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The purpose of the current study is to validate the Counseling Competencies Scale Revised (CCS-R). We used convenience sampling to recruit counselors and counselors-in-training (N = 156). Specifically, we had 130 female (83.3%) and 26 male (16.7%) participants, and the mean age was 33.16 (SD = 11.18), ranging from 20 to 62 years old. We used correlational analyses, ANOVA, and confirmatory factor analysis to understand the characteristics of the sample and assess the psychometrics of the CCS-R-K. Results showed the validity and reliability of the data, including the acceptable model fits and high alpha reliability coefficient values. We also found that the scores of the CCS-R-K were positively related to participants' years of clinical experience and educational levels. The CCS-R-K can be used as a measurement tool to objectively and comprehensively evaluate Korean counselors' competency in counselor education, contributing to cultivating counselors with the professional competencies required by our society. [ABSTRACT FROM AUTHOR]

Background: Epstein–Barr virus (EBV)-associated gastric cancer (EBVaGC) has been reported to account for approximately 5–16% of all GCs with good prognosis compared to EBV-negative GC. We evaluated the clinicopathological characteristics of EBVaGC including survival rate in South Korea. Methods: A total of 4,587 patients with GC who underwent EBV in situ hybridization (EBV–ISH) were prospectively enrolled at the Seoul National University Bundang Hospital from 2003 to 2021. Age, sex, smoking status, cancer type and stage, tumor size and location, histological type, molecular features and survival information were analyzed. Results: A total of 456 patients with GC (9.9%) were positive for EBV. The EBVaGC group displayed a higher proportion of males (P < 0.001), a predominant presence in the proximal stomach (P < 0.001), a higher proportion of undifferentiated cancer (P < 0.001), and a lower cancer stage (P = 0.004) than the EBV-negative group. Cox multivariate analyses revealed age (hazard ratio [HR] = 1.025, P < 0.001), tumor size (HR = 1.109, P < 0.001), and cancer stage (stage2 HR = 4.761, P < 0.001; stage3 HR = 13.286, P < 0.001; stage4 HR = 42.528, P < 0.001) as significant risk factors for GC-specific mortality, whereas EBV positivity was inversely correlated (HR = 0.620, P = 0.022). Furthermore, the EBVaGC group displayed statistically significant survival advantages over the EBV-negative cancer group in terms of both overall (P = 0.021) and GC-specific survival (P = 0.007) on the Kaplan–Meier survival curve. However, this effect was evident only in males. Conclusions: EBVaGC patients showed better prognoses despite their association with proximal location and poorly differentiated histology in male, probably due to the difference in immunity between males and females. [ABSTRACT FROM AUTHOR]

Nanoencapsulation of living cells within artificial shells is a powerful approach for augmenting the inherent capacity of cells and enabling the acquisition of extrinsic functions. However, the current state of the field requires the development of nanoshells that can dynamically sense and adapt to environmental changes by undergoing transformations in form and composition. This paper reports the compositional transformation of an enzyme‐embedded nanoshell of Fe3+‐trimesic acid complex to an iron phosphate shell in phosphate‐containing media. The cytocompatible transformation allows the nanoshells to release functional molecules without loss of activities and biorecognition, while preserving the initial shell properties, such as cytoprotection. Demonstrations include the lysis and killing of Escherichia coli by lysozyme, and the secretion of interleukin‐2 by Jurkat T cells in response to paracrine stimulation by antibodies. This work on micrometric Transformers will benefit the creation of cell‐in‐shell nanobiohybrids that can interact with their surroundings in active and adaptive ways. [ABSTRACT FROM AUTHOR]

The current study investigated the relationship between research self-efficacy, perceived research training environment and research productivity among 174 doctoral students enrolled in counselling programmes in universities across the United States. Results indicated that students’ research self-efficacy was positively correlated with their research productivity, and research training environment was also positively related to their research productivity. Moreover, students’ perceived research training environment was found to moderate the relationship between research self-efficacy and research productivity. Implications for programme faculty and doctoral research training are discussed. [ABSTRACT FROM AUTHOR]

We aimed to investigate whether mitochondrial dysfunction in extracellular cerebrospinal fluid (CSF), which is associated with autophagy and mitophagy, might be involved in neurological outcomes in adult patients with hemorrhagic moyamoya disease (MMD) whose pathogenesis related to poor outcomes is not well-known. CSF samples were collected from 43 adult MMD patients and analyzed according to outcomes at 3 months. Fluorescence-activated cell sorter analysis (FACS) and the JC-1 red/green ratio were used to assess mitochondrial cells and intact mitochondrial membrane potential (MMP). We performed quantitative real-time polymerase chain reaction and Western blotting analyses of autophagy and mitophagy-related markers, including HIF1α, ATG5, pBECN1, BECN1, BAX, BNIP3L, DAPK1, and PINK1. Finally, FACS analysis with specific fluorescence-conjugated antibodies was performed to evaluate the potential cellular origin of CSF mitochondrial cells. Twenty-seven females (62.8%) with a mean age of 47.4 ± 9.7 years were included in the study. Among 43 patients with hemorrhagic MMD, 23 (53.5%) had poor outcomes. The difference in MMP was evident between the two groups (2.4 ± 0.2 in patients with poor outcome vs. 3.5 ± 0.4 in patients with good outcome; p = 0.02). A significantly higher expression (2–ΔCt) of HIF1α, ATG5, DAPK1 followed by BAX and BNIP3L mRNA and protein was also observed in poor-outcome patients compared to those with good outcomes. Higher percentage of vWF-positive mitochondria, suggesting endothelial cell origins, was observed in patients with good outcome compared with those with poor outcome (25.0 ± 1.4% in patients with good outcome vs. 17.5 ± 1.5% in those with poor outcome; p < 0.01). We observed the association between increased mitochondrial dysfunction concomitant with autophagy and mitophagy in CSF cells and neurological outcomes in adult patients with hemorrhagic MMD. Further prospective multicenter studies are needed to determine whether it has a diagnostic value for risk prediction. [ABSTRACT FROM AUTHOR]

Background: The association between Helicobacter pylori (HP) infection and coronary heart disease (CHD) is controversial. This study aimed to investigate the effect of H. pylori eradication on CHD, especially in terms of age and sex. Materials and Methods: From May 2003 to March 2022, 4765 subjects with H. pylori infection and without CHD (median follow‐up: 51 months) were prospectively enrolled. The participants were categorized into two groups: H. pylori eradication and H. pylori non‐eradication. After propensity‐score matching (PSM), the effect of H. pylori eradication on CHD was analyzed using Cox proportional hazards. Results: There were no significant differences in age, sex, alcohol consumption, smoking habits, history of diabetes, hypertension, and dyslipidemia, and aspirin intake between the eradication and non‐eradication groups (3783 vs. 982) before and after PSM. Multivariate analysis after PSM showed that H. pylori eradication (HR: 0.489, CI: 0.314–0.761, p =.002), age (HR: 1.027, CI: 1.007–1.047, p =.007), hypertension (HR: 2.133, CI: 1.337–3.404, p = 001), dyslipidemia (HR: 1.758, CI: 1.086–2.848, p =.022), and aspirin intake (HR: 2.508, CI: 1.566–4.017, p <.001) were associated with CHD development. H. pylori eradication prevented CHD in males ≤65 years (HR: 0.133, CI: 0.039–0.455, p =.001), but not in those aged >65 years (p =.078) (p for interaction =.022). In contrast, females aged >65 years (HR: 0.260, CI: 0.110–0.615, p =.002) were protected by H. pylori eradication and not those ≤65 years (p =.485) (p for interaction =.003). This preventive effect increased more after PSM, particularly in males ≤65 years and females >65 years. Conclusions: H. pylori eradication prevented CHD and this effect was different depending on age and sex. [ABSTRACT FROM AUTHOR]

We investigated the effect of careless or insufficient effort (C/IE) responses in a study using Amazon's Mechanical Turk. A factor mixture model was used to identify latent classes based on the pattern of responses with biases and examine the effect of C/IE responses on the fit of the theoretical model. [ABSTRACT FROM AUTHOR]

3Comparisons of gastric cancer-specific survival depending on Helicobacter pylori eradication. The benefits of gastric cancer-specific survival were observed in the successfully eradicated group before (a) and after (b) propensity score matching compared to non-eradicated group, with statistical significance (P < 0.001). Correction: Effect of Helicobacter pylori eradication after subtotal gastrectomy on the survival rate of patients with gastric cancer: follow-up for up to 15 years. [Extracted from the article]

This study investigated the optimum task sequence for second language (L2) novice learners of English. One set of task sequences was manipulated using a deductive and theoretical SSARC (simplify–stabilize–automatize–restructure–complexify) model, and two sets of task sequences were manipulated based on a teacher's inductive classroom observations. A total of 76 undergraduates at a private university in Korea were divided into three groups for the task sequences: task complexity (TC), guided planning with vocabulary (GPV), and guided planning with content (GPC). While the four oral tasks were sequenced according to the resource-directing dimensions [± elements] and [± reasoning] in all three groups, the TC group received pretask planning, the GPV group received teacher-led guided planning with words, and the GPC group received teacher-led guided planning with content for the resource-dispersing dimensions. Pretest and posttest of syntactic complexity, accuracy, and fluency were used as the main data. The analysis showed that the TC group outperformed the GPV and GPC groups significantly in increasing overall syntactic complexity, and the GPV group outperformed the GPC group significantly in improving speed fluency. Both sequencing TC and GPV tasks significantly increased syntactic complexity and speed fluency. Sequencing TC tasks decreased accuracy and increased dysfluency, whereas sequencing GPV tasks increased accuracy and decreased dysfluency. Meanwhile, sequencing GPC tasks did not produce overall positive effects on oral performance compared with the two other groups. [ABSTRACT FROM AUTHOR]

Background: The incidence and mortality rates of colorectal cancer (CRC) has been reported to be strongly associated to sex/gender difference. CRC shows sexual dimorphism, and sex hormones have been shown to affect the tumor immune microenvironment. This study aimed to investigate location-dependent sex differences in tumorigenic molecular characteristics in patients with colorectal tumors, including adenoma and CRC. Methods: A total of 231 participants, including 138 patients with CRC, 55 patients with colorectal adenoma, and 38 healthy controls, were recruited between 2015 and 2021 at Seoul National University Bundang Hospital. All patients underwent colonoscopy and acquired tumor lesion samples were further analyzed for programmed death-ligand 1 (PD-L1), epidermal growth factor receptor (EGFR) expression, deficient mismatch repair (dMMR), and microsatellite instability (MSI) status. This study was registered with ClinicalTrial.gov, number NCT05638542. Results: The average of combined positive score (CPS) was higher in serrated lesions and polyps (lesions/polyps) compared to conventional adenomas (5.73 and 1.41, respectively, P < 0.001). No significant correlation was found between sex and PD-L1 expression within the groups, regardless of histopathological diagnosis. In multivariate analysis where each sex was further stratified by tumor location due to their interaction in CRC, PD-L1 expression was inversely correlated with males having proximal CRC with a CPS cutoff of 1 (Odds ratio (OR) 0.28, P = 0.034). Females with proximal CRC showed a significant association with dMMR/MSI-high (OR 14.93, P = 0.032) and high EGFR expression (OR 4.17, P = 0.017). Conclusion: Sex and tumor location influenced molecular features such as PD-L1, MMR/MSI status and EGFR expression in CRC, suggesting a possible underlying mechanism of sex-specific colorectal carcinogenesis. [ABSTRACT FROM AUTHOR]

Background: Failure of Helicobacter pylori (H. pylori) eradication is principally caused by antimicrobial resistance. Nowadays, multidrug resistance could be a major determinant of eradication failure. To assess minimal inhibitory concentration (MIC), antimicrobial resistance rates and trends in H. pylori isolated from patients with upper gastrointestinal disease with long‐term period. Materials and Methods: Patients who had H. pylori colonies isolated from culture were consecutively enrolled during the period of 2003–2022. From each patient, one to ten isolates were collected from culture of mucosal biopsy. MIC test was performed for amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and moxifloxacin using agar dilution method. Trends in MIC distribution, prevalence of resistances with single and multiple were investigated which were suspected to be related to the failure of empirical H. pylori eradication treatment. Results: From 2003 to 2022, a total of 873 patients were enrolled and 2735 H. pylori isolates were successfully collected. Increase in the primary resistance rate was found in clarithromycin (16.1%–31.0%, p =.022), metronidazole (30.6%–38.1%, p < 0.001), and both of levofloxacin and moxifloxacin (7.3%–35.7%, p < 0.001). The prevalence of multidrug resistance to both clarithromycin and metronidazole (9.2%–37.9%, p < 0.001), clarithromycin and fluoroquinolone (2.8%–41.7%, p < 0.001), and clarithromycin, metronidazole, and fluoroquinolone (1.4%–28.2%, p < 0.001) was found to significantly increase. Conclusions: The prevalence of multiple resistance against H. pylori in Korea is ongoing. Its trend should be considered when establishing an empirical treatment strategy (ClinicalTrials. gov: NCT05247112). [ABSTRACT FROM AUTHOR]

This article introduces a combined supervision model, the Integrative Developmental Model for Narrative Supervision (IDMNS), which incorporates the Integrative Developmental Model and Narrative Supervision Model. This model provides concrete guidelines for supervisors to incorporate narrative processes in clinical supervision while attending to supervisees' developmental needs. Specifically, the proposed tenets of the model include multicultural awareness, supervisory relationship, and narrative facilitation. The benefits and the limitations of the model are identified along with a case study of the IDMNS in practice. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Enhancing multicultural and social justice counselling competencies (MSJCC) has been important in the counselling field for a number of years. As such, counsellor educators are called to provide the relevant education for counselling students. To identify ways to increase counselling students' MSJCC, the researchers conducted an experimental study investigating the effects of reflective practice on MSJCC of counselling students. Participants were recruited from a large university in the U.S. and completed a survey at the beginning and the end of their practicum semester. They were divided into an experimental (n = 35) and control (n = 37) group. Students in the experimental group wrote reflective journals after working with clients from different backgrounds. Specifically, we used the intervention derived from cultural auditing where individuals answer questions based on the prompts that facilitated participants' reflection regarding their counselling sessions. In our study, we selectively provided participants with the prompts from the cultural auditing process. For instance, we asked what their initial reactions were to a specific client, what those reaction may indicate about their own beliefs, values and assumptions, what the client's rationale was for the problem and how it may fit with the ways that problems were conceptualised within their culture. Based on these prompts, counselling students in the experimental group wrote reflective journals. An analysis of covariance (ANCOVA) was employed. Results showed that MSJCC was higher for those in the control group than those in the experimental group, F(286.573, 1) = 5.119, p =.027, ηp2 = 0.071. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Tight junction proteins (TJPs) play a role in epithelial defense mechanisms. However, the effect of Helicobacter pylori (Hp) on TJPs remains unclear. This study aimed to evaluate the expression of TJPs in relation to Hp infection and eradication in gastric carcinogenesis. Methods: In total, 510 subjects (284 controls and 226 gastric cancer [GC] patients) were prospectively enrolled in the study. The expression of claudin‐1 and ‐2 (CLDN‐1, ‐2), occludin (OCLN), and tight junction protein 1 (TJP1) was measured based on their Hp infection status in normal corpus mucosa and evaluated following Hp eradication using quantitative real‐time polymerase chain reaction (qPCR) and immunohistochemistry (IHC). Results: The expression of TJP1 in Hp+ controls was significantly lower than that in Hp− controls (p = 0.006), whereas it was higher in Hp+ than in Hp− GC patients (p = 0.001). Moreover, the increased expression of TJP1 in Hp+ GC patients was reduced to levels in Hp−within a year after Hp eradication and was maintained for more than 5 years. Furthermore, IHC results for TJP1 were similar to qPCR results. In particular, the higher IHC staining intensity of TJP1 in the cytosol of GC patients (p = 0.019) decreased after Hp eradication (p = 0.040). Conclusion: Hp infection affects TJP expression. The high expression of TJP1 in Hp+ GC patients was restored to control levels after Hp eradication, suggesting that TJP1 plays a role in gastric carcinogenesis. [ABSTRACT FROM AUTHOR]

Background: Single-cell RNA sequencing (scRNA-seq) enables the systemic assessment of intratumoral heterogeneity within tumor cell populations and in diverse stromal cells of the tumor microenvironment. Gain of treatment resistance during tumor progression or drug treatment are important subjects of tumor-centric scRNA-seq analyses, which are hampered by scarce tumor cell portions. To guarantee the inclusion of tumor cells in the data analysis, we developed a prescreening strategy for lung adenocarcinoma.Methods: We obtained candidate genes that were differentially expressed between normal and tumor cells, excluding stromal cells, from the scRNA-seq data. Tumor cell-specific expression of the candidate genes was assessed via real-time reverse transcription-polymerase chain reaction (RT-PCR) using lung cancer cell lines, normal vs. lung cancer tissues, and lymph node biopsy samples with or without metastasis.Results: We found that CEA cell adhesion molecule 5 (CEACAM5) and high mobility group box 3 (HMGB3) were reliable markers for RT-PCR-based prescreening of tumor cells in lung adenocarcinoma.Conclusions: The prescreening strategy using CEACAM5 and HMGB3 expression facilitates tumor-centric scRNA-seq analyses of lung adenocarcinoma. [ABSTRACT FROM AUTHOR]

The human ventromedial prefrontal cortex (vmPFC) has been traditionally associated with decision-making under risk. Neuroimaging studies of such decision-making processes have largely focused on patients with vmPFC lesions or pathological gambling behavior, leading to a relative paucity of work focusing on the structural variability of the vmPFC in healthy individuals. To address this, we developed a decision-making task that allowed healthy players to choose to participate in either low stakes or high-stakes gambling on a trial-by-trial basis, and computed a metric that indexes the propensity for engaging in gambles with greater potential payoffs. We leveraged voxel-based morphometric analyses to examine the association between prefrontal gray matter volume and individual differences in the propensity for seeking high-risk/high-reward situations. Our analyses showed that vmPFC gray matter volume was inversely correlated with an increased tendency for engaging in high-stakes gambling. These results converge with findings from functional neuroimaging and brain lesion studies of vmPFC, and further extend them to show that normative variability in brain structure could also underpin risk-taking behavior. [ABSTRACT FROM AUTHOR]

This study examined the association between parental perceived need for counseling or mental health care services and adolescents' subgroups of anxiety and depression symptoms (Anxiety-only, Depression-only, Anxiety-Depression, and None). Adolescent sample (N = 20,486, M = 14.69 years old, SD = 1.69) was drawn from the National Survey of Children's Health 2017–2018 (NSCH 2017–2018). A chi-square test was used to analyze the association between two categorical variables. The Chi-square test was statistically significant, Χ2(6) = 7,914.33, p <.01, V =.44. Adolescents from the Anxiety-Depression group received counseling or mental health care the most (80.94%), while 69.03% of those in the depression-only group and 44.86% in the Anxiety-only group received mental health services. Caregivers of adolescents with Anxiety-only tended to perceive the least need for counseling or mental health care, compared with those with depression or both, suggesting the need to enhance mental health awareness. [ABSTRACT FROM AUTHOR]

This study aimed to inactivate Aspergillus flavus on green coffee beans using organic acid vapor treatment. Green coffee beans inoculated with A. flavus spores (approximately 5.2–5.9 log cfu/5 beans) were treated with vapor (100 mg/L) generated from acetic acid, formic acid, or propionic acid at 25 °C or 50 °C and relative humidity (RH) of 43 % or 100 % for up to 6 h. Exposure to acetic acid or propionic acid vapor for 6 h decreased the number of A. flavus on the beans by 1.2–3.1 or 0.5–3.3 log cfu/5 beans, respectively. Treating green coffee beans with formic acid vapor for 6 h reduced number of A. flavus spores to below the detection limit (1.7 log cfu/5 beans), regardless of temperature and RH. Formic acid treatment did not alter the color values (L *, a* , and b* values) of the beans; however, it significantly decreased the pH. Mold did not grow on beans treated with formic acid vapor during storage, whereas untreated beans and those treated with acetic acid or propionic acid showed visible mold after 5 days. The treatment of organic acid vapor significantly reduced A. flavus populations on the beans and high temperatures or RH synergistically enhanced mold inactivation effect of organic acid vapor. • Organic acid vapor prevented growth of A. flavus at 12 °C or 25 °C. • Mold did not grow on coffee beans treated with organic acid vapor during storage. • Organic acid vapor has a minor impact on the color and pH of green coffee beans. • Organic acid vapor successfully enhanced the microbial safety of coffee beans. [ABSTRACT FROM AUTHOR]

The characteristic clinical features of EBP are intense pruritus, pretibial nodular prurigo-like lesions and scarring with milia, mainly distributed on the extensor extremities.[1] Although treatment options for EBP can range from topical steroids and oral antihistamines to immunosuppressants, treatment outcomes are often unsatisfactory. Although the aims of EBP treatment focus on relieving pruritus and controlling new lesions, the exact pathogenesis of pruritus in EBP is unknown. Epidermolysis bullosa pruriginosa (EBP) is a rare variant of dystrophic epidermolysis bullosa (DEB) caused by I COL7A1 i mutations. [Extracted from the article]

During normal reading, readers' perceptions of time in a narrative shift according to grammatical and semantic cues. This study investigated the extent to which second-language (L2) readers' interpretations of situations depicted in narratives are influenced by the grammatical aspect (perfective/progressive) and temporal duration (short/long) of intervening events. The study further examined whether reading fluency and L2 proficiency modulated how readers' mentally constructed the depicted situations. Thirty-one L2 learners of English and 37 English-first-language (L1) controls completed a reading comprehension task in which each of 40 stories contained a target event with an inherent endpoint, with accomplishment verbs that were described as completed or in progress, followed by a short- or long-duration event. A reading-fluency task and a cloze test were administered. While grammatical marking played a significant role for both groups of participants, grammatical aspect and event duration showed an interaction only for L2 learners. The construction of a situation was modulated for both groups by reading fluency. [ABSTRACT FROM AUTHOR]

Adolescence is the period when teenagers need to enhance competencies, develop independence and experience important transitions in their lives. In addition to typical developmental tasks, Korean adolescents experience unique stressors due to highly competitive nature of the educational system in the country. It is commonly believed that they are more likely to get high‐paying jobs or higher social status once they enter prestigious universities. This belief forces the students to spend a considerable amount of time studying and results in pressure to show high levels of academic performance. Consequently, Korean adolescents experience excessive academic stress, which may lead to a broad range of psychological difficulties. These stressors have led to an increased number of clients seeking counselling services in the past years, with a total of 5 million students at all school levels presenting in 2018. The presenting issues and concerns included interpersonal relationships, academic/career difficulties, mental health issues and juvenile delinquency. In order to best serve adolescent clients, Korea has different service delivery systems including Community Youth Safety‐Net (CYS‐Net). This system provides at‐risk adolescents with customised services including counselling, protection, education and shelters by linking youth‐related resources in the community. Overall, the current article provides information regarding the Korean counselling system for adolescents. Specifically, we present (a) characteristics of the counselling system, (b) prevalence of presenting issues in counselling, (c) client characteristics, (d) service delivery systems, and (e) employment status of adolescent counsellors and school counsellors. Future directions for Korean adolescent counselling and implications are discussed. [ABSTRACT FROM AUTHOR]

Increasing renewable energy is posing a challenge to the stability of electricity grid, and the importance of an energy storage system (ESS) is becoming clearer. A Liquid Air Energy Storage System (LAES) is proposed as one of the promising ESS technologies. LAES converts electricity to liquid air efficiently and economically. However, since the storage temperature of liquid air is −196 °C, loss of liquid air is inevitable due to evaporation, i.e., boil-off gas (BOG). A loss of liquid air has negative effect on the round-trip efficiency of LAES; therefore, the BOG rate must be minimized. In this research, the insulation performance of liquid air tank is evaluated. To calculate the heat ingress and BOG rate, a partial equilibrium model is developed. The insulation performance is evaluated with varying insulation thickness, emissivity, aspect ratio and materials. The results show that the BOG rate of vacuum insulation can reach 1.8 %/day. For foam glass insulation, the BOG rate can become 2.25 %/day. With optimal geometry, 0.7 %/day for vacuum insulation and 1 %/day for foam glass insulation can be achieved. The vacuum insulation generally shows better insulation performance, however, there is area where the foam glass insulation shows better performance depending on the insulation thickness and emissivity. • A partial-equilibrium thermo-fluid model for liquid air tank is developed. • The model predicts the heat ingress and boil-off gas rate of liquid air tank. • The effects of insulation thickness, emissivity, and aspect ratio are investigated. • Vacuum insulation generally shows better insulation performance than foam glass. • The change of oxygen concentration should be carefully monitored. [ABSTRACT FROM AUTHOR]

Background: Failure of second or third‐line eradication treatment against Helicobacter pylori (H. pylori) is principally caused by antimicrobial resistance and reduced treatment adherence. Aims: To evaluate the efficacy and safety of culture‐based rescue eradication treatments in patients who have previously experienced failed eradication treatment. Methods: Patients who had persistent H. pylori infection following at least one eradication treatment were recommended to undergo culture analysis to determine the minimal inhibitory concentrations of various antimicrobials via endoscopic resection. Consenting patients were assigned one of four therapeutic treatments based on an algorithm determined by antimicrobial resistance. These treatments consisted of 7 or 14‐day administration of clarithromycin‐containing proton pump inhibitor (PPI) triple therapy; esomeprazole, moxifloxacin, and amoxicillin (MEA) therapy; esomeprazole, bismuth, metronidazole, and tetracycline (quadruple) therapy; or lansoprazole, rifabutin, and amoxicillin (RLA) therapy. Eradication efficacy, adherence, and adverse events were assessed aside clinical outcomes. Results: A total of 132 patients were enrolled, with 84 patients completing the study. The overall resistance rates to amoxicillin, clarithromycin, metronidazole, and moxifloxacin were 13.1%, 83.3%, 47.6%, and 71.4%, respectively. The patients were allocated to the PPI triple (n = 11), MEA (n = 15), quadruple (n = 53), or RLA triple (n = 5) therapy group. The eradication rates in the intention‐to‐treat and per‐protocol analyses were 90.5% (76 of 84 patients) and 93.8% (76 of 81 patients), respectively. Nausea was the most frequent adverse event (25.0%). Conclusions: As a rescue therapy, culture‐based susceptibility‐guided eradication treatment was both effective and safe, even for patients exhibiting high antimicrobial resistance. [ABSTRACT FROM AUTHOR]

We investigated the effectiveness of a 5‐week wellness group curriculum for counselors‐in‐training (N = 60). A repeated measures multivariate analysis of variance was conducted to evaluate whether the curriculum positively affected perceived wellness among participants. The results showed statistically significant differences in scores, indicating a higher level of wellness after the intervention. [ABSTRACT FROM AUTHOR]

Summary: A graphene nanosheet‐TiO2 nanoparticle composite (L‐GNS‐TiO2) was prepared for an application as a high‐performance lithium storage device (or lithium‐ion battery anode). The composite features a well‐defined hybrid structure of GNS and homogeneously distributed anatase TiO2 nanoparticles due to nanoparticulation and modification by organic ligands (polyacrylic acid, tartaric acid, and diethylene glycol). Despite its low overall carbon content (~8.4%), the L‐GNS‐TiO2 composite‐based anode exhibited highly reversible lithiation/delithiation (Coulombic efficiency >97%), excellent capacity retention (206 (92%) and 331 (147%) mAh g−1 after 50 and 450 cycles, respectively, at 0.15 A g−1) and decent rate capability (164 mAh g−1 at 0.75 A g−1). In addition, the stable morphology/structure of the composite after lengthy cycle tests reflected its mechanical robustness and electrochemical reversibility. The excellent performance of L‐GNS‐TiO2 was attributed to the enhanced electronic conductivity, retained charge storage sites, and a short Li+ diffusion pathway enabled by the unique composite structure constructed through optimized ligand mediation. Highlights: A graphene nanosheet‐TiO2 nanoparticle composite (L‐GNS‐TiO2) was prepared for Li storage applications.L‐GNS‐TiO2 possesses a structure containing uniformly distributed anatase TiO2 nanoparticles on GNS due to optimized mediation and nanoparticulation by organic ligands.L‐GNS‐TiO2 exhibits enhanced conductivity, retains charge storage sites, and facilitates Li+ transport/charge transfer.Excellent cycle stability (>100% capacity retention, 331 mAh g−1) and Coulombic efficiency (>99%) were realized after 450 cycles at 0.15 A g−1.Decent rate capability was achieved with a high capacity (164 mAh g−1) at 0.75 A g−1. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children; survivors experience long-term cognitive and motor deficits. To date, studies predicting outcome following pediatric TBI have primarily focused on acute behavioral responses and proxy measures of injury severity; unsurprisingly, these measures explain very little of the variance following heterogenous injury. In adults, certain acute imaging biomarkers help predict cognitive and motor recovery following moderate to severe TBI. This multi-center, retrospective study, characterizes the day-of-injury computed tomographic (CT) reports of pediatric, adolescent, and young adult patients (2 months to 21 years old) who received inpatient rehabilitation services for TBI (n = 247). The study also determines the prognostic utility of CT findings for cognitive and motor outcomes assessed by the Pediatric Functional Independence Measure, converted to age-appropriate developmental functional quotient (DFQ), at discharge from rehabilitation. Subdural hematomas (66%), contusions (63%), and subarachnoid hemorrhages (59%) were the most common lesions; the majority of subjects had less severe Rotterdam CT scores (88%, ≤ 3). After controlling for age, gender, mechanism of injury, length of acute hospital stay, and admission DFQ in multivariate regression analyses, the highest Rotterdam score (β = -25.2, p < 0.01) and complete cisternal effacement (β = -19.4, p < 0.05) were associated with lower motor DFQ, and intraventricular hemorrhage was associated with lower motor (β = -3.7, p < 0.05) and cognitive DFQ (β = -4.9, p < 0.05). These results suggest that direct detection of intracranial injury provides valuable information to aid in prediction of recovery after pediatric TBI, and needs to be accounted for in future studies of prognosis and intervention. [ABSTRACT FROM AUTHOR]

Background: Inactivation of TP53, a tumor suppressor gene, is associated with the development of several malignancies, including gastric cancer (GC). The present study aimed to evaluate the correlation between the overexpression of p53 and survival in different Lauren-type GCs. Methods: From May 2003 to December 2019, 3608 GC patients treated endoscopically or surgically at the Seoul National University Bundang Hospital were enrolled for the study. Immunohistochemical staining for p53 was performed on all endoscopic and surgical gastric specimens. Clinicopathologic characteristics with Lauren classification, survival rate, and cancer recurrence were analyzed according to p53 overexpression. Results: Among 3608 GC patients, p53 overexpression was seen in 1334 patients (37%). p53 overexpression was associated with lower depth of invasion (P = 0.026) and Early gastric cancer (P = 0.044) in intestinal-type GC, and with advanced TNM stage (P < 0.001) and Advanced gastric cancer (P < 0.001) in diffuse-type GC. The overall survival (OS) and GC-specific survival (GCSS) were significantly lower in p53 overexpression positive patients. This significance was more pronounced and enhanced in the diffuse-type GC and was absent in the intestinal-type GC. In multivariate analyses, p53 overexpression was associated with poor OS in both subtypes of GC and cancer recurrence in diffuse-type GC. (OS in intestinal-type: adjusted hazard ratio [aHR] = 1.423, P = 0.022; OS in diffuse-type: aHR = 1.401 P = 0.035; cancer recurrence in diffuse-type: aHR = 1.502, P = 0.039). Conclusion: p53 overexpression was associated with poor prognosis in GC, especially in diffuse-type. In addition, p53 overexpression was associated with early stage disease in intestinal-type GC and with advanced stage disease in diffuse-type GC. [ABSTRACT FROM AUTHOR]

Background: The overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS) is associated with more severe gastrointestinal (GI) symptoms and lower quality of life. However, the gender differences in FD-IBS overlap remain unclear. This study aimed to investigate the gender differences in patients with FD-IBS overlap.Methods: Controls and cases were prospectively enrolled from July 2019 to June 2020 at nine tertiary referral centers. The patients underwent esophagogastroduodenoscopy, and their symptoms were evaluated using a questionnaire including GI symptom-related items and the Hospital Anxiety Depression Scale (HADS). FD and IBS were diagnosed according to the Rome IV criteria, and the clinical characteristics of the FD-IBS overlap group were compared with those of the FD-only or IBS-only group.Results: Among 667 subjects (334 healthy controls, 168 with FD-only, 37 with IBS-only, 128 with FD-IBS overlap), the FD-IBS overlap group (19.2%) showed a higher rate of preference for dairy products, a higher rate of history of Helicobacter pylori eradication, and higher HADS scores than the non-overlap group (P < 0.05). In the FD-IBS overlap group, men complained of reflux symptom and loose/watery stools more than women (P < 0.05), whereas women showed more severe GI symptoms, especially epigastric pain/burning symptoms, and higher depression scores than men (all P < 0.05).Conclusions: FD-IBS overlap patients are associated with severe upper GI symptoms and depression compared to non-overlap patients. Moreover, women with FD-IBS overlap experience more severe GI and depression symptoms than men. [ABSTRACT FROM AUTHOR]

Background and aims: The phase‐based model of smoking cessation treatment suggests that treatment needs may vary across phases (e.g. pre‐cessation, cessation). This study tested the comparative effects of varenicline and combination nicotine replacement therapy (C‐NRT) relative to nicotine patch monotherapy on pre‐cessation and cessation phase candidate withdrawal, expectancy and motivation mediators; relations between mediators and abstinence; and indirect effects of enhanced treatments on abstinence via candidate mediators. Design Secondary mediation analysis of data from the open‐label, randomized Wisconsin Smokers' Health Study 2, a comparative effectiveness trial of varenicline or C‐NRT, versus patch monotherapy, in adults who smoked, recruited via media and community outreach. Setting: Research clinics in Madison and Milwaukee, Wisconsin, USA. Participants: A total of 1051 daily smokers motivated to quit smoking (52.5% female; mean age = 48.1, standard deviation = 11.6). Interventions: Twelve weeks of varenicline (n = 407) or 12 weeks of combination nicotine patch and nicotine lozenge therapy (n = 421), both compared with 12 weeks of patch control condition (n = 230), with individual smoking cessation counseling. Measurements The primary abstinence outcome was biochemically verified 7‐day point‐prevalence abstinence 4 weeks post‐target quit day (TQD). Candidate mediators (craving, positive smoking expectancies, withdrawal symptoms, and quitting motivation) were assessed via ecological momentary assessment from 1 week prior (pre‐cessation phase) to 4 weeks after (cessation phase) the TQD. Findings Pre‐cessation and cessation mean levels and slopes of craving [adjusted odds ratio (aOR) = 0.34–0.79], smoking expectancies (aOR = 0.46–0.79) and quitting motivation (aOR = 1.35–7.21) significantly predicted 4‐week post‐TQD abstinence (P < 0.05). Significant varenicline mediation occurred via greater suppression in pre‐cessation craving [mediated effect (ab) = 0.09, standard error (SE) = 0.03, 95% confidence interval (CI) = 0.04–0.14] and smoking expectancies (ab = 0.06, SE = 0.02, 95% CI = 0.02–0.12). C‐NRT mediation occurred via greater reduction in pre–post‐TQD changes in craving (ab = 0.04, SE = 0.02, 95% CI = 0.01–0.08) and expectancies (ab = 0.03, SE = 0.02, 95% CI = 0.001–0.07), relative to patch monotherapy. Conclusion: Among adult smokers seeking to quit, varenicline seems to work through its effects on suppression of craving and smoking expectancies pre‐cessation while combination nicotine replacement therapy mediation seems to work through cessation‐related reduction in craving and smoking expectancies changes. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors unleash inhibitory signals on T cells conferred by tumors and surrounding stromal cells. Despite the clinical efficacy of checkpoint inhibitors, the lack of target expression and persistence of immunosuppressive cells limit the pervasive effectiveness of the therapy. These limitations may be overcome by alternative approaches that co-stimulate T cells and the immune microenvironment. Methods: We analyzed single-cell RNA sequencing data from multiple human cancers and a mouse tumor transplant model to discover the pleiotropic expression of the Interleukin 7 (IL-7) receptor on T cells, macrophages, and dendritic cells. Results: Our experiment on the mouse model demonstrated that recombinant IL-7 therapy induces tumor regression, expansion of effector CD8 T cells, and pro-inflammatory activation of macrophages. Moreover, spatial transcriptomic data support immunostimulatory interactions between macrophages and T cells. Conclusion: These results indicate that IL-7 therapy induces anti-tumor immunity by activating T cells and pro-inflammatory myeloid cells, which may have diverse therapeutic applicability. [ABSTRACT FROM AUTHOR]

Issue: Hospital alcohol and/or other drug (AOD) testing is important for identifying AOD‐related injuries; however, testing methods vary. This systematic review aimed to examine biological AOD testing methods from hospital‐based studies of injured patients and quantify what proportion reported key information on those testing methods. Approach: Observational studies published in English from 2010 onwards involving biological AOD testing for injured patients presenting to hospital were included. Studies examining single injury causes were excluded. Extracted data included concentration thresholds for AOD detection (e.g., lower limits of detection, author‐defined cut‐offs), test type (e.g., immunoassay, breathalyser) and approach (e.g., routine, clinical discretion), timing of testing, sample type and the proportion of injured cases tested for AODs. Key Findings: Of 83 included studies, 76 measured alcohol and 37 other drugs. Forty‐nine studies defined blood alcohol concentration thresholds (ranging from 0 to 0.1 g/100 mL). Seven studies defined concentration thresholds for other drugs. Testing approach was reported in 39/76 alcohol and 18/37 other drug studies. Sample type was commonly reported (alcohol: n = 69/76; other drugs: n = 28/37); alcohol was typically measured using blood (n = 60) and other drugs using urine (n = 20). Studies that reported the proportion of cases tested (alcohol: n = 53/76; other drugs: n = 28/37), reported that between 0% and 89% of cases were not tested for alcohol and 0% and 91% for other drugs. Timing of testing was often unreported (alcohol: n = 61; other drugs: n = 30). Implications and Conclusion: Variation in AOD testing methods alongside incomplete reporting of those methods limits data comparability and interpretation. Standardised reporting of testing methods will assist AOD‐related injury surveillance and prevention. [ABSTRACT FROM AUTHOR]

Objective: It remains unknown whether individuals with a family history (FH) of gastric cancer (GC) are associated with aberrant DNA methylation. The aim of this study was to investigate the association between aberrant DNA methylation and FH of GC. Design: Using quantitative MethyLight assay, MOS, miR124a-3, NKX6-1, EMX1, CDH1, and TWIST1 methylation levels in the noncancerous gastric mucosa was compared between subjects with and without FH based on GC and Helicobacter pylori (Hp) infection. Changes in the methylation levels were evaluated over time after Hp eradication. Results: In Hp-positive GC patients, MOS (P < 0.001), CDH1 (P < 0.001), and TWIST1 (P = 0.004) methylation were decreased in subjects with FH (n = 64) than in those without FH (n = 58). In Hp-positive controls, MOS methylation was lower in subjects with FH (n = 73) than in those without FH (n = 50) (P = 0.042), while miR124a-3 (P = 0.006), NKX6-1 (P < 0.001), and CDH1 (P < 0.001) methylation were higher in subjects with FH. CDH1 methylation constantly decreased from 2 years in GC patients and 3–4 years in controls after Hp eradication (all P < 0.001). A persistent decrease in methylation over time was not observed in other genes after eradication. Conclusion: The methylation of MOS and CDH1 provided an association between aberrant DNA methylation and gastric carcinogenesis in FH of GC, a useful marker for GC risk in individuals with FH. Furthermore, CDH1 methylation decreased after Hp eradication. [ABSTRACT FROM AUTHOR]

Aims: To identify when smoking cessation treatments affect craving, negative affect and anhedonia, and how these symptoms relate to abstinence, to help evaluate the effects of particular intervention components in multi‐component treatments and accelerate treatment refinement. Design Secondary analysis of data from a two‐arm randomized controlled trial. Setting: Seven primary care clinics in Wisconsin, United States. Participants: Adult primary care patients who smoked daily (n = 574). Intervention and comparator: Intervention was abstinence‐optimized treatment (A‐OT, n = 276) comprising 3 weeks of nicotine mini‐lozenges pre‐target quit day (TQD), 26 weeks of combination nicotine patch and mini‐lozenges post‐TQD and extensive psychosocial support. The comparator was recommended usual care (RUC, n = 298), comprising brief counseling and 8 weeks of nicotine patch post‐TQD. Measurements Time‐varying effect models examined dynamic effects of A‐OT (versus RUC) on the primary outcomes of nightly cigarette craving, negative affect and anhedonia from 1 week pre‐ to 2 weeks post‐TQD. Exploratory models examined within‐person relations between nicotine medication use and same‐day symptom ratings. Secondary logistic regression analyses examined associations between post‐TQD craving, negative affect and anhedonia and 1‐month post‐TQD abstinence. Findings A‐OT significantly suppressed pre‐ and post‐TQD craving (β = −0.27 to −0.46 across days) and post‐TQD anhedonia (β = −0.24 to −0.38 across days), relative to RUC. Within individuals, using patches was associated with lower negative affect in RUC (β = −0.42 to −0.52), but not in A‐OT. Using more mini‐lozenges was associated with greater craving (β = 0.04–0.07) and negative affect (β = 0.03–0.05) early, and with lower anhedonia (β = −0.06 to −0.12) later. Greater post‐TQD craving (OR = 0.68) and anhedonia (OR = 0.85) predicted lower odds of abstinence 1 month post‐TQD. Conclusion: Time‐varying effect models showed that a multi‐component treatment intervention for smoking cessation suppressed significant withdrawal symptoms more effectively than recommended usual care among daily adult smokers motivated to quit. The intervention reduced craving pre‐ and post‐target quit day (TQD) and anhedonia post‐TQD. [ABSTRACT FROM AUTHOR]

Background/Aims: Favorable outcomes of potassium-competitive acid blocker (PCAB)-containing eradication therapy have been reported. In fact, tegoprazan, a recently developed PCAB, was presumed to show good eradication efficacy even for resistant Helicobacter pylori. We aimed to investigate the anti-H. pylori efficacy of tegoprazan compared with that of vonoprazan. Methods: A total of 220 resistant clinical H. pylori isolates were utilized. The anti-H. pylori efficacy of PCABs was determined by evaluating the minimum inhibitory concentrations (MICs) of clarithromycin, fluoroquinolone, metronidazole, and amoxicillin in combination with vonoprazan or tegoprazan by the agar dilution method. The impact of the mutations responsible for resistance development, such as 23S rRNA, gyrA, rdxA, frxA, and pbp1 mutations, was also analyzed. Results: H. pylori growth was significantly inhibited in a medium containing 1 μg/mL clarithromycin with tegoprazan (128 μg/mL). The MICs of clarithromycin (46.3%), fluoroquinolone (46.7%), metronidazole (55.6%), and amoxicillin (34.5%) against resistant H. pylori isolates improved after tegoprazan administration. Tegoprazan demonstrated more frequent susceptibility acquisition with metronidazole than with vonoprazan (20.6% vs 4.7%, p=0.014). However, there were no significant differences depending on the mutational status of each antimicrobial agent. Conclusions: Tegoprazan administration may improve the susceptibility of antimicrobial-resistant H. pylori, independent of acid suppression. [ABSTRACT FROM AUTHOR]

Objective: Helicobacter pylori (HP) is known to play an important role in the development of gastric cancer (GC). The aim of this study was to analyze the effect of HP eradication on the survival rate and cancer recurrence in patients who underwent subtotal gastrectomy for GC. Design: Totally 1,031 patients diagnosed with gastric adenocarcinoma who received surgical treatment at the Seoul National University Bundang Hospital from 2003 to 2017 and positive for HP infection were analyzed. The overall and GC-related survival according to HP eradication were compared; risk factors for GC-specific death and cancer recurrence were analyzed, and propensity score matching (PSM) was performed. Results: Statistically significant benefits of overall and GC-specific survival were observed in the eradicated group compared to the non-eradicated group (P < 0.001), and these benefits were maintained after PSM (P < 0.001) in both of early and advance stage. In Cox proportional hazards multivariate analyses, cancer stage (stage II, adjusted hazard ratio [aHR] = 9.33, P < 0.001; stage III or IV, aHR = 26.17, P < 0.001), and HP positivity (aHR = 3.41, P = 0.001) were independent risk factors for GC-specific death; cancer stage (cancer stage II, aHR = 7.08, P < 0.001; cancer stage III or IV, aHR = 19.64, P < 0.001) and HP positivity (aHR = 2.70; P = 0.005) were independent risk factors for cancer recurrence. Conclusion: Our results suggest that HP needed to be conducted more intensively in patients who are surgically treated for GC, regardless of cancer stage. [ABSTRACT FROM AUTHOR]

Background and Aim: Few studies have evaluated the change in serum pepsinogen (sPG) levels after the eradication of Helicobacter pylori. The aim of this study was to evaluate the effect of H. pylori eradication on sPG levels in patients with gastric cancer/dysplasia in comparison to a control group. Methods: We prospectively enrolled 368 patients with gastric cancer/dysplasia and 610 control subjects. H. pylori status and sPG levels were measured before and after eradication. The follow‐up time points were classified as < 12, 12–23, 24–35, and ≥ 36 months. Results: In 179 H. pylori‐eradicated patients with gastric cancer/dysplasia and 168 control group subjects, sPG I significantly decreased, and the sPG I/II ratio significantly increased after eradication compared to baseline, and this improvement in sPG values was maintained during all follow‐up time points. Significant differences in sPG I and the sPG I/II ratio were observed between the gastric cancer/dysplasia group and the control group < 24 months after eradication. However, these differences in sPG values disappeared after ≥ 24 months of follow up. Moreover, significant differences in the intestinal metaplasia grade were observed between these two groups before eradication until < 24 months after eradication. However, these differences in the intestinal metaplasia grade disappeared after ≥ 24 months of follow up in the corpus. Conclusion: The sPG values and intestinal metaplasia grade (corpus) in the gastric cancer/dysplasia group became similar to those in the control group at long‐term follow up after H. pylori eradication. It might be related with the reduction of metachronous gastric neoplasm. [ABSTRACT FROM AUTHOR]

The composition of the gut microbiota is influenced by sex hormones and colorectal cancer (CRC). Previously, we reported that 17β-estradiol (E2) inhibits azoxymethane/dextran sulfate sodium (AOM/DSS)-induced tumorigenesis in male mice. Here, we investigated whether the composition of the gut microbiota is different between male and female, and is regulated by estrogen as a secondary outcome of previous studies. We established four groups of mice based on the sex and estrogen status [ovariectomized (OVX) female and E2-treated male]. Additionally, three groups of males were established by treating them with AOM/DSS, and E2, after subjecting them to AOM/DSS treatment. The mice were sacrificed at 21 weeks old. The composition of the gut microbiota was analyzed using 16S rRNA metagenomics sequencing. We observed a significant increase in the microbial diversity (Chao1 index) in females, males supplemented with E2, and males treated with AOM/DSS/E2 compared with normal males. In normal physiological condition, sex difference and E2 treatment did not affect the ratio of Firmicutes/Bacteroidetes (F/B). However, in AOM/DSS-treated male mice, E2 supplementation showed significantly lower level of the F/B ratio. The ratio of commensal bacteria to opportunistic pathogens was higher in females and E2-treated males compared to normal males and females subjected to OVX. Unexpectedly, this ratio was higher in the AOM/DSS group than that determined in other males and the AOM/DSS/E2 group. Our findings suggest that estrogen alters the gut microbiota in ICR (CrljOri:CD1) mice, particularly AOM/DSS-treated males, by decreasing the F/B ratio and changing Shannon and Simpson index by supply of estrogen. This highlights another possibility that estrogen could cause changes in the gut microbiota, thereby reducing the risk of developing CRC. [ABSTRACT FROM AUTHOR]

Background: Bismuth‐containing quadruple therapy is widely used as second‐line treatment for Helicobacter pylori infection. This prospective study investigated the changes in the annual H. pylori eradication rates of quadruple therapy. Methods: This study included an intention‐to‐treat (ITT) population of 452 subjects who failed first‐line eradication therapy for H. pylori between 2003 and 2018. All subjects received a 14‐day course of bismuth‐containing quadruple therapy consisting of esomeprazole (40 mg twice daily), metronidazole (500 mg thrice daily), bismuth subcitrate (120 mg four times daily), and tetracycline (500 mg four times daily). Per‐protocol (PP) analysis of data was performed in subjects who followed up with strict treatment adherence. Eradication was confirmed based on the results of the 13C‐urea breath test, rapid urease test (CLOtest®), and histopathologic evaluation. Compliance and adverse effects were also investigated. A minimal inhibitory concentration test was performed on tissue samples obtained from 103 subjects. Results: The overall eradication rates following ITT and PP analyses were 78.8% (356/452) and 89.5% (314/351), respectively. The annual eradication success rate did not show significant changes (P =.062 [ITT], P =.857 [PP]) over the 15‐year study period. Adverse events were reported in 57.3% of the ITT population. The rates of resistance to metronidazole and tetracycline were 44.7% and 18.4%, respectively. Conclusions: Despite high antibiotic resistance rates, no significant reduction in annual eradication rates was observed during the study period. [ABSTRACT FROM AUTHOR]

We investigate the effect of continuous-wave laser irradiation on the cavity evolution behind a sphere in water entry. By tuning the irradiation time, the surface temperature (Ts) of the sphere before the impact varies in 105–355 °C. We change the radius and impact velocity of the sphere, by which both the shallow and deep seals are considered. Compared to the reference case (the sphere was roughened to have a cavity initially), we find that the cavity expands or shrinks depending on Ts. Overall, for all cases, the cavity bubble expands to the maximum size and shrinks steeply with increasing Ts. At higher Ts, the cavity is destroyed significantly, even smaller than the reference case. However, the detailed interaction between the cavity and laser-induced cavitation bubbles is quite different. In a shallow-seal case, nucleate boiling occurs on the sphere surface and vapor bubbles merge into the cavity, resulting in the expansion of the cavity. At a highly subcooled condition, on the other hand, the vapor bubble collapses into microbubbles as soon as it contacts water, resulting in the cavity reduction. As the impact speed increases (for a deep-seal condition), the flux of entrained air becomes dominant and the stage of cavity expansion is quite narrow. As Ts increases, the heated cavity collapses into microbubbles and almost 90% is destroyed. Finally, we investigate the effects of modified cavity on hydrodynamic forces on the sphere. While the temporal variation of hydrodynamic forces is complex, the drag reduction over 40% is achieved. [ABSTRACT FROM AUTHOR]

Advances in genomic technologies and the development of targeted therapeutics are making the use of precision medicine increasingly possible. In this study, we explored whether precision medicine can be applied for the management of refractory/relapsed pediatric solid tumors by discovering actionable alterations using targeted panel sequencing. Samples of refractory/relapsed pediatric solid tumors were tested using a targeted sequencing panel covering the exonic DNA sequences of 381 cancer genes and introns across 22 genes to detect clinically significant genomic aberrations in tumors. The molecular targets were tiered from 1 to 5 based on the presence of actionable genetic alterations, strength of supporting evidence, and drug availability in the Republic of Korea. From January 2016 to October 2018, 55 patients were enrolled. The median time from tissue acquisition to drug selection was 29 d (range 14–39), and tumor profiling was successful in 53 (96.4%) patients. A total of 27 actionable alterations in tiers 1–4 were detected in 20 patients (36.4%), and the majority of actionable alterations were copy number variations. The tiers of molecular alterations were tier 1 (clinical evidence) in 4 variants, tier 2 (preclinical evidence) in 8 variants, tier 3 (consensus opinion) in 2 variants, and tier 4 (actionable variants with a drug that is available in other countries but not in the Republic of Korea) in 9 variants. In one patient with relapsed neuroblastoma with ALK F1174L mutation and ALK amplification, lorlatinib was used in a compassionate use program, and it showed some efficacy. In conclusion, using a targeted sequencing panel to discover actionable alterations in relapsed/refractory pediatric solid tumors was practical and feasible. [ABSTRACT FROM AUTHOR]

Several reports indicate crosstalk between the transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) and estrogen, which has a protective effect in colorectal cancer (CRC). The aim of this study was to investigate the role of Nrf2 signaling in the anti-inflammatory effect of estrogen using Nrf2 knockout (Nrf2 KO) mouse embryonic fibroblasts (MEFs), a powerful system to test the function of target genes due to their easy accessibility, and rapid growth rates. After inducing inflammation by tumor necrosis factor alpha (TNF-α), the effects of 17β-estradiol (E2) on the expression of proinflammatory mediators [i.e., NF-κB and inducible nitric oxide synthase (iNOS)] and estrogen receptors were evaluated by Western blot. In wild type (WT) MEFs, E2 treatment ameliorated TNF-α-induced nuclear translocation of NF-κB and expression of its target protein iNOS. Estrogen receptor beta (ERβ) expression was decreased by TNF-α-induced inflammation and restored by E2 treatment. When treated to WT MEFs, E2 induced nuclear translocation of Nrf2. The inhibitory effect of E2 on TNF-α-induced enhancement of iNOS was markedly dampened in Nrf2 KO MEFs. Notably, ERβ expression was significantly diminished in Nrf2 KO MEFs compared to that in WT cells. Promoter Database (EPD) revealed two putative anti-oxidant response elements (AREs) within the mouse ERβ promoter. Furthermore, in WT MEFs, E2 treatment repressed TNF-α-induced expression of iNOS protein and recovered by 4-(2-phenyl-5,7-bis(trifluoromethyl)pyrazolo(1,5-a)pyrimidin-3-yl)phenol (PHTPP), a selective ERβ antagonist, treatment, but not in Nrf2 KO MEFs. In conclusion, Nrf2 plays a pivotal role in the anti-inflammatory of estrogen by direct regulating the expression of ERβ. [ABSTRACT FROM AUTHOR]

Background and Aim: Helicobacter pylori (H. pylori) infection causes extra-gastrointestinal as well as gastric diseases. This analytical cross-sectional study was performed to investigate the association between H. pylori infection and metabolic syndrome in a Korean population.Methods: Anthropometric and metabolic data, as well as anti-H. pylori IgG antibodies, were measured in 21,106 subjects who participated in a health checkup between January 2016 and June 2017. The classification of metabolic syndrome followed the revised National Cholesterol Education Program criteria.Results: After excluding subjects with a history of H. pylori eradication therapy, or gastric symptoms, the seropositivity of H. pylori was 43.2% in 15,195 subjects. H. pylori-positive participants had significantly higher body mass index (BMI), waist circumference, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and lower high-density lipoprotein (HDL-C) than did seronegative participants (P < 0.05). After adjusting for confounders, high TC, low HDL-C, and high LDL-C were associated with H. pylori seropositivity. Finally, the prevalence of metabolic syndrome was higher in H. pylori-seropositive subjects than in negative ones (27.2% vs. 21.0%, P < 0.05), and H. pylori seropositivity increased the likelihood of metabolic syndrome (OR 1.19, 95% CI 1.09-1.31, P < 0.001) after adjusting for sex, age, BMI, smoking, residence, household income, and education level. However, the association between H. pylori seropositivity and metabolic syndrome disappeared in those ≥ 65 years old.Conclusions: H. pylori infection plays an independent role in the pathogenesis of metabolic syndrome in Koreans under 65 years old. [ABSTRACT FROM AUTHOR]

The cascade of gastric cancer, a leading cause of cancer incidence and mortality, is multifactorial. Helicobacter pylori (HP) infection plays a major role in gastric cancer (GC), and there has been an accumulation of data regarding the chemopreventive effect of HP eradication. However, it remains unclear how HP infection causes GC and how HP eradication prevents GC. To clarify this issue, the following approaches were performed in this review article. First, how HP‐induced atrophic gastritis (AG) and intestinal metaplasia (IM) provoke the development of GC is shown, followed by how long HP eradication takes to induce a reversible change in AG and IM. Second, epigenetic studies of PTPN6, MOS, DCC, CRK, and VAV1 were performed in noncancerous gastric specimens in terms of HP status. Among these genes, MOS was found to be a possible surrogate marker for GC development. HP eradication decreased aberrant DNA methylation in a gene‐specific manner, and MOS played a role in metachronous gastric neoplasms. Third, transforming growth factor‐β1 (TGF‐β1) and TGF‐β1‐induced epithelial‐mesenchymal transition (EMT) markers were investigated in gastric mucosa. HP infection triggered the TGF‐β1‐induced EMT pathway and caused the emergence of GC stem cells, such as CD44v8‐10. When HP was eradicated, these two pathways were inhibited. Finally, a 2222 cohort study showed that HP eradication significantly decreased the risk of noncardiac GC. Taken together, HP eradication is effective as a primary GC prevention method, and its underlying mechanism includes reversibility of AG and IM, methylation, EMT, and stem cells. [ABSTRACT FROM AUTHOR]

International students experience significant difficulties as they adjust to the dominant culture in the United States. However, there is a substantial gap between the reported academic and sociological distress these students experience and their help‐seeking behaviors. This article reviews international students' distinctive challenges in seeking professional help and proposes guidelines to effectively support these students by enhancing college counselors' multicultural counseling competence. [ABSTRACT FROM AUTHOR]

Most studies of Composite solid electrolytes (CSEs) are composed of a polymer matrix and ceramic fillers. Polymer matrix–based CSEs are prepared by dissolving a polymer and lithium (Li) salt in a toxic organic solvent; then, a ceramic filler is added, and the toxic solvent is evaporated. These electrolytes contain 80%–90% polymer; however, they still have low thermal and electrochemical stability and unsatisfactory suppression of Li dendrite growth compared to inorganic ceramic electrolytes (ICEs). Ceramic matrix–based CSEs have high electrochemical and thermal stability, and good interfacial contact with electrodes. In this study, ceramic matrix–based CSEs were fabricated at a low temperature using a nontoxic solvent via the cold sintering process (CSP). Then, polyvinylidene fluoride (PVDF) and lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) were introduced on the LiTa 2 PO 8 (LTPO) particle interface. In addition, the effect of the ratio of LTPO–PVDF and PVDF–LiTFSI at the LTPO particle interface on the microstructure and electrochemical properties of composite pellets was investigated. LTPO–PVDF pellets exhibited a relative density of 82%–86%, and high adhesion between LTPO particles was observed due to the formation of PVDF–LiTFSI amorphous layer on the particle interface. The LTPO–PVDF composite pellets exhibited a high total ionic conductivity of 4.59 × 10−4 S/cm at room temperature (RT), negligible electronic conductivity of 3.89 × 10−8 S/cm, low activation energy of 0.259 eV, and sufficient electrochemical stability. Coin cells with LiMn 0.6 Fe 0.4 PO 4 (LMFP) cathode exhibited a high initial discharge capacity of ∼145 mAh/g and capacity retention of approximately 85% after 50 cycles at RT. These results prove that the CSP is an ideal fabrication method for CSEs than the conventional methods that use toxic solvents and that introducing an amorphous layer at the particle interface in ceramic matrix–based CSEs improves their ionic conductivity. [ABSTRACT FROM AUTHOR]

Most studies of Composite solid electrolytes (CSEs) are composed of a polymer matrix and ceramic fillers. Polymer matrix–based CSEs are prepared by dissolving a polymer and lithium (Li) salt in a toxic organic solvent; then, a ceramic filler is added, and the toxic solvent is evaporated. These electrolytes contain 80%–90% polymer; however, they still have low thermal and electrochemical stability and unsatisfactory suppression of Li dendrite growth compared to inorganic ceramic electrolytes (ICEs). Ceramic matrix–based CSEs have high electrochemical and thermal stability, and good interfacial contact with electrodes. In this study, ceramic matrix–based CSEs were fabricated at a low temperature using a nontoxic solvent via the cold sintering process (CSP). Then, polyvinylidene fluoride (PVDF) and lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) were introduced on the LiTa 2 PO 8 (LTPO) particle interface. In addition, the effect of the ratio of LTPO–PVDF and PVDF–LiTFSI at the LTPO particle interface on the microstructure and electrochemical properties of composite pellets was investigated. LTPO–PVDF pellets exhibited a relative density of 82%–86%, and high adhesion between LTPO particles was observed due to the formation of PVDF–LiTFSI amorphous layer on the particle interface. The LTPO–PVDF composite pellets exhibited a high total ionic conductivity of 4.59 × 10−4 S/cm at room temperature (RT), negligible electronic conductivity of 3.89 × 10−8 S/cm, low activation energy of 0.259 eV, and sufficient electrochemical stability. Coin cells with LiMn 0.6 Fe 0.4 PO 4 (LMFP) cathode exhibited a high initial discharge capacity of ∼145 mAh/g and capacity retention of approximately 85% after 50 cycles at RT. These results prove that the CSP is an ideal fabrication method for CSEs than the conventional methods that use toxic solvents and that introducing an amorphous layer at the particle interface in ceramic matrix–based CSEs improves their ionic conductivity. [ABSTRACT FROM AUTHOR]

Substance use is a risk factor for being both a perpetrator and a victim of violence. The aim of this systematic review was to report the prevalence of acute pre-injury substance use in patients with violence-related injuries. Systematic searches were used to identify observational studies that included patients aged ≥15 years presenting to hospital after violence-related injuries and used objective toxicology measures to report prevalence of acute pre-injury substance use. Studies were grouped based on injury cause (any violence-related, assault, firearm, and other penetrating injuries including stab and incised wounds) and substance type (any substance, alcohol only, drugs other than alcohol only), and they were summarized using narrative synthesis and meta-analyses. This review included 28 studies. Alcohol was detected in 13%–66% of any violence-related injuries (five studies), 4%–71% of assaults (13 studies), 21%–45% of firearm injuries (six studies; pooled estimate = 41%, 95% CI: 40%–42%, n = 9,190), and 9%–66% of other penetrating injuries (nine studies; pooled estimate = 60%, 95% CI: 56%–64%, n = 6,950). Drugs other than alcohol were detected in 37% of any violence-related injuries (one study), 39% of firearm injuries (one study), 7%–49% of assaults (five studies), and 5%–66% of penetrating injuries (three studies). The prevalence of any substance varied across injury categories: any violence-related injuries = 76%–77% (three studies), assaults = 40%–73% (six studies), firearms = n/a, other penetrating injuries = 26%–45% (four studies; pooled estimate = 30%, 95% CI: 24%–37%, n = 319).Overall, substance use was frequently detected in patients presenting to hospital for violence-related injuries. Quantification of substance use in violence-related injuries provides a benchmark for harm reduction and injury prevention strategies. [ABSTRACT FROM AUTHOR]

• Are there similarities in executive attention pathophysiology following TBI and in normal age-related decline?. • We derived a biomarker of executive attention pathophysiology that was common to both aging-related and post-TBI-related impairments, and in moderate-severe TBI. • Our findings identify biomarkers to track recovery, impact of interventions and guide development of targeted therapeutics following brain injuries. Executive attention impairments are a persistent and debilitating consequence of traumatic brain injury (TBI). To make headway towards treating and predicting outcomes following heterogeneous TBI, cognitive impairment specific pathophysiology first needs to be characterized. In a prospective observational study, we measured EEG during the attention network test aimed at detecting alerting, orienting, executive attention and processing speed. The sample (N = 110) of subjects aged 18–86 included those with and without traumatic brain injury: n = 27, complicated mild TBI; n = 5, moderate TBI; n = 10, severe TBI; n = 63, non-brain-injured controls. Subjects with TBI had impairments in processing speed and executive attention. Electrophysiological markers of executive attention processing in the midline frontal regions reveal that, as a group, those with TBI and elderly non-brain-injured controls have reduced responses. We also note that those with TBI and elderly controls have responses that are similar for both low and high-demand trials. In subjects with moderate-severe TBI, reductions in frontal cortical activation and performance profiles are both similar to that of controls who are ∼4 to 7 years older. Our specific observations of frontal response reductions in subjects with TBI and in older adults is consistent with the suggested role of the anterior forebrain mesocircuit as underlying cognitive impairments. Our results provide novel correlative data linking specific pathophysiological mechanisms underlying domain-specific cognitive deficits following TBI and with normal aging. Collectively, our findings provide biomarkers that may serve to track therapeutic interventions and guide development of targeted therapeutics following brain injuries. [ABSTRACT FROM AUTHOR]