Low-Power Phototransistor with Enhanced Visible-Light Photoresponse and Electrical Performances Using an IGZO/IZO Heterostructure.

In this study, we demonstrated the effective separation of charge carriers within the IGZO/IZO heterostructure by incorporating IZO. We have chosen IGZO for its high mobility and excellent on-off switching behavior in the front channel of our oxide-oxide heterostructure. Similarly, for an additional oxide layer, we have selected IZO due to its outstanding electrical properties. The optimized optoelectronic characteristics of the IGZO/IZO phototransistors were identified by adjusting the ratio of In:Zn in the IZO layer. As a result, the most remarkable traits were observed at the ratio of In:Zn = 8:2. Compared to the IGZO single-layer phototransistor, the IGZO/IZO(8:2) phototransistor showed improved photoresponse characteristics, with photosensitivity and photoresponsivity values of 1.00 × 107 and 89.1 AW-1, respectively, under visible light wavelength illumination. Moreover, the electrical characteristics of the IGZO/IZO(8:2) transistor, such as field effect mobility (µsat) and current on/off ratio (Ion/Ioff), were highly enhanced compared to the IGZO transistor. The µsat and Ion/Ioff were increased by about 2.1 times and 2.3 times, respectively, compared to the IGZO transistor. This work provides an approach for fabricating visible-light phototransistors with elevated optoelectronic properties and low power consumption based on an oxide-oxide heterostructure. The phototransistor with improved performance can be applied to applications such as color-selective visible-light image sensors and biometric sensors interacting with human-machine interfaces.

Enhancement of the Visible Light Photodetection of Inorganic Photodiodes via Additional Quantum Dots Layers.

Visible light photodetectors are extensively researched with transparent metal oxide holes/electron layers for various applications. Among the metal oxide transporting layers, nickel oxide (NiO) and zinc oxide (ZnO) are commonly adopted due to their wide band gap and high transparency. The objective of this study was to improve the visible light detection of NiO/ZnO photodiodes by introducing an additional quantum dot (QD) layer between the NiO and ZnO layers. Utilizing the unique property of QDs, we could select different sizes of QDs and responsive light wavelength ranges. The resulting red QDs utilized device that could detect light starting at 635 nm to UV (Ultra-violet) light wavelength and exhibited a photoresponsivity and external quantum efficiency (EQE) of 14.99 mA/W and 2.92% under 635 nm wavelength light illumination, respectively. Additionally, the green QDs, which utilized a device that could detect light starting at 520 nm, demonstrated photoresponsivity values of 8.34 mA/W and an EQE of 1.99% under 520 nm wavelength light illumination, respectively. In addition, we used X-ray photoelectron spectroscopy (XPS) and ultraviolet photoelectron spectroscopy (UPS) to investigate the origin of the photocurrents and the enhancement of the device's performance. This study suggests that incorporating QDs with metal oxide semiconductors is an effective approach for detecting visible light wavelengths in transparent optoelectronic devices.

Comparison of endoscopic healing and durability between infliximab originator and CT-P13 in pediatric patients with inflammatory bowel disease.

Background and aims: Favourable clinical data were published on the efficacy of CT-P13, the first biosimilar of infliximab (IFX), in pediatric inflammatory bowel disease (IBD); however, few studies have compared the effect on endoscopic healing (EH) and drug retention rate between the IFX originator and CT-P13. Therefore, we aimed to compare EH and the drug retention rate between the IFX originator and CT-P13. Methods: Children with Crohn's disease (CD) and ulcerative colitis (UC)/IBD-unclassified (IBD-U) at 22 medical centers were enrolled, with a retrospective review conducted at 1-year and last follow-up. Clinical remission, EH and drug retention rate were evaluated. Results: We studied 416 pediatric patients with IBD: 77.4% had CD and 22.6% had UC/IBD-U. Among them, 255 (61.3%) received the IFX originator and 161 (38.7%) received CT-P13. No statistically significant differences were found between the IFX originator and CT-P13 in terms of corticosteroid-free remission and adverse events. At 1-year follow-up, EH rates were comparable between them (CD: P=0.902, UC: P=0.860). The estimated cumulative cessation rates were not significantly different between the two groups. In patients with CD, the drug retention rates were 66.1% in the IFX originator and 71.6% in the CT-P13 group at the maximum follow-up period (P >0.05). In patients with UC, the drug retention rates were 49.8% in the IFX originator and 56.3% in the CT-P13 group at the maximum follow-up period (P >0.05). Conclusions: The IFX originator and CT-P13 demonstrated comparable therapeutic response including EH, clinical remission, drug retention rate and safety in pediatric IBD.

A Report on a Nationwide Surveillance System for Pediatric Acute Hepatitis of Unknown Etiology in Korea.

BACKGROUND: Several cases of pediatric acute hepatitis of unknown etiology related to adenoviral infections have been reported in Europe since January 2022. The aim of this study was to compare the incidence, severity, possible etiology, and prognosis of the disease with those in the past in Korea. METHODS: The surveillance group collected data between May and November 2022 using a surveillance system. Acute hepatitis of unknown etiology was defined in patients aged < 16 years with a serum transaminase level > 500 IU/L, not due to hepatitis A-E or other underlying causes. For comparison, data from 18 university hospitals were retrospectively collected as a control group between January 2021 and April 2022. RESULTS: We enrolled 270 patients (mean age, 5 years). The most common symptom was fever. However, the incidence was similar between 2021 and 2022. Liver function test results, number of patients with acute liver failure (ALF), liver transplantation (LT), death, and adenovirus detection rates did not differ between the two groups. None of the adenovirus-positive patients in either group experienced ALF, LT, or death. In the surveillance group, adenovirus-associated virus-2 was detected in four patients, one of whom underwent LT. Patients with an unknown etiology showed significantly higher bilirubin levels, a lower platelet count, and a higher LT rate than patients with a possible etiology. CONCLUSION: The incidence of pediatric acute hepatitis of unknown etiology and adenovirus detection rate have not increased in Korea.

Fecal Calprotectin at Postinduction Is Capable of Predicting Persistent Remission and Endoscopic Healing after 1 Year of Treatment with Infliximab in Pediatric Patients with Crohn's Disease.

Background/Aims: : The recent update on Selecting Therapeutic Targets in Inflammatory Bowel Disease initiative has added a decrease in fecal calprotectin (FC) to an acceptable range as an intermediate target for Crohn's disease (CD). We aimed to investigate whether postinduction FC could predict future persistent remission (PR) and endoscopic healing (EH) after 1 year of treatment with infliximab (IFX) in pediatric patients with CD. Methods: : This multicenter retrospective observational study included pediatric patients with CD who were followed up for at least 1 year after starting IFX. The association of postinduction FC with PR and EH was investigated. Results: : A total of 132 patients were included in this study. PR and EH were observed in 71.2% (94/132) and 73.9% (82/111) of the patients, respectively. In multivariate logistic regression analysis, only the postinduction FC level was associated with PR (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.08 to 0.66; p=0.009). The FC levels at initiation of IFX and postinduction were significantly associated with EH (OR, 0.73; 95% CI, 0.53 to 0.99; p=0.044 and OR, 0.20; 95% CI, 0.06 to 0.49; p=0.002, respectively). According to the receiver operating characteristic curve analysis, the optimal cutoff level for postinduction FC associated with PR was 122 mg/kg, and that associated with EH was 377 mg/kg. Conclusions: : Postinduction FC was associated with PR and EH after 1 year of treatment with IFX in pediatric patients with CD. Our findings emphasize the importance of FC as an intermediate target in the treat-to-target era.

Humulus japonicus ameliorates irritant contact dermatitis by suppressing NF­κB p65­dependent inflammatory responses in mice.

As a type of contact dermatitis (CD), irritant CD (ICD) is an acute skin inflammation caused by external irritants, such as soap, water and chemicals. Humulus japonicus (HJ) is a herbal medicine widely distributed in Asian countries and has anti-inflammatory, antimicrobial and antioxidant effects. The current study aimed to investigate the anti-dermatitis effect of HJ on ICD and determine the molecular basis of this effect using 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced dermatitis mice models and lipopolysaccharide (LPS)-stimulated RAW264.7 cells. Mice were orally administered HJ and luteolin, the major compound in HJ, and topically administered TPA on the right ear to induce dermatitis. Topical application of TPA induced ear redness, oedema and increased infiltration of neutrophils and macrophages, which ameliorated following HJ and luteolin administration. The gene expression levels of inflammatory cell migrating chemokines, chemokine ligand 3 (CCL3) and chemokine (C-X-C motif) ligand 2 (CXCL2), and pro-inflammatory cytokine, IL-1ß, were reduced in the ears of HJ- and luteolin-treated mice. HJ and luteolin also inhibited the gene expression of chemokines, CCL3 and CXCL2, and pro-inflammatory cytokines, IL-1ß, IL-6 and TNF-α, in LPS-stimulated RAW264.7 cells. Moreover, HJ and luteolin decreased the expression levels of two key inflammatory enzymes, cyclooxygenase-2 (COX2) and inducible nitric oxide synthase (iNOS), and total and active phosphorylation of NF-κB p65. These results suggest that HJ could have a protective effect against ICD by suppressing inflammatory responses; therefore, HJ is a promising therapeutic strategy for ICD treatment.

Effectiveness of tumor­treating fields to reduce the proliferation and migration of liposarcoma cell lines.

Liposarcoma (LPS) is a rare type of soft tissue sarcoma that constitutes 20% of all sarcoma cases in adults. Effective therapeutic protocols for human LPS are not well-defined. Tumor-treating fields (TTFields) are a novel and upcoming field for antitumor therapy. TTFields combined with chemoradiotherapy have proven to be more effective than TTFields combined with radiotherapy or chemotherapy alone. The present study aimed to assess the effectiveness of TTFields in inhibiting cell proliferation and viability for the anticancer treatment of LPS. The present study used TTFields (frequency, 150 kHz; intensity, 1.0 V/cm) to treat two LPS cell lines (94T778 and SW872) and analyzed the antitumor effects. According to trypan blue and MTT assay results, TTFields markedly reduced the viability and proliferation of LPS cell lines along with the formation of colonies in three-dimensional culture. Based on the Transwell chamber assay, TTFields treatment also markedly reduced the migration of LPS cells. Furthermore, as shown by the higher activation of caspase-3 in the Caspase-3 activity assay and the results of the reactive oxygen species (ROS) assay, TTFields increased the formation of ROS in the cells and enhanced the proportion of apoptotic cells. The present study also investigated the inhibitory effect of TTFields in combination with doxorubicin (DOX) on the migratory capacity of tumor cells. The results demonstrated that TTFields treatment synergistically induced the ROS-induced apoptosis of LPS cancer cell lines and inhibited their migratory behavior. In conclusion, the present study demonstrated the potential of TTFields in improving the sensitivity of LPS cancer cells, which may lay the foundation for future clinical trials of this combination treatment strategy.

Research Note: Evaluation of standardized ileal amino acid digestibility in feed ingredients for Pekin ducks.

The digestibility of crude protein (CP) and amino acids (AA) in feedstuffs including corn, soybean meal (SBM), and corn distillers dried grains with solubles (DDGS) was investigated in White Pekin ducks. The test ingredients were the sole source of AA and CP. A nitrogen-free diet was also formulated for determining endogenous losses of AA and nitrogen. Birds were fed a standard starter diet for the first 15 d posthatch. On d 16, 96 ducklings (860 ± 50 g BW) were selected and allocated into 1 of 4 dietary treatments containing the test ingredients with 6 replicates per treatment in a randomized complete block design. All the crumbled assay diets were offered ad-libitum for 5 d and contained chromic oxide as an indigestible marker at 0.05%. On d 21, ducks were euthanized to collect the ileal digesta for digestibility analysis. Basal endogenous losses were abundant in glutamine, aspartic acid, leucine, proline, and serine, consecutively. For apparent ileal digestibility (AID), lysine and methionine were the highest (P < 0.05) in SBM, followed by corn and DDGS. For threonine, the highest values (P < 0.05) were similarly noted for SBM, followed by DDGS and corn; the values were 80.44, 69.88, and 64.89%, consecutively. Considering standardized ileal digestibility (SID), higher values (P < 0.05) for SBM were similarly noted for all the amino acids including lysine, methionine, and threonine; the values were 89.40, 93.58, and 86.50%, respectively. Conclusively, improved AA and CP digestibility was noted with SBM. Dietary protein source affected the extent of digestibility at the distal ileum; and the utilization of digestible amino acid coefficients during ducks' feed formulation is emphasized.

Differences in bedding material could alter the growth performance of White Pekin ducks raised for 42 days.

The effect of different commercially available bedding materials on the growth performance and carcass characteristics of ducks for 42 days was investigated. 336 one-day-old White-Pekin ducklings (60.48 ± 0.16 g) were randomly allocated into 24-floor pens with one of the three beddings namely i) coco peat, ii) rice husks, or iii) sawdust. 14 ducklings per pen and 8 replicate pens per bedding material were used. Birds were fed a starter diet from days 1-21 and a grower diet from days 22-42. Weekly growth performance evaluation was conducted for the average body weight, weight gains, daily feed intake, and feed conversion efficiency. One bird per pen was sacrificed on day 42 for the evaluation of carcass characteristics including the carcass, breast, and leg muscle percentages. Breast and leg muscle samples were then collected and analyzed for their proximate and pH values. Higher body weights (p < 0.05) were noticed with rice husks on day 42 only. Improved daily gains (p < 0.05) were also noticed for birds raised with rice husks over the entire period (days 1-42). Concerning feed intake, higher values (p < 0.05) were similarly noted with rice husks for the grower phase (days 22-42), and the entire experimental period (days 1-42). Marginally improved feed intake values were also noted with the use of rice husks as the bedding materials on day 42 (p = 0.092). Improved feed efficiency (p < 0.05) was noticed with rice husks on day 35, the grower period, and the entire 42-day period. However, no significant differences were noticed for most of the carcass characteristics that were evaluated. Nevertheless, higher (p < 0.05) pH values for the breast muscle were noticed with the use of coco peat and sawdust as the bedding. Conclusively, the bedding type could have a significant impact on the growth performance of ducks without adverse effects on carcass characteristics. The use of rice husks as bedding might be advantageous and is therefore recommended.

Fecal Calprotectin Levels Significantly Correlate with Polyp Size in Children and Adolescents with Juvenile Colorectal Polyps.

Purpose: We aimed to investigate factors that correlate with fecal calprotectin (FC) levels in children and adolescents with colorectal polyps. Methods: Pediatric patients aged <19 years who underwent colonoscopic polypectomy for a juvenile polyps (JPs) and FC tests were simultaneously conducted in a multicenter, retrospective study. Baseline demographics, colonoscopic and histological findings, and laboratory tests, including FC levels, were investigated. Correlations between the factors were investigated, and linear regression analysis revealed factors that correlated with FC levels. FC levels measured after polypectomies were investigated and the FC levels pre- and post-polypectomies were compared. Results: A total of 33 patients were included in the study. According to Pearson correlation analysis, the polyp size was the only factor that showed a statistically significant correlation with FC levels (r=0.75, p<0.001). Furthermore, according to the multivariate linear regression analysis, polyp size was the only factor that showed a statistically significant correlation with FC levels (adjusted R2 =0.5718, ß=73.62, p<0.001). The median FC level was 400 mg/kg (interquartile range [IQR], 141.6-1,000 mg/kg), and the median polyp size was 14 mm (IQR, 9-20 mm). Nineteen patients underwent post-polypectomy FC tests. FC levels showed a significant decrease after polypectomy from a median of 445.2 mg/kg (IQR, 225-1,000) to 26.5 mg/kg (11.5-51) (p<0.001). Conclusion: FC levels significantly correlated with polyp size in children and adolescents with JPs.

Life stress, dietary attitudes, and frequency of snack intake for college students in Seoul and Gyeonggi area: the difference between male and female students.

BACKGROUND/OBJECTIVES: This study examines life stress, dietary attitudes, and snacking frequency for college students living in Seoul and Gyeonggi Province. The purpose of this study is to assist college students feeling stressed by offering desirable dietary attitudes and choices of the appropriate snacks by providing educational materials that offer appropriate nutrition education and nutritional information. SUBJECTS/METHODS: A survey was conducted on a total of 600 college students aged 19-29-year-olds living in Seoul and Gyeonggi Province (234 male students and 366 female students). Collected data were analyzed using SPSS WIN 28.0 program. RESULTS: Life stress among college students did not differ significantly between the genders. Male students were more stressed about lover (P < 0.01), while female students were more stressed about value problems (P < 0.01) and future problems (P < 0.05). Dietary attitude ratings were 3.1 for both male and female students with no significant difference. The overall snacking frequency was 4.1 times/day-4.2 times/day for male students and 4.0 times/day for female students-thus, there was no significant difference. Male students consumed 'beverage' (P < 0.01) more frequently than female students. Life stress and snacking were positively correlated for 'biscuit/cookie,' 'chip,' 'cereal,' 'juice/smoothie,' 'café americano,' 'café latte,' 'tea,' 'jelly,' 'chocolate,' 'rice cake,' 'milk,' 'flavored milk,' and 'ice cream' among male students. Among female students, life stress and snacking were positively correlated with 'cereal,' 'caramel,' and 'soymilk,' and negatively correlated for 'biscuit/cookie' and 'carbonated drink.' CONCLUSIONS: College students should manage their stress by identifying its causes and learning how to deal with stressful situations. Additionally, providing them with proper nutrition education based on the correct nutritional information is essential for promoting good food attitudes and snacking behaviors.

Comprehensive experimental and theoretical investigations on the effect of microbubble two-phase flow on the performance of direct-contact membrane distillation.

This study provides a comprehensive and systematic overview of the application of gas-liquid two-phase flow with microbubbles in the feed stream to improve heat and mass transfer in direct-contact membrane distillation (DCMD) processes for seawater desalination. A swirl-flow-type microbubble generator (MBG) was installed at the feed-side inlet of the DCMD module to investigate its effect on transmembrane flux. The maximum improvement in the MBG-assisted DCMD permeation flux was found to be approximately 18% at a lower feed temperature (40 °C) and optimal air flow rate (50 cc/min), and an optimal MBG geometry comprising a swirler, a nozzle tip of diameter 2 mm, and a diffuser at an angle of 30°. The results were observed to be related to the number density of microbubbles less than 100 µm in size, which plays an important role in improving heat and mass transfer in two-phase flow. In addition, the simulation results based on conventional heat transfer correlations of bubbly flow underestimated the experimental results. Therefore, this study also aims to propose and verify a new two-phase flow heat transfer correlation. The proposed correlation considers the effects of bubble size distribution to accurately predict the performance of MBG-assisted DCMD processes.

Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required.

Background/Aims: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy. Methods: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated. Results: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively). Conclusions: In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.

Hepatocyte DAX1 Deletion Exacerbates Inflammatory Liver Injury by Inducing the Recruitment of CD4+ and CD8+ T Cells through NF-κB p65 Signaling Pathway in Mice.

Fulminant hepatitis is characterized by rapid and massive immune-mediated liver injury. Dosage-sensitive sex reversal-adrenal hypoplasia congenita critical region on the X chromosome, gene 1 (DAX1; NR0B1) represses the transcription of various genes. Here, we determine whether DAX1 serves as a regulator of inflammatory liver injury induced by concanavalin A (ConA). C57BL/6J (WT), myeloid cell-specific Dax1 knockout (MKO), and hepatocyte-specific Dax1 knockout (LKO) mice received single intravenous administration of ConA. Histopathological changes in liver and plasma alanine aminotransferase and aspartate aminotransferase levels in Dax1 MKO mice were comparable with those in WT mice following ConA administration. Unlike Dax1 MKO mice, Dax1 LKO mice were greatly susceptible to ConA-induced liver injury, which was accompanied by enhanced infiltration of immune cells, particularly CD4+ and CD8+ T cells, in the liver. Factors related to T-cell recruitment, including chemokines and adhesion molecules, significantly increased following enhanced and prolonged phosphorylation of NF-κB p65 in the liver of ConA-administered Dax1 LKO mice. This is the first study to demonstrate that hepatocyte-specific DAX1 deficiency exacerbates inflammatory liver injury via NF-κB p65 activation, thereby causing T-cell infiltration by modulating inflammatory chemokines and adhesion molecules. Our results suggest DAX1 as a therapeutic target for fulminant hepatitis treatment.

Hepatocyte-Specific Deficiency of DAX-1 Protects Mice from Acetaminophen-Induced Hepatotoxicity by Activating NRF2 Signaling.

Acetaminophen (APAP) is a widely used analgesic and antipyretic drug, but its overdose can cause acute liver failure. The dosage-sensitive sex reversal adrenal hypoplasia congenita critical region on the X chromosome, gene 1 (DAX-1, NR0B1), is an orphan nuclear receptor that acts as a transcriptional co-repressor of various genes. In this study, we identified the role of DAX-1 in APAP-induced liver injury using hepatocyte-specific Dax-1 knockout (Dax-1 LKO) mice. Mouse primary hepatocytes were used as a comparative in vitro study. APAP overdose led to decreased plasma alanine aminotransferase and aspartate aminotransferase levels in Dax-1 LKO mice compared to C57BL/6J (WT) controls, accompanied by reduced liver necrosis. The expression of the genes encoding the enzymes catalyzing glutathione (GSH) synthesis and metabolism and antioxidant enzymes was increased in the livers of APAP-treated Dax-1 LKO mice. The rapid recovery of GSH levels in the mitochondrial fraction of APAP-treated Dax-1 LKO mice led to reduced reactive oxygen species levels, resulting in the inhibition of the prolonged JNK activation. The hepatocyte-specific DAX-1 deficiency increased the protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2) compared with WT controls after APAP administration. These results indicate that DAX-1 deficiency in hepatocytes protects against APAP-induced liver injury by Nrf2-regulated antioxidant defense.

The Changes in Trends of Lower Gastrointestinal Endoscopy Conducted in Children and Adolescents after the COVID-19 Outbreak in Korea.

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic has affected medical practice in diverse ways. We aimed to investigate the change in trends of lower gastrointestinal (LGI) endoscopy conducted in children and adolescents after the COVID-19 outbreak in Korea. Material and Methods: This was a multicenter, retrospective study conducted in Korea. We included children and adolescents aged <19 years who had undergone their first LGI endoscopy between 2016 and 2020. We compared clinicodemographic and endoscopic factors between groups divided according to the pre- and postCOVID-19 era in Korea. Results: We included 1307 patients in this study. Colonoscopies, instead of sigmoidoscopies, were conducted in most patients in the postCOVID-19 era compared to those in the preCOVID-19 era (86.9% vs. 78.5%, p = 0.007). The diagnosis of inflammatory bowel disease (IBD) was also significantly higher in the postCOVID-19 era compared to the preCOVID-19 era (47.2% vs. 28.5%, p < 0.001). According to multivariate logistic regression analysis, age at LGI endoscopy, LGI bleeding indication, and IBD diagnosis were independently associated with the use of a colonoscopy over a sigmoidoscopy (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.12−1.27, p < 0.001; OR 0.56, 95% CI 0.37−0.83, p = 0.005; OR 1.80, 95% CI 1.20−2.77, p = 0.006, respectively). Conclusions: The COVID-19 pandemic has changed LGI endoscopy practice trends of pediatric gastroenterologists in Korea, who tended to perform lesser LGI endoscopies compared to previous years while conducting significantly more colonoscopies than sigmoidoscopies in the postCOVID-19 era. Furthermore, these colonoscopies were significantly associated with the diagnosis of IBD, as well as a significant increase in IBD diagnosis in the postCOVID-19 era.

Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study.

Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

Epidemiological Trends of Pediatric Inflammatory Bowel Disease in Korea: A Multicenter Study of the Last 3 Years Including the COVID-19 Era.

BACKGROUND: Studies on how the coronavirus pandemic has affected pediatric inflammatory bowel disease (PIBD) are lacking. We aimed to investigate the trends in epidemiology, characteristics, initial management, and short-term outcomes of PIBD in South Korea over the recent three years including the era of coronavirus disease 2019 (COVID-19). METHODS: This multicenter study retrospectively investigated temporal trends in the epidemiology of PIBD in Korea. Annual occurrences, disease phenotypes, and initial management at diagnosis were analyzed from January 2018 to June 2021. RESULTS: A total of 486 patients from 17 institutions were included in this epidemiological evaluation. Analysis of the occurrence trend confirmed a significant increase in PIBD, regardless of the COVID-19 pandemic. In Crohn's disease, patients with post-coronavirus outbreaks had significantly higher fecal calprotectin levels than those with previous onset (1,339.4 ± 717.04 vs. 1,595.5 ± 703.94, P = 0.001). Patients with post-coronavirus-onset ulcerative colitis had significantly higher Pediatric Ulcerative Colitis Activity Index scores than those with previous outbreaks (48 ± 17 vs. 36 ± 15, P = 0.004). In the initial treatment of Crohn's disease, the use of 5-aminosalicylic acid (5-ASA) and steroids significantly decreased (P = 0.006 and 0.001, respectively), and enteral nutrition and the use of infliximab increased significantly (P = 0.045 and 0.009, respectively). There was a significant increase in azathioprine use during the initial treatment of ulcerative colitis (P = 0.020). CONCLUSION: Regardless of the COVID-19 pandemic, the number of patients with PIBD is increasing significantly annually in Korea. The initial management trends for PIBD have also changed. More research is needed to establish appropriate treatment guidelines considering the epidemiological and clinical characteristics of Korean PIBD.

Physiological responses of broiler chickens fed reduced-energy diets supplemented with emulsifiers.

OBJECTIVE: To investigate the physiological effects of exogenous emulsifiers in broiler chickens that were fed tallow-incorporated reduced-energy diets over 35 days. METHODS: A total of 256 Ross 308 one-day-old broilers (42.28±0.16 g) were randomly allocated in a 2×2 factorial arrangement to 32 pens with eight chicks per cage. Birds were fed one of four dietary treatments as follows: i) positive control (PCN; energy sufficient diet); ii) negative control (NCN; energy-deficient diet, -100 ME kcal/kg); iii) PCL (PCN plus 0.05% emulsifier); and iv) NCL (NCN plus 0.05% emulsifier). Growth performance was evaluated weekly whereas assessments for the carcass traits, digestibility, some blood metabolites, ileal morphology, and meat quality were measured on d 21 and d 35. RESULTS: Birds fed the NCL diet had higher (p<0.05) body weights, daily gains, daily feed intake, and improved feed efficiency over the entire 35-day period. Improvements (p<0.05) for the ileal digestibility of crude fat, energy, and dry matter commensurate with longer (p<0.05) villus heights were also observed with emulsifiers in the NCL and PCL diets. For the carcass measurements, only the liver weights were increased (p<0.05) with emulsifiers in the supplemented groups. For blood metabolites, higher (p<0.05) lipase levels were noticed with emulsifiers in the NCL and PCL diets. In addition, marginal reductions (p = 0.076; p = 0.095, respectively) were also noted with emulsifiers for the total cholesterol and triglyceride contents on d 35. Regarding meat quality, breast muscle yellowness was increased (p<0.05) with emulsifier use in supplemented groups. CONCLUSION: Our results suggest that emulsifier supplementation at 0.05% in diets could potentially improve the growth performance and nutrient digestibility of broilers over 35 days. This could compensate for the lower growth performance that could be recorded with fat-incorporated lower-energy diets.

Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia.

BACKGROUND: Colorectal polyps are the most common cause of isolated hematochezia in children, which requires a colonoscopy for diagnosis. We aimed to investigate the potential utility of fecal calprotectin (FC) in assessing colorectal polyps detected by colonoscopy among children presenting with isolated hematochezia. METHODS: Pediatric patients of the age of < 18 years who had undergone both colonoscopy and FC tests for isolated hematochezia from June 2016 to May 2020 were included in the present multicenter, retrospective, cross-sectional study. Comparative analysis was conducted between major causes of isolated hematochezia and FC cut-offs for discriminating colorectal polyps were explored. RESULTS: A total 127 patients were included. Thirty-five patients (27.6%) had colorectal polyps, followed by anal fissure (14.2%), ulcerative colitis (UC; 12.6%), and others. A significant difference in FC levels was observed between patients with colorectal polyps (median, 278.7 mg/kg), anal fissures (median, 42.2 mg/kg), and UC (median, 981 mg/kg) (P < 0.001). According to receiver operating characteristic curve analysis, among patients diagnosed with colorectal polyp or anal fissure, the most accurate FC cut-off for discriminating colorectal polyps from anal fissures on colonoscopy was 225 mg/kg (sensitivity, 59.4%; specificity, 94.4%; positive predictive value [PPV], 95.0%; negative predictive value [NPV], 56.7%; area under the curve [AUC], 0.8; 95% confidence interval [CI], 0.678-0.923; P < 0.001), while among patients diagnosed with colorectal polyp or UC, the most accurate FC cut-off for discriminating colorectal polyps from UC on colonoscopy was 879 mg/kg (sensitivity, 81.2%; specificity, 56.2%; PPV, 78.8%; NPV, 60.0%; AUC, 0.687; 95% CI, 0.521-0.852; P < 0.001). CONCLUSION: FC may assist in assessing the cause of lower gastrointestinal tract bleeding in children who present with isolated hematochezia.