CEBPA double mutations associated with ABO antigen weakness in hematologic diseases.

ABSTRACT: ABO antigen weakness is rarely observed in ABO typing for transfusion. Hematologic diseases and associated gene mutations have been suggested as potential causes of this phenomenon, yet the precise etiology has not been elucidated. Through ABO typing and genetic analysis data conducted over 7 years, we have reconfirmed the association between ABO antigen weakness and hematologic diseases, especially acute myeloid leukemia (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.12-5.83) and myelodysplastic syndrome (OR, 6.94; 95% CI, 2.86-16.83), and discovered previously unidentified candidate genes, CEBPA (OR, 43.70; 95% CI, 18.12-105.40), NRAS (OR, 3.37; 95% CI, 1.46-7.79), U2AF1 (OR, 8.12; 95% CI, 2.86-23.03), and PTPN11 (OR, 4.52; 95% CI, 1.51-13.50), seemingly associated with this phenomenon. Among these, CEBPA double mutations displayed a significant association, with ABO antigen weakness being observed in 20 of the 25 individuals (80.0%) possessing these mutations. From this study, new factors associated with ABO antigen weakness have been identified.

Evaluating the TaqMan Jra-Genotyping Method for Rapidly Predicting the Presence of Anti-Jra Antibodies.

Background: The Jra antigen is a high-prevalence red blood cell (RBC) antigen. Reports on cases of fatal hemolytic disease of the fetus and newborn and acute hemolytic transfusion reactions suggest that antibodies against Jra (anti-Jra) have potential clinical significance. Identifying anti-Jra is challenging owing to a lack of commercially available antisera. We developed an alternative approach to rapidly predict the presence of anti-Jra using the TaqMan single-nucleotide polymorphism (SNP)-genotyping method. Methods: Residual peripheral blood samples from 10 patients suspected of having the anti-Jra were collected. Two samples with confirmed Jr(a-) RBCs and anti-Jra were used to validate the TaqMan genotyping assay by comparing the genotyping results with direct sequencing. The accuracy of the assay in predicting the presence of anti-Jra was verified through crossmatching with in-house Jr(a-) O+ RBCs. Results: The TaqMan-genotyping method was validated with two Jr(a-) RBC- and anti-Jra-confirmed samples that showed concordant Jra genotyping and direct sequencing results. Jra genotyping for the remaining samples and crossmatching the serum samples with in-house Jr(a-) O+ RBCs showed consistent results. Conclusions: We validated a rapid, simple, accurate, and cost-effective method for predicting the presence of anti-Jra using a TaqMan-based SNP-genotyping assay. Implementing this method in routine practice in clinical laboratories will assist in solving difficult problems regarding alloantibodies to high-prevalence RBC antigens and ultimately aid in providing safe and timely transfusions and proper patient care.

Implementing Point-of-Care Ultrasound for Acute Scrotal Pain in the Pediatric Emergency Department: Screening Testicular Torsion and Patient Flow Analysis.

OBJECTIVES: Testicular torsion (TT) is a pediatric surgical emergency that requires prompt treatment. This study investigated the feasibility of point-of-care ultrasound (POCUS) for diagnosing TT in the pediatric emergency department (ED). METHODS: We retrospectively reviewed the medical records of patients, aged 18 years or younger, who visited a university-affiliated hospital pediatric ED with acute scrotal pain without trauma history and underwent diagnostic ultrasounds between January 2010 and October 2022. RESULTS: This study included 731 patients (median age: 9 years), Of these, 315 (43%) were in the POCUS-performed group: 188 in the POCUS-only group, and 127 in the POCUS-and-RADUS group. The other 416 patients (56.9%) were in the RADUS-only group. In total, 45 patients (6.2%) were diagnosed with TT (19 in the POCUS-performed group and 26 in the RADUS-only group). The sensitivity, specificity, and positive and negative predictive values of POCUS for diagnosing TT were 94.7%, 92.9%, 46.2%, and 99.6%, respectively. The median time to perform POCUS was shorter than RADUS (23 versus 61 minutes, P < .001). The POCUS-performed group had a shorter ED length of stay than the RADUS-only group (93 versus 170 minutes, P < .001). Among the patients diagnosed with TT, performing POCUS first did not significantly delay the ED process, including time to operation (250 versus 205 minutes, P = .142). CONCLUSIONS: For patients with acute scrotal pain, evaluation performed by pediatric emergency physicians using POCUS performs well in screening TT, and can decrease length of stay in the ED.

Development and Characterization of Inula britannica Extract-Loaded Liposomes: Potential as Anti-Inflammatory Functional Food Ingredients.

We investigated the potential of Inula britannica extract encapsulated in liposomes as a functional food ingredient with enhanced bioavailability and stability. Inula britannica, known for its anti-inflammatory properties and various health benefits, was encapsulated using a liposome mass production manufacturing method, and the physical properties of liposomes were evaluated. The liposomes exhibited improved anti-inflammatory effects in lipopolysaccharide-activated RAW 264.7 macrophages, suppressing the production of pro-inflammatory mediators such as nitric oxide and prostaglandin E2 and downregulating the expression of iNOS and COX-2 transcription factors. Additionally, we observed reduced production of pro-inflammatory cytokines TNF-α, IL-6, and IL-1ß, and modulation of the NF-κB and mitogen-activated protein kinase signaling pathways. These findings suggest that Inula britannica extract encapsulated in liposomes could serve as a valuable functional food ingredient for managing and preventing inflammation-related disorders, making it a promising candidate for incorporation into various functional food products. The enhanced absorption and stability provided by liposomal encapsulation can enable better utilization of the extract's beneficial properties, promoting overall health and well-being.

Safety and efficacy of pediatric sedation protocol for diagnostic examination in a pediatric emergency room: A retrospective study.

Pediatric patients undergoing diagnostic tests in the pediatric emergency room are frequently sedated. Although efforts are made to prevent adverse events, no sedation protocol has specified the optimal regimen, dosage, and interval of medication to prevent adverse events. This study analyzed the safety and efficacy of sequential pediatric sedation protocols for pediatric patients undergoing diagnostic tests in the pediatric emergency room of a single tertiary medical center. The medical records of patients aged < 18 years who visited the pediatric emergency room of Seoul Asan Medical Center between January and December 2019 for diagnostic testing were retrospectively reviewed. Sedation protocols consisted of 50 mg/kg and 25 mg/kg chloral hydrate, 0.1 mg/kg and 0.1 mg/kg midazolam, and 1 mg/kg and 0.5 to 1 mg/kg ketamine, administered sequentially at intervals of 30, 20, 10, 10, and 10 minutes, respectively. Patients were assessed prior to sedation, and adverse events were investigated. Of the 289 included patients, 20 (6.9%) experienced adverse events, none serious, and nine (3.1%) failed to reach the depth of sedation required to complete the test. The regimen (P = .622) and dosage (P = .777) of the sedatives were unrelated to the occurrence of adverse events when sedation was performed according to protocol. The sedation protocol used in these patients, consisting of sequential administration of minimum dosages, achieved a sufficient depth of sedation with relatively few adverse events, indicating that this protocol can be used safely and effectively for painless sedation in pediatric patients undergoing diagnostic testing.

Correction to: Versatile biotechnological applications of amylosucrase, a novel glucosyltransferase.

[This corrects the article DOI: 10.1007/s10068-019-00686-6.].

Correction to: Nanoemulsions as delivery systems for lipophilic nutraceuticals: strategies for improving their formulation, stability, functionality and bioavailability.

[This corrects the article DOI: 10.1007/s10068-019-00731-4.].

Effect of cavity shape on microstructural evolution of pure aluminum in electrically-assisted solidification.

Grain refinement is a crucial issue in metallic materials. One of the emerging techniques to obtain equiaxed grains is to apply an electric current to the liquid metal during solidification. With this view, in this paper, the effect of electric current on the solidification behavior in various cavity shapes of mold was investigated. Cylinder-, cube-, and cuboid-shaped cavities designed to have similar cavity volume were used. By applying an electric current during the solidification of liquid aluminum, the grains were effectively refined with a grain size of approximately 350 µm for all three types of cavities. The circulating flow of liquid aluminum was observed to have a similar shear rate intensity in all three types of cavities, which is known to be sufficiently high (over hundreds of s-1) to induce dendrite fragmentation resulting newly generated nuclei. Dispersion of nuclei on unsolidified aluminum appeared differently according to the shape of the cavity, which influences final shape of refined zone. The area fraction of refined zone was affected by the relative relationship between the solidification completion time and the electric current application time. This study will provide insight to control of process parameters when electrically-assisted solidification is applied to a real product with a complex shape.

Influence of the type and concentration of hydrocolloids on Ostwald ripening of emulsions stabilized with small molecular and non-ionic surfactants.

The effects of hydrocolloid gum, gum arabic, carrageenan, and xanthan on the Ostwald ripening of emulsions fabricated using Brij or Tween surfactants were examined. Emulsions prepared using pure n-decane exhibited low stability to Ostwald ripening, and modifying the oil composition by mixing corn oil improved the stability to Ostwald ripening. When gums were added to emulsions prepared using pure n-decane, the stability to Ostwald ripening decreased further, except for xanthan in emulsions stabilized using Tween surfactant. This could be because gums may affect interactions between water molecules and the hydrophilic head of the surfactant, increasing the water solubility of n-decane. However, gum addition (or viscosity increment) increased the stability of emulsions prepared using the modified oil composition (90% n-decane and 10% corn oil). In conclusion, emulsions unstable to Ostwald ripening may be negatively affected by gum addition, whereas emulsions relatively stable to Ostwald ripening may be positively affected.

Solubilization of α-tocopherol and curcumin by polyoxyethylene alkyl ether surfactants: Effect of alkyl chain structure.

The effects of the structural characteristics of the alkyl chains of polyoxyethylene alkyl ether-type surfactants (Brij) on the solubilization of α-tocopherol and curcumin by surfactant micelles were investigated: Brij L23 (lauryl; C12:0); S20 (stearyl; C18:0); and Brij O20 (oleyl; C18:1). When α-tocopherol or curcumin were solubilized in Brij micelle solutions below their maximum solubilization concentrations (Cmax), the Brij L23 micelles exhibited the largest increase in dimensions due to the presence of the guest molecules. Above Cmax, excess α-tocopherol existed as microemulsion droplets whereas excess curcumin existed as insoluble crystals. Our results suggest that the guest molecules were preferentially located within the palisade layers of micelles, which can be attributed to the fact that they contained bother polar and non-polar moieties. These results may be important for the formulation of colloidal delivery systems to encapsulate and deliver oil-soluble vitamins and nutraceuticals.

Fabrication of Whey Protein Isolate-Pectin Nanoparticles by Thermal Treatment: Effect of Dynamic High-Pressure Treatment.

This study investigated the impact of dynamic high-pressure (DHP) treatment on the ability of whey protein isolate (WPI) to form associative complexes with pectin and to form aggregate particles after their subsequent heat treatment. Light scattering showed that DHP treatments disrupted preexisting WPI aggregates and assembled pectin chains. Complexes formed from WPI/pectin mixtures at pH 4.5 were an order of magnitude smaller when formed after DHP treatment, regardless of the degree of esterification. WPI/pectin complexes formed after DHP treatment were more stable against subsequent pH neutralization than complexes formed without DHP treatment, and WPI/high-methoxyl pectin (HMP) complexes had greater stability than WPI/low-methoxyl pectin (LMP) complexes. WPI/pectin particles prepared by thermal treatment of complexes at pH 4.5 were also smaller when prepared after DHP treatment. WPI/HMP particles were stable to subsequent pH neutralization, while WPI/LMP particles became larger after neutralization.

Impacts of the Dynamic High-Pressure Pre-Treatment and Post-Treatment of Whey Protein Aggregates on Their Physicochemical Properties and Emulsifying Activities.

The impacts of dynamic high-pressure (DHP) pretreatment and post-treatment (100 MPa) on the physicochemical and functional properties of whey protein isolate (WPI) aggregates formed by thermal treatment were investigated in this study. When WPI aggregates were formed by thermal treatment, the size of the aggregates formed with the DHP pretreated WPI was smaller than that of the aggregates formed with the original WPI. The size of the WPI aggregates formed by thermal treatment decreased with DHP post-treatment. The conformational parameters (ζ-potential, surface hydrophobicity, and intrinsic fluorescence intensity) of the WPI subjected to DHP pretreatment were not significantly influenced by thermal treatment. However, DHP post-treatment affected these parameters for the WPI aggregates formed during thermal treatment because of dissociation caused by intense shear and cavitation forces during DHP treatment. The emulsifying activity index (EAI) of the WPI aggregates slightly improved with DHP treatment, but its order had little effect on the magnitude of the EAI increase. DHP pretreatment or post-treatment can modulate the conformational structures and the physicochemical properties of protein aggregates.

Impacts of COVID-19 on bike-sharing usages in Seoul, South Korea.

The COVID-19 pandemic and social distancing restrictions have had a significant impact on urban mobility. As micro mobility offers less contact with other people, docked or dockless e-scooters and bike-sharing have emerged as alternative urban mobility solutions. However, little empirical research has been conducted to investigate how COVID-19 might affect micro mobility usage, especially in a major Asian city. This research aims to study how COVID-19 and other related factors have affected bike-sharing ridership in Seoul, South Korea. Using detailed urban telecommunication data, this study explored the spatial-temporal patterns of a docked bike-sharing system in Seoul. Stepwise negative binomial panel regressions were conducted to find out how COVID-19 and various built environments might affect bike-sharing ridership in the city. Our results showed that open space areas and green infrastructure had statistically significant positive impacts on bike-sharing usage. Compared to registered population factors, real-time telecommunication floating population had a significant positive relationship with both bike trip count and trip duration. The model showed that telecommunication floating population has a significant positive impact on bike-sharing trip counts and trip duration. These findings could offer useful guidelines for emerging shared mobility planning during and after the COVID-19 pandemic.

Influence of interfacial characteristics and antioxidant polarity on the chemical stability of ß-carotene in emulsions prepared using non-ionic surfactant blends.

To evaluate the effects of characteristics of the interfacial region and physical location of antioxidants on the chemical stability of ß-carotene in emulsions, ß-carotene-loaded emulsions were prepared with the blends of surfactants with different hydrophilic head sizes (ethylene oxide (EO) unit number). In addition, antioxidants having the different solubilities, tert-butylhydroquinone (TBHQ) and lauryl gallate as lipophilic and amphiphilic antioxidants, respectively, were incorporated into emulsions. Decrease in the average EO unit number at interfacial region by surfactant blending did not affect the stability of ß-carotene in emulsions at neutral pH but it had a positive effect on the ß-carotene stability at acidic pH. Decrease in the average EO unit number at interfacial region reduced the ability of antioxidants, regardless of their polarity, to protect ß-carotene in emulsions at neutral and acidic pH. TBHQ was more effective in retarding ß-carotene degradation than lauryl gallate, independent of the interfacial composition and surfactant concentration.

Decreased Incidence of Pediatric Intussusception during COVID-19.

Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019-January 2020) and after (February 2020-January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases-defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08-4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (-4.8 mmol/L vs. -3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic.

Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department.

OBJECTIVES: This study aimed to investigate the feasibility of point-of-care ultrasound (POCUS) for diagnosing hypertrophic pyloric stenosis (HPS) in the emergency department (ED). METHODS: A retrospective study was conducted in infants aged younger than 90 days who were brought to the ED due to vomiting between January 2015 and December 2019. Of these, infants who were clinically suspected of having HPS and underwent ultrasound were included and categorized into 3 groups: POCUS only, POCUS followed by radiologist-performed ultrasound (RADUS), and RADUS only. All confirmative diagnoses of HPS were made by RADUS. The diagnostic performance of POCUS was analyzed, and the ED patient flow was compared between the POCUS-performed (POCUS only or POCUS followed by RADUS) and RADUS-only groups. RESULTS: Overall, 171 patients with a median age of 34 days were included. Of these, 79 patients (46.2%) underwent POCUS only, and none had HPS; 50 patients (29.2%) underwent POCUS followed by RADUS; and 42 patients (24.5%) underwent RADUS only. Overall, 41 patients (24.0%) were diagnosed with HPS, and POCUS showed a sensitivity of 96.6% and specificity of 94.0%. In the total cohort, length of stay in the ED (EDLOS) was shorter in the POCUS-performed group than in the RADUS-only group (2.6 vs 3.8 hours, P = 0.015). Among non-HPS patients, time to disposition (1.8 vs 2.7 hours, P = 0.005) and EDLOS (2.0 vs 3.0 hours, P = 0.004) were shorter in the POCUS-performed group than in the RADUS-only group. Performing POCUS followed by RADUS did not significantly delay the treatment among HPS patients. CONCLUSIONS: Point-of-care ultrasound is accurate and useful for diagnosing HPS and improved the ED patient flow by reducing EDLOS and door-to-disposition time in non-HPS patients.

Pediatric Sedation in the Emergency Department: Trends from a Nationwide Population-based Study in Korea, 2007-2018.

BACKGROUND: Pediatric sedation in the emergency department (ED) is widely performed in Korea; thus exploring the trends of its use is necessary. This study aimed to investigate the characteristics of patients and sedatives use in the ED and verify their changes over recent years. METHODS: A nationwide population-based retrospective study was conducted including pediatric patients aged ≤ 15 years who received sedative medication in the ED and were discharged during 2007-2018, using the Korean Health Insurance Review and Assessment Service database. Patient characteristics (age, sex, level of ED, and diagnosis) and type of sedative used were analyzed. RESULTS: Sedation was performed in total 468,221 visits during 2007-2018 (399,320 visits, at least 3.8% of overall ED visits during 2009-2018). Among these, 71.0% were children aged 1-3 years and 93.5% were sedated to support diagnosis of injury. An increase in total sedation was observed in patients aged 4-6 years during the study period (from 13.8% to 21.8%). A gradual decrease in the use of chloral hydrate (CH) compared with an increase in ketamine use was observed (CH, from 70.6% to 28.6%; ketamine, from 23.8% to 60.7%). Therefore, ketamine was the most used sedative since 2014. The most frequently used sedatives over the study period differed according to age groups (CH in <1 year and 1-3 years; ketamine in 4-6 years and 7-10 years; and midazolam in 11-15 years). CONCLUSIONS: The characteristics of patients related to sedatives use in the ED have changed over time. These changes should be considered in the development of future Korean guidelines regarding pediatric sedation in the ED.

Isothermal and temperature-cycling retrogradation of high-amylose corn starch: Impact of sonication on its structural and retrogradation properties.

In this study, the effects of sonication and temperature-cycled storage on the structural properties and resistant starch content of high-amylose corn starch were investigated. Sonication induced a partial depolymerization of the molecular structures of amylopectin and amylose. Sonication treatment induced the appropriate structural changes for retrogradation. Although the relative crystallinity of sonicated starch was lower than that of non-sonicated starch, sonicated starch after retrogradation showed much higher relative crystallinity than non-sonicated starch. Regardless of sonication treatment, temperature-cycled storage resulted in a higher degree of retrogradation than isothermal storage, but the rate of retrogradation was greater in sonicated starch than in non-sonicated starch, as supported by retrogradation enthalpy, the Avrami constant, and relative crystallinity. The highly developed crystalline structure in sonicated starches due to retrogradation was reflected by the large amount of resistant starch.

Influence of Blending of Nonionic Emulsifiers Having Various Hydrophilic Head Sizes on Lipid Oxidation: Investigation of Antioxidant Polarity Interfacial Characteristics Relationship.

The purpose of this study was to deliver insights into the effect of interfacial composition and antioxidant polarity on the lipid oxidation of emulsions. Emulsions were created using blends of nonionic ethoxylated fatty acid alcohol surfactants with different hydrophilic head sizes, and lipophilic (TBHQ) and amphiphilic (lauryl gallate) antioxidants were incorporated into the emulsions. At the same surfactant concentration, emulsion stabilized with surfactant with a smaller hydrophilic head was more susceptible to lipid oxidation than that stabilized with surfactant with a larger hydrophilic head. When surfactants with a similar hydrophilic head size were used, lipid oxidation in emulsion containing more surfactant was slightly faster than that containing less surfactant. When emulsions were created with a 1:1 molar ratio mixture of surfactants with small and large hydrophilic heads, surfactant concentration (1.00 and 2.932 mM) had little effect on lipid peroxide generation rate. However, the concentration of thiobarbituric acid-reactive substances (TBARSs) in the emulsion prepared at 1.00 mM increased faster than that prepared at 2.93 mM. Alteration of interfacial composition and surfactant concentration did not affect antioxidant ability, regardless of antioxidant polarity, to inhibit lipid peroxide generation. However, the ability of lauryl gallate and TBHQ to prevent TBARS generation was elevated by mixing surfactants with small and large hydrophilic heads and by decreasing surfactant concentration. In most emulsions, lauryl gallate showed a more effective antioxidant ability than TBHQ.

Modeling of in vitro digestion behavior of corn starches of different digestibility using modified log of slope (LOS) method.

This study aimed to further improve the previously described first-order equation representing in vitro digestion of starch by extensively explaining modified log of slope (LOS) plot method. Hydrolysis curves of various starches were analyzed using original and/or modified LOS plot methods. Some starches showed significant differences in the results from the two methods; specifically, the modified method better described the digestive behavior of starch with various digestion properties, supported by higher determination coefficient values and better estimation of the digestibility data over digestive phase. The digestion parameters obtained from the modified method provided multiple types of information, including amount and digestion rate of each starch fraction (rapidly digestible, slowly digestible, and resistant starch), supporting the concept of digestible fraction classification. Therefore, the modified LOS plot method described here can be applied as an effective tool for analyzing and describing the multi-scale in vitro digestion behavior of starch.