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Henoch–Schönlein purpura (HSP) is a disease commonly manifesting purpura, joint pain, and gastrointestinal symptoms. It can lead to glomerulonephritis (Henoch–Schönlein purpura nephritis, HSPN), which is directly associated with mortality and progression to chronic kidney disease (CKD). While HSP occurs more commonly in children, deadly outcomes occur at a higher rate in adult patients. Previous studies have not reported effective treatment of HSPN by Western or traditional medicine. Here, we report two cases of adult HSPN patients treated with the herbal medicine Jarotang (JRT, modified Sipjeondaebo-tang, modified SJDBT). Two female patients (Cases 1 and 2), who were 26 and 27 years old, respectively, came to visit us complaining mainly of cutaneous purpura. Both women were diagnosed with HSP, and the results of urinalysis indicated that the HSP had already progressed to renal involvement (3+ proteinuria with 3+ urine occult blood in case 1; 100–120 RBC/HPF with 2+ urine occult blood in Case 2). Both patients were given modified SJDBT in the name of JRT, with some herbs added to disperse and circulate stagnant qi, relieve indigestion, and clear heat. After treatment, patient 1 showed only a trace level of urine occult blood, with disappearance of purpura and proteinuria. Patient 2 showed complete remission of purpura and hematuria. Modified SJDBT, namely, JRT was effective in treating 2 cases of adulthood HSP and subsequent nephritis. This may be due to the ability of this therapy to replenish qi and blood and/or its immunological effect on T cells. The medication can serve as an effective cure for HSPN. [ABSTRACT FROM AUTHOR]

A method for determining the optimal combination of a group of assets for enabling combinatorial auctions for obtaining better allocations in biddings is presented.

We report the case of a healthy 17-year-old girl who underwent surgery for excision of a painless, rapidly enlarging subconjunctival mass. The mass was found to be tightly adherent to the medial rectus muscle of the left eye, requiring extensive dissection. Histopathology revealed a mass of bland and foamy spindle cells in a storiform pattern that was positive for CD68, PGM1, and factor XIIIA and negative for S-100. The clinical and histopathologic findings are consistent with benign fibrous histiocytoma. [ABSTRACT FROM AUTHOR]

The internet is a major source of health information for patients and parents. The information found online influences patients' and caregivers' understanding of diagnoses and decision making regarding management. We report the results of a survey completed by 4 fellowship-trained pediatric ophthalmologists evaluating the accuracy and clarity of various websites that provide information on amblyopia and strabismus. [ABSTRACT FROM AUTHOR]

This study investigated the current status of the Health Promotion Programme using Traditional Korean Medicine (HaPP-TKM). A survey of public health Traditional Korean Medicine (TKM) doctors asked for suggestions on developing the system and programmes so that TKM public health doctors can practice effectively in different circumstances. TKM public health doctors working in health centres in the Republic Korea were asked about the performance status of HaPP-TKM and their opinions on the programme. The questionnaire took about 20 min to complete and included basic information about the respondent, plus performance status and opinions on HaPP-TKM and the TKM public health doctor system. The survey was administered to 908 doctors through SurveyMonkey. The response rate was 96.2% (n = 838) of which 31.1% (n = 236) of respondents were administering HaPP-TKM. The top three programmes that TKM doctors implemented were; stroke (23.1%, n = 61), smoking cessation (20.1%, n = 53), and osteoarthritis (14.8%, n = 39). Over 50% of TKM public health doctors reported that the difficulties performing the programmes were a result of insufficient infrastructure, followed by lack of information and training on TKM health promotion programmes (32.6%, n = 86). The study results show that TKM is in high demand and appropriate for stroke, smoking cessation, and osteoarthritis. The activation plan for TKM health promotion programmes are as follows: first, well trained human resources, spaces, facilities, and budget are essential, second, programme development and training manual development should run concurrently and last, it is necessary to consider ways to specialize the health promotion programmes and medical treatment according to specialty areas. [ABSTRACT FROM AUTHOR]

Introduction: This study was performed to evaluate the clinical effect of a Korean medicine treatment for livedoid vasculopathy (LV).Methods: Five patients with LV were selected who exhibited blood stasis due to qi stagnation () caused by external cold () or dual deficiency of qi and blood () and who had suffered from chronic episodic LV for at least 2 years. The treatment consisted of Korean herbal medicine, Haechungtang (, HC). Five cases were evaluated based on visual symptoms. The symptoms at first visit were scored on a visual analogue scale (VAS) from 1 to 10.Results: Following treatment, all of the symptoms except pigmentation disappeared completely in all cases. No symptom control with corticosteroids or warfarin was necessary.Conclusion: These case reports suggest that HC could be effective for treating LV. Follow-up studies and further clinical studies are needed to evaluate recurrence and to provide more efficient treatment. [ABSTRACT FROM AUTHOR]

Background: The purpose of this report is to demonstrate the clinical effect of Korean medicine treatment for pigmented purpuric dermatosis (PPD).Methods: Five cases of PPD with skin purpura and blood heat due to blood deficiency were evaluated. All patients had been in a chronic disease state for at least 1 year. The treatment consisted only of the Korean herbal medicine Gami-Samultang (GS). The degree of symptoms that the patients experienced when they first visited our clinic was set at a visual analog scale (VAS) score of 10.Results: After treatment, body purpura disappeared in all cases. In contrast, the patients' symptoms had not resolved following previous steroid treatment. All patients were satisfied with the treatment results and showed a VAS score of 0 for purpura.Conclusion: This report suggests that GS can be used to effectively treat PPD. Additional clinical studies on PPD are needed to develop more comprehensive treatment guidelines. [ABSTRACT FROM AUTHOR]

• In newborns, age of specimen collection influences creatine kinase-MM concentrations. • Creatine kinase-MM levels are lower in low birth weight and premature newborns. • Females have lower mean and median creatine kinase-MM concentrations than male newborns. • Asian newborns have higher mean and median creatine kinase-MM levels than non-Asian newborns. • Multi-tiered creatine kinase-MM cut-offs are recommended for Duchenne first-tier screening. Newborn screening for Duchenne muscular dystrophy can be performed via a first-tier creatine kinase-MM measurement followed by reflex testing to second-tier molecular analysis of the DMD gene. In order to establish appropriate cut-offs for the creatine kinase-MM screen, factors that influence creatine kinase-MM in newborns were investigated. Creatine kinase-MM data from a consented pilot study in New York State were collected over a two-year period and combined with de-identified validation data and analyzed. Univariate analysis and multiple linear regression analysis were performed. The analysis indicated that age of newborn at specimen collection, gestational age and birth weight were significant influencers of CK-MM levels in newborns. In addition, to a lesser extent, sex, race/ethnicity and seasonal temperature also affect CK-MM levels in newborns. To reduce false positive and false negative cases, newborn screening programs should be cognizant of factors that influence CK-MM when determining cut-offs for the assay. Variability based on age at specimen collection and birth weight are primarily observed within the first week of life. Therefore, particularly during this time period, multi-tiered cut-offs based on age of collection and lower cut-offs for premature and low birth weight babies are recommended. Other cut-off determinants may include sex, race/ethnicity and seasonal temperature. [ABSTRACT FROM AUTHOR]

Kearns-Sayre syndrome (KSS) is a rare mitochondrial DNA (mtDNA) deletion syndrome that typically presents before 20 years of age and is characterized by chronic progressive external ophthalmoplegia, pigmentary retinopathy, and a combination of cardiac conduction defects, cerebellar ataxia, and elevated cerebrospinal fluid protein levels. The mtDNA defects interfere with oxidative phosphorylation and can affect a number of cellular energy processes in various organs. We report the case of a 15-year-old girl with KSS that was uniquely associated with bilateral, symmetrical exophthalmos. [ABSTRACT FROM AUTHOR]

Objectives: Traditional, complementary, and alternative medicine (TC&AM) play an exceptional role in health care around the world as many patients has sought a holistic approach.Setting: In this study, a multinational survey was developed and administered to obtain experience, attitude, and promotion information with regard to the international use of TC&AM among nine countries: Germany, United States, Japan, China, Malaysia, Vietnam, Russia, Kazakhstan, and United Arab Emirates (UAE). The survey was administered via online to members of SurveyMonkey Audience, a proprietary panel of respondents who were recruited from a diverse population worldwide.Results: A total of 1071 participants has completed the survey. The participants were in favor of the treatments and therapies as well as expressed positive attitudes and also have used herbal medicine treatment more than acupuncture therapy and also used the modalities to promote metabolism rather than treating musculoskeletal diseases. Moreover, participants mentioned that TC&AM should be applied for treating and managing infectious diseases, such as COVID-19. Additionally, participants recommended using Facebook channel to promote its treatments and therapies.Conclusion: Based on the results, this study provides initial insights on TC&AM that may influence the non-users globally and perhaps inspire a need for further research including more countries in different continents. [ABSTRACT FROM AUTHOR]

Introduction Korea has a unique health system that includes two independent systems: Western medicine and traditional Korean medicine (TKM). This review aimed to explore the impact and role of doctors practising TKM on the Korean public healthcare system. Methods A search was conducted of official government agency websites, doctors’ associations and 3 Korean databases using the key words: ‘public doctor’, ‘public TKM doctor’ and ‘public health system’. The search was conducted on September 15, 2015. Neither the publication language nor the publication date were restricted. Results The TKM public health system commenced in 1998 and after a two-year pilot project was expanded nationwide in 2002. In 2001, there were only 38 public health TKM doctors, this had increased to 1026 by 2015. Most of these practitioners work in public health centres (23.38%) and branch offices of community health centres (68.12%). Conclusions This review has considered the public health doctor system with a focus on TKM doctors including assignment status of public health TKM doctors, the development of the TKM public health doctor system. Roles of public health TKM doctors. Although the public health doctor system has contributed to the improvement of Korean public health for 30 years, continuous development is required to improve the working conditions, provide reasonable regulation for the medical system, and strengthen the medical information and management. [ABSTRACT FROM AUTHOR]

Context: China, Japan, Korea, and Taiwan have developed modernized education systems in traditional medicine.Objective: This study aims to provide an overview of the education systems in these countries and compare them.Methods: Data were collected through the websites of government agencies, universities, and relevant organizations.Results: These countries have systemically developed basic medical education (BME), postgraduate medical education (PGME), and continuing medical education (CME) in traditional medicine. BME is provided at colleges of traditional medicine at the undergraduate level and graduate levels. The length of education at the undergraduate level is five, six, and seven years in China, Korea, and Taiwan, respectively; the length at the graduate level is four years in Korea and five years in Taiwan. A seven- or eight-year program combining undergraduate and graduate courses is unique to China. In Japan, unlike in other countries, there are two distinct education systems-one is comprised of courses on traditional medicine included in the curriculum for Western medical doctors, and the other is a three- or four-year undergraduate program for practitioners including acupuncturists and moxibustionists. PGME in Korea consists of one-year internship and three-year residency programs which are optional; however, in China and Taiwan, internship is required for the national licensing examination and further training is in the process of standardization. The required credits for maintenance of CME are eight per year in Korea, 25 per year in China, and 180 over six years in Taiwan.Conclusions: The design of the educational systems in these countries can provide useful information for the development of education in traditional medicine around the world. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to introduce Health Promotion Programs using Traditional Korean Medicine (HaPP-TKM) into public health centre programmes. We investigated the history and the current status of implementing the programmes in public health centres. Methods The results from the HaPP-TKM were analysed to show the status of TKM in the public health system, including the history of the public health system in TKM and health promotion programmes with TKM interventions. Results Since 2005, TKM health promotion programmes can be described in three stages. In the first step, the each hub health centre which included a health promotion project chose the programmes among developed programmes in 2005–2012. In the second step, each local public health centre chose the health promotion programmes prioritising the disease group for integration into the local community. In 2015 and for subsequent years, HaPP-TKM will be run for each life cycle as an integrated health promotion programmes in the local community. Conclusions To promote the role of traditional medicine (TM) in the public health sector, our study suggests the need to integrate TM into the public health system to promote the role of TM. In the future, the government and related researchers in each country should develop measures for solving the identified causes of implementation difficulties and dealing with the most urgent needs for activating the implementation of programmes which are reflected in each countries’ medical situation. [ABSTRACT FROM AUTHOR]

Background: Warm needle acupuncture (WA) is considered a potential intervention in the treatment of osteoarthritis (OA).Purpose: To systematically evaluate the clinical efficacy and safety of WA in the treatment of OA.Study Design: Systematic review and meta-analysis METHODS: Fourteen databases were searched from their inception until May 2022. Randomized controlled trials (RCTs) of WA for treating OA were identified. Study selection and data extraction were performed by two independent reviewers. The Cochrane risk of bias tool and the Grading of Recommendations Assessment, Development and Evaluation program were used to assess all included RCTs.Results: A total of 66 RCTs met the inclusion criteria for this review. Most of the included studies had an unclear risk of bias, and the certainty of the evidence was very low. Twenty-four RCTs compared the effects of WA with those of oral drug therapies. Meta-analysis showed superior effects of WA for the total effective rate (risk ratio (RR): 1.22, 95% confidence interval (CI): 1.17 to 1.27, I2 = 26%, p < 0.001, 24 studies, n = 2278), pain, and function. Eight RCTs compared the effects of WA+drug therapy, and meta-analysis showed favorable effects for the total effective rate (RR: 1.27, 95% CI: 1.18 to 1.35, I2 =0%, p < 0.001, 8 studies, n = 646). Eight RCTs compared the effects of WA and intra-articular sodium hyaluronate (IASH) injection on OA and found equivalent effects of WA on the symptoms of OA. Twenty-eight RCTs compared the effects of WA+IASH injection with those of IASH injection, and meta-analysis showed superior effects of WA+IASH in terms of the total effective rate (RR: 1.15, 95% CI: 1.11 to 1.19, I2 =27.3%, p < 0.001, 25 studies, n = 2208), pain, and function. None of the RCTs reported serious adverse events.Conclusions: WA may have some distinct advantages in the treatment of OA. However, well-designed RCTs with larger sample sizes are needed. [ABSTRACT FROM AUTHOR]

Introduction Every year, more than 6 million people die from smoking-related diseases. One method used to promote smoking cessation is acupuncture. The present study aims to assess the efficacy of acupuncture for smoking cessation by conducting a review of the currently available evidence. Methods and analysis Sixteen databases will be searched for studies conducted through March 2017. We will include randomized controlled trials (RCTs) assessing acupuncture for smoking cessation. All RCTs on acupuncture or related interventions will be included. Risk of bias will be assessed using the Cochrane risk of bias assessment tool, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. Ethics and dissemination This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide healthcare practices. [ABSTRACT FROM AUTHOR]

Mirk/Dyrk1B is a serine/threonine kinase widely expressed in colon cancers. Serum starvation induced HD6 colon carcinoma cells to enter a quiescent G0 state, characterized by a 2N DNA content and a lower RNA content than G1 cells. Compared with cycling cells, quiescent cells exhibited 16-fold higher levels of the retinoblastoma protein p130/Rb2, which sequesters E2F4 to block entry into G1, 10-fold elevated levels of the CDK inhibitor p27kipl, and 10-fold higher levels of Mirk. However, depletion of Mirk did not prevent entry into G0, but enabled quiescent HD6, SW480, and colo320 colon carcinoma cells to acquire some biochemical characteristics of G1 cells, including increased levels of cyclin D1 and cyclin D3 because of slower turnover, increased activity of their CDK4/cyclin D complexes, and increased phosphorylation and decreased E2F4 sequestering ability of the CDK4 target, p130/Rb2. As a result, depletion of Mirk allowed some cells to escape quiescence and enabled cells released from quiescence to traverse G1 more quickly. The kinase activity of Mirk was increased by the chemotherapeutic drug 5-fluorouracil (5-FU). Treatment of p53 mutant colon cancer cells with 5-FU led to an elongated G1 in a Mirk-dependent manner, as G1 was shortened by ectopic overexpression of cyclin D1 mutated at the Mirk phosphorylation site (T288A), but not by wild-type cyclin D1. Mirk, through regulating cyclin D turnover, and the CDK inhibitor p27, as shown by depletion studies, functioned independently and additively to regulate the exit of tumor cells from quiescence. [ABSTRACT FROM AUTHOR]

Abstract: We study a variation of the packing-delivery problem, which involves K distinct products, a single capacitated truck, and a fixed sequence of customer locations to be visited. We show that the non-split version of the problem is strongly polynomial solvable. For the split delivery case, we analyze the conditions of optimality and propose a local optimization algorithm with a computational complexity of O(n 3 log(n)). Based on 14,000 randomly generated test problems, a consistent performance improvement achieved by the proposed local optimization algorithm over that by the optimal non-split packing-delivery schedules is observed. [Copyright &y& Elsevier]

Hydrochemical and isotopic characteristics of crystalline bedrock aquifers were investigated down to 500 m below ground level at two geological disposal research sites. Groundwater samples were collected every 50 m during drilling including water from several fracture zones (n = 24) and at water-conducting fracture zones after the drilling was completed (n = 27) to understand the impact of sampling times, i.e., during versus after drilling, on the characterization result. Both aquifers were highly weathered and showed transport in fractured rocks, which made it difficult to determine the effect of sampling times. Despite the similar ranges of hydraulic conductivities, the BH (gneiss) groundwater showed higher total dissolved solids including Na, F, and HCO 3 and carbon-13 isotopes of dissolved inorganic carbon, older carbon-14 ages, but lower dissolved oxygen, oxygen and hydrogen isotopes of water, and sulfur isotopes of sulfate than the AH (granite) groundwater, indicating the extensive water rock interaction through long pathways in BH. Sulfate reduction was also observed in deep anoxic environment in BH, whereas the AH groundwater seemed to be affected by recent recharge through permeable fractures regardless of depth. Redox potential (Eh) increased in samples collected after drilling, in particular in AH, and Fe and negative Eh were not detected in groundwater collected after drilling in both areas, which implied oxidization after drilling in particular in aquifers with recent recharge. The study result suggests isotopic investigations combined with hydrochemical characterization to assess anoxic conditions for geological disposal, if possible, during drilling before grouting to accurately assess the redox condition in crystalline bedrock aquifers. • Hydrochemical and isotopic properties assessed in two (AH and BH) crystalline bedrock aquifers. • Investigations at equal intervals during drilling and at water-conducting fracture zones after drilling. • Long-term water-rock interactions in BH while the impact of recent recharge in AH. • The effect of sampling times not clear due to fracture-dependent variations. • Isotopic investigation combined with hydrogeochemisty suggested for geological disposal. [ABSTRACT FROM AUTHOR]