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Prolactinomas are the most prevalent type of pituitary neuroendocrine adenomas, primarily affecting women of reproductive age. Unlike other pituitary tumors, the first-line management has traditionally been pharmacological rather than surgical. This preference is due to the effectiveness of dopamine agonists (DAs), which typically reduce tumor size and normalize prolactin levels in most patients. However, this does not imply that there is no room for improvement; the duration of treatment and medication side effects often lead to compliance issues among patients. Recent advances in surgical techniques and molecular biology have paved the way for the development of precision medicine, allowing for more flexible and personalized treatment strategies for prolactinomas. This review aims to enhance clinical decision-making and patient care for endocrinologists by focusing on several key factors: predictive markers of DA sensitivity, clinical characteristics and suitability for transsphenoidal adenomectomy as a potential first-line treatment, factors determining the successful withdrawal of DAs after prolonged use, safety concerns during pre/post-pregnancy and breastfeeding, and determinants of tumor aggressiveness. Through tailored therapy—a patient-focused, multidisciplinary approach— we aim to improve the management of prolactinoma patients.

Abstract Understanding emotional states is pivotal for the development of next-generation human-machine interfaces. Human behaviors in social interactions have resulted in psycho-physiological processes influenced by perceptual inputs. Therefore, efforts to comprehend brain functions and human behavior could potentially catalyze the development of AI models with human-like attributes. In this study, we introduce a multimodal emotion dataset comprising data from 30-channel electroencephalography (EEG), audio, and video recordings from 42 participants. Each participant engaged in a cue-based conversation scenario, eliciting five distinct emotions: neutral, anger, happiness, sadness, and calmness. Throughout the experiment, each participant contributed 200 interactions, which encompassed both listening and speaking. This resulted in a cumulative total of 8,400 interactions across all participants. We evaluated the baseline performance of emotion recognition for each modality using established deep neural network (DNN) methods. The Emotion in EEG-Audio-Visual (EAV) dataset represents the first public dataset to incorporate three primary modalities for emotion recognition within a conversational context. We anticipate that this dataset will make significant contributions to the modeling of the human emotional process, encompassing both fundamental neuroscience and machine learning viewpoints.

Summary: Pituitary adenoma-induced excess endocrine growth hormone (GH) secretion can lead to breast cancer development and metastasis. Herein, we used an acromegaly mouse model to investigate the role of excess endocrine GH on triple-negative breast cancer (TNBC) growth and metastasis. Additionally, we aimed to elucidate the molecular mechanism of transcription factor 20 (TCF20)/nuclear factor erythroid 2-related factor 2 (NRF2) signaling-mediated aggressiveness and metastasis of TNBC. Excess endocrine GH induced TCF20 activates the transcription of NRF2 and NRF2-target genes to facilitate TNBC metastasis. Inhibition of GH receptor (GHR) and TCF20 activity using the GHR antagonist or small-interfering RNA-induced gene knockdown resulted in reduced tumor volume and metastasis, suggesting that excess endocrine GH stimulates TCF20/NRF2 pathways in TNBC and promotes metastasis to the lung. GHR inhibitors present an effective therapeutic strategy to prevent TNBC cell growth and metastasis. Our findings revealed functional and mechanistic roles of the GH-TCF20-NRF2 signaling axis in TBNC progression.

Highlights A scalable tape-casting method produces self-supported porous Li6.4La3Zr1.4Ta0.6O12. Combining the in-situ polymerization approach, a composite solid electrolyte with superior electrochemical properties is fabricated. Solid-state Li|CSE|LiNi0.8Co0.1Mn0.1O2 cells show remarkable cyclability and rate capability. LiF-and B-rich interphase layers mitigate interfacial reactions, enhancing solid-state battery performance.

(1) Background: Dental glass–ceramics shrink during crystallization, complicating restoration manufacturing. Thermo-pressure molding was introduced to address this, with lithium disilicate crystals providing high strength. Residual tensile stresses can influence the chipping strength of single tooth crowns. (2) Methods: Insync dentine was layered onto three lithia-based disilicate core ceramics (Amber Press, IPS e.max Press) for microtensile bond strength tests. The Vickers test assessed the residual tensile stress and interfacial bonding. Porcelain-veneered posterior ceramic crowns were fabricated and subjected to axial loading, measuring fracture loads (three per group). (3) Results: A chemical bonding layer formed at the interface, which was thicker in the Insync-IPS e.max Press and increased with more firings. The ultimate tensile bond strength was 28.5 MPa for the four-times-fired Insync-Amber Press, similar to the twice-fired Insync-IPS e.max Press. No residual tensile stress was found in the Insync-Amber Press; the Insync-IPS e.max Press showed crack growth within 250 μm of the bonded interface. The average fracture resistance was twice as high for the Insync-Amber Press. (4) Conclusions: The Insync-Amber Press exhibited better thermal harmony with no crack growth, while the IPS e.max Press showed crack growth due to residual tensile stress. Insync-Amber Press posterior ceramic crowns had significantly greater fracture resistance than Insync-IPS e.max Press crowns.

Nuclear power plants are subjected to various processes during decommissioning, including cutting, decontamination, disposal, and treatment. The cutting of massive bio-shields is a significant step in the decommissioning process. Cutting is performed near the target structure, and during this process, workers are exposed to potential radioactive elements. However, studies considering worker exposure management during such cutting operations are limited. Furthermore, dismantling a nuclear power plant under certain circumstances may result in the unnecessary radiation exposure of workers and an increase in secondary waste generation. In this study, a cutting scenario was formulated considering the bio-shield as a representative structure. The specifications of a standard South Korean radioactive waste disposal drum were used as the basic conditions. Additionally, we explored the hot-to-cold and cold-to-hot methods, with and without the application of polishing during decontamination. For evaluating various scenarios, different cutting time points up to 30 years after permanent shutdown were considered, and cutting speeds of 1–10nullm2/h were applied to account for the variability and uncertainty attributable to the design output and specifications. The obtained results provide fundamental guidelines for establishing cutting methods suitable for large structures.

Abstract Background Chronic subdural hematoma (CSDH) is a common clinical situation in neurosurgical practice, but the optimal treatment option is controversial. This study aimed to evaluate the effect of cholesterol-lowering medications on and how they affected the prognoses of CSDH patients. Methods In this multi-institutional observational study performed in Korea, data from recently treated CSDH patients were gathered from 5 hospitals. A total of 462 patients were collected from March 2010 to June 2021. Patient clinical characteristics, history of underlying diseases and their treatments, radiologic features, and surgical outcomes were analyzed. Results Seventy-five patients experienced recurrences, and 62 had reoperations after the initial burr hole surgery. Among these, 15 patients with recurrences and 12 with reoperations were taking cholesterol-lowering medications. However, the use of medications did not significantly affect recurrence or reoperation rates (P = 0.350, P = 0.336, respectively). When analyzed by type of medication, no clinically relevant differences in total cholesterol (TC), triglyceride (TG), or low-density lipoprotein cholesterol (LDL-C) levels were identified. The combination of a statin drug and ezetimibe significantly elevated high-density lipoprotein cholesterol (HDL-C) levels (P = 0.004). TC, LDL-C, and TG levels did not significantly affect patient prognoses. However, HDL-C levels and recurrence (odds ratio (OR) = 0.96; 95% confidence interval (CI): 0.94–0.99; p = 0.010) were negatively correlated. An HDL-C level of 42.50 mg/dL was identified as the threshold for recurrence and reoperation. Conclusions In this study, using cholesterol-lowering medications did not significantly impact the prognosis of patients who underwent surgical management for a chronic subdural hematoma. However, the findings showed that the higher the HDL-C level, the lower the probability of recurrence and reoperation.

PURPOSE The purpose of this study was to identify a sport-specific assessment for elite race walking athletes by comparing physiological responses to different types of walking graded exercise test (GTX) protocols. METHODS Six elite race walking athletes completed two types of walking protocols in a randomized crossover design with 1 week of interval between trials. Exercise time, oxygen uptake (VO2), ventilation (VE), and heart rate (HR) were measured in each trial; the lactate level was measured during the recovery period. RESULTS VO2, VE, and HR differed significantly between the trials (p

Four imidazolium-based ionic liquids (ILs) with two cations 1-pentyl-3-butylimidazolium [PBIM]+ and 1-benzyl-3-butylimidazolium tetrafluoroborate [BzBIM]+, and two anions tetrafluoroborate (BF4−) and trifluoromethanesulfonate (OTf−) were synthesized for NH3 solubility enhancement. The structural, thermal, and electrochemical stabilities, ionic conductivity, and viscosity of the four ILs, namely, [PBIM]BF4, [BzBIM]BF4, [PBIM]OTf, and [BzBIM]OTf, were investigated. Due to the intermolecular interaction of the benzyl group attached to the imidazolium ring, [BzBIM]+-based ILs exhibited higher thermal stability but lower ionic conductivity compared to [PBIM]+-based ILs. Further, the NH3 solubility in all ILs was measured using a custom-made setup at temperatures ranging from 293.15 to 323.15 K and pressures ranging from 1 to 5 bar. The effects of the cation and anion structures of ILs, as well as pressure and temperature, on the NH3 solubility in the ILs were also investigated. [PBIM]BF4 showed the best solubility because of its high free volume and low viscosity. Density functional calculations validated the superior NH3 solubility in [PBIM]BF4, attributable to the minimal reorganization of the [cation]anion complex geometry during the solvation process, yielding a low solvation free energy. The findings of this study suggest that ILs exhibit a high NH3 solubility capacity and cation and anion structures considerably affect the NH3 solubility in ILs.

The temperature distribution of the reactor pool under natural circulation induced by the RVACS operation was experimentally studied. According to the Bo’ based similarity law, which could reproduce the temperature distribution of the working fluid under natural circulation, SINCRO-2D facility was designed based on the PGSFR. It was reduced to 1 : 25 in length scale, having water as a simulant of the sodium, which is the original working fluid. In general, temperature was stratified, however, effect of the natural circulation flow could be observed by the entrainment of the stratified temperature. Relative cooling contribution of the upper plenum (narrow gap) and lower plenum was approximately 0.2 and 0.8, respectively. In the range of decay heat from 0.2% to 1.0%, only the magnitude of the temperature was changed, while the normalized temperature maintained. Boundary temperature distribution change made a global temperature offset of the pool, without a significant local change. Therefore, the decay heat and cooling boundary condition had no significant effect on temperature distribution characteristics of the pool within the given range of the decay heat and boundary temperature distribution.

The thermal cutting of contaminated or activated metals during decommissioning nuclear power plants inevitably results in the release of radioactive aerosol. Since radioactive aerosols are pernicious particles that contribute to the internal dose of workers, air conditioning units with a HEPA filter are used to remove radioactive aerosols. However, a HEPA filter cannot be used permanently. This study evaluates the efficiency and lifetime of filters in actual metal cutting condition using a plasma arc cutter and a high-resolution aerosol detector. The number concentration and size distribution of aerosols from 6 nm to 10 μm were measured on both the upstream and downstream sides of the filter. The total aerosol removal efficiency of HEPA filter satisfies the standard of removing at least 99.97% of 0.3 μm airborne particles, even if the pressure drop increases due to dust feeding load. The pressure drop and particle size removal efficiency at 0.3 μm of the HEPA filter were found to increase with repeated cutting experiments. By contrast, the efficiency of used HEPA filter reduced in removing nano-sized aerosols by up to 79.26%. Altogether, these results can be used to determine the performance guidance and replacement frequency of HEPA filters used in nuclear power plants.

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant morbidity and mortality worldwide. Despite a successful vaccination programme, the emergence of mutated variants that can escape current levels of immunity mean infections continue. Herein, we report the development of CT-P63, a broad-spectrum neutralizing monoclonal antibody. In vitro studies demonstrated potent neutralizing activity against the most prevalent variants, including Delta and the BA.1 and BA.2 sub-lineages of Omicron. In a transgenic mouse model, prophylactic CT-P63 significantly reduced wild-type viral titres in the respiratory tract and CT-P63 treatment proved efficacious against infection with Beta, Delta, and Omicron variants of SARS-CoV-2 with no detectable infectious virus in the lungs of treated animals. A randomized, double-blind, parallel-group, placebo-controlled, Phase I, single ascending dose study in healthy volunteers (NCT05017168) confirmed the safety, tolerability, and pharmacokinetics of CT-P63. Twenty-four participants were randomized and received the planned dose of CT-P63 or placebo. The safety and tolerability of CT-P63 were evaluated as primary objectives. Eight participants (33.3%) experienced a treatment-emergent adverse event (TEAE), including one grade ≥3 (blood creatine phosphokinase increased). There were no deaths, treatment-emergent serious adverse events, TEAEs of special interest, or TEAEs leading to study drug discontinuation in the CT-P63 groups. Serum CT-P63 concentrations rapidly peaked before declining in a biphasic manner and systemic exposure was dose proportional. Overall, CT-P63 was clinically safe and showed broad-spectrum neutralizing activity against SARS-CoV-2 variants in vitro and in vivo.

The RVACS is a versatile and robust safety system driven by two natural circulations: in-vessel coolant and ex-vessel air. To observe interaction between the two natural circulations, SINCRO-IT facility was designed with two different similarity laws simultaneously. Bo’ based similarity law was employed for the in-vessel, while Ishii’s similarity law for the ex-vessel excluding the radiation. Compared to the prototype, the sodium and air system, SINCRO-IT was designed with Wood’s metal and air, having 1:4 of the length reduction, and 1.68:1 of the time scale ratio. For the steady state, RV temperature limit was violated at 0.8% of the decay heat, while the sodium boiling was predicted at 1.3%. It showed good accordance with the system code, TRACE. For an arbitrary re-criticality scenario with RVACS solitary operation, sodium boiling was predicted at 25,100 s after power increase from 1.0 to 2.0%, while the system code showed 30,300. Maximum temperature discrepancy between the experiments and system code was 4.2%. The design and methodology were validated by the system code TRACE in terms of the convection, and simultaneously, the system code was validated against the simulating experiments SINCRO-IT. The validated RVACS model could be imported to further accident analysis.

ABSTRACTThe International Maritime Organization is making multiple efforts to reduce greenhouse gas and air pollutant emissions. However, it is difficult to achieve this because of the absence of technological developments. Consequently, there is an urgent need to develop alternative fuels. In this study, marine gas oil and biodiesel were blended at ratios of 0%, 5%, 10%, and 20% to assess their applicability to ships (Component analysis, metal corrosion, and storage stability) and potential for emission reduction (engine performance, environmental effects, and engine durability). The composition of the test fuels meet the ISO 8217:2017 standard. Metal corrosion was insignificant for carbon steel, iron, aluminum, and nickel, but not copper. Storage stability showed no sludge generation or fuel separation, although biodiesel experienced some discoloration owing to its high oxygen content. Engine performance showed no significant differences between marine gas oil and biodiesel. Emissions of NOx increased with higher biodiesel blending ratios, whereas SOx, CO, CO2, and Total hydro carbons decreased. Engine durability was good throughout the 160 hours sea trial. This study demonstrated that even at a 20% biodiesel blending ratio exceeding the 7% ratio suggested by ISO 8217:2017, can be safely used as a long-term marine fuel.

The study aimed to investigate the antioxidant and antidiabetic activity of Brugmansia arborea L. flower extracts, solvent fractions, and isolated compounds. B. arborea L flowers were extracted with aqueous methanol, and concentrated extract was successively partitioned into EtOAc, n-BuOH, and H2O fractions. Repeated silica gel and octadecyl silica gel column chromatographies for EtOAc and n-BuOH fractions led to the isolation of a new phenylalkyl glycoside (6), along with five known ones. Several spectroscopic data led to the structure determination of one new phenylalky glycoside as brugmansioside C (named) (6) and five known ones as benzyl-O-β-D-glucopyranoside (1), benzyl-O-β-D-glucosyl-(1→6)-β-D-glucopyranoside (2), 2-phenylethyl-O-β-D-glucopyranoside (3), 2-phenylethyl-O-β-D-glucosyl-(1→6)-β-D-glucopyranoside (4), and 3-phenylpropyl-O-β-D-glucopyranoside (5). The five known ones (1–5) were isolated from B. arborea flowers for the first time in this study. The extract, solvent fractions, and all isolated compounds showed radical scavenging activities using ABTS radical, and EtOAc fraction showed the highest scavenging capacity, whereas compounds 2, 4, and 6 did not display the capacity to use the DPPH radical. The extract, solvent fractions, and all isolated compounds showed a protective effect on pancreatic islets damaged by alloxan treatment in zebrafish larvae. The pancreatic islet size treated with EtOAc, n-BuOH fractions, and all compounds significantly increased by 64.0%, 69.4%, 82.0%, 89.8%, 80.0%, 97.8%, 103.1%, and 99.6%, respectively, compared to the alloxan-induced group. These results indicate that B. arborea flowers and their isolated compounds are useful as potential antioxidant and antidiabetic agents.

Abstract Background Mini-screws are widely used as temporary anchorages in orthodontic treatment, but have the disadvantage of showing a high failure rate of about 10%. Therefore, orthodontic mini-screws should have high biocompatibility and retention. Previous studies have demonstrated that the retention of mini-screws can be improved by imparting bioactivity to the surface. The method for imparting bioactivity proposed in this paper is to sequentially perform anodization, periodic pre-calcification, and heat treatments with a Ti–6Al–4V ELI alloy mini-screw. Materials and methods A TiO2 nanotube-structured layer was formed on the surface of the Ti–6Al–4V ELI alloy mini-screw through anodization in which a voltage of 20 V was applied to a glycerol solution containing 20 wt% H2O and 1.4 wt% NH4F for 60 min. Fine granular calcium phosphate precipitates of HA and octacalcium phosphate were generated as clusters on the surface through the cyclic pre-calcification and heat treatments. The cyclic pre-calcification treatment is a process of immersion in a 0.05 M NaH2PO4 solution and a saturated Ca(OH)2 solution at 90 °C for 1 min each. Results It was confirmed that the densely structured protrusions were precipitated, and Ca and P concentrations, which bind and concentrate endogenous bone morphogenetic proteins, increased on the surface after simulated body fluid (SBF) immersion test. In addition, the removal torque of the mini-screw fixed into rabbit tibias for 4 weeks was measured to be 8.70 ± 2.60 N cm. Conclusions A noteworthy point in this paper is that the Ca and P concentrations, which provide a scaffold suitable for endogenous bone formation, further increased over time after SBF immersion of the APH group specimens. The other point is that our mini-screws have a significantly higher removal torque compared to untreated mini-screws. These results represent that the mini-screw proposed in this paper can be used as a mini-screw for orthodontics.

Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare, serious complication after adenoviral COVID-19 vaccine administration that can involve various organ systems. We aimed to investigate the clinical significance of hepatosplenic thrombosis in patients with VITT. Methods: We searched PubMed ePubs, Scopus, Embase, and Web of Science databases for studies published until April 28, 2021, involving patients with VITT after ChAdOx1 nCoV-19 vaccination. Demographic and clinical characteristics, including laboratory measurements, were collected and compared. Results: Four case series and three case reports involving 48 cases of VITT were included. Hepatosplenic thrombosis was present in 8 cases (17%). Patients with hepatosplenic thrombosis had lower platelet counts (13,000 vs. 29,500/μL, p=0.016) and higher D-dimer levels (140.0 vs. 57.3 times upper limit of normal range, p=0.028). Multiple-site thrombosis was also associated with hepatosplenic thrombosis (88% vs. 15%, p

The downward discharge of the molten fuel to the lower structure of the fuel assembly could increase of the pressure drop and degrade of coolability of the assembly. To analyze the phenomena, experiments for the generation of the debris bed were conducted as LOF-DT series. Based on the debris bed in the LOF-DT, pressure drop experiment was conducted with intact and blocked component. Parametric study on the pressure drop was conducted by CFD. The LOF-DT experiments were conducted for the position and porosity of the debris bed. 85% of the debris were sedimented in the lower reflector, and 15% were in the nose piece, approximately. Porosity of the debris bed were about 0.7 and 0.85 in the lower reflector and nose piece, respectively. Pressure drop increased significantly with debris bed, especially in the lower reflector. More than 120 time of the pressure drop increased in the lower reflector, while only 10% increased in the nose piece. According to the parametric study, mass of the debris was the most important for pressure drop. The lower discharge phenomena could have a significant effect to the total pressure drop of the fuel assembly, approximately 10.8 times for the base case.

Curcumin (CM), demethoxycurcumin (DMC), and bisdemethoxycurcumin (BDMC) are major curcumin derivatives found in the rhizome of turmeric (Curcuma longa L.), and have yielded impressive properties to halt various diseases. In the present study, we carried out a method validation for curcumin derivatives and analyzed the contents simultaneously using HPLC with UV detection. For validation, HPLC was used to estimate linearity, range, specificity, accuracy, precision, limit of detection (LOD), and limit of quantification (LOQ). Results showed a high linearity of the calibration curve, with a coefficient of correlation (R2) for CM, DMC, and BDMC of 0.9999, 0.9999, and 0.9997, respectively. The LOD values for CM, DMC, and BDMC were 1.16, 1.03, and 2.53 ng/μL and LOQ values were 3.50, 3.11, and 7.67 ng/μL, respectively. Moreover, to evaluate the ability of curcumin derivatives to reduce liver lipogenesis and compare curcumin derivatives’ therapeutic effects, a HepG2 cell model was established to analyze their hepatoprotective properties. Regarding the in vivo study, we investigated the effect of DMC, CM, and BDMC on nonalcoholic fatty liver disease (NAFLD) caused by a methionine choline deficient (MCD)-diet in the C57BL/6J mice model. From the in vitro and in vivo results, curcumin derivatives alleviated MCD-diet-induced lipid accumulation as well as high triglyceride (TG) and total cholesterol (TC) levels, and the protein and gene expression of the transcription factors related to liver adipogenesis were suppressed. Furthermore, in MCD-diet mice, curcumin derivatives suppressed the upregulation of toll-like receptors (TLRs) and the production of pro-inflammatory cytokines. In conclusion, our findings indicated that all of the three curcuminoids exerted a hepatoprotective effect in the HepG2 cell model and the MCD-diet-induced NAFLD model, suggesting a potential for curcuminoids derived from turmeric as novel therapeutic agents for NAFLD.

Purpose: To investigate the association between intraocular pressure (IOP) and serum testosterone according to the severity of obesity. Materials and Methods: We investigated the correlation of IOP-testosterone according to the anthropometric obesity indices, such as obesity index (OI), body mass index (BMI), and waist circumference to height ratio (WtHR). Each of the obesity indices was classified into three groups: normal, overweight, and obesity. In additional, the association of IOP-testosterone was compared between testosterone 3.0 ng/mL below and above. Results: Total of 3,949 participants, the mean age was 58.86±10.06 years, mean IOP was 14.40±2.61 mmHg, mean arterial blood pressure (MAP) was 93.67±11.47 mmHg, and mean serum testosterone was 4.21±1.83 ng/mL. The association of MAP and IOP was significantly positively correlated according to the severity of obesity, but testosterone showed a significant negative relationship (p

Purpose We analyzed the characteristics and outcomes of patients with bicycle-related injuries at a regional trauma center in northern Gyeonggi Province as a first step toward the development of improved prevention measures and treatments. Methods The records of 239 patients who were injured in different types of bicycle-related accidents and transported to a single regional trauma center between January 2017 and December 2018 were examined. This retrospective single-center study used data from the Korea Trauma Database. Results In total, 239 patients experienced bicycle-related accidents, most of whom were males (204, 85.4%), and 46.9% of the accidents were on roads for automobiles. Forty patients (16.7%) had an Injury Severity Score (ISS) of 16 or more. There were 125 patients (52.3%) with head/neck/face injuries, 97 patients (40.6%) with injuries to the extremities, 59 patients (24.7%) with chest injuries, and 21 patients (8.8%) with abdominal injuries. Patients who had head/neck/face injuries and an Abbreviated Injury Score (AIS) ≥3 were more likely to experience severe trauma (ISS ≥16). In addition, only 13 of 125 patients (10.4%) with head/neck/face injuries were wearing helmets, and patients with injuries in this region who were not wearing helmets had a 3.9-fold increased odds ratio of severe injury (AIS ≥2). Conclusions We suggest that comprehensive accident prevention measures, including safety training and expansion of safety facilities, should be implemented at the governmental level, and that helmet wearing should be more strictly enforced to prevent injuries to the head, neck, and face.

BackgroundRegional anesthesia is increasingly used in acute postoperative pain management. Ultrasound has been used to facilitate the performance of the regional block, increase the percentage of successfully performed procedures and reduce the complication rate. Artificial intelligence (AI) has been studied in many medical disciplines with achieving high success, especially in radiology. The purpose of this review was to review the evidence on the application of artificial intelligence for optimization and interpretation of the sonographic image, and visualization of needle advancement and injection of local anesthetic.MethodsTo conduct this scoping review, we followed the PRISMA-S guidelines. We included studies if they met the following criteria: (1) Application of Artificial intelligence-assisted in ultrasound-guided regional anesthesia; (2) Any human subject (of any age), object (manikin), or animal; (3) Study design: prospective, retrospective, RCTs; (4) Any method of regional anesthesia (epidural, spinal anesthesia, peripheral nerves); (5) Any anatomical localization of regional anesthesia (any nerve or plexus) (6) Any methods of artificial intelligence; (7) Settings: Any healthcare settings (Medical centers, hospitals, clinics, laboratories.ResultsThe systematic searches identified 78 citations. After the removal of the duplicates, 19 full-text articles were assessed; and 15 studies were eligible for inclusion in the review.ConclusionsAI solutions might be useful in anatomical landmark identification, reducing or even avoiding possible complications. AI-guided solutions can improve the optimization and interpretation of the sonographic image, visualization of needle advancement, and injection of local anesthetic. AI-guided solutions might improve the training process in UGRA. Although significant progress has been made in the application of AI-guided UGRA, randomized control trials are still missing.

Background/Aims Beta-blockers (BBs) have been shown to improve clinical outcomes in heart failure (HF) patients. We evaluated the prescribing status of BBs in patients with HF with reduced ejection fraction (HFrEF) at discharge according to the presence or not of bradycardia, and its effect on prognosis. Methods Study data were obtained from a multicenter cohort of 3,200 patients hospitalized for HF. Patients were classified into four groups according to the presence of bradycardia and use of BBs at discharge. The primary outcome was the incidence of all-cause death during follow-up. Results Of 1,584 patients with HFrEF, 281 patients died during follow-up (median 523 days, mean 578.5 ± 429.7 days). In patients with bradycardia, the all-cause death rate did not significantly differ according to the use of BBs, but in those patients without bradycardia, the incidence of all-cause death was significantly lower in the BBs group than the no BBs group. Among these four groups, patients with heart rate (HR) ≥ 60 beats/min with no BBs group had the lowest cumulative death-free survival rate. In addition, HR ≥ 60 beats/min with BBs use was independently associated with a 31% reduced risk of all-cause death in patients with HFrEF. Conclusions BBs had a beneficial effect on clinical prognosis only in those HFrEF patients without bradycardia. Therefore, BBs should be given by clinicians to HF patients without bradycardia to improve their clinical outcomes.

To regulate the safety protocols in nuclear facilities, radioactive aerosols have been extensively researched to understand their health impacts. However, most measured particle-size distributions remain at low resolutions, with the particle sizes ranging from nanometer to micrometer. This study combines the high-resolution detection of 500 size classes, ranging from 6 nm to 10 μm, for aerodynamic diameter distributions, with a regional lung deposition calculation. We applied the new approach to characterize particle-size distributions of aerosols generated during the plasma arc cutting of simulated non-radioactive steel alloy wastes. The high-resolution measured data were used to calculate the deposition ratios of the aerosols in different lung regions. The deposition ratios in the alveolar sacs contained the dominant particle sizes ranging from 0.01 to 0.1 μm. We determined the distribution of various metals using different vapor pressures of the alloying components and analyzed the uncertainties of lung deposition calculations using the low-resolution aerodynamic diameter data simultaneously. In high-resolution data, the changes in aerosols that can penetrate the blood system were better captured, correcting their potential risks by a maximum of 42%. The combined calculations can aid the enhancement of high-resolution measuring equipment to effectively manage radiation safety in nuclear facilities.

Acne vulgaris is a common skin disease characterized by increased sebum production, inflammation, and Cutibacterium acnes (CA: formerly Propionibacterium acnes) hyperproliferation in pilosebaceous follicles. This study evaluated the efficacy of FRO, a formula composed of fermented Rhus verniciflua Stokes and Orostachys japonicus, against acne pathogenesis via antimicrobial assessment and an in vitro analysis. Stimulated model cells treated with hormones, CA, or lipopolysaccharide (LPS) were designed based on the characteristics of acne pathogenesis, including inflammation and sebum hypersecretion. High-performance liquid chromatography, disc diffusion, MTS, and western blotting assays were used to examine potential anti-acne effects. FRO was determined to contain phenolics such as gallic acid, fisetin, quercetin, and kaempferol. FRO exerted antimicrobial activity against CA and inhibited reactive oxygen species production that was otherwise increased by LPS or CA in HaCaT cells. Additionally, FRO exerted anti-inflammatory effects by inhibiting iNOS, TNF-α, IL-6, p-STAT-3, and p-NF-κB, which were previously upregulated by LPS or CA in THP-1 and HaCaT cells. FRO inhibited lipogenesis induced by steroid hormones and CA by decreasing FAS and SREBP-1 levels in sebocytes. Additionally, FRO down-regulated the androgen receptor, 5α-reductase, SREBP-1, and FAS levels, which were upregulated by steroid hormone in LNCaP cells. Taken together, our findings suggest that FRO alleviates acne by inhibiting the growth of CA, inflammation, and excess sebum and could be used for functional cosmetics or acne treatments.

Introduction and objective: The purpose of this study was to compare the severity of lower urinary tract symptoms (LUTS) between patients with and without premature ejaculation (PE). Materials and method: The relationship between the severity of LUTS and PE was investigated among 825 male subjects, who underwent medical check-up between July 2013 and July 2018 in our hospital. PE was defined by self-reported intravaginal ejaculation latency time (IELT). The severity of LUTS was determined by international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), transrectal ultrasonography (TRUS), and uroflow rate. A total of 825 subjects were classified into three groups: PE-group (N = 60), Self-reported PE-group (N = 353), and Non-PE group (N = 412). Results: In comparison analysis involving the two groups, the PE-group and the Self-reported PE-group were analyzed to be statistically significantly higher in IPSS items and OABSS items, compared to the Non-PE group (P < 0.05). This showed the same results in the univariate analysis (P < 0.05). Multivariate analysis conducted with the PE-group versus the Non-PE group, and the Self-reported PE-group versus the Non-PE group, revealed significant differences in the values of total IPSS (P < 0.05). Conclusion: Comparison between the PE-group, which included the Self-reported PE-group, and the Non-PE group suggest that the severity of LUTS was comparatively higher in the PE-group. Thus, it is thought that being associated with or without PE may be a significant factor to consider, which affects LUTS severity.

Lower urinary tract symptoms (LUTS) are a cluster of voiding symptoms, such as weak stream, hesitancy, intermittency, urinary frequency, urgency, and nocturia. LUTS are frequent in elderly men and it considered the ultimate clinical symptoms of benign prostatic hyperplasia. With aging, male hypogonadism is increased which is defined as decreased ability of the testes to produce sperm and sex steroids because of a pituitary/hypothalamic, or testicular deficiency. In academic andrology associations, the term “male hypogonadism” is commonly used to categorize testosterone deficiency. Testosterone deficiency syndrome (TDS) is defined as a decrease in serum testosterone accompanied by symptoms such as libido decrease, depressive disorder, erectile dysfunction, and fatigue. Although the mechanism about testosterone-replacement therapy (TRT) effects on men with hypogonadism is not yet identified, TRT has been shown to effectively relieve the symptoms of TDS as well as LUTS by several studies. Although the present review demonstrates the effectiveness and safety of TRT in men with TDS by prior studies, future large scale of clinical trials should be conducted to present more high-quality evidence to clinicians and patients.

Background: Dental caries and periodontal disease are bacterial infectious disease, mainly caused by plaque, a bacterial colony deposited on the tooth surface and gum tissue. Dental plaque disclosants easily stain the dental plaque, making them effective for scaling and tooth brushing education. As the erythrosine typically contained in dental plaque disclosants is highly cytotoxic, a low toxicity additive is needed. In this study, we aimed to examine the natural pigments with negligible cytotoxicity but can effectively stain the dental plaques for use in dental plaque disclosants.Methods: The pigmentation of eight types of natural pigments was tested on bovine tongue and teeth, as well as on head and neck tissue sections of experimental ICR mice. The cytotoxicity of gingival epithelial cells was measured via MTT assay. Pigmentation was performed on the bovine tongue and tooth surface. Pigmentation in the oral environment was observed in four mandibular incisors. A 2 Tone was used as a control.Results: Of the eight types of natural pigments, purple and blue pigments were effective in coloring dental plaques on the enamel surface as well as in the head and neck tissue sections. Additionally, purple and blue pigments were visible on the surface of the bovine tongue. Red, pink, orange, green, purple, and yellow pigments showed strong cytotoxicity, whereas brown and blue pigments had relatively low cytotoxicity. Blue pigment was effective in staining the dental plaque of four mandibular incisors. Conclusion: We suggest that the blue pigment derived from Gardenia jasminoides Ellis (Rubiaceae), which is effective for coloring dental plaques and has low cytotoxicity, is useful as a naturally derived dental disclosant.

Abstract Hypokalemia is a common electrolyte disturbance and is related to poor prognosis in patients with cardiovascular disease. However, the role of hypokalemia in patients with vasospastic angina (VSA) has not yet been studied. The present study enrolled 1454 patients diagnosed with VSA according to ergonovine provocation test results and available admission serum potassium data. The primary outcome was a composite of cardiac death, acute coronary syndrome, and new-onset life-threatening arrhythmia. Based on a hypokalemia definition as serum potassium concentration ≤ 3.5 mEq/L, the hypokalaemia group included 70 patients (4.8%). The median potassium levels were 3.4 mEq/L [interquartile range (IQR) 3.3–3.5] in the hypokalemia group and 4.1 mEq/L (IQR 3.9–4.3) in the no-hypokalemia group. The median follow-up duration was 764 days. Primary outcomes occurred in seven patients (10.0%) in the hypokalemia group and 51 patients (3.7%) in the no-hypokalemia group. The Kaplan–Meier analysis showed a higher cumulative incidence of primary outcomes in the hypokalemia group compared to that in the no-hypokalemia group (log-rank P = 0.014). Multivariate Cox regression analysis also showed that hypokalemia was an independent predictor of primary outcomes. In conclusion, hypokalemia at admission was associated with adverse clinical outcomes in VSA.

Background/Aims Calcium channel blockers (CCBs) are the most widely prescribed medication for patients with vasospastic angina (VA). However, few studies have compared the prognosis of VA patients who are prescribed different CCBs. Methods We enrolled 2,960 patients who received provocation test prospectively in 11 university hospitals in Korea. We divided 1,586 patients received four major CCBs into two groups: a first generation CCB (diltiazem and nifedipine) group and a second generation CCB (amlodipine and benidipine) group. Primary outcome was time to events of composite of death from any cause, acute coronary syndrome (ACS) and symptomatic arrhythmia during 3-year follow-up. We also compared the effect of each CCB on the control of angina symptoms. Results There was no difference of the primary outcome among the two groups with a cumulative incidence rate of 5.4%, 2.9%, and a person-month incidence rate of 2.33 and 1.26, respectively (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.25 to 1.17; p = 0.120, as reference with the 1st generation CCBs). The incidence of ACS was significantly lower in 2nd generation CCBs group with a person-month incidence rate of 1.66 vs. 0.35 (HR, 0.22; 95% CI, 0.05 to 0.89; p = 0.034). Use of benidipine showed a significant better control of angina symptom compared with diltiazem for 3 years (odds ratio, 0.17; 95% CI, 0.09 to 0.32; p < 0.0001 at 3rd year). Conclusions The first and second generation CCB groups did not differ in terms of composite outcome occurrence. However, the ACS incidence rate was significantly lower in the users of the 2nd generation CCBs.

Background: The formation of a nanotube layer on a titanium nanotube (N-Ti) plate facilitates an active reaction between bone cells and the material surface via efficient delivery of the surface materials of the dental implant into the tissues. Studies have reported that Korean Red Ginseng extracts (KRGEs) are involved in a variety of pharmacological activities: we investigated whether implantation with a KRGE-loaded N-Ti miniimplant affects osteogenesis and osseointegration. Methods: KRGE-loaded nanotubes were constructed by fabrication on pure Ti via anodization, and MC3T3-E1 cells were cultured on the N-Ti. N-Ti implants were subsequently placed on a rat's edentulous mandibular site. New bone formation and bone mineral density were measured to analyze osteogenesis and osseointegration. Results: KRGE-loaded N-Ti significantly increased the proliferation and differentiation of MC3T3-E1 cells compared with cells on pure Ti without any KRGE loading. After 1–4 weeks, the periimplant tissue in the edentulous mandibular of the healed rat showed a remarkable increase in new bone formation and bone mineral density. In addition, high levels of the bone morphogenesis protein-2 and bone morphogenesis protein-7, besides collagen, were expressed in the periimplant tissues. Conclusion: Our findings suggest that KRGE-induced osteogenesis and osseointegration around the miniimplant may facilitate the clinical application of dental implants.

Background: Cardiac arrest during or after office-based cosmetic surgery is rare, and little is known about its prognosis. We assessed the clinical outcomes of patients who de-veloped cardiac arrest during or after cosmetic surgery at office-based clinics.Methods: Between May 2009 and May 2016, 32 patients who developed cardiac arrest during or after treatment at cosmetic surgery clinics were consecutively enrolled. We com-pared clinical outcomes, including complications, between survivors (n=19) and non-sur-vivors (n=13) and attempted to determine the prognostic factors of mortality.Results: All 32 of the patients were female, with a mean age of 30.40±11.87 years. Of the 32 patients, 13 (41%) died. Extracorporeal life support (ECLS) was applied in a greater per-centage of non-survivors than survivors (92.3% vs. 47.4%, respectively; p=0.009). The mean duration of in-hospital cardiopulmonary resuscitation (CPR) was longer for the non-sur-vivors than the survivors (31.55±33 minutes vs. 7.59±9.07 minutes, respectively; p=0.01). The mean Acute Physiology and Chronic Health Evaluation score was also higher among non-survivors than survivors (23.85±6.68 vs. 16.79±7.44, respectively; p=0.01). No predictor of death was identified in the patients for whom ECLS was applied. Of the 19 survivors, 10 (52.6%) had hypoxic brain damage, and 1 (5.3%) had permanent lower leg ischemia. Logistic regression analyses revealed that the estimated glomerular filtration rate was a predictor of mortality.Conclusion: Patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics experienced poor prognoses, even though ECLS was applied in most cases. The survivors suffered serious complications. Careful monitoring of subjects and ac-tive CPR (when necessary) in cosmetic surgery clinics may be essential.