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Abstract Free radical is a marker in various inflammatory diseases. The antioxidant effect protects us from this damage, which also plays an essential role in preventing inflammation. Inflammation protects the body from biological stimuli, and pro-inflammatory mediators are negatively affected in the immune system. Inflammation caused by LPS is an endotoxin found in the outer membrane of Gram-negative bacteria, which induces immune cells to produce inflammatory cytokines such as cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase. Based on this, the antioxidant and anti-inflammatory effects of plant extracts were investigated. First, the main phenolic compounds for the five peaks obtained from Stachys affinis extract (SAE) were identified. The antioxidant effect of each phenolic compound was confirmed through HPLC analysis before and after the competitive binding reaction between DPPH and the extract. Afterward, the anti-inflammatory effect of each phenolic compound was confirmed through competitive binding between COX2 and the extract in HPLC analysis. Lastly, the anti-inflammatory effect of SAE was confirmed through in vitro experiments and also confirmed in terms of structural binding through molecular docking. This study confirmed that phenolic compounds in SAE extract have potential antioxidant and anti-inflammatory effects, and may provide information for primary screening of medicinal plants.

Background Conjunctival bacterial flora is a common cause of endophthalmitis after ophthalmic procedures. This study investigated the conjunctival bacterial flora, especially coagulase-negative Staphylococcus (CoNS), and their antibiotic sensitivity in patients who underwent ophthalmic procedures. Factors related to fluoroquinolone resistance were also investigated. Methods In total, 167 samples were analyzed from 135 patients who underwent cataract surgery or intravitreal injection at Kosin University Gospel Hospital between April 14, 2014, and September 29, 2016. Bacterial identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or VITEK 2 equipment. Antibiotic sensitivity tests were performed using an AST-P600 card with VITEK 2 equipment. Clinical information was extracted from patients’ medical records. Sixty-eight individuals with conjunctival flora containing CoNS were classified into the fluoroquinolone-sensitive and fluoroquinolone-resistant CoNS groups, and their characteristics were compared. Results A total of 192 isolates of Gram-positive bacteria were identified, including Staphylococcus epidermidis (33.3%), Corynebacterium spp. (18.8%), and CoNS other than S. epidermidis (9.2%). Of the 106 CoNS isolates, 68.9%, 69.8%, and 58.5% were sensitive to ciprofloxacin, levofloxacin, and norfloxacin, respectively. In patients with CoNS, statin use within 3 months before sample collection was significantly associated with fluoroquinolone resistance (p=0.016). Statin use was a significant risk factor for fluoroquinolone resistance in multivariate logistic regression analysis (odds ratio, 4.86; 95% confidence interval, 1.25–18.91; p=0.022). Conclusions CoNS, including S. epidermidis, was the most common conjunctival bacterial flora, with a fluoroquinolone sensitivity rate ranging from 58.5% to 69.8% in patients undergoing ophthalmic procedures. Statin use was a significant risk factor for fluoroquinolone resistance.

Abstract Digital in-line holographic microscopy (DIHM) is a non-invasive, real-time, label-free technique that captures three-dimensional (3D) positional, orientational, and morphological information from digital holographic images of living biological cells. Unlike conventional microscopies, the DIHM technique enables precise measurements of dynamic behaviors exhibited by living cells within a 3D volume. This review outlines the fundamental principles and comprehensive digital image processing procedures employed in DIHM-based cell tracking methods. In addition, recent applications of DIHM technique for label-free identification and digital tracking of various motile biological cells, including human blood cells, spermatozoa, diseased cells, and unicellular microorganisms, are thoroughly examined. Leveraging artificial intelligence has significantly enhanced both the speed and accuracy of digital image processing for cell tracking and identification. The quantitative data on cell morphology and dynamics captured by DIHM can effectively elucidate the underlying mechanisms governing various microbial behaviors and contribute to the accumulation of diagnostic databases and the development of clinical treatments.

Abstract The polymeric gel electrolytes are attractive owing to their higher ionic conductivities than those of dry polymer electrolytes and lowered water activity for enlarged potential window. However, the ionic conductivity and mechanical strength of the Na‐ion conducting polymeric gel electrolytes are limited by below 20 mS cm−1 and 2.2 MPa. Herein, we demonstrate Na‐ion conducting and flexible polymeric hydrogel electrolytes of the chemically coupled poly(diallyldimethylammonium chloride)‐dextrin‐N,N′‐methylene‐bis‐acrylamide film immersed in NaClO4 solution (ex‐DDA‐Dex + NaClO4) for flexible sodium‐ion hybrid capacitors (f‐NIHC). In particular, the anion exchange reaction and synergistic interaction of ex‐DDA‐Dex with the optimum ClO4− enable to greatly improve the ionic conductivity up to 27.63 mS cm−1 at 25°C and electrochemical stability window up to 2.6 V, whereas the double networking structure leads to achieve both the mechanical strength (7.48 MPa) and softness of hydrogel electrolytes. Therefore, the f‐NIHCs with the ex‐DDA‐Dex + NaClO4 achieved high specific and high‐rate capacities of 192.04 F g−1 at 500 mA g−1 and 116.06 F g−1 at 10 000 mA g−1, respectively, delivering a large energy density of 120.03 W h kg−1 at 906 W kg−1 and long cyclability of 70% over 500 cycles as well as demonstrating functional operation under mechanical stresses.

AI education aims to teach AI concepts, essential knowledge, and skills related to the fundamental ideas in AI. As AI becomes increasingly prevalent in our daily lives, schools and educators have started to recognize the importance of AI education in K-12 schools. However, there have been a limited number of studies reporting on the implementation of AI education in classrooms. This systematic review aimed to provide an overview of the current state of AI education in K-12 schools, exploring topics, instructional approaches, and learning outcomes. Twenty-five peer-reviewed journal articles published between 2018 and 2023 were selected for this systematic review. The findings highlighted that various topics were covered in K-12 AI education, including fundamental AI concepts, different types of AI, AI applications, and ethical considerations related to AI. To facilitate meaningful learning experiences, educators frequently integrated hands-on activities and project-based learning. The findings supported the benefits of AI education in enhancing students' AI literacy, problem-solving skills, and ethical reflections on AI's societal impact. Furthermore, it fostered motivation, positive attitudes toward AI, and an interest in technology while inspiring career aspirations. It is recommended to develop tailored AI curricula, instructional strategies, and appropriate tools and resources that seamlessly integrate into various subjects within the standard school curriculum.

Abstract Magnesium‐ion batteries (MIBs) have promising applications because of their high theoretical capacity and the natural abundance of magnesium Mg. However, the kinetic performance and cyclic stability of cathode materials are limited by the strong interactions between Mg ions and the crystal lattice. Here, we demonstrate the unique Mg2+‐ion storage mechanism of a hierarchical accordion‐like vanadium oxide/carbon heterointerface (V2O3@C), where the V2O3 crystalline structure is reconstructed into a MgV3O7∙H2O phase through an anodic hydration reaction upon first cycle, for the improved kinetic and cyclic performances. As verified by in situ/ex situ spectroscopic and electrochemical analyses, the fast charge transfer kinetics of the V2O3@C cathode were due to the crystal‐reconstruction and chemically coupled heterointerface. The V2O3@C demonstrated an ultrahigh rate capacity of 130.4 mAh g−1 at 50 000 mA g−1 and 1000 cycles, achieving a Coulombic efficiency of 99.6%. The high capacity of 381.0 mA h g−1 can be attributed to the reversible Mg2+‐ion intercalation mechanism observed in the MgV3O7∙H2O phase using a 0.3 M Mg(TFSI)2/ACN(H2O) electrolyte. Additionally, within the voltage range of 2.25 V versus Mg/Mg2+, the V2O3@C exhibited a capacity of 245.1 mAh g−1 when evaluated with magnesium metal in a 0.3 M Mg(TFSI)2 + 0.25 M MgCl2/DME electrolyte. These research findings have important implications for understanding the relationship between the Mg‐ion storage mechanism and reconstructed crystal phase of vanadium oxides as well as the heterointerface reconstruction for the rational design of MIB cathode materials.

Hydrogel electrolytes, where water solvents and salts are confined in the porous networks of polymeric or inorganic solids, are attractive because they can resolve technical challenges of liquid electrolytes such as leakage, water decomposition, and mechanical instability. Herein, we demonstrate polyacrylic acid tethered onto the surface of vinyl functionalized silica nanoparticles (PAA-VSNP) hydrogel electrolytes through a sol-gel and radical polymerization process. The synthesis chemistry, the associated chemical structure, and the morphology of PAA-VSNP hydrogel electrolytes were comprehensively characterized analyzing FTIR, XPS and 13C and 29Si solid-state MAS NMR spectroscopies. The resulting PAA-VSNP hydrogel electrolytes were mechanically stable as verified by the stretchability up to 1122.75% of original length as well as ionically conductive as demonstrated by higher ionic conductivity of 20.23 mS cm−1 and lower activation energy of 0.106 eV than those of PVA counterparts. Integrating this PAA-VSNP hydrogel electrolytes with activated carbon and Na3V2(PO4)3/carbon composite and, flexible sodium ion hybrid supercapacitors (AC//PAA-VSNP //NVP@C SHSC SHSC) full cells could be fabricated. The as-fabricated AC//PAA-VSNP//NVP@C SHSC achieved a long-term cyclability over 4000 cycles and flexibility, delivering the larger energy and power densities 86.95 W h kg−1 and 19.94 kW kg−1 than those of AC//PVA//NVP@C and other works using hydrogel electrolytes.

Background This study aimed to observe the extent of retinal vascularization in patients with retinopathy of prematurity (ROP) who underwent deferred laser treatment (LT) after a single intravitreal bevacizumab injection (IVB). Methods This study retrospectively evaluated 40 consecutive eyes in 21 infants who received a single IVB or LT. Deferred LT was performed in cases of ROP recurrence after a single IVB. To assess the amount of retinal vascularization between the initial IVB and deferred LT, the cases were divided into three groups based on treatment: single IVB, deferred LT after a single IVB, and prompt LT. The growth and associated complications were compared between groups. Results There were 12, 16, and 12 eyes in the single IVB, deferred LT, and prompt LT groups, respectively. Deferred LT was performed at an average of 7.9 weeks after a single IVB. In the single IVB group, retinal vascularization proceeded to zone III, whereas the prompt LT group did not show any growth of vascularization beyond the laser scars. In the deferred LT group, during the window period before LT, retinal vascularization progressed from zone I to zone II posterior and from zone II posterior to zone II anterior, respectively, without further ROP recurrence. Conclusions Retinal vascularization progressed during the deferred window period, thereby reducing the area of the retina ablated by LT. A single IVB followed by deferred LT can be an alternative treatment option to prevent ablation of zone I or multiple IVBs.

Cirsium japonicum is a medicinal plant that has been used due to its beneficial properties. However, extensive information regarding its therapeutic potential is scarce in the scientific literature. The antioxidant and anti-inflammatory potential of polyphenols derived from the Cirsium japonicum extracts (CJE) was systematically analyzed. High-performance liquid chromatography (HPLC) with mass spectrometry (MS) was used to examine the compounds in CJE. A total of six peaks of polyphenol compounds were identified in the extract, and their MS data were also confirmed. These bioactive compounds were subjected to ultrafiltration with LC analysis to assess their potential for targeting cyclooxygenase-2 (COX2) and DPPH. The outcomes showed which primary compounds had the highest affinity for binding both COX2 and DPPH. This suggests that components that showed excellent binding ability to DPPH and COX2 can be considered significant active substances. Additionally, in vitro analysis of CJE was carried out in macrophage cells after inducing inflammation with lipopolysaccharide (LPS). As a result, it downregulated the expression of two critical pro-inflammatory cytokines, COX2 and inducible nitric oxide synthase (iNOS). In addition, we found a solid binding ability through the molecular docking analysis of the selected compounds with inflammatory mediators. In conclusion, we identified polyphenolic compounds in CJE extract and confirmed their potential antioxidant and anti-inflammatory effects. These results may provide primary data for the application of CJE in the food and pharmaceutical industries with further analysis.

Abstract Real-time monitoring of suspended particulate matter (PM) has become essential in daily life due to the adverse effects of long-term exposure to PMs on human health and ecosystems. However, conventional techniques for measuring micro-scale particulates commonly require expensive instruments. In this study, a smartphone-based device is developed for real-time monitoring of suspended PMs by integrating a smartphone-based digital holographic microscopy (S-DHM) and deep learning algorithms. The proposed S-DHM-based PM monitoring device is composed of affordable commercial optical components and a smartphone. Overall procedures including digital image processing, deep learning training, and correction process are optimized to minimize the prediction error and computational cost. The proposed device can rapidly measure the mass concentrations of coarse and fine PMs from holographic speckle patterns of suspended polydisperse PMs in water with measurement errors of 22.8 ± 18.1% and 13.5 ± 9.8%, respectively. With further advances in data acquisition and deep learning training, this study would contribute to the development of hand-held devices for monitoring polydisperse non-spherical pollutants suspended in various media.

Abstract We evaluated the effectiveness of intravitreal anti-vascular endothelial growth factor (anti-VEGF) antibody injection (IVAI) for the prevention of recurrent vitreous hemorrhage (VH) due to neovascularization on disc (NVD) in patients with proliferative diabetic retinopathy (PDR) after panretinal photocoagulation (PRP). This retrospective case series reviewed the medical records of 12 PDR patients with recurrent VH after PRP from NVD. The interval between IVAIs was decided on the basis of the interval between VH recurrences after the initial IVAI, and NVD regression/recurrence during follow-up. We recorded the success rate of VH prevention, and the interval between IVAIs. Fundus examination revealed NVD regression at 1 month after the injection. However, NVD progressed gradually and VH recurred after 3–4 months. Thereafter, IVAIs were administered every 3–4 months; VH did not recur and visual acuity remained stable during the treatment period. In one case, NVD did not recur after 4 years of periodic injections. No systemic or ocular complications of IVAI were observed. In conclusion, proactive and periodic IVAIs (at 3–4-month intervals) may prevent recurrent VH in association with NVD in PDR patients after PRP.

With the rapid increase in the demand for lithium as an energy-critical element, the recovery of Li+ ions from seawater is a worldwide challenging issue. Herein, we propose a new facile and fast selective recovery approach of Li+ using an Al3+-crosslinked poly(N-isopropylacrylamide) (PNIPAAm)/alginate (Alg) (PNP/Alg(Al)) adsorbent. The in situ TEM images indicate that Alg–Al3+ coordination is reorganized via the rearrangement of PNIPAAm and Alg networks, as the temperature increases. The reorganization eventually leads to the formation of polycrystalline structure. The in situ FTIR results exhibit that PNP/Alg(Al) composite has peculiar phase transitions, which includes a retrogressive phase change from hydrophobic to hydrophilic. The synergetic effect of the strong repulsion force of Al3+ ions and the attractive force of negatively charged polymeric chains enables the efficient adsorption of Li+ ions with a low affinity from Li-spiked seawater. 7.3% of Li+ ions are recovered from Li-spiked seawater although the concentration of Li-spiked seawater is very high. In addition, Li+ ions can be extracted from PNP/Alg(Al) composite with the use of a small thermal energy. The proposed thermoresponsive IPN gel provides a strong potential in practical applications for Li+ recovery as an innovative energy-material strategy.

Abstract Nepenthes alata‐inspired micro/nano‐textured lubricant‐infused surface (LIS) has shown strong potential in the fields of drag reduction (DR), anti‐biofouling, and self‐cleaning. However, its surface‐slippery property is largely degraded under turbulent shear flow conditions due to the loss of the impregnated oil. This condition inhibits its practical applications to marine vehicles. The mucus‐impregnated tissue systems of marine creatures are primarily based on fatty acid amides (FAAs), such as erucamide or oleamide, which have been commercially utilized as solid‐slip additives. A stable lubricant interface of erucamide‐PDMS composite (EPC) oleogel is formed by cross‐linking erucamide with PDMS gel network prior to infusion of silicon oil. In this study, the surface stability and lubricant retention of EPC are investigated in consideration of DR applications. The fabricated EPC‐oleogel surface exhibits shear stable DR under harsh conditions, such as high pressure, temperature, and shear flow conditions. The surface shows a shear stable DR performance of about 14% even up to a high‐speed flow of 12 ms−1, corresponding to friction Reynolds number (Reτ) of approximately 5000. The superior lubrication stability of FAA‐oleogel at the flow conditions of cruising ships ensures its strong potential for sustainable fuel economy of marine vehicles.

Voice change is a common complaint after thyroid surgery and has a significant impact on quality of life. The Korean Society of Laryngology, Phoniatrics and Logopedics assembled a task force to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations encompass preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, and include in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQs) in three categories—preoperative (KQ 1–2), intraoperative (KQ 3–8), and postoperative (KQ 9–14) management—and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. A detailed evidence profile is presented for each recommendation. The level of evidence for each recommendation was classified as high-quality, moderate-quality, or low-quality. The strength of each recommendation was designated as strong or weak considering the level of evidence supporting the recommendation. The guidelines are primarily targeted toward physicians who treat thyroid surgery patients and speech-language pathologists participating in patient care. These guidelines will also help primary care physicians, nurses, healthcare policymakers, and patients improve their understanding of voice changes and voice care after thyroid surgery.

Abstract This study aimed to demonstrate pharmacokinetic (PK) equivalence of a single dose of the proposed adalimumab biosimilar CT‐P17 to United States‐licensed adalimumab (US‐adalimumab) and European Union‐approved adalimumab (EU‐adalimumab). This double‐blind, parallel‐group, phase I trial (clinicaltrials.gov NCT03970824) was conducted at 10 hospitals (Republic of Korea), in which healthy subjects (1:1:1) were randomized to receive a single 40 mg (100 mg/ml) subcutaneous injection of CT‐P17, US‐adalimumab, or EU‐adalimumab. Primary end points were PK equivalence in terms of: area under the concentration–time curve from time zero to infinity (AUC0–inf); AUC from time zero to the last quantifiable concentration (AUC0–last); and maximum serum concentration (Cmax). PK equivalence was concluded if 90% confidence intervals (CIs) for percent ratios of geometric least squares means (GLSMs) for pairwise comparisons were within the equivalence margin of 80–125%. Additional PK end points, safety, and immunogenicity were evaluated. Of the 312 subjects who were randomized (103 CT‐P17; 103 US‐adalimumab; 106 EU‐adalimumab), 308 subjects received study drug. AUC0–inf, AUC0–last, and Cmax were equivalent among CT‐P17, US‐adalimumab, and EU‐adalimumab, because 90% CIs for the ratios of GLSMs were within the 80–125% equivalence margin for each pairwise comparison. Secondary PK end points, safety, and immunogenicity were similar between treatment groups. In conclusion, PK equivalence for single‐dose administration of CT‐P17, EU‐adalimumab, and US‐adalimumab was demonstrated in healthy adults. Safety and immunogenicity profiles were comparable between treatment groups and consistent with previous reports for adalimumab biosimilars.

Abstract Particulate matter (PM) has become a severe environmental issue, and ultrafine PM particles such as PM2.5 or PM1 can cause various complications and respiratory diseases to human beings. In particular, heavy metals contained in PM particles can contaminate edible plants; for example, plant leaves are exposed to PM particle-laden raindrops. The contaminated edible plants can injure the human health by ingestion, so a detailed understanding on the accumulation of PM particles inside edible plants is essential. In this study, we investigate the infiltration of PM particles in plant tissues with a hypothesis that ultrafine PM particles are absorbed through stomatal pathways. As an edible test plant, Perilla frutescens is selected. Drops of gold nanoparticle (AuNP) suspension are deposited on a leaf of P. frutescens to simulate the scenario where PM particle-laden raindrops fall on patulous stomata of the test plant. To examine AuNP adsorption on the P. frutescens foliar surface and diffusional AuNP absorption through stomatal apertures, we investigate three physical dynamics of AuNPs suspended in a sessile drop: sedimentation, evaporation-driven convective flow, and shrinkage of the drop interface. Quantitative information on the 3D spatial distribution of AuNPs in plant tissues was measured by X-ray imaging and two-photon excitation microscopy.

Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

Abstract Branch retinal vein occlusion (BRVO) is ocular vascular disease affecting approximately 14 million people worldwide, and is closely associated with high blood pressure (BP). Although macular ischemia is a critical factor in the visual prognosis of BRVO, the relationship between macular ischemia and different patterns of nocturnal BP is unknown. Here, we investigated whether a dipping pattern of nocturnal BP is associated with the development of macular ischemia in patients with BRVO. A total of 273 patients were reviewed; of these, 86 (86 eyes) patients were included. All recruited patients had a macular thickness map by optical coherence tomography and underwent 24-h ambulatory BP monitoring. According to their dipping patterns, the participants were divided into dipper and non-dipper groups. The non-dipper group had worse visual outcomes at the initial and 6-month visits (P = 0.014 and P = 0.003, respectively). Five of 32 eyes (15.6%) in the dipper group and 32 of 54 (59.3%) in the non-dipper group had macular ischemia. In a multivariate analysis, the night-to-day systolic BP ratio was associated with the degree of macular ischemia (β = − 0.313, P = 0.004). Thus, a non-dipping pattern may be a risk factor for macular ischemia in patients with BRVO.

Abstract Background A subcutaneous (SC) formulation of infliximab biosimilar CT-P13 is approved in Europe for the treatment of adult patients with rheumatoid arthritis (RA). It may offer improved efficacy versus intravenous (IV) infliximab formulations. Methods A network meta-regression was conducted using individual patient data from two randomised trials in patients with RA, which compared CT-P13 SC with CT-P13 IV, and CT-P13 IV with reference infliximab IV. In this analysis, CT-P13 SC was compared with CT-P13 IV, reference infliximab IV and pooled data for both reference infliximab IV and CT-P13 IV. Outcomes included changes from baseline in 28-joint Disease Activity Score based on C-reactive protein (DAS28-CRP), Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI), and rates of remission, low disease activity or clinically meaningful improvement in functional disability per Health Assessment Questionnaire–Disability Index (HAQ-DI). Results The two studies enrolled 949 patients with RA; pooled data for 840 and 751 patients were evaluable at weeks 30 and 54, respectively. For the CT-P13 SC versus pooled IV treatment arm comparison, differences in changes from baseline in DAS28-CRP (− 0.578; 95% confidence interval [CI] − 0.831, − 0.325; p

Abstract Background To demonstrate equivalent efficacy of the proposed high-concentration (100 mg/ml), citrate-free adalimumab biosimilar CT-P17 to European Union-approved adalimumab (EU-adalimumab) in subjects with active rheumatoid arthritis (RA). Methods This randomized, double-blind phase III study ( ClinicalTrials.gov , NCT03789292) randomized (1:1) subjects with active RA at 52 centers to receive CT-P17 or EU-adalimumab 40 mg subcutaneously every 2 weeks until week 52. Results to week 24 are reported here. The primary endpoint was 20% improvement by American College of Rheumatology criteria (ACR20) response rate at week 24. Equivalence was concluded if the corresponding confidence intervals (CIs) for the estimate of treatment difference were within predefined equivalence margins: − 15 to 15% (95% CI; European Medicines Agency assumption); − 12 to 15% (90% CI; Food and Drug Administration assumption). Additional efficacy, pharmacokinetic, usability, safety, and immunogenicity endpoints were evaluated. Results 648 subjects were randomized (324 CT-P17; 324 EU-adalimumab). The ACR20 response rate at week 24 was 82.7% (n = 268/324) in both groups (intention-to-treat population). The 95% CI (− 5.94 to 5.94) and 90% CI (− 4.98 to 4.98) were within predefined equivalence margins for both assumptions and equivalent efficacy was concluded. Additional endpoints and overall safety were comparable between groups. Mean trough serum concentrations of CT-P17 were slightly higher than those of EU-adalimumab. Immunogenicity was slightly lower numerically for the CT-P17 group than for the EU-adalimumab group. Conclusions CT-P17 and EU-adalimumab have equivalent efficacy and comparable safety and immunogenicity in subjects with active RA. Overall safety of CT-P17 is consistent with the known safety profile of reference adalimumab. Trial registration ClinicalTrials.gov, NCT03789292 . Registered 28 December 2018—retrospectively registered.

Abstract Background To investigate the effect of intravitreal dexamethasone implant (DEX implant) on hard exudate (HE) accompanying diabetic macular edema (DME). Methods This study was a non-comparative non-randomized 1-year prospective interventional study. Patients with DME and HE were treated using DEX implant two or three times. Color fundus photography and optical coherence tomography (OCT) were performed at every visit. HE area was measured semi-automatically from the fundus photographs. Results Thirty-five patients completed the study. Eleven patients (31.4%) received two injections, while the remaining received three times. HE area (primary outcome) significantly decreased from 1.404±2.094 mm2 (baseline) to 0.212±0.592 mm2 (last visit), which was 24% of the baseline HE area (P

Abstract This study was performed to investigate the efficacy of the treat-and-extend regimen using aflibercept for treating diabetic macular oedema (DME). This prospective, multicentre, interventional, single-arm, 104-week clinical trial included 48 patients with DME visual impairment. The patients’ eyes received five consecutive intravitreal injections (2 mg aflibercept) every four weeks with two-week adjustments based on central subfield macular thickness (CSMT) changes. Injections were deferred when CSMT was stable. The number of injections, best-corrected visual acuity (BCVA), CSMT, and diabetic retinopathy severity scale scores were analysed. Compared to baseline, BCVA improved by + 9.1 letters at 52 weeks and was maintained with + 9.4-letter gain at 104 weeks (P

Abstract Background Staphylococcus epidermidis is the most common pathogen in postoperative endophthalmitis and causes various infectious eye diseases. However, there is very little information on fluoroquinolone antibiotic resistance to S. epidermidis identified in conjunctival microbe and analysis of related genes. Here, the authors investigated the rate of resistance to fluoroquinolones of Staphylococcus epidermidis isolated from normal conjunctival microbes and mutations in the quinolone-resistance determining region (QRDR). Methods 377 eye samples from 187 patients who underwent intravitreal injection and cataract surgery were included. Specimens were taken from the bilateral lower conjunctival sacs using a cotton swab and cultured. The cultures were identified using MALDI-TOP MS and gyrA, gyrB, parC, and parE gene mutations of QRDR were confirmed by DNA extraction from resistant strains of S. epidermidis with a micro-dilution method using ciprofloxacin, levofloxacin, and moxifloxacin. Results The culture positive rate was 61.8% (231) for 374 eye samples. Of the 303 total strains cultured, S. epidermidis was the most common with 33.7% (102). Ten types of gene mutations were observed in the resistant S. epidermidis of 21 strains. One-point mutation was observed mainly in gyrA and parC, and a small number of mutations were observed in parE in the form of a double point mutations. When there were multiple point mutations in both gyrA and parC, the highest minimum inhibitory concentration was observed. Conclusions The quinolone resistance rate of S. epidermidis increased in comparison with previous studies, and resistant S. epidermidis showed mostly QRDR mutations, which were mainly found in gyrA and parC, and showed strong resistance when mutated in both genes.

PurposeConsidering the scarcity of normal and strabismic images, this study proposed a method that combines a meta-learning approach with image processing methods to improve the classification accuracy when meta-learning alone is used for screening strabismus.MethodsThe meta-learning approach was first pre-trained on a public dataset to obtain a well-generalized embedding network to extract distinctive features of images. On the other hand, the image processing methods were used to extract the position features of eye regions (e.g., iris position, corneal light reflex) as supplementary features to the distinctive features. Afterward, principal component analysis was applied to reduce the dimensionality of distinctive features for integration with low-dimensional supplementary features. The integrated features were then used to train a support vector machine classifier for performing strabismus screening. Sixty images (30 normal and 30 strabismus) were used to verify the effectiveness of the proposed method, and its classification performance was assessed by computing the accuracy, specificity, and sensitivity through 5,000 experiments.ResultsThe proposed method achieved a classification accuracy of 0.805 with a sensitivity (correct classification of strabismus) of 0.768 and a specificity (correct classification of normal) of 0.842, whereas the classification accuracy of using meta-learning alone was 0.709 with a sensitivity of 0.740 and a specificity of 0.678.ConclusionThe proposed strabismus screening method achieved promising classification accuracy and gained significant accuracy improvement over using meta-learning alone under data scarcity.

Abstract Corneal chemical burns can lead to blindness following serious complications. As most of these complications are caused by failure of reepithelization during the acute phase, treatment at this stage is critical. Although there have been some studies on corneal injury recovery using adipose tissue-derived stem cells (ADSCs), none has reported the effect of topical cell-free conditioned culture media (CM) derived from ADSCs on corneal epithelial regeneration. Here, the best conditions for CM were selected and used for in vitro and in vivo experiments. Corneal burn in rats was induced using 100% alcohol. The chosen CM was administered to corneal burn rats (CM-treated [CT] group) four times a day for three days and this group was compared with the normal control and corneal burn (CB) groups. Biomicroscopic fluorescence images and the actual physical corneas were taken over time and used for analysis. mRNA levels of hepatocyte growth factor and epidermal growth factor (EGF) were significantly increased, whereas those of vascular endothelial growth factor, interleukin (IL)-1β, IL-6, IL-10, and matrix metalloproteinase-9 were significantly decreased in the CT group compared with those in the CB group. The numbers of proliferating cell nuclear antigen- and zonular occludens-1-positive cells in the CT group were significantly higher than those in the CB group. The macrophage-infiltrating corneas in the CT group expressed significantly more of the M2 marker arginase than corneas in the CB group. Optimal CM (× 0.5 concentration) treatment significantly accelerated the migration of corneal epithelial cells and induced upregulation of the expression of IL-6, EGF, and C-X-C chemokine receptor type 4 mRNAs. Overall, in this study, topical administration of cell-free CM promoted regeneration of the corneal epithelium after induction of chemical burns.

ABSTRACTPostoperative endophthalmitis (PE) is the devastating complication that frequently results in vision loss. Recently, enterococcus have emerged as a major cause of PE in several countries and resulted in poor visual outcome. However, the reason remains elusive. We investigate whether selection pressure of fluoroquinolone exerts effects on microorganism profiles isolated from PE. Medical records of patients who were diagnosed with PE at eight resident training institutions between January 2004 and December 2015 were reviewed. The most common isolate was Enterococcus faecalis (28.0%), followed by Staphylococcus epidermidis (18.6%) and other coagulase negative Staphylococci (7.6%). However, the rates of E. faecalis isolated from conjunctival microbes were 6.2% (16/257) and their resistance to fluoroquinolones was higher than those of S. epidermidis. In vitro and in vivo co-culture models of E. faecalis and S. epidermidis were established for survival assays after administration of fourth-generation fluoroquinolone. In in vitro co-culture model, the survival assay of E. faecalis and S. epidermidis against the treatment of moxifloxacin showed that E. faecalis survived significantly better than S. epidermidis in the presence of moxifloxacin 1 µg/mL and more. In in vivo co-culture model, E. faecalis survived significantly better than S. epidermidis after topical treatment of moxifloxacin (5 mg/mL). E. faecalis has been the most common causative strain of PE in Korea. We suggest that the increase of E. faecalis in PE could be associated with the selection pressure of fourth-generation fluoroquinolone.Summary: Enterococcus spp. have emerged as a leading causative strain of postoperative endophthalmitis in 11-year clinical data. We suggest that the increase of Enterococcus spp. is associated with the selection pressure of fourth-generation fluoroquinolone.

Purpose: To establish in vitro and in vivo ocular co-culture models of Staphylococcus epidermidis and Enterococcus faecalis and to study how various concentrations of moxifloxacin affect the survival of these two endophthalmitis-causing bacteria.Methods: Standard strains of S. epidermidis and E. faecalis were used. Color detection agar plates were employed to distinguish their colonies. To establish the in vitro and in vivo co-culture models, S. epidermidis and E. faecalis were co-cultivated at different ratios for various periods. For the in vivo model, various volumes and concentrations of either a mono-culture or co-culture were inoculated into the lower conjunctival sac of rabbits. Finally, the newly developed in vitro and in vivo co-culture models were subjected to the moxifloxacin treatment to access its effect on S. epidermidis and E. faecalis.Results: When S. epidermidis and E. faecalis were cultured separately in tryptic soy broth, their growth peaked and plateaued at approximately 16 and 6 h, respectively. When they were co-cultured, the growth peak of S. epidermidis got delayed, whereas the growth peak of E. faecalis did not change. The number of E. faecalis was significantly higher in the co-culture than that in the mono-culture. Treatment with moxifloxacin in the in vitro co-culture model rapidly decreased the number of S. epidermidis cells at doses ≥ 0.125 μg/ml. In contrast, the number of E. faecalis did not change significantly up to 16 μg/ml moxifloxacin. In in vivo co-culture (at 1:1), the S. epidermidis count decreased in a pattern similar to that seen in in vivo mono-culture and was barely detectable at 24 h after inoculation. In contrast, the of E. faecalis count increased up to 16 h and then decreased. When moxifloxacin was applied (zero, one, or two times) to this model, the S. epidermidis count decreased in proportion to the number of treatments. In contrast, the E. faecalis count increased with moxifloxacin treatment.Conclusions: The in vitro and in vivo co-culture models of S. epidermidis and E. faecalis were established to determine the influence of moxifloxacin eye drops on these bacteria. The results clearly show that the moxifloxacin eye drops can make E. faecalis dominant on the ocular surface.

Contamination of vegetables due to the foliar uptake of atmospheric toxic elements could pose severe health risks. However, the uptake mechanisms of potencially toxic elements (PTEs) from the atmosphere and translocation by plant leaves remain unclear. In this study, carboxylic acid-functionalized water-soluble CdSe/ZnS quantum dot nanoparticles (QD NPs) were used as an experimental particle model of PTEs in the edible plant garlic chive (Allium tuberosum). A droplet of QD NP suspension was deposited to simulate the conditions of raindrops containing metal particles falling on a plant leaf. The 3D spatial distribution of QD NPs in plant leaves was measured using three complementary imaging techniques: synchrotron X-ray microcomputed tomography (micro-CT), nano-CT, and two-photon microscopy (TPM). The TPM and micro-CT results revealed that QD NPs deposited on garlic chive leaves penetrated the plant leaves. Nano-CT images showed that QD NPs are absorbed into mesophyll cells and phloem vessels. The results of TEM and TPM imaging demonstrated that QD NPs penetrate through the leaves and translocate in the direction of the stem. The use of these emerging imaging techniques improved the ability to detect and visualize NPs in a plant leaf. These observations also provide mechanistic insights into foliar metal uptake and their translocation and accumulation.

Air plastron in a superhydrophobic (SHPo) surface works as a lubricant that induces drag reduction on the surface. By air plastron, air is trapped between structures of the SHPo surface. However, air plastron is easily depleted by static water pressure or external flow conditions. Various nanostructures have been introduced to enhance the air stability of SHPo surfaces. In this study, the effects of such nanostructure on the air stability were experimentally investigated under high water pressure and flow conditions. Polyvinyl chloride solution was employed to form the nanostructure on the ridged SHPo surface. The critical pressure for the depletion of air plastron is 70% higher on SHPo surfaces introduced with the nanostructure than on surfaces without the nanostructure. Pressure drops (ΔP) in rectangular channels with the SHPo surface on the bottom side were measured to quantify the air stability under a flow condition. ΔP gradually decreases as the air plastron disappears on both SHPo surfaces. The hierarchical ridged surfaces with the nanostructure showed better air stability under static and flow conditions compared with the simple ridged surfaces without the nanostructure. The present results are helpful to understand the effects of the nanostructure on the air stability and its drag reduction mechanism.

Objectives To investigate the effect of absorbable suture on surgically-induced corneal astigmatism in 3.0-mm sclera tunnel cataract surgeries. Methods Medical records of patients who underwent phacoemulsification cataract surgery using a 3.0-mm sclera tunnel incision made by a single surgeon were reviewed. Uncorrected distant visual acuity, corneal astigmatism and surgically-induced astigmatism were measured in 56 patients' eyes that underwent sclera tunnel cataract surgery with absorbable sutures (sutured group) and in 23 patients' eyes without sutures (unsutured group). Uncorrected visual acuity, intraocular pressure, slit lamp examination, and automated keratometry were evaluated preoperatively and at 3 days, 2 weeks, 4 weeks, and 8 weeks after cataract operation. Results There were no significant differences in preoperative average uncorrected distant visual acuity of the two groups (sutured group: 0.79 ± 0.64, unsutured group: 0.68 ± 0.72, P = 0.145). Corneal astigmatism measured using keratometry in the sutured and unsutured group at postoperative day 3 were 2.27 ± 2.12 D versus 0.83 ± 0.55 D at (P < 0.001), a difference which had disappeared after 4 weeks. Surgically induced astigmatism using the Holladay and Vector methods showed similar outcomes, suggesting that the sutured group exhibited higher astigmatism compared with the unsutured group until 2 weeks post-surgery. Conclusions TPatients undergoing scleral tunnel cataract surgery with absorbable sutures have greater surgically induced astigmatism, especially in the early postoperative period, compared with those without sutures. However, this surgically induced astigmatism due to absorbable sutures in scleral tunnel cataract surgery is temporary and disappears at 4 weeks post-surgery.

Objectives To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

OBJECTIVES Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV) types 6 and 11 and is potentially preventable through vaccination. This study estimated the incidence of juvenile-onset RRP before the implementation of the national HPV vaccination program in Korea. METHODS We conducted a cohort study using claims data provided by a mandatory insurance program to estimate the incidence of RRP and associated healthcare use. Patients with juvenile RRP were defined as those aged ≤12 years with ≥2 admissions or ≥2 outpatient visits during which they received the International Classification of Diseases, 10th revision code for benign neoplasms of the larynx (D14.1). RESULTS During 2002-2014, 123 children (74 boys and 49 girls) were diagnosed with RRP. The patients had a mean of 6.5 person-years of follow-up. The incidence was estimated at 0.30/100,000 person-years. The median age at diagnosis was 4.0 years (mean, 4.3). Thirty-six (29.3%) patients underwent surgery, including 23 patients (18.7%) who underwent 2 or more surgical procedures. Severe disease, measured by more frequent surgical procedures and shorter time intervals between consecutive operations, was associated with a younger age at diagnosis. CONCLUSIONS The estimated incidence of juvenile-onset RRP in Korea was similar to that reported in other countries. The RRP burden should continue to be monitored using National Health Insurance Service claims data.

PurposeThis study aims to provide an automatic strabismus screening method for people who live in remote areas with poor medical accessibility.Materials and methodsThe proposed method first utilizes a pretrained convolutional neural network-based face-detection model and a detector for 68 facial landmarks to extract the eye region for a frontal facial image. Second, Otsu's binarization and the HSV color model are applied to the image to eliminate the influence of eyelashes and canthi. Then, the method samples all of the pixel points on the limbus and applies the least square method to obtain the coordinate of the pupil center. Lastly, we calculated the distances from the pupil center to the medial and lateral canthus to measure the deviation of the positional similarity of two eyes for strabismus screening.ResultWe used a total of 60 frontal facial images (30 strabismus images, 30 normal images) to validate the proposed method. The average value of the iris positional similarity of normal images was smaller than one of the strabismus images via the method (p-valueConclusionThe experimental results of 60 images show that the proposed method is a promising automatic strabismus screening method for people living in remote areas with poor medical accessibility.

Liquid-infused surfaces are a promising passive technique for frictional drag reduction. However, their practical application is limited by the easy depletion of the lubricant infused in the surface by external forces. Miyeok contains mucus on its surface, which induces a sustainable slippery surface under flow conditions. In this study, the effect of the surface morphological structures of miyeok on slippery characteristics was examined. The surface of miyeok has bump-like microstructures and tiny pores of mucilage gland cells with a re-entrant inlet configuration. A replica model of the miyeok surface was fabricated by adopting a molding process using polydimethylsiloxane. The miyeok replica model was dipped into a silicone oil solution to obtain a slippery surface property. The surface structures of fresh miyeok and the replica were checked by comparing their scanning electron microscopy images. A replica of a kelp surface was also fabricated by employing the same method. The heights of the surface microstructures of the miyeok replica were more uniform than those of the kelp replica. The sustainable drag reduction effect of the replica models’ surfaces was assessed by a sessile drop method. The liquid-infused miyeok replica surface (LIMRS) showed better sustainability than other surfaces. The slippery properties of the LIMRS were examined by measuring slip length and pressure drop. The drag reduction rates measured by the two methods were approximately 24% and 19%. The present results would be helpful for understanding the effects of the surface structure of natural miyeok on sustainable drag reduction and developing a biomimetic sustainable drag-reducing surface.

PurposeWe investigated risk factors for breakthrough vitreous hemorrhage (VH) after an intravitreal tissue plasminogen activator (tPA) and gas injection in patients with submacular hemorrhage (SMH) associated with age-related macular degeneration (AMD).MethodsThe medical records of patients diagnosed with SMH associated with AMD who received an intravitreal tPA (50 μg/0.05 mL) and perfluoropropane gas (0.3 mL) injection were reviewed retrospectively. We analyzed the associations of breakthrough VH with age, sex, best-corrected visual acuity, intraocular pressure, AMD subtype, accompanying sub-retinal pigment epithelium (RPE) hemorrhage, history of cataract surgery, history of hypertension and diabetes mellitus, history of drinking and smoking, and history of antiplatelet or anticoagulant medication. We also examined the relationships between various parameters, including the area ratio of the SMH to the optic disc (AHD) and the height of the SMH obtained from optical coherence tomography.ResultsIn total, 52 eyes from 52 patients were enrolled in this study; 16 eyes (30%) showed breakthrough VH. The proportions of patients with a current smoking history were 75.0% in the VH group and 22.2% in the non-VH group (p = 0.010). Other factors did not differ significantly between the two groups. The proportion of cases with accompanying sub-RPE hemorrhage was 50.0% and 58.3% in the VH and non-VH groups, respectively (p = 0.763). The AHD (p = 0.001) and SMH height (p < 0.001) were significantly greater in the VH group. In a receiver operating characteristic curve analysis, the cut-off values of AHD and SMH height were 20.1 and 1208 μm, respectively. According to logistic regression analysis, when the AHD and SMH height were greater than the individual cut-off values, the odds ratio of VH increased by 10.286 fold (95% confidence interval [CI], 2.452-43.148; p = 0.001) and 75.400 fold (95% CI, 7.991-711.441; p < 0.001), respectively, with respect to their respective reference groups (less than the cut-off value). Among the significant factors associated with VH occurrence, including current smoking, AHD, and SMH height, only current smoking and SMH height were found to be significant in multiple regression analysis (p = 0.040, 0.016).ConclusionsThe incidence of breakthrough VH was significantly higher in those with current smoking status and for SMH with a larger AHD and greater height. The height of the SMH was more predictable of the possibility of VH than AHD.

Objectives The post-tonsillectomy pain and post-tonsillectomy hemorrhage are the two main problems after tonsillectomy. The aim of this study was to investigate the beneficial effects of water soluble ethanol extract propolis on post-tonsillectomy patient. Methods One hundred and thirty patients who underwent tonsillectomy or adenotonsillectomy were randomly divided into the control and propolis groups, each including 65 patients. The propolis group was applied with propolis orally immediately after surgery and by gargle. The pain scores were assessed on post-tonsillectomy 0, 1st, 2nd, 3rd, and 7th–10th day using a visual analogue scale score. Postoperative wound healing was evaluated by scoring pinkish membrane of tonsillar fossae on postoperative days 3 and 7–10. The incidence of post-tonsillectomy bleeding was examined in each group. Results Post-tonsillectomy pain was significantly less in propolis group compared to control group on postoperative days 3 and 7–10. Post-tonsillectomy hemorrhage was significantly less in the propolis group compared to the control group (P

Abstract Mosquitoes transmit various diseases; thus, controlling them is necessary to prevent mosquito-borne infections. Unlike flying adult mosquitoes, those in the immature stages are easy to control because of being restricted to their habitats found in an aquatic environment. In this study, we aimed to evaluate of respiration and survivorship in the larvae of Aedes togoi. The mechanism of actions of the oil-film layer and the surfactant as well as their effects on the siphonal respiration of submerged Aedes togoi larvae were analyzed by checking the survival time of mosquito larvae against oil-film layer and surfactant, and conducting experiments using a siphon-model. Compared with an impermeable membrane used for reference (762.4 min; average time in all cases), the survival time of mosquito larvae was 5% longer for the oil-film layer (808.1 min) and 40% longer for the surfactant (1086.9 min). The surface of the siphon was changed from hydrophobic to hydrophilic by addition of a surfactant. In addition, the surface tension and wettability have a significant influence on the opening and closing of siphon. This study would be helpful for understanding the basic mechanism of physical control measures for disturbing the siphonal respiration of mosquito larvae in a way of dissolved oxygen and surface tension. The present results would guide the establishment of effective control measures for mosquitoes.

This study investigated the low-temperature fracture behavior of an 80-mm-thick low-carbon steel plate welded by submerged arc. The relationship between impact absorbed energy and ductility–brittle transition temperature (DBTT) based on the microstructures was evaluated through quantitative analysis on grain size and complex constituent phases using advanced EBSD technique. The microstructure formed differently depending on the heat affections, which determined fracture properties in a low-temperature environment. Among the various microstructures of the heat-affected zone (HAZ), acicular ferrite has the greatest resistance to low-temperature impact due to its fine interlocking formation and its high-angle grain boundaries.

Abstract Sepsis causes multiple organs failures and eventually death. Changes in blood constituents due to sepsis lead to alterations in hemorheological properties, and cell adhesiveness. In this study, a new microfluidic system is proposed to measure temporal variations in biophysical properties of blood after injecting lipopolysaccharide (LPS) into a rat extracorporeal model under ex vivo condition. To measure blood viscosity, the interfacial line between blood and a reference fluid is formed in a Y-shaped channel. Based on the relation between interfacial width and pressure ratio, the temporal variation in blood viscosity is estimated. Optical images of blood flows are analyzed by decreasing flow rate for examination of red blood cell (RBC) aggregation. Platelets initiated by shear acceleration around the stenosis adhere to the post-stenosed region. By applying a correlation map that visualizes the decorrelation of the streaming blood flow, the area of adhered platelets can be quantitatively attained without labeling of platelets. To assess sepsis inflammation, conventional biomarkers (PCT and IL-8) are also monitored. The increasing tendency for blood viscosity, RBC aggregation, platelet adhesion, and septic biomarkers are observed after LPS injection. This microfluidic system would be beneficial for monitoring the changes in hemorheological properties and platelet activation caused by sepsis.

Abstract Fabrication of superhydrophobic surfaces is an area of great interest because it can be applicable to various engineering fields. A simple, safe and inexpensive fabrication process is required to fabricate applicable superhydrophobic surfaces. In this study, we developed a facile fabrication method of nearly perfect superhydrophobic surfaces through plasma treatment with argon and oxygen gases. A polytetrafluoroethylene (PTFE) sheet was selected as a substrate material. We optimized the fabrication parameters to produce superhydrophobic surfaces of superior performance using the Taguchi method. The contact angle of the pristine PTFE surface is approximately 111.0° ± 2.4°, with a sliding angle of 12.3° ± 6.4°. After the plasma treatment, nano-sized spherical tips, which looked like crown-structures, were created. This PTFE sheet exhibits the maximum contact angle of 178.9°, with a sliding angle less than 1°. As a result, this superhydrophobic surface requires a small external force to detach water droplets dripped on the surface. The contact angle of the fabricated superhydrophobic surface is almost retained, even after performing an air-aging test for 80 days and a droplet impacting test for 6 h. This fabrication method can provide superb superhydrophobic surface using simple one-step plasma etching.

Abstract Background To compare the related factors or manifestations of the two most common isolates of post-operative endophthalmitis, which were Enterococcus spp. and coagulase-negative staphylococci (CNS) in South Korea. Methods Medical records were reviewed for cases of post-operative endophthalmitis caused by Enterococcus spp. and CNS at eight institutions between January 2004 and July 2010. Various factors including age, sex, residence, systemic diseases, smoking and drinking history, and best corrected visual acuity, and length of time between causative intraocular surgery and symptom development were compared between the two groups. Results The total number of post-operative endophthalmitis cases was 128 and in 116 cases, microbiological culture tests from the aqueous humor or vitreous were performed. Among these cases, 67 (57.8%) were culture proven. Among these 67 cases, 19 (28.4%) were caused by Enterococcus spp., 14 (20.9%) were caused by Staphylococcus epidermidis endophthalmitis, and 5 (7.5%) were caused by other CNS spp. Age, sex, causative procedure, past medical history, social history, and laterality were not different in the two groups. Mean initial and final visual acuity were significantly worse in the Enterococcus spp. endophthalmitis group than in the CNS group (p = 0.049, 0.042, respectively). Length of time between the causative procedure and symptom development was significantly shorter in cases of Enterococcus spp. endophthalmitis (p = 0.004). Conclusions Enterococcus spp. induce more severe and rapid-onset postoperative endophthalmitis than CNS. Infectious endophthalmitis developed within 2 days after cataract operation could be caused by Enterococcus spp. and have chance to be poor prognosis in South Korea.

Porous structures, such as perforation plates and pit membranes, have attracted considerable attention due to their hydraulic regulation of water flow through vascular plant networks. However, limited information is available regarding the hydraulic functions of such structures during water-refilling and embolism repair because of difficulties in simultaneous in vivo measurements of refilling flow and pressure variations in xylem vessels. In this study, we developed a xylem-inspired microchannel with a porous mesh for systematic investigation on the hydraulic contribution of perforation plates on water-refilling. In particular, the “stop-and-acceleration” phenomenon of the water meniscus at the porous mesh structure was carefully examined in macroscopic and microscopic views. This distinctive phenomenon usually occurs in the xylem vessels of vascular plants during embolism repair. Based on the experimental results, we established a theoretical model of the flow characteristics and pressure variations around the porous structure inside the microchannel. Perforation plates could be speculated to be a pressure-modulated flow controller that facilitates embolism recovery. Furthermore, the proposed xylem-inspired channel can be used to investigate the hydraulic functions of porous structures for water management in plants.

AIM:To investigate the retinal vascular caliber, retinal nerve fiber layer(RNFL)thickness, and optic disc changes in patients after pars plana vitrectomy and adjunctive intraoperative procedures.METHODS:We examined 40 eyes in 40 patients who had undergone unilateral pars plana vitrectomy and adjunctive intraoperative procedure at three time points:prior to surgery, and at 3mo and 6mo after the operation. The diameters of central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent(CRAE)and central retinal venular equivalent(CRVE)were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using Stratus optical coherence tomography. The cup-to-disc vertical ratio of the optic disc was evaluated using stereo optic disc photography.RESULTS:There were no significant differences between the eyes of individual patients before the operation. Cup-to-disc vertical ratios of the optic disc were significantly increased 3mo and 6mo postoperatively(PPPPPPCONCLUSION:Whereas there were no changes in RNFL thickness, vitrectomy and adjunctive intraoperative procedures induced changes in the cup-to-disc vertical ratio of the optic disc and retinal vessel diameter for at least 6mo after surgery.

Most retinitis pigmentosa (RP) mutations arise in rod photoreceptor genes, leading to diminished peripheral and nighttime vision. Using a pig model of autosomal-dominant RP, we show glucose becomes sequestered in the retinal pigment epithelium (RPE) and, thus, is not transported to photoreceptors. The resulting starvation for glucose metabolites impairs synthesis of cone visual pigment-rich outer segments (OSs), and then their mitochondrial-rich inner segments dissociate. Loss of these functional structures diminishes cone-dependent high-resolution central vision, which is utilized for most daily tasks. By transplanting wild-type rods, to restore glucose transport, or directly replacing glucose in the subretinal space, to bypass its retention in the RPE, we can regenerate cone functional structures, reactivating the dormant cells. Beyond providing metabolic building blocks for cone functional structures, we show glucose induces thioredoxin-interacting protein (Txnip) to regulate Akt signaling, thereby shunting metabolites toward aerobic glucose metabolism and regenerating cone OS synthesis.

Abstract Objectives To assess the inadvertent intraocular retention of perfluorocarbon liquid (PFCL) after vitreoretinal surgery and their complications. Methods We retrospectively reviewed the medical records of 108 patients who underwent vitreoretinal surgeries using intraoperative PFCL (perfluoro-n-octane (C8F18), 0.69 centistoke at 25℃, PERFLUORN®, Alcon, USA) and the removal of PFCL through fluid-air exchange. The analysis was focused on the occurrence of intraocular retained PFCL, diagnoses, surgicalprocedures, and complications. Results Retinal detachment (51 cases, 47%) was the most common surgery which used PFCL intraoperatively. Other causes were vitreous hemorrhage (24 cases, 22%), posteriorly dislocated lens (22 cases, 21%), and trauma (11 cases, 10%). Intraocular PFCL was found in a total of 9 (8.3%) eyes. PFCL bubbles remained in anterior chamber and vitreous cavity were observed in 4 cases and subretinal retained PFCL was observed in 5 cases. Three of 5 cases of subretinal PFCL exhibited in subfoveal space. Among the three subfoveal cases, macular hole developed after PFCL removal in 1 case, epiretinal membrane in the area where had been PFCL bubble. However, we observed no complications in 1 case of subfoveal PFCL that was removed by surgery. PFCL in anterior chamber and vitreous cavity were in 4 cases. Conclusions The presence of subfoveal PFCL might affect visual and anatomic outcomes. However, subfoveal PFCL may induce visual complications, and therefore requires special attention.

Cactus roots function as a hydraulic safety valve by conducting available water quickly and preventing water loss under drought condition. In particular, the root–stem (R–S) junction is responsible for effective water transport by direct coupling of the water absorptive thin roots and the moisture-filled bulky stem. In this study, the morphological features of the R–S junction were observed by using X-ray micro-imaging technique. Their structural and functional characteristics were also elucidated according to a hydrodynamic viewpoint. With regard to the axial water transport through xylem, the R–S junction prevents water leakage by embolizing large-scale vessels with relatively high hydraulic conductivity. In addition, the axial theoretical hydraulic conductivity of xylem vessels from the roots to the stem drastically increases to facilitate water absorption and prevent water loss. The cortex cell layer of a cactus is thinner than that of other plant species. In the viewpoint of radial conductivity, this property can be the hydraulic strategy of the cactus R–S junction to transport water quickly from the root surface into the xylem. These results suggest that the R–S junction functions as a hydraulic safety valve that can maximize water uptake in axial and radial directions at limited rainfall. This junction can also prevent the stem from leaking water under drought condition.

[This corrects the article DOI: 10.1371/journal.pone.0169856.].

Although hemodynamic influence of the subprosthetic tissue, termed as pannus, may contribute to prosthetic aortic valve dysfunction, the relationship between pannus extent and hemodynamics in the prosthetic valve has rarely been reported. We investigated the fluid dynamics of pannus formation using in vitro experiments with particle image velocimetry. Subvalvular pannus formation caused substantial changes in prosthetic valve transvalvular peak velocity, transvalvular pressure gradient (TPG) and opening angle. Maximum flow velocity and corresponding TPG were mostly affected by pannus width. When the pannus width was 25% of the valve diameter, pannus formation elevated TPG to >2.5 times higher than that without pannus formation. Opening dysfunction was observed only for a pannus involvement angle of 360°. Although circumferential pannus with an involvement angle of 360° decreased the opening angle of the valve from approximately 82° to 58°, eccentric pannus with an involvement angle of 180° did not induce valve opening dysfunction. The pannus involvement angle largely influenced the velocity flow field at the aortic sinus and corresponding hemodynamic indices, including wall shear stress, principal shear stress and viscous energy loss distributions. Substantial discrepancy between the velocity-based TPG estimation and direct pressure measurements was observed for prosthetic valve flow with pannus formation.

Being an essential component in various metabolic activities, water is important for the survival of plants and animals. Cacti grown in arid areas have developed intrinsic water management systems, such as water collection through spines, water absorption through trichome, and water storage using mucilage. The water collection method of cactus is well-documented, but its water absorption and storage strategies remain to be elucidated. Thus, this study analyzed the morphology and wettability of cactus trichomes by using advanced bio-imaging techniques and by performing in vitro experiments on an artificial system mimicking these structures, respectively. In addition, the in situ water absorption process through the trichome cluster was quantitatively visualized. This paper proposes a new bio-inspired technique for dew collection based on information about the water management strategies of cactus. This study discusses the underlying water absorption and storage strategies of cactus and provides the experimental database required to develop a biomimetic water management device.