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[Display omitted] Allergic rhinitis (AR) phenotypes in childhood are unclear. This study sought to determine AR phenotypes and investigate their natural course and clinical and transcriptomic characteristics. Latent class trajectory analysis was used for phenotyping AR in 1050 children from birth through 12 years using a birth cohort study. Blood transcriptome analyses were performed to define the underlying mechanisms of each phenotype. Five AR phenotypes were identified: early onset (n = 88, 8.4%), intermediate transient (n = 110, 10.5%), late onset (n = 209, 19.9%), very late onset (n=187, 17.8%), and never/infrequent (n = 456, 43.4%). Children with early-onset AR were associated with higher AR severity and sensitizations to foods at age 1 year and inhalants at age 3 years and asthma symptoms, but not with bronchial hyperresponsiveness (BHR). Children with late-onset AR phenotype associated with sensitizations to various foods at age 1 year but not from age 3 years, and to inhalants from age 7 years and with asthma with BHR. Children with very late–onset AR phenotype associated with sensitizations to foods throughout preschool age and to inhalants at ages 7 and 9 years and with asthma with BHR. Transcriptome analysis showed that early-onset AR was associated with viral/bacterial infection–related defense response, whereas late-onset AR was associated with T cell–related immune response. Early-onset AR phenotype was associated with sensitization to foods and inhalants at an early age and asthma symptoms, but not with BHR, whereas very late– and late-onset AR phenotypes were positively associated with sensitization to inhalants and asthma with BHR. Transcriptomic analyses indicated that early- and late-onset AR phenotypes had distinct underlying mechanisms related to AR as well. [ABSTRACT FROM AUTHOR]

The risks of leaflet thrombosis and the associated cerebral thromboembolism are unknown according to different anticoagulation dosing after transcatheter aortic valve replacement (TAVR). The aim was to evaluate the incidence of leaflet thrombosis and cerebral thromboembolism between low-dose (30 mg) or standard-dose (60 mg) edoxaban and dual antiplatelet therapy (DAPT) after TAVR. In this prespecified subgroup analysis of the ADAPT-TAVR trial, the primary endpoint was the incidence of leaflet thrombosis on 4-dimensional computed tomography at 6-months. Key secondary endpoints were new cerebral lesions on brain magnetic resonance imaging and neurological and neurocognitive dysfunction. Of 229 patients enrolled in this study, 118 patients were DAPT group and 111 were edoxaban group (43 [39.1%] 60 mg vs 68 [61.3%] 30 mg). There was a significantly lower incidence of leaflet thrombosis in the standard-dose edoxaban group than in the DAPT group (2.4% vs 18.3%; odds ratio [OR] 0.11; 95% confidence interval [CI], 0.01-0.55; P =.03). However, no significant difference was observed between low-dose edoxaban and DAPT (15.0% vs 18.3%; OR 0.79; 95% CI, 0.32-1.81; P =.58). Irrespective of different antithrombotic regiments, the percentages of patients with new cerebral lesions on brain MRI and worsening neurological or neurocognitive function were not significantly different. In patients without an indication for anticoagulation after TAVR, the incidence of leaflet thrombosis was significantly lower with standard-dose edoxaban but not with low-dose edoxaban, as compared with DAPT. However, this differential effect of edoxaban on leaflet thrombosis was not associated with a reduction of new cerebral thromboembolism and neurological dysfunction. OAC = Oral anticoagulation; SLT = Subclinical leaflet thrombosis; TIA = Transient ischemic attack [Display omitted] [ABSTRACT FROM AUTHOR]

Subclinical aortic valve complex (valvular and perivalvular) thrombus is not rare after transcatheter aortic valve replacement (TAVR). The risk factors and clinical implications of these findings remain uncertain. This study sought to evaluate the frequency, predictors, and clinical outcome of aortic valve complex thrombus after TAVR. In the ADAPT-TAVR (Anticoagulation Versus Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization After Transcatheter Aortic Valve Replacement) trial comparing edoxaban vs dual antiplatelet therapy in TAVR patients without an indication for chronic anticoagulation, the frequency of valvular (subclinical leaflet thrombus) and perivalvular (supravalvular, subvalvular, and sinus of Valsalva) thrombus was evaluated by 4-dimensional computed tomography at 6 months. The association of these phenomena with new cerebral thromboembolism on brain magnetic resonance imaging, neurologic and neurocognitive dysfunction, and clinical outcomes was assessed. Among 211 patients with 6-month computed tomography evaluations, 91 patients (43.1%) had thrombus at any aortic valve complex, 30 (14.2%) patients had leaflet thrombus, and 78 (37.0%) patients had perivalvular thrombus. A small maximum diameter of the stent at the valve level and low body surface area were independent predictors of aortic valve complex and perivalvular thrombus, and decreased renal function was an independent predictor of leaflet thrombus. No significant differences were observed in new cerebral lesions, neurologic or neurocognitive functions, or clinical outcomes among patients with or without valvular or perivalvular thrombus. Subclinical aortic valve complex (valvular and perivalvular) thrombus was common in patients who had undergone successful TAVR. However, these imaging phenomena were not associated with new cerebral thromboembolism, neurologic or neurocognitive dysfunction, or adverse clinical outcomes. (Anticoagulation Versus Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization After Transcatheter Aortic Valve Replacement [ADAPT-TAVR]; NCT03284827) [Display omitted] [ABSTRACT FROM AUTHOR]

The accurate differential diagnosis between autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC) is clinically important. We aimed to determine significant MRI features for differentiating AIP from PDAC, including assessment of diffusion-weighted imaging (DWI). We performed a systematic search using three databases. The pooled diagnostic odds ratio was calculated using a bivariate random effects model to determine significant MRI features for differentiating AIP from PDAC. The pooled sensitivity and specificity were calculated. The qualitative systematic review for DWI assessment was performed. Of nine studies (775 patients), multiple main pancreatic duct (MPD) strictures, absence of upstream marked MPD dilatation, peripancreatic rim, and duct penetration sign were significant MRI features for differentiating AIP from PDAC. Absence of MPD dilatation had the highest pooled sensitivity (87%, 95% CI=68–96%), whereas peripancreatic rim had the highest pooled specificity (100%, 95% CI=88–100%). Of 12 studies evaluating DWI, seven reported statistically significant differences in apparent diffusion coefficient (ADC) values between AIP and PDAC; however, four reported lower ADC values in AIP than in PDAC, but three reported the opposite result. The four significant MRI features can be useful to differentiate AIP from PDAC, but DWI assessment might be limited. [ABSTRACT FROM AUTHOR]

Sarcopenia, known as physical frailty, is highly prevalent in older patients and is related to adverse outcomes after cardiac surgery. However whether sarcopenia assessment can reclassify an individual patient's risk, which is estimated by Society of Thoracic Surgeons–predicted risk of mortality scores in patients who undergo surgical aortic valve replacement, is unclear. This retrospective, single-center, cohort study comprised 874 patients aged ≥65 years who underwent surgical aortic valve replacement between 2009 and 2016. Total skeletal muscle area was calculated using height squared (cm2/m2) and was measured by preoperative computed tomography at the third lumbar vertebra inferior border using machine learning–based analysis. Sex-specific Z-scores were calculated, and patients in the lowest Z-score tertile were considered to have sarcopenia. The primary endpoint was 30-day mortality, and secondary endpoints were in-hospital events, 1-year mortality, and long-term mortality. Thirty-day mortality, 30-day in-hospital events, and 1-year mortality rates were 4.7%, 17.6%, and 8.0%, respectively. As the Z-score decreased, the odds of an early adverse event showed a stepwise increase. Sarcopenia was independently associated with higher 30-day mortality, 30-day in-hospital events, and 1-year mortality. Reclassification analyses showed improvements in the ability to predict early adverse events after adding the Z-scores over and above The Society of Thoracic Surgeons–predicted risk of mortality scores (all P <.005). Sarcopenic patients had significantly higher risks of early adverse events and long-term mortality after undergoing surgical aortic valve replacement than nonsarcopenic patients. Sarcopenia determined by preoperative computed tomography can enhance the prediction of postoperative outcome risk. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] • Red imported fire ant (RIFA), hitchhiked in lumber can cause economic damage. • RIFA was more sensitive to ethyl formate fumigation than Japanese termite (JP). • EF effectively controlled JP at four different temperatures (<5, 5, 13, 23 °C). • 4 h-EF-fumigation completely controlled JP on imported lumber in commercial trials. The interception of exotic ants and termites from stone and lumber imported into Korea is on the rise, including Solenopsis invicta. Currently, a relatively long exposure (24 h) of methyl bromide (MB) fumigation is the only practical disinfestation option for exotic ants and termites on imported stone and lumber. In this study, ethyl formate (EF) wase evaluated as a potential MB alternative to disinfest ants and termites in imported lumber, with a focus on S. invicta. As S. invicta is not established in Korea, we first determined whether Reticulitermes speratus , established in Korea, could be considered as an EF surrogate of S. invicta. From 1 h EF fumigation trials, workers of S. invicta were more sensitive to EF than those of R. speratus based on lethal concentration × time causing 99% mortality (LCt 99%), supporting that R. speratus can be used as an EF surrogate of S. invicta. When R. speratus workers were further fumigated with EF for 4 h at four different temperatures, LCt 99% values for R. speratus workers were 108.00, 63.31, 77.24, and 67.24 g h/m3 at 2, 5, 13, and 23 °C, respectively. From scale-up (0.65 m3) and commercial scale (76.4 m3) trials containing two infestation-prone lumber species, lauan (Shorea spp.) and acacia (Acacia spp.), 140 g/m3 EF at >5 °C for 4 h resulted in the complete control of R. speratus workers, suggesting that 140 g/m3 4 h-EF-fumigation may be applicable as a potential MB-alternative treatment for disinfestation of invasive S. invicta on imported lumber. [ABSTRACT FROM AUTHOR]

We have sought to develop proper and useful indices for muscle quality measurements other than muscle attenuation (Hounsfield unit; HU) and to determine the diagnostic cutoff points for myosteatosis by using those indices measured at the L3 lumbar vertebrae level by CT scan. This cross-sectional analysis included 20,664 healthy adult subjects (12,697 men and 7967 women) who underwent abdominal CT scans. Total abdominal muscle area (TAMA), on the L3 vertebra was demarcated using predetermined thresholds. Intermuscular adipose tissue area (IMAT) and skeletal muscle area (SMA) were measured. SMA was divided into normal attenuation muscle area (NAMA) and low attenuation muscle area (LAMA). Their various indices were calculated. We identified the sex-specific mean values of NAMA, LAMA, IMAT, and their indices and the cutoff points equivalent to the T-scores in the young reference group. The mean values of the NAMA and NAMA indices decreased with age in both sexes, LAMA, IMAT, and their indices showed an increasing tendency with age in both sexes. When using T-score < −2.0 as the cutoff for myosteatosis, the sex-specific cutoff points of NAMA, NAMA/BMI, NAMA/TAMA index, and SMA and TAMA attenuation in men and women were 103.0 and 64.5 cm2, 4.0 and 2.8, 66.4 and 65.1, 40.2 and 39.9 HU, and 34.1 and 33.5 HU, respectively. Using these cutoff points, the prevalence of myosteatosis by NAMA, NAMA/BMI, NAMA/TAMA index, or SMA or TAMA attenuation ranged from 5.9 to 8.8% in men and from 10.2 to 20.5% in women. The NAMA/TAMA index developed in this study was useful for assessing myosteatosis. This is the first study to report the sex-specific diagnostic cutoff points for myosteatosis of trunk muscles based on T-scores measured by CT scans in healthy population. These diagnostic cutoff points may be particularly useful in the treatment and prevention of sarcopenia and myosteatosis. [ABSTRACT FROM AUTHOR]

The relationship between allergic and eosinophilic inflammation, either systemic or local, in allergic diseases remains unclear. We performed combined genome-wide association study (GWAS) and epigenome-wide (EWAS) for atopy and tissue eosinophilia to identify both genetic and epigenetic signatures between systemic and local allergic inflammation, and to capture global patterns of gene regulation. We included 126 subjects for atopy analysis and 147 for tissue eosinophilia analysis, as well as 18 normal nasal tissue samples. We identified differentially methylated positions (DMPs) and genes associated with atopy and tissue eosinophilia. Furthermore, we performed mendelian randomization analysis and penalized regression along with replication in an independent cohort. EWAS identified genes, including Musashi RNA binding protein 2 (MSI2) , associated with atopy, which contained enriched DMPs that genetically affect atopy. A direct association was observed between MSI2 single-nucleotide polymorphisms and atopy, as was a causal effect of changes in MSI2 expression and methylation on atopy, which was replicated in a Costa Rican population. Regarding tissue eosinophilia, EWAS identified genes with enriched DMPs directly contributing to tissue eosinophilia at the gene level, including CAMK1D. The gene ontology terms of the identified genes for both phenotypes encompassed immune-related terms. EWAS combined with GWAS identified novel candidate genes, especially the methylation of MSI2 , contributing to systemic allergic inflammation. Certain genes displayed a greater association with either systemic or local allergic inflammation; however, it is expected that a harmonized effect of these genes influences immune responses. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: We investigated whether adoptive cell therapy with ex vivo-activated natural killer (NK) cells enhances the therapeutic efficacy of local tumor radiation therapy (RT) using a human triple-negative breast cancer xenograft model.Methods and Materials: NK cells from healthy donors were expanded ex vivo. MDA-MB-231/Luc-GFP cells were subcutaneously implanted into the thighs of NSG mice. The animals were divided into 4 experimental groups: control, RT, NK, and RT + NK. On day 17 after tumor implantation, tumors from the RT groups were irradiated. The ex vivo-expanded NK cells were intravenously administered twice, on days 17 and 19. Primary and secondary tumors were evaluated using long-term bioluminescence imaging, and histopathology was performed on resected tumor tissue specimens.Results: The luciferase signals of the primary tumors in the RT + NK group were significantly lower than those of comparably sized primary tumors in the RT group. The long-term migration and infiltration of NK cells into the primary tumor sites were significantly higher in RT + NK than in NK mice. Moreover, lymphatic metastasis to the axillary lymph nodes and liver and lung metastases were highly suppressed in the RT + NK group, as demonstrated by BLI and p53 immunohistochemistry. The long-term survival of the RT + NK group was significantly higher than that of the RT or NK groups.Conclusions: Reduction in tumor burden by combining RT and systemic NK cell therapy improved the suppression of primary tumor growth, with efficient NK cell migration and penetration into the primary tumor site. Administered NK cells were maintained in the primary tissue for a significantly longer time in RT + NK group compared with NK group. Both lymphatic spread and distant metastasis to the lungs and liver were effectively suppressed by the combined therapy. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: Variation in tissue damage after cerebral ischemia/reperfusion (I/R) can cause uncertainty in stroke-related studies, which can be reduced if the damage can be predicted early after ischemia by measuring the apparent diffusion coefficient (ADC). We investigated whether ADC measurement in the acute phase can predict permanent cerebral I/R injury.Materials and Methods: The middle cerebral artery occlusion model was established using the intraluminal suture method to induce 60 minutes of ischemia followed by reperfusion in rats. T2-weighted images and diffusion-weighted images were obtained at 30 minutes and 24 hours after ischemia. Neuronal cell survival was assessed by neuronal nuclei (NeuN) immunofluorescence staining. The correlation between relative ADC (rADC) values at 30 minutes and I/R injury at 24 hours after ischemia was analyzed. Magnetic resonance imaging results were confirmed by histologic analysis.Results: The correlation between rADC values at 30 minutes and 24 hours was strong in the ischemic core and peri-infarct region but moderate in the anterior choroidal and hypothalamic region. Histologic analysis revealed that the correlation between rADC values at 30 minutes and the number of NeuN-positive cells at 24 hours was strong in the ischemic core and peri-infarct region but moderate in the anterior choroidal and hypothalamic region. Furthermore, there was a strong positive correlation between the sum of rADC values of three regions at 30 minutes and the infarct volume at 24 hours.Conclusion: ADC measurement in the acute phase can predict permanent cerebral I/R injury and provide important information for the evaluation of ischemic stroke. [ABSTRACT FROM AUTHOR]

• The overall incidence of ALK inhibitor pneumonitis was 2.14% in advanced NSCLC. • Patients from Japanese cohorts had a higher incidence of ALK-inhibitor pneumonitis. • Further studies of mechanisms and risk factors of ALK pneumonitis are needed. We evaluated the incidence of pneumonitis in clinical trials of anaplastic lymphoma kinase (ALK) inhibitors in patients with advanced non-small cell lung cancer (NSCLC) and compared the incidence among different cohorts, in order to identify possible predisposing factors for ALK inhibitor-related pneumonitis. MEDLINE and EMBASE search up to 1/30/18 using the keywords, "alectinib", "ceritinib", "crizotinib", "brigatinib", and "lung cancer", resulting in a total of 20 eligible cohorts with 2261 patients treated with ALK inhibitor monotherapy for advanced NSCLC. The pooled incidences of all-grade, high-grade, and grade 5 pneumonitis were calculated. Subgroup analyses were conducted with meta-regression using study-level covariates. The overall pooled incidence of pneumonitis was 2.14% (95% CI: 1.37–3.34) for all grade, 1.33% (95% CI: 0.80–2.21) for high grade, and 0.22% (95% CI: 0.09-0.52) for grade 5 pneumonitis. The incidence was significantly higher in studies from Japan compared to studies of non-Japan origin, for all-grade (6.25% vs 1.14%, p < 0.001) and high-grade pneumonitis (3.31% vs 0.39%, p < 0.001). Multivariate meta-regression demonstrated the cohorts from Japanese studies had significantly higher odds of pneumonitis for all-grade (odds ratio [OR]: 4.329 [95% CI: 1.918, 9.770], p < 0.001) compared to those of non-Japan origin, after adjusting for types of ALK inhibitors. The overall incidence of ALK inhibitor pneumonitis was 2.14% in patients with advanced NSCLS. The patients from Japanese cohorts had a higher incidence of ALK-inhibitor pneumonitis, which indicates the need for increased awareness and caution for pneumonitis in Japanese patients treated with ALK inhibitors. [ABSTRACT FROM AUTHOR]

Abstract Aerosol chemistry measurements were performed during the routine monitoring periods in the urban atmosphere of Gwangju, Korea. Routine aerosol monitoring was carried out every sixth day in order to investigate the dependence of domestic sources and air mass transport characteristics on physicochemical and optical properties of atmospheric aerosol. Aerosol optical properties; atmospheric extinction and scattering coefficients were also measured continuously with a transmissometer and a nephelometer, respectively in order to investigate the causes of visibility impairment. Prevailing atmospheric condition was classified into four categories; one affected by stagnant condition (D), one affected by continental and domestic aerosols (CD), one affected by marine and domestic aerosols (MD), and one affected by continental, marine and domestic aerosols (CMD). Atmospheric condition type was further classified into thirteen sub-categories with the occurrences of episodic events such as Asian dust storm, biomass burning, and airborne pollen. The air mass types of D, CD, MD, and CMD were observed to be 11, 18, 43, and 78 events out of total 150 events, respectively. The fine mass concentration increased under continental air mass types. The average fine mass concentration of 23.0 ± 8.6 μg m−3 for CD type was slightly larger than that of 20.7 ± 5.2 μg m−3 for CMD type. Both of them were higher than that for D (18.9 ± 4.5 μg m−3) type. Increments of the fine mass concentrations for Asian dust storm (A) and Biomass-burning (B) events ranged from 141 to 151% and from 152 to 160% compared to those for D and CD types, respectively. The increments in the mass concentrations of nitrate, OC, EC, and BC for CD and CMD types in comparison with D air mass type were calculated to be approximately 17, 6, 8, and 22%, respectively. The mean mass extinction efficiency of PM 10 was relatively higher in D (3.6 ± 1.6 m2 g−1) type and B events (4.1 ± 1.5 m2 g−1), but it was the lowest in MD air mass type. The aerosols observed in Gwangju were found to be influenced by the continental aerosol during the A events. Aerosol of CMD air mass type caused mainly poor visibility. The visibility reduction of Gwangju was influenced by the increase of carbonaceous particles under both domestically stagnant condition and air mass pathway from the continent. And ammonium sulfates and ammonium nitrates contributed the largest in CMD air mass type. Highlights • The fine mass concentration increased under continental air mass types. • The biomass-burning events were mainly attributed to domestic aerosols. • The contributions of NHSO, NHNO, and OMC increased as visibility became poor. • Haze was dominantly influenced by visibility-impairing aerosol rather than RH. [ABSTRACT FROM AUTHOR]

Abstract Flexible zeolite fibers based on a core-shell fiber structure were prepared by an electrospinning method, and then the surface of the as-spun fiber was partially etched by a wet etching process. Zeolite porous ceramic particles were embedded in the core-shell fiber structure of poly(vinylidene fluoride) (PVDF)/polyvinylpyrrolidone (PVP), and the adsorption sites of the zeolite began to be exposed by partially wet etching of the hydrophilic PVP polymer in the shell parts. The specific surface area increased significantly by exposing the adsorption sites of the zeolite on the surface, and at the same time, flexibility and strength were maintained by the existing hydrophobic PVDF polymer acting as a skeleton. The morphology of the partially etched surface of the flexible zeolite fibers was observed by field-emission scanning electron microscopy (FE-SEM) and atomic force microscope (AFM), and the specific surface area was measured by N 2 adsorption/desorption isotherm. The improved adsorption/desorption characteristics of the flexible zeolite fiber filters were observed by gas chromatography (GC). Graphical abstract Unlabelled Image Highlights • Flexible zeolite fibers based on a core-shell fiber structure were prepared by a single step electrospinning process. • The adsorption sites of the zeolite began to be exposed by wet-etching of the hydrophilic PVP in the shell. • The specific surface area increased significantly by exposing the adsorption sites of the zeolite on the surface. • The zeolite fibers had high flexibility and high strength by remaining the hydrophobic PVDF in the skeleton. • The improved adsorption/desorption characteristics of the flexible zeolite fiber filters were observed by GC. [ABSTRACT FROM AUTHOR]

Four naphthalimide-based dyes with a diacetylene linkage at the 3- or 4-position were synthesized to improve the thermal stability of the fluorescence dye as well as the efficiency of fluorescent emission at blue region. The absorption and fluorescence properties of the synthesized dyes were also investigated. The geometries and molecular orbitals of the dyes prepared were simulated using by density functional theory and time-dependent density functional theory using Gaussian 09. Furthermore, the suitability of the dyes for application in light-conversion films was examined. N -Phenyl groups were found to have a greater effect on the fluorescence of naphthalimide-based dyes than analogue containing an N -alkyl group. In addition, investigation of the effect of diacetylene linkages at the 3- or 4-positions of naphthalimide-based dyes showed that the fluorescence was influenced by the electron-donating effect of the diacetylene linkage which could afford more conjugation of π orbitals of the dyes. Four blue fluorescence dyes derived from 1,8-naphthalimide containing a diacetylene linkage were synthesized and then coated in PE film. The photophysical properties were analyzed using density functional theory (DFT) calculations, and excitations from the highest occupied molecular orbitals (HOMOs) to the lowest unoccupied molecular orbitals (LUMOs) of the dyes were simulated at the B3LYP/6-31G level of theory via the Gaussian 09 suite of programs. Using these methods, the influences of the position of the ethynyl linkages, alkyl groups, and phenyl groups on the electronic and fluorescence properties of the dyes were also clarified. [ABSTRACT FROM AUTHOR]

Before the 21st century, visibility monitoring techniques are mainly categorized by human eye-based and optical-based measurements. In order to automate and objectify the former measurement, the latter measurement method has been developed and meteorological optical range (MOR) is used as a concept similar to the visual range. However, in the 21st century, MOR has been found to have some differences with visual range that is recognized by human beings. As image analysis technology is improved, a variety of image-based on-site visibility measurement techniques are being developed using a camera. In this study, image-based visibility measurement that is based on the measured distance to visible objects was performed at about 3 km northwest of the Seoul Meteorological Observatory where the human eye-based and the optical-based visibility monitoring are observed simultaneously. As a result of correlation analysis between three measurement data, the image-based visual range (IVR) was found to be more comparable to the human eye-based visual range (HVR) than to the optical-based MOR. HVR tended to be lower than IVR as visibility improved, but MOR was predominantly higher than IVR as visibility was reduced. Perceived visibility measurement of IVR and HVR were revealed to be more accurate in severe poor visibility conditions. In this study, the system uncertainty of IVR estimation is expected to be within 10% up to about 33 km and approach 20% under above a hundred km of visibility. The Visual Range Meter (VRM) program developed for IVR estimation was made up of an individual measurement mode and a real-time measurement mode. The operational errors of approximately 15% excluding precipitation and other meteorological effects occurred in real-time IVR estimation using the VRM. [ABSTRACT FROM AUTHOR]

Background Perturbations of the infant gut microbiota can shape development of the immune system and link to the risk of allergic diseases. Objective We sought to understand the role of the gut microbiome in patients with atopic dermatitis (AD). The metagenome of the infant gut microbiome was analyzed according to feeding types. Methods Composition of the gut microbiota was analyzed in fecal samples from 129 infants (6 months old) by using pyrosequencing, including 66 healthy infants and 63 infants with AD. The functional profile of the gut microbiome was analyzed by means of whole-metagenome sequencing (20 control subjects and 20 patients with AD). In addition, the total number of bacteria in the feces was determined by using real-time PCR. Results The gut microbiome of 6-month-old infants was different based on feeding types, and 2 microbiota groups ( Bifidobacterium species–dominated and Escherichia/Veillonella species–dominated groups) were found in breast-fed and mixed-fed infants. Bacterial cell amounts in the feces were lower in infants with AD than in control infants. Although no specific taxa directly correlated with AD in 16S rRNA gene results, whole-metagenome analysis revealed differences in functional genes related to immune development. The reduction in genes for oxidative phosphorylation, phosphatidylinositol 3-kinase–Akt signaling, estrogen signaling, nucleotide-binding domain–like receptor signaling, and antigen processing and presentation induced by reduced colonization of mucin-degrading bacteria ( Akkermansia muciniphila , Ruminococcus gnavus , and Lachnospiraceae bacterium 2_1_58FAA) was significantly associated with stunted immune development in the AD group compared with the control group ( P < .05). Conclusions Alterations in the gut microbiome can be associated with AD because of different bacterial genes that can modulate host immune cell function. [ABSTRACT FROM AUTHOR]

In this study, a composite polymer matrix for gel polymer electrolyte (GPE) is prepared by the electrospinning process, combining poly(vinylidene fluoride-co-hexafluoropropylene) and nano-sized Al 2 O 3 ceramic particles. The composite matrix is impregnated with a liquid electrolyte to prepare the GPE-Al 2 O 3 composite and its properties are compared with those of pure GPE. The GPE-Al 2 O 3 composite improves the interfacial resistance, ion coordination and the electrochemical stability of the GPE. The electrochemical performances are analyzed by applying the GPEs to LiNi 1/3 Mn 1/3 Co 1/3 O 2 (NMC) and Li 4 Ti 5 O 12 (LTO) cells. The GPE-Al 2 O 3 composite exhibits a higher discharge capacity than the GPE at 0.1 C-rate and excellent performance in both the LTO and the NMC half-cells under cyclic conditions. The GPE-Al 2 O 3 composite shows good compatibility and high electrochemical property on LTO/NMC full-cell. [ABSTRACT FROM AUTHOR]

Purpose: To create and validate an evidence-based prediction rule to optimize use of follow-up chest CT for ovarian cancer.Methods: In this Institutional Review Board-approved retrospective study performed at two academic medical centers, electronic medical records from January through December 2013 at center 1 (USA) and January 2012 through December 2013 at center 2 (South Korea) were searched to identify consecutive chest CTs performed within 5 years of initial cytoreductive surgery in patients with pathologically proven ovarian cancer. Three separate study cohorts were created: cohort 1, 316 CTs (in 150 patients) with high-grade serous ovarian cancer (HGSC) from center 1; cohort 2, 374 CTs (81 patients) with HGSC from center 2; and cohort 3, 87 CTs (56 patients) with non-HGSC histologies from center 1. A radiologist blinded to outcome of CT, using a prediction rule that utilized previously available information, categorized each CT into "high-risk" (stage 4 at presentation and/or preexisting abdominal disease [disease below diaphragmatic dome, visualized on abdominal CT]) or "low-risk" (neither of above). A blinded radiologist then reviewed chest CTs in random order to record thoracic metastases above the diaphragmatic dome, and outcome was compared with prediction rule risk category.Results: Among the three cohorts and in the total population, the prediction rule identified 94 of 316 (30%), 170 of 374 (45%), 53 of 87 (61%), and 317 of 777 (41%) CTs as "low-risk," respectively. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were as follows: cohort 1: 95%, 35%, 24%, 97%, 1.46, 0.14; cohort 2: 88%, 53%, 29%, 95%, 1.87, 0.22; cohort 3: 88%, 66%, 21%, 98%, 2.59, 0.18; total population: 91%, 47%, 26%, 96%, 1.72, 0.19. False-negative rate in the three cohorts and in total population was 3 of 94 (3%), 8 of 170 (5%), 1 of 53 (2%), and 12 of 317 (4%); however, in each of these cases there was concurrent new abdominal disease.Conclusions: The easy-to-use prediction rule helps avoid unnecessary chest CTs in patients with ovarian cancer with high sensitivity and negative predictive value, and with minimal risk of missing thoracoabdominal metastases. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the correlation between liver stiffness measurement using transient elastography (TE-LSM) and hepatic venous pressure gradient and the diagnostic performance of TE-LSM in assessing clinically significant portal hypertension through meta-analysis. Eleven studies were included from thorough literature research and selection processes. The summary correlation coefficient was 0.783 (95% confidence interval [CI], 0.737-0.823). Summary sensitivity, specificity and area under the hierarchical summary receiver operating characteristic curve (AUC) were 87.5% (95% CI, 75.8-93.9%), 85.3 % (95% CI, 76.9-90.9%) and 0.9, respectively. The subgroup with low cut-off values of 13.6-18 kPa had better summary estimates (sensitivity 91.2%, specificity 81.3% and partial AUC 0.921) than the subgroup with high cut-off values of 21-25 kPa (sensitivity 71.2%, specificity 90.9% and partial AUC 0.769). In summary, TE-LSM correlated well with hepatic venous pressure gradient and represented good diagnostic performance in diagnosing clinically significant portal hypertension. For use as a sensitive screening tool, we propose using low cut-off values of 13.6-18 kPa in TE-LSM. [ABSTRACT FROM AUTHOR]

A carbonating tank is continuously operated and filled with water supplied by an immersed flow injecting nozzle. At the same time, CO 2 gas is introduced from the gas tank. CO 2 gas can be dissolved in water and can form carbonated water with minimum production of gas bubbles depending on various process conditions. Therefore, the flow mixing phenomenon of CO 2 and water can be affected by the placement of the injecting nozzle and the flow rate in consideration of the interfacial surface. In this study, the gas–liquid flow mixing with the mass transport inside the carbonation process tank is numerically predicted. The Euler–Euler methodology is used to observe the effects of the design of the injecting nozzle, the gas bubble size, as well as the velocities of liquid and gas on the gas volume fraction, liquid velocity, gas concentration, interfacial area, and mass transfer coefficient. [ABSTRACT FROM AUTHOR]

Purpose: Steam popping frequently occurs during conventional high-power radiofrequency (RF) ablation, increasing the risk of tumor spread. The aim of this study was to evaluate the effect of a low-power RF ablation protocol on the intensity and timing of steam popping in ex vivo bovine liver.Materials and Methods: High-power (maximum 200 W; group 1) and low-power (maximum 70 W; group 2) RF ablation protocols were established. In the first phase, RF ablation was conducted for 12 min. Ablation volume, intensity, and timing of maximal popping sounds and total energy generated for RF ablation were compared between groups 1 and 2. In the second phase, RF ablation was conducted until maximal popping occurred, and ablation zones on histologic specimens were compared.Results: Relative to group 1, maximal popping occurred at significantly delayed timing in group 2 (50 s ± 11 vs 397 s ± 117; P < .001), but without a difference in intensity (ratios vs reference sound of 0.70 ± 0.18 vs 0.83 ± 0.26; P = .138). The ablation volume after 12 min of RF ablation did not differ between groups 1 and 2 (18.46 cm(3) ± 1.35 vs 15.78 cm(3) ± 0.64; P = .086). However, in the histologic specimens obtained when maximal popping occurred, the area of complete coagulative necrosis was significantly larger in group 2 (P < .05).Conclusions: Low-power RF ablation delays steam popping while providing comparable therapeutic effects to high-power RF ablation. Delaying maximal popping may prevent tumor cell dispersion because maximal popping occurs after an adequate ablation zone has been achieved. [ABSTRACT FROM AUTHOR]

Background Response Evaluation Criteria in Solid Tumours (RECIST)-based tumour burden measurements involve observer variability, the extent of which ought to be determined. Methods A literature search identified studies on observer variability during manual measurements of tumour burdens via computed tomography according to the RECIST guideline. The 95% limit of agreement (LOA) values of relative measurement difference (RMD) were pooled using a random-effects model. Results Twelve studies were included. Pooled 95% LOAs of RMD in measuring unidimensional longest diameters of single lesions ranged from −22.1% (95% confidence interval [CI], −30.3% to −14.0%) to 25.4% (95% CI, 17.2% to 33.5%) between observers and −17.8% (95% CI, −23.6% to −11.9%) to 16.1% (95% CI, 10.1% to 21.8%) for a single observer. Pooled 95% LOAs of RMD in measuring the sum of multiple lesions ranged from −19.2% (95% CI, −23.7% to −14.9%) to 19.5% (95% CI, 15.2% to 23.9%) between observers, and −9.8% (95% CI, −19.0% to −0.3%) to 13.1% (95% CI, 3.6% to 22.6%) for a single observer. Pooled 95% LOA of RMD in calculating the interval change of tumour burden with a single lesion ranged from −31.3% (95% CI, −46.0% to −16.5%) to 30.3% (95% CI, 15.3% to 44.8%) between observers. Studies on calculating the interval change of tumour burden for a single observer or with multiple lesions were lacking. Conclusion Interobserver RMD in measuring single tumour burden and calculating its interval change may exceed the 20% cut-off for progression. Variability decreased when tumour burden was measured by a single observer or assessed by the sum of multiple lesions. [ABSTRACT FROM AUTHOR]

This paper reports the systematic development of tape spring hinges for a solar array by an optimization method considering various deployment performances. The nonlinear behavior between the moment and the rotation angle of a tape spring hinge is determined through experimental results rather than through finite element analysis results or theoretical solutions in order to identify the moment–rotation profile accurately. Response surfaces comprising the measured moment–rotation profile and design parameters of a tape spring hinge are generated by a Box–Behnken experimental design. Furthermore, to consider deployment performances such as low latch-up load, latching without overshoot, high deployment stiffness, and high torque margin, the deployment equation is derived by Kane's dynamic equation considering any number of solar panels. The present study proposes a systematic approach for designing tape spring hinges for any number of solar panels; the designed hinges satisfy all design requirements. The approach involves minimizing the cost function including several design requirements and solving the deployment equation containing the response surfaces of the moment–rotation profiles simultaneously. To verify the effectiveness of the proposed approach, several examples are demonstrated. [ABSTRACT FROM AUTHOR]

The purpose of this study was to perform a meta-analysis and systematic review of the clinical efficacy and safety of radiofrequency (RF) ablation in the treatment of intrahepatic cholangiocarcinoma (ICC). A comprehensive literature search of Ovid MEDLINE and EMBASE identified studies describing the use of RF ablation in the treatment of ICC. Data describing overall survival, local tumor progression, and complications were collected. Seven observational studies that comprised 84 patients were reviewed. The pooled 1-year, 3-year, and 5-year survival rates were 82% (95% confidence interval [CI], 72%–90%), 47% (95% CI, 28%–65%), and 24% (95% CI, 11%–40%). One or 2 major complications occurred in 4 studies, and 1 patient died of liver abscess and subsequent sepsis despite treatment with percutaneous drainage and antibiotics. RF ablation is a locoregional treatment option that prolongs survival rates in patients with ICC who are ineligible for surgery. [ABSTRACT FROM AUTHOR]

The pathophysiology of childhood food allergy (FA) and its natural history are poorly understood. Clarification of the underlying mechanism may help identify novel biomarkers and strategies for clinical intervention in children with FA. This study aimed to identify metabolites associated with the development and resolution of FA. The metabolomic profiles of 20 children with FA and 20 healthy controls were assessed by liquid chromatography–tandem mass spectrometry. Comparative analysis was performed to identify metabolites associated with FA and FA resolution. For subjects with FA, serum samples were collected at the time of diagnosis and after resolution to identify the changes in metabolite levels. The selected metabolites were then quantified in a quantification cohort to validate the results. Finally, genome-wide association analysis of the metabolite levels was performed. The study demonstrated a significantly higher level of sphingolipid metabolites and a lower level of acylcarnitine metabolites in children with FA than those in healthy controls. At diagnosis, subjects with resolving FA had a significantly high level of omega-3 metabolites and a low level of platelet-activating factors compared to persistent FA. However, the level of omega-3 metabolites decreased in children with resolving FA but increased in children with persistent FA during the same time. The quantification data of omega-3–derived resolvins, platelet-activating factor, and platelet-activating factor acetylhydrolase activity further supported these results. The lipid metabolite profile is closely related to childhood FA and FA resolution. This study suggests potential predictive biomarkers and provides insight into the mechanisms underlying childhood FA. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To evaluate the diagnostic values of CT findings of nutcracker syndrome (NCS). Methods and materials: Twenty seven subjects that underwent CT and renal venography, were divided into three groups based on the venographic renocaval pressure gradient (PG) and collateral veins of the left renal vein (LRV): non-compensated NCS patients with PG≥3mm Hg (group 1, n =12), partially compensated NCS patients with borderline PG (1<3mm Hg) and collateral veins (group 2, n =6), and control group with low PG (0–1mm Hg) without collateral veins (group 3, n =9). The CT findings were analyzed with regard to abrupt narrowing of the LRV with an acute angle (beak sign), aortomesenteric angle between the superior mesenteric artery and aorta on sagittal images, and LRV diameter ratio (hilar-aortomesenteric). Results: Beak sign of the LRV was found in 91.7% (11/12) of group 1, 50% (3/6) of group 2, and in 11.1% (1/9) of group 3 with the significant difference between groups 1 and 3 (P <.05, χ 2 test). Mean values of all quantitative CT parameters differed significantly only between groups 1 and 3 (P <.05, one-way ANOVA test). For differentiating the non-compensated NCS from the control group, the beak sign showed 91.7% sensitivity and 88.9% specificity. Of the various CT parameters, the beak sign and LRV diameter ratio of ≥4.9 showed the greatest diagnostic accuracy (AUC 0.903, ROC analysis). Conclusion: Beak sign of the LRV and CT findings can be useful in diagnosing the non-compensated NCS. [Copyright &y& Elsevier]

Abstract: Purpose: The purpose of this study was to retrospectively assess possible clinical predictors of malignant pleural effusion in patients with ovarian cancer. Materials and methods: This review was performed on 38 ovarian cancer patients that showed pleural effusion in a CT scan and who underwent thoracocentesis before treatment. CT scans were obtained using a 4-channel multi-detector CT scanner. Fisher''s exact test was used to determine the probability of malignant pleural effusion as a function of; amount of ascites, lymph node enlargement, amount of pleural effusion, pleural nodules, and pleural thickening. Results: Sixteen (42.1%) of the 38 patients had malignant pleural effusion and malignant pleural effusion amounts were greater than those with nonmalignant effusion. Pleural nodules were more frequently found in the malignant pleural effusion group (eight [50%] patients) than in the nonmalignant group (zero [0%] patient) (p <0.001). Supradiaphragmatic lymph node enlargement (with short axis diameter 1cm or more) was more frequent in malignant group (12 [75%] patients) than in the nonmalignant group (two [9.1%] patients) (p <0.001). Conclusion: The probability of malignant pleural effusion in patients with ovarian cancer was found to be correlated with the amount of pleural effusion, the presence of pleural nodules, and supradiaphragmatic lymph node enlargement. [Copyright &y& Elsevier]

Background: Some studies have proposed that subclinical hypothyroidism (SCH) has adverse effects on the cardiovascular system, but little is known about the effect on patients undergoing cardiovascular operations. We examined the influence of preoperative SCH on postoperative outcome in patients undergoing coronary artery bypass grafting (CABG). Methods: Among patients who underwent CABG between July 2005 and June 2007 at Seoul National University Bundang Hospital, 224 with normal thyroid function and 36 with SCH were enrolled. Preoperative risks and postoperative outcomes were evaluated prospectively without thyroid hormone replacement. Results: There were no significant differences in primary outcomes (major adverse cardiovascular events) and secondary outcomes such as wound problems, mediastinitis, leg infection, respiratory complications, delirium, or reoperation during the same hospitalization. However, patients with SCH had a higher incidence of postoperative atrial fibrillation than those with normal thyroid function after adjustment for age, gender, body mass index, and other independent variables such as emergency operation, the use of cardiopulmonary bypass, combined valvular operation, preoperative creatinine levels, left ventricular systolic dysfunction, and nonuse of β-blockers (45.5% vs 29%; odds ratio, 2.552; 95% confidence interval, 1.117 to 5.830; p = 0.026). Conclusions: SCH appears to influence the postoperative outcome for patients by increasing the development of postoperative atrial fibrillation. However, it is still unproven whether preoperative thyroxine replacement therapy for patients with SCH might prevent postoperative atrial fibrillation after CABG. [Copyright &y& Elsevier]

Summary: Cytoplasmic polyadenylation is a key mechanism of gene control. In Caenorhabditis elegans, GLD-2 and GLD-3 provide the catalytic and RNA-binding subunits, respectively, of a major cytoplasmic poly(A) polymerase (PAP). Here, we identify RNP-8 as a second GLD-2 partner. RNP-8 binds GLD-2 and stimulates GLD-2 activity to form a functional PAP, much like GLD-3. Moreover, GLD-2/RNP-8 and GLD-2/GLD-3 exist as separate complexes that form selectively during development, and RNP-8 and GLD-3 appear to have distinct RNA-binding specificities. Therefore, GLD-2 can form either of two discrete PAPs. In C. elegans hermaphrodites, gamete production begins with spermatogenesis and transitions later to oogenesis. We suggest that the combinatorial use of GLD-2 contributes to this transition, as GLD-2/GLD-3 promotes spermatogenesis, whereas GLD-2/RNP-8 specifies oogenesis. Indeed, RNP-8 and GLD-3 antagonize each other, as evidenced by genetic cosuppression and molecular competition for GLD-2 binding. We conclude that GLD-2 and its binding partners control gamete identity. [Copyright &y& Elsevier]

Pyruvate dehydrogenase (PDH) deficiency is an inherited metabolic disorder caused by a defect in any subunit of the pyruvate dehydrogenase complex (PDHC), which has an essential role in glucose metabolism. The causes of disease progression in PDH deficiency are not fully understood yet. Based on repeated observations of a patient with PDH deficiency at our center, we hypothesized that stress-induced gluconeogenesis contributes to rapid exacerbation of the disease. This link has not been established previously. [ABSTRACT FROM AUTHOR]