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Background: Although an inverse association between the N-terminal prohormone brain natriuretic peptide (NT-proBNP) and obesity exists, only few major studies have assessed the association between NT-proBNP levels and skeletal muscle mass in asymptomatic healthy adults. Therefore, this cross-sectional study was conducted.Methods: We assessed participants who underwent health examinations at Kangbuk Samsung Hospital in South Korea from January 2012 to December 2019. Appendicular skeletal muscle mass was measured using a bioelectrical impedance analyzer, and the skeletal muscle mass index (SMI) was calculated. Participants were divided into the control, mildly low skeletal muscle mass (LMM) (−2 standard deviation [SD] < SMI ≤−1 [SD]), and severely LMM groups (SD ≤−2) based on their SMI. The association between elevated NT-proBNP level (≥125 pg/mL) and skeletal muscle mass was assessed using multivariable logistic regression analysis with adjustment for confounding factors.Results: This study enrolled 15,013 participants (mean age, 37.52±9.52; men, 54.24%; control, n=12,827; mildly LMM, n=1,998; severely LMM, n=188). Prevalence of elevated NT-proBNP was higher in mildly and severely LMM groups than in the control group (control, 1.19%; mildly LMM, 1.4%; severely LMM, 4.26%; P=0.001). The adjusted odds ratio (OR) of elevated NT-proBNP was significantly higher in severely LMM (OR, 2.87; 95% confidence interval [CI], 1.3 to 6.37) than in control (OR, 1.00; reference) or mildly LMM groups (OR, 1.24; 95% CI, 0.81 to 1.89).Conclusion: Our results showed that NT-proBNP elevation were more prevalent in participants with LMM. In addition, our study showed an association between skeletal muscle mass and NT-proBNP level in a relatively young and healthy adult population.

We analyzed the quality characteristics of wheat-free, gluten-free dough, steam-treated dough, and cooked noodles. Dough was prepared from soaked-and-dried soybean (SDS) powder amended with 10%, 25%, or 40% psyllium husk; the SDS was prepared by soaking soybeans for 12 h at room temperature and hot air drying at 60°C for 24 h. Dough was then steam-treated at 120°C for 5, 10, or 15 min and subsequently formed into noodles. Dough and noodle can be made using SDS powder and psyllium husk powder, but it is difficult to maintain noodle shape after cooking without steam treatment. Steam treatment improved the texture of the dough, enabling noodle production. The hardness, gumminess, springiness, cohesiveness, and chewiness of the steam-treated dough were improved compared to nonsteamed dough, yielding a texture similar to wheat flour dough. Moreover, the dough cross-section became denser after steam treatment. As the cooking time increased, the hardness, gumminess, cohesiveness, and chewiness of cooked noodles decreased, and the springiness of cooked noodles increased by increasing of water absorption rate; overall, their form was maintained. Therefore, steam-treated psyllium husk-containing dough enables noodle production without the addition of gluten.

Background: In cross-sectional and retrospective cohort studies, we examined comparative associations between nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction–associated fatty liver disease (MAFLD) and risk of having or developing coronary artery calcification (CAC). Methods: Participants who had health examinations between 2010 and 2019 were analyzed. Liver ultrasonography and coronary artery computed tomography were used to diagnose fatty liver and CAC. Participants were divided into a MAFLD and no-MAFLD group and then NAFLD and no-NAFLD groups. Participants were further divided into no fatty liver disease (reference), NAFLD-only, MAFLD-only, and both NAFLD and MAFLD groups. Logistic regression modeling was performed. Cox proportional hazard model was used to examine the risk of incident CAC in participants without CAC at baseline and who had at least two CAC measurements. Results: In cross-sectional analyses, 162 180 participants were included. Compared with either the no-NAFLD or no-MAFLD groups, the NAFLD and MAFLD groups were associated with a higher risk of prevalent CAC (NAFLD: adjusted odds ratio [OR], 1.34 [95% CI, 1.29–1.39]; MAFLD: adjusted OR, 1.44 [95% CI, 1.39–1.48]). Among the 4 groups, the MAFLD-only group had the strongest association with risk of prevalent CAC (adjusted OR, 1.60 [95% CI, 1.52–1.69]). Conversely, the NAFLD-only group was associated with a lower risk of prevalent CAC (adjusted OR, 0.76 [95% CI, 0.66–0.87]). In longitudinal analyses, 34 233 participants were included. Compared with either the no-NAFLD or no-MAFLD groups, the NAFLD and MAFLD groups were associated with a higher risk of incident CAC (NAFLD: adjusted hazard ratio, 1.68 [95% CI, 1.43–1.99]; MAFLD: adjusted hazard ratio, 1.82 [95% CI, 1.56–2.13]). Among these 4 groups, the MAFLD-only group had the strongest associations with risk of incident CAC (adjusted hazard ratio, 2.03,[95% CI, 1.62–2.55]). The NAFLD-only group was not independently associated with risk of incident CAC (adjusted hazard ratio, 0.88 [95% CI, 0.44–1.78]) Conclusions: Both NAFLD and MAFLD are significantly associated with an increased prevalence and incidence of CAC. These associations tended to be stronger for MAFLD.

BACKGROUND: Older men are more vulnerable to fatal falls than women, and gait disturbances contribute to the risk of falls. Studies have assessed the association between arterial stiffness and gait dysfunction, but the results have been inconclusive. This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial–ankle pulse wave velocity (baPWV) and gait assessment in older men. METHODS: Data from the 2014–2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis. The inclusion criteria were men aged > 65 years with gait assessment [the 30-s chair stand test (30s-CST), the timed up and go (TUG) test, the figure-of-8 walk (F8W) test, the 2-min step test (2MST), and the 6-min walk test (6MWT)] and baPWV measurement data. Generalized linear regression analysis was conducted with multiple confounding factor adjustments, including lower extremity isometric strength. RESULTS: A total of 291 participants were included in the analysis. The mean age was 71.38 ± 4.40 years. The mean values were as follows: (1) 30s-CST, 17.48 ± 5.00; (2) TUG test, 6.01 ± 1.10 s; (3) F8W test, 25.65 ± 4.71 s; (4) 2MST, 102.40 ± 18.83 per 2 min; and (5) 6MWT, 500.02 ± 85.65 m. After multivariable adjustment, baPWV was associated with the 6MWT (β = −0.037, 95% CI: −0.072–−0.002), TUG test (β = 0, 95% CI: 0.000–0.001), and F8W test (β = 0.002, 95% CI: 0.000–0.004). baPWV was not associated with the 30s-CST and 2MST. CONCLUSIONS: The current study showed a statistically significant association between gait assessments and arterial stiffness, independent of lower extremity strength. However, this association was modest. Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.

Background and Objectives Drug-induced sleep endoscopy (DISE) usefully determines the sites of airway obstruction in patients with sleep-disordered breathing. It is widely accepted that obesity increases obstructive sleep apnea. However, no study has explored how and where obesity causes obstructions. In this study, we described the patterns of upper airway obstruction revealed by DISE in patients of various body mass indices (BMIs) with sleep-disordered breathing.Subjects and Method All subjects had sleep-disordered breathing and underwent DISE. Endoscopic findings at the retropalatal (upper lateral, upper anteroposterior [AP]) and retrolingual (lower lateral, lower AP) levels were graded; obstruction was complete (2), partial (1), or none (0). Subjects with BMI 2 (>30 group) were compared using a dummy variable; to this end, we employed R ver. 4.0.5.Results For the total of 153 patients reviewed, the mean age was 43.1±12.2 years and the mean BMI was 26.0±3.4 kg/m2. At the retropalatal AP level, the DISE grade was significantly higher in the 25p=0.029) but not in the >30 group (p=0.248). At the retropalatal lateral level, significant increases were evident in both of the higher BMI groups (p=0.06 and p=0.024, respectively). No significant relationship was found at the retrolingual level.Conclusion In terms of the retropalatal AP and lateral diameters, a higher BMI is associated with a greater incidence of more severe obstruction.

Background and Objectives The most common cause of snoring in children is enlarged tonsils and adenoids. However, there is insufficient evidence to determine whether the subjective measurement of tonsil hypertrophy, the most common prevailing method, reflects the actual tonsil size and volume. Therefore, we tried to determine whether the subjective grading of tonsil size and actual tonsil volume is related, and whether tonsil volume, weight, and adenoid index are correlated with the acoustic analysis of snoring.Subjects and Method The study was conducted on 21 children between the ages of 4 and 15 who came for tonsillectomy and adenoidectomy due to snoring symptoms. The degree of adenotonsillar hypertrophy was measured using the Brodsky grading scale and adenoid index. After tonsillectomy, the volume and weight of resected tonsil were measured. For acoustic analysis, the Praat software was used to determine formant frequency and sound intensity. A linear regression model and a dummy variable were used to determine the correlation between the quantitative values of tonsil, adenoid and the result of acoustic analysis.Results The Brodsky tonsil grade tended to match the actual tonsil volume, but it was not statistically significant (p=0.073). There was no correlation between snoring intensity and actual tonsil volume, weight, and adenoid index. Formant frequency 1 and 2 were statistically negatively correlated with the actual tonsil volume (p=0.011, 0.002).Conclusion The study confirmed that the acoustic analysis of pediatric snoring could be a screening test to predict tonsil volume and changes in the vocal tract due to tonsil hypertrophy.

Background Malignant phyllodes tumour (MPT) is a rare breast malignancy with epithelial and mesenchymal features. Currently, there are no appropriate research models or effective targeted therapeutic approaches for MPT. Methods We collected fresh frozen tissues from nine patients with MPT and performed whole-exome and RNA sequencing. Additionally, we established patient-derived xenograft (PDX) models from patients with MPT and tested the efficacy of targeting dysregulated pathways in MPT using the PDX model from one MPT. Results MPT has unique molecular characteristics when compared to breast cancers of epithelial origin and can be classified into two groups. The PDX model derived from one patient with MPT showed that the mouse epithelial component increased during tumour growth. Moreover, targeted inhibition of platelet-derived growth factor receptor (PDGFR) and phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) by imatinib mesylate and PKI-587 showed in vivo tumour suppression effects. Conclusions This study revealed the molecular profiles of MPT that can lead to molecular classification and potential targeted therapy, and suggested that the MPT PDX model can be a useful tool for studying the pathogenesis of fibroepithelial neoplasms and for preclinical drug screening to find new therapeutic strategies for MPT.

The clinical progression of neurodegenerative diseases correlates with the spread of proteinopathy in the brain. The current understanding of the mechanism of proteinopathy spread is far from complete. Here, we propose that inflammation is fundamental to proteinopathy spread. A sequence variant of α-synuclein (V40G) was much less capable of fibril formation than wild-type α-synuclein (WT-syn) and, when mixed with WT-syn, interfered with its fibrillation. However, when V40G was injected intracerebrally into mice, it induced aggregate spreading even more effectively than WT-syn. Aggregate spreading was preceded by sustained microgliosis and inflammatory responses, which were more robust with V40G than with WT-syn. Oral administration of an anti-inflammatory agent suppressed aggregate spreading, inflammation, and behavioral deficits in mice. Furthermore, exposure of cells to inflammatory cytokines increased the cell-to-cell propagation of α-synuclein. These results suggest that the inflammatory microenvironment is the major driver of the spread of synucleinopathy in the brain.

Background: This retrospective study aimed to determine whether there were correlations between the number and type of accompanying symptoms of peripheral facial nerve palsy, and surface electromyography (SEMG) and clinical assessment scales to help diagnosis.Methods: There were 30, cases of peripheral facial nerve palsy at Visit 1 to the Korean Medicine Hospital, Dong-eui University, 22 cases at Visit 2 and 10 cases at Visit 3. The study period was from July 19, 2021 to November 31, 2021. Symptoms were evaluated three times (with two-week intervals which began 7 days from onset) using SEMG, clinical assessment scales and accompanying symptoms. In this study, the House-Brackmann grading system (HBGS), and the Yanagihara’s unweighted grading system (Y-score) clinical assessment scales were used. The Pearson or Spearman correlation was used for statistical analysis.Results: On Visit 1, the number of accompanying symptoms of peripheral facial nerve palsy had no significant correlation with other measures. On Visits 1-3, the HBGS score had a significant negative correlation with the Y-score. On Visit 2, most of the mean values measured had significant correlations with each other although not between SEMG-Z and SEMG-O that Z means a zygomaticus muscle and O means a orbicularis oris muscle. On Visit 3, the number of accompanying symptoms significantly correlated with the clinical assessment scales. The HBGS score, Y-score, and SEMG measurements (except SEMG-Z) had significant correlations with each other. A significant positive correlation between SEMG-Z and SEMG-T was noted.Conclusion: We predict accompanying symptoms can be used to diagnose the peripheral facial nerve palsy including both clinical assessment scales and SEMG measurements at 2-5 weeks after onset.

SUMMARYThunder-induced seismic waves recorded at dense seismic stations in Seoul, South Korea are analysed for inversion of thunder source spectra. Thunder-induced seismic waves from four local thunder events are analysed. A theory is introduced for the inversion of acoustic source spectra from thunder-induced seismic waves. In the course of source-spectral inversion, the propagation and acoustic-to-seismic coupling effects are counted. The thunder-induced seismic signals were well identified at distances of 20 Hz). Vertical peak ground accelerations of thunder-induced seismic waves in local regions (0.024–0.110 m s−2 at distances of 2.4–3.7 km) are equivalent to the ground motion levels induced by a moderate-size (∼M5) earthquake at regional distances. The thunder-induced acoustic waves in the atmosphere are obtained by removing the acoustic-to-seismic coupling effect and site-response effect from the observed thunder-induced seismic waves. The quality factors for acoustic wave attenuation in the atmosphere are determined. Urban landscapes and atmospheric effects cause strong acoustic attenuation over atmospheric absorption. Acoustic thunder source spectra are determined by stacking the inverted acoustic spectra at all stations. The peak frequencies of acoustic thunder source spectra are around 34–36 Hz, suggesting the acoustic energy per unit length in lightning strikes to be ∼4 × 106 J m−1. Local seismic records are applicable for the investigation of thunder and lightning properties.

DNA methyltransferases (Dnmts) play an important role in regulating DNA methylation during early developmental processes and cellular differentiation. In this study, we aimed to investigate the role of Dnmts in neural differentiation of embryonic stem cells (ESCs) and in maintenance of the resulting neural stem cells (NSCs).We used three types of Dnmt knockout (KO) ESCs, including Dnmt1 KO, Dnmt3a/3b double KO (Dnmt3 DKO), and Dnmt1/3a/3b triple KO (Dnmt TKO), to investigate the role of Dnmts in neural differentiation of ESCs. All three types of Dnmt KO ESCs could form neural rosette and differentiate into NSCsTaken together, the data suggested that, although deficiency of Dnmts had no effect on the differentiation of ESCs into NSCs, the latter had defective maintenance, thereby indicating that Dnmts are crucial for self-renewal of NSCs.

The purpose of this study is to identify the factors affecting the job stress of commercial sports center workers on organizational commitment and turnover intention. The causal relationship between their demographic characteristics and job stress was investigated for 261 out of 300 workers working at commercial sports centers in Seoul, Incheon, and Gyeonggi province. There was a difference by work type, and it was found that there was a difference between regular and contract workers. Role-related and interpersonal relationships had a negative influence relationship in terms of tenure commitment, normative commitment, and affective commitment. Job characteristics, role-related, interpersonal relationship, and compensation system had an influence on turnover intention. In other words, it was found that role-related and interpersonal relationships had a positive effect on turnover intention, and job characteristics and compensation system had a negative effect on turnover intention. It was found that job stress affects both organizational commitment and turnover intention. The results of this study indicate that job stress, organizational commitment, and turnover intention should be dealt with mainly in order to reduce turnover intention of commercial sports center workers. In other words, clearer guidelines on the role of commercial sports center workers and various welfare programs for improving human relationships should be provided. Therefore, commercial sports centers should continuously research and develop ways to maximize job satisfaction from the perspective of workers in order to reduce job stress and induce positive organizational commitment.

Resolving the spatial distribution of RNA and protein in tissues at subcellular resolution is a challenge in the field of spatial biology. We describe spatial molecular imaging, a system that measures RNAs and proteins in intact biological samples at subcellular resolution by performing multiple cycles of nucleic acid hybridization of fluorescent molecular barcodes. We demonstrate that spatial molecular imaging has high sensitivity (one or two copies per cell) and very low error rate (0.0092 false calls per cell) and background (~0.04 counts per cell). The imaging system generates three-dimensional, super-resolution localization of analytes at ~2 million cells per sample. Cell segmentation is morphology based using antibodies, compatible with formalin-fixed, paraffin-embedded samples. We measured multiomic data (980 RNAs and 108 proteins) at subcellular resolution in formalin-fixed, paraffin-embedded tissues (nonsmall cell lung and breast cancer) and identified18 distinct cell types, ten unique tumor microenvironments and 100 pairwise ligand-receptor interactions. Data on800,000 single cells and ~260 million transcripts can be accessed at http://nanostring.com/CosMx-dataset .

The myofibril protein (MP) isolate-saccharide graft reactions was prepared using the Maillard reaction with saccharides. The effects of various saccharides on protein functionality and quality of the Maillard reaction were investigated and compared with those of MP. The grafting degree of the MP isolate-saccharide graft reaction was significantly higher in the reducing sugar-treated groups (lactose, glucose, fructose, and palatinose). The browning intensity of the MP isolate-saccharide graft reaction with fructose, sucrose, and erythitol was higher than that observed in the control reaction (p0.05). MP that reacted with reducing sugars (glucose, fructose, palatinose, and lactose) had fainter bands than MP that reacted with non-reducing sugars (sucrose, erythitol, trehalose, sorbitol, and xylitol). MPs conjugated with glucose exhibited higher protein solubility. The palatinose and lactose treatments were maximum in water binding capacity, though no significant difference in oil binding capacity among the saccharide treatments was observed. The emulsion stability of the MP isolate-saccharide graft reaction with palatinose and erythitol was higher than that of the control reaction. Therefore, reducing sugars have good protein functionality in the MP isolate-saccharides graft reaction.

The drying of duck blood provides safety and commercial benefits, but each drying method has its own characteristics. Moreover, information on the effects of diverse drying methods on the quality of duck blood is limited. This study aimed to investigate the effects of various drying methods on the chemical and functional properties of duck blood. The physicochemical characteristics and functional properties of duck blood subjected to spray drying (SD), freeze drying (FD), vacuum drying (VD), and hot air drying (HD) were examined. The carbonyl content of FD duck blood powder was the lowest and the thermal stability was higher than that of the other treatments (p0.05). The gel obtained from spray-dried blood displayed the lowest malondialdehyde content. The hardness, gumminess, and chewiness were the highest in the heat-induced gel prepared from FD duck blood powder (p0.05). The gel obtained from FD duck blood displayed a denser structure than the other gel samples. Taken together, the FD duck blood exhibited excellent chemical properties and processing suitability.

We introduce a novel method to determine the azimuthal orientation of borehole seismometer using microseisms that are ubiquitously present in seismic records. The microseisms are dominantly composed of Rayleigh waves that construct plane wavefronts over local stations. We determine the borehole seismometer orientation by comparing the polarization directions of Rayleigh waves in microseisms between borehole and surface stations. The Rayleigh wave polarization directions are determined using the nature of Rayleigh wave ground motions that present a 90° phase difference between the radial and vertical components. The azimuthal differences in apparent Rayleigh wave polarization directions between borehole seismometer and local surface seismometer provide information on the misorientation angle of borehole seismometer. Both the primary and secondary microseisms can be used. The method is applied to determine the misorientation angles of two deep borehole seismometers in the Yonsei Earth Observatory in Seoul, South Korea. The misorientation angles of borehole seismometers are determined stably using 18-hour-long ambient noise records, suggesting instant determination of borehole seismometer orientation based on short-time ambient noise records. Regional-event seismic waveforms at borehole seismometers match well with those at collocated surface station, supporting the correct determination of borehole seismometer orientation. The proposed method does not require information on seismic source locations and ray paths unlike conventional methods, allowing prompt determination of borehole seismometer orientation with high precision.

Cell-to-cell propagation of α-synuclein is thought to be the underlying mechanism of Parkinson’s disease progression. Recent evidence suggests that inflammation plays an important role in the propagation of protein aggregates. However, the mechanism by which inflammation regulates the propagation of aggregates remains unknown. Here, using in vitro cultures, we found that soluble factors secreted from activated microglia promote cell-to-cell propagation of α-synuclein and further showed that among these soluble factors, TNF-α had the most robust stimulatory activity. Treatment of neurons with TNF-α triggered cellular senescence, as shown by transcriptomic analyses demonstrating induction of senescence-associated genes and immunoanalysis of senescence phenotype marker proteins. Interestingly, secretion of α-synuclein was increased in senescent neurons, reflecting acquisition of a senescence-associated secretory phenotype (SASP). Using vacuolin-1, an inhibitor of lysosomal exocytosis, and RNAi against rab27a, we demonstrated that the SASP was mediated by lysosomal exocytosis. Correlative light and electron microscopy and immunoelectron microscopy confirmed that propagating α-synuclein aggregates were present in electron-dense lysosome-like compartments. TNF-α promoted the SASP through stimulation of lysosomal exocytosis, thereby increasing the secretion of α-synuclein. Collectively, these results suggest that TNF-α is the major inflammatory factor that drives cell-to-cell propagation of α-synuclein by promoting the SASP and subsequent secretion of α-synuclein.

Although natural language processing (NLP) can rapidly extract disease labels from radiology reports to create datasets for deep learning models, this may be less accurate than having radiologists manually review the images. In this study, we compared agreement between natural language processing (NLP) and radiologist-curated labels for possible tuberculosis (TB) on chest radiographs (CXR) and evaluated the performance of deep convolutional neural networks (DCNN) trained to identify TB using the preceding two sets of labels. We collected 10,951 CXRs from the NIH ChestX-ray14 dataset and labeled them as positive or negative for possible TB based on two methods: 1) NLP-derived disease labels and 2) radiologist-review of images. These images were used to train DCNNs on varying dataset sizes for possible TB and tested on an external dataset of 800 CXRs. Area under the ROC curve (AUC) was used to evaluate DCNNs. There was poor agreement between NLP and radiologist-curated labels for potential TB (Kappa coefficient 0.34). DCNNs trained using radiologist-curated labels had higher performance than the algorithm trained using the NLP-labels, regardless of the number of images used for training. The best-performing DCNN had an AUC of 0.88, which was trained on 10,951 images using the radiologist-annotated sets. DCNNs trained on CXRs labeled by a radiologist consistently outperformed those trained on the same CXRs labeled by NLP, highlighting the benefit of radiologists' determining groundtruth for machine learning dataset curation.

Background Few studies have assessed the correlation between coexisting mental disorders in participants with diabetes mellitus (DM) and the risk of heart failure (HF). Herein, we conducted a cohort study to determine the association between the accumulation of mental disorders in participants with DM and the risk of HF. Methods The Korean National Health Insurance Service records were assessed. 2,447,386 adults with DM who underwent health screening between 2009 and 2012 were analyzed. Participants with major depressive disorder, bipolar disorder, schizophrenia, insomnia, or anxiety disorders were included. In addition, participants were categorized based on the number of coexisting mental disorders. Each participant was followed until December 2018 or until the onset of HF. Cox proportional hazard modelling with confounding factors adjustment was conducted. In addition, a competing risk analysis was conducted. Subgroup analysis assessed the impact of clinical variables on the association between the accumulation of mental disorders and the risk of HF. Results The median follow-up duration was 7.09 years. The accumulation of mental disorders was associated with a risk of HF (zero mental disorder (0), reference; 1 mental disorder, adjusted hazard ratio (aHR): 1.222, 95% confidence intervals (CI): 1.207–1.237; 2 mental disorders, aHR: 1.426, CI: 1.403–1.448; ≥3 mental disorders, aHR: 1.667, CI: 1.632–1.70. In the subgroup analysis, the strength of association was the strongest in the younger age group (inter Conclusions Comorbid mental disorders in participants with DM are associated with an increased risk of HF. In addition, the association was stronger in a younger age group. Participants with DM and mental disorders should be monitored with increased frequency for signs of HF; for which they have a higher risk than the general population.