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Background: We aimed to elucidate the effects of anticoagulation therapy in patients with atrial fibrillation (AF) according to the difference in renal function and define a chronic kidney disease (CKD) population that could benefit from anticoagulation therapy. Methods: Using datasets from the Asan Biomedical Research Environment Database between 2006 and 2017, 12,641 patients with nonvalvular AF were analyzed. The primary outcome was the net clinical outcome, defined as a composite of all-cause mortality, thromboembolic events, and major bleeding. Results: Patients were categorized into groups according to their baseline creatinine clearance. There was a trend for a progressive increase in the prevalence of stroke or systemic embolism, major bleeding, and all-cause mortality as the renal function deteriorated. The clinical benefit of anticoagulation therapy was the most prominent in patients with normal renal function and was reduced in those with advanced-stage CKD. Among CKD 5 patients, the benefit of anticoagulation therapy was only evident in those with a very high risk of embolism (CHA2DS2-VASc score ≥4). Conclusion: Advanced CKD is associated with a higher risk of the net clinical outcome. The clinical benefit of anticoagulation therapy reduces with the increasing degree of CKD. In CKD5, anticoagulation should be considered in high risk of embolism.

Wearable pressure sensors having versatile device structures have been extensively investigated to achieve high sensitivity under mechanical stimuli. Here, we introduce piezoelectric pressure sensors based on fabrics woven using polyvinylidene fluoride (PVDF) weft and polyethylene terephthalate (PET) warp yarns with different weave structures: 1/1 (plain), 2/2, and 3/3 weft rib patterns. The dependence of the pressure-sensing performance on the weave pattern is demonstrated with an actual large-scale fabric up to the ~2 m scale. An optimized pressure sensor with a 2/2 weft rib pattern produced a high sensitivity of 83 mV N−1, which was 245% higher than that of the 1/1 pattern. The detection performance of the optimal fabric was extensively evaluated with a variety of ambient input sources, such as pressing, bending, twisting, and crumpling, as well as various human motions. Further, a large all-fabric pressure sensor with arrayed touch pixel units demonstrated highly sensitive and stable sensing performance.

Since glufosinate irreversibly inhibits glutamine synthetase, leading to intracellular accumulation of ammonia, hyperammonemia is considered one of the main mechanisms of glufosinate ammonium toxicity in humans. However, whether hyperammonemia causes neurotoxicity has not yet been studied. Therefore, the purpose of this study was to determine whether the serum ammonia level is elevated before the development of neurotoxicity. In this retrospective observational study, we analyzed data from consecutive patients diagnosed with acute glufosinate ammonium poisoning. The primary outcome was the development of neurotoxicity following the poisoning. Patients who developed neurotoxicity were characterized by higher initial ammonia levels compared to patients without neurotoxicity (121.0 µg/dL [87.0; 141.0] vs 83.0 µg/dL [65.0; 119.0], p 0.01). However, there was no increase in ammonia levels over time in both the asymptomatic and neurotoxicity groups when serial serum ammonia levels were examined from emergency department admission to hospital discharge. In addition, there was no statistically significant difference between the peak ammonia levels in the asymptomatic group and the peak ammonia levels before symptom onset in the neurotoxicity group (135.0 µg/dL [109.0; 158.0] vs 144.0 µg/dL [120.0; 189.0], p = 0.15). Following the onset of neurotoxicity, the serum ammonia level increased significantly (125.0 [111.0; 151.0] µg/dL to 148.0 [118.0; 183.0] µg/dL, p 0.01). In conclusion, hyperammonemia cannot be assumed as the cause of neurotoxicity in glufosinate ammonium poisoning and further research is needed to examine the exact mechanism of GA poisoning.

Background Spastin significantly influences microtubule regulation in neurons and is implicated in the pathogenesis of hereditary spastic paraplegia (HSP). However, post-translational regulation of the spastin protein remains nebulous. The association between E3 ubiquitin ligase and spastin provides a potential therapeutic strategy. Results As evidenced by protein chip analysis, FBXL17 inversely correlated with SPAST-M1 at the protein level in vitro and, also in vivo during embryonic developmental stage. SPAST-M1 protein interacted with FBXL17 specifically via the BTB domain at the N-terminus of SPAST-M1. The SCFFBXL17 E3 ubiquitin ligase complex degraded SPAST-M1 protein in the nuclear fraction in a proteasome-dependent manner. SPAST phosphorylation occurred only in the cytoplasmic fraction by CK2 and was involved in poly-ubiquitination. Inhibition of SCFFBXL17 E3 ubiquitin ligase by small chemical and FBXL17 shRNA decreased proteasome-dependent degradation of SPAST-M1 and induced axonal extension. The SPAST Y52C mutant, harboring abnormality in BTB domain could not interact with FBXL17, thereby escaping protein regulation by the SCFFBXL17 E3 ubiquitin ligase complex, resulting in loss of functionality with aberrant quantity. Although this mutant showed shortening of axonal outgrowth, low rate proliferation, and poor differentiation capacity in a 3D model, this phenotype was rescued by inhibiting SCFFBXL17 E3 ubiquitin ligase. Conclusions We discovered that a novel pathway, FBXL17-SPAST was involved in pathogenicity of HSP by the loss of function and the quantitative regulation. This result suggested that targeting FBXL17 could provide new insight into HSP therapeutics.

The aim of this study is to quantitatively investigate the microstructural properties of the optic nerve (ON) in vivo using diffusion tensor imaging (DTI) in patients with unilateral optic atrophy (OA) and to determine their association with retinal nerve fiber layer (RNFL) thickness of the optic nerve head (ONH). Six patients with unilateral OA and 11 control subjects underwent DTI. ONs from ONH to the orbital apex were tracked. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were computed in both ONs and their correlation with RNFL thickness measured using optical coherence tomography was also analyzed. FA of atrophic ON was lower than that of non-affected and control ONs (atrophic [A], 0.136 ± 0.059; non-affected [N], 0.384 ± 0.048; control [C], 0.389 ± 0.053). MD and RD of atrophic ONs were higher than those of non-affected and control ONs (MD, A, 0.988 ± 0.247; N, 0.658 ± 0.058; C, 0.687 ± 0.079; RD, A, 0.920 ± 0.247; N, 0.510 ± 0.054; C, 0.532 ± 0.078). All DTI measures of atrophic ON except for AD showed a significant correlation with RNFL thickness of ONH; FA showed the strongest correlation, followed by RD and MD (FA, R2 = 0.936, P R2 = 0.795, P R2 = 0.655, P = 0.001). This study reports quantitative analysis of the ON using DTI and differences in DTI measures between atrophic and normal ONs. The significant correlation between DTI measures and RNFL thickness suggests the applicability of DTI as a clinical tool to evaluate the ON.

We investigated the association of insulin administration method with the achievement of mean glucose ≤ 180 mg/dL and neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors who had hyperglycemia after the return of spontaneous circulation. From a multicenter prospective registry, we extracted the data of adult OHCA survivors who underwent targeted temperature management (TTM) between 2015 and 2018. Blood glucose levels every 4 h after initiating TTM were obtained for 72 h. We divided insulin administration methods into three categories: subcutaneous (SQI), intravenous bolus (IBI), and continuous intravenous (CII). We calculated the mean glucose and standard deviation (SD) of glucose. The primary outcome was the achievement of mean glucose ≤ 180 mg/dL. The secondary outcomes were the 6-month neurological outcome based on the Cerebral Performance Category (CPC) scale (good, CPC 1–2; poor, CPC 3–5), mean glucose, and SD of glucose. Of the 549 patients, 296 (53.9%) achieved mean glucose ≤ 180 mg/dL, and 438 (79.8%) had poor neurological outcomes, 134 (24.4%), 132 (24.0), and 283 (51.5%) were in the SQI, IBI, and CII groups, respectively. The SQI (adjusted odds ratio [aOR], 0.848; 95% confidence intervals [CIs], 0.493–1.461) and IBI (aOR, 0.673; 95% CIs, 0.415–1.091) groups were not associated with mean glucose ≤ 180 mg/dL and the SQI (aOR, 0.660; 95% CIs, 0.335–1.301) and IBI (aOR, 1.757; 95% CIs, 0.867–3.560) groups were not associated with poor neurological outcomes compared to the CII group. The CII (168 mg/dL [147–202]) group had the lowest mean glucose than the SQI (181 mg/dL [156–218]) and IBI (184 mg/dL [162–216]) groups. The CII (45.0[33.9–63.5]) group had a lower SD of glucose than the IBI (50.8 [39.1–72.0]) group. The insulin administration method was not associated with achieving mean glucose ≤ 180 mg/dL and 6-month neurological outcomes.

Characterizing the genetic diversity and population structure of breeding materials is essential for breeding to improve crop plants. The potato is an important non-cereal food crop worldwide, but breeding potatoes remains challenging owing to their auto-tetraploidy and highly heterozygous genome. We evaluated the genetic structure of a 110-line Korean potato germplasm using the SolCAP 8303 single nucleotide polymorphism (SNP) Infinium array and compared it with potato clones from other countries to understand the genetic landscape of cultivated potatoes. Following the tetraploid model, we conducted population structure analysis, revealing three subpopulations represented by two Korean potato groups and one separate foreign potato group within 110 lines. When analyzing 393 global potato clones, country/region-specific genetic patterns were revealed. The Korean potato clones exhibited higher heterozygosity than those from Japan, the United States, and other potato landraces. We also employed integrated extended haplotype homozygosity (iHS) and cross-population extended haplotype homozygosity (XP-EHH) to identify selection signatures spanning candidate genes associated with biotic and abiotic stress tolerance. Based on the informativeness of SNPs for dosage genotyping calls, 10 highly informative SNPs discriminating all 393 potatoes were identified. Our results could help understanding a potato breeding history that reflects regional adaptations and distinct market demands.

To determine the association between the induction rate and 6-month neurologic outcomes in out-of-hospital cardiac arrest (OHCA) survivors who underwent targeted temperature management (TTM). This retrospective observational study analyzed data prospectively collected from adult comatose OHCA survivors treated with TTM at the Chonnam National University Hospital in Gwangju, Korea, between October 2015 and December 2020. We measured the core body temperature (BT) through an esophageal probe and recorded it every 5 minutes throughout TTM. Induction time was defined as the elapsed time between the initiation of TTM and the achievement of target BT of 33°C. We calculated the induction rate as the change of BT divided by induction time. The primary outcome was a poor 6-month neurologic outcome, defined as cerebral performance category 3-5. Of the OHCA survivors, 218 patients were included, and 137 (62.8%) patients had a poor neurologic outcome. Patients with a poor neurologic outcome had lower BT at the initiation of TTM, shorter induction time, and higher induction rate than those with good neurologic outcomes. After adjusting for confounders, induction time (odds ratio [OR] 0.995; 95% confidence interval [CI], 0.992-0.999) and induction rate (OR 2.362; 95% CI, 1.178-4.734) were independently associated with poor neurologic outcome. BT at TTM initiation was not associated with a poor neurologic outcome. Induction rate was independently associated with a poor neurologic outcome in OHCA survivors who underwent TTM at 33°C.

Background/Objectives: Today, the deep neural network has more intermediate layers along with learning data and has gradually become larger to draw a lower result due to the bound conventional neural network. Methods/Statistical analysis: Therefore, in this paper, we proposed the line-segment feature extraction for input dimensionality reduction in pattern mining. The proposed algorithm extracts the line segment information, constituting the image of input data, and assigns a unique value to each segment using predefined filters. Using such unique values to identify the number of line segments, create a one-dimensional vector, in the size of 256 or 512. Findings: This vector is used as the input data for a multi-layer perceptron (MLP). For performance evaluation, LFA was compared with principal component analysis (PCA). As a result, LFA-256 (at 96.81% accuracy) had −0.1% lower performance but a faster speed than PCA (96.91% accuracy), and LFA-512 (at 97.25% accuracy) had 0.35% higher performance than PCA. Improvements/Applications: We will study the recognition service possible to use in industry (mobile devices, PC, edge computing, etc.) and real-life through this algorithm.

Nowadays, video content consumption through video platforms is growing exponentially. In the education field, although video content is used more often than text content, but there are certain challenges. In this paper, we propose a system that can easily and efficiently create summary notes for the video while playing educational content videos. The summary notes will include keyword-based text information, image information at specific points in the video, and video bookmark information based on video frame and play time. When playing a video, a user can repeat two kinds of events at the moment a specific scene appears, capture a particular video frame in the video, and generate a keyword. The system provides functions for text extraction and to input of user comments that help organize the video information so that summary notes can be created more conveniently. It can collectively organize the video information to lessen the user’s time summarizing video information. it is also possible to quickly search the contents of the summary note using keyword.

We developed a new numerical method which converts creep data to dynamic moduli without relying on viscoelastic spectra of relaxation or retardation times. This algorithm is an improvement of the previous ones (Kwon et al., 2016) in the reduction of artificial waviness in the terminal regime as well as the noise due to measurement errors. The method is the application of the point-wise polynomial regression which reduces the polynomial order dramatically compared with previous method in order to suppress the waviness.

Trovafloxacin (TVX) is associated with idiosyncratic drug-induced liver injury (iDILI) and inflammation-mediated hepatotoxicity. However, the inflammatory stress-regulated mechanisms in iDILI remain unclear. Herein, we elucidated the novel role of tumor-necrosis factor alpha (TNFα), an inflammatory stress factor, in TVX-induced in vitro hepatotoxicity and synergistic toxicity. TVX specifically induced synergistic toxicity in HepG2 cells with TNFα, which inhibits autophagy. TVX-treated HepG2 cells induced protective autophagy by inhibiting the expression of mTOR signaling proteins, while ATG5 knockdown in HepG2 cells, responsible for the impairment of autophagy, enhanced TVX-induced toxicity due to the increase in cytochrome C release and JNK pathway activation. Interestingly, the expression of mTOR signal proteins, which were suppressed by TVX, disrupted the negative feedback of the PI3K/AKT pathway and TNFα rebounded p70S6K phosphorylation. Co-treatment with TVX and TNFα inhibited protective autophagy by maintaining p70S6K activity, which enhanced TVX-induced cytotoxicity. Phosphorylation of p70S6K was inhibited by siRNA knockdown and rapamycin to restore TNFα-inhibited autophagy, which prevented the synergistic effect on TVX-induced cytotoxicity. These results indicate that TVX activates protective autophagy in HepG2 cells exposed to toxicity and an imbalance in negative feedback regulation of autophagy by TNFα synergistically enhanced the toxicity. The finding from this study may contribute to a better understanding of the mechanisms underlying iDILI associated with inflammatory stress.

Actinomycosis is an inflammatory disease with various clinical presentations including inflammation and formation of masses. There are several reports suggesting the infiltrative mass-like nature of actinomycosis that is misunderstood as a tumor. A 39-year-old male clinically presented with a fungating mass-like lesion during colonoscopy for healthcare screening. Biopsy was performed for the lesion, and chronic inflammation was diagnosed. Abdominal computed tomography (CT) suggested severe edematous changes in the appendix with an appendicolith, suspected chronic inflammation, and wall thickening of the cecal base, but malignancy could not be definitively ruled out. The patient underwent a laparoscopic single-port cecectomy based on the possibility of cecal cancer. The final biopsy was diagnosed as actinomycosis, and the patient was prescribed antibiotics and showed no recurrence in the follow-up CT scan. We present this rare case of mass-like appendiceal actinomycosis treated with the single-port laparoscopic method.

Hands are the part of the body that are most commonly involved in burns, and the main complications are finger joint contractures and nerve injuries. Hypertrophic scarring cannot be avoided despite early management of acute hand burn injuries, and some patients may need the application of an exoskeleton robot to restore hand function. To do this, it is essential to individualize the customization of the robot for each patient. Three-dimensional (3D) technology, which is widely used in the field of implants, anatomical models, and tissue fabrication, makes this goal achievable. Therefore, this report is a study on the usefulness of an exoskeleton robot using 3D technology for patients who lost bilateral hand function due to burn injury. Our subject was a 45-year-old man with upper limb dysfunction of 560 days after a flame and chemical burn injury, with resultant impairment of manual physical abilities. After wearing an exoskeleton robot made using 3D printing technology, he could handle objects effectively and satisfactorily. This innovative approach provided considerable advantages in terms of customization of size and reduction in manufacturing time and costs, thereby showing great potential for use in patients with hand dysfunction after burn injury.

Atypical lipomatous tumor (ALT), one of the histologic subtypes of liposarcoma, is locally aggressive with intermediate malignant potential and is categorized as a synonymous entity with well-differentiated liposarcoma (ALT/WDLPS). Although ALT/WDLPS is the most common subtype of liposarcoma in the oral and maxillofacial region, its occurrence is extremely rare, and asymptomatic clinical behavior often delays definitive diagnosis and treatment. We present an extremely rare case of ALT/WDLPS in the buccal mucosa of an elderly Japanese woman. A provisional diagnosis of benign tumor was made from clinical symptoms that involved findings on magnetic resonance imaging. Microscopic examination revealed mature adipocytes with substantial variation in cell size, fewer multivacuolated lipoblasts, and positive stain with MDM-2 and P16, which resulted in a definitive diagnosis of ALT/WDLPS. Conservative surgical resection resulted in locoregional recurrence; however, no evidence of dedifferentiation was detected, and repeat conservative resection finally allowed the patient to avoid esthetic and functional disorder and to obtain an uneventful clinical prognosis over the long-term follow-up period. We also review previous reports of cases of ALT/WDLPS arising from the cheek/buccal mucosa.

Alzheimer’s disease, a major cause of dementia, is characterized by impaired cholinergic function, increased oxidative stress, and amyloid cascade induction. Sesame lignans have attracted considerable attention owing to their beneficial effects on brain health. This study investigated the neuroprotective potential of lignan-rich sesame cultivars. Among the 10 sesame varieties studied, Milyang 74 (M74) extracts exhibited the highest total lignan content (17.71 mg/g) and in vitro acetylcholinesterase (AChE) inhibitory activity (66.17%, 0.4 mg/mL). M74 extracts were the most effective in improving cell viability and inhibiting reactive oxygen species (ROS) and malondialdehyde (MDA) generation in amyloid-β25-35 fragment-treated SH-SY5Y cells. Thus, M74 was used to evaluate the nootropic effects of sesame extracts and oil on scopolamine (2 mg/kg)-induced memory impairment in mice compared to the control cultivar (Goenback). Pretreatment with the M74 extract (250 and 500 mg/kg) and oil (1 and 2 mL/kg) effectively improved memory disorder in mice (demonstrated by the passive avoidance test), inhibited AChE, and enhanced acetylcholine (Ach) levels. Moreover, immunohistochemistry and Western blot results showed that the M74 extract and oil reversed the scopolamine-induced increase in APP, BACE-1, and presenilin expression levels in the amyloid cascade and decreased BDNF and NGF expression levels in neuronal regeneration.

Malignant melanoma of the anorectum is a rare disorder. Patients often present with local symptoms similar to benign diseases. The prognosis is very poor, and almost all patients die because of metastases. We report 2 female patients with unremarkable histories. Both of them received previous operations before visiting our center after they were diagnosed with anorectal malignant melanoma. One case underwent abdominoperineal resection and postoperative chemotherapy. The other had been treated with ultralow anterior resection followed by immunotherapy.

In this letter, a synchronization signal design technique for millimeter-wave cellular vehicle-to-everything (C-V2X) communications is proposed. The proposed vehicle synchronization signal generated using a generalized reciprocal sequence of m-sequence is shown to have desirable properties for orthogonal frequency division multiplexing (OFDM)-based C-V2X, particularly for vehicle-to-vehicle (V2V) synchronization. It is shown that the detection probabilities of synchronization signals in C-V2X are not degraded when base stations and vehicles coexist, owing to minimal interference between the synchronization signals. Moreover, the computational complexity required for signal detection and synchronization in V2V links can be significantly reduced with the proposed vehicle synchronization signal.

We suggest a numerical method to calculate molecular weight distribution from linear viscoelastic data. The calculation method consists of three components: (1) a viscoelastic model of a monodisperse polymer as a function of molecular weight; (2) the mixing rule connecting viscoelastic data of monodisperse and polydisperse polymers through molecular weight distribution; (3) an algorithm which calculates the molecular weight distribution from the chosen mixing rule. Since we cannot measure the relaxation modulus of all monodisperse samples, we need an accurate monodisperse model for any molecular weight. It is known that a dynamic test is more reliable than a relaxation test, while the mixing rule needs relaxation modulus. Hence, we should have a smart numerical method that can convert dynamic data to relaxation modulus with the minimum conversion error. If we use the numerical method, then we have to generate numerical data from the model. Then it takes quite a long time. On the other hand, if we have a monodisperse model with the analytical relaxation spectrum, then calculation time can be reduced dramatically. Since the conversion from relaxation modulus to dynamic modulus suffers from smaller errors than the reverse conversion because of ill-posedness of the interconversion, the analytical conversion can be implemented more quickly at an acceptable level of errors. This paper proposes a new method satisfying the requirements.

The 6th nuclear test of North Korea on September 3, 2017 produced an mb 6.1 artificial earthquake and significant surface deformations detectable from satellite observations. Wang et al. (2018) have reported the surface displacement of the Mt. Mantap caused by the explosion by applying offset-tracking method to TerraSAR-X SAR images. Based on the assumption of elastic behaviour of the mountain body, they have modelled the rise and collapse of the mountain and suggested the location, depth and energy of the explosion. However, we suspect that the surface displacement might be caused by landslide in which case the elastic modelling would be misleading. In this paper, we use both SAR interferometry and offset-tracking method to quantify the elastic and random deformation caused by the explosion. The 3-D displacement vectors around the rim of the explosion, where the inter-ferometric coherence is maintained, were obtained by using three ALOS-2 interferograms acquired in different orbits. Only east-west component of the displacement vector was valid due to orbital characteristics, which indicates the explosive tendency of the bedrock of up to 25 cm in the rim of the mountain. Deformation on the ruptured zone, where the interferometric coherence is lost, was detected through visual inspection and offset tracking by using two pairs of high-resolution ALOS-2 and TerraSAR-X images. It showed up to 3.5 m displacement on the mountain slope towards the direction of gravity, which is similar to the results of Wang et al. (2018). However, we have visually identified many stable points and features that have not moved at all in the mountain flank surrounded by active surface deformation, which is believed to be stable bedrocks and outcrops. This implies that the displacements observed by the offset method in the mountain flank of the ruptured zone were mostly of landslides caused by the topsoil and boulder stones. It is suggested that elastic behaviour of the mountain body due to the 6th nuclear test of North Korea is unidentifiable and the subsequent modelling might be invalid in the mountain flank of the ruptured zone where surface motion from landslides is dominant.

Although the safety and feasibility of conventional laparoscopic surgery (CLS) for appendiceal mucocele (AM) has been reported, studies on single-incision laparoscopic surgery (SILS) for AM have not been reported. Here, we aimed to compare the perioperative and short-term outcomes between SILS and CLS for AM and to evaluate the oncological safety of SILS. We retrospectively analyzed the medical records of patients, diagnosed based on computed tomography findings, who underwent laparoscopic surgery for AM between 2010 and 2018 at one institution. We excluded patients strongly suspected of having malignant lesions and those with preoperative appendiceal perforation. Patients were divided into two groups—CLS and SILS. Pathological outcomes and long-term results were investigated. The median follow-up period was 43.7 (range: 12.3–118.5) months. Ultimately, 116 patients (CLS = 68, SILS = 48) were enrolled. Patient demographic characteristics did not differ between the groups. The preoperative mucocele diameter was greater in the CLS than in the SILS group (3.2 ± 2.9 cm vs. 2.3 ± 1.4 cm, P = 0.029). More extensive surgery (right hemicolectomies and ileocecectomies) was performed in the CLS than in the SILS group (P = 0.014). Intraoperative perforation developed in only one patient per group. For appendectomies and cecectomies, the CLS group exhibited a longer operation time than the SILS group (63.3 ± 24.5 min vs. 52.4 ± 17.3 min, P = 0.014); the same was noted for length of postoperative hospital stay (2.9 ± 1.8 days vs. 1.7 ± 0.6 days, P

This paper suggests a viscoelastic method to analyze microscopic structure of polymer blends which could be characterized by DMA and TEM. The viscoelastic method is to use weighted relaxation spectrum. We used poly(lactic acid)/poly(butylene adipate-co-terephthalate) and poly(lactic acid)/poly(vinyl acetate) blends in order to check the validity of the viscoelastic method. The former is an immiscible blend and the latter is a miscible blend.

Graphical abstract, A protein binder with a desired epitope and binding affinity is critical to the development of therapeutic agents. Here we present computationally-guided design and affinity improvement of a protein binder recognizing a specific site on domain IV of human epidermal growth factor receptor 2 (HER2). As a model, a protein scaffold composed of Leucine-rich repeat (LRR) modules was used. We designed protein binders which appear to bind a target site on domain IV using a computational method. Top 10 designs were expressed and tested with binding assays, and a lead with a low micro-molar binding affinity was selected. Binding affinity of the selected lead was further increased by two-orders of magnitude through mutual feedback between computational and experimental methods. The utility and potential of our approach was demonstrated by determining the binding interface of the developed protein binder through its crystal structure in complex with the HER2 domain IV.

Aim of Study: Acute appendicitis is the most common non-obstetric surgical problem in pregnant patients. As minimally invasive surgery has developed, minimising surgical trauma and improving cosmetic outcomes have led to the development of single-port laparoscopic surgery (SPLS). The aim of this study was to assess the feasibility and safety of SPLS for acute appendicitis during pregnancy. Patients and Methods: Between September 2014 and May 2016, 12 pregnant patients diagnosed with acute appendicitis and having single-port laparoscopic appendectomy were included in the study. Results: The median gestational age at surgery was 16 weeks (6–30 weeks). All operations were completed safely and without vascular or visceral injury. Four patients (33.3%) required conversion to a reduced-port laparoscopic surgery with 3 patients (25%) having a 5 mm port inserted because of perforated appendicitis with drain placement, and 1 patient (8.3%) having a 2-mm needle instrument insertion. Median operation time was 60 min (32–100 min), and a drainage tube was placed in 5 patients (41.7%). Median total length of incision was 2 cm (1.2–2.5 cm). The median time to soft diet initiation and length of stay in the hospital were 1 day (0–9 days) and 5 days (2–11 days), respectively. Two patients (8.0%) developed post-operative complications: One wound site bleeding and two surgical site infections. One case of abortion (8.3%) was noted on the post-operative day 1 and one case of imperforate hymen was noted after delivery. Conclusions: SPLS appendectomy is feasible and safe for treating patients with acute appendicitis during pregnancy.

This paper proposes a downlink synchronization and cell identity (CID) estimation technique for cellular systems based on orthogonal time-frequency space (OTFS). In the proposed technique, each base station (BS) transmits one detection preamble (DP) and two OTFS symbols (pilot and secondary-CID (SCID) signal (SS)). The DP based on a linear frequency-modulated (LFM) waveform, called proposed-LFM (pLFM), carries the primary-CID (PCID) for symbol timing (ST) synchronization, whereas the SS based on the Zadoff-Chu (ZC) sequence mapped in the delay-Doppler domain carries the SCID. The pLFM is obtained by discretizing the LFM waveform, increasing the frequency sweeping parameter beyond the limit of the operational bandwidth, and incorporating the PCID into the LFM waveform. The autocorrelation and cross-correlation functions of the pLFM are analyzed to examine its correlation properties under the influence of a high Doppler shift. To reduce the undesirable correlation properties (side peak and time ambiguity), a receiver processing (RP) scheme is developed for the pLFM. It is found that the pLFM with RP is suitable for the DP design because it can provide an accurate ST in high-mobility scenarios. In addition, the influence of OTFS modulation on the ZC sequence is derived and a low-complexity detection algorithm based on message passing is applied to detect SCID at the user equipment. The simulation results demonstrate that the proposed downlink synchronization and CID estimation techniques are suitable for OTFS-based cellular systems in high-Doppler environments.

From late April 2020, 71 consecutive earthquakes with low magnitudes (the largest, Mw 3.2) were catalogued in the county of Haenam, South Korea. In this region, moderate to strong earthquakes were not reported by instrumental, historical, and geological records. We identified 155 uncatalogued events in the source region that occurred between April 25, 2020 and May 8, 2020 and determined the hypocenters of the 226 catalogued and detected events with relative meter-scale location errors based on the cross-correlation approach with data from permanent seismic networks. The clear lineament of the hypocenter distribution defines the fault plane as being 0.3 km by 0.3 km at a depth of ∼20 km, trending WNW-ESE with a dip of ∼70° in the SSW direction. The retrieved moment tensor of the largest event presents a strike of 98°, a dip of 65°, and a rake of 7°, which is close to the inferred fault geometry from relocation results. The hypocenters of the earthquake sequence progressed toward the upper east along the fault-strike direction until the largest event occurred on May 3, 2020 with left-lateral strike-slip motion at the shallower part of the fault plane where the migration is headed. We discuss potential mechanisms that cause non-volcanic earthquake swarms and suggest that the spreading of fluid flow induced the migratory behavior of the Haenam earthquake sequence. This conception of a fluid-driven earthquake swarm is supported by the presence of a seismic migration front that is comparable to a hydraulic diffusivity of 0.012 m2/s in conjunction with inherited WNW-ESE structural sets showing a fault-fracture mesh geometry that can channel the fluid flow. The final part of the sequence forming boundary of the hypocenter distribution could be interpreted as the possible fault-valve behavior at the western end and the permeability barrier at the eastern end, respectively. Our spatiotemporal patterns of the 2020 Haenam earthquake sequence are valuable for understanding earthquake swarms in intraplate stress fields.

Background Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation. Methods The participants included 486 farmers (238 men and 248 women), aged 40–69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression. Results A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000–19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears. Conclusion This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.

This study investigated the phenolics (TP) and phytochemical contents and radical-scavenging activity of ethanol extracts of Dendropanax morbiferus parts (leaf, stem, and root). The contents of chlorogenic acid (CA) and rutin (RT) and radical-scavenging activity of all extracts by parts were in the order of leaf, stem and root. In the case of leaf, the TP contents were 2.15-2.52 mg/g when extracted with hot water and ethanol concentration (30-70%), and there was no difference depending on extraction solvents and times. However, 95% alcohol extracts showed the lowest content of TP (extraction time: 2-4 h). Particularly, CA and RT contents of 70% ethanolic extract for 2 h were the highest as 12.33 mg/g and 14.01 mg/g, respectively, in which DPPH and ABTS radical scavenging activities were also highest (85% and 110%), respectively.

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.

Objective Electrocardiogram (ECG) patterns can change, especially in patients with central nervous system disorders such as spontaneous subarachnoid hemorrhage. However, the association between the prognosis of traumatic brain injury (TBI) and ECG findings is unknown. Therefore, this study aimed to compare and to analyze ECG findings to predict early mortality in patients with TBI. Methods This retrospective observational study included patients with severe trauma and TBI who were admitted to the emergency department (ED) between January 2018 and December 2020. TBI was defined as an abbreviated injury scale score of the head of ≥3. We examined ECG findings, including PR prolongation (≥ 200 ms), QRS complex widening (≥ 120 ms), corrected QT interval prolongation (QTP, ≥ 480 ms), ST-segment elevation, and ST-segment depression (STD) at ED arrival. The primary outcome was 48-h mortality. Results Of the total patients with TBI, 1024 patients were included in this study and 48-h mortality occurred in 89 patients (8.7%). In multivariate analysis, QTP (odds ratio [OR], 2.017; confidence interval [CI], 1.203–3.382) and STD (OR, 8.428; 95% CI, 5.019–14.152) were independently associated with 48-h mortality in patients with TBI. The areas under the curve (AUCs) of the revised trauma score (RTS), injury severity score (ISS), QTP, STD, and the combination of QTP and STD were 0.790 (95% CI, 0.764–0.815), 0.632 (95% CI, 0.602–0.662), 0.605 (95% CI, 0.574–0.635), 0.723 (95% CI, 0.695–0.750), and 0.786 (95% CI, 0.759–0.811), respectively. The AUC of the combination of QTP and STD significantly differed from that of ISS, QTP, and STD, but not RTS. Conclusion Based on the ECG findings, QTP and STD were associated with 48-h mortality in patients with TBI.