Clinical Manifestations and Genotype of Primary Ciliary Dyskinesia Diagnosed in Korea: Multicenter Study.

PURPOSE: Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disorder that leads to secondary ciliary dysfunction. PCD is a rare disease, and data on it are limited in Korea. This study systematically evaluated the clinical symptoms, diagnostic characteristics, and treatment modalities of pediatric PCD in Korea. METHODS: This Korean nationwide, multicenter study, conducted between January 2000 and August 2022, reviewed the medical records of pediatric patients diagnosed with PCD. Prospective studies have been added to determine whether additional genetic testing is warranted in some patients. RESULTS: Overall, 41 patients were diagnosed with PCD in 15 medical institutions. The mean age at diagnosis was 11.8 ± 5.4 years (range: 0.5 months-18.9 years). Most patients (40/41) were born full term, 15 (36.6%) had neonatal respiratory symptoms, and 12 (29.3%) had a history of admission to the neonatal intensive care unit. The most common complaint (58.5%) was chronic nasal symptoms. Thirty-three patients were diagnosed with transmission electron microscopy (TEM) and 12 patients by genetic studies. TEM mostly identified outer dynein arm defects (alone or combined with inner dynein arm defects, n = 17). The genes with the highest mutation rates were DNAH5 (3 cases) and DNAAF1 (3 cases). Rare genotypes (RPGR, HYDIN, NME5) were found as well. Chest computed tomography revealed bronchiectasis in 33 out of 41 patients. Among them, 15 patients had a PrImary CiliAry DyskinesiA Rule score of over 5 points. CONCLUSIONS: To our knowledge, this is the first multicenter study to report the clinical characteristics, diagnostic methods, and genotypes of PCD in Korea. These results can be used as basic data for further PCD research.

Efficacy and Safety of Low-Dose Cyclosporine Relative to Immunomodulatory Drugs Used in Atopic Dermatitis: A Systematic Review and Meta-Analysis.

Cyclosporine A (CsA) is effective in treating moderate-to-severe atopic dermatitis (AD). This systematic review and meta-analysis aimed to summarize the effectiveness and safety of low-dose (<4 mg/kg) versus high-dose (≥4 mg/kg) CsA and other systemic immunomodulatory agents in patients with AD. Five randomized controlled trials met the inclusion criteria. The meta-analysis included 159 patients with moderate-to-severe AD who were randomized to receive low-dose CsA, and 165 patients randomized to receive high-dose CsA and other systemic immunomodulatory agents. We found that low-dose CsA was not inferior to high-dose CsA and other systemic immunomodulatory agents in reducing AD symptoms [standard mean difference (SMD) -1.62, 95% confidence interval (CI) -6.47; 3.23]. High-dose CsA and other systemic immunomodulatory agents showed a significantly lower incidence of adverse events [incidence rate ratio (IRR) 0.72, 95% CI 0.56; 0.93], however, after sensitivity analysis, there was no difference between the two groups except for one study (IRR 0.76, 95% CI 0.54; 1.07). Regarding serious adverse events requiring discontinuation of treatment, we observed no significant differences between low-dose CsA and other systemic immunomodulatory agents (IRR 1.83, 95% CI 0.62; 5.41). Our study may justify the use of low-dose CsA rather than high-dose CsA and other systemic immunomodulatory agents in moderate-to-severe AD.

Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study.

BACKGROUND: Human coronaviruses (HCoV) cause mild upper respiratory infections; however, in 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged, causing an acute respiratory disease pandemic. Coronaviruses exhibit marked epidemiological and clinical differences. PURPOSE: This study compared the clinical, laboratory, and radiographic findings of children infected with SARS-CoV-2 versus HCoV. METHODS: SARS-CoV-2 data were obtained from the Korea Disease Control and Prevention Agency (KDCA) registry and 4 dedicated coronavirus disease 2019 (COVID-19) hospitals. Medical records of children admitted with a single HCoV infection from January 2015 to March 2020 were collected from 10 secondary/tertiary hospitals. Clinical data included age, sex, underlying disease, symptoms, test results, imaging findings, treatment, and length of hospital stay. RESULTS: We compared the clinical characteristics of children infected with HCoV (n=475) to those of children infected with SARS-CoV-2 (272 from KDCA, 218 from COVID-19 hospitals). HCoV patients were younger than KDCA patients (older than 9 years:3.6% vs. 75.7%; P<0.001) and patients at COVID-19 hospitals (2.0±2.9 vs 11.3±5.3; P<0.001). Patients with SARS-CoV-2 infection had a lower rate of fever (26.6% vs. 66.7%; P<0.001) and fewer respiratory symptoms than those with HCoV infection. Clinical severity, as determined by oxygen therapy and medication usage, was worse in children with HCoV infection. Children and adolescents with SARS-CoV-2 had less severe symptoms. CONCLUSION: Children and adolescents with COVID-19 had a milder clinical course and less severe disease than those with HCoV in terms of symptoms at admission, examination findings, and laboratory and radiology results.

Assessment of variables associated with prolonged admission duration in children with Mycoplasma pneumoniae pneumonia.

INTRODUCTION: Macrolide-resistant Mycoplasma pneumoniae (MRMP) has become prevalent in children. This study investigated the clinical and laboratory variables of MRMP and macrolide-sensitive M. pneumoniae (MSMP) and identified factors associated with prolonged hospital admission in children. METHODS: A prospective multicenter study was conducted in 1063 children <18 years old in July 2018-June 2020. The 454 had a positive M. pneumoniae polymerase chain reaction assay. RESULTS: Most subjects had MRMP (78.4%), and all mutated strains had the A2063G transition. We defined MRMP* (n = 285) as MRMP pneumonia requiring admission and MSMP* (n = 72) as MSMP pneumonia requiring admission. Patients with MRMP pneumonia were older, more likely to have segmental/lobar pneumonia, and had more febrile days than those with MSMP pneumonia. C-reactive protein (CRP), lactate dehydrogenase (LDH), and percentage neutrophils were more strongly associated with MRMP* than MSMP* groups. Percentage neutrophils, CRP, and alanine aminotransferase significantly changed between admission and follow-up measurements in patients with MRMP* (P < 0.05). The duration of admission positively correlated with the number of febrile days after initiation of antibiotic medication and laboratory variables (white blood cell count, CRP, and aspartate aminotransferase [AST]) (P < 0.05). Random forest analysis indicated that the number of febrile days after initiation of antibiotic medication, AST, and percentage neutrophils at admission was over five. CONCLUSIONS: This study indicated that children with M. pneumoniae pneumonia with a higher number of febrile days after initiation of antibiotic medication, AST, and percentage neutrophils at admission were more likely to have prolonged admission duration.

Classification of atopic dermatitis phenotypes according to allergic sensitization by cluster analysis.

A cluster study to classify atopic dermatitis (AD) phenotypes into subgroups is required to better understand and manage the disease owing to the heterogeneity of its clinical features. This study aimed to identify the phenotypic subgroups of childhood AD according to allergic sensitization. In 258 children with AD, hierarchical cluster analysis based on specific immunoglobulin (Ig) E sensitization revealed four distinct clusters. Cluster A (n = 71) revealed no IgE sensitization, whereas cluster B (n = 28) showed sensitization to egg white only. Cluster B was highly associated with early-onset AD (<3 months) and a family history of atopic diseases. Cluster C (n = 68) and D (n = 91), sensitized to multiple foods and inhalants, respectively, showed a higher prevalence of skin infection within the last 1 year than others. Cluster D was related to late-onset AD (>12 months) and had more atopic comorbidities. In addition, cluster D showed the most severely impaired health-related quality of life and more frequent use of immunosuppressants. Therefore, childhood AD can be classified into 4 clusters based on the allergic sensitization status, and clinical phenotypes and treatment strategy may be different according to clusters.

Characteristics of anaphylaxis patients who visited emergency departments in Korea: Results from a national emergency department information system.

BACKGROUND: Anaphylaxis is an allergic disease with fatal respiratory or cardiovascular symptoms that require immediate emergency treatment. We aimed to understand the characteristics and frequency of emergency department (ED) visits of patients with anaphylaxis in Korea. METHODS: Between 2007 and 2013, using data from 147 ED from the National Emergency Department Information System in Korea, we retrospectively evaluated patients with a primary diagnosis of anaphylaxis. RESULTS: During the study, a total 23,313 patients visited the ED due to anaphylaxis. The number of patients with anaphylaxis who visited the ED increased from 3.0 per 100,000 population in 2007 to 11.6 per 100,000 population in 2013 (P<0.001). Overall, the frequency of anaphylaxis emergency department visits increased by 1.24 times each year (95% CI 1.23-1.25). The risk of visiting ED due to anaphylaxis by population-based age-specific group was highest in the 60-69 years old (OR 2.30, 95% CI 1.96-2.70). Deaths from anaphylaxis increased by 1.35 times per year (95% CI 1.13-1.62). The causes of anaphylaxis were unknown (80.8%; 95% CI 80.35-81.38), drugs (8.9%; 95% CI 8.47-9.24), food (4.1%; 95% CI 3.87-4.39), bees (3.2%; 95% CI 3.02-3.48) and arthropods (2.3%; 95% CI 2.11-2.48). In 2009, drugs were the most common cause of anaphylaxis in November (35.5%), followed by food in May (15.5%) (P<0.001). Between July and September, stings from insects were the most common causes (P<0.001). By age, food was the most common cause in children aged <6 years (7.6%, <12 months; 9.0%, 1-6 years) and drugs in those aged ≥7 years. The 7-year overall mortality rate was 0.104 case per 1,000,000 population; men accounted for 77.8% of the deaths. By region, the number of cases was the highest in metropolitan areas, Gyeonggi and Seoul; however, the number of anaphylaxis cases per 100,000 population was the highest in Jeju and Gangwon. CONCLUSION: Based on ICD-10 codes, the number of ED visits due to anaphylaxis is increasing in Korea, and the incidence of anaphylaxis varies by region, season, and age.

Analysis of national surveillance of respiratory pathogens for community-acquired pneumonia in children and adolescents.

BACKGROUND: Respiratory infections among children, particularly community-acquired pneumonia (CAP), is a major disease with a high frequency among outpatient and inpatient visits. The causes of CAP vary depending on individual susceptibility, the epidemiological characteristics of the community, and the season. We performed this study to establish a nationwide surveillance network system and identify the causative agents for CAP and antibiotic resistance in Korean children with CAP. METHODS: The monitoring network was composed of 28 secondary and tertiary medical institutions. Upper and lower respiratory samples were assayed using a culture or polymerase chain reaction (PCR) from August 2018 to May 2020. RESULTS: A total of 1023 cases were registered in patients with CAP, and PCR of atypical pneumonia pathogens revealed 422 cases of M. pneumoniae (41.3%). Respiratory viruses showed a positivity rate of 65.7% by multiplex PCR test, and human rhinovirus was the most common virus, with 312 cases (30.5%). Two hundred sixty four cases (25.8%) were isolated by culture, including 131 cases of S. aureus (12.8%), 92 cases of S. pneumoniae (9%), and 20 cases of H. influenzae (2%). The cultured, isolated bacteria may be colonized pathogen. The proportion of co-detection was 49.2%. The rate of antibiotic resistance showed similar results as previous reports. CONCLUSIONS: This study will identify the pathogens that cause respiratory infections and analyze the current status of antibiotic resistance to provide scientific evidence for management policies of domestic respiratory infections. Additionally, in preparation for new epidemics, including COVID-19, monitoring respiratory infections in children and adolescents has become more important, and research on this topic should be continuously conducted in the future.

Source tracking of dissolved organic nitrogen at the molecular level during storm events in an agricultural watershed.

Accelerated export of nitrogen-containing dissolved organic matter (DOM) or dissolved organic nitrogen (DON) to streams and rivers from agricultural watersheds has been reported worldwide. However, few studies have examined the dynamics of DOM molecular composition with the attention paid to the relative contributions of DON from various sources altered with flow conditions. In this study, end-member mixing analysis (EMMA) was conducted with the optical properties of DOM to quantify the relative contributions of several major organic matter sources (litter, reed, field soil, and manure) in two rivers of a small agricultural watershed. DOC and DON concentration increased during the storm events with an input of allochthonous DOM as indicated by an increase in specific ultraviolet absorbance at 254 nm (SUVA254) and a decrease in biological index (BIX), fluorescence index (FI), and protein-like component (%C3) at high discharge. EMMA results based on a Bayesian mixing model using stable isotope analysis in R (SIAR) were more accurate in source tracking than those using the traditional IsoSource program. Manure (>30%) and field soil (also termed as "manure-impacted field soil") (>23%) end-members revealed their predominant contributions to the riverine DOM in SIAR model, which was enhanced during the storm event (up to 56% and 38%, respectively). The molecular composition of the riverine DOM exhibited a distinct footprint from the manure and manure-impacted field soil, with a larger number of CHON formulas and abundant polyphenols and condensed aromatics in peak flow samples in the studied rivers. The riverine DOM during peak flow contained many unique molecular formulas in both rivers (4980 and 2082) of which >60% originated from manure and manure-impacted field soil. Combining the EMMA with DOM molecular composition clearly demonstrated the effect of manure fertilizer on the riverine DOM of the watershed with intensive agriculture. This study provides insights into the source tracking and regulation of DON leaching from anthropogenically altered river systems worldwide.

Investigation of adverse events following bacille Calmette-Guérin immunization using immunization safety surveillance system in Korea Centers for Disease Control and Prevention.

PURPOSE: The report of adverse events following immunization (AEFI) in Korea has continued since 1994, and the most frequently reported cases of AEFI of Korea Centers for Disease Control and Prevention (KCDC) is bacille Calmette-Guérin (BCG). Meanwhile, various inoculation methods and strains have been used in the past 6 years in Korea. Therefore, we investigated AEFI of BCG by strain types and inoculation methods using immunization safety surveillance of KCDC. MATERIALS AND METHODS: We reviewed BCG AEFIs registered in the KCDC from January 2013 to June 2018. RESULTS: There were 336 AEFI cases during the period, and average time interval from vaccination to symptom onset was within 2 months. AEFI proportion was 6.4 cases per 100,000 doses for BCG percutaneous Tokyo strain, 41.6 cases per 100,000 doses of BCG intradermal Danish strain, and 25.9 cases per 100,000 doses of BCG intradermal Tokyo strain. Intradermal type was more reported AEFI than percutaneous type in the same strain. The most common adverse events were local reaction like BCG lymphadenitis and severe adverse reactions such as osteomyelitis or disseminated BCG disease were 0.1 to 0.2 cases per 100,000 doses which are correlated with the range of World Health Organization published AEFI rates. CONCLUSION: The AEFI reporting rate does not equal the actual proportion of AEFI occurrence. Because AEFI monitoring is a passive surveillance system, various factors might influence the number of events reported. Nevertheless, it is important to analyze BCG AEFI by vaccine strains and inoculation method using surveillance data of KCDC.

Tracking the evolution of particulate organic matter sources during summer storm events via end-member mixing analysis based on spectroscopic proxies.

Despite the growing attention to the effects of hydrological precipitation on organic carbon export along the continuum land-river-ocean, limited effort has been made to understand the export and the reactivity of particulate organic carbon (POC) compared to those of dissolved organic carbon (DOC). Yet, further understanding of the controlling mechanisms on the export of particulate organic matter (POM) from terrestrial systems is fundamental. In this study, we assessed the temporal changes of the source contributions to riverine POM in two adjacent rivers of the same watershed during two summer storm events, which included the early and the late events, using end-member mixing analysis (EMMA) based on spectroscopic proxies. The EMMA showed relatively high contributions of terrestrial materials to the riverine POM for both rivers during the early summer storm event. However, this trend did not persist until the late summer storm event, which presented the decreased contributions of the terrestrial sources and less dynamic changes in the source distributions compared to those observed in the early summer rain event. These results demonstrate the combined impacts of the land use/surrounding area, the hydrology, and the intra-seasonal variations on the dominant riverine POM sources. This study provides an interesting insight into the importance of the intense hydrological events on the export of the terrestrial OM and further on the potential modification of the existing carbon mass balance along the continuum land-river-ocean.

Immigration history, lifestyle characteristics, and breast density in the Vietnamese American Women's Health Study: a cross-sectional analysis.

PURPOSE: Breast density is an important risk factor for breast cancer and varies substantially across racial-ethnic groups. However, determinants of breast density in Vietnamese immigrants in the United States (US) have not been studied. We investigated whether reproductive factors, immigration history, and other demographic and lifestyle factors were associated with breast density in Vietnamese Americans. METHODS: We collected information on demographics, immigration history, and other lifestyle factors and mammogram reports from a convenience sample of 380 Vietnamese American women in California aged 40 to 70 years. Breast Imaging Reporting and Data System (BI-RADS) breast density was abstracted from mammogram reports. Multivariable logistic regression was used to investigate the association between lifestyle factors and having dense breasts (BI-RADS 3 or 4). RESULTS: All participants were born in Viet Nam and 82% had lived in the US for 10 years or longer. Younger age, lower body mass index, nulliparity/lower number of deliveries, and longer US residence (or younger age at migration) were associated with having dense breasts. Compared to women who migrated at age 40 or later, the odds ratios and 95% confidence intervals for having dense breasts among women who migrated between the ages of 30 and 39 and before age 30 were 1.72 (0.96-3.07) and 2.48 (1.43-4.32), respectively. CONCLUSIONS: Longer US residence and younger age at migration were associated with greater breast density in Vietnamese American women. Identifying modifiable mediating factors to reduce lifestyle changes that adversely impact breast density in this traditionally low-risk population for breast cancer is warranted.

Biochar-induced metal immobilization and soil biogeochemical process: An integrated mechanistic approach.

The nature of biochar-derived dissolved organic matter (DOM) has a crucial role in the interactions between biochar and metal immobilization, carbon dynamics, and microbial communities in soil. This study utilized excitation-emission matrix coupled with parallel factor analysis (EEM-PARAFAC) modeling to provide mechanistic evidence of biochar-induced influences on main soil biogeochemical processes. Three biochars produced from rice straw, wood, and grass residues were added to sandy and sandy loam soils and incubated for 473 d. Microbial and terrestrial humic-like fluorescent components were identified in the soils after incubation. The sandy loam soil exhibited a higher DOM with microbial sources than did the sandy soil. All biochars reduced Pb bioavailability, whereas the rice straw biochar enhanced the As bioavailability in the sandy loam soil. The biochar-derived aliphatic-DOM positively correlated with As bioavailability (r = 0.82) in the sandy loam soil and enhanced the cumulative CO2-C (r = 0.59) in the sandy soil. The promoted cumulative CO2-C in the sandy soil with all biochars correlated with the enhanced microbial communities, in particular, gram-positive (r = 0.59) and gram-negative (r = 0.59) bacteria. Our results suggest that the integration of EEM-PARAFAC with spectroscopic indices could be useful for a comprehensive interpretation of the soil quality changes in response to the application of biochar.

Enhancing copper binding property of compost-derived humic substances by biochar amendment: Further insight from two-dimensional correlation spectroscopy.

Little is known about the environmental impacts of biochar (BC) amendment on the immobilization of heavy metals in compost-treated fields. In consequence, this study was designed to explore the effects of BC amendment on the copper (Cu) binding properties of compost-derived humic substances (HS). To this end, unamended and 4.7% (by wet weight) BC-amended compost were incubated in parallel with regular wetting for 6 months. The stability constants for Cu binding, calculated based on the fluorescence quenching technique, were higher for the compost-derived HS with versus without BC amendment. The result suggests that BC addition to compost may intensify the immobilization of heavy metals in a compost-treated field. Copper binding efficacy increased after the incubation with or without BC amendment. However, the enhanced Cu binding efficacy of the BC-amended HS was preserved even after the long-term incubation. Two-dimensional correlation spectroscopy revealed that the short wavelength fulvic-like fluorescence followed by humic-like fluorescence were preferentially associated with Cu binding. However, the range of wavelengths that tracked the binding of Cu were modified after BC amendment. This study evidenced beneficial and synergetic effects of BC amendment on the abatement of the potential environmental risk from heavy metal polluted field on a long-term basis.

Evaluating the contributions of different organic matter sources to urban river water during a storm event via optical indices and molecular composition.

Dissolved organic matter (DOM) in river water dynamically changes with respect to its major sources during heavy rain events. However, there has been no established tool to estimate the relative contributions of different organic sources to river water DOM. In this study, the evolution in the contributions of ten different organic matter (OM) sources to storm water DOM was explored with a selected urban river, the Geumho River in South Korea, during storm events via an end-member mixing analysis (EMMA) based on fluorescence indices and Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR-MS). The OM source materials included treated effluent, road runoff, groundwater, topsoil, deep soil, leaves, reeds, riparian plants, attached algae, and suspended algae. The EMMA results provided quantitative estimates of the variations in the dominant OM sources with the progress of storms. Treated effluent was the prevailing source at the beginning period of the storm, while topsoil, leaves, riparian plants, and groundwater predominated during and after the peak period. The fluorescence indices-based evaluation was consistent with the statistical comparison of the molecular formulas derived from FT-ICR-MS conducted on the ten potential OM sources and the storm samples. The observed variations in the OM sources agreed with the typical characteristics of urban rivers in connection with anthropogenic inputs and the impact of surrounding impervious surfaces. This study demonstrates the application of intuitive and facile tools in estimating the relative impacts of OM sources in urban watersheds.

Photochemical release of dissolved organic matter from particulate organic matter: Spectroscopic characteristics and disinfection by-product formation potential.

In this study, we investigated the photochemical release of dissolved organic matter (DOM) from the particulate organic matter (POM) of soil and litter leaves (broad leaves; coniferous leaves) and compared the releasing characteristics of the DOM using UV-visible and fluorescence spectroscopy. The disinfection by-product formation potential (DBPFP) of the released DOM was also examined. Additional dissolved organic carbon (DOC) was released by UV irradiation for all POM sources (10.58 ±â€¯2.7 mg-C L-1 g-1 for BL, 8.32 ±â€¯2.6 mg-C L-1 g-1 for CL, and 0.20 ±â€¯0.1 mg-C L-1 g-1 for soil). The excitation-emission matrix combined with parallel factor analysis results showed that the photo-released DOM from soil was mainly humic-like components (C1, C3) produced by photodesorption, resulting in high trihalomethane formation potential, while protein-like component (C2) was the major component of the photodissolved DOM from litter leaves, resulting in high haloaceticacid formation potential. Further, DBPFP from soil and litter leaves showed high correlation with humic-like components (C1+C3) and SUVA254, respectively. In conclusion, this study demonstrates that significant amounts of DOM could be released from POM under UV irradiation, although the characteristics and DBP formation of the photo-released DOM were highly dependent upon the POM source.

Clinical characteristics and etiologies of bronchiectasis in Korean children: A multicenter retrospective study.

BACKGROUND: Bronchiectasis is a chronic pulmonary disease characterized by progressive and irreversible bronchial dilatation. The aim of the present study was to investigate the etiologies and clinical features of bronchiectasis in Korean children. METHODS: We performed a retrospective review of the medical records for children diagnosed with bronchiectasis between 2000 and 2017 at 28 secondary or tertiary hospitals in South Korea. RESULTS: A total of 387 cases were enrolled. The mean age at diagnosis was 9.2 ±â€¯5.1 years and 53.5% of the patients were boys. The most common underlying cause of bronchiectasis was preexisting respiratory infection (55.3%), post-infectious bronchiolitis obliterans (14.3%), pulmonary tuberculosis (12.3%), and heart diseases (5.6%). Common initial presenting symptoms included chronic cough (68.0%), recurrent pneumonia (36.4%), fever (31.1%), and dyspnea (19.7%). The most predominantly involved lesions were left lower lobe (53.9%), right lower lobe (47.1%) and right middle lobe (40.2%). No significant difference was observed in the distribution of these involved lesions by etiology. The forced expiratory volume in 1 s (FEV1) levels were lowest in cases with interstitial lung disease-associated bronchiectasis, followed by those with recurrent aspiration and primary immunodeficiency. CONCLUSIONS: Bronchiectasis should be strongly considered in children with chronic cough and recurrent pneumonia. Long-term follow-up studies on pediatric bronchiectasis are needed to further clarify the prognosis and reduce the disease burden in these patients.

A potential dermal substitute using decellularized dermis extracellular matrix derived bio-ink.

Upon bioprinting, cells are mixed with a biomaterial to fabricate a living tissue, thus emphasizing the importance of biomaterials. The biomaterial used in this study was a bio-ink prepared using skin decellularized extracellular matrix (dECM). Skin dECM was extracted by treating the dermis with chemicals and enzymes; the basic structural and functional proteins of the ECM, including collagen, glycosaminoglycans (GAGs), bioreactive materials and growth factors, were preserved, whereas the resident cells that might cause immune rejection or inflammatory responses were removed. The bio-ink based on dECM powder, together with human dermal fibroblasts (HDFs), was loaded into the nozzle of the 3D bioprinter to create the 3D construct. This construct underwent gelation with changing temperature while its shape was maintained for 7 days. The cells showed over 90% viability and proliferation. By analysing the gene expression pattern in the cells of the construct, the skin regenerative mechanism of the bio-ink was verified. Microarray results confirmed that the gene expression related to skin morphology and development had been enhanced because the bioreactive molecules and growth factors, in addition to residual ECM in dECM, provided an optimal condition for the HDFs.

Using fluorescence surrogates to track algogenic dissolved organic matter (AOM) during growth and coagulation/flocculation processes of green algae.

Tracking the variation of the algogenic organic matter (AOM) released during the proliferation of green algae and subsequent treatment processes is crucial for constructing and optimizing control strategies. In this study, the potential of the spectroscopic tool was fully explored as a surrogate of AOM upon the cultivation of green algae and subsequent coagulation/flocculation (C/F) treatment processes using ZrCl4 and Al2(SO4)3. Fluorescence excitation emission matrix coupled with parallel factor analysis (EEM-PARAFAC) identified the presence of three independent fluorescent components in AOM, including protein-like (C1), fulvic-like (C2) and humic-like components (C3). Size exclusion chromatography (SEC) revealed that C1 in AOM was composed of large-sized proteins and aromatic amino acids. The individual components exhibited their unique characteristics with respect to the dynamic changes. C1 showed the highest correlation with AOM concentrations (R2 = 0.843) upon the C/F processes. C1 could also be suggested as an optical predictor for the formation of trihalomethanes upon the C/F processes. This study sheds a light for the potential application of the protein-like component (C1) as a practical surrogate to track the evolution of AOM in water treatment or wastewater reclamation systems involving Chlorella vulgaris green algae.

A new molecular weight (MW) descriptor of dissolved organic matter to represent the MW-dependent distribution of aromatic condensation: Insights from biodegradation and pyrene binding experiments.

In this study, we utilized a size exclusion chromatography (SEC) system that was equipped with a fluorescence emission scanning mode to explore the heterogeneous distribution of the humification index (HIX) values within bulk dissolved organic matter (DOM). The HIX-based SEC chromatograms showed that the molecular weight (MW)-dependent distribution of aromatic condensation was heavily affected by the DOM sources and the progress of biodegradation. The HIX heterogeneity across different MW was more pronounced for terrestrial versus aquatic DOM sources. Microbial incubation of leaf litter DOM led to the initial enhancement of the HIX at a relatively low MW, followed by a gradual increase at larger MW values. The dynamic changes of the HIX can be attributed to (1) the preferential removal of non-aromatic or less-aromatic molecules by microorganisms, (2) the production of microbial metabolites, (3) microbial humification, and (4) self-assemblage of humic-like molecules. From the SEC chromatograms, the HIX-based average molecular weight (or MWHIX) was proposed as a unifying surrogate to represent an MW that was highly associated with aromatic condensation. The MWHIX discriminated four different DOM sources and described well the biodegradation-induced changes. The MWHIX also presented a good positive correlation with pyrene organic carbon-normalized binding coefficients (Koc). The prediction capability of the MWHIX for pyrene Koc was higher than those based on the single descriptors of bulk DOM, such as HIX and MW, which revealed its superior linkage with the DOM reactivity related to both MW and HIX.

The changes of prevalence and etiology of pediatric pneumonia from National Emergency Department Information System in Korea, between 2007 and 2014.

PURPOSE: Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. METHODS: We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. RESULTS: Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was 1-3 years old (48.6%) and the next was less than 12 months of age (17.4%). Based on International Classification of Diseases, 10th revision diagnostic codes, confirmed cases of viral pneumonia comprised 8.4% of all cases, pneumonia due to Mycoplasma pneumoniae comprised 3.8% and confirmed cases of bacterial pneumonia 1.3%. The prevalence of confirmed bacterial pneumonia decreased from 3.07% in 2007 and 4.01% in 2008 to 0.65% in 2014. The yearly rate of pneumococcal pneumonia also decreased from 0.47% in 2007 to 0.08% in 2014. A periodic prevalence of M. pneumoniae pneumonia (MP) was identified. CONCLUSION: The increased number of patients with pneumonia, bacterial pneumonia, pleural effusion, and empyema in 2011 and 2013-2014 resulted from an MP epidemic. We provide evidence that the frequency of confirmed cases of bacterial pneumonia and pneumococcal pneumonia has declined from 2007 to 2014, which can simultaneously reflect the effectiveness of the pneumococcal conjugate vaccine.