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Abstract Background Effective management of adverse events is required to maintain sufficient imatinib dosing when treating patients with gastrointestinal stromal tumors (GISTs). Skin rash is a common adverse event of imatinib, which can be effectively controlled by systemic steroid treatment without imatinib dose modification or interruption. However, the impact of the use of systemic steroids on the efficacy of imatinib treatment remains unclear. Methods Between October 2014 and February 2022, 277 consecutive patients from a prospective registry of GIST patients were included as the study population. Patients who started systemic steroids due to grade ≥ 3 skin rash or grade 2 skin rash with grade 2 pruritis were classified as the steroid group, whereas patients who did not develop a skin rash or those who did not require steroids for a mild skin rash were classified as the control group. Efficacy outcomes were compared between the two groups. Results Among the 277 patients, 30 (10.8%) were treated with systemic steroids for skin rash. There was no significant difference in progression free survival (PFS) or overall survival (OS) between the steroid and control groups (3-year PFS, 67.7% vs. 65.1%, p = 0.53; 3-year OS, 91% vs. 89.9%, p = 0.67, respectively). The use of systemic steroids was not an independent factor associated with PFS (hazard ratio 0.73, 95% confidence interval 0.36–1.49, p = 0.39) and OS (hazard ratio 0.37, 95% confidence interval 0.12–1.18, p = 0.09). In the steroid group, patients who successfully maintained the imatinib dosage showed a trend toward more favorable survival outcomes than those who did not (3-year PFS, 73.3% vs. 44.4%, p = 0.34; 3-year OS, 95.8% vs. 75.0%, p = 0.15, respectively). Conclusions The use of systemic steroids for the control of imatinib induced severe skin rash did not adversely affect the efficacy outcomes of imatinib in patients with advanced GIST.

Abstract Social animals, including rodents, primates, and humans, partake in competition for finite resources, thereby establishing social hierarchies wherein an individual’s social standing influences diverse behaviors. Understanding the neurobiological underpinnings of social dominance is imperative, given its ramifications for health, survival, and reproduction. Social dominance behavior comprises several facets, including social recognition, social decision-making, and actions, indicating the concerted involvement of multiple brain regions in orchestrating this behavior. While extensive research has been dedicated to elucidating the neurobiology of social interaction, recent studies have increasingly delved into adverse social behaviors such as social competition and hierarchy. This review focuses on the latest advancements in comprehending the mechanisms of the mesocorticolimbic circuit governing social dominance, with a specific focus on rodent studies, elucidating the intricate dynamics of social hierarchies and their implications for individual well-being and adaptation.

Abstract Background Effective communication between patients and healthcare providers in the emergency department (ED) is challenging due to the dynamic nature of the ED environment. This study aimed to trial a chat service enabling patients in the ED and their family members to ask questions freely, exploring the service’s feasibility and user experience. Objectives To identify the types of needs and inquiries from patients and family members in the ED that could be addressed through the chat service and to assess the user experience of the service. Methods We enrolled patients and family members aged over 19 years in the ED, providing the chat service for up to 4 h per ED visit. Trained research nurses followed specific guidelines to respond to messages from the participants. After participation, participants were required to complete a survey. Those who agreed also participated in interviews to provide insights on their experiences with the ED chat service. Results A total of 40 participants (20 patients and 20 family members) sent 305 messages (72 by patients and 233 by family members), with patients sending an average of 3.6 messages and family members 11.7. Research nurses resolved 41.4% of patient inquiries and 70.9% of family member inquiries without further healthcare provider involvement. High usability was reported, with positive feedback on communication with healthcare workers, information accessibility, and emotional support. Conclusions The ED chat service was found to be feasible and led to positive user experiences for both patients and their family members.

This study raises a critical question: 'what does it mean to be smart teachers in the era of technology?'. To provide a concrete and comprehensive answer, the authors analyse multiple discourses revolving around SMART education, an education technology reform initiative in South Korea. This article critically examines the significance of SMART education as dominant discourse to shed light on the formation of smart teachers. The results show that SMART education is conceptualised as 'panacea' that can practically solve all kinds of educational problems, which leaves no choice for teachers but to accept it. The authors also analyse teachers' perceptions and practices by drawing on interviews conducted in a Korean smart city, where the SMART education was first enacted. It is argued that smart teachers are supposed to be 'adaptive' to survive by proving themselves as 'compatible'. This article concludes that it is necessary to imagine more diverse versions of smart teachers.

Abstract Sargassum horneri (S. horneri), a brown seaweed excessively proliferating along Asian coastlines, are damaging marine ecosystems. Thus, this study aimed to enhance nutritional value of S. horneri through lactic acid bacteria fermentation to increase S. horneri utilization as a functional food supplement, and consequently resolve coastal S. horneri accumulation. S. horneri supplemented fermentation was most effective with Lactiplantibacillus pentosus SH803, thus this product (F-SHWE) was used for further in vitro studies. F-SHWE normalized expressions of oxidative stress related genes NF-κB, p53, BAX, cytochrome C, caspase 9, and caspase 3, while non-fermented S. horneri (SHWE) did not, in a H2O2-induced HT-29 cell model. Moreover, in an LPS-induced HT-29 cell model, F-SHWE repaired expressions of inflammation marker genes ZO1, IL1β, IFNγ more effectively than SHWE. For further functional assessment, F-SHWE was also treated in 3T3-L1 adipocytes. As a result, F-SHWE decreased lipid accumulation, along with gene expression of adipogenesis markers PPARγ, C/EBPα, C/EBPβ, aP2, and Lpl; lipogenesis markers Lep, Akt, SREBP1, Acc, Fas; inflammation markers IFN-γ and NF-κB. Notably, gene expression of C/EBPβ, IFN-γ and NF-κB were suppressed only by F-SHWE, suggesting the enhancing effect of fermentation on obesity-related properties. Compositional analysis attributed the protective effects of F-SHWE to acetate, an organic acid significantly higher in F-SHWE than SHWE. Therefore, F-SHWE is a novel potential anti-obesity agent, providing a strategy to reduce excess S. horneri populations along marine ecosystems.

Streptococcus suis is a zoonotic pathogen that affects pigs and humans when they handle pigs or eat undercooked pork products. Globally, an outbreak of infection occurred in China in 2005, [...]

Objectives This study compared the scientific publication speeds of Korean medical journals before and during the coronavirus disease 2019 (COVID-19) era. Methods We analyzed 2,064 papers from 43 international Korean medical journals, selecting 12 papers annually from 2019 to 2022. We assessed publication speed indicators, including the time from submission to revision and from submission to publication. Additionally, we examined variations in publication speed based on journal and paper characteristics, including whether the studies were related to COVID-19. Results Among the 43 journals analyzed, 39.5% disclosed the peer review duration from submission to the first decision, and 11.6% reported their acceptance rates. The average time from submission to acceptance was 127.0 days in 2019, 126.1 days in 2020, 124.6 days in 2021, and 126.4 days in 2022. For COVID-19-related studies, the average time from submission to revision was 61.4 days, compared to 105.1 days for non-COVID-19 studies; from submission to acceptance, it was 87.4 days for COVID-19-related studies and 127.1 days for non-COVID-19 studies. All indicators for COVID-19-related studies showed shorter durations than those for non-COVID-19 studies, and the proportion of studies accepted within 30 or 60 days was significantly higher for COVID-19-related studies. Conclusions This study investigated the publication speed of Korean international medical journals before and during the COVID-19 pandemic. The pandemic influenced journals’ review and publication processes, potentially impacting the quality of academic papers. These findings provide insights into publication speeds during the COVID-19 era, suggesting that journals should focus on maintaining the integrity of their publication and review processes.

Abstract Purpose To develop a deep learning (DL) model for generating automated regions of interest (ROIs) on 99mTc-diethylenetriamine pentaacetic acid (DTPA) renal scans for glomerular filtration rate (GFR) measurement. Methods Manually-drawn ROIs retrieved from a Picture Archiving and Communications System were used as ground-truth (GT) labels. A two-dimensional U-Net convolutional neural network architecture with multichannel input was trained to generate DL ROIs. The agreement between GFR values from GT and DL ROIs was evaluated using Lin’s concordance correlation coefficient (CCC) and slope coefficients for linear regression analyses. Bias and 95% limits of agreement (LOA) were assessed using Bland-Altman plots. Results A total of 24,364 scans (12,822 patients) were included. Excellent concordance between GT and DL GFR was found for left (CCC 0.982, 95% confidence interval [CI] 0.981–0.982; slope 1.004, 95% CI 1.003–1.004), right (CCC 0.969, 95% CI 0.968–0.969; slope 0.954, 95% CI 0.953–0.955) and both kidneys (CCC 0.978, 95% CI 0.978–0.979; slope 0.979, 95% CI 0.978–0.979). Bland-Altman analysis revealed minimal bias between GT and DL GFR, with mean differences of − 0.2 (95% LOA − 4.4–4.0), 1.4 (95% LOA − 3.5–6.3) and 1.2 (95% LOA − 6.5–8.8) mL/min/1.73 m² for left, right and both kidneys, respectively. Notably, 19,960 scans (81.9%) showed an absolute difference in GFR of less than 5 mL/min/1.73 m². Conclusion Our DL model exhibited excellent performance in the generation of ROIs on 99mTc-DTPA renal scans. This automated approach could potentially reduce manual effort and enhance the precision of GFR measurement in clinical practice.

Purpose We assessed the clinical relevance of waist-height ratio (WHtR) as an indicator of cardiometabolic risk and body fat mass measured by dual-energy x-ray absorptiometry (DXA) among Korean children and adolescents. Methods Data from 1,661 children and adolescents aged 10–18 years who participated in the Korea National Health and Nutrition Examination Survey were analyzed. Unadjusted Pearson correlation, age- and sex-adjusted Pearson correlation, and multiple linear regression analyses were performed to investigate the relationships between WHtR standard deviation score (SDS) and cardiometabolic risk factors, as well as DXA-assessed parameters. Results WHtR SDS was correlated with cardiometabolic risk factors, including systolic blood pressure, glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride, and low-density lipoprotein cholesterol, as well as DXA-assessed parameters such as lean mass SDS, fat mass SDS, and fat mass percentage SDS in both whole body and trunk using an adjusted Pearson correlation analyses among all participants (p

Abstract Background Many cases of deep vein thrombosis (DVT) are diagnosed in the emergency department, and abbreviated lower extremity venous point-of-care ultrasound (POCUS) has already shown an accuracy comparable to that of specialists. This study aimed to identify the learning curve necessary for emergency medicine (EM) residents to achieve expertise-level accuracy in diagnosing DVT through a 3-point lower extremity venous POCUS. Methods This prospective study was conducted at an emergency department between May 2021 and October 2022. Four EM residents underwent a one-hour POCUS training session and performed DVT assessments in participants with DVT symptoms or confirmed pulmonary embolism. POCUS was performed at three proximal lower extremity sites to evaluate the thrombi presence and vein compressibility, with results validated by specialized radiology ultrasound. Cumulative sum (CUSUM) and the Bush and Mosteller models were used to analyze the learning curve, while generalized estimating equations were used to identify factors affecting diagnostic accuracy. Results 91 POCUS scans were conducted in 49 patients, resulting in 22% DVT confirmed by specialized venous ultrasound. In the CUSUM analysis, all four EM residents attained a 90% success rate at the common femoral vein, whereas only half achieved this rate when all three sites were considered. According to Bush and Mosteller models, 13–18 cases are required to attain 90–95% diagnostic accuracy. After 10–16 cases, the examination time for each resident decreased, and a 20% increase in examiner confidence was linked to a 2.506-fold increase in the DVT diagnosis accuracy. Conclusion EM residents generally required 13–18 cases for 90–95% DVT diagnostic accuracy, but proficiency varied among individuals, particularly requiring more cases for regions outside the common femoral vein.

Swarm robot systems are an important application of autonomous unmanned surface vehicles on water surfaces. For monitoring natural environments and conducting security activities within a certain range using a surface vehicle, the swarm robot system is more efficient than the operation of a single object as the former can reduce cost and save time. It is necessary to detect adjacent surface obstacles robustly to operate a cluster of unmanned surface vehicles. For this purpose, a LiDAR (light detection and ranging) sensor is used as it can simultaneously obtain 3D information for all directions, relatively robustly and accurately, irrespective of the surrounding environmental conditions. Although the GPS (global-positioning-system) error range exists, obtaining measurements of the surface-vessel position can still ensure stability during platoon maneuvering. In this study, a three-layer convolutional neural network is applied to classify types of surface vehicles. The aim of this approach is to redefine the sparse 3D point cloud data as 2D image data with a connotative meaning and subsequently utilize this transformed data for object classification purposes. Hence, we have proposed a descriptor that converts the 3D point cloud data into 2D image data. To use this descriptor effectively, it is necessary to perform a clustering operation that separates the point clouds for each object. We developed voxel-based clustering for the point cloud clustering. Furthermore, using the descriptor, 3D point cloud data can be converted into a 2D feature image, and the converted 2D image is provided as an input value to the network. We intend to verify the validity of the proposed 3D point cloud feature descriptor by using experimental data in the simulator. Furthermore, we explore the feasibility of real-time object classification within this framework.

Abstract The sulfur utilization efficiency of lithium–sulfur batteries is often limited by the uncontrolled electrodeposition of the insulating Li2S and the resulting electrode passivation. Herein, purposeful electrode and electrolyte design is used to realize site‐selective three‐dimensional (3D) Li2S electrodeposition and thus mitigate the above problem. Site‐selective Li2S nucleation is induced at the tips of CoP nanoneedles grown on a carbon cloth electrode, and the 3D growth of Li2S at these tips without the passivation of the inner part is achieved using a LiBr‐containing high‐donor‐number electrolyte. The controlled Li2S morphology is rationalized by considering the tip effect, the energy of Li2S binding on the electrode surface, and the solubility of Li2S in the electrolyte. Owing to the suppressed electrode passivation, CoP nanoneedle–decorated carbon cloth electrode and LiBr‐containing electrolyte deliver a capacity of >1400 mAh gs−1 at a current density of 0.33 A gs−1. Thus, this work paves the way for the active control of Li2S morphology for high‐performance lithium–sulfur batteries.

Objective Estimating children’s target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner’s formula to predict children’s final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner’s formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children.Design/setting Data were derived from the Korean National Health and Nutrition Examination Survey 2010–2019.Patients A total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner’s formula could not be calculated because of missing parental height data.Main outcome measures Tanner-based TH was compared with the FAH.Results The difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons’ and daughters’ heights, respectively.Conclusions Tanner’s formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.

We would like to thank Dr [...]

Abstract In this work, we study the end-of-the-world (EOW) branes anchored to the boundaries of BCFT $${}_2$$ 2 dual to the BTZ black hole. First, we explore the thermodynamics of the boundary system consisting of the conformal boundary and two EOW branes. This thermodynamics is extended by the tension appearing as the effective cosmological constant of JT black holes on the EOW branes. The tension contribution is identified with the shadow entropy equivalent to the boundary entropy of the BCFT $${}_2$$ 2 . The thermodynamics of the JT black holes and the bulk of BCFT $${}_2$$ 2 can be combined into a novel grafted thermodynamics based on the first law. Second, we focus on the observer’s view of the EOW branes by lowering the temperature. We show that the EOW branes generate a scale called “reefs” inside the horizon. This scale also appears in the grafted thermodynamics. At high temperatures, observers on the EOW branes see their respective event horizons. The reef starts to grow relatively to the horizon size at the temperature, $$T_{grow}$$ T grow . As the temperature cools down the reef area fills the entire interior of the JT black holes at the temperature $$T_{out}$$ T out . Then, the observers recognize their horizons disappear and see the large density of the energy flux. At this temperature, the two JT regions become causally connected. This connected spacetime has two asymptotic $$AdS_2$$ A d S 2 boundaries with a conformal matter. Also, we comment on the grafted thermodynamics to higher dimensions in Appendix B.

Various X-ray techniques are employed to investigate specimens in diverse fields. Generally, scattering and absorption/emission processes occur due to the interaction of X-rays with matter. The output signals from these processes contain structural information and the electronic structure of specimens, respectively. The combination of complementary X-ray techniques improves the understanding of complex systems holistically. In this context, we introduce a multiplex imaging instrument that can collect small-/wide-angle X-ray diffraction and X-ray emission spectra simultaneously to investigate morphological information with nanoscale resolution, crystal arrangement at the atomic scale and the electronic structure of specimens.

Abstract Emergency departments (ED) are complex, triage is a main task in the ED to prioritize patient with limited medical resources who need them most. Machine learning (ML) based ED triage tool, Score for Emergency Risk Prediction (SERP), was previously developed using an interpretable ML framework with single center. We aimed to develop SERP with 3 Korean multicenter cohorts based on common data model (CDM) without data sharing and compare performance with inter-hospital validation design. This retrospective cohort study included all adult emergency visit patients of 3 hospitals in Korea from 2016 to 2017. We adopted CDM for the standardized multicenter research. The outcome of interest was 2-day mortality after the patients’ ED visit. We developed each hospital SERP using interpretable ML framework and validated inter-hospital wisely. We accessed the performance of each hospital’s score based on some metrics considering data imbalance strategy. The study population for each hospital included 87,670, 83,363 and 54,423 ED visits from 2016 to 2017. The 2-day mortality rate were 0.51%, 0.56% and 0.65%. Validation results showed accurate for inter hospital validation which has at least AUROC of 0.899 (0.858–0.940). We developed multicenter based Interpretable ML model using CDM for 2-day mortality prediction and executed Inter-hospital external validation which showed enough high accuracy.

In Jeju Island, South Korea, a patient who consumed raw pig products had subdural empyema, which led to meningitis, sepsis, and status epilepticus. We identified Streptococcus suis from blood and the subdural empyema. This case illustrates the importance of considering dietary habits in similar clinical assessments to prevent misdiagnosis.

Abstract Methylcyclohexane (MCH) dehydrogenation is an equilibrium‐limited reaction that requires high temperatures (>300 °C) for complete conversion. However, high‐temperature operation can degrade catalytic activity and produce unwanted side products. Thus, a hybrid zeolite membrane (Z) is prepared on the inner surface of a tubular support and used it as a wall in a membrane reactor (MR) configuration. Pt/C catalysts is packed diluted with quartz sand inside the Z‐coated tube and applied the MR for MCH dehydrogenation at low temperatures (190–250 °C). Z showed a remarkable H2‐permselectivity in the presence of both toluene and MCH, yielding separation factors over 350. The Z‐based MR achieved higher MCH conversion (75.3% ± 0.8% at 220 °C) than the conventional packed‐bed reactor (56.4% ± 0.3%) and the equilibrium state (53.2%), owing to the selective removal of H2 through Z. In summary, the hybrid zeolite MR enhances MCH dehydrogenation at low temperatures by overcoming thermodynamic limitations and improves the catalytic performance and product selectivity of the reaction.

The present study focuses on investigating the effect of incorporating silica aerogel on the electrical characteristics and sensing capabilities of carbon nanotube (CNT)-embedded PDMS nanocomposites. Initially, the concept of developing nanohybrid clusters composed of CNT and silica aerogel was introduced, followed by comprehensive evaluations of their formation including zeta potential, Raman spectra and FT-IR spectrum. Subsequently, the nanocomposites with varied silica aerogel contents from 0.5 to 2 % by polymer mass were assessed for their sensing capability. It is observed that porosity has exerts perceptible influence on the overall effective electrical conductivity of the sensor below the percolation thresholds, while it does not have any impact beyond this threshold. In addition, the effective medium proposition theory has been modified to analyze both the effective electrical conductivity and the piezoelectric properties of the sensors fabricated. Based on the theoretical and experimental results, the developed CNT@aerogel nanohybrid clusters displayed the potential to enhance sensing sensitivity and increase linearity during stretching condition.

The fast-paced advances in technology and scientific knowledge in the 21st century call for learners to possess professional skills that complement their technical skills to make meaningful contributions in communities. This article introduces a cross-disciplinary leadership training program, Graduate Scholars Leadership, Engagement, and Development (GS LEAD), that was designed and implemented to train students in professional skills including problem-solving, interdisciplinary teamwork, leadership, communication, and engagement. This training program provided learning opportunities for incoming graduate students to work beyond their laboratories, across disciplines, and into communities to identify real-world problems and design sustainable solutions. The design and implementation of the program, the findings of participating students' development in Program Year 1, and suggestions for future program design are discussed.

Modern AI applications have caused broad societal implications across key public domains. While previous research primarily focuses on individual user perspectives regarding AI systems, this study expands our understanding to encompass general public perceptions. Through a survey (N = 1506), we examined public trust across various tasks within education, healthcare, and creative arts domains. The results show that participants vary in their trust across domains. Notably, AI systems’ abilities were evaluated higher than their benevolence across all domains. Demographic traits had less influence on trust in AI abilities and benevolence compared to technology-related factors. Specifically, participants with greater technological competence, AI familiarity, and knowledge viewed AI as more capable in all domains. These participants also perceived greater systems’ benevolence in healthcare and creative arts but not in education. We discuss the importance of considering public trust and its determinants in AI adoption.

Abstract Background Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE has shown efficacy in patients with metastatic neuroendocrine tumours (NETs). Personalised dosimetry is crucial to optimise treatment outcomes and minimise adverse events. In this study, we investigated the correlation between the tumour-absorbed dose (TAD) estimated from [177Lu]Lu-DOTA-TATE SPECT/CT and the therapeutic response. Method A retrospective analysis was conducted on patients with advanced well-differentiated NETs grades 1–3 who underwent PRRT and exhibited greater uptake than liver on pre-therapeutic [68Ga]Ga-DOTA-TOC PET/CT. Target lesions were selected based on the RECIST 1.1 and PERCIST 1.0 criteria using [177Lu]Lu-DOTA-TATE SPECT/CT and pre-therapeutic contrast-enhanced CT scans. For anatomical image analysis, the sum of the longest diameter (SLD) of the target lesions was measured using the RECIST 1.1 criteria for patient-based analysis and the longest diameter (LD) of the target lesion using the RECIST-L criteria for lesion-based analysis. Standardised uptake values (SUVs) were measured on SPECT/CT images, and TADs were calculated based on the SUVs. Dosimetry was performed using a single SPECT/CT imaging time point at day 4–5 post-therapy. Statistical analyses were conducted to investigate correlations and determine the target lesion responses. Results Twenty patients with primary tumour sites and hepatic metastases were included. Fifty-five target lesions, predominantly located in the pancreas and liver, were analysed. The cumulative TAD (lesion-based analysis: r = 0.299–0.301, p = 0.025–0.027), but not the cycle 1 SUV (lesion-based analysis: r = 0.198–0.206, p = 0.131–0.147) or cycle 1 TAD (lesion-based analysis: r = 0.209–0.217, p = 0.112–0.126), exhibited a significant correlation with the change in LD of the target lesion. Binary logistic regression analysis identified the significance of the cumulative TAD in predicting disease control according to the RECIST-L criteria (odds ratio = 1.031–1.051, p = 0.024–0.026). Conclusions The cumulative TAD estimated from [177Lu]Lu-DOTA-TATE SPECT/CT revealed a significant correlation with change in LD, which was significantly higher for the cumulative TAD than for the cycle 1 SUV or TAD. A higher cumulative TAD was associated with disease control in the target lesion. However, considering the limitations inherent to a confined sample size, careful interpretation of these findings is required. Estimation of the cumulative TAD of [177Lu]Lu-DOTA-TATE therapy could guide the platform towards personalised therapy.