Layer-specific pain relief pathways originating from primary motor cortex.

The primary motor cortex (M1) is involved in the control of voluntary movements and is extensively mapped in this capacity. Although the M1 is implicated in modulation of pain, the underlying circuitry and causal underpinnings remain elusive. We unexpectedly unraveled a connection from the M1 to the nucleus accumbens reward circuitry through a M1 layer 6-mediodorsal thalamus pathway, which specifically suppresses negative emotional valence and associated coping behaviors in neuropathic pain. By contrast, layer 5 M1 neurons connect with specific cell populations in zona incerta and periaqueductal gray to suppress sensory hypersensitivity without altering pain affect. Thus, the M1 employs distinct, layer-specific pathways to attune sensory and aversive-emotional components of neuropathic pain, which can be exploited for purposes of pain relief.

How will multifaceted trust impact domestic travel during the COVID-19 pandemic and subjective well-being? A comparison between Korea and the US.

This study examines the impact of extended tourist trust constructs on domestic travel experiences, subjective well-being, and future travel intention in the pandemic. Data was obtained through a survey conducted on 1181 Korean and American domestic tourists. The results show that policy trust and destination trust have positive effects on travel frequency and satisfaction. Moreover, interactional trust positively impacted travel satisfaction. While both travel frequency and travel satisfaction have positive impacts on subjective well-being of travelers, travel satisfaction has a stronger impact on subjective well-being than travel frequency. However, certain relationships were influenced by national backgrounds (U·S vs. Korea).

Travel decision determinants during and after COVID-19: The role of tourist trust, travel constraints, and attitudinal factors.

The COVID-19 pandemic has forced tourism practitioners to create efficient strategies to attract travelers. Using three theoretical frameworks, such as tourist trust (political, destination, and interactional trust), travel constraint (intrapersonal, interpersonal, and "social distancing" structural constraint), and extended theory of planned behavior (travel attitude, perceived behavioral control, subjective norm, perceived health risk, past travel experience), we develop a comprehensive framework to explain the impact of travel promoting, restricting, and attitudinal factors on travel decision during and after the pandemic. Data was obtained through an extensive survey conducted on 1451 Korean travelers and was analyzed using probabilistic choice models and count models. The results show the specific factors that determine travel decisions during the pandemic (whether to travel and frequency) and travel intention after the pandemic. This study provides important theoretical and practical insights into how to develop successful COVID-19 recovery strategies in the tourism industry.

The impact of hotel CSR for strategic philanthropy on booking behavior and hotel performance during the COVID-19 pandemic.

During the novel coronavirus (COVID-19) pandemic, some hotels have engaged in corporate social responsibility (CSR) activities to help overcome the crisis. Given that most existing research examines the impact of hotel CSR on a single stakeholder, how hotel CSR activities in a crisis are perceived by multiple stakeholders is unknown. Drawing on the concept of strategic philanthropy, this study examines the impact of hotel CSR activities during the pandemic, such as providing accommodations to healthcare workers, on hotel firms' market value and prospective hotel customers' booking behavior. Adopting mixed-methods approach, this study finds negative impacts of hotel CSR for strategic philanthropy on firm market value and customer booking behavior. The study result indicates that the value of hotel CSR depends on the nature and environmental contexts of CSR. Specific theoretical and practical implications are provided.

Reducing perceived health risk to attract hotel customers in the COVID-19 pandemic era: Focused on technology innovation for social distancing and cleanliness.

As an essential risk-reduction strategy, technology innovation is likely to play a key role in the hotel industry's recovery from the 2020 coronavirus pandemic. However, its impact on customer decision-making behavior is unknown. Focusing on technology innovation for reducing guest interaction with employees and enhancing cleanliness, the purpose of this research was to examine the impact of expected interaction and expected cleanliness on perceived health risk and hotel booking intention. Three experimental studies were conducted using online consumer samples. The studies found that low levels of expected interaction through technology-mediated systems lead to low levels of perceived health risk. Perceived health risk mediates the relationship between expected interaction and hotel booking intention. In addition, high levels of expected cleanliness through advanced cleaning technologies moderate the impacts of expected interaction on perceived health risk. Importantly, the proposed perceived risk mechanism was effective in post-pandemic scenarios. Theoretical and practical implications are discussed.

Global warming offsets the ecophysiological stress of ocean acidification on temperate crustose coralline algae.

Dramatic increases in the release of anthropogenic CO2 and global temperatures have resulted in alterations to seawater carbonate chemistry and metabolisms of marine organisms. There has been recent interest in the effects of these stressors on crustose coralline algae (CCA) because photosynthesis and calcification are influenced by all components of carbonate chemistry. To examine this, a mesocosm experiment was conducted to evaluate photosynthesis, calcification and growth in the temperate CCA Chamberlainium sp. under acidification (doubled CO2), warming (+5 °C), and greenhouse (doubled CO2 and +5 °C) conditions compared to present-day conditions. After 47 days of acclimation to these conditions, productivity was lowest under acidification, although photochemical properties were improved, while respiration was highest under warming. Likewise, growth was lowest under acidification, but this negative response was offset by elevated temperature under greenhouse. Together, these results suggest that warming offsets the negative effects of acidification by creating more suitable conditions for photosynthesis and growth.

Complete Atrioventricular Block due to Infective Endocarditis of Bicuspid Aortic Valve.

A 38-year-old man visited our emergency department presenting with a 6-day persistent fever. The man had undergone an orthodontic procedure 7 days prior to the visit. He had a fever with a temperature of 38.2℃ and a diastolic murmur (grade III) was detected at the left sternal border. Reddish-brown lines beneath the nails were present, and raised lesions which were red and painful were detected on the soles of the patient's feet. Laboratory findings showed an elevated inflammatory marker. Transthoracic and transesophageal echocardiograms, showed a bicuspid aortic valve, and moderate aortic regurgitation and vegetation were noted. Treatment with antibiotics was given, but 4 days later, a 12 lead electrocardiogram revealed complete atrioventricular (AV) block. Immediately, a temporary pacemaker was inserted, and the following day an aortic valve replacement was performed. Intraoperative findings revealed a fistula around the AV node. He has suffered no subsequent cardiac events during the follow-up.

A case report of carbon monoxide poisoning induced cardiomyopathy complicated with left ventricular thrombus.

The heart and the brain, most oxygen-dependent organs, may be severely affected after carbon monoxide (CO) exposure. CO induced cardiotoxicity may occur as a consequence of moderate to severe CO poisoning, including angina attack, myocardial infarct, arrhythmias, and heart failure. We present a rare case of CO poisoning induced cardiomyopathy with left ventricular (LV) thrombus. It is thought that LV thrombus may have been caused severely decreased LV function with dyskinesis. After short-term anticoagulant therapy, echocardiography findings revealed complete recovery of LV dyskinesis and resolution of LV thrombus.

Vitiligo Coexistent with Nevus Depigmentosus: This Was Treated with Narrow-Band UVB and These Lesions Were Followed Using the Mexameter®, a Pigment-Measuring Device.

Nevus depigmentosus (ND) is a congenital, non-progressive, hypopigmented lesion that is usually stable throughout an affected individual's lifetime. The clinical features of vitiligo are similar to those of ND, but the two diseases have different treatment responses and prognoses. We report here on a rare case of vitiligo that was coexistent with ND. Both conditions were treated with narrow-band UVB. An 11-year-old boy presented with two distinct types of hypopigmented lesions, one on the forehead and the other on his back. The first was a hypopigmented patch with leukotrichia, and it was incidentally discovered 3 months before the child was examined at our clinic and it had rapidly increased in size. The second hypopigmented patch was detected at birth and it had slowly been increasing in size. The hypopigmented lesion on the child's forehead was diagnosed as vitiligo, and the one on his back as ND. Once- or twice-weekly narrow-band UVB treatment was initiated. Improvements in the two lesions were assessed with clinical photography and using a Mexameter® (Courage-Khazaka Electronic, Germany), which is a pigment-measuring device.

Successful treatment of lichen spinulosus with topical tacalcitol cream.

Lichen spinulosus (LS) is a rare idiopathic cutaneous eruption characterized by follicular keratotic spiny papules that are grouped in large patches. Here, we report two cases of LS in the submental area, an uncommon site, which were treated effectively and safely with topical tacalcitol cream.

A case of adams-oliver syndrome.

Adams-Oliver syndrome (AOS) is a congenital condition characterized by aplasia cutis congenita, transverse limb defects, and cutis marmorata telangiectatica. AOS can also be associated with extensive lethal anomalies of internal organs, including the central nervous, cardiopulmonary, gastrourointestinal, and genitourinary systems. Generally, the more severe these interrelated anomalies are, the poorer the prognosis becomes. In the relevant literature on this topic, it is somewhat unclear as to whether the prognosis of AOS without lethal anomalies alters the lifespan. We report a case of AOS with typical skin defects only, and no internal organ anomalies.

A case of hypermelanosis in a phylloid pattern.

Pigmentary anomalies display a variety of different patterns. The phylloid pattern is characterized by a leaf-shaped arrangement reminiscent of floral ornaments. We describe a 20-year-old Korean man with hyperpigmented oblong patches and atypically short, thick hairs in a phylloid pattern on the face, the left shoulder, and the left side of the trunk. Associated musculoskeletal anomalies included equinovarus deformities, bilateral club foot, lumbar lordosis, spina bifida, and relative hypertrophy of the right thigh muscles.

A case of syphilitic keratoderma concurrent with syphilitic uveitis.

Syphilitic keratoderma is a rare cutaneous manifestation of secondary syphilis, characterized by symmetrical and diffuse hyperkeratosis of the palms and soles. In addition, no cases of syphilitic keratoderma and uveitis have been reported in the dermatologic literature. A 69-year-old woman presented with steroid-resistant hyperkeratotic patches on the palms and soles and uveitis for 4 months. As steroid-resistant uveitis must be evaluated for syphilis, viral infections, and autoimmune diseases, we ran several laboratory tests and the serologic test for VDRL was reactive (titer; 1:128). After treatment with penicillin G (4 MU, IV every 4 hours for 2 weeks), her skin lesions and visual disturbance were completely resolved. Therefore she was diagnosed as having syphilitic keratoderma and uveitis. Here, we report a rare case of syphilitic keratoderma concurrent with syphilitic uveitis and suggest that evaluation for syphilis may be required when skin lesions and ocular disturbance are resistant to long-term steroid therapy.