Influence of Unit Water Content Control on Concrete Performance in the Ready-Mixed Concrete Production Process.

This study examined the effects of increasing concrete unit water content and artificially controlling water content on concrete performance in the production process of ready-mixed concrete. Results showed that changes in the unit water content of 20 concrete mix proportions without air-entraining significantly reduced concrete compressive strength, increased porosity, and in-creased occurrence of bleeding. A unit water content increase of 25 kg/m3 or more may reduce the compressive strength of concrete below the design standard and significantly affect the occurrence of bleeding water. Moreover, an extra unit water content of at least 25 kg/m3 could significantly affect the diffusion of chloride ions in the concrete. The carbonation depth of concrete was extremely high with the increase in unit water content and water addition. In the production of concrete requiring at least normal strength or durability, the extra water change to total unit water content should be maintained at 15 kg/m3 or less. And a water-cement ratio of 48% or less and a unit water content of 155 kg/m3 or less are considered effective for management of concrete quality. Considering the aggregate type, absorption rate, and moisture state, the management of unit water content error in concrete production processes requires greater.

Efficacy of pulse oximetry for early diagnosis of pulmonary embolism after total knee arthroplasty.

INTRODUCTION: Early diagnosis and aggressive treatment of pulmonary embolism (PE) are crucial for preventing severe complications after total knee arthroplasty (TKA). This study aimed to examine the efficacy of measuring oxygen saturation (SpO2) using a pulse oximeter for early diagnosis of PE after total knee arthroplasty (TKA). MATERIALS AND METHODS: We consecutively examined 1645 patients who underwent TKA between January 2015 and November 2019. Postoperative SpO2 was measured with a pulse oximeter, which was stopped if SpO2 was maintained at ≥ 95% until postoperative day 2 (POD2). To diagnose PE, computed tomographic pulmonary angiography (CTPA) was performed for specific indications, including persistently low SpO2 < 95% (group 1), sudden decrease in SpO2 (group 2), and decrease in SpO2 after POD3 with presenting symptoms (group 3). Also, we divided the patients into unilateral, simultaneous and sequential TKA groups and compared the results with specific statistical techniques. RESULTS: Of the 1645 patients who underwent TKA, there were 20 patients with PE (1.2%), and symptomatic PE was observed in only 4 patients (0.24%). CTPA was performed in 58 (3.5%) patients, of whom 20 were diagnosed with PE. In groups 1 (n = 34), 2 (n = 21), and 3 (n = 3), CTPA was performed 2.4, 2.6, and 8.3 days after TKA, respectively, and 12, 8, and 0 patients were diagnosed with PE, respectively. Of the 782, 416, and 447 unilateral, simultaneous, and sequential (done in same admission with interval 1 or 2 weeks) patients with TKA, 38, 18, and 2 received CTPA, and 13, 6, and 1 were diagnosed with PE, respectively. All patients diagnosed with PE have persistently low SpO2 < 95% (group 1), or sudden decrease in SpO2 (group 2) until POD2. Of the patients diagnosed with PE, SpO2 decreased without the presentation of symptoms in 16 patients (11 and 5 from groups 1 and 2, respectively) and with the presentation of symptoms, such as mild dyspnea and chest discomfort, in 4 patients (1 and 3 from groups 1 and 2, respectively). CONCLUSIONS: Measuring SpO2 using a pulse oximeter until POD2 was an effective method for early diagnosis of PE after TKA. No case of morbidity or mortality was observed after early diagnosis with early stage CTPA and management of PE. We recommend measuring SpO2 with a pulse oximeter for early diagnosing of PE in TKA.

Pharmacological effects of biologically synthesized ginsenoside CK-rich preparation (AceCK40) on the colitis symptoms in DSS-induced Caco-2 cells and C57BL mice.

BACKGROUND: Despite the notable pharmacological potential of natural ginsenosides, their industrial application is hindered by low oral bioavailability. Recent research centers on the production of less-glycosylated minor ginsenosides. PURPOSE: This study aimed to explore the effect of a biologically synthesized ginsenoside CK-rich minor ginsenoside complex (AceCK40), on ameliorating colitis using DSS-induced colitis models in vitro and in vivo. METHODS: The ginsenoside composition of AceCK40 was determined by HPLC-ELSD and UHPLC-MS/MS analyses. In vitro colitis model was established using dextran sodium sulfate (DSS)-induced Caco-2 intestinal epithelial model. For in vivo experiments, DSS-induced severe colitis mouse model was established. RESULTS: In DSS-stimulated Caco-2 cells, AceCK40 downregulated mitogen-activated protein kinase (MAPK) activation (p < 0.05), inhibited monocyte chemoattractant protein-1 (MCP-1) production (p < 0.05), and enhanced MUC2 expression (p < 0.05), mediated via signaling pathway regulation. Daily AceCK40 administration at doses of 10 and 30 mg/kg/day was well tolerated by DSS-induced severe colitis mice. These doses led to significant alleviation of disease activity index score (> 36.0% decrease, p < 0.05), increased luminal immunoglobulin (Ig)G (> 37.6% increase, p < 0.001) and IgA (> 33.8% increase, p < 0.001), lowered interleukin (IL)-6 (> 65.7% decrease, p < 0.01) and MCP-1 (> 116.2% decrease, p < 0.05), as well as elevated serum IgA (> 51.4% increase, p < 0.001) and lowered serum IL-6 (112.3% decrease at 30 mg/kg, p < 0.001). Hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining revealed that DSS-mediated thickening of the muscular externa, extensive submucosal edema, crypt distortion, and decreased mucin droplets were significantly alleviated by AceCK40 administration. Additionally, daily administration of AceCK40 led to significant recovery of colonic tight junctions damaged by DSS through the elevation in the expression of adhesion molecules, including occludin, E-cadherin, and N-cadherin. CONCLUSION: This study presents the initial evidence elucidating the anti-colitis effects of AceCK40 and its underlying mechanism of action through sequential in vitro and in vivo systems employing DSS stimulation. Our findings provide valuable fundamental data for the utilization of AceCK40 in the development of novel anti-colitis candidates.

Lymphangioleiomyomatosis and mTOR inhibitors in real world-a narrative review.

Background and Objective: Lymphangioleiomyomatosis (LAM) is a rare disease developing mostly on lung and leading to various pulmonary and extra-pulmonary manifestations. Management of this intractable illness has been mostly symptomatic and supplementary until the advent and application of a novel drug, i.e., the mechanistic target of rapamycin (mTOR) inhibitor, and successful disease control using mTOR inhibitors is improving LAM patients. Although mTOR inhibitors are showing remarkable results there are still many rooms for further progress, and partly solved issues on problems seen in LAM still remain. We searched multiple reports and investigational studies regarding LAM, especially the therapeutic achievement won by mTOR inhibitors. This article summarized several characteristics of LAM including pathogenesis, clinical manifestation, laboratory findings, and management. We also attempted to review the latest knowledge and efficacy of mTOR inhibitors and some new drugs. Methods: Online searching of literature was performed. The National Center for Biotechnology Information (NCBI), PubMed, Cochrane Library, Google Scholar, and EMBASE were searched. Key Content and Findings: LAM is a genetic disease with a high predilection toward female subjects. Not only lung but also other organs are involved, hence extrapulmonary symptoms and signs are also noted. Representative objective finding is a progressive deterioration of lung function, sometimes leading to respiratory failure. Supportive and symptomatic care has been the mainstay of therapy with suboptimal result, until a novel drug, the mTOR inhibitor, was developed. Successful deterrence of disease progression was achieved on management with mTOR inhibitors. Several unsolved problems using mTOR inhibitors are a pending issue, such as duration of treatment. Conclusions: LAM has been a rare, stubborn disease to ameliorate in health due to its complex pathogenesis and accompanied by other manifestations. Adopting various tools for relief has been usually suboptimal, but mTOR inhibitors proved to achieve significant improvement in various aspects. Further investigation is needed including refinement of currently available therapeutic applications, development of novel remedies, and so on.

A Deep Reinforcement Learning Strategy for Surrounding Vehicles-Based Lane-Keeping Control.

As autonomous vehicles (AVs) are advancing to higher levels of autonomy and performance, the associated technologies are becoming increasingly diverse. Lane-keeping systems (LKS), corresponding to a key functionality of AVs, considerably enhance driver convenience. With drivers increasingly relying on autonomous driving technologies, the importance of safety features, such as fail-safe mechanisms in the event of sensor failures, has gained prominence. Therefore, this paper proposes a reinforcement learning (RL) control method for lane-keeping, which uses surrounding object information derived through LiDAR sensors instead of camera sensors for LKS. This approach uses surrounding vehicle and object information as observations for the RL framework to maintain the vehicle's current lane. The learning environment is established by integrating simulation tools, such as IPG CarMaker, which incorporates vehicle dynamics, and MATLAB Simulink for data analysis and RL model creation. To further validate the applicability of the LiDAR sensor data in real-world settings, Gaussian noise is introduced in the virtual simulation environment to mimic sensor noise in actual operational conditions.

The Incidence Rate, Microbiological Etiology, and Results of Treatments of Prosthetic Joint Infection following Total Knee Arthroplasty.

Periprosthetic joint infection (PJI) remains among the most challenging and costly complications. PJI rates vary from 0.39% to 3.9% after total knee arthroplasty (TKA). This study aimed to identify the causative microorganisms involved and to report our experience of subsequent treatment of PJI following over 7000 TKAs performed over 19 years. A retrospective study was conducted on 4547 patients (7019 cases) from March 2000 to September 2019. The incidence rate of PJI was 0.5%. Gram-positive bacteria accounted for 88.8% (n = 16) of the 18 cases, and S. aureus was the most commonly isolated pathogen (n = 7, 38.8%). There were six cases of MSSA and one case of MRSA. Streptococcus species (n = 7, 38.8%) also showed the same pattern. The CoNS species (n = 2, 11.1%) and Gram-negative bacteria (n = 1, 5.5%) were also reported. Candida species were isolated from 1 patient (5.5%). Successful I&D and implant retention (DAIR procedures) was achieved at the final follow-up in 19 patients (82.6%). The incidence of causative microorganisms was different for each PJI onset type. The overall infection rate of PJI was less than 1%. Although the success rate of DAIR procedures is lower than the two-stage exchange arthroplasty in this study, it is possible to achieve acceptable success rates if DAIR procedures are carefully selected considering the virulence of the microorganism, duration since symptom onset, and early-onset infection.

Primary Production in the Kara, Laptev, and East Siberian Seas.

Understanding of the primary production of phytoplankton in the Kara Sea (KS), the Laptev Sea (LS), and the East Siberian Sea (ESS) remains limited, despite the recognized importance of phytoplankton in the Arctic Ocean. To address this knowledge gap, we conducted three NABOS (Nansen and Amundsen Basins Observational System) expeditions in 2013, 2015, and 2018 to measure in situ primary production rates using a 13C-15N dual-tracer method and examine their major controlling factors. The main goals in this study were to investigate regional heterogeneity in primary production and derive its contemporary ranges in the KS, LS, and ESS. The daily primary production rates in this study (99 ± 62, 100 ± 77, and 56 ± 35 mg C m-2 d-1 in the KS, LS, and ESS, respectively) are rather different from the values previously reported in each sea mainly because of spatial and regional differences. Among the three seas, a significantly lower primary production rate was observed in the ESS in comparison to those in the KS and LS. This is likely mainly because of regional differences in freshwater content based on the noticeable relationship (Spearman, rs = -0.714, p < 0.05) between the freshwater content and the primary production rates observed in this study. The contemporary ranges of the annual primary production based on this and previous studies are 0.96-2.64, 0.72-50.52, and 1.68-16.68 g C m-2 in the KS, LS, and ESS, respectively. Further intensive field measurements are warranted to enhance our understanding of marine microorganisms and their community-level responses to the currently changing environmental conditions in these poorly studied regions of the Arctic Ocean.

Particulated Costal Allocartilage With Microfracture Versus Microfracture Alone for Knee Cartilage Defects: A Multicenter, Prospective, Randomized, Participant- and Rater-Blinded Study.

Background: Microfracture is the first-line treatment for cartilage defects; however, the suboptimal quality of the repaired cartilage remains an issue. Purpose/Hypothesis: The aim of this first in-human study was to compare the clinical efficacy and safety of a combination of particulated costal allocartilage and microfracture versus microfracture alone in treating knee cartilage defects. We hypothesized that the particulated costal allocartilage with microfracture would result in superior cartilage repair quality and better clinical outcomes at 48 weeks postoperatively. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients with cartilage defects were allocated randomly to the treatment group (particulated costal allocartilage with microfracture) and control group (microfracture alone). Magnetic resonance imaging (MRI) outcomes of cartilage repair (the primary outcome measure) were evaluated at the 48-week follow-up using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. Patient-reported clinical outcomes (visual analog scale [VAS] pain score, Knee injury and Osteoarthritis Outcome Score [KOOS], and International Knee Documentation Committee score) and adverse events were evaluated at 12, 24, and 48 weeks postoperatively. Results: Overall, 88 patients were included (44 patients each in the treatment and control groups). The total MOCART score at 48 weeks postoperatively was significantly higher in the treatment group than in the control group (P < .001). Among the 9 MOCART variables, 6 were significantly superior in the treatment versus the control group: degree of repair and defect filling (P < .001), integration to the border zone (P < .001), surface (P = .006), structure (P = .011), signal intensity of the repair tissue (P < .001), and subchondral lamina (P = .005). There were significant between-group differences in KOOS-Pain (P = .014), KOOS-Activities of Daily Living (P = .010), KOOS-Sports (P = .029), and KOOS-Symptoms (P = .039) at 12 weeks postoperatively and in VAS pain (P = .012) and KOOS-Pain (P = .005) at 24 weeks postoperatively. At 48 weeks postoperatively, clinical outcomes were comparable between the groups. Conclusion: Microfracture augmented with particulated costal allocartilage resulted in superior cartilage repair quality compared with microfracture alone in terms of MRI evaluation of the knee joint cartilage defect at the 48-week follow-up. Functional outcomes were favorable for both treatments at final follow-up. Registration: KCT0004936 (Clinical Research Information Service [CRiS] of the Republic of Korea).

C2RL: Convolutional-Contrastive Learning for Reinforcement Learning Based on Self-Pretraining for Strong Augmentation.

Reinforcement learning agents that have not been seen during training must be robust in test environments. However, the generalization problem is challenging to solve in reinforcement learning using high-dimensional images as the input. The addition of a self-supervised learning framework with data augmentation in the reinforcement learning architecture can promote generalization to a certain extent. However, excessively large changes in the input images may disturb reinforcement learning. Therefore, we propose a contrastive learning method that can help manage the trade-off relationship between the performance of reinforcement learning and auxiliary tasks against the data augmentation strength. In this framework, strong augmentation does not disturb reinforcement learning and instead maximizes the auxiliary effect for generalization. Results of experiments on the DeepMind Control suite demonstrate that the proposed method effectively uses strong data augmentation and achieves a higher generalization than the existing methods.

Design and Optimization of Composite Cathodes for Solid-State Batteries Using Hybrid Carbon Networks with Facile Electronic and Ionic Percolation Pathways.

Solid-state batteries (SSBs) have emerged as a promising alternative to conventional liquid electrolyte batteries due to their potential for higher energy density and improved safety. However, achieving high performance in SSBs is difficult because of inadequate contact and interfacial reactions that generate high interfacial resistance, as well as inadequate solid-solid contact between electrodes. These chronic issues are associated with inhomogeneous ion and electron transport networks owing to imperfect solid-solid interfacial contact. This study developed an optimal interfacial engineering strategy to facilitate an ion-electron transport network by designing an active material (NCM622) uniformly filled with a thin layer of a solid electrolyte (garnet-type Li6.25Ga0.25La3Zr2O12) and conductive additives. The optimal composite electrode architecture enhanced the high capacity, high rate capability, and long-term cycle stability, even at room temperature, owing to the percolating network for facile ionic conduction that assured a homogeneous reaction. In addition to mitigating the mechanical degradation of the cathode electrode, it also reduced the crosstalk effects on the anode-solid electrolyte interface. Effectively optimizing the selection and use of conductive additives in composite electrodes offers a promising approach to addressing key performance-limiting factors in SSBs, including interfacial resistance and solid-solid contact issues. This study underscores the critical importance of cathode architecture design for achieving high-performance SSBs by ensuring that the interfaces are intact with solid electrolytes at both the cathode and anode interfaces while promoting uniform reactions. This study provides valuable insights into the development of SSBs with improved performance, which could have significant implications for a wide range of applications.

Spatio-temporal variations in organic carbon composition driven by two different major phytoplankton communities in the Ross Sea, Antarctica.

The compositions of organic carbon could be important in determining biological carbon pump efficiency. However, little information on them in relation to each algal assemblage is currently available in the Ross Sea. Here, we investigated the seasonal variations in organic carbon composition and the relative abundance of each organic carbon, including particulate organic carbon (POC), dissolved organic carbon (DOC), and transparent exopolymer particles (TEPs), characterized by different algal groups in the Ross Sea. The average POC and DOC contributions to the total organic carbon (TOC = POC + DOC) were 13.8 ± 3.7 % and 86.2 ± 3.7 % in mid-January 2019 and 20.9 ± 4.1 % and 79.1 ± 4.1 % in February-March 2018, respectively. The carbon content of TEP (TEP-C) contributed 19.6 ± 11.7 % and 4.6 ± 7.0 % of POC and TOC in mid-January and 36.2 ± 14.8 % and 9.0 ± 6.7 % in February-March, respectively. We found that the organic carbon compositions were affected by seasonal variations in the phytoplankton bloom phase, physical characteristics, and phytoplankton community structure. DOC concentrations and contributions to the TOC increased as phytoplankton cells became senescent in mid-January and decreased in February-March when phytoplankton were relatively active. From February-March, the deepened mixed layer depth encouraged TEP formation, subsequently increasing the TEP contributions. Regardless of the sampling season, all organic carbon concentrations per unit Chl-a were significantly higher in P. antarctica-abundant groups. The DOC contributions to the TOC were correspondingly higher at the P. antarctica-abundant stations in mid-January, which indicates that P. antarctica could be also important in the DOC contributions in the Ross Sea. The rapid alteration in environmental characteristics and phytoplankton community structures in the Ross Sea due to climate change could affect the organic carbon pool at the euphotic layer which consequently could determine the efficiency of the biological pump.

Histone variant HTB4 delays leaf senescence by epigenetic control of Ib bHLH transcription factor-mediated iron homeostasis.

Leaf senescence is an orderly process regulated by multiple internal factors and diverse environmental stresses including nutrient deficiency. Histone variants are involved in regulating plant growth and development. However, their functions and underlying regulatory mechanisms in leaf senescence remain largely unclear. Here, we found that H2B histone variant HTB4 functions as a negative regulator of leaf senescence. Loss of function of HTB4 led to early leaf senescence phenotypes that were rescued by functional complementation. RNA-seq analysis revealed that several Ib subgroup basic helix-loop-helix (bHLH) transcription factors (TFs) involved in iron (Fe) homeostasis, including bHLH038, bHLH039, bHLH100, and bHLH101, were suppressed in the htb4 mutant, thereby compromising the expressions of FERRIC REDUCTION OXIDASE 2 (FRO2) and IRON-REGULATED TRANSPORTER (IRT1), two important components of the Fe uptake machinery. Chromatin immunoprecipitation-quantitative polymerase chain reaction analysis revealed that HTB4 could bind to the promoter regions of Ib bHLH TFs and enhance their expression by promoting the enrichment of the active mark H3K4me3 near their transcriptional start sites. Moreover, overexpression of Ib bHLH TFs or IRT1 suppressed the premature senescence phenotype of the htb4 mutant. Our work established a signaling pathway, HTB4-bHLH TFs-FRO2/IRT1-Fe homeostasis, which regulates the onset and progression of leaf senescence.

Joint Replacement Surgery in Patients with Rheumatoid Arthritis in South Korea: Analysis of a Large National Database.

Background: We aimed to investigate the current trend of joint replacement surgery incidence in patients with rheumatoid arthritis (RA) in South Korea and to compare the incidence of joint replacement surgery in each affected joint. Methods: We performed this big data analysis to investigate the current trend of joint replacement surgery incidence in patients with RA in South Korea and to compare the incidence of joint replacement surgery in each affected joint. This retrospective study was based on data from the Korea National Health Insurance claims database. Results: The prevalence of RA increased every year (0.13% in 2008, 0.25% in 2016). The number of newly diagnosed patients increased from 29,184 in 2010 to 38,347 in 2016. The incidence rate of joint replacement surgery in patients with RA increased from 0.72% in 2010 to 4.03% in 2016. The knee (68.3%) was the most commonly replaced joint. The relative risk (RR) of additional joint replacement surgery was highest for the shoulder joint (RR,1.454; 95% confidence interval, 0.763-2.771). The median time from diagnosis to surgery was the shortest in the elbow joint (379 days) and the longest in the shoulder joint (955 days). The median time for each joint was short in order of the elbows, ankles, hips, knees, and shoulders (p < 0.01). Conclusions: The most frequently and initially replaced joints were different, but the prevalence and incidence of RA, as well as those of joint replacement surgery, have recently increased in South Korea. Joint replacement surgery in RA was the highest for the knee joint. The median time from diagnosis to surgery was shortest for the elbow, followed by the ankle, hip, knee, and shoulder. Regardless of whether patients are symptomatic, evaluation of large joints such as the knee, elbow, ankle, and hip should be considered from an early stage.

Workplace Violence Experienced by Community Mental Health Workers.

A cross-sectional online survey was conducted to 1) investigate the prevalence of workplace violence and workers' emotional distress, 2) explore factors associated with workplace violence, and 3) assess workers' needs for preventive measures. A total of 763 community mental health workers participated in Korea. Among them, 85.85% of workers experienced workplace violence, including verbal (74.31%), emotional (66.45%), infectious (47.44%), informational (42.60%), sexual (32.50%), and physical (23.72%) abuse. Binary logistic regression analysis indicated that sex, occupation, certification, and working institution were significantly associated with workplace violence. Workplace violence affects workers' depression, anger, and anxiety negatively. The most-needed preventive measure is a two-person home visit.

Identification and Fungicide Control of Bipolaris sorokiniana Causing Leaf Spot and Blight on Common Hop (Humulus lupulus) in Korea.

Hop (Humulus lupulus) is a perennial herbaceous vine belonging to the family Cannabaceae. This crop is commercially grown for the brewing industry for its bitter and aromatic flavor, as well as its antiseptic properties. In June 2021, leaf spot and blight was observed on common hop plants in Buan-gun, Jeollabuk-do, South Korea. The typical symptoms were small to large, dark-brown, necrotic lesions with yellow halos on the leaves. This study aimed to clarify the causal agent of this disease. Two fungal species, Alternaria alternata and Bipolaris sorokiniana, were isolated from the diseased leaf samples and identified by combining morphological observations and phylogenetic analysis using sequence datasets of internal transcribed spacer (ITS), Alt a1, rpb2, endoPG, and OPA10-2; and ITS, gpd, and tef1, respectively. Pathogenicity of the fungal isolates on detached leaves and living plants revealed that B. sorokiniana is the causal pathogen of this disease, while A. alternata is potentially a saprophyte. Fungicide sensitivity of the pathogen B. sorokiniana was further estimated in vitro using three classes of fungicides represented by fluxapyroxad, pyraclostrobin, and hexaconazole. The effective concentrations that inhibited 50% of spore germination (EC50) were 0.72, 1.90, and 0.68 µg ml-1, respectively. Moreover, all of these fungicides were able to control B. sorokiniana on detached common hop leaves at their recommended concentrations. In conclusion, this study reports leaf spot and blight of common hop caused by B. sorokiniana for the first time and proposes potential fungicides for this disease.

Combined PCL and PLC Reconstruction Improves Residual Laxity in PCL Injury Patients with Posterolateral Knee Laxity Less Than Grade III.

PURPOSE: To compare the short-term clinical and radiologic outcomes of combined posterior cruciate ligament (PCL) and posterolateral complex (PLC) reconstruction to those of isolated PCL reconstruction (PCLR) for patients with posterolateral knee laxity less than grade III. MATERIALS AND METHODS: We retrospectively reviewed 49 patients (51 knees) who underwent PCLR between January 2008 and December 2015. Patients with a minimum follow-up of 24 months were included and divided into two groups (group A, isolated PCLR; group B, combined PCL and PLC reconstruction). Clinical outcomes were evaluated as the International Knee Documentation Committee (IKDC) subjective, Lysholm, and Tegner activity scale scores. Radiologic outcomes were also assessed using the side-to-side differences in posterior tibial translation via stress radiographs. RESULTS: A total of 30 cases were analyzed. There were no significant differences in the Lysholm and Tegner activity scale scores between the two groups preoperatively and at the final follow-up. However, group B showed a higher IKDC subjective score compared to group A at the final follow-up (group A, 72.8±8.9; group B, 77.7±10.1; p<0.05). Regarding the radiologic outcomes, group B also showed a significantly less side-to-side difference in posterior tibial translation compared to group A at the final follow-up (group A, 4.8±2.3 mm; group B, 3.8±2.1 mm; p<0.05). CONCLUSION: Combined PCL and PLC reconstruction resulted in improved clinical and radiologic outcomes than isolated PCLR in patients who have less than grade III posterolateral laxity of the knee. In cases of PCL rupture with ambiguous PLC injury, combined PCL and PLC reconstruction may help to improve posterior residual laxity of the knee.

Serum S100B Levels in Patients with Liver Cirrhosis and Hepatic Encephalopathy.

Hepatic encephalopathy (HE) is one of the main complications of liver cirrhosis (LC) and is classified into minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy (overt HE). S100B is expressed mainly in astrocytes and other glial cells, and S100B has been reported to be associated with various neurological disorders. The present study aimed to investigate the diagnostic ability of serum S100B to discriminate the grade of HE and the parameters correlated with serum S100B levels. Additionally, we investigated whether serum S100B levels can be used to predict 1-year mortality in cirrhotic patients. In total, 95 cirrhotic patients were consecutively enrolled and divided into the following three groups: (i) without any types of HEs; (ii) with MHE; and (iii) with overt HE. The diagnosis of MHE was made by the Mini-Mental State Examination (MMSE) and Psychometric Hepatic Encephalopathy Score (PHES). Among the three groups, there were no significant differences in serum S100B levels regardless of HE severity. The clinical parameters correlated with serum S100B levels were age, serum bilirubin, and creatinine levels. The Model for End-Stage Liver Disease (MELD) score showed a significant positive correlation with serum S100B levels. The relationship between serum S100B levels and MELD score was maintained in 48 patients without any type of HE. Additionally, hyperammonemia, low cholesterol levels, and the combination of serum S100B levels ≥ 35 pg/mL with MELD score ≥ 13 were factors for predicting 1- year mortality. In conclusion, serum S100B level was not useful for differentiating the severity of HE. However, we found that serum S100B levels can be affected by age, serum bilirubin, and creatinine in cirrhotic patients and are associated with MELD scores. Additionally, serum S100B levels showed the possibility of predicting 1-year mortality in cirrhotic patients. These findings suggest that serum S100B levels may reflect liver dysfunction and prognosis in liver disease.

Platelet-to-White Blood Cell Ratio: A Feasible Biomarker for Pyogenic Liver Abscess.

The platelet-to-white blood cell ratio (PWR) has been reported to predict the severity of patients with various diseases. However, no previous studies have assessed the use of the PWR as a prognostic marker for pyogenic liver abscesses (PLA). This observational retrospective study was performed between January 2008 and December 2017, including 833 patients with PLA from multiple centers. The enrolled patients, on average, had a PWR of 17.05, and 416 patients had a PWR lower than 17.05. A total of 260 patients (31.2%) with PLA showed complications of metastatic infection, pleural effusion and abscess rupture. A low PWR level was identified as a strong risk factor for metastatic infection and pleural effusion. The low PWR group also had a longer hospital stay. In the multivariate analysis, old age, anemia, albumin and CRP levels and unidentified pathogens were significant factors for low PWR levels. A low PWR, old age, male sex, abscess size, albumin, ALP and unidentified causative pathogens showed significant associations with a hospital stay longer than 28 days. As a result, PLA patients presenting with a low PWR were shown to have more complications and a poor prognosis. Considering its cost-effectiveness, PWR could be a novel biomarker used to predict a prognosis of PLA.

Mortality of septic knee arthritis in Korea: risk factors analysis of a large national database.

This study aimed to analyze the risk factors for mortality of septic knee arthritis in Korea through a large nationwide data research. The National Health Insurance Service-Health Screening database was used to analyze 89,120 hospitalizations for septic knee arthritis between 2005 and 2018. In-hospital, thirty-day, and ninety-day mortality, and their association with patient's demographic factors, various comorbidities (i.e., cerebrovascular disease, congestive heart failure, and myocardial infarction) and Charlson Comorbidity Index (CCI) were assessed. Secondary outcomes of complications (osteomyelitis, knee arthroplasty, recurrence) were analyzed. The number of hospitalization with septic knee arthritis increased from 1847 cases in 2005 to 8749 cases in 2018. There was no significant difference in mortality after diagnosis of septic knee arthritis between years. The risk of mortality in patients who hospitalized with septic knee arthritis increased in comorbidities like Congestive heart failure, dementia, myocardial infarction, chronic kidney disease. Hazard ratio (HR) decreased in patients who have comorbidities such as rheumatoid arthritis, liver disease, rheumatologic disease. HR for mortality in septic knee arthritis increased in patients with CCI more than 1. The risk factors for mortality in all periods were male sex, old age, high CCI, comorbidities such as congestive heart failure, dementia, myocardial infarction, chronic kidney disease. Efforts to reduce mortality should be concentrate more on patients with these risk factors.

Toxic gas detection using 3-channel spark-induced plasma spectroscopy for indoor air quality monitoring.

This study explored the toxic gas detection using a set of two spark-induced plasma emission spectroscopy (SIPS) modules as an alternative to conventional chemical sensors. This opens up a new possibility for detecting toxic molecules (formaldehyde, acetaldehyde, acetic acid, toluene, and ammonia) in real-time (<3 s) at relatively high sensitivity (<5 ppm). An optimized electrical controller (Raspberry Pi), manufactured as a compact and economical 3-channel optical measuring device, was developed for handling the high-resolution time-resolved electrical signals from the plasma emissions. Subsequently, the findings of this research elucidate the usability of the 3-channel SIPS device for quantitative monitoring of toxic gases.