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Introduction: Cerebral small vessel disease (SVD) is a major cause of cognitive impairment and stroke. Neuroinflammation and blood-brain barrier (BBB) leakage may play a role in pathogenesis, but no definitive causal link has been established. In a rodent SVD model, minocycline treatment reduced brain lesions, neuroinflammation and BBB permeability. We tested whether these processes can be altered in SVD. Methods: MINERVA was a phase II, double-blind, randomised controlled trial in moderate-to-severe symptomatic SVD. Participants with lacunar stroke and confluent white matter hyperintensities underwent simultaneous dynamic contrast-enhanced MRI to measure BBB permeability and 11C- PK11195 positron emission tomography (PET) to quantify microglial signal (figure 1). They were randomised to either minocycline 100mg bd or placebo for three months, after which PET-MRI was repeated. The co-primary outcomes were volumes of ‘hotspots’ of increased BBB permeability and 11C-PK11195 binding in the normal appearing white matter above the 95th percentile of healthy control reference values. A sample size of 44 allowed detection of a 20% reduction in these metrics (power = 80%, α=0.05). Results: 44 patients were recruited from September 2019 - June 2022 at 23.1±24.7 months after lacunar stroke. Mean age was 69.9±10.8 years and 28/44 (63.6%) were male. 86.4% had a history of hypertension, 75.0% of hypercholesterolaemia and 18.2% were diabetic. Participants had mean white matter lesion volume of 31.3±26.0cc and median 2 (IQR 1–3) lacunes. The BBB permeability ‘hotspot’ tissue was 4.08±3.69% in the treatment group at baseline and 6.19±5.09% at follow-up; ‘hotspot’ tissue was 8.49±8.45% in the placebo group at baseline and 13.04±9.24% at follow-up (relative risk of treatment 0.97, 95% CI 0.91–1.03). The 11C-PK11195 ‘hotspot’ tissue was 10.71±4.04% in the treatment group at baseline and 9.97±5.50% at follow-up; ‘hotspot’ tissue was 10.11±4.67% in the placebo group at baseline and 7.79±5.67% at follow-up (RR 1.01, 95% CI 0.98–1.04; figure 2). Discussion: Minocycline does not alter BBB permeability or microglial activity (measured using DCE-MRI and 11C-PK11195 respectively) in SVD patients. Secondary outcomes include changes in a panel of serum inflammatory biomarkers, and one-year progression of MRI white matter damage and cognitive performance.International Clinical Trials Registry Platform reference: ISRCTN15483452 (http://isrctn.com/ISRCTN15483452)

This report describes an alternative endovascular approach to iliac branch devices for treatment of an abdominal aortic aneurysm with concomitant bilateral short common iliac aneurysms. The short distance between the renal arteries and internal iliac artery origins made the addition of distal iliac branch devices to the proximal fenestrated stent graft challenging. We elected to perform physician-modified fenestrated branched endovascular repair, using four fenestrations for the visceral and renal arteries and an additional two directional branches for the bilateral internal iliac arteries. The patient recovered uneventfully, and the 24-month follow-up imaging shows successful aneurysm exclusion with patent internal iliac artery branches.

Integration of geological and geophysical data is essential to elucidate the configuration and geometry of surface and subsurface structures, as well as their long-term evolution. The NNW–SSE-striking incised valley and parallel mountain range in the southeastern margin of the Korean Peninsula, extending 50 km from Gyeongju to Ulsan cities, are together regarded as one of the most prominent geographical features in South Korea. This paper presents an investigation into the structural architecture and deformation history of the valley and mountain range during the late Cenozoic based on combined data from field observations and gravity and electrical resistivity surveys. Our results based on integrated and reconciled geological, structural, and geophysical data are as follows. First, the incised fault valley can be divided into 1) the northern part, which comprises several distributed buried or exposed fault strands; and 2) the southern part, which comprises a concentrated deformation zone along the eastern margin of the valley. Different deformation features between the two parts are controlled by the lithology of host rocks and by the location and geometry of the neighboring major structures, that is, the Yeonil Tectonic Line (YTL) and the Yangsan Fault. Second, we defined the Ulsan Fault Zone as a NNW–SSE-to N–S-striking fault within the incised valley and along the eastern margin of the valley. In particular, the constituent strands located along the eastern margin of the valley have acted mainly as an imbricate thrust zone, characterized by an east-side-up geometry with moderate to low dip angles and reverse-dominant kinematics in the shallow subsurface during the Quaternary. Third, reactivated strands within the Ulsan Fault Zone during the Quaternary are interpreted as shortcut faults developed in the footwall of Miocene subvertical structures, predominantly the YTL. In addition, movements on the Ulsan Fault Zone and the YTL during the Miocene to Quaternary were arrested by the NNE–SSW-striking Yangsan Fault, which was a prominent and mature pre-existing structure. Our results highlight the spatiotemporal structural variation in SE Korea and emphasize the strong control of the configuration and geometry of pre-existing structures on the distribution and characteristics (i.e., geometry and kinematics) of the subsequent deformation under changing tectonic environments through the late Cenozoic.

Although several sleep-regulating neuronal populations have been identified, little is known about how they interact with each other to control sleep/wake states. We previously identified neuropeptide VF (NPVF) and the hypothalamic neurons that produce it as a sleep-promoting system (Lee et al., 2017). Here we show using zebrafish that npvf-expressing neurons control sleep via the serotonergic raphe nuclei (RN), a hindbrain structure that is critical for sleep in both diurnal zebrafish and nocturnal mice. Using genetic labeling and calcium imaging, we show that npvf-expressing neurons innervate and can activate serotonergic RN neurons. We also demonstrate that chemogenetic or optogenetic stimulation of npvf-expressing neurons induces sleep in a manner that requires NPVF and serotonin in the RN. Finally, we provide genetic evidence that NPVF acts upstream of serotonin in the RN to maintain normal sleep levels. These findings reveal a novel hypothalamic-hindbrain neuronal circuit for sleep/wake control.

Abstract Background Vertebral fractures are a common medical issue. Physical activity helps improve bone health and manage the risk of fractures. However, much controversy exists about the association between physical activity and vertebral fractures. Therefore, we aimed to investigate the association between changes in regular physical activity (RPA) and vertebral fractures. Methods This study was a nationwide, observational cohort study based on claim data from the Korean National Health Insurance Service. Physical activity level was obtained from self-reported questionnaires from 2009 to 2012. Participants were divided depending on their levels of physical activity and the occurrence of vertebral fractures from 2013 to 2016 was recorded. Results The group with sufficient RPA, compared to the Insufficient group (incidence rate showed a decrease of 1.93/1,000 PY; adjusted HR (aHR): 0.83; 95% CI: 0.81–0.84), had a reduced risk of vertebral fracture. From the perspective of RPA changes, the Continuous Sufficient group had an aHR of 0.74, 95% CI 0.72–0.76, and the Increased group had an aHR of 0.87, 95% CI 0.85–0.88. The Decreased group had an aHR of 0.94, 95% CI 0.92–0.95. Conclusion The degree of RPA could reduce the risk of vertebral fracture. Continuous sufficient RPA helped lower the risk of vertebral fracture.

Abstract Background Inflammation is a critical protective response in the body, essential for combating infections and healing injuries. However, chronic inflammation can be harmful and significantly contribute to the development and progression of chronic diseases, with macrophage-mediated responses being central to these processes. This study presents “SBR-Pel,” a new therapeutic blend of Shinbaro tab (SBR), a traditional herbal formula, and pelubiprofen (Pel), a non-steroidal anti-inflammatory drug, and investigated their combined anti-inflammatory effects to create a treatment that both improves efficacy and reduces side effects. Methods To this end, we performed both in vitro and in vivo analyses, utilizing a mouse model of inflammation. Viability and cytotoxicity assays, immunohistochemistry, enzyme-linked immunosorbent assays, real-time polymerase chain reaction assays, nociception assays, writhing tests, and blood biochemical analyses were performed. Results In vitro, SBR-Pel synergistically reduced the production of nitric oxide and reactive oxygen species and the expression of pro-inflammatory cytokines. SBR-Pel also significantly attenuated paw edema in vivo in a Complete Freund’s adjuvant-induced inflammation model in adult mice. Furthermore, immunohistochemical analyses showed that treatment with SBR-Pel reduced both the infiltration of CD68+ macrophages and the expression of pro-inflammatory cytokines in inflamed tissues. Additionally, compared with individual treatment alone, SBR-Pel enhanced the expression of anti-inflammatory cytokines CD206, TGF-β, and IL-10, indicating a synergistic effect. Our research demonstrates that SBR-Pel effectively diminishes inflammatory pain by reducing macrophage infiltration and pro-inflammatory cytokine secretion. Additionally, while 1.5 mg/kg of Pel alone increases levels of liver and kidney toxicity markers, such as aspartate aminotransferase, alanine aminotransferase, and creatinine, combining it with SBR at a reduced dosage of 0.5 mg/kg maintains these markers at normal levels. Conclusions This combined effect highlights SBR-Pel’s potential as an effective treatment for inflammatory diseases driven by heightened macrophage activity, while also minimizing side effects by reducing the Pel dosage.

Animal models are valuable tools for studying the underlying mechanisms of and potential treatments for intervertebral disc diseases. In this review, we discuss the advantages and limitations of animal models of disc diseases, focusing on lumbar spinal stenosis, disc herniation, and degeneration, as well as future research directions. The advantages of animal models are that they enable controlled experiments, long-term monitoring to study the natural history of the disease, and the testing of potential treatments. However, they also have limitations, including species differences, ethical concerns, a lack of standardized protocols, and short lifespans. Therefore, ongoing research focuses on improving animal model standardization and incorporating advanced imaging and noninvasive techniques, genetic models, and biomechanical analyses to overcome these limitations. These future directions hold potential for improving our understanding of the underlying mechanisms of disc diseases and for developing new treatments. Overall, although animal models can provide valuable insights into pathophysiology and potential treatments for disc diseases, their limitations should be carefully considered when interpreting findings from animal studies.

Abstract Airway compromise due to prevertebral soft tissue swelling is a potentially devastating complication following anterior cervical discectomy and fusion (ACDF). However, there are no studies on the postoperative patient posture for enhancing airway patency after ACDF. This study aimed to analyze the effect of neck and mouth postures on airway patency following ACDF and to suggest the beneficial postoperative patient posture for improving airway patency. A retrospective review of 39 patients who underwent ACDF in C3 or C4 level was conducted. Airway diameter and prevertebral soft tissue thickness were measured in six different neck-mouth postures using lateral radiographs. The diameters of the airway and prevertebral soft tissues showed significant changes in relation to the neck postures and mouth openings after ACDF (P

Almonds are a plant-based source of lipids, proteins, fibers, micronutrients, and phytochemicals associated with cardiometabolic health benefits. We examined blood glucose homeostasis, lipid profile, anthropometrics, blood pressure, food cravings, and mood both pre- and post-feeding, using a randomized, crossover design with 26 healthy adults (37±6 y) consuming either ALMOND (57 g/d) or an isocaloric amount of pretzels (CONTROL) for 8 weeks. Almond supplementation was expected to improve all primary outcomes when compared to CONTROL. ALMOND improved diet quality through increased intakes of monounsaturated fat (Δ+58 %), polyunsaturated fat (Δ+24 %), α-tocopherol (Δ+133 %), β-tocopherol (Δ+33 %), and magnesium (Δ+30 %) relative to CONTROL (Interaction: all p 0.05). This study demonstrates that a 57 g/d serving of almonds modestly improves diet quality and waist circumference. However, almond supplementation elicited no clinically significant benefits on lipid profile, blood pressure, physical activity, and assessments of cravings and mood. Future mechanistic studies are warranted to understand the effect of almond supplementation on cardiometabolic health in various populations. ClinicalTrials.gov Identifier: NCT04787718.

Background: Watermelon and its rind are rich in fiber, vitamins, minerals, and L-citrulline. Despite these nutritional benefits, research on the effects of blenderized watermelon (WM), especially in adolescents, remains limited. This study aimed to address this gap by examining the impact of blenderized WM (Citrullus lanatus, including both flesh and rind) on satiety, postprandial glucose responses, and overall acceptability among overweight and obese adolescents. Methods: In a randomized crossover design, 20 participants consumed 240 mL of either blenderized watermelon (WM) or an isocaloric sugar-sweetened beverage (SSB) on separate days. A triangle sensory test assessed participants' ability to distinguish between WM with and without rind, while acceptability assessments rated flavor, sweetness, and overall satisfaction using a seven-point hedonic scale. Results: Blenderized WM consumption resulted in significantly lower postprandial glucose levels at 20 and 40 min (P

Objective: To evaluate the effectiveness of telehealth programs on dietary habits, quality of life, renal function, and blood pressure in adults with chronic kidney disease (CKD). Patients and Methods: A systematic literature review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Using PubMed/Medline, Scopus, Embase, and ScienceDirect databases, articles published between 2012 and 2024 were selected using the following keywords: telehealth, eHealth, mHealth, telemedicine, telenutrition, and chronic kidney disease. Results: A total of 13 studies—10 randomized controlled trials and 3 single-arm trials—were chosen for this review. In these trials, telehealth interventions were administered using mobile applications, phone calls, web-based communications, text messaging, wearable devices, or a combination of these tools to provide treatment for adults with CKD. Interdisciplinary collaboration between a dietitian and other health care team members was shown to improve renal function and dietary habits when providing telehealth interventions via mobile applications, phone calls, and text messaging. Web-based telehealth delivery that involves diverse health care personnel has been shown to improve the quality of life in adult patients with CKD. Conclusion: Receiving treatment using telehealth communication methods may be a beneficial option for adult patients with CKD by enhancing accessibility, promoting multidisciplinary collaboration, and effectively managing blood pressure and dietary habits, leading to improved quality of life for patients. Future research administering homogeneous and rigorously controlled experimental methods with larger and more diverse populations, as well as longer study durations, is necessary to further elucidate the effectiveness of CKD treatment delivery via telehealth for adult patients.

Background/Objectives: Lumbar spinal stenosis (LSS) is a degenerative condition characterized by the narrowing of the spinal canal, resulting in chronic pain and impaired mobility. However, the molecular mechanisms underlying LSS remain unclear. In this study, we performed RNA sequencing (RNA-seq) to investigate differential gene expression in a rat LSS model and identify the key genes and pathways involved in its pathogenesis. Methods: We used bioinformatics analysis to identify significant alterations in gene expression between the LSS-induced and sham groups. Results: Pearson’s correlation analysis demonstrated strongly consistent intragroup expression (r > 0.9), with distinct gene expression between the LSS and sham groups. A total of 113 differentially expressed genes (DEGs) were identified, including upregulated genes such as Slc47a1 and Prg4 and downregulated genes such as Higd1c and Mln. Functional enrichment analysis revealed that these DEGs included those involved in key biological processes, including synaptic plasticity, extracellular matrix organization, and hormonal regulation. Gene ontology analysis highlighted critical molecular functions such as mRNA binding and integrin binding, as well as cellular components such as contractile fibers and the extracellular matrix, which were significantly affected by LSS. Conclusions: Our findings provide novel insights into the molecular mechanisms underlying LSS and offer potential avenues for the development of targeted therapies aimed at mitigating disease progression and improving patient outcomes.

The COVID-19 pandemic has highlighted the significant infection risks posed by aerosol-generating procedures (AGPs), such as intubation and cardiopulmonary resuscitation (CPR). Despite existing protective measures, high-risk environments like these require more effective safety solutions. In response, our research team has focused on developing a novel respiratory barrier enclosure designed to enhance the safety of healthcare workers and patients during AGPs. We developed a hood that covers the patient’s respiratory area, incorporating a negative pressure system to contain aerosols. Using computational fluid dynamics (CFD) analysis, we optimized the hood’s design and adjusted the negative pressure levels based on simulations of droplet dispersion. To test the design, Polyalphaolefin (PAO) particles were generated inside the hood, and leakage was measured every 10 s for 90 s. The open side of the hood was divided into nine sections for consistent leakage measurements, and a standardized structure was implemented to ensure accuracy. Our target was to maintain a leakage rate of less than 0.3%, in line with established filter-testing criteria. Through iterative improvements based on leakage rates and intubation efficiency, we achieved significant results. Despite reducing the hood’s size, the redesigned enclosure showed a 36.2% reduction in leakage rates and an approximately 3204.6% increase in aerosol extraction efficiency in simulations. The modified hood, even in an open configuration, maintained a droplet leakage rate of less than 0.3%. These findings demonstrate the potential of a CFD-guided design in developing respiratory barriers that effectively reduce aerosol transmission risks during high-risk medical procedures. This approach not only improves the safety of both patients and healthcare providers but also provides a scalable solution for safer execution of AGPs in various healthcare settings.

For the prolonged, controlled delivery of systemic drugs, we propose an implantable drug-delivery chip (DDC) embedded with pairs of a microchannel and drug-reservoir serving as a drug diffusion barrier and depot, respectively. We pursued a DDC for dual drugs: a main-purpose drug, diclofenac (DF), for systemic exposure, and an antifibrotic drug, tranilast (TR), for local delivery. Thus, the problematic fibrotic tissue formation around the implanted device could be diminished, thereby less hindrance in systemic exposure of DF released from the DDC. First, we separately prepared DDCs for DF or TR delivery, and sought to find a proper microchannel length for a rapid onset and sustained pattern of drug release, as well as the required drug dose. Then, two distinct DDCs for DF and TR delivery, respectively, were assembled to produce a Dual_DDC for the concurrent delivery of DF and TR. When the Dual_DDC was implanted in living rats, the DF concentration in blood plasma did not drop significantly in the later periods after implantation relative to that in the early periods before fibrotic tissue formation. When the Dual_DDC was implanted without TR, there was a significant decrease in the blood plasma DF concentration as the time elapsed after implantation. Biopsied tissues around the Dual_DDC exhibited a significant decrease in the fibrotic capsule thickness and collagen density relative to the Dual_DDC without TR, owing to the effect of the local, sustained release of the TR.

Recently, as the offshore structures are operated in the deep-sea oil fields, interest in the analysis of relative wave elevation around platforms is increased. In this study, it is examined how the analysis results differ depending on the characteristics of the wave probe when interpreting the relative wave elevation in the model test. First, by conducting the wave probe comparison experiment in the two-dimensional wave tank, it is confirmed how the measured values differ according to the type of wave probe for the same physical phenomenon. Two types of wave probe are selected, the resistance type and the capacitance type, and the causes of the difference in measured values is studied. After that, the model test of the semi-submersible platform is conducted to investigate the relative wave elevation. Relative wave elevation is measured with the wave probes used in the wave probe comparison experiment and analyzed to estimate the asymmetric factor and the extreme upwell. The results between the two types of wave probes are compared, and qualitative study for the cause of the difference is conducted by photographing the physical phenomenon using a high-speed camera. Through the above study, it is confirmed that the capacitance type wave probe shows a larger measured value than the resistance type under the breaking-wave condition, and the same results are obtained for the asymmetric factor and the extreme upwell. These results is thought to be due to the difference in the measurement principle between wave probes, which is whether or not they measured water bubbles. This implies that the model test should be conducted using appropriate wave probes by considering the physical phenomenon to be analyzed.

Background/Aims Hypoxemia in chronic obstructive pulmonary disease (COPD) leads to reduced ability to exercise, decreased quality of life, and, eventually, increased mortality. Home oxygen therapy in patients with severe COPD reduces distress symptoms and mortality rates. However, there have been few studies on physicians’ prescription behavior toward home oxygen therapy. Therefore, we investigated the respiratory specialists’ perspective on home oxygen therapy. Methods In this cross-sectional, study, a questionnaire was completed by 30 pulmonary specialists who worked in tertiary hospitals and prescribed home oxygen therapy. The questionnaire consisted of 28 items, including 15 items on oxygen prescription for outpatients, four for inpatients, and nine on service improvement. Results All physicians were prescribing less than 2 L/min of oxygen for either 24 (n = 10, 33.3%) or 15 hours (n = 9, 30.3%). All (n = 30) used pulse oximetry, 26 (86.7%) analyzed arterial blood gas. Thirteen physicians had imposed restrictions and recommended oxygen use only during exercise or sleep. Sixteen (53.3%) physicians were educating their patients about home oxygen therapy. Furthermore, physicians prescribed home oxygen to patients that did not fit the typical criteria for long-term oxygen therapy, with 30 prescribing it for acute relief and 17 for patients with borderline hypoxemia. Conclusions This study identified the prescription pattern of home oxygen therapy in Korea. Respiratory physicians prescribe home oxygen therapy to hypoxemic COPD patients for at least 15 hours/day, and at a rate of less than 2 L/min. More research is needed to provide evidence for establishing policies on oxygen therapy in COPD patients.

Background. The sepsis screening tool is essential because it enables the rapid identification of high-risk patients and facilitates prompt treatment. Quick Sequential Organ Failure Assessment (qSOFA) is a widely used screening tool for sepsis. However, it has limitations in predicting patient prognosis. We developed the S-S.M.A.R.T (sepsis evaluation with shock index, mental status, age, and ROX index on triage) and aimed at evaluating it as a screening tool for patients with suspected sepsis in the emergency department. Methods. We conducted a single-center retrospective chart review of patients with suspected sepsis in the emergency department. We compared the prognosis prediction abilities of the S-S.M.A.R.T and qSOFA scores in patients with suspected sepsis. The primary outcome was 7-day mortality, and the secondary outcomes included 30-day mortality and ICU admission. The receiver operating characteristic (ROC) curve analysis and the chi-square test were used. Results. In total, 401 patients were enrolled. The mean age of the patients was 72.2 ± 15.6 years, and 213 (53.1%) of them were female. The S-S.M.A.R.T had superior predictive ability for prognosis of patients with suspected sepsis compared to qSOFA (area under the ROC curve (AUC) of 0.789 vs. 0.699; p=0.02 for 7-day mortality, AUC of 0.786 vs. 0.681; p

Objective. This study is aimed at translating and cross-culturally adapting the Drooling Infants and Preschoolers Scale (DRIPS) into Korean cultural context and examine the content validity and reliability of the Korean version, which is referred as K-DRIPS. Methods. An iterative forward-backward translation sequence of the DRIPS was performed by 20 Korean health professional experts (i.e., occupational therapists (OTs) and professors) with more than 10 years of experience. The study subjects were 77 children with cerebral palsy (CP) exhibiting drooling symptoms aged 2-7 years. They were recruited from two children’s rehabilitation hospitals in Korea and completed the K-DRIPS. The content validity and internal consistency of the K-DRIPS items were examined. Results. An assessment with 20 K-DRIPS items was adequately and cross-culturally adapted into Korea. All the items exhibited good content validity (content validity ratio range 4.00-4.95) and good internal consistency (Cronbach’s α=0.98). Conclusion. The study findings indicated that the K-DRIPS was successfully adapted to the Korean cultural context and demonstrated good psychometric properties. This instrument could be used for drooling assessment tool in Korean children with disabilities.

The aims of this study were to develop a milk protein-based probiotic delivery system using a modified rennet-induced gelation method and to determine how the skim milk powder concentration level and pH, which can affect the rennet-induced intra- and inter-molecular association of milk proteins, affect the physicochemical properties of the probiotic delivery systems, such as the particle size, size distribution, encapsulation efficiency, and viability of probiotics in simulated gastrointestinal tract. To prepare a milk protein-based delivery system, skim milk powder was used as a source of milk proteins with various concentration levels from 3 to 10% (w/w) and rennet was added to skim milk solutions followed by adjustment of pH from 5.4 or 6.2. Lactobacillus rhamnosus GG was used as a probiotic culture. In confocal laser scanning microscopic images, globular particles with a size ranging from 10 μm to 20 μm were observed, indicating that milk protein-based probiotic delivery systems were successfully created. When the skim milk powder concentration was increased from 3 to 10% (w/w), the size of the delivery system was significantly (p < 0.05) increased from 27.5 to 44.4 μm, while a significant (p < 0.05) increase in size from 26.3 to 34.5 μm was observed as the pH was increased from 5.4 to 6.4. An increase in skim milk powder concentration level and a decrease in pH led to a significant (p < 0.05) increase in the encapsulation efficiency of probiotics. The viability of probiotics in a simulated stomach condition was increased when probiotics were encapsulated in milk protein-based delivery systems. An increase in the skim milk powder concentration and a decrease in pH resulted in an increase in the viability of probiotics in simulated stomach conditions. It was concluded that the protein content by modulating skim milk powder concentration level and pH were the key manufacturing variables affecting the physicochemical properties of milk protein-based probiotic delivery systems.

Abstract Background With an aging population, the number of elderly individuals exposed to traumatic injuries is increasing. The elderly age criterion for traumatic injuries has been inconsistent in the literature. This study aimed at specifying the elderly age criterion when the traumatic mortality rate increases. Methods This is a multicenter retrospective cohort study that was conducted utilizing the data from the Emergency Department-based Injury In-depth Surveillance Registry of the Korea Disease Control and Prevention Agency, collected between January 2014 and December 2018 from 23 emergency departments. The outcome variable was in-hospital mortality. Multivariable logistic regression analysis was used to calculate the adjusted mortality rate for each age group. By using the shape-restricted regression splines method, the relationship between age and adjusted traumatic mortality was plotted and the point where the gradient of the graph had the greatest variation was calculated. Results A total of 637,491 adult trauma patients were included. The number of in-hospital deaths was 6504 (1.0%). The age at which mortality increased the most was 65.06 years old. The adjusted odds ratio for the in-hospital mortality rate with age in the ≤ 64-year-old subgroup was 1.038 (95% confidence interval (CI) 1.032–1.044) and in the ≥ 65-year-old subgroup was 1.059 (95% CI 1.050–1.068). The adjusted odds ratio for in-hospital mortality in the ≥ 65-year-old compared to the ≤ 64-year-old subgroup was 4.585 (95% CI 4.158–5.055, p

Abstract Metasurfaces allow the rapid development of compact and flat electromagnetic devices owing to their capability in manipulating the wavefront of electromagnetic waves. Particularly, with respect to the metasurface lenses, wide operational bandwidth and wide incident angle behavior are critically required for practical applications. Herein, a single-layer phase gradient metasurface lens is presented to achieve millimeter-wave focusing at a focal point of 13 mm regardless of the incident angle. The proposed metasurface lens is fabricated by constructing subwavelength-thick (

Objective To evaluate the effects of maternal body mass index (BMI) and plurality on maternal and umbilical cord serum magnesium levels after antenatal magnesium sulfate treatment. Methods This was a retrospective cohort analysis of 135 women treated with antenatal magnesium sulfate at less than 32 weeks of gestation between January 2012 and June 2018. Subjects were stratified into groups according to maternal BMI (group I [18.5–22.9 kg/m2], group II [23.0–24.9 kg/m2], and group III [≥25.0 kg/m2]) and plurality (singleton and twin). Univariable and multivariable analyses were performed to compare the umbilical cord serum magnesium levels between the groups. Results Maternal serum magnesium levels were not significantly different between the maternal BMI groups and singleton and twin pregnancies. Umbilical cord serum magnesium levels were significantly different among the maternal BMI groups (3.3±1.2 mg/dL in group I, 3.3±1.2 mg/dL in group II, and 4.0±1.4 mg/dL in group III, P=0.003). The trend of increase in magnesium levels was statistically significant (P=0.001, Jonckheere-Terpstra test). Umbilical cord serum magnesium levels were not significantly different according to plurality. However, in the multivariable analysis, maternal BMI and plurality were not significantly associated with umbilical cord serum magnesium levels after adjusting for indication and total dose of magnesium sulfate treatment, gestational age at delivery, mode of delivery, neonatal sex, and birth weight. Conclusion Maternal BMI and plurality were not significantly associated with maternal or umbilical cord serum magnesium levels after exposure to antenatal magnesium sulfate treatment.

Abstract Background Healthcare-associated pneumonia (HCAP) is a heterogeneous disease. We redefined nursing-home- and hospital-associated infections (NHAI) group by revising existing HCAP risk factors. The NHAI group comprised nursing home residents with a poor functional status, or recent (past 90 days) hospitalization or recent (past 180 days) antibiotic therapy. Our aim was to determine whether respiratory microbiota profiles are related to newly defined NHAI group in critically ill patients on mechanical ventilation. Methods The 180 endotracheal aspirates (ETAs) from 60 mechanically ventilated ICU patients (NHAI group, n = 24; non-NHAI group, n = 36) were prospectively collected on days 1, 3 and 7 in a university hospital. The bacterial community profiles of the ETAs were explored by 16S rRNA gene sequencing. A phylogenetic-tree-based microbiome association test (TMAT), generalized linear mixed models (GLMMs), the Wilcoxon test and the reference frame method were used to analyze the association between microbiome abundance and disease phenotype. Results The relative abundance of the genus Corynebacterium was significantly higher in the pneumonia than in the non-pneumonia group. The microbiome analysis revealed significantly lower α-diversity in the NHAI group than in the non-NHAI group. In the analysis of β-diversity, the structure of the microbiome also differed significantly between the two groups (weighted UniFrac distance, Adonis, p

Understanding the relationship between body weight perception (BWP) and weight control is an important influencer on adolescents’ health behaviours. The purpose of this study was to examine the relationships between BWP, body mass index (BMI), physical activity and food choices in adolescent males and females (N = 1,212). Across BMI categories, more females perceived themselves as overweight and tried to control their weight, where more males tried to gain weight or never tried to control their weight (p

ObjectiveTo analyze the changes in the clinical characteristics and perinatal outcomes of twin pregnancies delivered at a tertiary referral center in Korea during a 24-year period.MethodsThis was a retrospective cohort study of twin pregnancies delivered at 24–40 weeks of gestation, from 1995 to 2018. The subjects were divided into 4 groups according to the year of delivery: 1995–2000, 2001–2006, 2007–2012, and 2013–2018. The trends in the changes in the twin birth rate, maternal age, assisted reproductive technology (ART) pregnancy rate, chorionicity, obstetric complications, delivery outcomes, and neonatal outcomes over the periods were analyzed.ResultsA total of 2,133 twin pregnancies were included in the study. The twin birth rate increased from 16.7/1,000 in 1995–2000 to 42.2/1,000 in 2001–2006, 49.5/1,000 in 2007–2012, and 61.8/1,000 in 2013–2018. The maternal age and ART pregnancy and dichorionic twin rates increased, while the monochorionic twin rate decreased over the periods. The incidence of fetal congenital anomalies, cervical incompetence, gestational diabetes mellitus, preeclampsia, and placental abruption increased over the periods. The preterm birth (PTB) rate significantly decreased owing to the decreasing elective late-PTB rate; however, the early-PTB rate significantly increased.ConclusionThis study found that twin pregnancies increased steadily over the last 24 years and that the increase was related to increased maternal age and ART pregnancy rate. The incidence of obstetric complications increased over the periods; however, the neonatal intensive care unit admission rate decreased, along with decreases in the elective late-PTB rate.