The role of supervisor support in the association between night work and depressive symptoms: a gender-stratified analysis of 22,422 full-time wage workers in South Korea.

Objectives: This study investigated the relationship between night work, supervisor support, and depressive symptoms among full-time wage workers, with a focus on gender differences. Methods: A nationwide sample of 22,422 full-time wage workers from the Sixth Korean Working Conditions Survey (2020-2021) was analyzed. Experiences of night work were categorized into 5 groups based on the number of night work days per month: 0, 1-5, 6-10, 11-15, and 16-31. Depressive symptoms were evaluated using the 5-item World Health Organization Well-Being Index. Supervisor support was assessed with 5 items. Results: Workers who engaged in 1-5 days (prevalence ratio [PR], 1.23; 95% CI, 1.12-1.36) and 6-10 days (PR, 1.17; 95% CI, 1.06-1.30) of night work per month exhibited a higher prevalence of depressive symptoms than those without night work. After stratifying by supervisor support levels, workers with 1-5, 6-10 and 11-15 days of night work per month were more likely to experience depressive symptoms compared to those without night work in the low supervisor support group. In contrast, no association was found between night work (≥ 6 days) and depressive symptoms in the high supervisor support group. Furthermore, gender differences were notable: female workers with 6-10 days (PR, 1.45; 95% CI, 1.23-1.70), and 11-15 days (PR, 1.43; 95% CI, 1.08-1.90) of night work per month exhibited a higher prevalence of depressive symptoms, whereas their male counterparts did not. This pattern of gender difference was also found among those with low supervisor support. Conclusion: Supervisor support may mitigate the adverse effects of night work on depressive symptoms among full-time wage workers, with differences manifested across genders.

The Protective Role of Transcription Factor Nrf2 in Murine Macrophage Activation Syndrome.

OBJECTIVE: Macrophage activation syndrome (MAS) is characterized by multi-lineage cytopenias, hypercytokinemia, and tissue hemophagocytosis. Transcription factor Nrf2 is a master regulator of redox homeostasis. In this work we aim to investigate the role of Nrf2 in murine hyperinflammation and the mechanisms by which Nrf2 activation by red blood cell products regulates pro-inflammatory cytokine production. METHODS: We induce murine MAS in wildtype and Nrf2 knockout (Nrf2 -/-) mice by repeat administration of TLR9-agonist CpG. Clinical and biochemical markers of disease were measured including complete blood counts, liver and spleen pathology, serum free heme, ferritin, and cytokine profiles. In vitro bone marrow derived macrophages and dendritic cells were used to investigate regulation of CpG-induced cytokine expression by oxidized red blood cells and hemin. RESULTS: Patients with hyperinflammatory disease have higher levels of Nrf2 gene expression. Mice with CpG-induced hyperinflammation have elevated systemic lipid peroxidation which is exacerbated in Nrf2 -/- mice. Compared to wildtype controls, Nrf2 -/- mice develop significantly worse organomegaly, organ pathology, and reticulocytosis. Nrf2 -/- mice have exacerbated hypercytokinemia in cytokines central MAS physiology: IL-12, IFNg, and IL-10. In vitro we found that oxidized red blood cell lysates and hemin are able to suppress IL-12 transcription and protein production from bone marrow derived dendritic cells in a Nrf2-dependent manner. CONCLUSION: Together our findings show that transcription factor Nrf2 is highly expressed in patients with hyperinflammatory disease and demonstrate a protective role for Nrf2 in a murine model of MAS in part due to Nrf2-mediated suppression of proinflammatory cytokine production.

Customer verbal abuse is associated with depressive symptoms among high-workload cosmetics sales workers in South Korea.

This study sought to investigate whether association between customer verbal abuse and depressive symptoms differed by workload. We conducted a cross-sectional survey of 795 cosmetic sales workers at department store in South Korea. Experience of customer verbal abuse over the past one month was measured by using a yes/no question. Depressive symptoms during the preceding week were assessed by using 20 items from the Center for Epidemiologic Studies-Depression scale. Workload during the past week was measured by asking the number of customers a worker dealt with on average in a day and classified into two categories: 1) Low (15 people or less), and 2) High (more than 15 people). Cosmetics sales workers' experience of customer verbal abuse was associated with a higher prevalence of depressive symptoms (PR: 1.37, 95% CI: 1.15-1.63). After being stratified by workload, customer verbal abuse showed a statistically significant association with depressive symptoms among high workload groups (PR: 1.46, 95% CI: 1.19-1.79), whereas the association was not statistically significant among low workload group (PR: 1.23, 95% CI: 0.91-1.65). Our findings suggest that experience of customer verbal abuse could have a negative influence on depressive symptoms among high-workload cosmetics sales workers in South Korea.

Disparities in Workplace Hazards and Organizational Protection Resources by Enterprise Size: A National Representative Study of South Korean Manufacturing Workers.

Background: This study aimed to identify the prevalence of workplace hazards and organizational protection resources according to the size of the enterprise in the manufacturing industry of the Republic of Korea. Methods: We analyzed data of waged workers (weighted N = 5,879) from the Fifth Korean Working Conditions Survey (2017). Enterprise sizes were categorized as "micro enterprises" (less than five employees), "small enterprises" (5-49 employees) and "medium-large enterprises" (50 or more employees). Self-reported exposure to 18 physical, chemical, ergonomic, and psychological hazards were measured. The presence of organizational protection resources such as a labor union, a safety delegate working at the company, designated spaces to deal with safety, and the provision of health and safety information was evaluated. Results: Compared to workers in medium-large enterprises, those in micro enterprises showed a higher proportion of exposure to most of physical, chemical, ergonomic, and psychological hazards, except for exposure to solvents, prolonged sitting, and experiencing a state of emotional unrest. On the other hand, workers in micro enterprises had the lowest proportion of access to organizational protection resources. Conclusion: Our study demonstrates that manufacturing workers at the micro enterprise in the Republic of Korea are exposed to the most hazardous work environment and yet have access to the fewest organizational protection resources.

Serum cytokine panels in pediatric clinical practice.

BACKGROUND: Cytokines are soluble signaling proteins that regulate inflammation and coordinate immune responses. Serum cytokine panels are increasingly used in medical practice, yet our understanding of cytokines as biomarkers for disease remains limited. OBJECTIVE: We sought to analyze real-world single-center use of a multiplexed cytokine panel, correlate its results with diagnosis and severity, and explore its use in pediatric practice. METHODS: A multiplexed cytokine panel, able to return same-day results, was implemented in April 2020 at the Children's Hospital of Philadelphia (Philadelphia, Pa) and its performance was validated for clinical use. Coded patient data were collected using the REDCap database, and correlations between cytokine levels and outcomes of interest were analyzed retrospectively. RESULTS: Cytokine levels correlate with acuity of care, with patients admitted to the pediatric intensive care unit having the highest cytokine values. Patients with familial hemophagocytic lymphohistiocytosis (fHLH) showed prominent peaks in IFN-γ, IL-10, and TNF, whereas patients with sepsis exhibited high IL-6 and IL-8 with relatively modest IFN-γ. Cytokine release syndrome (CRS) after chimeric antigen receptor T-cell therapy often demonstrated pan-panel positivity at peak levels, with a similar pattern as that of fHLH. A ratio of [IFN-γ] + [IL-10]/[IL-6] + [IL-8] levels was able to distinguish fHLH and CRS from severe sepsis. CONCLUSIONS: Cytokine levels correlate with severity of illness and can help differentiate between syndromes that present similarly, including fHLH and CRS compared with sepsis. Cytokine panels can be used as biomarkers to inform diagnosis and management decisions, but significant work remains to dissect complex clinical patterns of disease.

Transcriptome Analysis of the Striatum of Electroacupuncture-treated Naïve and Ischemic Stroke Mice.

Objectives: Electroacupuncture (EA) has been demonstrated to aid stroke recovery. However, few investigations have focused on identifying the potent molecular targets of EA by comparing EA stimulation between naïve and disease models. Therefore, this study was undertaken to identify the potent molecular therapeutic mechanisms underlying EA stimulation in ischemic stroke through a comparison of mRNA sequencing data obtained from EA-treated naïve control and ischemic stroke mouse models. Methods: Using both naïve control and middle cerebral artery occlusion (MCAO) mouse models, EA stimulation was administered at two acupoints, Baihui (GV20) and Dazhui (GV14), at a frequency of 2 Hz. Comprehensive assessments were conducted, including behavioral evaluations, RNA sequencing to identify differentially expressed genes (DEGs), functional enrichment analysis, protein-protein interaction (PPI) network analysis, and quantitative real-time PCR. Results: EA stimulation ameliorated the ischemic insult-induced motor dysfunction in mice with ischemic stroke. Comparative analysis between control vs. MCAO, control vs. control + EA, and MCAO vs. MCAO + EA revealed 4,407, 101, and 82 DEGs, respectively. Of these, 30, 7, and 1 were common across the respective groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed upregulated DEGs associated with the regulation of inflammatory immune response in the MCAO vs. MCAO + EA comparison. Conversely, downregulated DEGs in the control vs. control + EA comparison were linked to neuronal development. PPI analysis revealed major clustering related to the regulation of cytokines, such as Cxcl9, Pcp2, Ccl11, and Cxcl13, in the common DEGs of MCAO vs. MCAO + EA, with Esp8l1 identified as the only common downregulated DEG in both EA-treated naïve and ischemic models. Conclusion: These findings underscore the diverse potent mechanisms of EA stimulation between naïve and ischemic stroke mice, albeit with few overlaps. However, the potent mechanisms underlying EA treatment in ischemic stroke models were associated with the regulation of inflammatory processes involving cytokines.

Digital in-line holographic microscopy for label-free identification and tracking of biological cells.

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.

People-Oriented Culture and Its Association With Burnout, Depressive Symptoms, and Sleep Problems During COVID-19 Pandemic Among EMS Providers in Korea.

OBJECTIVE: This study examined how perceived people-oriented culture (POC) was associated with burnout, depressive symptoms, and sleep problems during the COVID-19 pandemic among emergency medical service (EMS) providers in Korea. METHODS: We conducted a cross-sectional survey among 693 EMS providers in 2021. RESULTS: Overall, prevalence of personal burnout, work-related burnout, and citizen-related burnout were 61.5%, 60.0%, and 60.6%, respectively. Prevalence of depressive symptoms was 25.1%. Prevalence of poor sleep quality, unrestful sleep, and sleep disturbance were 46.5%, 58.2%, and 52.2%, respectively. Compared to high POC group, higher prevalence of depressive symptoms was observed among medium (prevalence ratio: 1.57, 95% CI: 1.06, 2.32) and low (prevalence ratio: 2.70, 95% CI: 1.92, 3.79) POC group. Similar trends were observed in the analysis of burnout and sleep problems. CONCLUSIONS: Our findings underscore that low POC could play a critical role in worsening burnout, depressive symptoms, and sleep problems among EMS providers.

Ethnic discrimination, asking for fair treatment, and poor self-rated health: a gender stratified analysis of 13,443 Korean Chinese waged workers in South Korea.

BACKGROUND: In South Korea, Korean Chinese workers experience ethnic discrimination although they share physical similarities and ethnic heritage with native-born Koreans. This study aimed to examine whether perceived ethnic discrimination is associated with poor self-rated health and whether the association differs by gender among Korean Chinese waged workers in South Korea. METHODS: We conducted a pooled cross-sectional analysis using data of 13,443 Korean Chinese waged workers from the Survey on Immigrants' Living Conditions and Labor Force conducted in 2018, 2020, and 2022. Based on perceived ethnic discrimination, asking for fair treatment, and subsequent situational improvement, respondents were classified into the following four groups: "Not experienced," "Experienced, not asked for fair treatment," "Experienced, asked for fair treatment, not improved," and "Experienced, asked for fair treatment, improved." Poor self-rated health was assessed using a single question "How is your current overall health?" We applied logistic regression to examine the association between perceived ethnic discrimination and poor self-rated health, with gender-stratified analyses. RESULTS: We found an association between ethnic discrimination and poor self-rated health among Korean Chinese waged workers. In the gender-stratified analysis, the "Experienced, not asked for fair treatment" group was more likely to report poor self-rated health compared to the "Not experienced" group, regardless of gender. However, gender differences were observed in the group stratified by situational improvements. For male workers, no statistically significant association was found in the "Experienced, asked for fair treatment, improved" group with poor self-rated health (odd ratios: 0.87, 95% confidence intervals: 0.30-2.53). Conversely, among female workers, a statistically significant association was observed (odd ratios: 2.63, 95% confidence intervals: 1.29-5.38). CONCLUSIONS: This study is the first to find an association between perceived ethnic discrimination and poor self-rated health, along with gender differences in the association between situational improvements after asking for fair treatment and poor self-rated health among Korean Chinese waged workers in South Korea.

Identifying Candidate Polyphenols Beneficial for Oxidative Liver Injury through Multiscale Network Analysis.

Oxidative stress, a driver of liver pathology, remains a challenge in clinical management, necessitating innovative approaches. In this research, we delved into the therapeutic potential of polyphenols for oxidative liver injury using a multiscale network analysis framework. From the Phenol-Explorer database, we curated a list of polyphenols along with their corresponding PubChem IDs. Verified target information was then collated from multiple databases. We subsequently measured the propagative effects of these compounds and prioritized a ranking based on their correlation scores for oxidative liver injury. This result underwent evaluation to discern its effectiveness in differentiating between known and unknown polyphenols, demonstrating superior performance over chance level in distinguishing these compounds. We found that lariciresinol and isopimpinellin yielded high correlation scores in relation to oxidative liver injury without reported evidence. By analyzing the impact on a multiscale network, we found that lariciresinol and isopimpinellin were predicted to offer beneficial effects on the disease by directly acting on targets such as CASP3, NR1I2, and CYP3A4 or by modulating biological functions related to the apoptotic process and oxidative stress. This study not only corroborates the efficacy of identified polyphenols in liver health but also opens avenues for future investigations into their mechanistic actions.

Change in employment status and its causal effect on suicidal ideation and depressive symptoms: A marginal structural model with machine learning algorithms.

OBJECTIVE: This study aimed to assess the causal effect of a change in employment status on suicidal ideation and depressive symptoms by applying marginal structural models (MSM) with machine-learning (ML) algorithms. METHODS: We analyzed data from the 8-15th waves (2013-2020) of the Korean Welfare Panel Study, a nationally representative longitudinal dataset. Our analysis included 13 294 observations from 3621 participants who had standard employment at baseline (2013-2019). Based on employment status at follow-up year (2014-2020), respondents were classified into two groups: (i) maintained standard employment (reference group), (ii) changed to non-standard employment. Suicidal ideation during the past year and depressive symptoms during the past week were assessed through self-report questionnaire. To apply the ML algorithms to the MSM, we conducted eight ML algorithms to build the propensity score indicating a change in employment status. Then, we applied the MSM to examine the causal effect by using inverse probability weights calculated based on the propensity score from ML algorithms. RESULTS: The random forest algorithm performed best among all algorithms, showing the highest area under the curve 0.702, 95% confidence interval (CI) 0.686-0.718. In the MSM with the random forest algorithm, workers who changed from standard to non-standard employment were 2.07 times more likely to report suicidal ideation compared to those who maintained standard employment (95% CI 1.16-3.70). A similar trend was observed in the analysis of depressive symptoms. CONCLUSIONS: This study found that a change in employment status could lead to a higher risk of suicidal ideation and depressive symptoms.

Photonic control of ligand nanospacing in self-assembly regulates stem cell fate.

Extracellular matrix (ECM) undergoes dynamic inflation that dynamically changes ligand nanospacing but has not been explored. Here we utilize ECM-mimicking photocontrolled supramolecular ligand-tunable Azo+ self-assembly composed of azobenzene derivatives (Azo+) stacked via cation-π interactions and stabilized with RGD ligand-bearing poly(acrylic acid). Near-infrared-upconverted-ultraviolet light induces cis-Azo+-mediated inflation that suppresses cation-π interactions, thereby inflating liganded self-assembly. This inflation increases nanospacing of "closely nanospaced" ligands from 1.8 nm to 2.6 nm and the surface area of liganded self-assembly that facilitate stem cell adhesion, mechanosensing, and differentiation both in vitro and in vivo, including the release of loaded molecules by destabilizing water bridges and hydrogen bonds between the Azo+ molecules and loaded molecules. Conversely, visible light induces trans-Azo+ formation that facilitates cation-π interactions, thereby deflating self-assembly with "closely nanospaced" ligands that inhibits stem cell adhesion, mechanosensing, and differentiation. In stark contrast, when ligand nanospacing increases from 8.7 nm to 12.2 nm via the inflation of self-assembly, the surface area of "distantly nanospaced" ligands increases, thereby suppressing stem cell adhesion, mechanosensing, and differentiation. Long-term in vivo stability of self-assembly via real-time tracking and upconversion are verified. This tuning of ligand nanospacing can unravel dynamic ligand-cell interactions for stem cell-regulated tissue regeneration.

Optimal bilayer composites for temperature-tracking wireless electronics.

Modern silicone-based epidermal electronics engineered for body temperature sensing represent a pivotal development in the quest for advancing preventive medicine and enhancing post-surgical monitoring. While these compact and highly flexible electronics empower real-time monitoring in dynamic environments, a noteworthy limitation is the challenge in regulating the infiltration or obstruction of heat from the external environment into the surface layers of these electronics. The study presents a cost-effective temperature sensing solution by embedding wireless electronics in a multi-layered elastomeric composite to meet the dual needs of enhanced thermal insulation for encapsulation in contact with air and improved thermal conductivity for the substrate in contact with the skin. The encapsulating composite benefits from the inclusion of hollow silica microspheres, which reduce the thermal conductivity by 40%, while non-spherical aluminum nitride enhances the thermal conductivity of the substrate by 370%. The addition of particles to the respective composites inevitably leads to an increase in modulus. Two composite elements are engineered to coexist while maintaining a matching low modulus of 3.4 MPa and a stretchability exceeding 30%, all without compromising the optimized thermal properties. Consecutive thermal, electrical, and mechanical characterization confirms the sensor's capacity for precise body temperature monitoring during a single day's lifespan, while also assessing the influence of behavioral factors on body temperature.

Accuracy of zirconia crown manufactured using stereolithography and digital light processing.

OBJECTIVES: The aim of this study is to evaluate the accuracy of zirconia crowns fabricated using stereolithography (SLA) and digital light processing (DLP) and to compare their accuracy with those fabricated using the subtractive manufacturing (SM) method. METHODS: A typodont model with a prepared maxillary first molar was scanned, and the anatomical contour crown was designed using dental computer-aided-design (CAD) software. The designed file in standard tessellation language (STL) format was used to fabricate 10 crowns per group. The crowns were manufactured using a dental milling machine (Datron D5; MLC group), SLA (CERAMAKER 900; SLAC group), and DLP (ZIPRO; DLPC group) printers. The fabricated crowns were scanned using a dental laboratory scanner and saved in three parts: the external, intaglio, and marginal surfaces. For accuracy assessment, these parts were superimposed to the reference file. Root mean square (RMS) values were evaluated using three-dimensional analysis software (Geomagic Control X). Statistical significance was evaluated using a nonparametric Kruskal-Wallis test (α = 0.05) and a post-hoc Mann-Whitney U test with Bonferroni correction (α = 0.016). RESULTS: Trueness evaluation revealed the lowest RMS value in all areas in the MLC group, followed by that in the DLPC group. The precision evaluation revealed the lowest RMS value in all areas in the MLC group. Statistically significant differences were observed among the groups in the external, intaglio, and marginal surface (P < 0.05). CONCLUSIONS: Although the restorations fabricated using SM revealed higher accuracy, the crowns manufactured using SLA and DLP methods were considered clinically acceptable. CLINICAL SIGNIFICANCE: In the production of zirconia crowns, subtractive manufacturing continues to demonstrate significantly higher accuracy compared to additive manufacturing. However, crowns fabricated using the additive manufacturing method also demonstrated high accuracy.

Utilizing Gate-Controlled Supercurrent for All-Metallic Tunable Superconducting Microwave Resonators.

Hybridizing a microwave mode with a quantum state requires precise frequency matching of a superconducting microwave resonator and the corresponding quantum object. However, fabrication always brings imperfections in geometry and material properties, causing deviations from the desired operating frequencies. An effective and universal strategy for their resonant coupling is to tune the frequency of a resonator, as quantum states like phonons are hardly tunable. Here, we demonstrate gate-tunable, titanium-nitride (TiN)-based superconducting resonators by implementing a nanowire inductor whose kinetic inductance is tuned via the gate-controlled supercurrent (GCS) effect. We investigate their responses for different gate biases and observe 4% (∼150 MHz) frequency tuning with decreasing internal quality factors. We also perform temperature-controlled experiments to support phonon-related mechanisms in the GCS effect and the resonance tuning. The GCS effect-based method proposed in this study provides an effective route for locally tunable resonators that can be employed in various hybrid quantum devices.

Female workers with long working hours are more likely to have depressive symptoms when having family-to-work conflict.

PURPOSE: Workers' health can be influenced by risk factors from their family environments as well as their work environments. This paper sought to examine how the association between long working hours and depressive symptoms differs based on the level of FWC after being stratified by worker's gender. METHODS: We used the dataset of 20,384 full-time wage workers from the sixth Korean Working Conditions Survey (2020). Long working hours were defined as working 52 h or more per week. FWC was measured using a 2-item questionnaire, and depressive symptoms were measured using the WHO-5 well-being index. Applying modified Poisson regression, we evaluated how the association between long working hours and depressive symptoms differs by the level of FWC male and female workers separately. RESULTS: In the analysis of the female workers, long working hours were associated with depressive symptoms in the high FWC group (PR 1.35, 95% CI 1.17, 1.55) after adjusting for potential confounders whereas no association was observed in the low FWC group. Among the male workers, a statistically significant association was observed in both high FWC (PR 1.22, 95% CI 1.07, 1.38) and low FWC (PR 1.28, 95% CI 1.12, 1.47) groups. CONCLUSION: FWC may act as a workplace stressor that potentially amplifies the health impact of long working hours among female workers.

Necking Reduction at Low Temperature in Aspect Ratio Etching of SiO2 at CF4/H2/Ar Plasma.

This study investigated the effect of temperature on the aspect-ratio etching of SiO2 in CF4/H2/Ar plasma using patterned samples of a 200 nm trench in a low-temperature reactive-ion etching system. Lower temperatures resulted in higher etch rates and aspect ratios for SiO2. However, the plasma property was constant with the chuck temperature, indicated by the line intensity ratio from optical emission spectroscopy monitoring of the plasma. The variables obtained from the characterization of the etched profile for the 200 nm trench after etching were analyzed as a function of temperature. A reduction in the necking ratio affected the etch rate and aspect ratio of SiO2. The etching mechanism of the aspect ratio etching of SiO2 was discussed based on the results of the surface composition at necking via energy-dispersive X-ray spectroscopy with temperature. The results suggested that the neutral species reaching the etch front of SiO2 had a low sticking coefficient. The bowing ratio decreased with lowering temperature, indicating the presence of directional ions during etching. Therefore, a lower temperature for the aspect ratio etching of SiO2 could achieve a faster etch rate and a higher aspect ratio of SiO2 via the reduction of necking than higher temperatures.

Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients.

Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a mediating factor in the association between galectin-3 and mortality. Serum galectin-3 and baseline aortic arch calcification (AoAC) score were measured in 477 incident HD patients. Mortality data were obtained at a median follow-up of 40 months. Causal mediation analysis was performed to examine the effect of vascular risk factors on galectin-3-related mortality. The prevalence of AoAC in HD patients was 57% (n = 272), and elevated galectin-3 levels were associated with a significantly increased risk of AoAC. When the galectin-3 level was divided by the median level of 37 ng/mL, a higher galectin group increased the risk of all-cause mortality by 1.71-fold (95% CI 1.02-2.92, p = 0.048), even after adjustment for multiple CV risk factors. Mediation analysis showed that both the direct effect of the galectin-3 on mortality (ß = 0.0368, bootstrapped 95% CI [0.0113-0.0622]) and the indirect effects were significant. AoAC score and high-sensitivity CRP levels significantly mediated the association between galectin-3 and mortality (total indirect effects: ß = 0.0188, bootstrapped 95% CI [0.0066-0.0352]). This study suggests that the association between high galectin-3 and mortality may be partially mediated by higher VC and inflammatory state in HD patients.

Usefulness of a drill stopper to prevent iatrogenic soft tissue injury in orthopedic surgery.

Objective: This study introduces a novel technique utilizing a drill stopper to limit drill penetration depth and to prevent iatrogenic injuries, specifically neurovascular damage, in orthopedic surgeries. Orthopedic surgeries frequently involve the use of drills, which are essential tools for various procedures. However, improper handling of drills can lead to iatrogenic soft tissue injuries, causing severe consequences such as permanent disability or life-threatening complications. To address this issue, we propose the use of a drill stopper as a safeguard to prevent excessive drill penetration and reduce the risk of soft tissue damage during surgery. Materials and Methods: The study involved 32 orthopedic surgeons, half of whom were experienced and the other half inexperienced. Synthetic femur bone models (Synbone) were used for drilling exercises, employing four configurations: a sharp drill bit without a stopper (SF, Sharp Free), a sharp drill bit with a stopper (SS, Sharp Stopper), a blunt drill bit without a stopper (BF, Blunt Free), and a blunt drill bit with a stopper (BS, Blunt Stopper). Each participant conducted three trials for each configuration, and the penetration depth was measured after each trial. Results: For experienced surgeons, the average penetration depths were 3.83 (±1.826)mm for SF, 11.02 (±3.461)mm for BF, 2.88 (±0.334)mm for SS, and 2.75 (±0.601)mm for BS. In contrast, inexperienced surgeons had average depths of 8.52 (±4.608)mm for SF, 18.75 (±4.305)mm for BF, 2.96 (±0.683)mm for SS, and 2.83 (±0.724)mm for BS. Conclusion: The use of a drill stopper was highly effective in controlling drill penetration depth and preventing iatrogenic injuries during orthopedic surgeries. We recommend its incorporation, particularly when using a blunt drill bit or when an inexperienced surgeon operates in an anatomically unfamiliar area. Using the drill stopper, the risk of severe injuries from excessive drill penetration can be minimized, leading to improved patient safety and better surgical outcomes.