An exploratory clinical trial of preoperative non-invasive localization before breast-conserving surgery using augmented reality technology.

PURPOSE: This single-center, randomized, prospective, exploratory clinical trial was conducted to assess the clinical efficacy of an augmented reality (AR)-based breast cancer localization imaging solution for patients with breast cancer. METHODS: This clinical trial enrolled 20 women who were diagnosed with invasive breast cancer between the ages of 19 and 80, had a single lesion with a diameter ≥ 5 mm but ≤ 30 mm, had no metastases to other organs, and had not received prior chemotherapy. All patients underwent mammography, ultrasound, computed tomography, and magnetic resonance imaging for preoperative assessment. Patients were randomly assigned to ultrasound-guided skin marking localization (USL) and AR-based localization (ARL) groups (n = 10 in each group). Statistical comparisons between USL and ARL groups were made based on demographics, radiologic features, pathological outcomes, and surgical outcomes using chi-square and Student t-tests. RESULTS: Two surgeons performed breast-conserving surgery on 20 patients. Histopathologic evaluation of all patients confirmed negative margins. Two independent pathologists evaluated the marginal distances, and there were no intergroup differences in the readers' estimates (R1, 6.20 ± 4.37 vs. 5.04 ± 3.47, P = 0.519; R2, 5.10 ± 4.31 vs. 4.10 ± 2.38, P = 0.970) or the readers' average values (5.65 ± 4.19 vs. 4.57 ± 2.84, P = 0.509). In comparing the tumor plane area ratio, there was no statistically significant difference between the two groups in terms of either reader's mean values (R1, 15.90 ± 9.52 vs. 19.38 ± 14.05, P = 0.525; R2, 15.32 ± 9.48 vs. 20.83 ± 12.85, P = 0.290) or the overall mean values of two readers combined (15.56 ± 9.11 vs. 20.09 ± 13.38, P = 0.388). Convenience, safety, satisfaction, and reusability were all superior in the AR localization group (P < 0.001) based on the two surgeons' responses. CONCLUSION: AR localization is an acceptable alternative to ultrasound-guided skin marking with no significant differences in surgical outcomes.

Effect of information provision on parental intention toward COVID-19 vaccination for children: a nationwide survey experiment.

The reluctance of parents to vaccinate their children against COVID-19 was prevalent particularly when uncertainty over vaccination outcomes prevailed. We conducted a nationwide randomized online survey experiment to assess the effect of information provision on parental intention for COVID-19 vaccination before the government started vaccination for children in South Korea. Parents of elementary school children were provided with either no information (Control), information on vaccine profile (vaccine informed group; VI), or COVID-19 (disease informed group; DI). Among 359,110 participants, parental intention for vaccination of children was significantly higher in both VI and DI groups compared with the Control group. In terms of effect size, information on COVID-19 vaccine increased likelihood to vaccinate by 1620 per 100,000 parents and reduced vaccine hesitancy by 1340 per 100,000 parents. Consistently with the positive effect on vaccination intention, both VI and DI interventions increased participants' perceptions on vaccination benefits being higher than its risks and vaccination risks being lower than health risks of COVID-19 infection, and self-reported trust in COVID-19 information. Our results lend strong support to the claim that the provision of targeted, tailored information on COVID-19 vaccine and infection increases parental intention to vaccinate children and reduces vaccine hesitancy.

Solution-Based Deep Prelithiation for Lithium-Ion Capacitors with High Energy Density.

Lithium-ion capacitors (LICs) exhibit superior power density and cyclability compared to lithium-ion batteries. However, the low initial Coulombic efficiency (ICE) of amorphous carbon anodes (e.g., hard carbon (HC) and soft carbon (SC)) limits the energy density of LICs by underutilizing cathode capacity. Here, a solution-based deep prelithiation strategy for carbon anodes is applied using a contact-ion pair dominant solution, offering high energy density based on a systematic electrode balancing based on the cathode capacity increased beyond the original theoretical limit. Increasing the anode ICE to 150% over 100%, the activated carbon (AC) capacity is doubled by activating Li+ cation storage, which unleashes rocking-chair LIC operation alongside the dual-ion-storage mechanism. The increased AC capacity results in an energy density of 106.6 Wh kg-1 AC+SC , equivalent to 281% of that of LICs without prelithiation. Moreover, this process lowers the cathode-anode mass ratio, reducing the cell thickness by 67% without compromising the cell capacity. This solution-based deep chemical prelithiation promises high-energy LICs based on transition metal-free, earth-abundant active materials to meet the practical demands of power-intensive applications.

Is living alone beneficial to older adults during the COVID-19 pandemic? Examining associations between living arrangements and life satisfaction by gender in Korea.

OBJECTIVES: This study examines associations between living arrangements and life satisfaction and the associated effects of gender among Korean older adults during the pandemic. METHOD: Data were drawn from the 2020 National Survey of Older Koreans-a nationally representative survey. Living arrangements were categorized into four groups: living alone; living with spouse only; living with family and spouse; and living with family without spouse. Logistic regression analyses were used to examine associations between living arrangements and life satisfaction measured as a binary outcome. RESULTS: Older adults living alone were more likely to be satisfied with life compared with those who lived with a spouse only. However, living alone became nonsignificant after controlling for social contact with friends or neighbors and social participation. Interestingly, there was a significant interaction between living arrangements and gender, showing that living alone was beneficial to older women but not to men. Subsample analysis by gender confirmed that older women living alone had a greater likelihood of being satisfied with life than those living with a spouse only, whereas men living alone had lower life satisfaction. CONCLUSION: Findings suggest that living alone is not always deleterious to older adults, particularly women. During the pandemic, older Korean women living with their spouse and/or family might be less satisfied with life due to the dual burden of family care and housework, associated with traditional gendered norms and social context.

Double jeopardy: Exploring the moderating effect of educational mismatch in the relationship between work-family conflict and depressive symptoms among Korean working women.

RATIONALE: Despite a growing body of empirical evidence on the detrimental effects of work-family conflict (WFC) on psychological health, little attention has been given to whether educational mismatch in the workplace, which refers to the perceived level of match between one's attained education and the required educational level for a position, may exacerbate these effects. OBJECTIVE: The purpose of this study was to examine the relationship between WFC, educational mismatch, and depressive symptoms in Korean working women, with a particular focus on the potential moderating effects of educational mismatch on the association between WFC and depressive symptoms. METHODS: The data utilized for this study were collected from 5174 married working women over five waves (16,610 person-observations) of the Korean Longitudinal Survey of Women and Families spanning 8 years between 2012 and 2020. Fixed effects (FE) models were estimated to account for unobserved individual-level heterogeneity. RESULTS: FE estimates indicated that WFC is associated with an increase in depressive symptoms, even after accounting for unobserved confounding factors and time-varying covariates. The interaction model provides evidence for the moderating role of educational mismatch in the association between WFC and depressive symptoms. The positive association between WFC and depressive symptoms was more pronounced among those who perceive themselves as "overeducated." The estimated coefficient for the association was about 45% larger for those who perceive themselves as "overeducated" than their "well-matched" counterparts. CONCLUSION: The study's findings suggest a robust link between WFC and depressive symptoms and further elaborate on how this association varies depending on educational mismatch. In Korea, where conservative gender role norms of female-caregiver ideology are still prevalent, WFC and educational mismatch can act as double jeopardy, exacerbating the mental health of working women.

Immune Checkpoint-Blocking Nanocages Cross the Blood-Brain Barrier and Impede Brain Tumor Growth.

Glioblastoma (GBM) is the deadliest tumor of the central nervous system, with a median survival of less than 15 months. Despite many trials, immune checkpoint-blocking (ICB) therapies using monoclonal antibodies against the PD-1/PD-L1 axis have demonstrated only limited benefits for GBM patients. Currently, the main hurdles in brain tumor therapy include limited drug delivery across the blood-brain barrier (BBB) and the profoundly immune-suppressive microenvironment of GBM. Thus, there is an urgent need for new therapeutics that can cross the BBB and target brain tumors to modulate the immune microenvironment. To this end, we developed an ICB strategy based on the BBB-permeable, 24-subunit human ferritin heavy chain, modifying the ferritin surface with 24 copies of PD-L1-blocking peptides to create ferritin-based ICB nanocages. The PD-L1pep ferritin nanocages first demonstrated their tumor-targeting and antitumor activities in an allograft colon cancer model. Next, we found that these PD-L1pep ferritin nanocages efficiently penetrated the BBB and targeted brain tumors through specific interactions with PD-L1, significantly inhibiting tumor growth in an orthotopic intracranial tumor model. The addition of PD-L1pep ferritin nanocages to triple in vitro cocultures of T cells, GBM cells, and glial cells significantly inhibited PD-1/PD-L1 interactions and restored T-cell activity. Collectively, these findings indicate that ferritin nanocages displaying PD-L1-blocking peptides can overcome the primary hurdle of brain tumor therapy and are, therefore, promising candidates for treating GBM.

Learnability of Thyroid Nodule Assessment on Ultrasonography: Using a Big Data Set.

OBJECTIVE: The aims of the work described here were to evaluate the learnability of thyroid nodule assessment on ultrasonography (US) using a big data set of US images and to evaluate the diagnostic utilities of artificial intelligence computer-aided diagnosis (AI-CAD) used by readers with varying experience to differentiate benign and malignant thyroid nodules. METHODS: Six college freshmen independently studied the "learning set" composed of images of 13,560 thyroid nodules, and their diagnostic performance was evaluated after their daily learning sessions using the "test set" composed of images of 282 thyroid nodules. The diagnostic performance of two residents and an experienced radiologist was evaluated using the same "test set." After an initial diagnosis, all readers once again evaluated the "test set" with the assistance of AI-CAD. RESULTS: Diagnostic performance of almost all students increased after the learning program. Although the mean areas under the receiver operating characteristic curves (AUROCs) of residents and the experienced radiologist were significantly higher than those of students, the AUROCs of five of the six students did not differ significantly compared with that of the one resident. With the assistance of AI-CAD, sensitivity significantly increased in three students, specificity in one student, accuracy in four students and AUROC in four students. Diagnostic performance of the two residents and the experienced radiologist was better with the assistance of AI-CAD. CONCLUSION: A self-learning method using a big data set of US images has potential as an ancillary tool alongside traditional training methods. With the assistance of AI-CAD, the diagnostic performance of readers with varying experience in thyroid imaging could be further improved.

Does having children matter? Associations between transitions in work-family role combinations and depressive symptoms among married women in Korea.

Although having a variety of roles is generally beneficial for mental health, little is known about the relationships between work-family role combinations and depressive symptoms among married women in Korea, where child rearing is strongly considered a mother's responsibility. This study examines how the four types of work-family role combinations may be associated with depressive symptoms among married Korean women younger than 50 years old. Data were collected from 2012 through 2020 in five surveys by the Korean Longitudinal Survey of Women & Families. In total, 4811 married women (14,851 person-period observations) were analyzed using regression models with fixed effects. This enabled estimation of the within-person effects of transitions in work-family role combinations on depressive symptoms. Work-family role combinations were categorized as follows based on whether respondents had a job or at least one child: having both worker and mother roles, having a worker role only, having neither a worker nor a mother role, and having a mother role only. The findings indicate that married women who had only a mother role had more severe depressive symptoms than the other three groups. However, after controlling for whether respondents had a preschool-aged child, only those with both worker and mother roles had significantly lower levels of depressive symptoms compared with those with a mother role only. This study suggests that transitioning to being a working mother from a full-time mother may benefit the mental health of married Korean women. Furthermore, whether married women have a child critically impacts their mental health more than the number of roles. Raising a preschool-aged child seems to potentially be especially stressful for married Korean women. Working outside the home can protect the mental health of married Korean mothers who are affected by the social pressure to immerse themselves in child-rearing.

Reversible Magnesium Metal Cycling in Additive-Free Simple Salt Electrolytes Enabled by Spontaneous Chemical Activation.

Rechargeable magnesium (Mg) batteries can offer higher volumetric energy densities and be safer than their conventional counterparts, lithium-ion batteries. However, their practical implementation is impeded due to the passivation of the Mg metal anode or the severe corrosion of the cell parts in conventional electrolyte systems. Here, we present a chemical activation strategy to facilitate the Mg deposition/stripping process in additive-free simple salt electrolytes. By exploiting the simple immersion-triggered spontaneous chemical reaction between reactive organic halides and Mg metal, the activated Mg anode exhibited an overpotential below 0.2 V and a Coulombic efficiency as high as 99.5% in a Mg(TFSI)2 electrolyte. Comprehensive analyses reveal simultaneous evolution of morphology and interphasial chemistry during the activation process, through which stable Mg cycling over 990 cycles was attained. Our activation strategy enabled the efficient cycling of Mg full-cell candidates using commercially available electrolytes, thereby offering possibilities of building practical Mg batteries.

Safety and effectiveness of vortioxetine for major depressive disorder: Real-world evidence from a population-based study in South Korea.

Background: A post-marketing surveillance study was conducted to assess the real-world safety and effectiveness of vortioxetine for the treatment of major depressive disorder (MDD) in South Korea. Methods: Adult patients aged 19-94 years receiving vortioxetine for MDD at 72 hospitals and clinics in South Korea between 19th August 2014 and 18th August 2020 were included. Patients were followed for up to 24±2 weeks, at up to three visits. Adverse events (AEs) and effectiveness, assessed by both clinician and patient-reported measures, were analyzed. Results: A total of 3,263 patients (mean age: 51.28 years) were included in the safety set; 1,095 were aged ≥65 years. The majority of the safety set (61.97%) were female. The overall rate of any AEs and serious AEs were 17.13 and 1.56%, respectively. The majority of AEs were mild (88.32%). The rates of AEs did not differ statistically by age (≥65 years: 16.89% [185/1,095] versus <65 years: 17.25% [374/2,168)], p=0.7989), sex (male: 15.95% [198/1,241] versus female: 17.85% [361/2,022], p=0.1623), or liver impairment (with liver impairment: 20.90% [14/67] versus without liver impairment: 17.05% [545/3,196], p=0.4087). Effectiveness was assessed in 1,918 patients. By 24±2 weeks, there were significant clinical improvements from baseline, assessed by change in Montgomery-Asberg Depression Rating Scale total score (mean±standard deviation [SD]: -10.49±9.42 points, p <0.0001), the proportion of patients with improved symptoms using the Clinical Global Impression - Improvement scores (79.29%), and in both patient-reported measures, with a significant improvement in the Korean Version of the Perceived Deficits Questionnaire-Depression (mean±SD: -6.06±13.23, p <0.0001) and Digit Symbol Substitution Test (mean±SD: 4.83±9.81, p <0.0001) total scores from baseline. Similar to the safety profiles, the proportions of patients with improved symptoms compared with baseline using the Clinical Global Impression - Improvement scores did not differ by age (≥65 years: 82.09% versus <65 years: 78.32%, p=0.0511), sex (male: 77.45% versus female: 81.01%, p=0.0587), or liver impairment (with liver impairment: 67.57% versus without liver impairment: 79.85%, p=0.0663). Conclusion: Vortioxetine appears to be well-tolerated and effective for treating MDD patients in the real-world setting in South Korea, irrespective of age, sex, and liver impairment, reflecting the known profile of vortioxetine based on studies worldwide.

Relationship between Experience of Client Violence and Turnover Intention among Workers in Long-Term Care Facilities for Older Adults: Focusing on Nurses, Social Workers, and Care Workers.

To prevent discontinuity of long-term care service and guarantee the quality of care, it is important to clarify the determinants of turnover intentions of long-term care workers. They are at a higher risk of experiencing violence-including physical, emotional, and sexual-from patients or their families, possibly leading to high turnover intention. This study aims to verify how having experienced client violence affect turnover intention of long-term care workers and to suggest implications to prevent frequent turnover in long-term care field. Logistic regression analysis was conducted between groups who have experienced client violence and who have not, using 2019 Korean LTC Survey data. Results revealed that, first, there were differences in determinants of turnover intention depending on groups. Second, having experienced client violence had a different effect on turnover intention based on personal characteristics. Third, gender and occupational differences were found. Based on our results, we highlighted the need for discussions on interventions to address client violence exposure among long-term care workers.

In Situ Mesopore Formation in SiOx Nanoparticles by Chemically Reinforced Heterointerface and Use of Chemical Prelithiation for Highly Reversible Lithium-Ion Battery Anode.

SiOx is a promising next-generation anode material for lithium-ion batteries. However, its commercial adoption faces challenges such as low electrical conductivity, large volume expansion during cycling, and low initial Coulombic efficiency. Herein, to overcome these limitations, an eco-friendly in situ methodology for synthesizing carbon-containing mesoporous SiOx nanoparticles wrapped in another carbon layers is developed. The chemical reactions of vinyl-terminated silanes are designed to be confined inside the cationic surfactant-derived emulsion droplets. The polyvinylpyrrolidone-based chemical functionalization of organically modified SiO2 nanoparticles leads to excellent dispersion stability and allows for intact hybridization with graphene oxide sheets. The formation of a chemically reinforced heterointerface enables the spontaneous generation of mesopores inside the thermally reduced SiOx nanoparticles. The resulting mesoporous SiOx -based nanocomposite anodes exhibit superior cycling stability (≈100% after 500 cycles at 0.5 A g-1 ) and rate capability (554 mAh g-1 at 2 A g-1 ), elucidating characteristic synergetic effects in mesoporous SiOx -based nanocomposite anodes. The practical commercialization potential with a significant enhancement in initial Coulombic efficiency through a chemical prelithiation reaction is also presented. The full cell employing the prelithiated anode demonstrated more than 2 times higher Coulombic efficiency and discharge capacity compared to the full cell with a pristine anode.

The matricellular protein CCN5 induces apoptosis in myofibroblasts through SMAD7-mediated inhibition of NFκB.

We previously showed that the matricellular protein CCN5 reverses established cardiac fibrosis (CF) through inducing apoptosis in myofibroblasts (MyoFBs) but not in cardiomyocytes or fibroblasts (FBs). In this study, we set out to elucidate the molecular mechanisms underlying CCN5-mediated selective apoptosis of MyoFBs. We first observed that the apoptotic protein p53 and the anti-apoptotic protein NFκB are simultaneously induced in MyoFBs. When the expression level of p53 was suppressed using a siRNA, CCN5 did not induce apoptosis in MyoFBs. By contrast, when NFκB signaling was inhibited using IKK VII, an IκB inhibitor, MyoFBs underwent apoptosis even in the absence of CCN5. SMAD7 is one of the downstream targets of CCN5 and it was previously shown to potentiate apoptosis in epithelial cells through inhibition of NFκB. In accordance with these reports, when the expression of SMAD7 was suppressed using a siRNA, NFκB signaling was enhanced, and CCN5 did not induce apoptosis. Lastly, we used a luciferase reporter construct to show that CCN5 positively regulated SMAD7 expression at the transcriptional level. Collectively, our data suggest that a delicate balance between the two mutually antagonistic proteins p53 and NFκB is maintained for MyoFBs to survive, and CCN5 tips the balance in favor of the apoptotic protein p53. This study provides insight into the anti-fibrotic activity of CCN5 during the regression of CF.

I Am Not Supposed to Be Treated Like This: Associations Between Age Discrimination, Perceived Social Respect for Older Adults, and Depressive Symptoms in Korean Older Adults.

OBJECTIVES: This study examines the relationships between age discrimination, perceived social respect for older adults as a proxy of perceived social climate, and depressive symptoms in older adults in Korea. In doing so, it clarifies whether and how age discrimination has a differential effect on mental health, depending on the level of perceived social respect. METHODS: This study uses multiple regression analyses to examine the data obtained from the 2020 National Survey of Older Koreans, a nationally representative survey. RESULTS: Findings show that age discrimination was positively associated with depressive symptoms, whereas perceived social respect for older adults was negatively associated with depressive symptoms. Older respondents exhibited fewer depressive symptoms if they felt that older adults were respected in Korea. The results also revealed a significant interaction between age discrimination and perceived social respect; age discrimination had a more harmful impact on depressive symptoms in older adults with a higher level of perceived social respect. DISCUSSION: The findings suggest that a positive social climate for older adults is beneficial to their mental health, but ironically, it may form a more stressful context for older adults who experience age discrimination that is characteristically opposite from their subjective evaluation of that social climate. The gap between the expected social climate and individual discriminatory experiences may have a deleterious effect on the mental health of older adults.

Sarcopenia increases the risk of major organ or vessel invasion in patients with papillary thyroid cancer.

While sarcopenia is associated with poor overall survival and cancer-specific survival in solid cancer patients, the impact of sarcopenia on clinicopathologic features that can influence conventional papillary thyroid cancer (PTC) prognosis remains unclear. To investigate the impact of sarcopenia on aggressive clinicopathologic features in PTC patients, prospectively collected data on 305 patients who underwent surgery for PTC with preoperative staging ultrasonography and bioelectrical impedance analysis were retrospectively analyzed. Nine sarcopenia patients with preoperative sarcopenia showed more patients aged 55 or older (p = 0.022), higher male proportion (p < 0.001), lower body-mass index (p = 0.015), higher incidence of major organ or vessel invasion (p = 0.001), higher T stage (p = 0.002), higher TNM stage (p = 0.007), and more tumor recurrence (p = 0.023) compared to the non-sarcopenia patients. Unadjusted and adjusted logistic regression analyses showed that sarcopenia (odds ratio (OR) 9.936, 95% confidence interval (CI) 2.052-48.111, p = 0.004), tumor size (OR 1.048, 95% CI 1.005-1.093, p = 0.027), and tumor multiplicity (OR 3.323, 95% CI 1.048-10.534, p = 0.041) significantly increased the risk of T4 cancer. Sarcopenia patients showed significantly lower disease-free survival probability compared to non-sarcopenia patients. Therefore, preoperative sarcopenia in PTC patients should raise clinical suspicion for a more locally advanced disease and direct appropriate management and careful follow-up.

Cancer yield and imaging features of probably benign calcifications at digital magnification view.

OBJECTIVES: To investigate the malignancy rate of probably benign calcifications assessed by digital magnification view and imaging and clinical features associated with malignancy. METHODS: This retrospective study included consecutive women with digital magnification views assessed as probably benign for calcifications without other associated mammographic findings from March 2009 to January 2014. Initial studies rendering a probably benign assessment were analyzed, with biopsy or 4-year imaging follow-up. Fisher's exact test and univariable logistic regression were performed. Cancer yields were calculated. RESULTS: A total of 458 lesions in 422 patients were finally included. The overall cancer yield was 2.2% (10 of 458, invasive cancer [n = 4] and DCIS [n = 6]). Calcification distribution (OR = 23.80, p = .041), calcification morphology (OR = 10.84, p = .005), increased calcifications (OR = 29.40, p = .001), and having a concurrent newly diagnosed breast cancer or high-risk lesion (OR = 10.24, p = .001) were associated with malignancy. Cancer yields did not significantly differ between grouped punctate calcifications vs. calcifications with other features (1.2% [2 of 162] vs. 2.7% [8 of 296], p = .506). The cancer yield was 1.6% (7 of 437) in women without newly diagnosed breast cancer or high-risk lesions. CONCLUSION: The cancer yield of probably benign calcifications assessed by digital magnification view was below the 2% threshold for grouped punctate calcifications and for women without newly diagnosed breast cancer or high-risk lesions. Calcification distribution, morphology, increase in calcifications, and the presence of newly diagnosed breast cancer/high-risk lesion were associated with malignancy. KEY POINTS: • Among 458 probably benign calcifications assessed by digital magnification view, the overall cancer yield was 2.2% (10 of 458). • The cancer yield was below the 2% threshold for grouped punctate calcifications (1.2%, 2 of 162) and in women without newly diagnosed breast cancer or high-risk lesions (1.6%, 7 of 437). • Calcification distribution, morphology, increase in calcifications, and the presence of newly diagnosed breast cancer/high-risk lesion were associated with malignancy (all p < .05).

Using ultrasonographic features to predict the outcomes of patients with small papillary thyroid carcinomas: a retrospective study implementing the 2015 ATA patterns and ACR TI-RADS categories.

BACKGROUND: The aim of this study was to evaluate whether risk stratification systems using ultrasonographic (US) features show associations with the outcomes of patients with small papillary thyroid carcinomas (PTCs). METHODS: This retrospective study received institutional review board approval. From March 2007 to February 2010, 775 patients who underwent surgery for small PTCs (10-20 mm) were included. Based on preoperative US features, PTCs were categorized according to the 2015 American Thyroid Association (ATA) guideline and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). The associations of clinicopathological and US features with postoperative patient outcomes were evaluated. RESULTS: In total, 61 patients had high-volume central lymph node metastasis (CLNM, 7.9%) and 100 patients had lateral lymph node metastasis (LLNM, 12.9%). In univariable analyses, a high number of suspicious US features and higher ACR TI-RADS point totals were significantly associated with both high-volume CLNM (P=0.001, each) and LLNM (P<0.001, each). In multivariable analyses of preoperative features, a higher number of suspicious US features and higher ACR TI-RADS point totals were independently associated with high-volume CLNM (odds ratio [OR], 1.516 and 1.201; P=0.002 and P=0.001, respectively) and LLNM (OR, 1.763 and 1.293; all P<0.001). Individual US features, ATA categories, and ACR TI-RADS point totals were not significantly associated with recurrence or distant metastasis. CONCLUSION: The number of suspicious US features and the ACR TI-RADS point total are potential risk factors for cervical lymph node metastasis in patients with small PTCs.

Weakly Solvating Solution Enables Chemical Prelithiation of Graphite-SiOx Anodes for High-Energy Li-Ion Batteries.

Although often overlooked in anode research, the anode's initial Coulombic efficiency (ICE) is a crucial factor dictating the energy density of a practical Li-ion battery. For next-generation anodes, a blend of graphite and Si/SiOx represents the most practical way to balance capacity and cycle life, but its low ICE limits its commercial viability. Here, we develop a chemical prelithiation method to maximize the ICE of the blend anodes using a reductive Li-arene complex solution of regulated solvation power, which enables a full cell to exhibit a near-ideal energy density. To prevent structural degradation of the blend during prelithiation, we investigate a solvation rule to direct the Li+ intercalation mechanism. Combined spectroscopy and density functional theory calculations reveal that in weakly solvating solutions, where the Li+-anion interaction is enhanced, free solvated-ion formation is inhibited during Li+ desolvation, thereby mitigating solvated-ion intercalation into graphite and allowing stable prelithiation of the blend. Given the ideal ICE of the prelithiated blend anode, a full cell exhibits an energy density of 506 Wh kg-1 (98.6% of the ideal value), with a capacity retention after 250 cycles of 87.3%. This work highlights the promise of adopting chemical prelithiation for high-capacity anodes to achieve practical high-energy batteries.

How the Popularity of Bullies Influences the Self-Esteem of Their Classmates: A Study of First-Year Middle School Students in South Korea.

This study investigated whether and how classroom-level bullies' friendship networks, which reflect the popularity of bullies, were associated with the self-esteem of middle school students in the classroom. We analyzed survey data from 2,444 students in 101 classrooms from 22 middle schools in Korea. Respondents reported their friends' and bullies' names from their classroom. For each student, we generated the number of close friends that a respondent reported (outdegree) and the number of classmates who nominated him or her as a close friend (indegree). Bullies' popularity was measured by the sum of all the bullies' indegrees in a classroom. The findings showed that students in a classroom of bullies with larger popularity had a lower level of self-esteem. Moreover, bullies' popularity was harmful to nonvictims' self-esteem as well as victims' self-esteem. This study suggests that even indirect exposure to bullying in a classroom can decrease the self-esteem of nonvictims by leading to negative emotions such as anger, anxiety, fear, and/or guilty feelings.

Digital technology use and depressive symptoms among older adults in Korea: beneficial for those who have fewer social interactions?

OBJECTIVES: Our study examines the relationship between digital technology use and depressive symptoms among older Koreans and whether social interaction moderates the relationship. METHODS: The data were drawn from the 2017 Survey of Living Conditions and Welfare Needs of Korean Older Persons, a nationally representative survey. Digital technology use was measured by the number of digital functions that respondents perform with their electronic devices. Social interactions were measured by the frequencies of face-to-face and remote connections with friends or neighbors. Relationships were estimated with multiple regression analyses. RESULTS: Digital technology use was inversely associated with depressive symptoms even after adjusting for covariates including cognitive function. Both remote and face-to-face connections with friends or neighbors were associated with fewer depressive symptoms. An interaction between digital technology use and remote contact also was detected: the effect of digital technology use on depressive symptoms was more beneficial for older adults with infrequent remote contact with friends or neighbors than for those with frequent remote contact. CONCLUSION: Findings suggest that digital technology use can reduce depressive symptoms of older adults, especially those who have fewer social interactions. Educating older adults to increase their digital literacy level and use of remote interactions may improve their psychological wellbeing, perhaps even during times of a viral pandemic.