8%, and the incidence of DGF was 3.9%. Mean central venous pressures (CVPs) were higher in recipients with SGF or DGF (11.7 mmHg) compared to those with immediate graft function (9.7 mmHg). Higher CVP was identified as an independent risk factor for SGF or DGF (odds ratio 1.219, p = 0.006). This study suggests that intraoperative monitoring of CVP is crucial for predicting short-term graft function in deceased donor kidney transplantation and should be managed to prevent excessive fluid intake., (© 2024. The Author(s).)

Preeclampsia is a hypertensive disorder of pregnancy that can lead to stillbirth and preterm birth if not treated promptly. Currently, the diagnosis of preeclampsia relies on clinical symptoms such as hypertension and proteinuria, along with invasive blood tests. Here, we investigate the role of soluble proteins and exosomes in noninvasive diagnosing preeclampsia non-invasively using maternal urine and urine-derived exosomes. We quantified the levels of particles and the presence of TSG101 and CD63 in urine and urinary exosomes via the biologically intact exosome separation technology (BEST) platform. Then, we obtained higher levels of soluble proteins such as fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) from urine as it was than urinary exosomes. Compared to commercial blood tests, the sensitivity of the sFlt-1/PlGF ratio was found to be 4.0 times higher in urine tests and 1.5 times higher in tests utilizing urine-derived exosomes. Our findings offer promising possibilities for the early and non-invasive identification of high-risk individuals at risk of preeclampsia, allowing for comprehensive preventive management., (© 2024. The Author(s).)

This study aimed to explore the clinical applicability of the shade-matching function in intraoral scanners. This study measured the tooth colors of maxillary anterior dentitions of 83 adults using visual matching, a spectrophotometer, and a scanner according to two color systems: VITA Classical (VC) and VITA 3D-Master (V3D). Agreement between each method was assessed by weighted Cohen's kappa coefficient (K W , α = 0.05). For V3D, the overall agreement between the scanner and spectrophotometer (K W = 0.498) was higher than that between the scanner and visual matching (K W = 0.473). Similarly, the agreement between the scanner and spectrophotometer (K W = 0.283) was higher than that between a scanner and visual matching (K W = 0.140) for VC. Regarding tooth position, the highest agreement between the scanner and spectrophotometer was observed on the right central incisor (K W = 0.542) for V3D. Tooth color measurement with a scanner was comparable to that with a spectrophotometer, especially on the central incisors when using the VITA 3D-Master system. A scanner could serve as an alternative to a spectrophotometer for shade selection. However, color matching should still be visually verified., (© 2024. The Author(s).)

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease worldwide. However, it is still urgent to develop innovative treatments that can effectively manage refractory patients with unpredictable chronic disease courses. In this study, we evaluated the therapeutic efficacy of 1-palmitoyl-2-linoleoyl-3-acetyl-rac-glycerol (PLAG) as a novel agent for AD treatment using a human-like mouse model of AD. PLAG significantly improved 2,4-dinitrochlorobenzene (DNCB)-induced AD skin lesions compared to those in mice treated with DNCB alone. PLAG substantially modulated the AD-induced infiltration of monocytes and eosinophils into skin lesions and humoral systemic responses involving immunoglobulin E (IgE), interleukin (IL)-4, and IL-13, restoring them to a normal state. Next, we compared the therapeutic efficacy of PLAG and abrocitinib for severe AD treatment. PLAG exhibited a significant therapeutic effect on AD skin lesions compared to abrocitinib. Unlike abrocitinib, PLAG significantly reduced AD-induced eosinophil infiltration to a level similar to that observed in untreated negative controls. Notably, both PLAG and abrocitinib downregulated IgE, IL-4, and IL-13 in a similar pattern, reaching levels similar to those in the untreated negative controls. Our findings strongly suggest that PLAG may serve as a therapeutic agent for AD with an efficacy comparable to that of abrocitinib., (© 2024. The Author(s).)

Breast cancer metastasis is associated with a poor prognosis and a high rate of mortality. Cathepsin L (CTSL) is a lysosomal cysteine protease that promotes tumor metastasis by degrading the extracellular matrix. Gene set enrichment analysis revealed that CTSL expression was higher in tumorous than in non-tumorous tissues of breast cancer patients and that high-level CTSL expression correlated positively with the epithelial-mesenchymal transition. Therefore, we hypothesized that inhibiting CTSL activity in tumor cells would prevent metastasis. In this study, we characterized the inhibitory activity of SnuCalCpI15, the I29 domain of a CTSL-like cysteine protease from Calotropis procera R. Br., and revealed that the propeptide stereoselectively inhibited CTSL in a reversible slow-binding manner, with an inhibitory constant (K i ) value of 1.38 ± 0.71 nM, indicating its potency as an exogenous inhibitor in anti-cancer therapy. SnuCalCpI15 was localized intracellularly in MDA-MB-231 breast cancer cells and suppressed tumor cell migration and invasion. These results demonstrate the potential of SnuCalCpI15 as a novel agent to prevent breast cancer metastasis., (© 2024. The Author(s).)

Effective antihypertensive therapy is essential for achieving optimal blood pressure (BP) control and reducing cardiovascular events. This double-blind, multicenter, randomized trial aimed to compare the antihypertensive efficacy and safety of a combination of amlodipine (AML) and candesartan cilexetil (CC) versus AML monotherapy in patients with essential hypertension (HTN). After a 4-week run-in period with AML 5 mg, patients whose HTN remained uncontrolled (diastolic BP [DBP]) ≥ 90 mmHg and < 120 mmHg) were randomized to receive either AML + CC or AML alone for 8 weeks. Efficacy was assessed by measuring changes in DBP and systolic BP (SBP). The primary safety measure was the incidence of adverse events (AEs). A total of 174 participants were included in the efficacy analysis. After 8 weeks, DBP decreased by -9.92 ± 0.86 mmHg in the AML + CC arm and - 2.08 ± 0.86 mmHg in the AML arm (p < 0.0001). SBP decreased by -14.27 ± 1.39 mmHg in the AML + CC arm versus - 2.77 ± 1.39 mmHg in the AML arm (p < 0.0001). AEs occurred in 11.24% of the AML + CC group and 5.62% of the AML group (p = 0.1773). AML + CC combination therapy demonstrated superior efficacy with good tolerance, making it a promising option for patients with inadequately controlled hypertension on amlodipine alone., (© 2024. The Author(s).)

Infections originating from pathogenic microorganisms can significantly impede the natural wound-healing process. To address this obstacle, innovative bio-active nanomaterials have been developed to enhance antibacterial capabilities. This study focuses on the preparation of nanocomposites from thermally reduced graphene oxide and zinc oxide (TRGO/ZnO). The hydrothermal method was employed to synthesize these nanocomposites, and their physicochemical properties were comprehensively characterized using X-ray diffraction analysis (XRD), High-resolution transmission electron microscopy (HR-TEM), Fourier-transform infrared (FT-IR), Raman spectroscopy, UV-vis, and field-emission scanning electron microscopy (FE-SEM) techniques. Subsequently, the potential of TRGO/ZnO nanocomposites as bio-active materials against wound infection-causing bacteria, including Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli, was evaluated. Furthermore, the investigated samples show disrupted bacterial biofilm formation. A reactive oxygen species (ROS) assay was conducted to investigate the mechanism of nanocomposite inhibition against bacteria and for further in-vivo determination of antimicrobial activity. The MTT assay was performed to ensure the safety and biocompatibility of nanocomposite. The results suggest that TRGO/ZnO nanocomposites have the potential to serve as effective bio-active nanomaterials for combating pathogenic microorganisms present in wounds., (© 2024. The Author(s).)

This study aimed to evaluate the incidence of clinically significant intraocular inflammation (csIOI) after treatment with intravitreal injection (IVI) of brolucizumab and identify csIOI risk factors. We categorized 60,966 South Korean patients from a nationwide population-based cohort into 4 groups: groups 1 (Ranibizumab), 2 (Aflibercept), 3 (Brolucizumab), and 4 (switched to brolucizumab). We used the Kaplan-Meier method to estimate the cumulative incidence of csIOI in each group and calculated the hazard ratios (HRs) and 95% confidence intervals (CIs). We constructed a multivariate model using forward selection methods to identify risk factors for csIOI. The cumulative incidence of csIOI within 180 days of the index date in groups 1, 2, 3, and 4 was 0.36% (67/18,537), 0.49% (186/37,951), 3.47% (38/1,095), and 3.69% (125/3,383), respectively. Multivariate analysis revealed a significant increase in csIOI risk in groups 3 (HR 11.08, 95% CI 7.42-16.53, P < 0.001) and 4 (HR 10.40, 95% CI 7.67-14.09, P < 0.001). History of retinal vascular occlusion (HR 1.56, 95% CI 1.01-2.40, P = 0.043) significantly increased csIOI risk after brolucizumab IVI treatment; female sex (HR 0.78, 95% CI 0.64-0.96, p = 0.020) and diabetes (HR 0.72, 95% CI 0.58-0.90, p = 0.004) decreased the risk. csIOI incidence was higher after brolucizumab IVI treatment than after ranibizumab and aflibercept IVI treatment. Retinal vein occlusion history, female sex, and diabetes are associated with csIOI after brolucizumab IVI treatment., (© 2024. The Author(s).)

Oxide/Nitride/Oxide/Nitride (ONON; SiO 2 /SiN x /SiO 2 /SiN x ) stacked structure is widely used in the 3D vertical structure of semiconductor cells. Previously, to form a 3D cells, photoresist (PR) was patterned and repeatedly trimmed on the top of ONON after the etching of one ON layer. Due to the time-consuming process of etching layer-by-layer of ON layer, two-step etch processing using C 4 F 8 -based or C 4 F 6 -based gases composed of maskless ONON stack feature etching and followed one ON layer-by layer etching by PR trimming in the ONON stack feature are employed these days. However, the two-step etching method resulted in poor etch profiles of maskless ONON stack feature in addition to high global warming potential of C 4 F 8 and C 4 F 6 . In this study, we investigated the etching of maskless ONON stack feature using C 4 H 2 F 6 -based gas having a low global warming potential and the effects of C 4 H 2 F 6 -based gas on the etch characteristics of maskless ONON stack feature such as etch rate, etch profile, change in critical dimensional (CD), and etch selectivity between SiO 2 and SiN x have been investigated. C 4 H 2 F 6 -based gas showed the highest etch rates compared to C 4 F 6 and C 4 F 8 -based gases in addition to the etch selectivity of ~ 1:1 between SiO 2 and SiN x due to hydrogen included in the gas structure. In addition, the change in horizontal CD was lower in the order of C 4 H 2 F 6 , C 4 F 6 , and C 4 F 8 -based gases due to the more effective sidewall passivation in the order of C 4 F 8 , C 4 F 6 , and C 4 H 2 F 6 -based gases. The thicker carbon-based polymer layer on the sidewall also played an important role in maintaining the shape of the top edge shape of maskless ONON stack feature when etching a line feature in an environment without a mask., (© 2024. The Author(s).)

This study evaluates the diagnostic efficacy of automated machine learning (AutoGluon) with automated feature engineering and selection (autofeat), focusing on clinical manifestations, and a model integrating both clinical manifestations and CT findings in adult patients with ambiguous computed tomography (CT) results for acute appendicitis (AA). This evaluation was compared with conventional single machine learning models such as logistic regression(LR) and established scoring systems such as the Adult Appendicitis Score(AAS) to address the gap in diagnostic approaches for uncertain AA cases. In this retrospective analysis of 303 adult patients with indeterminate CT findings, the cohort was divided into appendicitis (n = 115) and non-appendicitis (n = 188) groups. AutoGluon and autofeat were used for AA prediction. The AutoGluon-clinical model relied solely on clinical data, whereas the AutoGluon-clinical-CT model included both clinical and CT data. The area under the receiver operating characteristic curve (AUROC) and other metrics for the test dataset, namely accuracy, sensitivity, specificity, PPV, NPV, and F1 score, were used to compare AutoGluon models with single machine learning models and the AAS. The single ML models in this study were LR, LASSO regression, ridge regression, support vector machine, decision tree, random forest, and extreme gradient boosting. Feature importance values were extracted using the "feature&#95;importance" attribute from AutoGluon. The AutoGluon-clinical model demonstrated an AUROC of 0.785 (95% CI 0.691-0.890), and the ridge regression model with only clinical data revealed an AUROC of 0.755 (95% CI 0.649-0.861). The AutoGluon-clinical-CT model (AUROC 0.886 with 95% CI 0.820-0.951) performed better than the ridge model using clinical and CT data (AUROC 0.852 with 95% CI 0.774-0.930, p = 0.029). A new feature, exp(-(duration from pain to CT) 3  + rebound tenderness), was identified (importance = 0.049, p = 0.001). AutoML (AutoGluon) and autoFE (autofeat) enhanced the diagnosis of uncertain AA cases, particularly when combining CT and clinical findings. This study suggests the potential of integrating AutoML and autoFE in clinical settings to improve diagnostic strategies and patient outcomes and make more efficient use of healthcare resources. Moreover, this research supports further exploration of machine learning in diagnostic processes., (© 2024. The Author(s).)

This study aimed to classifying wheat genotypes using support vector machines (SVMs) improved with ensemble algorithms and optimization techniques. Utilizing data from 302 wheat genotypes and 14 morphological attributes to evaluate six SVM kernels: linear, radial basis function (RBF), sigmoid, and polynomial degrees 1-3. Various optimization methods, including grid search, random search, genetic algorithms, differential evolution, and particle swarm optimization, were used. The radial basis function kernel achieves the highest accuracy at 93.2%, and the weighted accuracy ensemble further improves it to 94.9%. This study shows the effectiveness of these methods in agricultural research and crop improvement. Notably, optimization-based SVM classification, particularly with particle swarm optimization, saw a significant 1.7% accuracy gain in the test set, reaching 94.9% accuracy. These findings underscore the efficacy of RBF kernels and optimization techniques in improving wheat genotype classification accuracy and highlight the potential of SVMs in agricultural research and crop improvement endeavors., (© 2024. The Author(s).)