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In the absolute measurement method of nuclide radioactivity by the internal gas proportional counter, the reasonable correction of the small pulse counting loss is the key to accurately obtain the measurement results. During the activity measurement of radionuclides, counting loss from low-energy β-ray and wall effects can generally be corrected by extrapolating the energy deposition spectrum, changing the working gas pressure, and using Monte Carlo simulations or theoretical calculations. Considering the decay type and energy of radioactive gas nuclides, the influence of the low-energy β-ray and the wall effect counting loss on the activity measurement results is also different. To this end, three typical radioactive gas nuclides 37Ar, 3H and 85Kr were used to study the cause of counting loss based on the Geant4 simulation. According to the simulated particle decay characteristics and energy ranges, the physical process package FTFP_ BERT built in Geant4 was selected. The results show that the counting loss of small pulse in the activity measurement of 37Ar mainly comes from the wall effect generated by X-ray. Within the given gas pressure of 60-300 kPa, the simulated wall effect correction factors are 1063-1021, and the counting loss of the wall effect can be completely corrected by extrapolating the pressure and detection efficiency. The decay energy of β-ray generated by 3H is very low, and there is no obvious wall effect. The small pulse counting loss mainly comes from the low-energy β-ray contribution with the energy below the counting threshold, which can be corrected by extrapolating the β energy spectrum at a lower counting threshold (below 1 keV). For 85Kr nuclide, the small pulse count loss is mainly due to the wall effect of high-energy β-ray, and it can’t be completely corrected only by the extrapolation correction of β energy spectrum. In addition, the wall effect correction factors were also simulated in this paper. Below the threshold 1 keV at the pressure of 60-300 kPa, the results are 1017-1005, and the correction factors decrease as the counting threshold decrease.

Influence calculation and analysis are widely used in social networks,web page importance evaluation and other fields.There is still a lack of effective and universal solution for the multi-level influence calculation with inheritance chain and time span factors.At the same time,the calculation of maximizing the propagation influence is an NP hard problem,whose approximate algorithm has low accuracy and complicated computation.In order to solve the above problems,this paper proposes a multi-level inheritance influence and generalization algorithm based on knowledge graph to realize the calculation of inheritance influence and inheritance relationship.The algorithm uses the breadth first search hierarchy computing model of knowledge graph,and takes into account the time span constraints to calculate the inheritance influence and inheritance chain.In order to optimize the computational efficiency,the strategy of depth first search and different levels with different weights is further used to only calculate the influence of the top n levels.The above method can not only calculate the inheritance influence and inheritance chain well,but also can be generalized into various communication influence calculation models.On this basis,this paper proposes a local optimal search similarity algorithm to maximize the propagation influence by selecting the nodes with large propagation influence as spare nodes.It achieves competitive results in running speed and the maximum number of propagation nodes.Finally,the effectiveness of the proposed method is verified by a variety of simulation experiments.

Parkinson’s disease (PD) is the second most common neurodegenerative disorder, and no efficient therapy able to cure or slow down PD is available. In this study, dehydrated red cabbage was evaluated as a novel source of bio-compounds with neuroprotective capacity. Convective drying was carried out at different temperatures. Total phenolics (TPC), flavonoids (TFC), anthocyanins (TAC), and glucosinolates (TGC) were determined using spectrophotometry, amino acid profile by LC-DAD and fatty acid profile by GC-FID. Phenolic characterization was determined by liquid chromatography-high-resolution mass spectrometry. Cytotoxicity and neuroprotection assays were evaluated in SH-SY5Y human cells, observing the effect on preformed fibrils of α-synuclein. Drying kinetic confirmed a shorter processing time with temperature increase. A high concentration of bio-compounds was observed, especially at 90 °C, with TPC = 1544.04 ± 11.4 mg GAE/100 g, TFC = 690.87 ± 4.0 mg QE/100 g and TGC = 5244.9 ± 260.2 µmol SngE/100 g. TAC degraded with temperature. Glutamic acid and arginine were predominant. Fatty acid profiles were relatively stable and were found to be mostly C18:3n3. The neochlorogenic acid was predominant. The extracts had no cytotoxicity and showed a neuroprotective effect at 24 h testing, which can extend in some cases to 48 h. The present findings underpin the use of red cabbage as a functional food ingredient.

The effect of high hydrostatic pressure (HHP) and the proteolytic fraction P1G10 from papaya latex was studied to find out whether a synergy exists in the growth inhibition of Botrytis cinerea in grape juice, contributing to the improvement of conservation techniques and extending the shelf life and quality of food products. Grape juice (GJ) diluted to 16 °Brix with a water activity (aw) of 0.980 was prepared from a concentrated GJ and used in this study. Results indicated a 92% growth inhibition of B. cinerea when exposed to 1 mg/mL of P1G10 and 250 MPa/4 min of pressure treatment. The proximate composition and antioxidant compounds present in the GJ were not significantly affected after the treatments. Eight phenolic compounds and two flavonoids in GJ were identified and quantified, with values fluctuating between 12.77 ± 0.51 and 240.40 ± 20.9 mg/L in the control sample (0.1 MPa). The phenolic compounds showed a significant decrease after the applied treatments, with the HHP sample having a content of 65.4 ± 6.9 mg GAE/100 mL GJ. In conclusion, a synergistic effect at moderate HHP of 250 MPa/4 min with the addition of P1G10 was observed, and the successful development of a stable and acceptable GJ product was possible.

By feat of Maple 17 and a subsidiary ordinary differential equation, a new extension algebraic method is chosen to construct the travelling wave solutions to the proximate equation set involving an arbitrary parameter for long waves over shallow-water. Multiple triangle periodic solutions and new Jacobi elliptic function solutions are obtained. This procedure is applicable to other nonlinear partial differential equations as well.

The purpose of this study was to evaluate the effects of stathmin-1 on chk1 protein expression in cervical cancer cells and the influences on the cells' invasion and tumorigenicity. Suppressed stathmin-1 expression in Hela cells and C33A cells by lentiviral vector were utilized. Real time PCR and Western blot were used to examine the expression of chk1. Cell proliferation and invasion were studied using MTT assays and transwell migration assays.The differences of tumorigenicity in vivo were explored using xenograft experiments. In addition, stathmin-1 expressions in 24 cervical cancer patients were studied without regional lymph nodes metastasis and 16 metastatic patients by immunohistochemistry assays and real time PCR. This study found downregulating stathmin-1 reduced chk1 expressions and the proliferation and invasion in cervical cancer cells and reduced the tumorigenicity of tumor cells. [ABSTRACT FROM AUTHOR]

The snap-through and pull-in instability of the electrostatically actuated micro shallow arches incorporating Casimir force was investigated based on the modified couple stress theory. The nonlinear governing equation and boundary conditions were derived by using the principle of minimum total potential energy. The snap-through voltages, the pull-in voltages, the non-dimensional snap-through displacements and the non-dimensional pull-in displacements of the electrostatically actuated micro shallow arches were calculated by applying the generalized differential quadrature method（GDQM） and the generalized integral quadrature method（GIQM）. The results show that the snap-through and the pull-in instability of the electrostatically actuated micro shallow arches are size-dependent. The snap-through and pull-in voltages of the electrostatically actuated micro shallow arches based on the modified couple stress theory are smaller than the classical results. The Casimir force can reduce the snap-through voltages, the pull-in voltages, the non-dimensional snap-through and the pull-in displacements of the micro shallow arches. The initial rise of the micro shallow arches affects the snap-through and pull-in instability.

The groundwater samples of Pulau Bidong, Terengganu, Malaysia were collected from five sampling stations from June to October 2016. Physical parameters such as temperature, specific conductivity, dissolved oxygen (DO), pH, salinity, and DO saturation were measured in-situ by using handheld device. Meanwhile, total suspended solid (TSS), total dissolved solid (TDS), nitrate (NO3−), nitrite (NO2−), ammonium (NH4+) and phosphate (PO43−) were analysed and detected using UV–Vis Spectrophotometer. The inorganic nutrients (NO3−, NO2−, NH4+ and PO43−) were ranged from 0.000 to 4.310 mg/L, 0.000 to 0.190 mg/L, 0.000 to 0.807 mg/L and 0.003 to 0.028 mg/L, respectively. The monthly trends of specific conductivity, DO, salinity, DO saturation, NO3−, NO2− and NH4+ demonstrated significant variation in June (the lowest rainfall) compared to other months. Correlation matrix revealed that temperature was associated with the specific conductivity, and NH4+ strongly correlated with DO, NO3− and NO2−. Nevertheless, there is a strong negative correlation between physicochemical parameters and monthly rainfall distribution. Notably, future studies are required for long-term monitoring to ensure the good quality of groundwater from Pulau Bidong. The spatial and temporal variability of the present data has been reported by Tan et al. [1].

Cellulose, the most abundant constituent material of the plant cell walls, is a major structural component of plant biomass. Manipulating cellulose synthesis (CesA) genes by genetic engineering technology, to increase cellulose production may thus offer novel opportunities for plant growth and development. To investigate this, here we produced transgenic “Populus 895 plants” overexpressing the cellulose synthase (CesA2) gene derived from Pinus massoniana under the control of constitutive 35S promoter, via Agrobacterium-mediated transformation. Relative expression levels of PmCesA2 were functionally characterized in poplar hybrid clone “Nanlin895” (Populus deltoides × Populus euramericana). The results demonstrated the transgenic lines showed enhanced growth performance with increased biomass production than did the untransformed controls. It is noteworthy that the overexpression of PmCesA2 in poplar led to an altered cell wall polysaccharide composition, which resulted in the thickening of the secondary cell wall and xylem width under scanning electron microscopy. Consequently, the cellulose and lignin content were increased. Hence, this study suggests that overexpression of PmCesA2 could be used as a potential candidate gene to enhance cellulose synthesis and biomass accumulation in genetically engineered trees.

The influence of equilibrium and alloy elements on the precipitation phases of K488 alloy was calculated and experimental analyzed by using Thermo-Calc thermodynamic calculation software. The results of calculation and experiment are shown that the alloy equilibrium phases are γ,γ',σ and carbides. In the alloy solidification process, Mo, Ti segregations are more serious. With the increase of C and Nb content, MC precipitation increased, but precipitation temperature decreased, the content of Ti is on the contrary. the increase of Al, Ti contents, γ' phase precipitations amount and precipitation temperature gradually increased. The content of Cr has most influence on the precipitation amount and precipitation temperature of the sigma phase. The calculation and experimental results have good consistency.

The static pull-in instability of the electrostatically actuated cantilever micro-beams incorporating Casimir force was investigated based on the modified couple stress theory. The nonlinear governing equation and boundary conditions were derived using the principle of minimum total potential energy. The pull-in voltages and non-dimensional pull-in displacements of the electrostatically actuated cantilever micro-beams were calculated by applying the generalized differential quadrature method（GDQM）. The results show that the pull-in voltages of the electrostatically actuated cantilever micro-beams based on the modified couple stress theory are greater than the classical results and the size effects are obvious. The presence of the Casimir force can reduce the pull-in voltages and non-dimensional pull-in displacements of the cantilever micro-beams and the influence of the Casimir force can be neglected when the initial gap of the cantilever micro-beams g is far greater than the thickness of the beam h.

In this paper, a survey is conducted to study the attitudes of Hong Kong residents towards organ donation after death. It is found that 60.3% of the respondents are willing to donate organs, which is comparable to those cited in the literature. The results also indicate that the willingness to donate is related to age, occupation and attitude. A factor analysis of attitudes yielded four factors, including form of burial, altruism, lack of understanding on organ donation and lack of confidence in professional conduct of medical doctors. Further analysis of the factor scores provides information that is useful to the design of effective public education programs in organ donation. [ABSTRACT FROM AUTHOR]

Many types of equipment in the thermal power plant has special risks. Once a safety accident occurs, it often causes special consequences and losses. The indirect losses are difficult to calculate in general due to the special property. In this paper, a calculation model was proposed, considering collateral production impact on upstream and downstream industries, the inconvenience impact on people’s electricity and gas supply, and social security panic by rapidly spreading to media and public opinion. An example of a main steam pipe burst accident in a thermal power plant was analysed. The ratio of indirect economic losses and direct economic losses was obtained. Results showed that the ratio value (35.4) was much higher than the value (4) of general industrial accident loss. The ratio value maybe even much higher if the internal medium of special equipment has strong toxic and harmful effects. It is quite important to make concerted efforts to manufacture, usage, management, inspection, safety monitoring, and scientific supervision, in order to detect and eliminate hidden dangers early and ensure the safe operation of special equipment.

Based on the panel data of 35 OECD countries from 2001 to 2019, this paper empirically analyzes the nonlinear effect of exchange rate on economic growth of countries through PSTR model. The results show that exchange rate appreciation has a certain role in promoting economic growth. When the value of the local currency is high, the exchange rate appreciation has a stronger effect on promoting economic growth; when the value of the local currency is low, the exchange rate appreciation has a weaker effect on economic growth. Further research shows that when the local currency value is low, the development of export trade has a strong positive impact on economic growth, while the inflow of FDI has a weak effect on economic growth. When the currency value is low, the promotion effect of export trade on economic growth is relatively weak, while the inflow of FDI shows a stronger promoting effect on economic development, and the nonlinear effect of exchange rate on economic growth is positive. It is the comprehensive effect of these channels.

With the rapid development of urban construction and the increasing number of high-rise buildings, many problems have arisen, one of which is fire. High-rise building fires are developing rapidly, and it is difficult to extinguish them, which causes great losses and seriously threatens people’s safety in production and life. Early warning of high-rise building fire is an important means to prevent fire. In this paper, aiming at high-rise building fires, the causes of high-rise building fires in 2019 are analyzed statistically, and the causes of high-rise building fires are summarized. An intelligent early warning system of high-rise building fire based on multi-dimensional data fusion is proposed. Based on the actual forecast data, the early warning system based on multi-dimensional data fusion is analyzed through Matlab simulation, thus verifying the feasibility and reliability of the established fire early warning system. The research results have certain guiding significance for high-rise building fire warning.

In recent years, under the background of the country’s vigorous development of science and education, the construction of university laboratories has been continuously progressing and perfecting. Under such rapid development, the safety management mode of university laboratories has been lagging behind and many safety accidents have occurred threatening teachers and students. The safety of university laboratories urgently needs more attention. This research briefly analyzes the safety management system of domestic and foreign university laboratories and related laws, regulations and standards and analyzes the types and characteristics of accidents and the causes of accidents through statistics of 50 college laboratory accidents in recent years. Based on the analytic hierarchy process to study the weight of the cause of the accident. It is concluded that laboratory safety management and personnel management are the main reasons for the accident.

Natural gas station is an important part of the whole natural gas pipeline transmission system, in which the pipeline vibration is a hidden danger that cannot be ignored for the safe operation of the station. In view of the severe vibration of the pipeline in a natural gas station of an enterprise, the vibration acceleration sensors are used to test the vibration of each measuring point under different working conditions, and then the three-dimensional finite element model of the pipeline is established by using numerical simulation software to study its structural characteristics and gas column characteristics. Through the analysis of field test results and simulation results, it is found that there are two main vibration frequencies in the pipeline: 116.75 Hz and 123.0 Hz. The former is caused by the resonance between the gas column frequency and the natural frequency in pipe B; The latter is due to the impact of the gas column force in pipe A on pipe B.

In order to solve problems of existing pressure and temperature data collecting modes of coalbed methane well such as information island caused by manual collection, inability to collect data consecutively, water leakage of pressure sensor and temperature sensor and so on, a pressure and temperature monitoring system of coalbed methane well was proposed. System structure was given as well as compositions of hardware and software. Design scheme of a new type of sensor was focused on, which adopted MEMS technology, vacuum encapsulation and resistive load modulation mode to send collected data. Testing and trail running results show that the system has better reliability, real-time performance and operability, which can reduce field personnel and accidents effectively.

In recent years, there has been increasing interest in finding natural antioxidants, since they can protect the human body from free radicals and retard the progress of many chronic diseases. This study is to evaluate antioxidant of a certain molecular chitosan oligosaccharide (Mw 1000 Da, COST) in vitro. The antioxidant activities of COST were investigated in vitro by several antioxidant assays, including DPPH radical scavenging, hydroxyl radical scavenging, superoxide radical scavenging, reducing power and metal chelating activities.In vitro studies found that COST had noticeable scavenging activities on 2,2-diphenyl-1-picryl-hydrazyl (DPPH) radical, hydroxyl radical, and superoxide anion, and possessed reducing power and metal chelating activities, and its capability of anti-oxidation enhance with the increase of concentration.COST presents anexcellent biological rolein scavenging free radical, which could be explored as a potential antioxidant or dietary supplement to retard diseases caused by peroxide.

Background: The emergence of SARS-CoV-2 variants necessitates ongoing evaluation of vaccine performance. This study evaluates and compares the safety and immunogenicity of the Comirnaty and Spikevax monovalent XBB.1.5 COVID-19 vaccines in an elderly population., Methods: Altogether, 129 elderly individuals were recruited between 2 January and 3 February 2024, and received a booster dose of either Comirnaty (n=59) or Spikevax (n=70) monovalent XBB.1.5 COVID-19 vaccine. Blood samples were collected at before and one month after vaccination. Immunogenicity was assessed by measuring the percentage of IFNγ + CD4 + and IFNγ + CD8 + T cells, and neutralizing antibody titers (NT50) using a surrogate virus neutralization test (sVNT). Adverse reactions were recorded and analyzed., Findings: Both vaccines significantly increased the percentage of IFNγ + CD8 + T cells against XBB.1.5 and wild-type (WT) SARS-CoV-2 at one-month post-vaccination. Spikevax induced a significantly higher percentages of IFNγ + CD8 + and CD4 + T cells against XBB.1.5 than Comirnaty (p<0.001). The proportion of participants showing a positive T cell response to XBB1.5 after vaccination was higher in the Spikevax group (64.3% CD8, 71.4% CD4) than in the Comirnaty group (42.4% CD8, 57.6% CD4). Spikevax also elicited higher NT50 levels against XBB1.5, JN.1 and the latest variant KP.2 than Comirnaty (XBB1.5: p<0.01; KP.2: p<0.05). Fever was more common in the Spikevax group (fever: p=0.006). However, all side effects were short-term and resolved on their own., Interpretation: Both vaccines induce neutralizing antibody to XBB1.5, JN.1 and KP.2. Specifically, Spikevax induces higher cellular and humoral immune responses than Comirnaty in the elderly, but it is also associated with a higher incidence of fever. These findings can guide public health strategies for vaccinating the elderly population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Context: Fragility fractures in young adults present significant clinical challenges due to the limited evidence on the effectiveness of bisphosphonates in preventing subsequent fractures., Objective: To evaluate the effectiveness of bisphosphonate therapy in reducing the fracture risk among premenopausal women with a history of osteoporotic fractures., Design: A population-based retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) in South Korea, covering the years 2003 to 2014., Setting: A nationwide healthcare setting utilizing a representative cohort database., Participants: Among 2,087 premenopausal women with osteoporotic fractures, participants were propensity score-matched based on age and body mass index at a 1:3 ratio, resulting in 132 bisphosphonate users and 396 non-users., Intervention: Bisphosphonate treatment., Main Outcome Measures: The incidence of osteoporotic fractures., Results: Bisphosphonate users had a significantly lower risk of major osteoporotic fractures (HR 0.618, 95% CI 0.396 - 0.963) compared to non-users. Ibandronate users showed significant reductions in both major osteoporotic (HR 0.376, 95% CI 0.164 - 0.861) and nonvertebral fractures (HR 0.214, 95% CI 0.052 - 0.877). Also, longer duration of bisphosphonate use (≥180 days) was associated with a significantly lower risk of major osteoporotic and nonvertebral fractures (HR 0.528, 95% CI 0.300 - 0.929; HR 0.409, 95% CI 0.187 - 0.895, respectively)., Conclusions: Bisphosphonate therapy significantly reduces fracture risk in premenopausal women with previous osteoporotic fractures, especially at higher cumulative doses. These findings support considering bisphosphonates as a treatment option in premenopausal women at high risk of fractures., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. See the journal About page for additional terms.)

Microsatellite instability-high (MSI-H) gastric cancer (GC) exhibits high tumor-infiltrating lymphocyte (TIL) density. Despite the recognized significance of the immune microenvironment in MSI-H GC, our understanding of TIL remains limited. This study aimed to investigate the clinicopathologic and prognostic implications of T cell subsets in MSI-H GC. Single immunohistochemistry (IHC) for CD8, TCF1, and CD103, and double IHC for CD8/TCF1 and CD8/CD103 were performed in 382 surgically resected MSI-H GC samples. Densities of single or double positive immune cells were quantified and correlated with clinicopathologic features and overall survival (OS). TCF1 + cell densities showed weak correlations with CD8 + and CD103 + cell densities, while CD8+/TCF1 + cell density moderately correlated with CD8+/CD103 + cell density (R 2  = 0.539, p < 0.001). Single IHC analyses showed no significant associations between CD8+, TCF1+, or CD103 + cell densities and OS (p > 0.05). Notably, elevated CD8+/TCF1 + cell density and a high CD8+/TCF1 + to CD8 + ratio correlated with less aggressive clinicopathologic features and improved OS (p = 0.017 and 0.001, respectively). Multivariable Cox-regression identified CD8+/TCF1 + to CD8 + ratio as an independent prognostic factor (p = 0.028). We demonstrated the prognostic significance of CD8+/TCF1 + to CD8 + ratio using double IHC in a large cohort of MSI-H GC., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Purpose: Laparoscopic distal gastrectomy is now widely used in East Asia and worldwide with different preferences and outcomes. This study aimed to compare the short- and long-term outcomes and preferences between two high-volume gastric cancer centers in Korea and China., Methods: Patients who underwent laparoscopic-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) for gastric cancer from Seoul National University Hospital (SNUH) and the First Affiliated Hospital of Nanjing Medical University (NMUH) from 2017 to 2020 were enrolled in this study., Results: A total of 1166 SNUH cases and 847 NMUH cases enrolled in this study. The overall complication rate of SNUH (14.49%) did not differ from that of NMUH after LADG or TLDG (12.28%). The anastomosis-related complications rate (2.74%) did not show a significant difference with that of NMUH (2.01%) either. The median postoperative hospital stay for SNUH (7,(7,10)) was shorter than that for NMUH (8,(7,9)). The 5-year overall survival (OS) rate of SNUH was not significantly different from that of NMUH., Conclusion: There was no significant difference in the overall complication rate, anastomosis-related complication rate, resected lymph nodes, and 5- year overall survival rate between SNUH and NMUH except for the postoperative stay. Both the LADG and TLDG achieved satisfactory short- and long-term outcomes when performed by surgeons with adequate experience., Competing Interests: Declarations Conflict of interest The authors declare that they have no competing interests. Ethical approval The study was performed in accordance with the Declaration of Helsinki and was approved by the ethics committees of Seoul National University Hospital and the First Affiliated Hospital of Nanjing Medical University. Consent to participate The patients were informed about sample collection and signed informed consent forms. All human samples used in this study were unidentified. Consent for publication All authors of this article have directly participated in the planning and drafting, and all listed authors have read and approved the final version, including details and images., (© 2024. The Author(s).)

Purpose: This study aimed to develop and assess the feasibility and effectiveness of digital therapeutics for supportive care after gastrectomy., Materials and Method: The study included 39 patients with gastric cancer who underwent minimally invasive gastrectomy and were able to use a mobile application (app) on their smartphones. The developed research app automatically calculates and provides daily targets for calorie and protein intake based on the patient's body mass index (BMI). Patients recorded their daily diets, weights, and symptoms in the app and completed special questionnaires to assess the feasibility of the app in real-world clinical practice., Results: At the 10-week follow-up, the mean questionnaire scores for ease of learning, usability, and effectiveness of the app (primary endpoint) were 2.32±0.41, 2.35±0.43, and 2.4±0.39 (range: 0-3), respectively. Patients were classified as underweight (<18.5, n=4), normal (18.5-24.9, n=24), or overweight (≥25.0, n=11) according to predischarge BMI. Underweight patients showed higher compliance with app usage and a higher rate of achieving the target calorie and protein intake than normal weight and overweight patients (98% vs. 77% vs. 81%, p=0.0313; 102% vs. 75% vs. 61%, P=0.0111; 106% vs. 79% vs. 64%, P=0.0429). Two patients transitioned from underweight to normal weight (50.0%), one patient (4.3%) transitioned from normal weight to underweight, and two patients (22.2%) transitioned from overweight to normal weight., Conclusions: The mobile app is feasible and useful for postoperative supportive care in terms of ease of learning, usability, and effectiveness. Digital therapeutics may be an effective way to provide supportive care for postgastrectomy patients, particularly in terms of nutrition., Trial Registration: ClinicalTrials.gov Identifier: NCT04800991., Competing Interests: No potential conflict of interest relevant to this article was reported., (Copyright © 2024. Korean Gastric Cancer Association.)

Low muscle mass is a risk factor for mortality in patients with chronic kidney disease (CKD). However, it is not clear to what extent low muscle mass contributes to this risk, either independently or in combination with metabolic abnormalities and frailty. This study used data from the National Health and Nutrition Examination Survey 1999-2006 and 2011-2018. Low muscle mass was defined as Appendicular Skeletal Mass Index < 7 kg/m 2 in men or < 5.5 kg/m 2 in women. The follow-up duration was from the first anthropometric and clinical measurements to death or the last follow-up. This study enrolled 2072 patients with CKD. Low muscle mass was associated with a lower risk of metabolic abnormalities, but was associated with an elevated mortality risk. Conversely, central obesity was associated with a higher likelihood of metabolic abnormalities and frailty, yet showed no significant association with mortality risk. Subsequently conducted mediation analysis indicated that the effect of low muscle mass on mortality was direct, not mediated by frailty and metabolic abnormalities. In spite of the inverse relationship between low muscle mass and metabolic abnormalities, low muscle mass are directly associated with an increased risk of all-cause mortality. Low muscle mass may directly contribute to mortality in patients with CKD, independent of metabolic abnormalities and frailty in these patients., (© 2024. The Author(s).)

Backgruound: Adrenocortical carcinomas (ACCs) are rare tumors with aggressive but varied prognosis. Stage, Grade, Resection status, Age, Symptoms (S-GRAS) score, based on clinical and pathological factors, was found to best stratify the prognosis of European ACC patients. This study assessed the prognostic performance of modified S-GRAS (mS-GRAS) scores including modified grade (mG) by integrating mitotic counts into the Ki67 index (original grade), in Korean ACC patients., Methods: Patients who underwent surgery for ACC between January 1996 and December 2022 at three medical centers in Korea were retrospectively analyzed. mS-GRAS scores were calculated based on tumor stage, mG (Ki67 index or mitotic counts), resection status, age, and symptoms. Patients were divided into four groups (0-1, 2-3, 4-5, and 6-9 points) based on total mS-GRAS score. The associations of each variable and mS-GRAS score with recurrence and survival were evaluated using Cox regression analysis, Harrell's concordance index (C-index), and the Kaplan-Meier method., Results: Data on mS-GRAS components were available for 114 of the 153 patients who underwent surgery for ACC. These 114 patients had recurrence and death rates of 61.4% and 48.2%, respectively. mS-GRAS score was a significantly better predictor of recurrence (C-index=0.829) and death (C-index=0.747) than each component (P<0.05), except for resection status. mS-GRAS scores correlated with shorter progression-free survival (P=8.34E-24) and overall survival (P=2.72E-13)., Conclusion: mS-GRAS scores showed better prognostic performance than tumor stage and grade in Asian patients who underwent surgery for ACC.

Purpose: Hereditary diffuse gastric cancer (HDGC) presents a significant genetic predisposition, notably linked to mutations in the CDH1 and CTNNA1. However, the genetic basis for over half of HDGC cases remains unidentified. The aim of this study is to identify novel pathogenic variants in HDGC and evaluate their protein expression., Materials and Methods: Among 20 qualifying families, two were selected based on available pedigree and DNA. Whole genome sequencing (WGS) on DNA extracted from blood and whole exome sequencing on DNA from formalin-fixed paraffin-embedded tissues were performed to find potential pathogenic variants in HDGC. After selection of a candidate variant, functional validation, and enrichment analysis were performed., Results: As a result of WGS, three candidate germline mutations (EPHA5, MCOA2, and RHOA) were identified in one family. After literature review and in-silico analyses, the RHOA mutation (R129W) was selected as a candidate. This mutation was found in two gastric cancer patients within the family. In functional validation, it showed RhoA overexpression and a higher GTP-bound state in the RhoaR129W mutant. Decreased phosphorylation at Ser127/397 suggested altered YAP1 regulation in the Rho-ROCK pathway. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses linked RhoaR129W overexpression to changed migration/adhesion in MKN1 cell line. However, this RHOA mutation (R129W) was not found in index patients in other families., Conclusion: The RHOA mutation (R129W) emerges as a potential causative gene for HDGC, but only in one family, indicating a need for further studies to understand its role in HDGC pathogenesis fully.

This study aimed to conduct an in-depth examination of gene expression and microenvironmental profiles of gastric neuroendocrine carcinoma (NEC) and mixed adeno-NEC (MANEC). Tissue microarrays from 55 patients with gastric MANEC (N = 32) or NEC (N = 23) were analyzed using digital spatial profiling (GeoMx DSP, NanoString Technologies). Representative regions of interest were selected from the adenocarcinoma (ADC) portion (ADC-MANEC) and the NEC portion (NEC-MANEC) of the MANEC cores, and pure NEC (pNEC) cores. All regions of interest were separated into epithelial components and stromal components using the masking procedure in the GeoMx platform, followed by transcriptome analysis. Comparison of gene expression between ADC-MANEC and NEC-MANEC/pNEC identified several differentially expressed genes in the epithelial (including PEG10, MAP1B, STMN3, and AKT3) and stromal (FN1, COL1A1, SPARC, and BGN) components. Gene set enrichment analysis revealed that pathways related to the E2F target and G2M checkpoint were more enriched in NEC-MANEC and pNEC than in ADC-MANEC. Deconvolution analysis showed that the microenvironmental profile varied according to histologic differentiation. In ADC-MANEC, intraepithelial infiltrating immune cells were relatively more numerous, whereas fibroblasts in the stroma were more abundant in NEC-MANEC and pNEC. This study confirmed the distinct expression profile of each histologic component of MANEC according to its tumor vs stromal compartment using the DSP platform. Although each component of MANEC shares the same genetic origin, distinctive phenotypes should not be overlooked when managing patients with MANEC. This study provides a useful validation data set for future studies., (Copyright © 2024 United States & Canadian Academy of Pathology. Published by Elsevier Inc. All rights reserved.)

Purpose: Gastric cancer exhibits molecular heterogeneity, with the microsatellite instability-high (MSI-H) subtype drawing attention for its distinct features. Despite a higher survival rate, MSI-H gastric cancer lack significant benefits from conventional chemotherapy. The immune checkpoint inhibitors, presents a potential avenue, but a deeper understanding of the tumor immune microenvironment of MSI-H gastric cancer is essential., Materials and Methods: We explored the molecular characteristics of CD8+ T-cell subtypes in three MSI-H and three microsatellite stable (MSS) gastric cancer samples using single-cell RNA sequencing and spatial transcriptome analysis., Results: In MSI-H gastric cancer, significantly higher proportions of effector memory T cell (Tem), exhausted T cell (Tex), proliferative exhausted T cell (pTex), and proliferative T cell were observed, while MSS gastric cancer exhibited significantly higher proportions of mucosal-associated invariant T cell and natural killer T cell. In MSI-H gastric cancer, Tex and pTex exhibited a significant upregulation of the exhaustion marker LAG3, as well as elevated expression of effector function markers such as IFNG, GZMB, GZMH, and GZMK, compared to those in MSS gastric cancer. The interferon γ (IFN-γ) signaling pathway of Tex and pTex was retained compared to those of MSS gastric cancer. The spatial transcriptome analysis demonstrates the IFN-γ signaling pathway between neighboring Tex and malignant cell, showcasing a significantly elevated interaction in MSI-H gastric cancer., Conclusion: Our study reveals novel finding indicating that IFN-γ signaling pathway is retained in Tex and pTex of MSI-H gastric cancer, offering a comprehensive perspective for future investigations into immunotherapy for gastric cancer.

Motivated by theories of music-to-language transfer, we investigated whether and how musicianship benefits phonological and lexical prosodic awareness in first language (L1) Cantonese and second language (L2) English. We assessed 86 Cantonese-English bilingual children on rhythmic sensitivity, pitch sensitivity, nonverbal intelligence, inhibitory control, working memory, Cantonese phonological awareness, Cantonese tone awareness, English phonological awareness, and English stress awareness. Based on their prior music learning experience, we classified the children as musicians and non-musicians. The musicians performed better than the non-musicians on Cantonese phonological awareness, Cantonese tone awareness, and English phonological awareness. In addition, the musicians had superior pitch sensitivity, nonverbal intelligence, inhibitory control, and working memory than the non-musicians. For Cantonese and English phonological awareness, neither cognitive abilities nor pitch and rhythmic sensitivities turned out to be a unique predictor. However, working memory uniquely predicted Cantonese tone awareness, with age, rhythmic sensitivity, and pitch sensitivity controlled. From a theoretical perspective, our findings on Cantonese tone awareness favors the cognitive perspective of music-to-language transfer, in which working memory enhancement could explain the musicians' superior performance in Cantonese tone awareness. However, our findings on phonological awareness do not favor the cognitive perspective, nor do they favor the perceptual perspective, in which enhanced rhythmic and pitch sensitivities could explain musicians' advantage., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Claudin 18.2 (CLDN18.2) is a promising target for targeted therapies in gastric cancer (GC). This study investigated the prevalence of CLDN18.2 expression in patients with stages II-IV GC or gastroesophageal junction (GEJ) adenocarcinoma and its correlation with clinicopathologic features and other crucial GC biomarkers., Methods: We enrolled 1000 patients diagnosed with stages II-IV GC after surgical treatment. Immunohistochemistry for CLDN18 (43-14A clone), PD-L1 (22C3 pharmDx), HER2, and FGFR2 was performed. CLDN18.2 positivity was defined as moderate-to-strong (2+/3+) membranous staining in ≥75% of tumor cells. CLDN18.2 expression was compared with biomarker expression, Epstein-Barr virus (EBV) association and microsatellite instability status, and clinicopathologic features., Result: CLDN18.2 was positive in 34.4% of the patients. CLDN18.2 positivity was significantly higher in the middle and upper thirds than in the lower third gastric location (P < .001), but there was no correlation with age, sex, or stage (P > .05). CLDN18.2 positivity was rare (2.8%) in mucinous adenocarcinoma but frequent (90.9%) in a majority of gastric carcinomas with lymphoid stroma. CLDN18.2 positivity was higher in EBV-associated (P < .001) and PD-L1-positive (PD-L1 CPS ≥ 5) GC (P = .014) but lower in HER2 positive GC (P = .005). CLDN18.2 positivity was not significantly associated with overall survival and disease-free survival., Conclusion: This study provides a comprehensive evaluation of CLDN18.2 status and its correlation with the clinicopathologic characteristics of patients with stages II-IV GC in Korea and with crucial biomarkers. It may be valuable for guiding future drug development, expanding treatment options, and ultimately improving patient outcomes in GC., (© The Author(s) 2024. Published by Oxford University Press.)

The global industrial development and increase in the number of transportation vehicles, such as automobiles and ships, have led to a steady increase in the issues related to greenhouse gas emissions. NO 2 is a greenhouse gas emitted in large quantities from automobiles and factories, and its emission is unavoidable in the modern world. Therefore, a sensor capable of precise detection of NO 2 is required. The most commonly reported types of NO 2 sensors are those based on metal oxides. However, their operation at room temperature is impossible owing to their high-temperature operating characteristics, and therefore, a heater must be designed inside or installed outside the sensor for heating. Meanwhile, NO 2 sensors based on PbS quantum dots (QDs) are advantageous as they can operate at room temperature and can be easily manufactured through a solution process rather than a complicated semiconductor process. Herein, a NO 2 sensor was fabricated by doping PbS QDs with poly(3-hexylthiophene) (P3HT). The as-developed sensor exhibited high responsivity to 100-0.4-ppm NO 2 gas with a resolution of 200 ppb owing to the stability of the thin film and high hole mobility of P3HT., (© 2024. The Author(s).)

Objective: To evaluate the long-term outcomes of laparoscopic pylorus preserving gastrectomy (LPPG) with laparoscopic distal gastrectomy (LDG) for early gastric cancer (EGC)., Summary Background Data: PPG is considered as a function preserving surgery for EGC. However, there has been no multicenter randomized controlled trial comparing PPG with DG until now., Methods: A multicenter randomized controlled trial (KLASS-04) with 256 patients with cT1N0M0 gastric cancer located in the mid portion of the stomach was conducted. The primary endpoint was the incidence of dumping syndrome at postoperative 1 year. Secondary endpoints included survival and recurrence, gallstone formation, nutritional parameters, gastroscopic findings, and quality of life (QOL) for 3 years., Results: In the intention-to-treat analyses, there was no difference in the incidence of dumping syndrome at one year postoperatively (13.2% in LPPG vs. 15.8% in LDG, P=0.622). Gallstone formation after surgery was significantly lower in LPPG than in LDG (2.33% vs. 8.66%, P=0.026). Hemoglobin (+0.01 vs. -0.76 gm/dL, P<0.001) and serum protein (-0.15 vs. -0.35 gm/dL, P=0.002) were significantly preserved after LPPG. However, reflux esophagitis (17.8% vs. 6.3%, P=0.005) and grade IV delayed gastric emptying (16.3% vs. 3.9%, P=0.001) were more common in LPPG. Changes in body weight and postoperative QOL were not significantly different between groups. Three-year overall survival and disease-free survival were not different (1 case of recurrence of in each group, P=0.98)., Conclusions: LPPG can be used as an alternative surgical option for cT1N0M0 gastric cancer in the mid portion of the stomach., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The technical challenges and safety concerns of single-incision laparoscopic gastrectomy for overweight and obese gastric cancer patients remain unclear. This study aimed to evaluate the safety and feasibility of single-incision laparoscopic distal gastrectomy (SIDG) compared to multiport laparoscopic distal gastrectomy (MLDG) in overweight and obese gastric cancer patients., Methods: This study retrospectively analyzed overweight and obese patients (body mass index ≥ 25 kg/m 2 ) and pathologic stage T1 primary gastric adenocarcinoma treated with either SIDG or MLDG. The SIDG and MLDG groups were propensity score matched at a 1:2 ratio using age, sex, height, body weight, American Society of Anesthesiologists classification, year of surgery, pathologic N stage, and anastomosis method as covariates., Results: After 1:2 matching, the study included patients who underwent SIDG (n = 179) and MLDG (n = 358). No significant difference in the number of retrieved lymph nodes was found between the SIDG and MLDG groups (52.8 ± 19.3 vs. 53.9 ± 21.0, P = 0.56). Operation times were significantly shorter in the SIDG group (170.8 ± 60.0 min vs. 186.1 ± 52.6 min, P = 0.004). The postoperative hospital length of stay was comparable between the 2 groups (SIDG: 5.9 ± 3.4 days vs. MLDG: 6.3 ± 5.1 days, P = 0.23), as was postoperative complication rate (SIDG: 13.4% vs. MLDG: 12.8%, P = 0.89)., Conclusions: SIDG was shown to be as safe and feasible as MLDG for overweight and obese gastric cancer patients, with comparable early postoperative complication rates without compromising operation time compared to MLDG., (© 2024. The Author(s).)

Background: In this comprehensive retrospective nationwide cohort study, we examined the relationships between various asthma medications and bone health, utilizing data from the National Health Insurance Service database of South Korea., Methods: From 2015 to 2019, the relevant dataset included 168,611 individuals aged 66 years, among whom 8,747 were diagnosed with asthma. We focused on a subset of 6,173 patients, all 66-year-old women. Participants were categorized into four groups: nonusers of asthma medication (n=2,868), leukotriene antagonist users (n=2,281), inhaled corticosteroid (ICS) users (n=517), and those using a combination of ICS and long-acting beta-agonist (ICS+LABA) medication (n=507). The primary outcomes measured were the incidences of major osteoporotic fractures and hip fractures during the follow-up period., Results: Over 2.7 years of follow-up, 615 cases of major osteoporotic fractures and 96 cases of hip fractures were recorded. ICS users exhibited a heightened risk of both injuries, with hazard ratios of 1.38 (95% confidence interval [CI], 1.18 to 1.63; P<0.001) for major osteoporotic fractures and 1.56 (95% CI, 1.33 to 1.83; P<0.001) for hip fractures. Similarly elevated risks were observed in the ICS+LABA group. Notably, the risk associated with ICS was particularly pronounced among patients with osteopenia for both fracture types. Overall, the use of ICS, alone or in combination with LABA, in patients with asthma is associated with significantly increased risks of osteoporotic fractures, especially among those with osteopenia., Conclusion: These findings underscore the importance of considering bone health when managing asthma, especially in older patients and those with existing bone density issues.

The only characteristic of alpha-synuclein (AS) accumulation in the gastrointestinal (GI) tract of Parkinson's disease (PD) found in pathological studies is the "rostrocaudal gradient," which describes the more frequent presence of AS accumulation in the upper GI tract than in the lower GI tract. This study aimed to determine the diagnostic accuracy and identify predictors of AS accumulation in the GI tract of PD patients. The frequency of AS accumulation in the GI tract was compared between PD patients (N = 97) who underwent radical GI surgery for cancer and individually matched controls (N = 94). We evaluated AS accumulation in the neural structures using phosphorylated AS immunohistochemistry. A multivariable logistic regression analysis was conducted to determine the predictors of AS accumulation in the GI tract of PD patients. The frequency of AS accumulation was significantly higher in PD patients (75.3%) than in controls (8.5%, p-value < 0.001). The sensitivity and specificity of the full-layer evaluation were 75.3% and 91.5%, respectively. When the evaluation was confined to the mucosal/submucosal layer, the sensitivity and specificity were 46.9% and 94.7%, respectively. The rostrocaudal gradient of AS accumulation was found in PD patients. The duration from symptom onset to surgery was significantly longer in PD patients with AS accumulation (4.9 ± 4.9 years) than in PD patients without AS accumulation (1.8 ± 4.1 years, p-value = 0.005). Both disease duration and rostrocaudal gradient independently predicted the presence of AS accumulation in the GI tract of PD patients. Our study suggests PD-related AS accumulation in the GI tract follows a temporally increasing but spatially static progression pattern., (© 2024. The Author(s).)

This comprehensive review critically examines the detrimental impacts of endocrine-disrupting chemicals (EDCs) on bone health, with a specific focus on substances such as bisphenol A (BPA), per- and polyfluoroalkyl substances (PFASs), phthalates, and dioxins. These EDCs, by interfering with the endocrine system's normal functioning, pose a significant risk to bone metabolism, potentially leading to a heightened susceptibility to bone-related disorders and diseases. Notably, BPA has been shown to inhibit the differentiation of osteoblasts and promote the apoptosis of osteoblasts, which results in altered bone turnover status. PFASs, known for their environmental persistence and ability to bioaccumulate in the human body, have been linked to an increased osteoporosis risk. Similarly, phthalates, which are widely used in the production of plastics, have been associated with adverse bone health outcomes, showing an inverse relationship between phthalate exposure and bone mineral density. Dioxins present a more complex picture, with research findings suggesting both potential benefits and adverse effects on bone structure and density, depending on factors such as the timing and level of exposure. This review underscores the urgent need for further research to better understand the specific pathways through which EDCs affect bone health and to develop targeted strategies for mitigating their potentially harmful impacts.

We investigated the potential association between ketonuria during treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors and its renoprotective effect in patients with type 2 diabetes. We included 192 patients who had received SGLT2 inhibitors for more than 6 months. After propensity score matching, 52 patients each were allocated into groups with or without ketonuria, respectively. The estimated glomerular filtration rate exhibited a significant improvement only in subjects with ketonuria (without ketonuria: mean difference, -0.02 mL/min/1.73 m2 [95% confidence interval (CI), -3.87 to 3.83 mL/min/1.73 m2] vs. with ketonuria: mean difference, 6.81 mL/min/1.73 m2 [95% CI, 3.16 to 10.46 mL/min/1.73 m2]; P<0.001). Improvement in estimated glomerular filtration rate at 6 months was associated with female sex and lower baseline body weight, blood pressure, and triglyceride levels in patients with ketonuria. In conclusion, the presence of ketonuria was associated with the renoprotective effect of SGLT2 inhibitors, and female sex and the absence of metabolic syndrome components may serve as additional indicators of these medications' substantial renoprotective effects in individuals with ketonuria.

Background: With the progressive increase in aging populations, the use of opportunistic computed tomography (CT) scanning is increasing, which could be a valuable method for acquiring information on both muscles and bones of aging populations., Objective: The aim of this study was to develop and externally validate opportunistic CT-based fracture prediction models by using images of vertebral bones and paravertebral muscles., Methods: The models were developed based on a retrospective longitudinal cohort study of 1214 patients with abdominal CT images between 2010 and 2019. The models were externally validated in 495 patients. The primary outcome of this study was defined as the predictive accuracy for identifying vertebral fracture events within a 5-year follow-up. The image models were developed using an attention convolutional neural network-recurrent neural network model from images of the vertebral bone and paravertebral muscles., Results: The mean ages of the patients in the development and validation sets were 73 years and 68 years, and 69.1% (839/1214) and 78.8% (390/495) of them were females, respectively. The areas under the receiver operator curve (AUROCs) for predicting vertebral fractures were superior in images of the vertebral bone and paravertebral muscles than those in the bone-only images in the external validation cohort (0.827, 95% CI 0.821-0.833 vs 0.815, 95% CI 0.806-0.824, respectively; P<.001). The AUROCs of these image models were higher than those of the fracture risk assessment models (0.810 for major osteoporotic risk, 0.780 for hip fracture risk). For the clinical model using age, sex, BMI, use of steroids, smoking, possible secondary osteoporosis, type 2 diabetes mellitus, HIV, hepatitis C, and renal failure, the AUROC value in the external validation cohort was 0.749 (95% CI 0.736-0.762), which was lower than that of the image model using vertebral bones and muscles (P<.001)., Conclusions: The model using the images of the vertebral bone and paravertebral muscle showed better performance than that using the images of the bone-only or clinical variables. Opportunistic CT screening may contribute to identifying patients with a high fracture risk in the future., (©Sung Hye Kong, Wonwoo Cho, Sung Bae Park, Jaegul Choo, Jung Hee Kim, Sang Wan Kim, Chan Soo Shin. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.07.2024.)

Background and Objectives: As a treatment modality for advanced knee osteoarthritis, total knee arthroplasty is well established and has been performed on many patients over time. To improve surgical outcomes, fixed-bearing implant insertion with robotic-assisted TKA has been introduced; however, the insertion of mobile-bearing (MB) implants with the same method is challenging. The aim of this study was to compare the short-term postoperative follow-up outcomes of MB implant insertion using a robotic-assisted TKA system and conventional TKA. Materials and Methods: We investigated functional improvement in the knees of 60 patients who underwent the insertion of MB implants using either robotic-assisted TKA or conventional TKA. Isokinetic muscular function, range of motion, the Western Ontario and McMaster Universities Osteoarthritis Index score, visual analog scale (VAS) score, and Knee Society Score (KSS) were measured 6 months after surgery. The statistical analysis of outcome measurements was performed using the Mann-Whitney U test and the Wilcoxon signed-rank test. Results: Some isokinetic muscular functions, as well as Knee Society Scores (pain and function) and VAS scores, were significantly higher in patients who underwent MB insertion with robotic-assisted TKA than in those who underwent conventional TKA. Conclusions: When an MB implant is inserted using a robotic-assisted TKA system, a better surgical outcome can be expected.

The aim of this study was to determine the effects of a novel app-based rehabilitation counselling program in patients recovering from total knee arthroplasty. In the app-based rehabilitation counselling program, a counselor provides one-on-one rehabilitation exercises and management-focused psychological counselling after total knee arthroplasty (TKA). This study included 42 patients, who were divided into three groups of 14 patients each: Group A, whose rehabilitation training was based on a guideline leaflet; Group B, whose rehabilitation was based on the app-based rehabilitation counselling program; and Group C, whose rehabilitation training was based on continuous passive motion combined with the app-based rehabilitation counselling program. To determine the effects of rehabilitation, the isokinetic knee muscle strength and knee joint range of motion were measured in addition to knee function tests such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analogue scale (VAS) for pain at two and three months after rehabilitation. The comparison of the means of the three groups was analyzed using one-way analysis of variance (ANOVA), with Group C showing significant variance in isokinetic knee muscle strength ( p < 0.05), passive ROM ( p < 0.01), and WOMAC ( p < 0.05) after three months. As a result, this study confirmed the positive potential of the app-based rehabilitation counselling program.

Background: Obesity is known to increase overall disease burden but does obesity management actually help reduce disease burden?, Objectives: To investigate the effects of weight loss on disease burden in people with obesity using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) in Korea., Setting: Pure longitudinal observational study using Nationwide cohort database., Methods: Out of 514,866 NHIS-HEALS cohort, participants with class II obesity in Asia-Pacific region (30 ≤ body mass index [BMI] < 35) who underwent health check-up provided by NHIS during 2003-2004 (index date) were included. All final participants continued to receive a total of 5 biennial health check-ups over the next 10 years without missing. A group-based trajectory model (GBTM) was used to categorize subjects based on 10-year BMI change patterns. The changes of co-morbidities, healthcare resource utilization, and medical cost were analyzed., Results: The final study subjects (9857) were categorized into 3 trajectory clusters based on the pattern of BMI (kg/m 2 ) change: maintenance (57.35%) with an average change of -.02 ± .06, loss (38.65%) with -.04 ± .08, and substantial loss (4.0%) with -.10 ± .18. The annual increases in the number of co-morbidities per subject in each cluster were .18, .18, and .16 (all P < .001), respectively. The increase of healthcare resource utilization over time was lowest for the substantial loss compared to maintenance and loss. With each passing year, the average annual total healthcare cost increased by ₩21,200 ($16.48, P = .034) and ₩10,500 ($8.16, P = .498) in the maintenance and loss, respectively, but decreased by ₩62,500 ($48.59, P = .032) in the substantial loss., Conclusions: Weight loss in people with obesity was associated with a reduced burden of disease, as evidenced by lower co-morbidity, healthcare resource utilization rate, and decreased medical costs. This study highlights the potential positive long-term impact on Korean society when actively managing weight in individuals with obesity., (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)