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Endometrial cancer is the most common gynecologic malignancy. PTEN is a negative regulator of PI3K signaling and is deficient in > 50% of primary human endometrial cancer. Amplification of ERBB2 promotes tumorigenesis and pathogenesis of several human cancers. However, the effect of ERBB2 targeting has not been studied in endometrial cancer with PTEN mutations. The murine model Pgrcre/+Erbb2f/fPtenf/f (Erbb2d/d Ptend/d) was developed to evaluate the effect of ERBB2 targeted therapy in endometrial cancer with PTEN deficiency. Histopathological and molecular analysis was performed for Ptend/d and Erbb2d/dPtend/d mice. Histopathological analysis revealed that Erbb2d/dPtend/d mice significantly reduced development and progression of endometrial cancer compared to Ptend/d mice. Furthermore, percentage of proliferative cells in Erbb2d/dPtend/d mice revealed anti-tumorigenic effect of Erbb2 ablation compared to Ptend/d mice. Our results demonstrate that Erbb2 ablation reveals a significant suppression of tumorigenesis on endometrial cancer of Ptend/d mice. Our results suggest that Erbb2 functions as an oncogene in endometrial cancer of Ptend/d mice implying that Erbb2 targeting can be used as an effective therapeutic approach for treatment of endometrial cancer with PTEN deficiency to hinder cancer development. [ABSTRACT FROM AUTHOR]

The evidence about the associations of leukocyte telomere length (LTL) and intermediary cardiovascular phenotypes with adverse cardiovascular outcomes is inconclusive. This study assessed these relationships with cardiovascular imaging, electrocardiography, and the risks of sudden cardiac death (SCD), coronary events, and heart failure (HF) admission. We conducted a cross-sectional analysis of UK Biobank participants enrolled between 2006 and 2010. LTL was measured using quantitative polymerase chain reactions. Electronic health records were used to determine the incidence of SCD, coronary events, and HF admission. Cardiovascular measurements were made using cardiovascular magnetic resonance imaging and machine learning. The associations of LTL with SCD, coronary events, and HF admission and cardiac magnetic resonance imaging, electrocardiogram parameters of 33,043 and 19,554 participants were evaluated by multivariate regression. The median (interquartile range) follow-up period was 11.9 (11.2–12.6) years. Data was analyzed from January to May 2023. Among the 403,382 white participants without coronary artery disease or HF, 181,637 (45.0%) were male with a mean age of 57.1 years old. LTL was independently negatively associated with a risk of SCD (LTL third quartile vs first quartile: hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.72–0.92), coronary events (LTL third quartile vs first quartile: HR: 0.88, 95% CI: 0.84–0.92), and HF admission (LTL fourth quartile vs first quartile: HR: 0.84, 95% CI: 0.74–0.95). LTL was also independently positively associated with cardiac remodeling, specifically left ventricular mass index, left-ventricular-end systolic and diastolic volumes, mean left ventricular myocardial wall thickness, left ventricular stroke volume, and with electrocardiogram changes along the negative degree of T-axis. Cross-sectional study results showed that LTL was positively associated with heart size and cardiac function in middle age, but electrocardiography results did not show these associations, which could explain the negative association between LTL and risk of SCD, coronary events, and HF admission in UK Biobank participants. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the feasibility and limitations of deep learning–based coronary calcium scoring using positron emission tomography-computed tomography (PET-CT) in comparison with coronary calcium scoring using ECG-gated non-contrast-enhanced cardiac computed tomography (CaCT). Materials and methods: A total of 215 individuals who underwent both CaCT and PET-CT were enrolled in this retrospective study. The Agatston method was used to calculate the coronary artery calcium scores (CACS) from CaCT, PET-CT(reader), and PET-CT(AI) to analyse the effect of using different modalities and AI-based software on CACS measurement. The total CACS and CACS classified according to the CAC-DRS guidelines were compared between the three sets of CACS. The differences, correlation coefficients, intraclass coefficients (ICC), and concordance rates were analysed. Statistical significance was set at p < 0.05. Results: The correlation coefficient of the total CACS from CaCT and PET-CT(reader) was 0.837, PET-CT(reader) and PET-CT(AI) was 0.894, and CaCT and PET-CT(AI) was 0.768. The ICC of CACS from CaCT and PET-CT(reader) was 0.911, PET-CT(reader) and PET-CT(AI) was 0.958, and CaCT and PET-CT(AI) was 0.842. The concordance rate between CaCT and PET-CT(AI) was 73.8%, with a false-negative rate of 37.3% and a false-positive rate of 4.4%. Age and male sex were associated with an increased misclassification rate. Conclusions: Artificial intelligence–assisted CACS measurements in PET-CT showed comparable results to CACS in coronary calcium CT. However, the relatively high false-negative results and tendency to underestimate should be of concern. Clinical relevance statement: Application of automated calcium scoring to PET-CT studies could potentially select patients at high risk of coronary artery disease from among cancer patients known to be susceptible to coronary artery disease and undergoing routine PET-CT scans. Key Points: • Cancer patients are susceptible to coronary disease, and PET-CT could be potentially used to calculate coronary artery calcium score (CACS). • Calcium scoring using artificial intelligence in PET-CT automatically provides CACS with high ICC to CACS in coronary calcium CT. • However, underestimation and false negatives of CACS calculation in PET-CT should be considered. [ABSTRACT FROM AUTHOR]

Endometrial cancer (EC) is the most common gynecologic malignancy. While the majority of patients present with early-stage and low-grade EC and have an excellent prognosis, a subset has metastatic disease at presentation or develops distant recurrence after initial treatment of the primary. However, the lack of prognostic biomarkers for metastatic EC is a critical barrier. Arginase 1 (ARG1) regulates the last step of the urea cycle, and an increase in ARG1 has been correlated as a poor prognostic factor in a variety of cancers. In the present study, ARG1 expression was evaluated as a potential prognostic marker for metastatic EC in endometrial hyperplasia and cancer of mice with Pten mutation as well as Pten and Mig-6 double mutations. While Pten mutation in the uterus is not sufficient for distant metastasis, mice with concurrent ablation of Mig-6 and Pten develop distant metastasis. Our immunostaining and RT-qPCR analysis revealed that the expression of ARG1 in early stage of EC as well as endometrial hyperplasia from mice deficient in Mig-6 and Pten mutations significantly increased compared to Pten mutation in the uterus. The results suggest that a high level of ARG1 is associated with poor prognosis in association with EC of mouse. [ABSTRACT FROM AUTHOR]

Nitrogen (N) lost during beef cattle production accompanies various environmental risks and has become a rising concern among agricultural stakeholders. The objective of this study was to quantify the N footprint of producing Hanwoo beef cattle, which is a Korean indigenous breed of cattle, in Korea at the farm gate through a life cycle assessment approach. Field surveys were conducted on 106 farms across 9 provinces to identify regional distinctions in farming systems and evaluate total N losses from beef production. N losses were calculated using emission factors from the refined IPCC guidelines, which were then expressed as N footprint (g N/kg of live body weight (LBW)). Uncertainty and sensitivity analyses were deployed to evaluate the precision of the results and identify factors that contributed to the output. The N footprint averaged 132.7(± 61.8) g N/kg LBW and varied between provinces according to animal categories, manure management systems, land use and fertilizer application rates. Volatilization was the highest contributing factor, followed by leaching and denitrification, each representing 68.5, 21.4, and 10.1 percent of the N footprint, respectively. The uncertainty of the result was found to be 46.6 percent and was highly associated with emission factor uncertainties. We devised five mitigation scenarios that are cost effective and do not penalize productivity and evaluated their capacity for reducing N footprint: (i) dietary modifications to decrease animal N excretion rate; (ii) microorganism additives to reduce volatilization from housing; (iii) manure storages recycling manure within the farm to replace synthetic fertilizers; (iv) distributing biochar to the field after fertilizer application to curtail losses from crop production; (v) combination of i, ii, iii, and iv. Combining these scenarios demonstrated the potential to reduce 12.1 percent of the total N footprint. The extents of mitigation scenarios varied across provinces (ranging from 5.2 to 21.7 percent) and were shown to be contingent on feeding practices and type of crop cultivated. Overall, our study provides a national metric that can be utilized to communicate the environmental impacts of Korean beef production. The analyses indicate that more precise results could be achieved with future endeavors towards developing country-specific emission factors. The mitigation potentials of the presented scenarios propose possibilities for feasible and sustainable beef production in Korea. [ABSTRACT FROM AUTHOR]

Background: Early identification of the severity of hypoxic-ischemic brain injury (HIBI) after cardiac arrest can be used to help plan appropriate subsequent therapy. We evaluated whether conductivity of cerebral tissue measured using magnetic resonance-based conductivity imaging (MRCI), which provides contrast derived from the concentration and mobility of ions within the imaged tissue, can reflect the severity of HIBI in the early hours after cardiac arrest. Methods: Fourteen minipigs were resuscitated after 5 min or 12 min of untreated cardiac arrest. MRCI was performed at baseline and at 1 h and 3.5 h after return of spontaneous circulation (ROSC). Results: In both groups, the conductivity of cerebral tissue significantly increased at 1 h after ROSC compared with that at baseline (P = 0.031 and 0.016 in the 5-min and 12-min groups, respectively). The increase was greater in the 12-min group, resulting in significantly higher conductivity values in the 12-min group (P = 0.030). At 3.5 h after ROSC, the conductivity of cerebral tissue in the 12-min group remained increased (P = 0.022), whereas that in the 5-min group returned to its baseline level. Conclusions: The conductivity of cerebral tissue was increased in the first hours after ROSC, and the increase was more prominent and lasted longer in the 12-min group than in the 5-min group. Our findings suggest the promising potential of MRCI as a tool to estimate the severity of HIBI in the early hours after cardiac arrest. [ABSTRACT FROM AUTHOR]

Although pulmonary vein isolation (PVI) gaps and extrapulmonary vein triggers contribute to recurrence after atrial fibrillation (AF) ablation, their precise mechanisms remain unproven. Our study assessed the impact of PVI gaps on rhythm outcomes using a human AF digital twin. We included 50 patients (76.0% with persistent AF) who underwent catheter ablation with a realistic AF digital twin by integrating computed tomography and electroanatomical mapping. We evaluated the final rhythm status, including AF and atrial tachycardia (AT), across 600 AF episodes, considering factors including PVI level, PVI gap number, and pacing locations. Our findings revealed that antral PVI had a significantly lower ratio of AF at the final rhythm (28% vs. 56%, p = 0.002) than ostial PVI. Increasing PVI gap numbers correlated with an increased ratio of AF at the final rhythm (p < 0.001). Extra-PV induction yielded a higher ratio of AF at the final rhythm than internal PV induction (77.5% vs. 59.0%, p < 0.001). In conclusion, our human AF digital twin model helped assess AF maintenance mechanisms. Clinical trial registration: https://www.clinicaltrials.gov; Unique identifier: NCT02138695. [ABSTRACT FROM AUTHOR]

Cardiac diffusion weighted-magnetic resonance imaging (DWI) has slowly developed due to its technical difficulties. However, this limitation could be overcome by advanced techniques, including a stimulated echo technique and a gradient moment nulling technique. This study aimed to develop and validate a high-order DWI sequence, using echo-planar imaging (EPI) and second-order motion-compensated (M012) diffusion gradient applied to cardiac imaging in small-sized animals with fast heart and respiratory rates, and to investigate the feasibility of cardiac DWI, diagnosing acute myocardial injury in isoproterenol-induced myocardial injury rat models. The M012 diffusion gradient sequence was designed for diffusion tensor imaging of the rat myocardium and validated in the polyvinylpyrrolidone phantom. Following sequence optimization, 23 rats with isoproterenol-induced acute myocardial injury and five healthy control rats underwent cardiac MRI, including cine imaging, T1 mapping, and DWI. Diffusion gradient was applied using a 9.4-T MRI scanner (Bruker, BioSpec 94/20, gradient amplitude = 440 mT/m, maximum slew rate = 3440 T/m/s) with double gating (electrocardiogram and respiratory gating). Troponin I was used as a serum biomarker for myocardial injury. Histopathologic examination of the heart was subsequently performed. The developed DWI sequence using EPI and M012 provided the interpretable images of rat hearts. The apparent diffusion coefficient (ADC) values were significantly higher in rats with acute myocardial injury than in the control group (1.847 ± 0.326 * 10–3 mm2/s vs. 1.578 ± 0.144 * 10–3 mm2/s, P < 0.001). Troponin I levels were increased in the blood samples of rats with acute myocardial injury (P < 0.001). Histopathologic examinations detected myocardial damage and subendocardial fibrosis in rats with acute myocardial injury. The newly developed DWI technique has the ability to detect myocardial injury in small animal models, representing high ADC values on the myocardium with isoproterenol-induced injury. [ABSTRACT FROM AUTHOR]

The structural performance of derailment containment provision (DCP) was investigated using a grid steel frame. The DCP which was installed within the gauge of a track was capable of resisting the impact loading in the case of derailed wheels. It was also possible to control the excessive lateral movement of the derailed train. In this study, the structural performance of DCP with a post-installed anchor to a railway concrete sleeper was evaluated. For this purpose, a total of nine specimens were manufactured and static tests were conducted to investigate the structural performance. Furthermore, the shear resistance of the connecting anchor was also evaluated using grid steel frame specimens. The initial test indicated that the developed DCP for railway using grid steel frames had sufficient load-carrying capacity and performance equivalent to about 150% of the design load. The developed DCP also demonstrated sufficient load-carrying capacity up to about 140% of the designed load in combination tests that simulated conceivable boundary conditions. As analytical results, the overall DCP behavior for the specimen railway that utilized grid steel frames was appropriately tracked, and detailed information was presented. [ABSTRACT FROM AUTHOR]

Background: Perioperative hypoalbuminemia has a prognostic effect on mortality and morbidity in various cohorts. Patients undergoing open repair of ruptured abdominal aortic aneurysms (rAAA) are at a high risk of hypoalbuminemia due to bleeding and underlying diseases. Hence, this study aimed to investigate the predictive value of immediate postoperative hypoalbuminemia for the risk for acute kidney injury (AKI) in patients undergoing open rAAA repair. Methods: We retrospectively reviewed 143 patients who underwent open rAAA repair between January 2008 and May 2022. The patients were divided into two groups according to the presence of postoperative AKI. The perioperative serum albumin levels of the two groups were compared. The patients were further divided into two groups based on the median immediate postoperative albumin level (2.4 g/dL). The incidence of AKI was compared between the two groups. Multivariate logistic regression analysis was performed to assess the predictors of postoperative AKI. Kaplan-Meier survival curves were used to evaluate potential of AKI and albumin level as prognostic factors for mortality. Results: Immediate postoperative serum albumin was significantly lower in the AKI group than in the non-AKI group (2.11 ± 0.62 g/dL vs. 2.59 ± 0.62 g/dL, p < 0.001). The incidence of postoperative AKI was significantly higher in patients with albumin ≤ 2.4 g/dL than in patients with albumin > 2.4 g/dL (53.8% vs. 27.7%, p = 0.002). Immediate postoperative albumin level was an independent predictor of AKI (Odds ratio [OR], 0.310; 95% confidence interval [CI] 0.165–0.583, p < 0.001) and 1-year mortality (OR, 0.230; 95% CI 0.098–0.542, p = 0.001). Conclusions: Immediate postoperative hypoalbuminemia was associated with postoperative AKI and mortality in patients with rAAA. [ABSTRACT FROM AUTHOR]

In this paper, a new approach is developed to numerically evaluate the structural performance of deteriorated prestressed concrete beams using the finite element analysis application RCAHEST (Reinforced Concrete Analysis in Higher Evaluation System Technology). A prestressing steel element was modified to represent the interaction between deteriorated concrete and prestressing steel. Considering the corrosion effects—as shown by the reduction of the prestressing steel section and loss of bond—a nonlinear material model was proposed for deteriorated prestressed concrete behavior. The modified damage index is intended to provide a numerical method for quantifying the structural performance of deteriorated prestressed concrete beams. The analytical procedure developed for the performance evaluation of deteriorated beams was validated by comparison with the credible test results, thereby enabling a more reliable and rational prestressed concrete beams design process. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the association between periodontitis in the upper jaw and chronic rhinosinusitis (CRS) using the nationwide Korean National Health and Nutrition Examination Survey (KNHANES) data. In this cross-sectional study, data of KNHANES participants enrolled between 2008 and 2012 were reviewed. Periodontitis of the upper teeth was diagnosed by dentists according to the community periodontal index with standardized methods. CRS was diagnosed by otorhinolaryngologists according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 with nasal endoscopy findings. We also evaluated the association between periodontitis and CRS according to smoking and drinking status. Univariate and multivariate logistic regression analyses were performed. Overall, 28,761 participants were eligible for analysis, and 210 were diagnosed with CRS. Periodontitis was associated with CRS diagnosis (odds ratio [OR] = 1.391, 95% confidence interval [CI] = 1.013–1.912). Non-drinkers showed no significant association between periodontitis and CRS (OR = 1.142, 95% CI 0.746–1.749). However, among drinkers, periodontitis was significantly associated with CRS (OR = 1.733, 95% CI 1.091–2.753). The number of smokers with CRS was not statistically sufficient and a logistic regression model based on smoking status could not be generated. Individuals with periodontitis in the upper jaw may need to consult an otorhinolaryngologist for comorbid CRS especially according to drinking status. [ABSTRACT FROM AUTHOR]

Aortic surgery is one of the most challenging types of surgeries, which is possibly related to cognitive sequelae. We aimed to investigate the changes in resting-state functional connectivity (rsFC) associated with intraoperative circulatory arrest (CA) in aortic surgery, exploring the relationship between the altered connectivity and postoperative cognitive functions. Thirty-eight patients participated in this study (14 with CA, 24 without). Functional magnetic resonance imaging was scanned on the fifth day after surgery or after the resolution of delirium if it was developed. We assessed the differences in the development of postoperative cognitive changes and rsFC between patients with and without CA. The occurrence of postoperative delirium and postoperative cognitive dysfunction was not significantly different between the patients with and without the application of CA. However, patients with CA showed increased in posterior cingulate cortex-based connectivity with the right superior temporal gyrus, right precuneus, and right hippocampus, and medial prefrontal cortex-based connectivity with the dorsolateral prefrontal cortex. The application of moderate hypothermic CA with unilateral antegrade cerebral perfusion is unlikely to affect aspects of postoperative cognitive changes, whereas it may lead to increased rsFC of the default mode network at a subclinical level following acute brain insults. [ABSTRACT FROM AUTHOR]

Simple equations are expressed for tunnel conductivity, tunnel resistance and conductivity of a graphene-filled composite by the number of contacts and interphase part. More specially, the active filler amount is suggested by interphase depth, which changes the contact number. The conductivity of nanocomposite is presented by filler content, filler dimensions, tunneling length and interphase depth. The innovative model is surveyed by the experimented conductivity of real examples. Too, the impacts of numerous issues on the tunnel resistance, tunnel conductivity and conductivity of nanocomposite are discussed to validate the novel equations. The estimates agree with the experimented data and the impacts of several terms on the tunnel resistance, tunnel conductivity and conductivity of system are sensible. Thin and big nanosheets positively affect the nanocomposite's conductivity, but thick nanosheets improve the tunnel conductivity. High conductivity is found at short tunnels, while the nanocomposite's conductivity directly depends on the tunneling length. The dissimilar effects of these features on the tunneling properties and conductivity are described. [ABSTRACT FROM AUTHOR]

Alzheimer disease (AD) is the most prevalent cause of dementia in the elderly. Although impaired cognition and memory are the most prominent features of AD, abnormalities in visual functions often precede them, and are increasingly being used as diagnostic and prognostic markers for the disease. Retina contains the highest concentration of the essential fatty acid docosahexaenoic acid (DHA) in the body, and its deficiency is associated with several retinal diseases including diabetic retinopathy and age related macular degeneration. In this study, we tested the hypothesis that enriching retinal DHA through a novel dietary approach could ameliorate symptoms of retinopathy in 5XFAD mice, a widely employed model of AD. The results show that 5XFAD mice have significantly lower retinal DHA compared to their wild type littermates, and feeding the lysophosphatidylcholine (LPC) form of DHA and eicosapentaenoic acid (EPA) rapidly normalizes the DHA levels, and increases retinal EPA by several-fold. On the other hand, feeding similar amounts of DHA and EPA in the form of triacylglycerol had only modest effects on retinal DHA and EPA. Electroretinography measurements after 2 months of feeding the experimental diets showed a significant improvement in a-wave and b-wave functions by the LPC-diet, whereas the TAG-diet had only a modest benefit. Retinal amyloid β levels were decreased by about 50% by the LPC-DHA/EPA diet, and by about 17% with the TAG-DHA/EPA diet. These results show that enriching retinal DHA and EPA through dietary LPC could potentially improve visual abnormalities associated with AD. [ABSTRACT FROM AUTHOR]

Background: Risk factor management is crucial in the management of atrial fibrillation (AF). We investigated the association of changes in cardiovascular health (CVH) levels after AF diagnosis with incident cardiovascular events and mortality. Methods: From the Korea National Health Insurance Service database, 76,628 patients newly diagnosed with AF (2005–2015) with information on health examinations before and after AF diagnosis were assessed. According to the change in the 12-point CVH score before and after AF diagnosis, patients were stratified into four groups: consistently low (score 0–7 to 0–7), high-to-low (8–12 to 0–7), low-to-high (0–7 to 8–12), and consistently high (8–12 to 8–12) CVH levels. Risks of cardiovascular events and death were analyzed using weighted Cox regression models with inverse probability of treatment weighting (IPTW) for balance across study groups. Results: The mean age of study participants was 58.3 years, 50,285 were men (63.1%), and the mean follow-up was 5.5 years. After IPTW, low-to-high (hazard ratio [95% confidence interval], 0.83 [0.76–0.92]) and consistently high (0.80 [0.74–0.87]) CVH levels were associated with a lower risk of ischemic stroke than consistently low CVH. Low-to-high (0.66 [0.52–0.84]) and consistently high (0.52 [0.42–0.64]) CVH levels were associated with a lower risk of acute myocardial infarction. Maintaining high CVH was associated with reduced risks of heart failure hospitalization (0.85 [0.75–0.95]) and all-cause death (0.82 [0.77–0.88]), respectively, compared with consistently low CVH. Conclusions: Improving CVH levels and maintaining high CVH levels after AF diagnosis is associated with lower risks of subsequent cardiovascular events and mortality. [ABSTRACT FROM AUTHOR]

Obesity has been linked to atrial fibrillation (AF) burden and severity, and epidemiological studies suggest that AF is more prevalent in whites than Asian. We aimed to investigate whether obesity mediates associations with AF in Europe and Asia using patient-level data comparisons of two cohort studies. Using Korean National Health Insurance Service's Health Screening (NHIS-HealS) and U.K. Biobank data, we included 401,206 Korean and 477,926 British aged 40–70 years without previous AF who received check-ups. The incidence and risk of AF were evaluated regarding different body mass index (BMI) values. The obese proportion (BMI ≥ 30.0 kg/m2, 2.8% vs. 24.3%, P < 0.001) was higher in the U.K. than the Korean. In the Korean and U.K. cohort, the age- and sex-adjusted incidence rates of AF were 4.97 and 6.54 per 1000 person-years among obese individuals. Compared to Koreans, the risk of AF was higher in the British population, with adjusted hazard ratios of 1.41 (Korea, 95% CI 1.26–1.58) and 1.68 (UK, 95% CI 1.54–1.82) in obese participants (P for interaction < 0.05). Obesity was associated with AF in both populations. British subjects had a greater incidence of AF related to the high proportion of obese individuals, especially participants in the obesity category, the risk of AF also increased. [ABSTRACT FROM AUTHOR]

This paper presents a nonlinear analysis procedure for evaluating the seismic performance of reinforced concrete (RC) bridge columns with lap splices using a novel plastic hinge element considering shear deformation. To accurately assess the inelastic behavior of RC bridge columns, reliable three-dimensional (3D) constitutive models are required. However, developing a 3D nonlinear material model is difficult and computationally intensive. In this study, to address these issues, a new plastic hinge element considering shear deformation for RC bridge columns is developed. The new plastic hinge element is based on the Timoshenko beam theory and utilizes two-noded zero length element with six degrees of freedom. The finite element model was implemented in a computer program named Reinforced Concrete Analysis in Higher Evaluation System Technology (RCAHEST) developed by the authors. The developed plastic hinge element for seismic performance assessment of RC bridge columns with lap splices was validated through comparison of the numerical and experimental results. [ABSTRACT FROM AUTHOR]

Purpose: To assess trans-regional differences, reproducibility across different MRI scanners, and interobserver agreement of liver surface nodularity (LSN) score from routine liver MRI and to evaluate the correlation between LSN score and liver stiffness (LS) value on MR elastography. Materials and methods: Ninety patients who underwent gadoxetic acid-enhanced liver MRI twice using different MRI scanners within a year were evaluated. On axial hepatobiliary phase images, right anterior (LSNRT_ANT), right posterior (LSNRT_POST), and left anterior hepatic surface (LSNLT) were chosen for the quantification of LSN score. Repeated-measures ANOVA, paired t test, Pearson's correlation coefficient analysis, and intraclass correlation coefficient (ICC) were used for statistical analysis. Results: LSN scores from high to low were LSNRT_POST, LSNRT_ANT, and LSNLT, representing trans-regional differences (p < 0.001). Reproducibility of LSN measurement across different MRI scanners was high to excellent (ICC = 0.838–0.921). The mean difference between first and second examinations in LSNRT_ANT, LSNRT_POST, and LSNLT were 0.032 (p = 0.013), 0.002 (p = 0.910), and 0.010 (p = 0.285) for reader 1 and 0.051 (p = 0.004), 0.061 (p = 0.002), and 0.023 (p = 0.005) for reader 2. The first and second examinations were highly correlated in all hepatic regions (r = 0.712–0.839, p < 0.001). There was a low to moderate correlation between LSN score and LS value (r = 0.364–0.592, p ≤ 0.001), which was higher in the chronic hepatitis B (CHB) group than in the non-CHB group in all hepatic regions. Conclusions: In our study, LSN measurement on liver MRI showed trans-regional differences and excellent reproducibility across different MRI scanners. To use LSN score more widely, standardization of quantification software and selected hepatic regions is needed. [ABSTRACT FROM AUTHOR]

Menopausal hormone therapy (MHT) in women can reduce troublesome menopause symptoms and prevent cognitive decline. This cross-sectional study investigated the MHT-related effect on brain morphology and its association with sex hormones in menopausal women by using an optimized diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL)-based voxel-based morphometry (VBM) method. Twenty-one menopausal women without MHT (noMHT) and 20 menopausal women with MHT were included in this study. Magnetic resonance imaging data were processed using SPM 12 with DARTEL-based VBM whole brain analysis approach. A 2-sample t-test and analysis of covariance (ANCOVA) adjusting for age and total intracranial volume were used to compare GM volume between noMHT and MHT women. The association between MHT (treatment period, hormones levels) and brain volume variations were analyzed by Spearman correlation. MHT women showed significantly larger volumes of the superior/middle/inferior frontal gyri, hypothalamus, inferior temporal gyrus, parahippocampal gyrus, hippocampus, cerebellar cortex, postcentral gyrus, precuneus, angular gyrus, supplementary motor area, superior occipital gyrus, and precentral gyrus compared to the noMHT women. The volumes of the angular gyrus and hypothalamus in MHT women positively correlated with treatment period. On the other hand, the hypothalamic volume negatively correlated with FSH and LH levels, and the volumes of the inferior frontal gyrus, and angular gyrus negatively correlated with progesterone levels, respectively. MHT-treated women showed larger GM volume than noMHT women. The anatomical structures that showed greater volume in association with MHT included the deep brain areas, frontal, temporal, parietal, and occipital gyri. [ABSTRACT FROM AUTHOR]

Hemodynamics in aortic dissection (AD) is closely associated with the risk of aortic aneurysm, rupture, and malperfusion. Altered blood flow in patients with AD can lead to severe complications such as visceral malperfusion. In this study, we aimed to investigate the effect of cannulation flow on hemodynamics in AD using a fluid–structure interaction simulation. We developed a specific-idealized AD model that included an intimal tear in the descending thoracic aorta, a re-entry tear in the left iliac artery, and nine branches. Two different cannulation methods were tested: (1) axillary cannulation (AC) only through the brachiocephalic trunk and (2) combined axillary and femoral cannulation (AFC) through the brachiocephalic trunk and the right common iliac artery. AC was found to result in the development of a pressure difference between the true lumen and false lumen, owing to the difference in the flow rate through each lumen. This pressure difference collapsed the true lumen, disturbing blood flow to the celiac and superior mesenteric arteries. However, in AFC, the pressure levels between the two lumens were similar, and no collapse occurred. Moreover, the visceral flow was higher than that in AC. Lastly, the stiffness of the intimal flap affected the true lumen's collapse. [ABSTRACT FROM AUTHOR]

Highlights: Inducing a localized crystalline iron pyrophosphate in amorphous iron phosphate overlayer. Enhanced photoelectrochemical water oxidation activity with long-term durability. The heterogeneous hybrid structure overcoming the energy barrier in water oxidation. A rational regulation of the solar water splitting reaction pathway by adjusting the surface composition and phase structure of catalysts is a substantial approach to ameliorate the sluggish reaction kinetics and improve the energy conversion efficiency. In this study, we demonstrate a nanocrystalline iron pyrophosphate (Fe4(P2O7)3, FePy)-regulated hybrid overlayer with amorphous iron phosphate (FePO4, FePi) on the surface of metal oxide nanostructure with boosted photoelectrochemical (PEC) water oxidation. By manipulating the facile electrochemical surface treatment followed by the phosphating process, nanocrystalline FePy is localized in the FePi amorphous overlayer to form a heterogeneous hybrid structure. The FePy-regulated hybrid overlayer (FePy@FePi) results in significantly enhanced PEC performance with long-term durability. Compared with the homogeneous FePi amorphous overlayer, FePy@FePi can improve the charge transfer efficiency more significantly, from 60% of FePi to 79% of FePy@FePi. Our density-functional theory calculations reveal that the coexistence of FePi and FePy phases on the surface of metal oxide results in much better oxygen evolution reaction kinetics, where the FePi was found to have a typical down-hill reaction for the conversion from OH* to O2, while FePy has a low free energy for the formation of OH*. [ABSTRACT FROM AUTHOR]

Endometriosis is a condition of the female reproductive tract characterized by endometrium-like tissue growing outside the uterus. Though it is a common cause of pelvic pain and infertility, there is currently no reliable noninvasive method to diagnose the presence of endometriosis without surgery, and the pathophysiological mechanisms that lead to the occurrence of symptoms require further inquiry. Due to patient heterogeneity and delayed diagnosis, animal models are commonly used to study the development of endometriosis, but these are costly due to the large number of animals needed to test various treatments and experimental conditions at multiple endpoints. Here, we describe a method for synthesis of multimodal imaging gold-fluorescein isothiocyanate (FITC) nanoparticles with preclinical application via induction of nanoparticle-labeled endometriosis-like lesions in mice. Labeling donor endometrial tissue fragments with gold-FITC nanoparticles prior to induction of endometriosis in recipients enables in vivo detection of the gold-labeled lesions with photoacoustic imaging. The same imaging method can be used to visualize embryos noninvasively in pregnant mice. Furthermore, the conjugated FITC dye on the gold nanoparticles allows easy isolation of labeled lesion tissue under a fluorescence dissection microscope. After dissection, the presence of gold-FITC nanoparticles and endometrium-like histology of lesions can be verified through fluorescence imaging, gold enhancement, and immunostaining. This method for in vivo imaging of endometriosis-like lesions and fluorescence-guided dissection will permit new experimental possibilities for the longitudinal study of endometriosis development and progression as well as endometriosis-related infertility. [ABSTRACT FROM AUTHOR]

It has been becoming important to identify modifiable risk factors to prevent dementia. We investigated the association of individual and combined cardiovascular health (CVH) on dementia risk in older adults. From the National Health Insurance Service of Korea-Senior database, 191,013 participants aged ≥ 65 years without prior dementia or cerebrovascular diseases who had check-ups between 2004 and 2012 were assessed. Participants were stratified into three groups according to the number of optimal levels of CVH (low, 0–2; moderate, 3–4; and high CVH status, 5–6) and grouped by levels of individual CVH metrics, the number of optimal CVH metrics, and the CVH score. Over a median follow-up of 6.2 years, 34,872 participants were diagnosed with dementia. Compared with low CVH status, moderate and high CVH status were associated with a decreased risk of dementia (hazard ratio [95% confidence interval], 0.91 [0.89–0.92] for moderate; 0.78 [0.75–0.80] for high CVH status) including Alzheimer's and vascular dementia. The risk of dementia decreased with an increase in the number of optimal CVH metrics (0.94 [0.93–0.94] per additional optimal metric) and with an increase in the CVH score (0.93 [0.93–0.94] per 1-point increase). After censoring for stroke, the association of CVH metrics with dementia risk was consistently observed. Among individual metrics, physical activity had the strongest association with the risk of dementia. In an older Asian population without prior dementia or cerebrovascular disease, a consistent relationship was observed between the improvement of a composite metric of CVH and the reduced risk of dementia. [ABSTRACT FROM AUTHOR]

The efficient dimerization of (−)-Epigallocatechin gallate (EGCG), which is the major bioactive constituent isolated from the leaves of Camellia sinensis, was initially reported without changes in its stereochemistry using low-temperature plasma. The contribution of plasma during the dimerization of EGCG in a methanolic solution was quantified using a major factor, with the major factor demonstrated based on the contents of newly generated products, in this case the sum of oolonghomobisflavans A and B depending on the plasma treatment method. Samples were treated in three methods: plasma direct treatment, an indirect treatment using only reactive species, and an indirect treatment using effects other than those by reactive species. Ozone was identified as a major factor during the plasma treatment, and the operating ranges of the ozone concentration for regulated dimerization were evaluated. The mechanism by which EGCG synthesizes dimers A and B during the treatment process using low-temperature plasma was investigated using the derived major factor and prior literature. The ozone generated by the plasma reacted with methanol to form formaldehyde, and dimers A and B were synthesized by oligomers through a methylene-bridge by the formaldehyde. A plausible pathway of regulated dimerization was deduced based on these results, and the mechanism of EGCG dimerization by plasma is described using this pathway. [ABSTRACT FROM AUTHOR]

Purpose: Articulating cement spacers are frequently used in staged approaches for infected total knee arthroplasty (TKA). This study investigated whether a tibial cement spacer (TCS) with spikes could reduce spacer-related problems in two-stage revision TKA (R-TKA).Methods: A total of 27 patients (27 knees; 10 men and 17 women) who underwent two-stage R-TKA for infected TKA were retrospectively analyzed. Group A comprised 12 patients who used TCS with spikes added to the bottom surface, whereas group B consisted of 15 patients who used conventional TCS with a flat bottom. For each group, plain radiographs were obtained after cement spacer implantation and before R-TKA to measure mediolateral (ML) translation and TCS's tilting angle. Patients' demographic data, ML translation of the TCS, and changes in the TCS's tilting angle between the groups were analyzed.Results: The mean ML translation was significantly lower in group A than that in group B (1.7 mm vs. 5.4 mm, p = 0.04). The mean change in the tilting angle was significantly lower in group A than that in group B (4.5° vs. 19.4°, p = 0.047).Conclusion: The spiked TCS in two-stage R-TKA provides superior stability compared to the TCS with a conventional design. [ABSTRACT FROM AUTHOR]

The study aimed to develop and validate whether the computed tomography (CT) radiomics analysis is effective in differentiating cardiac tumors and thrombi. For this retrospective study, a radiomics model was developed on the basis of a training dataset of 192 patients (61.9 ± 13.3 years, 90 men) with cardiac masses detected in cardiac CT from January 2010 to September 2019. We constructed three models for discriminating between a cardiac tumor and a thrombus: a radiomics model, a clinical model, which included clinical and conventional CT variables, and a model that combined clinical and radiomics models. In the training dataset, the radiomics model and the combined model yielded significantly higher differentiation performance between cardiac tumors and cardiac thrombi than the clinical model (AUC 0.973 vs 0.870, p < 0.001 and AUC 0.983 vs 0.870, p < 0.001, respectively). In the external validation dataset with 63 patients (59.8 ± 13.2 years, 26 men), the combined model yielded a larger AUC compared to the clinical model (AUC 0.911 vs 0.802, p = 0.037). CT radiomics analysis is effective in differentiating cardiac tumors and thrombi. In conclusion, the combination of clinical, conventional CT, and radiomics features demonstrated an additional benefit in differentiating between cardiac tumor and thrombi compared to clinical data and conventional CT features alone. [ABSTRACT FROM AUTHOR]

The study aimed to develop and validate whether the computed tomography (CT) radiomics analysis is effective in differentiating cardiac tumors and thrombi. For this retrospective study, a radiomics model was developed on the basis of a training dataset of 192 patients (61.9 ± 13.3 years, 90 men) with cardiac masses detected in cardiac CT from January 2010 to September 2019. We constructed three models for discriminating between a cardiac tumor and a thrombus: a radiomics model, a clinical model, which included clinical and conventional CT variables, and a model that combined clinical and radiomics models. In the training dataset, the radiomics model and the combined model yielded significantly higher differentiation performance between cardiac tumors and cardiac thrombi than the clinical model (AUC 0.973 vs 0.870, p < 0.001 and AUC 0.983 vs 0.870, p < 0.001, respectively). In the external validation dataset with 63 patients (59.8 ± 13.2 years, 26 men), the combined model yielded a larger AUC compared to the clinical model (AUC 0.911 vs 0.802, p = 0.037). CT radiomics analysis is effective in differentiating cardiac tumors and thrombi. In conclusion, the combination of clinical, conventional CT, and radiomics features demonstrated an additional benefit in differentiating between cardiac tumor and thrombi compared to clinical data and conventional CT features alone. [ABSTRACT FROM AUTHOR]

Purpose: To compare the MRI-derived liver surface nodularity (LSN) scores acquired on both 1.5 T and 3 T. Materials and methods: Forty chronic liver disease patients who underwent gadoxetic acid-enhanced MRI at both 1.5 and 3 T were included. Axial hepatobiliary phase images with the same voxel size were used to calculate the LSN score in both liver lobes with a quantitative software. Rank correlation, Wilcoxon test, and Bland–Altman limits of agreement were used for statistical analysis. Results: There was a weak correlation between the right and left liver lobe on 1.5 T (rs = 0.331, p = 0.037) and 3 T (rs = 0.381, p = 0.015). The correlation between 1.5 T and 3 T on both liver lobes showed a very strong correlation (right, rs = 0.927, p < 0.001; left, rs = 0.845, p < 0.001). LSN scores differed significantly between both lobes on 1.5 T (median, 1.201 vs. 0.674, right vs. left) and 3 T (1.076 vs. 0.592) (all p < 0.001). LSN scores differed significantly between 1.5 T and 3 T on both lobes (all p < 0.001). The Bland–Altman plot comparing 1.5 T and 3 T on right and left liver lobes showed a systemic bias of 0.08 and 0.07, respectively. Conclusions: LSN scores differed significantly on 1.5 T vs. 3 T and right vs. left liver lobe. Caution should be made when comparing LSN scores derived from different field strengths or the hepatic lobe. Interplatform, interlobar reproducibility should be resolved to use LSN scores, which is relatively easy to perform without additional hardware or images. [ABSTRACT FROM AUTHOR]

Female subfertility is highly associated with endometriosis. Endometrial progesterone resistance is suggested as a crucial element in the development of endometrial diseases. We report that MIG-6 is downregulated in the endometrium of infertile women with endometriosis and in a non-human primate model of endometriosis. We find ERBB2 overexpression in the endometrium of uterine-specific Mig-6 knockout mice (Pgrcre/+Mig-6f/f; Mig-6d/d). To investigate the effect of ERBB2 targeting on endometrial progesterone resistance, fertility, and endometriosis, we introduce Erbb2 ablation in Mig-6d/d mice (Mig-6d/dErbb2d/d mice). The additional knockout of Erbb2 rescues all phenotypes seen in Mig-6d/d mice. Transcriptomic analysis shows that genes differentially expressed in Mig-6d/d mice revert to their normal expression in Mig-6d/dErbb2d/d mice. Together, our results demonstrate that ERBB2 overexpression in endometrium with MIG-6 deficiency causes endometrial progesterone resistance and a nonreceptive endometrium in endometriosis-related infertility, and ERBB2 targeting reverses these effects. Female subfertility is highly associated with endometriosis. Here the authors show that progesterone-induced MIG-6 is reduced in endometrium of infertile women and non-human primates with endometriosis, and in a mouse model find that Erbb2 is the key mediator of Mig-6 loss induced endometriosis-related infertility. [ABSTRACT FROM AUTHOR]

Delayed dark adaptation due to impaired rod photoreceptor homeostasis has been reported as the earliest symptom of eye diseases such as age-related macular degeneration, diabetic retinopathy, and retinitis pigmentosa. Objective measurement of dark adaptation can facilitate early diagnosis to enable prompt intervention to prevent vision loss. However, there is a lack of noninvasive methods capable of spatiotemporal monitoring of photoreceptor changes during dark adaptation. Here we demonstrate functional optical coherence tomography (OCT) for in vivo intrinsic signal optoretinography (ORG) of dark adaptation kinetics in the C57BL/6J mouse retina. Functional OCT revealed a shortening of the outer retina, a rearrangement of the cone and rod photoreceptor interdigitation zone, and a reduction in intrinsic signal amplitude at the photoreceptor inner segment ellipsoid (ISe). A strong positive correlation between the outer retinal shortening and ISe intensity reduction was also confirmed. Functional OCT of dark adaptation kinetics promises an objective method for rapid ORG assessment of physiological integrity of retinal photoreceptors. [ABSTRACT FROM AUTHOR]

This paper presents a nonlinear analysis procedure for the seismic performance assessment of deteriorated reinforced concrete bridges using a modified damage index. A finite-element analysis program, RCAHEST (Reinforced Concrete Analysis in Higher Evaluation System Technology), is used to analyze deteriorated two-span simply supported reinforced concrete bridges. The new nonlinear material models for deteriorated reinforced concrete behaviors were proposed, considering corrosion effects as shown in a reduction in reinforcement section and bond strength. A modified damage index aims to quantify the seismic performance level in deteriorated reinforced concrete bridges. Several parameters of two-span simply supported deteriorated reinforced concrete bridge have been studied to determine the seismic performance levels. The newly developed analytical method for assessing the seismic performance of deteriorated reinforced concrete bridges is verified by comparison with the experimental and analytical parameter results. [ABSTRACT FROM AUTHOR]

To assess the utility of machine learning (ML) algorithms in predicting clinically relevant atrial high-rate episodes (AHREs), which can be recorded by a pacemaker. We aimed to develop ML-based models to predict clinically relevant AHREs based on the clinical parameters of patients with implanted pacemakers in comparison to logistic regression (LR). We included 721 patients without known atrial fibrillation or atrial flutter from a prospective multicenter (11 tertiary hospitals) registry comprising all geographical regions of Korea from September 2017 to July 2020. Predictive models of clinically relevant AHREs were developed using the random forest (RF) algorithm, support vector machine (SVM) algorithm, and extreme gradient boosting (XGB) algorithm. Model prediction training was conducted by seven hospitals, and model performance was evaluated using data from four hospitals. During a median follow-up of 18 months, clinically relevant AHREs were noted in 104 patients (14.4%). The three ML-based models improved the discrimination of the AHREs (area under the receiver operating characteristic curve: RF: 0.742, SVM: 0.675, and XGB: 0.745 vs. LR: 0.669). The XGB model had a greater resolution in the Brier score (RF: 0.008, SVM: 0.008, and XGB: 0.021 vs. LR: 0.013) than the other models. The use of the ML-based models in patient classification was associated with improved prediction of clinically relevant AHREs after pacemaker implantation. [ABSTRACT FROM AUTHOR]

In Jeju Island, multiple land-based aquafarms were fully operational along most coastal region. However, the effect of effluent on distribution and behaviours of dissolved organic matter (DOM) in the coastal water are still unknown. To decipher characteristics of organic pollution, we compared physicochemical parameters with spectral optical properties near the coastal aquafarms in Jeju Island. Absorption spectra were measured to calculate the absorption coefficient, spectral slope coefficient, and specific UV absorbance. Fluorescent DOM was analysed using fluorescence spectroscopy coupled with parallel factor analysis. Dissolved organic carbon (DOC) and total dissolved nitrogen (TDN) were measured using high-temperature catalytic oxidation. The DOC concentration near the discharge outlet was twice higher than that in natural groundwater, and the TDN concentration exponentially increased close to the outlet. These distribution patterns indicate that aquafarms are a significant source of DOM. Herein, principal component analysis was applied to categorise the DOM origins. There were two distinct groups, namely, aquaculture activity for TDN with humic-like and high molecular weights DOM (PC1: 48.1%) and natural biological activity in the coastal water for DOC enrichment and protein-like DOM (PC2: 18.8%). We conclude that the aquafarms significantly discharge organic nitrogen pollutants and provoke in situ production of organic carbon. Furthermore, these findings indicate the potential of optical techniques for the efficient monitoring of anthropogenic organic pollutants from aquafarms worldwide. [ABSTRACT FROM AUTHOR]

We sought to evaluate the clinical implication of LAE based on left atrial anterior–posterior (LA AP) dimension or LA volume index (LAVI) in Korean patients with atrial fibrillation (AF). We enrolled 8159 AF patients from the CODE-AF registry. The primary outcome was rate of stroke or systemic embolism (SSE). The prevalence of mild, moderate, and severe LAE by LA AP dimension was 30.6%, 18.5%, and 21.4%, and by LAVI (available in 5808 patients) was 15.7%, 12.5% and 37.8%, respectively. Compared with no or mild LAE, patients with significant LAE (moderate to severe LAE, n = 3258, 39.9%) were associated with a higher rate of SSE (2.5% vs. 1.4%, P = 0.001). Multivariable analysis suggested presence of significant LAE by LA AP dimension was associated with a higher risk of SSE in the overall population (HR 1.57, 95% CI: 1.14–2.17, P = 0.005) and in patients using anticoagulants (n = 5836, HR 1.79, 95% CI: 1.23–2.63, P = 0.002). Patients with significant LAE by LAVI were also at higher risk of SSE (HR 1.58, 95% CI: 1.09–2.29, P = 0.017). In conclusion, significant LAE by LA dimension or LAVI was present in 39.9% and 50.2% of AF patients, respectively, and was associated with a higher rate of SSE. [ABSTRACT FROM AUTHOR]

In this nationwide cohort study, we assessed the effects of hypertension burden and blood pressure (BP) control on dementia in different age subgroups. From the Korean National Health Insurance Service-Health Screening cohort from January 1, 2005 to December 31, 2013, we enrolled 428,976 subjects aged 40–79 years without previous diagnosis of dementia or stroke. During a mean follow-up of 7.3 ± 1.5 years, 9435 (2.2%) were diagnosed with dementia. Per 10 mmHg increase in systolic BP (SBP), risk of dementia was increased by 22% (95% confidence interval [CI] 1.15–1.30) in subjects aged 40–59 years and 8% (95% CI 1.04–1.11) in subjects aged 60–69 years. No significant associations were observed in subjects aged ≥ 70 years. Among subjects aged 40–59 years, both vascular and Alzheimer's dementia risks were increased with increasing SBP. Increasing hypertension burden (proportion of days with increased BP) was associated with higher dementia risk (hazard ratio [HR] 1.09 per 10% increase, 95% CI 1.08–1.10). Among patients with baseline SBP ≥ 140 mmHg, optimal follow-up SBP (120–139 mmHg) was associated with decreased dementia risk (HR 0.69, 95% CI 0.50–0.95). Hypertension burden was associated with higher risks of dementia. Adequate BP control was associated with lower risk of dementia in individuals aged < 70 years. [ABSTRACT FROM AUTHOR]

Mirror invariance or generalisation is the ability to recognise objects as being the same regardless of their spatial orientation. However, when, for example, learning to read Roman script, children need to hone these skills so that they can readily discriminate between mirror letters such as b/d or p/b. Korean Hangul makes a particularly interesting comparison as it has both lateral and vertical perceptually similar mirror letter pairs (i.e., ㅏㅓ, ㅑㅕ, ㅗㅜ, ㅛㅠ). In the current study, we investigated the mirror generalisation effect in native readers of Korean Hangul. We used a similar negative priming paradigm as used by (Ahr et al., Brain and Cognition 117:1–8, 2017) with Roman script readers. In contrast to their findings, we did not find evidence of negative priming due to either lateral (e.g., ㅏ + ㅓ) or vertical (e.g., ㅗ + ㅜ) mirror letter primes in Korean readers. One explanation for these results is that adult readers of Korean Hangul may not experience mirror invariance to the same extent as Roman script readers due to script-specific characteristics. Thus, learning to read this distinctive script may result in readers being less sensitive to mirror reversals than Roman script readers. [ABSTRACT FROM AUTHOR]

Whether catheter ablation for atrial fibrillation (AF) improves survival and affects other outcomes in real-world heart failure (HF) patients is unclear. This study aimed to evaluate whether ablation reduces death, and other outcomes in real-world AF patients with HF. Among 834,735 patients with AF from 2006 to 2015 in the Korean National Health Insurance Service database, 3173 HF patients underwent AF ablation. Propensity score weighting was used to correct for differences between the groups. During median 54 months follow-up, the risk of all-cause death in ablated patients was less than half of that in patients with medical therapy (2.8 vs. 6.2 per 100 person-years; hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.27–0.65, p < 0.001). Ablation was related with lower risk of cardiovascular death (HR 0.38, 95% CI 0.32–0.62, p < 0.001), HF admission (HR 0.39, 95% CI 0.33–0.46, p < 0.001) and stroke/systemic embolism (HR 0.44, 95% CI 0.37–0.53, p < 0.001). In subgroup analysis, the risk of all-cause death was reduced in most subgroups except in the elderly (≥ 75 years) and strictly anticoagulated patients. Ablation may be associated with reduced risk of all-cause death and cardiovascular death in real-world AF patients with HF, supporting the role of AF ablation in patients with HF. [ABSTRACT FROM AUTHOR]

We examined the residence time, seepage rate, and submarine groundwater discharge (SGD)-driven dissolved nutrients and organic matter in Hwasun Bay, Jeju Island, Korea during the occurrence of a typhoon, Kong-rey, using a humic fluorescent dissolved organic matter (FDOMH)-Si mass balance model. The study period spanned October 4–10, 2018. One day after the typhoon, the residence time and seepage rate were calculated to be 1 day and 0.51 m day−1, respectively, and the highest SGD-driven fluxes of chemical constituents were estimated (1.7 × 106 mol day−1 for dissolved inorganic nitrogen, 0.1 × 106 mol day−1 for dissolved inorganic phosphorus (DIP), 1.1 × 106 mol day−1 for dissolved silicon, 0.5 × 106 mol day−1 for dissolved organic carbon, 1.6 × 106 mol day−1 for dissolved organic nitrogen, 0.4 × 106 mol day−1 for particulate organic carbon, and 38 × 106 g QS day−1 for FDOMH). SGD-driven fluxes of dissolved nutrient and organic matter were over 90% of the total input fluxes in Hwasun Bay. Our results highlight the potential of using the FDOMH-Si mass balance model to effectively measure SGD within a specific area (i.e., volcanic islands) under specific weather conditions (i.e., typhoon/storm). In oligotrophic oceanic regions, SGD-driven chemical fluxes from highly permeable islands considerably contribute to coastal nutrient budgets and coastal biological production. [ABSTRACT FROM AUTHOR]

To determine the distribution of dissolved organic matter (DOM) in the East China Sea (ECS) during the summer, we measured the dissolved organic carbon (DOC) and nitrogen (DON), fluorescent dissolved organic matter (FDOM), and chlorophyll a (Chl. a) in the upper 100-m layer of this region during July and September 2015. The DOC (r2 = 0.72 and 0.78 in July and September, respectively) and DON (r2 = 0.43 and 0.33) were significantly correlated with salinity, suggesting that the river is the primary origin of DOM. However, we found that at a DOC "pulse" under a salinity ranging from 24 to 35, the extrapolating DOC values (304 ± 11 μM) were twice higher than those with a salinity of close to 0, as found in a previous study. The excess DOC concentration seemed to be attributed to the microbial metabolism during transport from the estuary based on the good relationships between DOC and marine humic-like FDOM (r2 = 0.42 and 0.47), as well as the fluorescence, humification, and biological indexes, but showed no correlation with Chl. a. Thus, the results of our study indicate that microbial activities can be a significant factor controlling the distribution of DOM in the ECS during summer. [ABSTRACT FROM AUTHOR]

In sarcopenic obesity, the importance of evaluating muscle and fat mass is unquestionable. There exist diverse quantification methods for assessing muscle and fat mass by imaging techniques; thus these methods must be standardized for clinical practice. This study developed a quantification software for the body composition imaging using abdominal magnetic resonance (MR) images and compared the difference between sarcopenic obesity and healthy controls for clinical application. Thirty patients with sarcopenic obesity and 30 healthy controls participated. The quantification software was developed based on an ImageJ multiplatform and the processing steps are as follows: execution, setting, confirmation, and extraction. The variation in the muscle area (MA), subcutaneous fat area (SA), and visceral fat area (VA) was analyzed with an independent two sample T-test. There were significant differences in SA (p < 0.001) and VA (p = 0.011), whereas there was no difference in MA (p = 0.421). Regarding the ratios, there were significant differences in MA/SA (p < 0.001), MA/VA (p = 0.002), and MA/(SA + VA) (p < 0.001). Overall, intraclass correlation coefficients were higher than 0.9, indicating excellent reliability. This study developed customized sarcopenia-software for assessing body composition using abdominal MR images. The clinical findings demonstrate that the quantitative body composition areas and ratios can assist in the differential diagnosis of sarcopenic obesity or sarcopenia. [ABSTRACT FROM AUTHOR]

The interplay between glioblastoma stem cells (GSCs) and tumor-associated macrophages (TAMs) promotes progression of glioblastoma multiforme (GBM). However, the detailed molecular mechanisms underlying the relationship between these two cell types remain unclear. Here, we demonstrate that ARS2 (arsenite-resistance protein 2), a zinc finger protein that is essential for early mammalian development, plays critical roles in GSC maintenance and M2-like TAM polarization. ARS2 directly activates its novel transcriptional target MGLL, encoding monoacylglycerol lipase (MAGL), to regulate the self-renewal and tumorigenicity of GSCs through production of prostaglandin E2 (PGE2), which stimulates β-catenin activation of GSC and M2-like TAM polarization. We identify M2-like signature downregulated by which MAGL-specific inhibitor, JZL184, increased survival rate significantly in the mouse xenograft model by blocking PGE2 production. Taken together, our results suggest that blocking the interplay between GSCs and TAMs by targeting ARS2/MAGL signaling offers a potentially novel therapeutic option for GBM patients. How glioblastoma stem cells (GSCs) and tumor-associated macrophages (TAMs) interact to promote progression of glioblastoma multiforme (GBM) is currently unclear. Here, the authors demonstrate a role for the ARS2/MAGL signalling in regulating self-renewal and tumorigenicity of GSCs and M2-like TAM polarization. [ABSTRACT FROM AUTHOR]

We investigated bacterial production (BP) and respiration (BR), in combination with phytoplankton and environmental parameters, to elucidate major carbon sources regulating heterotrophic bacterial metabolic activity and to evaluate variations of trophic balance associated with seawater warming in Gyeonggi Bay (GB). BP was not significantly correlated with primary production (PP, p > 0.05), but was significantly correlated with dissolved organic carbon (DOC, p < 0.01). Bacterial growth efficiency (BGE) was generally low (average 0.06) and decreased with increasing C/N ratio of DOM and concentration of humic-like fluorescent DOM (FDOMH). This uncoupling between bacteria and phytoplankton and low BGE suggests that bacterial growth largely relied on allochthonous input of DOC, but metabolic activities of the bacteria were suppressed by the low nutritional quality of the FDOMH. High BP/PP and BR/PP ratios (generally >1) implied that trophic balance of GB represented heterotrophic conditions, and ratios showed an inverse relationship with Chl-a concentrations. In comparison to the early 1990s, increasing water temperatures were associated with significant decreases in PP and Chl-a (by a factor of 9 and 2, respectively), whereas changes in BP were insignificant; these changes resulted in a 14-fold increase in the BP/PP ratio. Therefore, our results strongly imply that warming in GB intensified the carbon flux through the microbial loop, which may reduce the efficiency of energy transfer to higher trophic levels. [ABSTRACT FROM AUTHOR]

Hypoxia has occurred worldwide in coastal and marginal oceans. The redox condition has recently garnered major interest as a favorable condition for delivering sedimentary organic matter to the water column. In this study, we measured the fluorescence of fluorescent dissolved organic matter (FDOM) in brackish Lake Shihwa, Korea, in which hypoxic conditions are typically observed during summer. Especially, fluorescent intensities of the humic FDOM (FDOMH) were relatively high during summer, with a relatively lower dissolved oxygen (DO) level, and exponentially increased with decreasing DO concentrations. The results indicated that the production of FDOMH is associated with anaerobic processes. It was further supported by a significantly positive relationship between FDOMH and ammonium. Based on the relatively low values of redox potential (up to 60.0 mV) and high concentration of phosphate with the low DO level, this enrichment of FDOMH seems to be linked to the input of anoxic porewater. Using a simple schematic diagram, the contribution of FDOMH from reducing environments is comparable to that from stream water, which is known to be a major source in coastal regions. This study highlights that the redox condition is a key factor contributing to the production of FDOMH in coastal marine environments. [ABSTRACT FROM AUTHOR]

We previously reported the feasibility and efficacy of a simulation-guided clinical catheter ablation of atrial fibrillation (AF) in an in-silico AF model. We developed a highly efficient realistic AF model reflecting the patient endocardial voltage and local conduction and tested its clinical feasibility. We acquired > 500 endocardial bipolar electrograms during right atrial pacing at the beginning of the AF ablation procedures. Based on the clinical bipolar electrograms, we generated simulated voltage maps by applying fibrosis and local activation maps adjusted for the fiber orientation. The software's accuracy (CUVIA2.5) was retrospectively tested in 17 patients and feasibility prospectively in 10 during clinical AF ablation. Results: We found excellent correlations between the clinical and simulated voltage maps (R = 0.933, p < 0.001) and clinical and virtual local conduction (R = 0.958, p < 0.001). The proportion of virtual local fibrosis was 15.4, 22.2, and 36.9% in the paroxysmal AF, persistent AF, and post-pulmonary vein isolation (PVI) states, respectively. The reconstructed virtual bipolar electrogram exhibited a relatively good similarities of morphology to the local clinical bipolar electrogram (R = 0.60 ± 0.08, p < 0.001). Feasibility testing revealed an in situ procedural computing time from the clinical data acquisition to wave-dynamics analyses of 48.2 ± 4.9 min. All virtual analyses were successfully achieved during clinical PVI procedures. We developed a highly efficient, realistic, in situ procedural simulation model reflective of individual anatomy, fiber orientation, fibrosis, and electrophysiology that can be applied during AF ablation. [ABSTRACT FROM AUTHOR]

TEMPO-modified cellulose nanofiber (TM CNF) microparticles (MPs) incorporating cysteamine (CA) were prepared by a spray-drying method. MPs on SEM micrographs were flat wrinkled balls-like and less than 10 μm in diameter. The energy-dispersive X-ray spectroscopy, the elemental mapping, and the X-ray photon spectroscopy were performed to understand the content and the distribution of CA in the TM CNF MPs. FT-IR spectroscopy showed that the thiol groups of CA molecules contained in MPs were oxidized by the treatment of H2O2. According to DSC analysis, CA contained in the MPs exhibited the melting point at a lower temperature (ca. 50–53 °C) than free CA (ca. 69 °C). The volume mean diameter of the MPs was 12.1 to 13.8 μm. The release of FITC-dextran loaded in MPs was promoted when H2O2 solution was used as a release medium. The promoted release could be ascribed to the oxidization-induced reorientation of CA molecules and the subsequently occurring dislocation of TM CNF. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is considered a hepatic manifestation of metabolic syndrome and is associated with cardiovascular outcomes. We investigated whether NAFLD was associated with coronary artery calcification (CAC) in participants without a previous history of cardiovascular disease and whether this association differed according to sex and obesity status after adjustment for other atherosclerosis risk factors, alcohol intake, and liver enzyme levels. Among 67,441 participants, data from 8,705 participants who underwent a fatty liver status and CAC assessment during routine health screening were analysed. CAC scores were calculated using computed tomography. NAFLD was diagnosed in patients with evidence of liver steatosis on ultrasonography. Obesity was defined as a body mass index of ≥25 kg/m2. Multivariate analysis showed a significant association between NAFLD and CAC in non-obese participants (odds ratio, 1.24 [95% confidence interval, 1.01–1.53]), whereas NAFLD and CAC were not associated in obese participants. Interaction analysis showed that the association between NAFLD and CAC was influenced by sex and obesity. Subgroup analysis revealed a significant association between NAFLD and CAC in non-obese male participants (odds ratio, 1.36 [1.07–1.75]), but not in female participants. Our study indicates that non-obese men with NAFLD are prone to CAC. [ABSTRACT FROM AUTHOR]