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Micro electrical discharge drilling (ED-drilling) is a machining method used to make micro holes in hard-to-cut materials. The RC-discharge generator is often used because it creates a short and strong discharge spark. However, this method has issues such as current oscillation between tool electrode and workpiece, causing polarity changes that increase tool wear, and a low material removal rate due to long spark delay time. Furthermore, micro ED-drilling results in a large taper angle due to second discharge sparks created by debris in the narrow gap. To address these issues, the effect of adding graphite powder to the working fluid was studied. The graphite powder in kerosene created a bridge effect that reduced tool wear and taper angle, while improving MRR and surface roughness. The electrical conditions were not changed, and the machining process was improved by only altering the working fluid without modifying the existing system. [ABSTRACT FROM AUTHOR]

Photonic lanterns (PLs) are tapered waveguides that gradually transition from a multimode fiber geometry to a bundle of single-mode fibers (SMFs). They can efficiently couple multimode telescope light into a multimode fiber entrance at the focal plane and convert it into multiple single-mode beams. Thus, each SMF samples its unique mode (lantern principal mode) of the telescope light in the pupil, analogous to subapertures in aperture masking interferometry (AMI). Coherent imaging with PLs can be enabled by the interference of SMF outputs and applying phase modulation, which can be achieved using a photonic chip beam combiner at the backend (e.g., the ABCD beam combiner). In this study, we investigate the potential of coherent imaging by the interference of SMF outputs of a PL with a single telescope. We demonstrate that the visibilities that can be measured from a PL are mutual intensities incident on the pupil weighted by the cross correlation of a pair of lantern modes. From numerically simulated lantern principal modes of a 6-port PL, we find that interferometric observables using a PL behave similarly to separated-aperture visibilities for simple models on small angular scales (< λ / D) but with greater sensitivity to symmetries and capability to break phase angle degeneracies. Furthermore, we present simulated observations with wave front errors (WFEs) and compare them to AMI. Despite the redundancy caused by extended lantern principal modes, spatial filtering offers stability to WFEs. Our simulated observations suggest that PLs may offer significant benefits in the photon-noise-limited regime and in resolving small angular scales at the low-contrast regime. [ABSTRACT FROM AUTHOR]

[Display omitted] mRNA technology has emerged as a successful vaccine platform that offered a swift response to the COVID-19 pandemic. Accumulating evidence shows that vaccine efficacy, thermostability, and other important properties, are largely impacted by intrinsic properties of the mRNA molecule, such as RNA sequence and structure, both of which can be optimized. Designing mRNA sequence for vaccines presents a combinatorial problem due to an extremely large selection space. For instance, due to the degeneracy of the genetic code, there are over 10632 possible mRNA sequences that could encode the spike protein, the COVID-19 vaccines' target. Moreover, designing different elements of the mRNA sequence simultaneously against multiple objectives such as translational efficiency, reduced reactogenicity, and improved stability requires an efficient and sophisticated optimization strategy. Recently, there has been a growing interest in utilizing computational tools to redesign mRNA sequences to improve vaccine characteristics and expedite discovery timelines. In this review, we explore important biophysical features of mRNA to be considered for vaccine design and discuss how computational approaches can be applied to rapidly design mRNA sequences with desirable characteristics. [ABSTRACT FROM AUTHOR]

Prenatal diagnosis of clubfoot traditionally relied on two-dimensional ultrasonography. To enhance diagnosis and predict postnatal outcomes, we examined the parameters that differentiate pathological clubfoot using three-dimensional ultrasonography. In our retrospective study, we examined the findings of prenatal ultrasound and the postnatal outcomes of pregnancies with suspected congenital clubfoot between 2018 and 2021. Based on the three-dimensional perspective, we measured the angles of varus, equinus, calcaneopedal block, and forefoot adduction and compared the sonographic variables between the postnatal treated and non-treated groups. We evaluated 31 pregnancies (47 feet) with suspected clubfoot using three-dimensional ultrasonography. After delivery, a total of 37 feet (78.7%) underwent treatment involving serial casting only or additional Achilles tenotomy. The treated group showed significantly greater hindfoot varus deviation (60.5° vs. 46.6°, p = 0.026) and calcaneopedal block deviation (65.6° vs. 26.6°, p < 0.05) compared to the non-treated group. The calcaneopedal block had an area under the curve of 0.98 with a diagnostic threshold of 46.2 degrees (sensitivity of 97%, specificity of 90%, positive predictive value of 97%, and negative predictive value of 90%). During prenatal evaluation of clubfoot using three-dimensional ultrasonography, the calcaneopedal block deviation has the potential to predict postnatal treatment. [ABSTRACT FROM AUTHOR]

The therapeutic potential of directly reprogrammed neural stem cells (iNSCs) for neurodegenerative diseases relies on reducing the innate tumorigenicity of pluripotent stem cells. However, the heterogeneity within iNSCs is a major hurdle in quality control prior to clinical applications. Herein, we generated iNSCs from human fibroblasts, by transfecting transcription factors using Sendai virus particles, and characterized the expression of iNSC markers. Using immunostaining and quantitative real time –polymerase chain reaction (RT –qPCR), no differences were observed between colonies of iNSCs and iNSC-derived neurons. Unexpectedly, patch-clamp analysis of iNSC-derived neurons revealed distinctive action potential firing even within the same batch product. We performed single-cell RNA sequencing in fibroblasts, iNSCs, and iNSC-derived neurons to dissect their functional heterogeneity and identify cell fate regulators during direct reprogramming followed by neuronal differentiation. Pseudotime trajectory analysis revealed distinct cell types depending on their gene expression profiles. Differential gene expression analysis showed distinct NEUROG1, PEG3, and STMN2 expression patterns in iNSCs and iNSC-derived neurons. Taken together, we recommend performing a predictable functional assessment with appropriate surrogate markers to ensure the quality control of iNSCs and their differentiated neurons, particularly before cell banking for regenerative cell therapy. [ABSTRACT FROM AUTHOR]

The most common causes of short stature (SS) in children are familial short stature (FSS) and idiopathic short stature (ISS). Recently, growth plate dysfunction has been recognized as the genetic cause of FSS or ISS. The aim of this study was to investigate monogenic growth failure in patients with ISS and FSS. Targeted exome sequencing was performed in patients categorized as ISS or FSS and the subsequent response to growth hormone (GH) therapy was analyzed. We found 17 genetic causes involving 12 genes (NPR2, IHH, BBS1, COL1A1, COL2A1, TRPS1, MASP1, SPRED1, PTPTN11, ADNP, NADSYN1, and CERT1) and 2 copy number variants. A genetic cause was found in 45.5% and 35.7% of patients with FSS and ISS, respectively. The genetic yield in patients with syndromic and non-syndromic SS was 90% and 23.1%, respectively. In the 11 genetically confirmed patients, a gain in height from −2.6 to −1.3 standard deviations after 2 years of GH treatment was found. The overall diagnostic yield in this study was 41.7%. We identified several genetic causes involving paracrine signaling, the extracellular matrix, and basic intracellular processes. Identification of the causative gene may provide prognostic evidence for the use of GH therapy in non-SGA children. [ABSTRACT FROM AUTHOR]

Simple Summary: In the agricultural sector, particularly the poultry industry, antibiotics have been used as feed additives to treat and prevent infections or to improve the growth, health, and welfare of chickens. Many nutritional alternative strategies, including natural ingredients, have been investigated for their role in improving gut health without any adverse effect on productivity. The possibility of using microalgae as a new source of nutrients and health additives in animal feed formulations has been increased. Therefore, the aim of this study was to determine the effect of dietary C. vulgaris or T. obliquus on the laying performance, egg quality, intestinal histology, immune characteristics, antioxidant status, and gut microbiome of the laying hen. A feeding trial was conducted to investigate the effect of dietary supplementation of Chlorella vulgaris (CV) or Tetradesmus obliquus (TO) on laying performance, egg quality, and gut health indicators of laying hens. A total of 144 Hy-Line Brown laying hens aged 21 weeks were randomly assigned to one of three dietary treatments with eight replicates of six hens. Dietary treatments were as follows: CON, basal diet; CV, basal diet + 5 g C. vulgaris/kg of diet; TO, basal diet + 5 g T. obliquus/kg of diet. The results showed that diets supplemented with CV or TO had insignificant effects on laying performance, egg quality (i.e., Haugh unit and eggshell strength and thickness), jejunal histology, cecal short-chain fatty acids, and antioxidant/immune markers in ileal mucosa samples of laying hens. Compared with the control group, the egg yolk color score was higher (p < 0.05) in laying hens fed on diets containing CV and TO, although the former was a more intense yellow than the latter. Small intestinal lamina propria cells were isolated using flow cytometry to examine the percentages of immune cell subpopulations. Dietary microalgae did not affect B cells or monocytes/macrophages but altered the percentage of CD4+ T cells and CD8− TCR γδ T cells. Collectively, diets supplemented with C. vulgaris or T. obliquus can improve egg yolk color and would modulate host immune development and competence in laying hens. [ABSTRACT FROM AUTHOR]

Objective: We aimed to analyze brain imaging findings and neurodevelopmental outcomes of preterm infants diagnosed with cerebral palsy. Design: Brain magnetic resonance imaging of preterm infants born between 23 and 32 wks' gestation and diagnosed with cerebral palsy at 2 yrs of corrected age were evaluated. Brain lesions were categorized as periventricular leukomalacia, intraventricular hemorrhage, and cerebellar hemorrhage and graded by the severity. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition, at 18–24 mos corrected age, and the Korean Ages and Stages Questionnaire at 18 and 24 mos of corrected age. Results: Cerebral palsy was found in 38 children (6.1%) among 618 survivors. Cerebellar injury of high-grade cerebellar hemorrhage and/or atrophy accounted for 25%. Among patients with supratentorial lesions, those having cerebellar injury showed significantly lower scores on each Korean Ages and Stages Questionnaire domain except gross motor than patients without cerebellar injury. They also revealed a high proportion of patients below the cutoff value of Korean Ages and Stages Questionnaire in language, fine motor, and problem-solving domains (P < 0.05) and lower Bayley Scales of Infant and Toddler Development, Third Edition, language composite scores (P = 0.038). Conclusions: Poor neurodevelopmental outcomes other than motor function were associated with cerebellar injury. Evaluation of the cerebellum may help predict functional outcomes of patients with cerebral palsy. [ABSTRACT FROM AUTHOR]

Introduction: The association between microalbuminuria and cardiovascular disease (CVD) is accumulating in various patient populations. However, when stratified by sex, the relationship between microalbuminuria and CVD remains unclear. Method: We obtained data from the 2011–2014 and 2019–2020 Korea National Health and Nutrition Examination Survey (KNHANES). Microalbuminuria was measured based on spot urine albumin-creatinine ratio (UACR). The Framingham risk score (FRS) model was implemented to evaluate the CVD risk. Linear and logistic regression models were used to identify the associations of microalbuminuria status with cardiometabolic predictors and CVD status determined by the FRS score. Results: Among 19,340 representative Korean participants, the (UACR) in Korean women and men with history of CVD was higher than in those without history of CVD. Among patients without history of CVD, multivariate regression analysis showed that a high UACR was related to older age, lower high-density lipoprotein cholesterol level, higher total cholesterol level, higher systolic blood pressure, higher prevalence of current smoking, higher prevalence of diabetes, and higher anti-hypertensive medication use in both women and men. The UACR showed a positive linear correlation with the Framingham risk score in both women and men. Conclusion: The presence of microalbuminuria was significantly associated with the cardiometabolic risk factors and the increased risk of CVD evaluated by FRS model in both women and men in a nationally representative sample of Korea. [ABSTRACT FROM AUTHOR]

In this study, we investigated the impact of uterine manipulation on endometrial cancer survival outcomes. We analyzed patients with endometrial cancer who underwent robot-assisted staging and open staging surgery between 2010 and 2020. Either uterine manipulators or vaginal tubes were utilized in robot-assisted staging. Propensity score matching was performed to correct baseline characteristics. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan–Meier curve analysis. In total, 574 patients, including those undergoing robot-assisted staging with a uterine manipulator (n = 213) or vaginal tube (n = 147) and staging laparotomy (n = 214), were analyzed. Propensity score matching was performed for age, histology, and stage as covariates. Before matching, Kaplan–Meier curve analysis showed that PFS and OS were significantly different among the three groups (p < 0.001 and p = 0.009, respectively). In the propensity-matched cohorts of 147 women, the previously suggested differences in PFS and OS were not observed in patients undergoing robot-assisted staging with a uterine manipulator or vaginal tube or open surgery. In conclusion, robotic surgery using a uterine manipulator or vaginal tube did not compromise survival outcomes in endometrial cancer management. [ABSTRACT FROM AUTHOR]

Simple Summary: Commercial poultry production is linked to a variety of stresses that arise from the environment, nutrition, and metabolism of the host. These stressors may result in metabolic disorders and oxidative stress. It is pertinent to recognize and prevent signs of stress to minimize production loss and improve the health and well-being of chickens. The use of in-feed anti-oxidants to eliminate oxidative stress is a successful method of preventing tissue damage and augmenting the performance, health, and well-being of chickens. The burgeoning demand for in-feed anti-oxidants has spurred a review of the role of methyl sulfonyl methane as a dietary anti-oxidant in poultry. Oxidative stress is defined as an imbalance between pro-oxidants and anti-oxidants within biological systems, leading to tissue damage and compromising the health of afflicted animals. The incorporation of dietary anti-oxidants into chicken diets has been a common practice to improve the performance, health, and welfare of the host by protecting against oxidative stress-induced damage. Methyl sulfonyl methane (MSM), a naturally occurring organosulfur compound found in various plant sources, has demonstrated various beneficial biological properties, including anti-inflammatory and anti-oxidant properties in both in vitro and in vivo studies. MSM has been utilized as a dietary supplement for humans for its anti-oxidant, analgesic, and anti-inflammatory properties. It has also been administered to domestic animals, including cattle, pigs, and chickens, owing to its recognized anti-oxidant effect. This review summarizes the biological and physiological functions of dietary MSM in poultry. [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests an association between the vitamin D levels and respiratory outcomes of preterm infants. The objective of this systematic review and meta-analysis was to explore whether premature neonates with a vitamin D deficiency have an increased risk of respiratory distress syndrome (RDS). Methods: We searched PubMed, EMBASE, and the Cochrane Library up through July 20, 2021. The search terms were 'premature infant', 'vitamin D', and 'respiratory distress syndrome'. We retrieved randomized controlled trials and cohort and case-control studies. For statistical analysis, we employed the random-effects model in Comprehensive Meta-Analysis Software ver. 3.3. We employed the Newcastle-Ottawa Scales for quality assessment of the included studies. Results: A total of 121 potentially relevant studies were found, of which 15 (12 cohort studies and 3 case-control studies) met the inclusion criteria; the studies included 2,051 preterm infants. We found significant associations between RDS development in such infants and vitamin D deficiency within 24 h of birth based on various criteria, thus vitamin D levels < 30 ng/mL (OR 3.478; 95% CI 1.817–6.659; p < 0.001), < 20 ng/mL (OR 4.549; 95% CI 3.007–6.881; p < 0.001), < 15 ng/mL (OR 17.267; 95% CI 1.084–275.112; p = 0.044), and < 10 ng/ml (OR 1.732; 95% CI 1.031–2.910; p = 0.038), and an even lower level of vitamin D (SMD = –0.656; 95% CI –1.029 to –0.283; p = 0.001). Conclusion: Although the vitamin D deficiency definitions varied and different methods were used to measure vitamin D levels, vitamin D deficiency or lower levels of vitamin D within 24 h of birth were always associated with RDS development. Monitoring of neonatal vitamin D levels or the maintenance of adequate levels may reduce the risk of RDS. [ABSTRACT FROM AUTHOR]

In this study, we examined the influence of water vapor on heavy rainfall events over the complex mountainous terrain of the southern Korean Peninsula using rawinsonde and global navigation satellite system (GNSS) datasets from a mobile observation vehicle (MOVE). Results demonstrated that the prevailing southeasterly winds enhanced precipitation on the leeward side of the mountainous region. The probability of severe rainfall increased in the highest precipitable water vapor (PWV) bin (>60 mm). A lead–lag analysis demonstrated that the atmosphere remained moist for 1 h before and after heavy rainfall. The temporal behavior of PWV retrieved from the MOVE-GNSS data demonstrated that during Changma (the summer monsoon) (Case 1), heavy rainfall events experience a steep decrease after a long increasing trend in PWV. However, the most intense rainfall events occurred after a rapid increase in PWV along with a strong southwesterly water vapor flow during convective instability (Case 2), and they had consistently higher moisture and greater instability than those in Case 1 over the entire period. The results of this study can provide some insights to improve the predictability of heavy rainfall in the southern Korean Peninsula. [ABSTRACT FROM AUTHOR]

Inflammation and loss of cholinergic transmission are involved in neurodegenerative diseases, but possible interactions between them within neurons, astrocytes, and microglia have not yet been investigated. We aimed to compare store-operated Ca2+ entry (SOCE) in neurons, astrocytes, and microglia following cholinergic dysfunction in combination with (or without) an inflammatory stimulus and to investigate the effects of linalyl acetate (LA) on this process. We used the SH-SY5Y, U373, and BV2 cell lines related to neurons, astrocytes, and microglia, respectively. Scopolamine or lipopolysaccharide (LPS) was used to antagonize the muscarinic receptors or induce inflammatory responses, respectively. The concentration of intracellular Ca2+ was measured using Fura-2 AM. Treatment with scopolamine and LPS significantly increased SOCE in the neuron-like cells and microglia but not in the scopolamine-pretreated astrocytes. LA significantly reduced SOCE in the scopolamine-pretreated neuron-like cells and microglia exposed to LPS, which was partially inhibited by the Na+-K+ ATPase inhibitor ouabain and the Na+/Ca2+ exchanger (NCX) inhibitor Ni2+. Notably, SOCE was significantly reduced in the LPS plus scopolamine-pretreated cells mixed with astrocytes and microglia, with a two-fold increase in the applied number of astrocytes. LA may be useful in protecting neurons and microglia by reducing elevated SOCE that is induced by inflammatory responses and inhibiting the muscarinic receptors via Na+-K+ ATPase and the forward mode of NCX. Astrocytes may protect microglia by reducing increased SOCE under the conditions of inflammation and a muscarinic receptor blockade. [ABSTRACT FROM AUTHOR]

Smoking is a widely recognized risk factor in the emergence of cancers and other lung diseases. Studies of non-cancer lung diseases typically investigate the role that smoking has in chronic changes in lungs that might predispose patients to the diseases, whereas most cancer studies focus on the mutagenic properties of smoking. Large-scale cancer analysis efforts have collected expression data from both tumor and control lung tissues, and studies have used control samples to estimate the impact of smoking on gene expression. However, such analyses may be confounded by tumor-related micro-environments as well as patient-specific exposure to smoking. Thus, in this paper, we explore the utilization of mutational signatures to study environment-induced changes of gene expression in control lung tissues from lung adenocarcinoma samples. We show that a joint computational analysis of mutational signatures derived from sequenced tumor samples, and the gene expression obtained from control samples, can shed light on the combined impact that smoking and tumor-related micro-environments have on gene expression and cell-type composition in non-neoplastic (control) lung tissue. The results obtained through such analysis are both supported by experimental studies, including studies utilizing single-cell technology, and also suggest additional novel insights. We argue that the study provides a proof of principle of the utility of mutational signatures to be used as sensors of environmental exposures not only in the context of the mutational landscape of cancer, but also as a reference for changes in non-cancer lung tissues. It also provides an example of how a database collected with the purpose of understanding cancer can provide valuable information for studies not directly related to the disease. [ABSTRACT FROM AUTHOR]

We investigated the utility of Positron emission tomography-Computed tomography (PET-CT) in the setting of two different sentinel lymph node (SLN) mapping techniques; the conventional cervical injection method (one-step) and the two-step method, which involves fundal injection followed by cervical injection. Patients with endometrial cancer undergoing FDG PET-CT followed by laparoscopic or robotic surgical staging with SLN mapping at the Yonsei Cancer Center between July 2014 and April 2021 were stratified into the PET-positive group (with suspected or likely lymph nodes metastasis) and PET-negative group. A chart review was performed for the number of harvested SLNs, patterns of SLN metastases, and recurrence. Among 466 patients undergoing one-step (n = 276) and two-step (n = 190) SLN mapping, LN metastasis was identified in 21 of 434 PET-negative and 18 of 32 PET-positive patients. The sensitivity and specificity of PET-CT for diagnosing lymph node metastasis were 46.2% and 96.7%, respectively. Among PET-positive patients with LN metastasis, anatomical distribution was concordant in 14/18 patients (77.8%). Among PET-negative patients, four (2.3%) had metastatic para-aortic SLNs, including three (1.7%) with isolated para-aortic metastases; metastatic para-aortic SLNs were exclusively found in the two-step group. Among PET-positive patients, para-aortic SLN metastasis was identified in 35.7% of two-step and 16.7% of one-step group. Among the 21 PET false-negative patients, recurrence was seen in four patients (19%) after a median follow-up of 34 months (range: 7–70 months). PET-CT served as a useful guide to clinicians with high anatomical concordance rate in patients with LN metastasis. However, despite high specificity, sensitivity was limited. SLN metastasis pattern, especially at the para-aortic level, indicates that the two-step SLN technique might be useful in PET-negative and PET-positive patients. • The usefulness of PET-CT was assessed in the setting of two different SLN mapping techniques in endometrial cancer. • With respect to LN metastasis, PET-CT showed a sensitivity of 46.2%, specificity of 96.7%, and false-negative rate of 4.8%. • Among PET-CT true-positive patients, anatomic distribution of LN metastasis was concordant with histopathology in 77.8%. • For para-aortic SLN assessment, the two-step SLN technique might be useful in PET-negative and -positive patients. [ABSTRACT FROM AUTHOR]

The aim of this meta-analysis was to determine the incidence and risk factors of early pulmonary hypertension (PHT) in preterm infants and evaluate the association of early PHT with morbidities such as bronchopulmonary dysplasia (BPD), late PHT, and in-hospital mortality. We searched the PubMed (1980–2021), Embase (1968–2021), CINAHL (2002–2021), Cochrane library (1989–2021), and KoreaMed (1993–2021). Observational studies on the association between early PHT diagnosed within the first 2 weeks after birth and its clinical outcomes in preterm infants born before 37 weeks of gestation or with very low birth weight (< 1500 g) were included. Two authors independently extracted the data and assessed the quality of each study using a modified Newcastle–Ottawa Scale. We performed meta-analysis using Comprehensive Meta-Analysis version 3.3. A total of 1496 potentially relevant studies were found, of which 8 studies (7 cohort studies and 1 case–control study) met the inclusion criteria comprising 1435 preterm infants. The event rate of early PHT was 24% (95% confidence interval [CI] 0.174–0.310). The primary outcome of our study was moderate to severe BPD at 36 weeks postmenstrual age, and it was associated with early PHT (6 studies; odds ratio [OR] 1.682; 95% CI 1.262–2.241; P < 0.001; heterogeneity: I2 = 0%; P = 0.492). Preterm infants with early PHT had higher OR of in-hospital mortality (6 studies; OR 2.372; 95% CI 1.595–3.528; P < 0.001; heterogeneity: I2 = 0%; P = 0.811) and developing late PHT diagnosed after 4 weeks of life (4 studies; OR 2.877; 95% CI 1.732–4.777; P < 0.001; heterogeneity: I2 = 0%; P = 0.648). Infants with oligohydramnios (4 studies; OR 2.134; 95% CI 1.379–3.303; P = 0.001) and those who were small-for-gestational-age (5 studies; OR 1.831; 95% CI 1.160–2.890; P = 0.009) had an elevated risk of developing early PHT. This study showed that early PHT is significantly associated with mortality and morbidities, such as BPD and late PHT. Preterm infants with a history of oligohydramnios and born small-for-gestational-age are at higher risk for developing early PHT; however, high-quality studies that control for confounders are necessary. [ABSTRACT FROM AUTHOR]

Background and Purpose: Recent population-based studies from the US and UK have identified an increase in the occurrence of Guillain–Barré syndrome (GBS) following coronavirus disease 2019 (COVID-19) vaccination. However, the localized variant of GBS might be underestimated due to its rarity and atypical features. We aimed to identify and characterize bilateral facial weakness with distal paresthesia (BFWdp) as a GBS variant following COVID-19 vaccination. Materials and Methods: Relevant studies published during the COVID-19 pandemic were searched and identified in the MEDLINE, Embase, and other databases. Results: This review found that 18 BFWdp cases presented characteristics similar to previous BFWdp cases as defined in the literature: male dominance, frequent albuminocytological dissociation, and acute inflammatory demyelinating neuropathy pattern. In contrast, facial nerve enhancement on brain MRI and antiganglioside antibody positivity were often observed in BFWdp following COVID-19 vaccination. Conclusions: The mechanism of BFWdp following COVID-19 vaccination appears to be somewhat different from that of sporadic BFWdp. Neurological syndromes with rare incidence and difficulty in diagnosis should be considered adverse events of COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Simple Summary: Lynch Syndrome (LS) is a hereditary cancer syndrome caused by an autosomal dominant mutation in one of the DNA mismatch repair (MMR) genes. Understanding the clinical traits of endometrial cancer, which is one of the most frequent as well as the earliest diagnosed cancer types of LS-associated cancers, has the potential to offer tailored screening programs and lifesaving interventions. Whereas most large-scale studies of LS-associated endometrial cancers are based on cohorts in Western countries, studies from a predominantly Korean population are relatively few. We conducted a multi-center, retrospective study of patients with endometrial cancer who underwent germline multigene panel testing that included MMR genes. Based on the analysis of 204 patients with endometrial cancer who underwent germline multigene panel testing, we investigated the prevalence of LS and non-LS mutation and the relative contribution of each MMR gene mutation that, in composite, led to the clinical phenotype of LS-associated endometrial cancer patients in a predominantly Korean population. We aimed to investigate the prevalence and relative contributions of LS and non-LS mutations in patients with endometrial cancer in Korea. We retrospectively reviewed the medical records of 204 patients diagnosed with endometrial cancer who underwent a germline next generation sequencing multigene panel test covering MLH1, MSH2, MSH6, PMS2, and EPCAM at three tertiary centers. Thirty patients (14.7%) with pathogenic mutations (12 MLH1; 6 MSH2; 10 MSH6; 2 PMS2) and 20 patients (9.8%) with 22 unclassified variants (8 MLH1; 8 MSH2; 2 MSH6; 3 PMS2; 1 EPCAM) were identified. After excluding four close relatives of a proband, the prevalence of LS was 13.0% (26/200). Patients with LS were more likely than those with sporadic cancer to be younger at diagnosis (48 vs. 53 years, p = 0.045) and meet the Amsterdam II criteria (66.7 vs. 3.5%, p < 0.001). Non-endometrioid histology was more prevalent in patients with MSH6 or PMS2 mutations (41.7%) than those with MLH1 or MSH2 mutations (5.6%, p = 0.026). In this pre-selected cohort of endometrial cancer patients who underwent next generation sequencing, the prevalence of LS was 13%, thus supporting the use of gene panel testing for endometrial cancer patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Coccidiosis is a parasitic disease in poultry that causes significant economic losses. It is understood that natural or synthetic antioxidants including plant extracts, vitamin E, and selenium have been proved to lessen the gut severity of Eimeria infection in chickens. Sulfur is an essential element and exhibits beneficial activities including parasitic, antioxidant, and anti-inflammatory. These functional features of sulfur might play a role in inhibiting the negative effect of chicken coccidiosis and, if proved, sulfur could be used as an anticoccidial agent. We tested dietary sulfur of both organic and inorganic forms with beneficial antioxidant properties in a mild coccidiosis disease broiler chicken model. The objective of this study was to evaluate the effects of dietary sulfur from either organic (methyl sulfonyl methane, MSM) or inorganic (sodium sulfate, SS) sources on the growth performance of broiler chickens challenged against a high-dose coccidiosis vaccine. A total of 320 day-old Ross 308 broiler chicks were randomly placed into 32 pens of 10 birds each (keeping 16 pens/control group and 8 pens/treatment group until 21 days post-hatch) and reared for 28 days. The experimental diets were formulated by mixing a corn and soybean meal-based control diet with MSM or SS. At 21 days post-hatch, half (n = 8) of the control and all of the sulfur-added diet-fed (i.e., MSM and SS) groups were challenged with a 30-fold dose of a commercially available Eimeria vaccine (Livacox® T coccidiosis vaccine). Unchallenged control chicks (n = 8) were considered as the negative control group. At 21 days (before coccidiosis vaccine challenge), the production parameters and cecal short-chain fatty acids were not affected by dietary treatments. The concentrations of total antioxidant capacity in liver samples were elevated in both the MSM and SS groups compared with the control group (p = 0.001). During 21 to 28 days (i.e., one week post coccidiosis vaccine challenge), challenge tended to lower body weight and feed intake by an average of 5.3% (p = 0.262) and 2.8% (p = 0.504), respectively, but to increase the feed conversion ratio by an average of 2.7% (p = 0.087) compared with the non-challenged control groups. None of dietary sulfur groups affected the body weight gain, feed intake, or feed conversion ratio of vaccine-challenged chickens. Mild Eimeria-specific lesions were noted in duodenum (p = 0.006), jejunum (p = 0.017), and ceca (p = 0.047), but dietary sulfur treatments did not affect the Eimeria-induced gut lesion scores. At 28 days, Eimeria challenge significantly impaired (p = 0.001) the apparent ileal digestibility of crude protein and crude ash compared with the naïve control group. Dietary MSM increased the apparent ileal digestibility of crude ash by 15.5% on average compared with the coccidiosis vaccine control group. We conclude that dietary antioxidant sulfur of organic or inorganic origins at the inclusion level (i.e., 0.7 g sulfur/kg of diet) has a limited effect on the growth performance of chickens challenged with coccidiosis vaccine. [ABSTRACT FROM AUTHOR]

This study aimed to determine the incidence of thrombotic events in ovarian cancer patients following a de-escalated prophylactic strategy and to stratify risk groups. We reviewed the records of patients who underwent debulking surgery for ovarian cancer at a single institution between January 2007 and May 2019. We identified clinically diagnosed and radiologically confirmed cases of thrombotic events—classified as pulmonary thromboembolism (PE), deep vein thrombosis (DVT), and other thrombotic events—within 6 months of debulking surgery. After excluding 13 patients diagnosed with thromboembolism at the baseline or during neoadjuvant chemotherapy, 799 were analyzed. Since the introduction of medical prophylaxis at our institution in 2009, 482 patients (60%) received medical prophylaxis with subcutaneous injection of low molecular weight heparin for 5 days with mechanical prophylaxis, whereas 317 (40%) received mechanical prophylaxis only. After debulking surgery, thrombotic events occurred in 28 patients (3.5%) including PE (n = 11), DVT (n = 10), and other thrombotic events (n = 7). Multivariable analysis identified age, body mass index (BMI), and operative duration as independent risk factors associated with thrombotic events. A thrombotic event was an independent prognostic factor for overall survival (HR 2.17, 95% CI 1.16–4.1). A cut-off analysis for pre-operative identifiable risk factors showed age < 57 years and BMI < 21 could help define low-risk groups. One patient from 172 low-risk patients (0.58%) experienced a thrombotic event. The thrombotic event incidence was low in our cohort. A de-escalated prophylaxis strategy may be considered in young (age < 57 years) and lean (BMI < 21) patients. • The incidence of thrombotic events within 6 months of surgery was low in our cohort. • Pre-operative identifiable risk factors such as age < 57 years and body mass index <21 may help define a low-risk group. • These findings help personalize thromboprophylaxis in postoperative ovarian cancer patients. [ABSTRACT FROM AUTHOR]

COVID-19 is substantially reshaping the tourism and hospitality industries but studies on the changes in travel behaviour in response to the pandemic are limited. Using tourism big data, this research applies network science analytics to determine behavioural changes in travel mobility of domestic travellers who visited Jeju Island, Korea, from June 2019 to December 2020. The findings reveal significant reductions in the number of trips to a destination but also limited spatial connectivity and diversity in travel flow during the pandemic. A higher intensity of travel mobility to outdoor and coastal areas and shorter travel distances are evident during COVID-19. [ABSTRACT FROM AUTHOR]

This study was performed to investigate supplementary effects of probiotic Lacticaseibacillus paracasei NSMJ56 strain on laying performance, egg quality, intestinal histology, antioxidant status, gut immunity and microbiota in laying hens. A total of ninety-six 21-wk-old Hy-Line Brown laying hens were randomly subjected to one of 2 dietary treatments: a control group fed a non-supplemented diet, or a probiotic group fed with a diet supplemented with 1 g of Lacticaseibacillus paracasei NSMJ56 (5 × 108 CFU/kg of diet). The trial lasted for 4 wk. Egg weight was increased (P < 0.05) in laying hens fed probiotic-fed diet compared with the control group. Dietary probiotics did not affect egg quality except for Haugh unit, which was improved (P < 0.05) in the probiotic-fed group. Neither jejunal histology nor cecal short-chain fatty acids were affected by dietary treatments. Dietary probiotics increased the activity of catalase compared with the control group. Flow cytometry analysis revealed that dietary probiotics elevated the CD4+ T cells, but not CD8+ T cells, in jejunal lamina propria. Based on the LEfSe analysis at the phylum and genus levels, Erysipelotrichales, Erysipelotrichia, Flintibater, Dielma, Hespellia, Coprobacter, Roseburia, Anaerotignum, and Coprococcus were enriched in the probiotic group compared with the control group. Taken together, our study showed that dietary probiotics could be used to improve some parameters associated with egg freshness and antioxidant capacity, and to partially alter T cell population and microbial community in laying hens. [ABSTRACT FROM AUTHOR]

Background: In immediately loaded implants within 72 h after the implant placement in the unilaterally and partially edentulous ridge, primary stability is considered critical, which can be influenced by the design of the implant fixture. Purpose To determine the outcomes at 1 year after the immediate loading of multiunit fixed partial prostheses over either tapered implants (TIs) or straight implants (SIs) in the posterior region. Materials and methods: Forty‐eight patients (24 patients, 52 implants in TI group; 24 patients, 50 implants in SI group) were included for the study. Except for the one SI group patient whose two implants showed the insertion torque less than 30 Ncm, provisional prostheses designed and fabricated from intraoral scan data obtained immediately after implant surgery were delivered to rest of the 47 subjects at 3–7 days. After a year, the survival rate was estimated by intention‐to‐treat (ITT) and per‐protocol (PP) analyses, and marginal bone loss (MBL) and implant stability were also analyzed statistically (p < 0.05). Results: Survival rate at implant level in TI group was 96.2%, and that of SI group in the ITT analysis was 86.0%. Intergroup difference, however, was not statistically significant (p > 0.05). Insertion torque was significantly higher in TI group than SI group (47.12 ± 6.37 Ncm vs. 41.60 ± 9.77 Ncm; p < 0.05). MBLs of both groups were less than 0.1 mm at 1‐year follow‐up and was similar between two groups (p > 0.05). Conclusions: Immediate loading of fixed partial prostheses after TI and SI placement showed reliable outcomes in the partially edentulous posterior ridge. In terms of the initial mechanical stability, the performance was superior for TIs than for SIs. [ABSTRACT FROM AUTHOR]

Copeptin levels reflect arginine vasopressin (AVP) release from the hypothalamus. Pituitary surgery often impairs AVP release and results in central diabetes insipidus (CDI). Here, we aimed to investigate how serum copeptin level changes 3 months after pituitary surgery and whether it has a diagnostic value for postoperative permanent CDI. Consecutive patients who underwent endoscopic transsphenoidal surgery at a single tertiary hospital were recruited. Serum copeptin levels were measured preoperatively and 3 months postoperatively. Among 88 patients, transient and permanent CDI occurred in 17 (19.3%) and 23 (26.1%), respectively. Three-month postoperative copeptin levels significantly declined from preoperative levels in permanent CDI group (P < 0.001, percentage difference = − 42.2%) and also in the transient CDI group (P = 0.002, − 27.2%). Three months postoperative copeptin level < 1.9 pmol/L under normal serum sodium levels was the optimal cutoff value for diagnosing permanent CDI with an accuracy of 81.8%, while 3-month postoperative copeptin level ≥ 3.5 pmol/L excluded the CDI with a negative predictive value of 100%. Conclusively, 3 months postoperative copeptin levels significantly decreased from preoperative levels in the transient CDI group as well as the permanent CDI group. Three-month postoperative copeptin levels ≥ 3.5 pmol/L under normal serum sodium levels may be diagnostic for excluding postoperative CDI. [ABSTRACT FROM AUTHOR]

Previous studies have shown that fetal abdominal obesity (FAO) was already observed at the time of gestational diabetes mellitus (GDM) diagnosis and persisted until delivery despite management in older and/or obese women. In this study, we investigated whether fetuses of women with milder hyperglycemia than GDM have accelerated abdominal growth, leading to adverse pregnancy outcomes. We retrospectively reviewed the medical records of 7,569 singleton pregnant women who were universally screened using a 50-g glucose challenge test (GCT) and underwent a 3-h 100-g oral glucose tolerance test (OGTT) if GCT result was ≥140mg/dL. GDM, one value abnormality (OVA), and normal glucose tolerance (NGT, NGT1: GCT negative, NGT2: GCT positive & OGTT negative) were diagnosed using Carpenter-Coustan criteria. With fetal biometry data measured simultaneously with 50-g GCT, relative fetal abdominal overgrowth was investigated by assessing the fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference(AC) per actual GA by the last menstruation period(LMP), biparietal diameter(BPD) or femur length(FL), respectively. FAO was defined as FAOR ≥90th percentile The FAORs of GA-AC/GA-LMP and GA-AC/GA-BPD were significantly higher in OVA subjects compared to NGT subjects but not in NGT2 subjects. Although the frequency of FAO in OVA (12.1%) was between that of NGT (9.6%) and GDM (18.3%) without statistically significant difference, the prevalence of large for gestational age at birth and primary cesarean delivery rates were significantly higher in OVA (9.8% and 29.7%) than in NGT (5.1% and 21.5%, p<0.05). Particularly, among OVA subjects with FAO, the prevalence (33.3% and 66.7%) was significantly higher than in those without FAO (9.7% and 24.2%, p<0.05). The degree of fetal abdominal growth acceleration in OVA subjects was intermediate between that of NGT and GDM subjects. OVA subjects with FAO at the time of GDM diagnosis were strongly associated with adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Analysis of conversations between international university students in the Corpus of English as a Lingua Franca Interaction (CELFI, McDonough & Trofimovich, 2019) has demonstrated that holds, which are temporary cessations of dynamic movement, are a robust visual cue of nonunderstanding that can be reliably interpreted by external observers as signals of listener comprehension difficulties (e.g. McDonough et al., 2019, 2022, 2023). Using CELFI materials, this study used an experimental design to explore whether business communication students (N = 64) benefit from instructional activities designed to raise their awareness of holds as a signal of nonunderstanding. The students carried out perception tests in Week 1 and Week 5 that presented video excerpts from CELFI showing the depicted listeners' hold onsets and releases, and the students rated those listeners' comprehension. In the interim, 31 students completed weekly awareness-raising activities via Moodle (2 hours per week) for four weeks. A mixed ANOVA showed that students who participated in the awareness-raising activities showed significant improvement in their ability to discriminate between hold onsets and releases. Implications for the use of awareness-raising activities to promote recognition of nonverbal behavior are discussed. L'analyse des conversations entre étudiants universitaires internationaux dans le Corpus of English as a Lingua Franca Interaction (CELFI, McDonough & Trofimovich, 2019) a démontré que des arrêts temporaires du mouvement dynamique sont un signe visuel solide de non-compréhension qui peuvent être interprétés de manière fiable par des observateurs externes comme des indicateurs de difficultés de compréhension de l'auditeur (par exemple, McDonough et al., 2019, 2022, 2023). À l'aide du matériel du CELFI, cette étude a utilisé une conception expérimentale pour déterminer si les étudiants en communication d'entreprise (N = 64) bénéficient d'activités pédagogiques conçues pour les sensibiliser aux arrêts des comportements non verbaux en tant que signe de non-compréhension. Au cours de la première et la cinquième semaine, les étudiants ont effectué des tests de perception qui présentaient des extraits vidéo du CELFI montrant les arrêts et les recommencements des mouvements non verbaux des auditeurs représentés, et les étudiants ont évalué la compréhension de ces auditeurs. Entre-temps, 31 étudiants ont suivi des activités de sensibilisation hebdomadaires via Moodle (2 heures par semaine) pendant quatre semaines. Une ANOVA mixte a montré que les étudiants qui ont participé aux activités de sensibilisation ont montré une amélioration significative de leur capacité à faire la distinction entre les arrêts et les recommencements des mouvements non verbaux. Les implications de l'utilisation d'activités de sensibilisation pour promouvoir la reconnaissance des comportements non verbaux sont discutées. When listening, people can signal that they do not understand the speaker by using words (e.g. 'what?') or body language. One type of body language that listeners use in many different languages and cultures to show that they do not understand the speaker is hold. A hold is a brief stop in dynamic movement that the listeners maintain until they understand again. In this study, we taught business communications students about holds to see if they could get better at recognizing them. This skill would help them know if their listeners were understanding so that they could change what they were saying. We taught some students about holds and compared them to other students who did not learn about holds. We found that the students with training did better at recognizing when a hold started and ended than the students who did not get training. [ABSTRACT FROM AUTHOR]

The left lateral ridge (LLR) is an important structure for ablation of atrial fibrillation (AF). This study assessed how the LLR shape is associated with the long-term outcomes of AF ablation and investigated the relationship with radiofrequency (RF) lesion formation. Clinical study - we assessed multi-detector computed tomography (MDCT) images in 247 patients who underwent AF ablation. Patients were classified into two groups according to the shape of the LLR: Narrow LLR group (n = 116; 47%) and Wide LLR group (n = 131; 53%). After a follow-up period 475 ± 245 days, the AF-free rate was significantly higher in the wide LLR than Narrow LLR group (83.2% vs. 62.9%, p = 0.0004). A multivariate analysis showed that the shape of the LLR was an independent predictor of AF recurrence after ablation (hazard ratio 2.58; 95% confidential interval = 1.48–4.51, p = 0.001). Experimental study - Two types of the ridge models were made with porcine atrial tissues: "Narrow ridge(4.2 ± 0.9 mm)" and "Wide ridge(9.7 ± 1.8 mm)" RF ablation was performed on each ridge model using a contact force (CF)-sensing catheter. The mean CF and the RF lesion volume of the narrow ridge were significantly less than those of the wide ridge model (5.42 ± 3.13 g vs. 10.37 ± 3.98 g, p = 0.001; 19.8 ± 9.9 mm3 vs. 44.2 ± 13.6 mm3, p < 0.001, respectively). AF recurrence after ablation was more frequent in patients with a narrow LLR. LLR shape as assessed using MDCT is associated with long-term outcomes after AF ablation. CF and lesion formation data using the porcine atrial tissue model support our clinical results. • The shape of LLR is significantly associated with long-term outcome of AF ablation. • There were more AF recurrences after RF ablation in the patients with narrow LLR. • In vitro study supported that tissue-catheter contact is related to RF lesion size during ablation • MDCT is a feasible and reliable imaging method for assessing the shape of LLR. [ABSTRACT FROM AUTHOR]

Aim of this study is to evaluate the differences in corneal endothelial cell morphology and corneal thickness in patients with and without type 2 diabetes related to age, disease duration, and HbA1c percentage. This retrospective cross-sectional study included 511 (1022 eyes) type 2 diabetes patients and 900 (1799 eyes) non-diabetic patients. The endothelial cell density (ECD), variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were analyzed using a noncontact specular microscope and a Pentacam Scheimpflug camera. We also examined the correlation between the corneal parameters and the duration of diabetes. For total ages, the subjects with type 2 diabetes showed significantly lower ECD, hexagonality, higher CV, and thicker CCT than the control group. This difference was more pronounced in patients with long-standing DM (≥ 10 years) and high HbA1c (≥ 7%). When stratified by age group, from the 60 s group, corneal endothelial cell parameters showed a statistically significant difference between DM and control groups. The duration of diabetes was inversely correlated with ECD (r = − 0.167; p = 0.000). These findings suggest that diabetes affects corneal endothelial cell in older age and those with long-standing DM and higher HbA1c. Regular corneal endothelial examinations are required in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Bleeding after thyroidectomy occurs due to violent coughing during emergence. Dexmedetomidine is helpful for the smooth emergence and suppression of cough. The purpose of the present study was to compare the effects of dexmedetomidine on postoperative bleeding after thyroidectomy. Methods: Randomized, double-blind, controlled trials were conducted in female patients (ASA I–II, aged 20 to 60 years). The patients were randomly allocated into two groups. Approximately 15 min before the end of the surgery, dexmedetomidine was administered (0.6 µg/kg/h) without a loading dose in group D (n = 69), and normal saline was administered in group S (n = 70) at the same infusion rate. Hemodynamic data, coughing reflex, extubation time, Ramsay sedation scale (RSS), and recovery time were assessed during the administration of the study drugs and recovery from anesthesia. The amount of postoperative hemorrhage was measured for 3 days. Results: Data from a total of 139 patients were analyzed. The incidence of severe cough was significantly lower in group D than in group S (4.3 % vs. 11.5 %, P = 0.022). The emergence agitation in the postanesthetic care unit was significantly lower in group D than in group S (P = 0.01). Postoperative bleeding was significantly lower in group D than in group S until the second postoperative day (P = 0.015). Conclusions: Dexmedetomidine can be helpful in decreasing bleeding after thyroidectomy by reducing coughing and emergence agitation. Trial registration: This study was registered at http://clinicaltrials.gov (registration number NCT02412150, 09/04/2015). [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence (AI) research is highly dependent on the nature of the data available. With the steady increase of AI applications in the medical field, the demand for quality medical data is increasing significantly. We here describe the development of a platform for providing and sharing digital pathology data to AI researchers, and highlight challenges to overcome in operating a sustainable platform in conjunction with pathologists.Methods: Over 3000 pathological slides from five organs (liver, colon, prostate, pancreas and biliary tract, and kidney) in histologically confirmed tumor cases by pathology departments at three hospitals were selected for the dataset. After digitalizing the slides, tumor areas were annotated and overlaid onto the images by pathologists as the ground truth for AI training. To reduce the pathologists' workload, AI-assisted annotation was established in collaboration with university AI teams.Results: A web-based data sharing platform was developed to share massive pathological image data in 2019. This platform includes 3100 images, and 5 pre-processing algorithms for AI researchers to easily load images into their learning models.Discussion: Due to different regulations among countries for privacy protection, when releasing internationally shared learning platforms, it is considered to be most prudent to obtain consent from patients during data acquisition.Conclusions: Despite limitations encountered during platform development and model training, the present medical image sharing platform can steadily fulfill the high demand of AI developers for quality data. This study is expected to help other researchers intending to generate similar platforms that are more effective and accessible in the future. [ABSTRACT FROM AUTHOR]

Prematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants. [ABSTRACT FROM AUTHOR]

Growth charts are essential for monitoring the postnatal growth of preterm infants. The preterm postnatal follow-up study (PPFS) of the Intergrowth-21st Project provides new growth standards based on a longitudinal study. This study was conducted to investigate the prevalence of extrautrine growth restriction (EUGR) and the associated factors of EUGR in preterm infants, using the PPFS charts and the Fenton charts. Data of 1,356 infants with gestational age (GA) less than 28 weeks from the Korean Neonatal Network were analysed. The prevalence of small for gestational age (SGA) of weight and length was higher with the Intergrowth charts than with the Fenton charts. EUGR in weight and length was more prevalent when using the Fenton charts. Multivariate analysis showed that low GA, high birthweight z score, male, treated patent ductus arteriosus (PDA), necrotizing enterocolitis, intraventricular haemorrhage and duration of parenteral nutrition (PN) were associated with EUGR in weight by the Intergrowth charts. High birthweight z score, treated PDA and PN duration were associated with EUGR defined by the Fenton charts. Conclusion: Compared to the Fenton charts, SGA was more defined and EUGR was less prevalent in extremely low gestational infants, while EUGR defined by the Intergrowth charts categorized infants with adverse clinical courses more elaborately. What is Known: •Preterm infants are at risk of postnatal growth restriction (PGR), although optimal postnatal growth is important for the long-term outcomes. • Growth charts are essential tools to monitor the postnatal growth of preterm infants. What is New: •PGR of weight and length were less defined with the Intergrowth charts than the Fenton charts. •PGR defined by the Intergrowth preterm postnatal follow-up study (PPFS) chart categorized preterm infants with morbidities more elaborately than the Fenton charts. [ABSTRACT FROM AUTHOR]

This study investigates the characteristics of cold clouds and snowfall in both the Yeongdong coastal and mountainous regions under different meteorological conditions based on the integration of numerical modeling and three-hourly rawinsonde observations with snow crystal photographs for a snowfall event that occurred on 29–30 January 2016. We found that rimed particles predominantly observed turned into dendrite particles in the latter period of the episode when the 850 hPa temperature decreased at the coastal site, whereas the snow crystal habits at the mountainous site were largely needle or rimed needle. Rawinsonde soundings showed a well-defined, two-layered cloud structure along with distinctive wind-directional shear, and an inversion in the equivalent potential temperature above the low-level cloud layer. The first experiment with a decrease in lower-layer temperature showed that the low-level cloud thickness was reduced to less than 1.5 km, and the accumulated precipitation was decreased by 87% compared with the control experiment. The difference in precipitation amount between the single-layered experiment and control experiment (two-layered) was not so significant to attribute it to the effect of the seeder-feeder mechanism. The precipitation in the last experiment by weakening wind-directional shear was increased by 1.4 times greater than the control experiment specifically at the coastal site, with graupel particles accounting for the highest proportion (∼62%). The current results would improve snowfall forecasts in complicated geographical environments such as Yeongdong in terms of snow crystal habit as well as snowfall amount in both time and space domains. [ABSTRACT FROM AUTHOR]

Advanced maternal age (AMA) is a growing trend world-wide and is traditionally defined as childbearing in women over 35 years of age. The purpose of our study was to determine the maternal age group within the Korean population, in which the risk of early neonatal mortality is increased. Korean birth and mortality data from 2011 to 2015 were used to estimate the influence of maternal age on the risk of early neonatal mortality. A Poisson regression was used for the analysis of multiple clinical variables such as year of delivery, maternal age, gestational age, infant gender, birth weight, multiple birth, parity, and socioeconomic variables. Furthermore, a generalized additive model was used to determine the maternal age at which the risk for neonatal mortality increases. We included 2,161,908 participants and found that 49.4% of mothers were 30–34 years of age at delivery. The proportion of mothers aged 35 and above increased over the 5-year analysis period. A maternal age lower than 29 years or higher than 40 years was associated with a relatively higher risk of early neonatal mortality. The trend and magnitude of the age-related risk on early neonatal mortality were independent of maternal socioeconomic factors such as living in an obstetrically underserved area, education level, and employment status. Furthermore, we showed that the risk for early neonatal mortality was higher until the maternal age of 28. However, there were no significant changes in the risk between the age of 35 and 40 years. According to recent national-wide data, age-related risk for early neonatal mortality is only apparent for mothers ≥ 40 years old whereas, age between 35 and 39 are not at increased risk for early neonatal mortality, despite being classified as AMA. [ABSTRACT FROM AUTHOR]

An independent determination of H0 is crucial given the growing tension between the Hubble constant, H0, derived locally and that determined from the modeling of the cosmic microwave background (CMB) originating in the early universe. In this work, we present a new determination of H0 using velocities and tip of the red giant branch (TRGB) distances to 33 galaxies located between the Local Group and the Virgo cluster. We use a model of the infall pattern of the local Hubble flow modified by the Virgo mass, which is given as a function of the cosmological constants (H0, ΩΛ), the radius of the zero-velocity surface R0, and the intrinsic velocity dispersion, σv. Fitting velocities and TRGB distances of 33 galaxies to the model, we obtain H0 = 65.8 ± 3.5 (stat) ± 2.4 (sys) km s−1 Mpc−1 and R0 = 6.76 ± 0.35 Mpc. Our local H0 is consistent with the global H0 determined from CMB radiation, showing no tension. In addition, we present new TRGB distances to NGC 4437 and NGC 4592, which are located near the zero-velocity surface: D = 9.28 ± 0.39 Mpc and D = 9.07 ± 0.27 Mpc, respectively. Their spatial separation is 0.29 Mpc, suggesting that they form a physical pair. [ABSTRACT FROM AUTHOR]

This paper identifies and analyzes contextual factors in the audit environment at the business group level, and finds that the structural complexity of business groups and business group owners' controlling power are significant factors that may influence auditor behavior during the audit negotiation process. Using data for the pre-audit earnings that is uniquely available in South Korea, we find that business group affiliation and the existence of circular control links within business groups are significantly and positively associated with auditors' agreement regarding earnings initially proposed by the management of client firms. We also find that both owners' excessive voting rights over cash-flow rights and related party transactions are significantly positively associated with auditors' agreement regarding the earnings initially proposed by the management of client firms. Our findings will help elucidate the contextual factors that can impact clients' bargaining powers in audit negotiation processes. [ABSTRACT FROM AUTHOR]

What is known and objective: The botulinum toxin (BoNT) has been widely used for various conditions associated with pain. Case description: Here, we report a case where celiac plexus block (CPB) with BoNT relieved intractable chronic pancreatic pain without complications. CPB was performed at the L1 level under fluoroscopic guidance, and 50 IU BoNT was injected on each side. After 15 weeks, pain was decreased to 0/10 on a visual analogue scale, without opioids or tramadol. What is new and conclusion: Our case demonstrates the efficacy of CPB with BoNT in intractable pain due to severe chronic pancreatitis. [ABSTRACT FROM AUTHOR]

Dachshund 1(Dach1) is a key component of the retinal determination gene network that plays significant roles in cell fate regulation. The vertebrate homolog of Drosophila dachshund has gained considerable importance as an essential regulator of development, but its functions during embryonic development remain elusive. We investigated the functional significance of dach1 during Xenopus embryogenesis using loss-of-function studies. Reverse transcription-polymerase chain reaction demonstrated the maternal nature of dach1 , showing enhanced expression at the neurula stage of development, and morpholino oligonucleotide injection of dach1 induced phenotypic anomalies of microcephaly and reduced body length. Animal cap assays followed by whole-mount in-situ hybridization indicated the perturbed expression of neural and neural crest (NC) markers. Our data suggest the prerequisite functions of dach1 in NC migration during Xenopus embryogenesis. However, the developmental pathways regulated by dach1 during embryogenesis require further elucidation. • dach1 is maternally expressed having predominant expression in developing nervous system. • dach1 knockdown led to phenotypical anomalies in dach1 morphants. • dach1 depletion resulted in abnormal expression of genes involved in neural development. • dach1 depletion led to perturbed expression of neural crest specifiers. • Dach1 have indispensable roles in neural crest migration and neural development during embryogenesis. [ABSTRACT FROM AUTHOR]

M64 is a nearby spiral galaxy with a Type III antitruncation component. To trace the origin of the Type III component, we present Hubble Space Telescope/Advanced Camera for Surveys (ACS) F606W/F814W photometry of resolved stars in a field located in the outer disk () of M64. At (7 kpc) to the east, we discover a new metal-poor globular cluster (pc and MV = −9.54 ± 0.09 mag), M64-GC1. This is the first globular cluster found in M64. The color–magnitude diagram (CMD) of the resolved stars in M64-GC1 is well matched by 12 Gyr isochrones with [Fe/H] = −1.5 ± 0.2, showing that this cluster belongs to a halo. The CMD of the resolved stars in the entire ACS field shows two distinguishable red giant branches (RGBs): a curved metal-rich RGB and a vertical metal-poor RGB. The metal-rich RGB represents an old metal-rich ([Fe/H] ≈ −0.4) disk population. In contrast, the CMD of the metal-poor RGB stars is very similar to the CMD of M64-GC1, showing that the metal-poor RGB represents a halo population. The radial number-density profile of the metal-rich RGB stars is described by an exponential disk law, while the profile of the metal-poor RGB stars is described by a de Vaucouleurs's law. From these, we conclude that the origin of the Type III component in M64 is a halo that has a much lower metallicity than the disk or bulge population. [ABSTRACT FROM AUTHOR]

Aim: Predictive accuracy of cervical funneling for successful vaginal delivery prior to labor induction was compared to that of conventional methods such as Bishop score and cervical length. Methods: Prospective observational study was conducted on nulliparous women at 38 gestational weeks or more with intact membranes who delivered vaginally following labor induction. Transvaginal ultrasound was performed prior to labor induction to evaluate the cervix, to determine the cervical length and to check for the presence of funneling. Following pelvic examinations, the Bishop score was calculated. Predictive accuracy of the three different methods, namely cervical funneling, cervical length and Bishop, were compared. Results: A total of 235 nulliparous women with intact membranes were recruited. Of these, 194 women (82.6%) had successful vaginal deliveries following induction. Cervical funneling was observed in 105 women (44.7%). The rate of successful vaginal delivery was significantly higher in women with cervical funneling than in those without funneling (90.5% vs 76.2%, P < 0.004). Multivariable analysis showed that cervical funneling, similar to traditional measures such as the Bishop score and cervical length, was an independent predictor of successful vaginal delivery following labor induction (odds ratio = 2.95; 95% confidence interval: 1.38–6.47; P = 0.007). Conclusions: Similar to the conventional methods of cervical evaluation, such as the Bishop score and cervical length, cervical funneling may serve as a useful and valid predictor of successful vaginal deliveries prior to labor induction. [ABSTRACT FROM AUTHOR]

Objectives: Birth order is one of the main factors that influences the neonatal outcome of twins. However, there is little prior data regarding the effect of birth order under different clinical circumstances. This study investigates the effect of birth order on the neonatal outcomes of twins delivered during early-preterm, late-preterm and term gestations according to chorionicity, delivery mode and indication for delivery.Methods: This is a retrospective cohort study of women with twin pregnancies delivered at 24-40 weeks of gestation between 1995 and 2014. We excluded twin pregnancies with the following complications: twin-to-twin transfusion syndrome, monoamnionic twins, delayed interval delivery and fetal death, chromosomal anomalies or major congenital malformation in one or more of the twins. The neonatal outcomes, including death, admission to neonatal intensive care unit (NICU), mechanical ventilator support, and respiratory distress syndrome (RDS) was compared between the first and second twin born at early-preterm (24-33 weeks of gestation), late-preterm (34-36 weeks of gestation) and term (≥37 weeks of gestation) gestations. These outcomes were further analyzed according to chorionicity, mode of delivery and indication for delivery by multivariable analysis (after adjusting for sex, presentation, and birth weight).Results: Among a total of 1,614 women with twin pregnancies who met the selection criteria, 423, 674 and 517 women delivered at early-preterm, late-preterm and term gestation, respectively. Overall, the second-born twins were lighter and had higher rates of NICU admission, mechanical ventilator support, and RDS than did first-born twins. Second twins born at early-preterm gestation had higher rates of RDS and mechanical ventilator support than did first twins. Second twins born at late-preterm gestation had higher rates of NICU admission and mechanical ventilator support than did first twins. Second twins born at term gestation also had a higher NICU admission rate than did first twins. However, in the multivariable analysis of the subgroups, the rates of NICU admission, mechanical ventilator support and RDS were not significantly different between most twin pairs. However, there were several significant differences. There was a higher risk of RDS in the second twins in the early-preterm premature rupture of membranes (PROM) subgroup, and a higher risk of mechanical ventilator support in the late-preterm PROM subgroup. Low birth weight was the only significant factor independently associated with a higher risk of adverse neonatal outcome in the second twins compared with the first twins in all subgroups.Conclusions: Second twins born at early-preterm, late-preterm and term were at higher risk of adverse neonatal outcome than were their respective first twins. However, this finding was mainly represented lower birth weight of the second twin. Still, second twins delivered due to early-preterm and late-preterm PROM had a higher risk of RDS and mechanical ventilator support, respectively, than did the first twin after adjusting for birth weight. [ABSTRACT FROM AUTHOR]

Background: Studies of cancer mutations have typically focused on identifying cancer driving mutations that confer growth advantage to cancer cells. However, cancer genomes accumulate a large number of passenger somatic mutations resulting from various endogenous and exogenous causes, including normal DNA damage and repair processes or cancer-related aberrations of DNA maintenance machinery as well as mutations triggered by carcinogenic exposures. Different mutagenic processes often produce characteristic mutational patterns called mutational signatures. Identifying mutagenic processes underlying mutational signatures shaping a cancer genome is an important step towards understanding tumorigenesis. Methods: To investigate the genetic aberrations associated with mutational signatures, we took a network-based approach considering mutational signatures as cancer phenotypes. Specifically, our analysis aims to answer the following two complementary questions: (i) what are functional pathways whose gene expression activities correlate with the strengths of mutational signatures, and (ii) are there pathways whose genetic alterations might have led to specific mutational signatures? To identify mutated pathways, we adopted a recently developed optimization method based on integer linear programming. Results: Analyzing a breast cancer dataset, we identified pathways associated with mutational signatures on both expression and mutation levels. Our analysis captured important differences in the etiology of the APOBEC-related signatures and the two clock-like signatures. In particular, it revealed that clustered and dispersed APOBEC mutations may be caused by different mutagenic processes. In addition, our analysis elucidated differences between two age-related signatures—one of the signatures is correlated with the expression of cell cycle genes while the other has no such correlation but shows patterns consistent with the exposure to environmental/external processes. Conclusions: This work investigated, for the first time, a network-level association of mutational signatures and dysregulated pathways. The identified pathways and subnetworks provide novel insights into mutagenic processes that the cancer genomes might have undergone and important clues for developing personalized drug therapies. [ABSTRACT FROM AUTHOR]

Age-related hearing loss (ARHL) is a neurodegenerative disease associated with an aged population. ARHL is influenced by biological factors such as aging, sex difference, and atherosclerosis. The mechanisms of ARHL caused by atherosclerosis have not been previously determined in apolipoprotein E knockout (ApoE KO) male mice. To investigate the onset and cause of the hearing loss, ApoE KO male mice were treated with a western diet (ApoE KO-WD) for 16 weeks. The lipid profile, atherosclerotic plaques throughout the aorta, and auditory brainstem response (ABR) thresholds were measured in the ApoE KO-WD male mice. The expression of S100 calcium-binding protein B (S100B), a neuronal damage biomarker, was also observed. Reactive oxygen species (ROS) and apoptosis rates were detected in the cochlea of the ApoE KO male mice. Atherosclerotic plaques on the aorta and ABR thresholds were significantly increased in the ApoE KO-WD male mice at 24 weeks of age. ABR thresholds had a statistically significant positive correlation with the area of atherosclerotic plaques (r = 0.783, p = 0.013) in male mice at 24 weeks of age. S100B protein expression and the dihydroethidium (DHE) reaction to ROS in the cochlear spiral ganglion neurons (SGNs) were significantly increased in the ApoE KO and ApoE KO-WD male mice. Cells positive for active caspase-3 and terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) in the SGNs were significantly increased in ApoE KO-WD male mice indicating an increased rate of cellular apoptosis. In conclusion, ROS in the SGNs were activated by increased S100B expression in ApoE KO-WD male mice, and this resulted in an increased apoptosis rate. Thus, hearing loss began at 16 weeks in ApoE KO-WD male mice. Our results suggest that the ApoE KO-WD male mice are a suitable animal model for studying ARHL associated with exacerbated atherosclerosis. • Hearing loss began at 16 weeks in ApoE KO male mice fed the western diet. • The hearing loss resulted from apoptosis in the spiral ganglion neurons following increased ROS. • These mice are useful to study age-related hearing loss related to atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Glycogen storage disease (GSD) Ia, caused by mutations in the glucose-6-phosphatase (G6PC) gene, is characterized by hepatomegaly, hypoglycemia, lactic acidosis, dyslipidemia, and hyperuricemia. This study aimed to investigate clinical and molecular features and late complications in Korean patients with GSD Ia.Results: Fifty-four Korean patients (33 males and 21 females) from 47 unrelated families, who were diagnosed with GSD Ia, based on genetic and biochemical data, between 1999 and 2017, were included in this study. The median age at diagnosis was 3.9 years (range: 5 months to 42 years), and the follow-up period was 8.0 ± 6.8 years. Most patients presented with hepatomegaly during infancy, but hypoglycemic symptoms were not predominant. Genetic analysis showed that all the patients had at least one c.648G > T allele. Homozygous c.648G > T mutations in the G6PC gene were identified in 34 families (72.3%), and compound heterozygotes with c.648G > T were found in the other families. The allele frequency of c.648G > T was 86.2% (81/94), and p.F51S, p.R83H, p.G122D, p.Y128*, p.G222R, and p.T255A were identified. Of 26 adult patients, 14 had multiple hepatic adenomas, and two were diagnosed with hepatocellular carcinoma. Thirteen patients showed renal complications, and seven patients presented gout, despite preventive allopurinol treatment. Twelve patients had osteoporosis, and two patients had pulmonary hypertension. The final heights were 157.9 cm (standard deviation score: - 3.1) in males and 157.8 cm (standard deviation score: - 0.6) in females.Conclusion: In our Korean patients with GSD Ia, the most common mutation in the G6PC gene was c.648G > T, suggesting a founder effect. Because of only mild hypoglycemia, the patients tended to be diagnosed late. Thus, adult patients with GSD Ia eventually developed diverse and serious complications, which indicates a need for careful monitoring and proper management of this disease. [ABSTRACT FROM AUTHOR]

Anastrozole is an aromatase inhibitor. Anastrozole competitively inhibits the aromatase enzyme, which synthesizes estrogen. It is used for estrogen receptor-positive breast cancers. A woman with breast cancer and anastrozole-induced dermatitis is described; the cutaneous side effects associated with aromatase inhibitors are also reviewed. Skin-related adverse events associated with aromatase inhibitor use are uncommon and may be delayed in appearance; the time of onset ranges from less than 5 days to 6 months (median 2 months). They present as either vasculitis, erythema nodosum, subacute cutaneous lupus erythematosus, or other dermatoses. Some patients demonstrate cutaneous lesions at either the original site of the breast malignancy or in areas that were previously treated with surgery or radiotherapy. The skin reactions are usually treated with discontinuation of the aromatase inhibitor; topical corticosteroids or oral corticosteroids or both are also used for some patients. Our patient's drug reaction occurred 2 months after starting the anastrozole and improved after a course of oral and topical corticosteroids. She was able to be switched to an alternate aromatase inhibitor without a recurrence of her adverse skin reaction. [ABSTRACT FROM AUTHOR]

Dermatomyositis (DM) is a rare inflammatory disorder affecting the muscle and skin. DM patients can present with spontaneous muscle hemorrhage, a potentially fatal complication. The best practice for management of hemorrhagic myositis in these patients remains unclear. Here we discuss the case of a patient who presented with progressive muscle weakness and intermittent rash that was diagnosed with dermatomyositis. During admission, she developed spontaneous hemorrhagic myositis of the right pectoralis major treated with surgical evacuation. She also developed a spontaneous left anterior thigh hematoma which was treated conservatively. She recovered and showed no evidence of recurrent bleeding at either location. We performed a literature review and identified ten cases of spontaneous hemorrhage in DM patients, with a 60% mortality rate among reported cases. Given the high mortality rate associated with spontaneous hemorrhage in DM patients, it is important for physicians to be aware of the diagnosis, workup, and management strategies. [ABSTRACT FROM AUTHOR]

Vibrational energy transfer through hydrogen bonding in water chains is a fast and efficient process. The chain consisting of 10 water molecules and a ground‐state nitric oxide at the end is collisionally excited by another nitric oxide molecule with an excess vibrational energy corresponding to in the v = 1 state from the other end, where the energy transfer proceeds through the hydrogen bonds. Energy transfer from the impact site to the end of chain occurs in a picosecond time scale, taking a subpicosecond over single hydrogen bond. The energy transfer pathway is a sequence of the initial OH‐stretching excitation on the impact to the OH bending overtone mode and then to the bound nitric oxide through a series of low‐frequency intermolecular vibrational states. More than 80% of the initial OH‐stretching excitation passes through the hydrogen bonds and deposits in the bound nitric oxide at the end of the chain. In the majority of trajectories, energy passing through the N...H bond at the terminal site leads to its subsequent bond rupture, thus producing a vibrationally excited nitric oxide in the region remote from the initial impact site. [ABSTRACT FROM AUTHOR]