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ObjectiveWe identified patients who initially did not have a maxillary sinus fungus ball on computed tomography (CT) but developed it on a subsequent CT scan. We assessed potential risk factors for developing a maxillary sinus fungus ball between the two scans.Patients and methodsThis study included 35 patients with 38 lesions who initially had no maxillary sinus fungus balls on CT but were later diagnosed with the condition and underwent surgery.ResultsWe analyzed 38 lesions in 35 patients, each of whom had normal CT scan results initially but later developed a maxillary sinus fungus ball. No specific risk factors for developing a maxillary sinus fungus ball were identified. However, when compared to the maxillary sinusitis group, facial trauma and dental implant surgery appeared to be associated with maxillary sinus fungus ball formation (p

Objectives. Due to the rarity of olfactory neuroblastoma (ONB), there is ongoing debate about optimal treatment strategies, especially for early-stage or locally advanced cases. Therefore, our study aimed to explore experiences from multiple centers to identify factors that influence the oncological outcomes of ONB. Methods. We retrospectively analyzed 195 ONB patients treated at nine tertiary hospitals in South Korea between December 1992 and December 2019. Kaplan-Meier survival analysis was used to evaluate oncological outcomes, and a Cox proportional hazards regression model was employed to analyze prognostic factors for survival outcomes. Furthermore, we conducted 1:1 nearest-neighbor matching to investigate differences in clinical outcomes according to the use of neoadjuvant chemotherapy. Results. In our cohort, the 5-year overall survival (OS) rate was 78.6%, and the 5-year disease-free survival (DFS) rate was 62.4%. The Cox proportional hazards model revealed that the modified Kadish (mKadish) stage and Dulguerov T status were significantly associated with DFS, while the mKadish stage and Hyams grade were identified as prognostic factors for OS. The subgroup analyses indicated a trend toward improved 5-year DFS with dural resection in mKadish A and B cases, even though the result was statistically insignificant. Induction chemotherapy did not provide a survival benefit in this study after matching for the mKadish stage and nodal status. Conclusion. Clinical staging and pathologic grading are important prognostic factors in ONB. Dural resection in mKadish A and B did not show a significant survival benefit. Similarly, induction chemotherapy also did not show a survival benefit, even after stage matching.

Zinc oxide is considered an outstanding photocatalyst candidate, but its low photo-corrosion resistance is a problem to be solved. In the ZnO-ZnS core-shell structure, ZnS acts as a protective layer for the ZnO core, and thus, it can enhance stability and long-term performance. The ZnO-ZnS core-shell structure is synthesized into various nanoscale morphologies with high specific surface areas to improve photocatalytic efficiency. However, they are easily agglomerated and are hard to separate from reaction media. In this study, micro-sized bumpy spheres of ZnO-ZnS core-shell structure were prepared via facile chemical transformation of as-prepared ZnO. After sulfurization of the ZnO template, it was confirmed through SEM, TEM, EDS, and XPS analysis that a uniform ZnS shell layer was formed without significant change in the initial ZnO morphology. The ZnO-ZnS core-shell microsphere has shown superior efficiency and stability in the photocatalytic degradation of Rhodamine B compared with pristine ZnO microspheres

Abstract Phytoestrogens, such as isoflavones, are known for their capacity to simulate various physiological impacts of estrogen in the human body. Our research evaluated the effects of isoflavone-enriched soybean leaves (IESL) on collagen fiber loss prompted by ovariectomy in Sprague Dawley (SD) rats, thereby simulating menopausal changes in women. IESL, bolstered with an increased concentration of isoflavones through a metabolite farming process, contained a significantly higher amount of isoflavones than regular soybean leaves. Our results indicate that the administration of IESL can counteract the decrease in relative optical density and dermal thickness of collagen fibers caused by ovariectomy in SD rats, with more pronounced effects observed at higher isoflavone dosages. These outcomes suggest that soybean leaves rich in isoflavones may hold potential benefits in combating collagen degradation and skin aging symptoms related to menopause. Further research is needed to fully understand the exact molecular pathways at play and the potential clinical relevance of these findings.

Abstract Although increase in physical activity is important to improve prognosis of cardiac patients in addition to hospital-based exercise cardiac rehabilitation, their physical activity levels are not properly understood. This study aimed to examine domain- and intensity-specific physical activity in individuals with coronary heart disease (CHD) and compare them with non-CHD individuals. Data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2019 were analyzed, including 1083 CHD patients and 38,532 non-CHD individuals. The inclusion criteria were age 19 years or older and data not missing for CHD information. Before and after propensity score matching (PSM) for age, sex, body mass index, education, household income, alcohol intake, and smoking status, domain (leisure, work, transportation)—and intensity (moderate, vigorous) -specific physical activity participation levels were compared between individuals with and without CHD. Before PSM, CHD individuals were older, less educated, more sedentary, and participated less in PAs compared to non-CHD individuals. After PSM, CHD individuals had similar levels of domain-specific PAs. However, they had higher work-related PA levels (29.7 ± 209.6 vs. 42.1 ± 291.3 min/week p = 0.022) and more sedentary time (487.2 ± 224.2 vs. 514.1 ± 228.7. p = 0.003) than those without CHD. Subgroup analysis revealed lower leisure-related PA in men with CHD (63.5 ± 165.5 vs. 47.3 ± 140.2, p

Abstract Background Chronic kidney disease (CKD) poses a significant health challenge, yet early detection remains difficult. Resting heart rate (RHR) has been shown to be a reliable indicator of type 2 diabetes, prompting interest in its potential as an independent predictor of CKD. This study aimed to investigate the association between RHR and CKD prevalence, as well as explore potential interactions between RHR and other risk factors for CKD in a sample of 25,246 adults. Methods Data from the Korean National Health and Nutrition Examination Survey (2011–2014) were utilized for this study, with 19,210 participants included after screening. Logistic regression analysis was employed to examine the relationship between RHR and CKD prevalence. Stratified analyses were conducted based on known risk factors for CKD. Results Participants with an RHR ≥ 90 bpm exhibited a 2.07-fold [95% confidence interval (CI): 1.28–3.34] and 2.22-fold (95% CI: 1.42–3.48) higher prevalence of CKD in men and women, respectively, compared to those with an RHR

BackgroundAfter the COVID-19 outbreak, interest in airborne virus infections has increased. We considered ways to reduce the risk of infection to other people by inactivating the virus before it is inhaled into the heating, ventilation, and air conditioning (HVAC) systems. We installed a recently developed air sterilizer in the newly remodeled outpatient clinic of a tertiary university hospital and confirmed its effectiveness.MethodsAfter remodeling the ENT outpatient clinic at Chonnam National University Hospital, 15 KOKKOS air sterilizers (Bentech Frontier Co., Ltd., Gwangju, Korea) were installed. Total culturable microorganisms (TCMs) and volatile organic compounds (VOCs) were measured in five separate inspection areas three days before installation, 2 weeks after installation, and 4 weeks after installation.ResultsAfter measurement of TCMs, improvement in air quality occurred 2 weeks after air sterilizer instatement at all timepoints except inspection area 5, and further improvement was achieved after 4 weeks (p < 0.05). After assessment of VOCs, improvement occurred 4 weeks after air sterilizer connection at all points (p < 0.05).ConclusionKOKKOS air sterilizers are effective in improving air quality in an outpatient clinic at a tertiary university hospital.

Abstract Skipping breakfast is highly prevalent but it is not clear whether breakfast frequency is associated with metabolic syndrome in young adults. We aimed to assess the association between breakfast frequency and metabolic syndrome in Korean young adults. This cross-sectional study was based on health check-up data of university students aged 18–39 years between 2016 and 2018. Participants were stratified into three groups by breakfast frequency (non-skipper, skipper 1–3 days/week, skipper 4–7 days/week). Multivariable-adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of metabolic syndrome. Out of 12,302 participants, 56.8% skipped breakfast at least 4 days/week. Metabolic syndrome prevalence was higher in those skipping breakfast for 4 or more days/week compared to non-skipper. (3.1% vs 1.7%) In the age- and sex-adjusted model, individuals skipping breakfast for 4–7 days per week had a higher OR of metabolic syndrome (OR 1.73, 95% CI 1.21–2.49) compared to non-skipper. Although this association became insignificant (OR 1.49, 95% CI 0.99–2.23) after a fully adjusted multivariable model, trends of positive association between frequency of breakfast skipping and metabolic syndrome was significant (P for trend = 0.038). Frequent breakfast skipping was associated with higher odds of metabolic syndrome in young adults. Further longitudinal studies in the long term are needed to understand the association of meal patterns with metabolic syndrome.

Malicious reverse engineering of software has served as a valuable technique for attackers to infringe upon and steal intellectual property. We can employ obfuscation techniques to protect against such attackers as useful tools to safeguard software. Applying obfuscation techniques to source code can prevent malicious attackers from reverse engineering a program. However, the ambiguity surrounding the protective efficacy of these source code obfuscation tools and techniques presents challenges for users in evaluating and comparing the varying degrees of protection provided. This paper addresses these issues and presents a methodology to quantify the effect of source code obfuscation. Our proposed method is based on three main types of data: (1) the control flow graph, (2) the program path, and (3) the performance overhead added to the process—all of which are derived from a program analysis conducted by human experts and automated tools. For the first time, we have implemented a tool that can quantitatively evaluate the quality of obfuscation techniques. Then, to validate the effectiveness of the implemented framework, we conducted experiments using four widely recognized commercial and open-source obfuscation tools. Our experimental findings, based on quantitative values related to obfuscation techniques, demonstrate that our proposed framework effectively assesses obfuscation quality.

Background and Objectives: The Clinical Frailty Scale (CFS), used to screen for prehospital frailty in patients aged >65 years, is simple, time-efficient, and has been validated in emergency departments (EDs). In this study, we analyzed whether the Korean Triage and Acuity Scale (KTAS) classification by level in older patients determined to have frailty based on the Korean version of the CFS increases the triage performance of the current KTAS. Materials and Methods: The primary outcome was 30-day in-hospital mortality, and secondary outcomes were hospital and intensive care unit (ICU) admissions. This study retrospectively analyzed prospectively collected data from three ED centers. Patients with a CFS score ranging from five (mildly frail) to nine (terminally ill) were categorized into the frailty group. We upgraded the KTAS classification of the frailty group by one level of urgency and defined this as the CFS-KTAS. Results: The cutoff values for predicting admission were three and two for the KTAS and CFS-KTAS, respectively. A significant difference was observed in the area under the receiver operating characteristic (AUROC) curve between the KTAS and CFS-KTAS. To predict ICU admission, the cutoff score was two for both scales. A significant difference was observed in the AUROC curve between the KTAS and CFS-KTAS. For predicting in-hospital mortality, the cutoff score was two for both scales. A significant difference was observed in the AUROC curve between the KTAS and CFS-KTAS. Conclusions: This study showed that the CFS-adjusted KTAS has a more useful prognostic value than the KTAS alone for predicting hospital outcomes in older patients.

Water intake has been suggested to be associated with weight control, but evidence for optimal water intake in terms of amount, timing, and temperature is sparse. Additionally, genetic predisposition to obesity, which affects satiety and energy expenditure, might interact with water intake in regulating individual adiposity risk. We conducted a cross-sectional study recruiting 172 Korean adults. Information on water intake and lifestyle factors was collected through self-reported questionnaires, and height, weight, and waist circumference (WC) were measured by researchers. The oral buccal swab was performed for genotyping of FTO rs9939609, MC4R rs17782313, BDNF rs6265 and genetic risk of obesity was calculated. Linear regression was performed to estimate mean difference in body mass index (BMI) and WC by water intake and its 95% confidence interval (95% CI). As a sensitivity analysis, logistic regression was performed to estimate odds ratio (OR) of obesity/overweight (BMI of ≥23kg/m2; WC of ≥90cm for men and of ≥80cm for women) and its 95% CI. Drinking >1L/day was significantly associated with higher BMI (mean difference: 0.90, 95% CI 0.09, 1.72) and WC (mean difference: 3.01, 95% CI 0.62, 5.41) compared with drinking ≤1L/day. Independent of total water intake, drinking before bedtime was significantly associated with lower BMI (mean difference: -0.98, 95% CI -1.91, -0.05). The results remained consistent when continuous BMI and WC were analyzed as categorical outcomes. By perceived temperature, drinking >1L/day of cold water was associated with higher BMI and WC compared with drinking ≤1L/day of water at room-temperature. By genetic predisposition to obesity, a positive association between water intake and WC was confined to participants with low genetic risk of obesity (P interaction = 0.04). In conclusion, amount, timing, and perceived temperature of water intake may be associated with adiposity risk and the associations might vary according to genetic predisposition to obesity.

Abstract The relationship between body mass index (BMI) and body fatness could differ according to age, sex, and race-ethnicity. We aimed to evaluate in which contexts BMI could be a good measure for body fatness compared to dual-energy X-ray absorptiometry (DXA) derived measures. The study population included 18,061 participants (9141 men and 8920 women) aged 18 and older who tested DXA from the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2006, and 8107 men and 10,754 women with DXA data from Korea NHANES from 2008 to 2011 to represent the Asian population. We calculated Pearson correlation coefficients between BMI and DXA derived fat mass index (FMI) and percentage body fat (PBF) depending on age, sex, and race-ethnicity. The correlation between BMI, FMI and PBF and obesity-related biomarkers was also estimated among the subgroup with both DXA and information on each biomarker. BMI was strongly correlated with FMI (r = 0.944 in men and 0.976 in women), PBF (r = 0.735 in men and 0.799 in women), and truncal fat mass (r = 0.914 in men and 0.941 in women) with correlations stronger in women than in men except for with waist-height ratio (r = 0.921 in men and 0.911 in women). The correlation between BMI and DXA derived adiposity weakened with age in both sexes. BMI was less correlated with FMI (r = 0.840 in men and 0.912 in women), PBF (r = 0.645 in men and 0.681 in women), and truncal fat mass (r = 0.836 in men and 0.884 in women) in Korean compared to other race-ethnicities. Among obesity-related biomarkers, insulin was the most strongly correlated to body adiposity indices in both sexes and strength of these correlations generally decreased with age. BMI predicted obesity-related biomarkers as well as FMI and truncal fat mass and superior to PBF. BMI could be a good measure for body fatness, particularly among young age groups, women, the US population, but less so in Korean populations. The lower correlation between BMI and body fatness in older compared to younger age groups could be related to increasing PBF and decreasing lean body mass.

Soil salinization is one of the leading threats to global ecosystems, food security, and crop production. Plant growth-promoting rhizobacteria (PGPRs) are potential bioinoculants that offer an alternative eco-friendly agricultural approach to enhance crop productivity from salt-deteriorating lands. The current work presents bacterial strain CNUC13 from maize rhizosphere soil that exerted several PGPR traits and abiotic stress tolerance. The strain tolerated up to 1000 mM NaCl and 30% polyethylene glycol (PEG) 6000 and showed plant growth-promoting (PGP) traits, including the production of indole-3-acetic acid (IAA) and siderophore as well as phosphate solubilization. Phylogenetic analysis revealed that strain CNUC13 was Microbacterium azadirachtae. Maize plants exposed to high salinity exhibited osmotic and oxidative stresses, inhibition of seed germination, plant growth, and reduction in photosynthetic pigments. However, maize seedlings inoculated with strain CNUC13 resulted in significantly improved germination rates and seedling growth under the salt-stressed condition. Specifically, compared with the untreated control group, CNUC13-treated seedlings exhibited increased biomass, including fresh weight and root system proliferation. CNUC13 treatment also enhanced photosynthetic pigments (chlorophyll and carotenoids), reduced the accumulation of osmotic (proline) and oxidative (hydrogen peroxide and malondialdehyde) stress indicators, and positively influenced the activities of antioxidant enzymes (catalase, superoxide dismutase, and peroxidase). As a result, CNUC13 treatment alleviated oxidative stress and promoted salt tolerance in maize. Overall, this study demonstrates that M. azadirachtae CNUC13 significantly enhances the growth of salt-stressed maize seedlings by improving photosynthetic efficiency, osmotic regulators, oxidative stress resilience, and antioxidant enzyme activity. These findings emphasize the potential of utilizing M. azadirachtae CNUC13 as a bioinoculant to enhance salt stress tolerance in maize, providing an environmentally friendly approach to mitigate the negative effects of salinity and promote sustainable agriculture.

Background Cell culture conditions during manufacturing can impact the clinical efficacy of chimeric antigen receptor (CAR) T cell products. Production methods have not been standardized because the optimal approach remains unknown. Separate CD4+ and CD8+ cultures offer a potential advantage but complicate manufacturing and may affect cell expansion and function. In a phase 1/2 clinical trial, we observed poor expansion of separate CD8+ cell cultures and hypothesized that coculture of CD4+ cells and CD8+ cells at a defined ratio at culture initiation would enhance CD8+ cell expansion and simplify manufacturing.Methods We generated CAR T cells either as separate CD4+ and CD8+ cells, or as combined cultures mixed in defined CD4:CD8 ratios at culture initiation. We assessed CAR T cell expansion, phenotype, function, gene expression, and in vivo activity of CAR T cells and compared these between separately expanded or mixed CAR T cell cultures.Results We found that the coculture of CD8+ CAR T cells with CD4+ cells markedly improves CD8+ cell expansion, and further discovered that CD8+ cells cultured in isolation exhibit a hypofunctional phenotype and transcriptional signature compared with those in mixed cultures with CD4+ cells. Cocultured CAR T cells also confer superior antitumor activity in vivo compared with separately expanded cells. The positive impact of CD4+ cells on CD8+ cells was mediated through both cytokines and direct cell contact, including CD40L-CD40 and CD70-CD27 interactions.Conclusions Our data indicate that CD4+ cell help during cell culture maintains robust CD8+ CAR T cell function, with implications for clinical cell manufacturing.

The security of in-vehicle networks has become an important issue as automobiles become more connected and automated. In this paper, we propose a graph-based intrusion detection and classification system, named G-IDCS, which aims to enhance the security of the in-vehicle controller area network (CAN) protocol. Existing intrusion detection systems (IDSs) using graph theory suffer from limitations, such as requiring a large number of CAN messages for detection and being unable to classify attack types despite analyzing numerous messages. Meanwhile, machine learning or deep learning-based systems have limited sensitivity to environmental changes such as attack type change due to model overfitting, and are unable to provide explanations for classification decisions. Using various graph features, our threshold-based intrusion detection method overcomes these limitations by integrating a threshold-based IDS and a machine learning-based attack type classifier. Our threshold-based intrusion detection method of G-IDCS reduces the number of CAN messages required for detection by more than 1/30 and improves the accuracy of combined attack detection by over 9% compared to an existing intrusion detection method that uses graph theory. Furthermore, unlike existing machine learning and deep learning-based intrusion detection systems, our threshold classifier is robust to changes in attack types and can provide explanations for the features used in attack detection. In addition, our machine learning-based attack type classifier outperforms existing techniques in all performance metrics and can serve as a digital forensic tool for investigating cyber attacks on in-vehicle networks. Using the classifier to identify attack types can facilitate the design of corresponding protection methods, thereby enhancing the security of in-vehicle networks.

Control-flow integrity (CFI) is considered a principled mitigation against control-flow hijacking even under the most powerful attacker who can arbitrarily write and read memory. However, existing schemes still demonstrated limitations in either guaranteeing high security level or achieving low performance and memory overhead. These limitations have restricted the application of CFI in real software. To improve its applicability similar to mandatory protection schemes such as DEP and ASLR, it is essential to improve both high security guarantee and low overhead. In this paper, we propose “BGCFI”, which is a fine-grained CFI based on a Bipartite Graph. The relationship between an indirect branch and a valid target address at the branch is represented by an edge in the bipartite graph. The verification of the indirect branch is achieved by checking the existence of the corresponding edge in the bipartite graph. The verification method for fine-grained CFI results in more efficiency on both computational and memory overhead, while completely preserving high security guarantee. We demonstrate our results through the implementation of a proof-of-concept module and evaluation on the SPEC CPU 2017 suite and the Firefox browser.

Introduction: While many patients visit the emergency department (ED) for various reasons, medical resources are limited. Therefore, various triage scale systems have been used to predict patient urgency and severity. South Korea has developed and used the Korean Triage and Accuracy Scale (KTAS) based on the Canadian classification tool. As the elderly population increases, the number of elderly patients visiting the ED also increases. However, in KTAS, there is no consideration for the elderly, and the same classification system as adults. The aim of this study is to verify the ability of KTAS to predict severity levels in the elderly group, compared to the adult group. Methods: This is a retrospective study for patients who visited the ED at two centers between February 1, 2018 and January 31, 2021. The initial KTAS level, changed level at ED discharge, general patient character, ED treatment results, in-hospital mortality, and lengths of hospital and ED stays were acquired. Area under the receiver operating characteristics (AUROC) was used to verify the severity prediction ability of the elderly group to KTAS, and logistic regression analysis was used for the prediction up-triage of KTAS. Results: The enrolled patients in the study were 87,220 in the adult group and 37,627 in the elderly group. The proportion of KTAS up-triage was higher in the elderly group (1.9 % vs. 1.2 %, p

Abstract This study aimed to evaluate the prevalence of left main or triple vessel coronary artery disease (CAD) in comatose out-of-hospital cardiac arrest (OHCA) survivors and assessed their outcome based on the revascularization strategy. This multicenter, retrospective, observational registry-based study was conducted at 9 Korean tertiary care hospitals. Adult comatose OHCA survivors with left main or triple vessel CAD documented by immediate (≤ 2 h) coronary angiography after return of spontaneous circulation between 2011 and 2019 were included. The primary outcome was neurologically intact survival at 1-month. Among 727 OHCA patients, 150 (25%) had left main or triple vessel CAD and underwent complete (N = 32), incomplete (N = 78), and no immediate (N = 40) revascularization, respectively. The rate of neurologically intact survival at 1 month was significantly different among the groups (53%, 32%, and 23% for complete, incomplete, and no immediate revascularization groups, respectively; P = 0.02). After adjustment using the inverse probability of treatment weighting, complete revascularization was associated with neurologically intact survival at 1 month (odds ratio, 2.635; P = 0.01). Left main or triple vessel CAD is not uncommon in OHCA patients. The complete revascularization was associated with better outcome. Further clinical trials to confirm the best revascularization strategy are needed.

Many countries have attempted to mitigate and manage issues related to harmful algal blooms (HABs) by monitoring and predicting their occurrence. The infrequency and duration of HABs occurrence pose the challenge of data imbalance when constructing machine learning models for their prediction. Furthermore, the appropriate selection of input variables is a significant issue because of the complexities between the input and output variables. Therefore, the objective of this study was to improve the predictive performance of HABs using feature selection and data resampling. Data resampling was used to address the imbalance in the minority class data. Two machine learning models were constructed to predict algal alert levels using 10 years of meteorological, hydrodynamic, and water quality data. The improvement in model accuracy due to changes in resampling methods was more noticeable than the improvement in model accuracy due to changes in feature selection methods. Models constructed using combinations of original and synthetic data across all resampling methods demonstrated higher prediction performance for the caution level (L-1) and warning level (L-2) than models constructed using the original data. In particular, the optimal artificial neural network and random forest models constructed using combinations of original and synthetic data showed significantly improved prediction accuracy for L-1 and L-2, representing the transition from normal to bloom formation states in the training and testing steps. The test results of the optimal RF model using the original data indicated prediction accuracies of 98.8% for L0, 50.0% for L1, and 50.0% for L2. In contrast, the optimal random forest model using the Synthetic Minority Oversampling Technique–Edited Nearest Neighbor (ENN) sampling method achieved accuracies of 85.0% for L0, 85.7% for L1, and 100% for L2. Therefore, applying synthetic data can address the imbalance in the observed data and improve the detection performance of machine learning models. Reliable predictions using improved models can support the design of management practices to mitigate HABs in reservoirs and ultimately ensure safe and clean water resources.

This study discusses the challenge of distinguishing between two high-quality mandarin cultivars, ‘Asumi’ and ‘Asuki’, which have been introduced and cultivated in Korea after being developed through crossbreeding in Japan. Owing to genetic similarities resulting from crossbreeding between the same parent cultivars, it is challenging to differentiate them morphologically at the seedling stage. This difficulty poses challenges for cultivation and harvesting on farms. To address this issue, we developed a method using sequence characteristic amplification region (SCAR) markers for rapid and accurate differentiation between the two cultivars. We selected specific primer sets from random amplified polymorphic DNA–SCAR combinations and sequence-related amplified polymorphism contrast markers. The multiplex PCR system using these molecular markers was able to identify 16 mandarin cultivars, including ‘Asumi’ and ‘Asuki’, among 30 cultivars. The use of these SCAR markers is expected to enhance citrus cultivation by accurately identifying mixed cultivars and facilitating proper harvest timing for citrus distribution. Additionally, the markers can help identify the genetic traits of hybrid varieties at the seedling stage.

With the rise in sophisticated cyber threats, traditional authentication methods are no longer sufficient. Risk-based authentication (RBA) plays a critical role in the context of the zero trust framework—a paradigm shift that assumes no trust within or outside the network. This research introduces a novel proposal as its core: utilization of the time required by OpenID Connect (OIDC) token exchanges as a new RBA feature. This innovative approach enables the detection of tunneled connections without any intervention from the user’s browser or device. By analyzing the duration of OIDC token exchanges, the system can identify any irregularities that may signify unauthorized access attempts. This approach not only improves upon existing RBA frameworks but is also in alignment with the broader movement toward intelligent and responsive security systems.

NAND flash memory-based IoT device can potentially still leave behind original personal data in an invalid area even if the data has been deleted. In this paper, we raise the forensic issue of original data remaining in unmanaged blocks caused by NAND flash memory and introduce methods for secure deletion of such data in the invalid area. We also propose a verification technique for secure deletion that is performed based on cell count information, which refers to the difference in bits between personal data and data stored in the block. The pass/fail of the verification technique according to the cell count information is determined in consideration of error correction capabilities. With the forensic issue of de-identification being a vital theme in the big data industry, the threat of serious privacy breaches coupled with our proposal to prevent these attacks will prove to be critical technological necessities in the future.

Objective The objective of this experiment was to investigate the effect of dietary glucose oxidase (GOD), catalase (CAT), or both supplementation on reproductive performance, oxidative stress, and apoptosis in sows. Methods A total of 104 multiparous sows were randomly assigned to four groups (n = 26) with each group given a basal diet, basal diet plus GOD at 60 U/kg, basal diet plus CAT at 75 U/kg, and basal diet plus GOD at 60 U/kg and CAT at 75 U/kg. Sows were fed the experimental diets throughout gestation and lactation. Results Dietary GOD supplementation increased average daily feed intake of sows and litter weight at weaning (p

This study was conducted to evaluate the relationship among market weight, slaughter age, yield grade, and primal cut yield in Hanwoo. A total of 403 Hanwoo (Korean native cattle) was assessed for carcass traits such as carcass cold weight, backfat thickness, ribeye area, dressing percentage, yield index, and marbling score. The production yield of the individual major primal cuts of Hanwoo beef was also measured. Carcass cold weight, ribeye area, and backfat thickness, which affect meat quality increased with increased market weight (p < 0.05). The production yield of the ten major primal cuts also increased with increased market weight (p < 0.05). In terms of slaughter age, carcass cold weight, ribeye area, and backfat thickness all increased from 25 months to 28–29 months, and the production yield of all prime cuts also increased with increasing slaughter age. According to the meat yield grade, carcass cold weight and backfat thickness increased from grade A to grade C, although the ribeye area was not affected. The combined findings of the study suggest that slaughtering Hanwoo at the weight of 651–700 kg and 701–750 and age of 28.23 and 29.83 months could be desirable to achieve the best quality and quantity grade of Hanwoo beef. However, the positive correlation of carcass cold weight and backfat thickness, and the negative correlation of the yield index according to primal cuts yield indicated that it is necessary to couple the slaughtering management of cattle with improved genetic and breeding method of Hanwoo to increase the production yield of the major prime cuts of Hanwoo beef.

Modern vehicles are becoming complex cyber-physical systems equipped with numerous electronic control units (ECUs). Over the controller area network (CAN), these ECUs communicate with each other to share information related to vehicle status as well as commands to efficiently control the vehicle. However, the increasing complexity of modern vehicles has inadvertently expanded potential attack surfaces, making them vulnerable to cyber attacks. In light of this, researchers are currently working to demonstrate remote vehicle maneuvering by compromising ECUs, and as a countermeasure to such malicious manipulation, to study automotive intrusion detection systems (IDSs) as potential remedies. In general, CAN messages are transmitted periodically, and as such, many researchers have relied on frequency-based IDSs in their solutions proposals. However, an attacker can bypass this defense by suspending the communication of the target ECU from the network and injecting malicious messages with the same frequency as the suspended messages. As a result, an attacker is able to masquerade as the original transmission frequency. In this paper, we propose a Transmission-resuming Time-based IDS (TTIDS), which is designed to detect such attacks. TTIDS detects when an ECU periodically transmitting messages is suspended, and then it estimates when the suspended ECU resumes periodic transmission. With this projection, TTIDS detects malicious messages transmitted while the ECU is suspended. We conduct the evaluation of TTIDS on two real vehicles and present the results, which show the TTIDS is able to effectively detect an enhanced attack that bypasses existing frequency-based IDSs with a false positive rate of 0.213% and a false negative rate of 0.027%.

Inflammation is a multifaceted marker resulting from complex interactions between genetic and lifestyle factors. Emerging evidence suggests Aryl hydrocarbon receptor (AHR) protein may be implicated in the regulation of immune system and inflammatory responses. To investigate whether rs4410790 genotype (TT, TC, CC) near AHR gene is related to serum IgG levels, a marker of chronic inflammation, and whether lifestyle factors modifies the relationship, we conducted a cross-sectional study by recruiting 168 Korean adults. Participants responded to a lifestyle questionnaire and provided oral epithelial cells and blood samples for biomarker assessment. Among these participants, C allele was the minor allele, with the minor allele frequency of 40%. The rs4410790 TT genotype was significantly associated with elevated IgG levels compared with TC/CC genotypes, after adjusting for potential confounders (p = 0.04). The relationship varied significantly by levels of alcohol consumption (P interaction = 0.046) and overweight/obese status (P interaction = 0.02), but not by smoking status (P interaction = 0.64) and coffee consumption (P interaction = 0.55). Specifically, higher IgG levels associated with the TT genotype were evident in frequent drinkers and individuals with BMI≥23kg/m2, but not in their counterparts. Thus, rs4410790 genotype may be associated with IgG levels and the genetic predisposition to higher IgG levels may be mitigated by healthy lifestyle factors like infrequent drinking and healthy weight.

OBJECTIVES We examined whether pericardial adipose tissue (PAT) is predictive of prediabetes and type 2 diabetes over time. METHODS In total, 2,570 adults without prediabetes/diabetes from the Coronary Artery Risk Development in Young Adults Study were followed up over 15 years. PAT volume was measured by computed tomography scans, and the new onset of prediabetes/diabetes was examined 5 years, 10 years, and 15 years after the PAT measurements. Multivariable Cox regression models were used to examine the association between the tertile of PAT and incident prediabetes/diabetes up to 15 years later. The predictive ability of PAT (vs. waist circumference [WC], body mass index [BMI], waist-to-height ratio [WHtR]) for prediabetes/diabetes was examined by comparing the area under the receiver operating characteristic curve (AUC). RESULTS The highest tertile of PAT was associated with a 1.56 times (95% confidence interval [CI], 1.03 to 2.34) higher rate of diabetes than the lowest tertile; however, no association was found between the highest tertile of PAT and prediabetes in the fully adjusted models, including additional adjustment for BMI or WC. In the fully adjusted models, the AUCs of WC, BMI, WHtR, and PAT for predicting diabetes were not significantly different, whereas the AUC of WC for predicting prediabetes was higher than that of PAT. CONCLUSIONS PAT may be a significant predictor of hyperglycemia, but this association might depend on the effect of BMI or WC. Additional work is warranted to examine whether novel adiposity indicators can suggest advanced and optimal information to supplement the established diagnosis for prediabetes/diabetes.

Abstract Background We assessed the prognostic accuracy of the standardized electroencephalography (EEG) patterns (“highly malignant,” “malignant,” and “benign”) according to the EEG timing (early vs. late) and investigated the EEG features to enhance the predictive power for poor neurologic outcome at 1 month after cardiac arrest. Methods This prospective, multicenter, observational, cohort study using data from Korean Hypothermia Network prospective registry included adult patients with out-of-hospital cardiac arrest (OHCA) treated with targeted temperature management (TTM) and underwent standard EEG within 7 days after cardiac arrest from 14 university-affiliated teaching hospitals in South Korea between October 2015 and December 2018. Early EEG was defined as EEG performed within 72 h after cardiac arrest. The primary outcome was poor neurological outcome (Cerebral Performance Category score 3–5) at 1 month. Results Among 489 comatose OHCA survivors with a median EEG time of 46.6 h, the “highly malignant” pattern (40.7%) was most prevalent, followed by the “benign” (33.9%) and “malignant” (25.4%) patterns. All patients with the highly malignant EEG pattern had poor neurologic outcomes, with 100% specificity in both groups but 59.3% and 56.1% sensitivity in the early and late EEG groups, respectively. However, for patients with “malignant” patterns, 84.8% sensitivity, 77.0% specificity, and 89.5% positive predictive value for poor neurologic outcome were observed. Only 3.5% (9/256) of patients with background EEG frequency of predominant delta waves or undetermined had good neurologic survival. The combination of “highly malignant” or “malignant” EEG pattern with background frequency of delta waves or undetermined increased specificity and positive predictive value, respectively, to up to 98.0% and 98.7%. Conclusions The “highly malignant” patterns predicted poor neurologic outcome with a high specificity regardless of EEG measurement time. The assessment of predominant background frequency in addition to EEG patterns can increase the prognostic value of OHCA survivors. Trial registration KORHN-PRO, NCT02827422 . Registered 11 September 2016—Retrospectively registered.

Abstract Background Globally, there are over 200 million cases of malaria annually and over 400,000 deaths. Early and accurate detection of low-density parasitaemia and asymptomatic individuals is key to achieving the World Health Organization (WHO) 2030 sustainable development goals of reducing malaria-related deaths by 90% and eradication in 35 countries. Current rapid diagnostic tests are neither sensitive nor specific enough to detect the low parasite concentrations in the blood of asymptomatic individuals. Methods Here, an imaging-based sensing technique, particle diffusometry (PD), is combined with loop mediated isothermal amplification (LAMP) on a smartphone-enabled device to detect low levels of parasitaemia often associated with asymptomatic malaria. After amplification, PD quantifies the Brownian motion of fluorescent nanoparticles in the solution during a 30 s video taken on the phone. The resulting diffusion coefficient is used to detect the presence of Plasmodium DNA amplicons. The coefficients of known negative samples are compared to positive samples using a one-way ANOVA post-hoc Dunnett’s test for confirmation of amplification. Results As few as 3 parasite/µL of blood was detectable in 45 min without DNA extraction. Plasmodium falciparum parasites were detected from asymptomatic individuals’ whole blood samples with 89% sensitivity and 100% specificity when compared to quantitative polymerase chain reaction (qPCR). Conclusions PD-LAMP is of value for the detection of low density parasitaemia especially in areas where trained personnel may be scarce. The demonstration of this smartphone biosensor paired with the sensitivity of LAMP provides a proof of concept to achieve widespread asymptomatic malaria testing at the point of care.

Introduction: Actinomycosis of the nasal cavity is very rare. Objective: The purpose of this study was to investigate the clinical features, treatment methods, and treatment results of actinomycosis of the nasal cavity in our hospital. Methods: We retrospectively enrolled 11 patients with histopathologically identified actinomycosis of the nasal cavity from January 2010 to May 2020. Results: This study included five males and six females. The most common symptom was purulent nasal discharge (36.4%). Nasal actinomycosis occurred in the maxillary sinus in 5 (45.5%) patients, the ethmoid sinus in two, the hard palate in two, the frontal sinus in one, and the nasal septum in one. After surgery, intravenous administration of antibiotics was performed on average for 7.4 days and oral antibiotics were prescribed for about 120.5 days. The clinical characteristics of the patients with nasal actinomycosis and the duration of antibiotic usage were not significantly different. Trauma was significantly associated with repeated nasal actinomycosis infections (p

Designed using vehicle requirements, Scalable service-Oriented MiddlewarE over IP (SOME/IP) has been adopted and used as one of the Ethernet communication standard protocols in the AUTomotive Open System Architecture (AUTOSAR). However, SOME/IP was designed without considering security, and its vulnerabilities have been demonstrated through research. In this paper, we propose a SOME/IP communication protection method using an authentication server (AS) and tickets to mitigate the infamous SOME/IP man-in-the-middle (MITM) attack. Reliable communication between the service-providing node and the node using SOME/IP communication is possible through the ticket issued from the authentication server. This method is relatively light in operation at each node, has good scalability for changes such as node addition, guarantees freshness, and provides interoperability with the existing SOME/IP protocol.

Germicidal lamps that primarily emit 254 nm ultraviolet (UV) radiation have been effectively utilized for surface sterilization, but they cannot be used on human skin and eyes due to their harmful and genotoxic activity. Recent reports have shown that far UV-C light (207–222 nm) can efficiently kill pathogens with potentially no harm to exposed human tissues. However, these methods still require additional filtering and/or further protective equipment. In this study, we demonstrate a filter-free, harmless, and single-wavelength far UV-C 207 nm germicidal light source that can be used to inactivate different respiratory viruses. It can be exploited as a safe and effective disinfection tool for various airborne viruses. We successfully developed a single-wavelength far UV-C source that produces an exact wavelength of 207 nm. We examined its safety on human skin and corneal cell lines, as well as its effects on inactivating different airborne viruses, such as coronavirus, adenovirus, and vaccinia virus. We expect that our far UV-C lamps can be safely and conveniently used to reduce COVID-19 infections and protect both our living spaces and hospitals from the threat of contamination by possible new or mutant viruses.

The inflammatory and insulinemic potentials of diets have been associated with colorectal cancer risk. However, it is unknown whether the plasma metabolite profiles related to inflammatory diets, or to insulinemic diets, underlie this association. The aim of this study was to evaluate the association between metabolomic profile scores related to the food-based empirical dietary inflammatory patterns (EDIP), the empirical dietary index for hyperinsulinemia (EDIH), and plasma inflammation (CRP, IL-6, TNFα-R2, adiponectin) and insulin (C-peptide) biomarkers, and colorectal cancer risk. Elastic net regression was used to derive three metabolomic profile scores for each dietary pattern among 6840 participants from the Nurses’ Health Study and Health Professionals Follow-up Study, and associations with CRC risk were examined using multivariable-adjusted logistic regression, in a case-control study of 524 matched pairs nested in both cohorts. Among 186 known metabolites, 27 were significantly associated with both the EDIP and inflammatory biomarkers, and 21 were significantly associated with both the EDIH and C-peptide. In men, odds ratios (ORs) of colorectal cancer, per 1 standard deviation (SD) increment in metabolomic score, were 1.91 (1.31–2.78) for the common EDIP and inflammatory-biomarker metabolome, 1.12 (0.78–1.60) for EDIP-only metabolome, and 1.65 (1.16–2.36) for the inflammatory-biomarkers-only metabolome. However, no association was found for EDIH-only, C-peptide-only, and the common metabolomic signatures in men. Moreover, the metabolomic signatures were not associated with colorectal cancer risk among women. Metabolomic profiles reflecting pro-inflammatory diets and inflammation biomarkers were associated with colorectal cancer risk in men, while no association was found in women. Larger studies are needed to confirm our findings.

Abstract Background The increasing number of cancer patients has an escalating economic impact to public health systems (approximately, International dollars- Int$ 60 billion annually in Brazil). Physical activity is widely recognized as one important modifiable risk factor for cancer. Herein, we estimated the economic costs of colon and post-menopausal breast cancers in the Brazilian Unified Health System (SUS) attributable to lack of physical activity. Methods Population attributable fractions were calculated using prevalence data from 57,962 adults who answered a physical activity questionnaire in the Brazilian National Health Survey, and relative risks of colon and breast cancer from a meta-analysis. Annual costs (1 Int$ = 2.1 reais) with hospitalization, chemotherapy and radiotherapy were obtained from the Hospital and Ambulatory Information Systems of the Brazilian SUS. Two counterfactual scenarios were considered: theoretical minimum risk exposure level (≥8000 MET-min/week) and physical activity guidelines (≥600 MET-min/week). Results Annually, the Brazilian SUS expended Int$ 4.5 billion in direct costs related to cancer treatment, of which Int$ 553 million due to colon and breast cancers. Direct costs related to colon and breast cancers attributable to lack of physical activity were Int$ 23.4 million and Int$ 26.9 million, respectively. Achieving at least the physical activity guidelines would save Int$ 10.3 mi (colon, Int$ 6.4 mi; breast, Int$ 3.9 mi). Conclusions Lack of physical activity accounts for Int$ 50.3 million annually in direct costs related to colon and post-menopausal breast cancers. Population-wide interventions aiming to promote physical activity are needed to reduce the economic burden of cancer in Brazil.

Abstract This study aimed to investigate the association between domain-specific physical activity (PA) and diabetes in Korean adults. We analyzed 26,653 men and women (aged > 18 years) from the Korea National Health and Nutrition Examination Survey (2014–2018). PA was measured using a validated Global PA Questionnaire. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for various confounders. Transport PA accounted for the majority of total PA (46%, men; 58%, women), followed by leisure-time PA (30%; 22%) and work PA (24%; 20%). In men, ORs (95% CI) of diabetes comparing ≥ 600 metabolic task of equivalent (MET)-min/week vs. no activity were 0.82 (0.71–0.95) for leisure-time PA, 0.85 (0.75–0.96) for transport PA, and 0.88 (0.78–0.99) for leisure-time + transport PA. In women, ORs (95% CI) of diabetes comparing the same groups were 0.73 (0.60–0.89) for leisure-time PA, 0.97 (0.85–1.10) for transport PA, and 0.88 (0.78–1.00) for leisure-time + transport PA. However, work PA showed no association with diabetes. In conclusion, leisure-time PA was inversely associated with diabetes in both men and women, while transport PA was inversely associated only in men. But work PA was not associated with diabetes in Korean adults.

Diabetes contributes to the onset of various diseases, including cancer and cardiovascular and neurodegenerative diseases. Recent studies have highlighted the similarities and relationship between diabetes and dementia as an important issue for treating diabetes-related cognitive deficits. Diabetes-related dementia exhibits several features, including blood-brain barrier disruption, brain insulin resistance, and Aβ over-accumulation. High-mobility group box1 (HMGB1) is a protein known to regulate gene transcription and cellular mechanisms by binding to DNA or chromatin via receptor for advanced glycation end-products (RAGE) and toll-like receptor 4 (TLR4). Recent studies have demonstrated that the interplay between HMGB1, RAGE, and TLR4 can impact both neuropathology and diabetic alterations. Herein, we review the recent research regarding the roles of HMGB1-RAGE-TLR4 axis in diabetes-related dementia from several perspectives and emphasize the importance of the influence of HMGB1 in diabetes-related dementia.

Abstract Background Physical activity has been associated with reduced risk of seven types of cancer. It remains unclear, however, whether muscle-strengthening activities also reduce cancer incidence and mortality. Methods PubMed, Embase, Web of Science and Scopus were searched from inception to March 2020. Summary hazard ratio (HR) and 95% confidence intervals (CI) were estimated using random-effects models. Results Twelve studies (11 cohorts; 1 case-control), 6 to 25 years of follow-up, including 1,297,620 participants, 32,196 cases and 31,939 deaths, met inclusion criteria. Muscle-strengthening activities were associated with a 26% lower incidence of kidney cancer (HR for high vs low levels of muscle-strengthening activities: 0.74; 95% CI 0.56 to 0.98; I 2 0%; 2 studies), but not with incidence of other 12 types of cancer. Muscle-strengthening activities were associated with lower total cancer mortality: HRs for high vs low levels of muscle-strengthening activities was 0.87 (95% CI 0.73 to 1.02; I 2 58%; 6 studies); and HR for ≥2 times/week vs

Abstract The EOS is a medical imaging system that incorporates simultaneous orthogonal images, producing three-dimensional (3D) reconstructions of the whole skeletal system in various functional positions. Despite growing interest in the pelvic 3D position, the validity of the EOS has not yet been well studied. We investigated the trueness and precision of EOS imaging for pelvic parameters and orientation and assessed whether the measurement using the EOS was affected by the pelvic orientation itself. The orientation of the anterior pelvic plane and pelvic parameters of a custom-made pelvic phantom were measured by three raters using the EOS, and the measurements obtained were compared with the true values. The standard deviations of the measurement errors were 3.23°, 0.26°, 0.23°, 2.98°, 0.88°, and 3.22° for flexion, obliquity, rotation, pelvic incidence, spinopelvic tilt, and sacral slope, respectively. The root-mean square averages of the standard deviation of each measurement were 4.05°, 0.41°, 0.28°, 4.80°, 0.99°, and 5.13°, respectively. The measurement errors for sacral slope correlated significantly with geometric means of flexion, obliquity, and rotation (r = 0.364, p = 2.67 × 10–11). The EOS rendered accurate and reliable measurements regarding pelvic 3D position, even with positional variation, but positional variation could affect measurements of sacral slope.

This study aimed to determine the blood lipid profiles, fatty acid composition, and lipogenic enzyme activities in rat adipose tissues as affected by the Angus beef fat (ABF) and Hanwoo beef fat (HBF) containing high oleic acid (OA) content. We assigned 60 Sprague Dawley rats with a mean bodyweight of 249 ± 3.04 g to three groups (n = 20 each) to receive diets containing 7% coconut oil (CON), 7% ABF, or 7% HBF. The OA content was highest in the HBF (45.23%) followed by ABF (39.51%) and CON (6.10%). The final body weight of the HBF-fed group was significantly increased, probably due to increased feed intake, indicating the palatability of the diet. The HBF and ABF significantly increased high-density lipoprotein cholesterol (HDL-C), decreased triglyceride (TG) and total cholesterol (TC) levels, and also tended to attenuate glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) levels in the bloodstream of the rats compared to CON. As compared to CON, lauric, myristic, and palmitic acids were significantly lower, and those of OA and α-linolenic acid (ALA) were significantly higher in the adipose tissues of HBF and ABF-fed groups. The HBF and ABF also reduced lipogenesis as induced by depleted fatty acid synthase (FAS) activity in rat adipose tissues. Nevertheless, between the two fats, HBF showed high feed intake due to its high palatability but reduced lipogenic enzyme activity, specifically that of FAS, and increased HDL-C, decreased TC and TG levels in the bloodstream, reduced saturated fatty acids (SFA), and increased oleic and ALA contents in rat adipose tissues indicating that HBF consumption does not pose significant risks of cardiovascular disease.

The pegylated interferon plus ribavirin combination therapy has been used as the primary treatment for chronic hepatitis C (CHC) but fails to produce a sustained viral response (SVR) in many patients. In recent years, the treatment of CHC has been rapidly changing because of the introduction of direct-acting antivirals (DAAs), which have a high cure rate. However, retreatment of patients after failure of the first DAA therapy is difficult. We report two rare cases of CHC that showed acquired SVR with other DAA combinations after failure to daclatasvir and asunaprevir.

Abstract Glioblastoma is the most lethal brain tumor and its pathogenesis remains incompletely understood. KDM4C is a histone H3K9 demethylase that contributes to epigenetic regulation of both oncogene and tumor suppressor genes and is often overexpressed in human tumors, including glioblastoma. However, KDM4C’s roles in glioblastoma and the underlying molecular mechanisms remain unclear. Here, we show that KDM4C knockdown significantly represses proliferation and tumorigenesis of glioblastoma cells in vitro and in vivo that are rescued by overexpressing wild-type KDM4C but not a catalytic dead mutant. KDM4C protein expression is upregulated in glioblastoma, and its expression correlates with c-Myc expression. KDM4C also binds to the c-Myc promoter and induces c-Myc expression. Importantly, KDM4C suppresses the pro-apoptotic functions of p53 by demethylating p53K372me1, which is pivotal for the stability of chromatin-bound p53. Conversely, depletion or inhibition of KDM4C promotes p53 target gene expression and induces apoptosis in glioblastoma. KDM4C may serve as an oncogene through the dual functions of inactivation of p53 and activation of c-Myc in glioblastoma. Our study demonstrates KDM4C inhibition as a promising therapeutic strategy for targeting glioblastoma.

In ARM TrustZone-based architecture, shared memory is one of the most useful schemes to enable isolated execution environments supported by TrustZone to communicate between environments. However, it is already known that shared memory is vulnerable to man-in-the-middle attacks since mechanisms to check integrity or authenticate callers for the shared memory payload are not supported in TrustZone. While an encryption-based method that resolves this limitation does exist, there are some architectural limitations. Indeed, even with key protection countermeasures applied, there is a risk that encryption keys may be leaked, as they are placed in insecure user memory during communication. Moreover, countermeasures for key leakage cause system performance overhead. In this paper, we propose a lightweight and secure scheme for shared memory, called Software One-Time Programmable Memory (SOTPM). SOTPM is a software-implemented, one-time programmable shared memory. It is based on the idea that payload encryption in the shared memory layer is unnecessary because sensitive data is already encrypted in the application layer before being written to the shared memory. SOTPM is set to read-only after data is written into SOTPM due to the one-time programmable characteristic. Therefore, attackers are unable to manipulate content in SOTPM during communication. Since it is not necessary for SOTPM to encrypt the payload in order to prevent malicious payload manipulation, it is possible to remove the risk of key leakage posed in previous studies. Additionally, in contrast with the existing method, our method can dramatically reduce system performance overhead. We implemented our prototype on an open-source hardware board with an Armv8-A processor and performed a security analysis and performance evaluation. The results show that SOTPM provides a sufficient level of security and less than 1% performance overhead, implying that SOTPM is a reasonable solution for current commercial products.

This paper proposes a safe copy-back program operation in a NAND flash memory, which is targeting digital forensics for a variety of reasons. Due to the background management operation of the NAND flash memory, the original data is highly likely to remain without truly being deleted. We have carefully investigated the possibility of data exposure due to a copy-back program operation, among, frequently used management operations as such data exposure increases the possibility of privacy invasion. We propose a safe copy-back program operation that lowers the possibility of privacy invasion. And we additionally introduce various techniques for solving the reliability problem of adjacent cells caused by the proposed copy-back program operation. For example, when deleting the original data in a copy-back program operation, overwriting is performed to minimize program disturbance. Also, after acquiring the victim cell information of the adjacent cell before proceeding with overwriting, program prohibition is determined on each page buffer based on the victim cell information. Our research results are meaningful for forensics and anti-forensics issues to be raised regarding NAND flash memories. We look forward to the development of NAND flash memories that guarantee privacy in subsequent studies.

As most malware is infectious, anti-analysis and packing techniques supported by commercial protectors are conventionally applied to hinder analysis. When analyzing to detect and block such protected malware, it is necessary to do so in a virtual environment to prevent infection. In terms of packing, it is necessary to analyze using dynamic binary instrumentation (DBI), a dynamic analysis tool, which is advantageous for unpacking because DBI inserts code at run time and analyzes it dynamically. However, malware terminates on its own when it detects a virtual environment or DBI due to anti-analysis techniques. Therefore, it is necessary to also bypass anti-VM and anti-DBI techniques in order to successfully analyze malware in a virtual environment using DBI. It is very difficult for analysts to bypass anti-VM and anti-DBI techniques that are used in commercial protectors because analysts generally have little information on what methods are used or how to even bypass these techniques. In this paper, we suggest guidelines to aid in easy analysis of malware protected by anti-VM and anti-DBI techniques supported by commercial protectors. We analyzed the techniques used by five of the most common commercial protectors, and herein present how to bypass anti-VM and anti-DBI techniques supported by commercial protectors via a detailed algorithm analysis. We performed a bypass experiment after applying each commercial protector to 1573 executable files containing vulnerabilities provided by the National Institute of Standards and Technology (NIST). To our knowledge, this is the first empirical study to suggest detailed bypassing algorithms for anti-VM and anti-DBI techniques used in commercial protectors.

Abstract Worldwide, South Korea had the second highest incidence rates of colorectal cancer (CRC) in 2018. To inform public health policy to prevent CRC, we aimed to identify major modifiable lifestyle factors underlying the alarming increase in CRC incidence. We obtained information on CRC statistics from the Korea National Cancer Incidence Database and on the distribution of dietary and lifestyle factors known to modify CRC risk from the Korea National Health and Nutrition Examination Survey. To examine time trends between 2001 and 2013, we calculated annual percent changes of CRC incidence rates and of prevalence of etiologic factors by sex and age. Across all sex and age groups, the most commonly diagnosed cancer was rectal cancer while the most rapidly increasing cancer was distal colon cancer. For the lifestyle factors examined, decreases in exercise were observed across all age groups of both sexes. Yet, obesity and alcoholic drinks appear more relevant CRC contributor to men, smoking to women aged 30–49 years, and processed meat intake to adults aged 30–49 years. The heterogeneous results suggest that dietary and lifestyle target to prevent CRC be tailored by sex and age.

Over-provisioning technology is typically introduced as a means to improve the performance of storage systems, such as databases. The over-provisioning area is both hidden and difficult for normal users to access. This paper focuses on attack models for such hidden areas. Malicious hackers use advanced over-provisioning techniques that vary capacity according to workload, and as such, our focus is on attack models that use variable over-provisioning technology. According to these attack models, it is possible to scan for invalid blocks containing original data or malware code that is hidden in the over-provisioning area. In this paper, we outline the different forensic processes performed for each memory cell type of the over-provisioning area and disclose security enhancement techniques that increase immunity to these attack models. This leads to a discussion of forensic possibilities and countermeasures for SSDs that can change the over-provisioning area. We also present information-hiding attacks and information-exposing attacks on the invalidation area of the SSD. Our research provides a good foundation upon which the performance and security of SSD-based databases can be further improved.

Objective High-quality intensive care, including targeted temperature management (TTM) for patients with postcardiac arrest syndrome, is a key element for improving outcomes after out-of-hospital cardiac arrest (OHCA). We aimed to assess the status of postcardiac arrest syndrome care, including TTM and 6-month survival with neurologically favorable outcomes, after adult OHCA patients were treated with TTM, using data from the Korean Hypothermia Network prospective registry. Methods We used the Korean Hypothermia Network prospective registry, a web-based multicenter registry that includes data from 22 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TTM between October 2015 and December 2018 were included. The primary outcome was neurological outcome at 6 months. Results Of the 1,354 registered OHCA survivors treated with TTM, 550 (40.6%) survived 6 months, and 413 (30.5%) had good neurological outcomes. We identified 839 (62.0%) patients with preClinsumed cardiac etiology. A total of 937 (69.2%) collapses were witnessed, shockable rhythms were demonstrated in 482 (35.6%) patients, and 421 (31.1%) patients arrived at the emergency department with prehospital return of spontaneous circulation. The most common target temperature was 33°C, and the most common target duration was 24 hours. Conclusion The survival and good neurologic outcome rates of this prospective registry show great improvements compared with those of an earlier registry. While the optimal target temperature and duration are still unknown, the most common target temperature was 33°C, and the most common target duration was 24 hours.

Abstract Background Serum neutrophil gelatinase-associated lipocalin (NGAL) could be used as a predictive marker of acute kidney injury (AKI) in patients with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) who are managed with targeted temperature management (TTM). However, the NGAL measurement timepoints vary from immediately after ROSC to several days later. The primary objective of this study was to determine an association between AKI and NGAL, both immediately (ROSC-NGAL) and 3 h after ROSC (3 h-NGAL), in OHCA patients with TTM. The secondary objective was to ascertain the association between NGAL levels in the early post-ROSC phase and the neurologic outcomes at discharge. Methods This prospective observational study was conducted between January 2016 and December 2018 and enrolled adult OHCA patients (≥18 years) with TTM after ROSC. The serum NGAL level was measured both immediately and 3 h after ROSC. Univariate and multivariate analyses were performed to identify the associations between AKI, poor neurologic outcome, and NGAL. Results Among 861 OHCA patients, 89 patients were enrolled. AKI occurred in 48 (55.1%) patients. On multivariate logistic regression analysis, 3 h-NGAL was significantly associated with AKI (odds ratio [OR] 1.022; 95% confidence interval [CI] 1.009–1.035; p = 0.001). The area under the receiver operating characteristic curve of 3 h-NGAL for AKI was 0.910 (95% CI 0.830–0.960), and a cut-off value of 178 ng/mL was identified. Both ROSC-NGAL and 3 h-NGAL were not significantly associated with poor neurologic outcome on multivariate logistic regression analysis (ROSC-NGAL; OR 1.017; 95% CI 0.998–1.036; p = 0.084, 3 h-NGAL; OR 0.997; 95% CI 0.992–1.001; p = 0.113). Conclusions The serum NGAL concentration measured 3 h after ROSC is an excellent early predictive marker for AKI in OHCA patients treated with TTM. Future research is needed to identify the optimal measurement timepoint to establish NGAL as a predictor of neurologic outcome and to validate the findings of this research.

Abstract Background The empirical dietary index for hyperinsulinemia (EDIH) score is a validated food-based dietary score that assesses the ability of whole-food diets to predict plasma c-peptide concentrations. Although the EDIH has been extensively applied and found to be predictive of risk of developing major chronic diseases, its influence on cancer survival has not been evaluated. We applied the EDIH score in a large cohort of colorectal cancer patients to assess the insulinemic potential of their dietary patterns after diagnosis and determine its influence on survival outcomes. Methods We calculated EDIH scores to assess the insulinemic potential of post-diagnosis dietary patterns and examined survival outcomes in a sample of 1718 stage I-III colorectal cancer patients in the Nurses’ Health Study and Health Professionals Follow-up Study cohorts. Multivariable-adjusted Cox regression was applied to compute hazard ratios (HR) and 95% confidence intervals (CI) for colorectal cancer-specific mortality and all-cause mortality. We also examined the influence of change in diet from pre- to post-diagnosis period, on mortality. Results During a median follow-up of 9.9 years, there were 1008 deaths, which included 272 colorectal cancer-specific deaths (27%). In the multivariable-adjusted analyses, colorectal cancer patients in the highest compared to lowest EDIH quintile, had a 66% greater risk of dying from colorectal cancer: HR, 1.66; 95% CI, 1.03, 2.69; and a 24% greater risk of all-cause death: HR, 1.24; 95%CI, 0.97, 1.58. Compared to patients who consumed low insulinemic diets from pre- to post-diagnosis period, patients who persistently consumed hyperinsulinemic diets were at higher risk of colorectal cancer death (HR,1.51; 95%CI, 0.98, 2.32) and all-cause death (HR, 1.31; 95%CI, 1.04, 2.64). Conclusion Our findings suggest that a hyperinsulinemic dietary pattern after diagnosis of colorectal cancer is associated with poorer survival. Interventions with dietary patterns to reduce insulinemic activity and impact survivorship are warranted.