Murine parainfluenza virus persists in lung innate immune cells sustaining chronic lung pathology.

Common respiratory viruses, including the human parainfluenza viruses, threaten human health seasonally and associate with the development of chronic lung diseases. Evidence suggests that these viruses can persist, but the sources of viral products in vivo and their impact on chronic respiratory diseases remain unknown. Using the murine parainfluenza virus Sendai, we demonstrate that viral protein and RNA persist in lung macrophages, type 2 innate lymphoid cells (ILC2s) and dendritic cells long after the infectious virus is cleared. Cells containing persistent viral protein expressed Th2 inflammation-related transcriptomic signatures associated with the development of chronic lung diseases, including asthma. Lineage tracing demonstrated that distinct functional groups of cells contribute to the chronic pathology. Importantly, targeted ablation of infected cells significantly ameliorated chronic lung disease. Overall, we identified persistent infection of innate immune cells as a key factor in the progression from acute to chronic lung disease after infection with parainfluenza virus.

Development of deep learning algorithm for detecting dyskalemia based on electrocardiogram.

Dyskalemia is a common electrolyte abnormality. Since dyskalemia can cause fatal arrhythmias and cardiac arrest in severe cases, it is crucial to monitor serum potassium (K+) levels on time. We developed deep learning models to detect hyperkalemia (K+ ≥ 5.5 mEq/L) and hypokalemia (K+ < 3.5 mEq/L) from electrocardiograms (ECGs), which are noninvasive and can be quickly measured. The retrospective cohort study was conducted at two hospitals from 2006 to 2020. The training set, validation set, internal testing cohort, and external validation cohort comprised 310,449, 15,828, 23,849, and 130,415 ECG-K+ samples, respectively. Deep learning models demonstrated high diagnostic performance in detecting hyperkalemia (AUROC 0.929, 0.912, 0.887 with sensitivity 0.926, 0.924, 0.907 and specificity 0.706, 0.676, 0.635 for 12-lead, limb-lead, lead I ECGs) and hypokalemia (AUROC 0.925, 0.896, 0.885 with sensitivity 0.912, 0.896, 0.904 and specificity 0.790, 0.734, 0.694) in the internal testing cohort. The group predicted to be positive by the hyperkalemia model showed a lower 30-day survival rate compared to the negative group (p < 0.001), supporting the clinical efficacy of the model. We also compared the importance of ECG segments (P, QRS, and T) on dyskalemia prediction of the model for interpretability. By applying these models in clinical practice, it will be possible to diagnose dyskalemia simply and quickly, thereby contributing to the improvement of patient outcomes.

Real-world safety and effectiveness of lenvatinib in unresectable hepatocellular carcinoma in Korea: post-marketing study.

Aim: This post-marketing surveillance study evaluated the safety and effectiveness of lenvatinib as first-line treatment for unresectable hepatocellular carcinoma in Korea.Materials & methods: Adverse drug reactions (ADRs) and other safety and effectiveness end points were assessed in patients who initiated lenvatinib according to the approved label in republic of Korea.Results: Among 658 lenvatinib-treated patients, ADRs were reported in 57.8%; ADRs grade ≥3 in 13.5%. The most common grade ≥3 ADRs were asthenia (1.2%) and hepatic encephalopathy (1.2%). Physician-reported tumor responses (n = 511) were complete (1.0%) or partial (12.9%) response and stable (45.2%) or progressive disease (40.9%); objective response rates were higher with longer lenvatinib treatment duration (p < 0.001).Conclusion: Lenvatinib was generally well tolerated and effective in real-world clinical practice in Korea.Clinical trial registration: ClinicalTrials.gov NCT05225207.

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High-Performance Electrochemical Creatinine Sensors Based on ß-Lead Dioxide/Single-Walled Carbon Nanotube Electrodes.

Creatinine is an important biomarker of kidney function and muscular metabolism. In this paper, we developed the ß-lead dioxide/single-walled carbon nanotube (ß-PbO2/CNT) and the ß-PbO2/CNT ion-selective electrode (ß-PbO2/CNT/ISE), which were used as highly sensitive potentiometric sensors for creatinine detection. The fabricated electrodes exhibited highly pH-sensitive characteristics due to the synergistic effect of the electrochemical properties of CNT and ß-PbO2. Moreover, an ammonium-ion-selective membrane coating allowed the ß-PbO2/CNT electrode to be NH4+-selective for direct detection of the ammonium ion. By exploiting the electrochemical characteristics of these electrodes, the creatinine assay was established through the one-step selective conversion of creatinine by creatinine deiminase, in which the OH- and NH4+ generated by the enzymatic reaction were detected using ß-PbO2/CNT and ß-PbO2/CNT/ISE electrodes as pH- and NH4+-responsive sensors, respectively. The total creatinine assay can be completed within ∼5 min. The assay results from ß-PbO2/CNT and ß-PbO2/CNT/ISE showed excellent sensitivity values of -75.56 and 64.62 mV in the detection range of 10-400 µM with a fast response (20 s), and the limits of detection were calculated to be 0.06 and 0.13 µM, respectively. Moreover, the developed creatinine sensor showed high selectivity against 11 interfering bio/chemical species with negligible interferences (selectivity coefficient <10-4) and excellent repeatability (>97% within 25 cycles) and long-term stability for 4 weeks of storage. In addition, the feasibility and practicality of the device were successfully demonstrated in human serum tests, with recoveries of 95-104% for PbO2/CNT and 92-110% for PbO2/CNT/ISE.

Optical and Mechanical Properties of the Multi-Transition Zones of a Translucent Zirconia.

OBJECTIVE: To characterize the composition, flexure resistance, and optical properties of a multilayer translucent zirconia in relation to its multi-transition zones. MATERIALS AND METHODS: A multilayer zirconia (5Y/4Y) and a conventional 3 mol% yttria partially stabilized zirconia (3Y) were investigated. Bar-shaped specimens were obtained from the enamel and dentin layers, and the vertical cross-section of 5Y/4Y (N = 10). A four-point flexural (σf) test was performed using a universal testing machine (1.0 mm/min). Plate-shaped specimens (N = 6) were also produced from the enamel, transition 1, transition 2, and dentin layers. Translucency parameters (TPab and TP00) were determined using a dental spectrophotometer (N = 6). X-ray fluorescence and X-ray diffraction techniques were used to analyze elemental (N = 2) and phase compositions (N = 2), respectively. Data were analyzed using analysis of variance (ANOVA) and Tukey's test (α = 0.05). RESULTS: The yttrium content and σf varied between layers of 5Y/4Y. 3Y had the highest σf, followed by dentin. Enamel and cross-section showed lower and statically similar σf. 3Y and dentin groups had similar but statistically lower TPab and TP00 than the enamel. CONCLUSIONS: Different layers of multilayered zirconia have distinct compositions, which affect their mechanical and optical properties. The weak enamel layer compromises the mechanical properties of cross-sectional specimens. CLINICAL SIGNIFICANCE: The development of novel cubic-containing multilayer zirconia ceramics to produce monolithic restorations brings new challenges to dental clinicians and laboratory technicians. The CAD/CAM design of multilayered 5Y/4Y restorations should consider the esthetic and mechanical requirements of each clinical case, as different properties are found in the different layers of these materials.

Potential Anti-tumor Properties of PDIA4 in Lung Adenocarcinoma.

BACKGROUND/AIM: Given the high frequency and mortality rate of lung cancer, diverse molecular studies have been undertaken to understand cancer pathophysiology and develop novel treatment strategies. The PDIA4 gene, which is involved in protein assembly and endoplasmic reticulum homeostasis, is overexpressed in various lung cancer subtypes. However, its exact function in lung adenocarcinoma (LUAD) remains elusive. The study aimed to investigate the role of PDIA4 in LUAD and explore its role as double-agent gene. MATERIALS AND METHODS: PDIA4 expression was knocked out in A549 and LA-4 lung adenoma cells using the Crispr/Cas9 technology. Cell growth, migration, and apoptosis were analyzed in control and PDIA4-deficient cells. RESULTS: PDIA4 deficiency resulted in increased cell growth, enhanced migration capacity, and greater resistance to apoptosis in both A549 and LA-4 lung cancer cells. Mechanistically, up-regulation of oxidative stress followed by NF-[Formula: see text]B activation may contribute to tumor-promoting effects observed upon PDIA4 silencing. CONCLUSION: PDIA4 appears to function as a tumor suppressor in lung adenocarcinoma, suggesting that PDIA4 may act as a double-agent gene, with roles both on tumor suppression and promotion depending on the context.

Bacterial Extracellular Vesicles as Potential Promoting Factors for Oral Lichen Planus Pathogenesis.

Oral lichen planus (OLP) is a chronic inflammatory disease characterized by an intensive infiltration of cytotoxic T cells, which causes keratinocyte death. Abnormal changes within keratinocytes might be critical for OLP onset and progression, but the pathogenic mechanism of OLP is still uncertain. The human oral microbiota, consisting of approximately 50-100 billion bacterial entities, encompasses around 200 dominant bacterial species. These bacteria continuously produce and release extracellular vesicles (EVs), which play a significant role in host-microbe interactions. However, the impact of these bacterial EVs on the progression of OLP has not been fully elucidated. In this study, through comprehensive database analysis and experimental validation, we observed that OLP lesions exhibit elevated inflammatory signatures and significantly increased phosphorylation of STAT3 compared to non-OLP tissues. Notably, EVs derived from key periodontal pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, were shown to induce an inflammatory response and activate STAT3 signaling pathways, closely mirroring the pathophysiological features observed in OLP. These results underscore the potential role of bacterial EVs in the pathogenesis of OLP and highlight STAT3 as a critical mediator in this process.

Enhancement of photovoltaic parameters of thermally stable graphene/LaVO3semitransparent solar cell by employing interfacial graphene quantum dots.

Semitransparent solar cells are attracting attention not only for their visual effects but also for their ability to effectively utilize solar energy. Here, we demonstrate a translucent solar cell composed of bis(trifluoromethane sulfonyl)-amide (TFSA)-doped graphene (Gr), graphene quantum dots (GQDs), and LaVO3. By introducing a GQDs intermediate layer at the TFSA-Gr/LaVO3interface, we can improve efficiency by preventing carrier recombination and promoting charge collection/separation in the device. As a result, the efficiency of the GQDs-based solar cell was 4.35%, which was higher than the 3.52% of the device without GQDs. Furthermore, the average visible transmittance of the device is 28%, making it suitable for translucent solar cells. The Al reflective mirror-based system improved the power conversion efficiency by approximately 7% compared to a device without a mirror. Additionally, the thermal stability of the device remains at 90% even after 2000 h under an environment with a temperature of 60 °C and 40% relative humidity. These results suggest that TFSA-Gr/GQDs/LaVO3-based cells have a high potential for practical use as a next-generation translucent solar energy power source.

A Novel Transgenic Sf9 Cell Line for Quick and Easy Virus Quantification.

The following study was conducted to generate a transgenic Sf9 cell line for rapid and easy virus quantification in the baculovirus expression system (BES). The hr3 (homologous region 3) and 39K and p10 promoters were used as the expression structures to induce rapid and intense expression of the enhanced green fluorescent protein gene in cells in response to viral infection. Of 20 transgenic Sf9 cell lines generated using the piggyBac system, the cell line that showed the highest fluorescence expression in the shortest time in response to viral infection was selected and named Sf9-QE. The average diameter of the Sf9-QE cells was around 16 µm, which is 2 µm smaller than the average diameter of Sf9 cells, whereas the rate of cell proliferation was around 1.6 times higher in the Sf9-QE cells. Virus quantification using the Sf9-QE cell line did not produce significantly different results compared to the other cell lines; however, the time required for complete virus quantification was approximately 5.3 to 6.0 days for the Sf9-QE cells, which is around 4 to 6 days shorter than the time required for the other cell lines, enabling convenient and accurate virus quantification via fluorescence photometry within around 6.0 to 6.3 days. The properties of the Sf9-QE cells were stable for up to at least 100 passages.

Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively. Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques. There has been a decrease in intravenous thrombolysis rates, from 12% in 2017-2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for non-cardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

Understanding medical students' transition to and development in clerkship education: a qualitative study using grounded theory.

BACKGROUND: Medical students perceive the transition to clerkship education as stressful and challenging and view themselves as novices during their rotation in clerkship education. The developmental perspective is thus important because the transition to clerkship supports rather than hinders growth. Accordingly, this study examines medical students' transition to clerkship and their developmental features. METHODS: In-depth interviews were conducted with 18 medical students or graduates who had completed clerkships as medical students. Based on Straussian grounded theory, the collected data were analyzed in terms of the differences between pre- and post-clerkship education. RESULTS: Our data analysis revealed five stages of the transition process: "anticipation and anxiety," "reality check," "seeking solutions," "practical application," and "transition and stability." The core category, that is, "growing up from being students to being student doctors," was driven by patients who perceived the participants as student doctors. Meanwhile, the participants recognized that having a solution that is agreed upon by colleagues was more important than knowing the correct answer. The participants undergoing the transition to clerkship showed developmental features divided into three categories: personal, social, and professional. Specifically, they attempted to balance clerkship and life through personal development, learned to navigate around the hospital and reduced tension through social development, and developed clinical competencies focused on efficiency through professional development. CONCLUSIONS: This study explores the process of students' transition to clerkship education and the developmental features that emerge during this period. The students were motivated by patients who perceived them as student doctors. Through the transition, they maintained a work-life balance and adapted to hospitals but developed an overly doctor-centered attitude by cultivating clinical competencies with a focus on efficiency. To develop them into medical professionals, it is essential to assist their transition and cultivate a patient-centered attitude.

Associations between keystroke and stylus metadata and depressive symptoms in adolescents.

BACKGROUND: Adolescents often experience a heightened incidence of depressive symptoms, which can persist without early intervention. However, adolescents often struggle to identify depressive symptoms, and even when they are aware of these symptoms, seeking help is not always their immediate response. This study aimed to explore the relationship between passively collected digital data, specifically keystroke and stylus data collected via mobile devices, and the manifestation of depressive symptoms. METHODS: A total of 927 first-year middle school students from schools in Seoul solved Korean language and math problems. Throughout this study, 77 types of keystroke and stylus data were collected, including parameters such as the number of key presses, tap pressure, stroke speed, and stroke acceleration. Depressive symptoms were measured using the self-rated Patient Health Questionnaire-9 (PHQ-9). RESULTS: Multiple regression analysis highlighted the significance of stroke length, speed, and acceleration, the average y-coordinate, the tap pressure, and the number of incorrect answers in relation to PHQ-9 scores. The keystroke and stylus metadata were able to reflect mood, energy, cognitive abilities, and psychomotor symptoms among adolescents with depressive symptoms. CONCLUSIONS: This study demonstrates the potential of automatically collected data during school exams or classes for the early screening of clinical depressive symptoms in students. This study has the potential to serve as a cornerstone in the development of digital data frameworks for the early detection of depressive symptoms in adolescents.

Association between Use of Combustible Cigarettes and Noncombustible Nicotine or Tobacco Products and Health-Related Quality of Life in Korean Men: A Nationwide Population-Based Study.

Background: Although the association between smoking and health-related quality of life (HRQoL) has been established, the effects of tobacco products, including combustible cigarettes (CCs) and non-combustible nicotine or tobacco products (NNTPs), on HRQoL remain unclear. This study examined the association between tobacco use and HRQoL in Korean men. Methods: Data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020 were analyzed. A total of 16,429 male participants aged ≥19 years completed the European Quality of Life-5 Dimensions (EQ-5D). Impaired HRQoL was defined as scoring in the lowest 20% of the EQ-5D index and having some or extreme problems in the following five domains of the EQ-5D: mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression. Multiple logistic regression was conducted to evaluate the risk of impaired HRQoL in current tobacco users. Results: Current tobacco users exhibited a significantly higher risk of impaired HRQoL compared with never users (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05-1.92). Compared to never users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05). Moreover, compared with former tobacco users, current tobacco users had a higher risk of impaired HRQoL (OR, 1.60; 95% CI, 1.18-2.17). Compared to former tobacco users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05). Conclusion: Use of CCs and NNTPs is associated with impaired HRQoL in Korean men. Therefore, further interventions for lifestyle modification and smoking cessation treatments are required to reduce the risk of impaired HRQoL among current tobacco users.

Acoustic deep brain modulation: Enhancing neuronal activation and neurogenesis.

BACKGROUND: Non-invasive deep brain modulation (DBM) stands as a promising therapeutic avenue to treat brain diseases. Acoustic DBM represents an innovative and targeted approach to modulate the deep brain, employing techniques such as focused ultrasound and shock waves. Despite its potential, the optimal mechanistic parameters, the effect in the brain and behavioral outcomes of acoustic DBM remains poorly understood. OBJECTIVE: To establish a robust protocol for the shock wave DBM by optimizing its mechanistic profile of external stimulation, and to assess its efficacy in preclinical settings. METHODS: We used shockwaves due to their capacity to leverage a broader spectrum of peak intensity (10-127 W/mm2) in contrast to ultrasound (0.1-5.0 W/mm2), thereby enabling a more extensive range of neuromodulation effects. We established various types of shockwave pressure profiles of DBM and compared neural and behavioral responses. To ascertain the anticipated cause of the heightened neural activity response, numerical analysis was employed to examine the mechanical dynamics within the brain. RESULTS: An optimized profile led to an enhancement in neuronal activity within the hypothalamus of mouse models. The optimized profile in the hippocampus elicited a marked increase in neurogenesis without neuronal damage. Behavioral analyses uncovered a noteworthy reduction in locomotion without significant effects on spatial memory function. CONCLUSIONS: The present study provides an optimized shock wave stimulation protocol for non-invasive DBM. Our optimized stimulation profile selectively triggers neural functions in the deep brain. Our protocol paves the way for new non-invasive DBM devices to treat brain diseases.

Toward Objectification of Subjective Chronic Pain based on Implicit Response in Biosignals.

OBJECTIVE: Chronic pain necessitates early intervention and accurate evaluation. Current subjective questionnaire -based methods have limitations. This study aims to develop a chronic pain assessment method based on multi-modal biosignal and to validate its feasibility. METHODS: We present a model utilizing electroencephalogram (EEG), photoplethysmogram (PPG), electrocardiogram (ECG), and facial temperature (FT) data from 59 subjects (26 chronic pain patients). A total of 112 features were derived from all signals, and 17 of them showed a significant difference between the chronic pains and the normal control. RESULTS: By optimizing signal types and feature combinations, our pain classification model significantly enhanced chronic pain assessment (AUROC: 0.802 to 0.864). Notable features included PPG systolic length (12.3%), EEG alpha band power (11.1%), and delta band power (9.4%). CONCLUSION: This multi-modal biosignal approach holds promise for effective chronic pain quantification.

Philosophies And Surgical Techniques on Os Odontoideum Treatment with Literature Review.

Introduction: Os-odontoideum is a rare condition described radiographically and clinically as a congenital anomaly of the second cervical vertebra (axis). It is a smooth, independent ossicle of variable size and shape separated from the base of a shortened odontoid process by an obvious gap, with no osseous connection to the body of C2. Materials and Methods: This study reviewed the literature on OO to evaluate its etiology, clinical presentations, differential diagnosis, imaging modalities, and outcomes in the management of asymptomatic and symptomatic cases of Os Odontoideum. Key articles from PubMed, EMBASE, Google Scholar, and Cochrane were searched. Discussion: Considering etiology, the traumatic hypothesis is favoured over the congenital hypothesis as per recent literature on OO. Clinical presentation varies from asymptomatic to mild neck pain to severe myelopathy and neurodeficit. Various C1-C2 instrumentation and fusion techniques like wiring, trans articular screw and laminar screws have been described with success rates. Conclusion: Os odontoideum is a rare condition with limited existing literature. Considering the significant risks involved if conservative management opts, like severe neuro deficit to sudden death on trivial trauma and the recent improvement of imaging tools helping to understand the pathology of the disease, surgery can be indicated even in an incidentally detected os odontoideum. However, a case-by-case approach can be considered for stable asymptomatic patients depending on factors such as age, activity level, comorbidities, syndromic association, and radiographic findings.

Male cuticular pheromones stimulate removal of the mating plug and promote re-mating through pC1 neurons in Drosophila females.

In birds and insects, the female uptakes sperm for a specific duration post-copulation known as the ejaculate holding period (EHP) before expelling unused sperm and the mating plug through sperm ejection. In this study, we found that Drosophila melanogaster females shortens the EHP when incubated with males or mated females shortly after the first mating. This phenomenon, which we termed male-induced EHP shortening (MIES), requires Or47b+ olfactory and ppk23+ gustatory neurons, activated by 2-methyltetracosane and 7-tricosene, respectively. These odorants raise cAMP levels in pC1 neurons, responsible for processing male courtship cues and regulating female mating receptivity. Elevated cAMP levels in pC1 neurons reduce EHP and reinstate their responsiveness to male courtship cues, promoting re-mating with faster sperm ejection. This study established MIES as a genetically tractable model of sexual plasticity with a conserved neural mechanism.

Comparison of Soy and Pea Protein for Cultured Meat Scaffolds: Evaluating Gelation, Physical Properties, and Cell Adhesion.

Cultured meat is under investigation as an environmentally sustainable substitute for conventional animal-derived meat. Employing a scaffolding technique is one approach to developing cultured meat products. The objective of this research was to compare soy and pea protein in the production of hydrogel scaffolds intended for cultured meat. We examined the gelation process, physical characteristics, and the ability of scaffolds to facilitate cell adhesion using mesenchymal stem cells derived from porcine adipose tissue (ADSCs). The combination of soy and pea proteins with agarose and agar powders was found to generate solid hydrogels with a porous structure. Soy protein-based scaffolds exhibited a higher water absorption rate, whereas scaffolds containing agarose had a higher compressive strength. Based on Fourier transform infrared spectroscopy analysis, the number of hydrophobic interactions increased between proteins and polysaccharides in the scaffolds containing pea proteins. All scaffolds were nontoxic toward ADSCs, and soy protein-based scaffolds displayed higher cell adhesion and proliferation properties. Overall, the soy protein-agarose scaffold was found to be optimal for cultured meat production.

Effect of settling time and organic loading rates on aerobic granulation processes treating high strength wastewater.

Despite its numerous advantages, the aerobic granular sludge (AGS) process faces several challenges that hinder its widespread implementation. One such challenge is the requirement for high organic load ratios (OLR), which significantly impacts AGS formation and stability, posing a barrier to commercialization. In response to these challenges, this study investigates the granulation and treatment efficacy of the AGS process for treating high-concentration wastewater under various OLR and settling time. Three sequential batch reactors (R1, R2, R3) were operated at OLRs of 0.167, 0.33, and 1 kg COD/m3·day. The study focuses on analyzing key parameters including sludge characteristics, extracellular polymeric substances (EPS) content, PN/PS ratio, and microbial clusters. Results demonstrate that reducing settling time from 90 to 30 min enhances sludge settleability, resulting in a maximum 50.8 % decrease in SVI30 (from 98.1 to 122.8 mL/g to 51.9-81.3 mL/g), thereby facilitating the selection of beneficial microorganisms during granulation. Particularly, at R2, the PN/PS ratio was 4.3, and EPS content increased by 1.52-fold, leading to a 1.41-fold increase in sludge attachment. This observation suggests a progressive maturation of AGS. Additionally, analysis of microbial diversity and cluster composition highlights the influence of OLR variations on the ratios of Proteobacteria and Bacteroidetes. These findings emphasize the significant impact of SBR operational strategies on AGS process performance and biological stability, offering valuable insights for the efficient operation of future high-concentration wastewater treatment processes.

Analysis of the waitlist performance and post-transplant outcomes of lung transplant in elderly recipients in Korea: A nationwide cohort study.

BACKGROUND: There is a lack of information on the waitlist performance and post-transplant outcomes of lung transplants in elderly recipients in Korea. METHODS: We retrospectively reviewed and analyzed data from the Korean Network for Organ Sharing database between March 2010 and August 2023. RESULTS: In total, 2574 patients were listed for lung transplantation during the study period, with 511 (19.9%) of them being over 65 years of age. Among these, 188 patients (36.8%) underwent transplantation, while 184 patients (36%) passed away without undergoing transplantation at the time of data extraction. The most prevalent underlying disease on the waitlist was idiopathic pulmonary fibrosis, accounting for 68.1%. The 1-year survival rate was significantly lower in the elderly compared to that in the nonelderly (65.4 vs. 75.4%; p = .004). In the multivariate Cox analysis, elderly (hazard ratio [HR], 1.49; 95% CI, 1.14-1.97; p = .004) and a high urgent status at registration (HR, 1.83; 95% CI, 1.40-2.40; p < .001) were significantly associated with post-transplant 1-year mortality. Kaplan-Meier curves demonstrated a significant difference in post-transplant mortality based on the urgency status at enrollment (χ2 = 8.302, p = .016). Even with the same highly urgent condition at the time of transplantation, different prognoses were observed depending on the condition at listing (χ2 = 9.056, p = .029). CONCLUSION: The elderly exhibited worse transplant outcomes than nonelderly adults, with a highly urgent status at registration identified as a significant risk factor. Unprepared, highly urgent transplantation was associated with poor outcomes.