Very Early Pulsed Dye Laser Intervention for Optimal Cosmetic Outcome in Post-Thyroidectomy Scars.

Purpose: Early intervention of surgical scars with a pulsed dye laser is known to effectively prevent pathologic scars. Despite multiple reports on the effectiveness of the treatment, very few studies have demonstrated its appropriate initiation timing. In this study, our objective was to determine the optimal timing for initiating laser treatment following thyroidectomy. Methods: This study retrospectively analyzed 91 patients undergoing pulsed dye laser treatment post-thyroidectomy, grouping them by treatment initiation timing. The patients underwent treatment at intervals of 3-4 weeks with at least five sessions. Those with a high pliability score were injected with intralesional corticosteroids. The Antera 3D® skin imaging analyzer was used to assess biophysical parameters. Results: The total Vancouver Scar Scale score significantly reduced after treatment in all groups. The Vancouver Scar Scale score reduction rate was significantly higher after treatment in the group for which the treatment was initiated within 3 weeks of surgery. The pigmentation and erythema score analyzed by Antera 3D® was also lower in this group. Conclusion: Early intervention using a pulsed dye laser within 3 weeks of thyroidectomy can substantially inhibit pathological scar development, providing physicians with a guide for optimal treatment commencement.

Evidence-Based Guideline for the Treatment of Smoking Cessation Provided by the National Health Insurance Service in Korea.

Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8-12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine's clinical guideline development process, this is South Korea's first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.

Impact of financial incentives for infection prevention and management on antibiotic use: A Korea National Health Insurance cohort study.

BACKGROUND: The Korean government implemented financial incentives to enhance infection prevention and management within general hospital settings. This study aimed to evaluate the impact of infection control compensation on antibiotic usage using a controlled interrupted time series analysis. METHODS: The main unit of analysis was 270,901 inpatient episodes extracted from the Korean National Health Insurance Service Cohort Database from 2013 to 2019. The 96-month period was examined before and after the intervention, which was set to September 1, 2017, by applying a 1-year lag time after the incentive was introduced. Segmented regression was used to estimate the effects of interventions in a controlled interrupted time series. Hospitals that received nationwide financial incentives for infection prevention and management were included in the analysis. The study's primary outcome was the use of antibiotics based on the WHO Access, Watch, and Reserve (AWaRe) classification of antibiotics, and the secondary outcome was the number of days of antibiotic use as days of therapy (DOTs) per patient day (PD). RESULTS: The probability of overall antibiotic use decreased between incentivized and unincentivized hospitals (odds ratio [OR], 0.922; 95% confidence interval [CI], 0.859-1.000). The difference in level change in the use of third-generation cephalosporins (OR,0.894; 95% CI, 0.817-0.977) and carbapenem (OR,0.790; 95% CI, 0.630-0.992) was significantly reduced between incentivized and unincentivized hospitals. The difference in slope change on DOTs/PD of glycopeptides was - 0.005 DOT/PDs, and that of carbapenem was - 0.003 between incentivized and unincentivized hospitals. CONCLUSION: We observed that incentives for infection prevention and management have had a positive impact on some aspects of antibiotic usage. A partial decrease was observed in antibiotic use, accompanied by a modest reduction in DOTs/PD, particularly for antibiotics aimed at addressing multidrug-resistant pathogens. Further investigation is necessary to establish evidence for extending these incentives.

MAPbBr3 Halide Perovskite-Based Resistive Random-Access Memories Using Electron Transport Layers for Long Endurance Cycles and Retention Time.

Recent studies have focused on exploring the potential of resistive random-access memory (ReRAM) utilizing halide perovskites as novel data storage devices. This interest stems from its notable attributes, including a high ON/OFF ratio, low operating voltages, and exceptional mechanical properties. Nevertheless, there have been reports indicating that memory systems utilizing halide perovskites encounter certain obstacles pertaining to their stability and dependability, mostly assessed through endurance and retention time. Moreover, the presence of these problems can potentially restrict their practical applicability. This study explores a resistive switching memory device utilizing MAPbBr3 perovskite, which demonstrates bipolar switching characteristics. The device fabrication procedure involves a low-temperature, all-solution process. For the purpose of enhancing the device's reliability, the utilization of TPBI(2,2',2″-(1,3,5-benzinetriyl)-tris(1-phenyl-1-H-benzimidazole) as an electron transfer material on the MAPbBr3 switching layer was implemented for the first time. The formation and rupture of Ag filaments in the MAPbBr3 perovskite switching layer are attributed to reduction-oxidation reactions. The TPBI is involved in the regulation of filaments during the SET and RESET processes. Hence, it can be shown that the MAPbBr3 device incorporating TPBI exhibited about 1000 endurance cycles when subjected to continuous voltage pulses. Moreover, the device consistently maintained ON/OFF ratios above 107. In contrast, the original MAPbBr3 device without TPBI demonstrated a significantly lower endurance with only 90 cycles observed. In addition, the MAPbBr3 device integrated with TPBI exhibited a retention time exceeding 3 × 103 s. The findings of this research provide compelling evidence to support the notion that electron transfer materials have promise for the development of halide perovskite memory systems owing to their favorable attributes of dependability and stability.

Recent Advances in Wide Bandgap Perovskite Solar Cells: Focus on Lead-Free Materials for Tandem Structures.

A tandem solar cell, which is composed of a wide bandgap (WBG) top sub-cell and a narrow bandgap (NBG) bottom subcell, harnesses maximum photons in the wide spectral range, resulting in higher efficiency than single-junction solar cells. WBG (>1.6 eV) perovskites are currently being studied a lot based on lead mixed-halide perovskites, and the power conversion efficiency of lead mixed-halide WBG perovskite solar cells (PSCs) reaches 21.1%. Despite the excellent device performance of lead WBG PSCs, their commercialization is hampered by their Pb toxicity and low stability. Hence, lead-free, less toxic WBG perovskite absorbers are needed for constructing lead-free perovskite tandem solar cells. In this review, various strategies for achieving high-efficiency WBG lead-free PSCs are discussed, drawing inspiration from prior research on WBG lead-based PSCs. The existing issues of WBG perovskites such as VOC loss are discussed, and toxicity issues associated with lead-based perovskites are also addressed. Subsequently, the natures of lead-free WBG perovskites are reviewed, and recently emerged strategies to enhance device performance are proposed. Finally, their applications in lead-free all perovskite tandem solar cells are introduced. This review presents helpful guidelines for eco-friendly and high-efficiency lead-free all perovskite tandem solar cells.

Perovskite Light-Emitting Diode Display Based on MoS2 Backplane Thin-Film Transistors.

The uniform deposition of perovskite light-emitting diodes (PeLEDs) and their integration with backplane thin-film transistors (TFTs) remain challenging for large-area display applications. Herein, an active-matrix PeLED display fabricated via the heterogeneous integration of cesium lead bromide LEDs and molybdenum disulfide (MoS2 )-based TFTs is presented. The single-source evaporation method enables the deposition of highly uniform perovskite thin films over large areas. PeLEDs are integrated with MoS2 TFTs to fabricate an active-matrix PeLED display with an 8 × 8 array, which exhibits excellent brightness control capability and high switching speed. This study demonstrates the potential of PeLEDs as candidates for next-generation displays and presents a novel approach for fabricating optoelectronic devices via the heterogeneous integration of 2D materials and perovskites, thereby paving the way toward the fabrication of practical future optoelectronic systems.

Single-cell transcriptional landscape of long non-coding RNAs orchestrating mouse heart development.

Long non-coding RNAs (lncRNAs) comprise the most representative transcriptional units of the mammalian genome. They are associated with organ development linked with the emergence of cardiovascular diseases. We used bioinformatic approaches, machine learning algorithms, systems biology analyses, and statistical techniques to define co-expression modules linked to heart development and cardiovascular diseases. We also uncovered differentially expressed transcripts in subpopulations of cardiomyocytes. Finally, from this work, we were able to identify eight cardiac cell-types; several new coding, lncRNA, and pcRNA markers; two cardiomyocyte subpopulations at four different time points (ventricle E9.5, left ventricle E11.5, right ventricle E14.5 and left atrium P0) that harbored co-expressed gene modules enriched in mitochondrial, heart development and cardiovascular diseases. Our results evidence the role of particular lncRNAs in heart development and highlight the usage of co-expression modular approaches in the cell-type functional definition.

MXene Hybrid Nanosheet of WS2/Ti3C2 for Electrocatalytic Hydrogen Evolution Reaction.

Designing low-cost hybrid electrocatalysts for hydrogen production is of significant importance. Recently, MXene-based materials are being increasingly employed in energy storage devices owing to their layered structure and high electrical conductivity. In this study, we propose a facile hydrothermal strategy for producing WS2/Ti3C2 nanosheets that function as electrocatalysts in the hydrogen evolution reaction (HER). WS2 provides a high surface area and active sites for electrocatalytic activity, whereas MXene Ti3C2 facilitates charge transfer. As a result, the synthesized WS2/Ti3C2 offers an increased surface area and exhibits an enhanced electrocatalytic activity in acidic media. The WS2/Ti3C2 (10%) catalyst exhibited a low onset potential of -150 mV versus RHE for the HER and a low Tafel slope of ∼62 mV dec-1. Moreover, WS2/Ti3C2 (10%) exhibited a double-layer capacitance of 1.2 mF/cm-2, which is 3 and 6 times greater than those of bare WS2 and Ti3C2, respectively. This catalyst also maintained a steady catalytic activity for the HER for over 1000 cycles.

Toward high-efficiency photovoltaics-assisted electrochemical and photoelectrochemical CO2 reduction: Strategy and challenge.

The realization of a complete techno-economy through a significant carbon dioxide (CO2) reduction in the atmosphere has been explored to promote a low-carbon economy in various ways. CO2 reduction reactions (CO2RRs) can be induced using sustainable energy, including electric and solar energy, using systems such as electrochemical (EC) CO2RR and photoelectrochemical (PEC) systems. This study summarizes various fabrication strategies for non-noble metal, copper-based, and metal-organic framework-based catalysts with excellent Faradaic efficiency (FE) for target carbon compounds, and for noble metals with low overvoltage. Although EC and PEC systems achieve high energy conversion efficiency with excellent catalysts, they still require external power and lack complete bias-free operation. Therefore, photovoltaics, which can overcome the limitations of these systems, have been introduced. The utilization of silicon and perovskite-based solar cells for photovoltaics-assisted EC (PV-EC) and photovoltaics-assisted PEC (PV-PEC) CO2RR systems are cost-efficient, and the III-V semiconductor photoabsorbers achieved high solar-to-carbon efficiency. This work focuses on PV-EC and PV-PEC CO2RR systems and their components and then summarizes the special cell configurations, including the tandem and stacked structures. Additionally, the study discusses current issues, such as low energy conversion, expensive PV, theoretical limits, and industrial scale-up, along with proposed solutions.

Corrected QTc interval combined with troponin value and mortality in acute ischemic stroke.

Background and Purpose: Cardiac biomarkers including, elevated troponin (ET) and prolonged heart rate-corrected QT (PQTc) interval on electrocardiography are known to frequent and have a prognostic significance in patients with acute ischemic stroke (AIS). However, it is still challenging to practically apply the results for appropriate risk stratification. This study evaluate whether combining ET and PQTc interval can better assess the long-term prognosis in AIS patients. Methods: In this prospectively registered observational study between May 2007 and December 2011, ET was defined as serum troponin-I ≥ 0.04 ng/ml and PQTc interval was defined as the highest tertile of sex-specific QTc interval (men ≥ 469 ms or women ≥ 487 ms). Results: Among the 1,668 patients [1018 (61.0%) men; mean age 66.0 ± 12.4 years], patients were stratified into four groups according to the combination of ET and PQTc intervals. During a median follow-up of 33 months, ET (hazard ratio [HR]: 4.38, 95% confidence interval [CI]: 2.94-6.53) or PQTc interval (HR: 1.53, 95% CI: 1.16-2.01) alone or both (HR: 1.77, 95% CI: 1.16-2.71) was associated with increased all-cause mortality. Furthermore, ET, PQTc interval alone or both was associated with vascular death, whereas only ET alone was associated with non-vascular death. Comorbidity burden, especially atrial fibrillation and congestive heart failure, and stroke severity gradually increased both with troponin value and QTc-interval. Conclusions: In patients with AIS, combining ET and PQTc interval on ECG enhances risk stratification for long-term mortality while facilitating the discerning ability for the burden of comorbidities and stroke severity.

2022 Clinical practice guidelines for central precocious puberty of Korean children and adolescents.

The Committee of Central Precocious Puberty of Korean Pediatrics and Adolescents of the Korean Society of Pediatric Endocrinology has newly developed evidence-based 2022 clinical practice guidelines for central precocious puberty in Korean children and adolescents. These guidelines provide the grade of recommendations, which includes both the strength of recommendations and the level of evidence. In the absence of sufficient evidence, recommendations are based on expert opinion. These guidelines have been revised and supplement the previous guidelines "Clinical Guidelines for Precocious Puberty 2011," and are drawn from a comprehensive review of the latest domestic and international research and the grade of recommendation appropriate to the domestic situation. This review summarizes the newly revised guidelines into 8 key questions and 27 recommendations and consists of 4 sections: screening, diagnosis, treatment, and long-term outcome of central precocious puberty.

Constructing a NiMnS electrode with a Mn-rich surface for hydrogen production in anion exchange membrane water electrolyzers.

Efficient alkaline hydrogen evolution electrodes must be used for hydrogen production in anion exchange membrane water electrolyzers (AEMWEs). Therefore, we fabricated a NiMnS catalyst with a Mn-rich surface, which was self-supported on Ti paper through one-step electrodeposition. Mn doping endowed the catalyst with a unique hollow morphology and lattice-distorted structure. Consequently, the NiMnS/Ti electrode exhibited a large number of exposed electrochemical surfaces and effective active sites and a high hydrogen evolution reaction (HER) activity. Specifically, in half-cell measurements, the NiMnS/Ti electrode exhibited an overpotential of 65 mV at 10 mA cm-2, which was lower than that of NiS/Ti (102 mV) and indicated its superior HER activity. When the proposed cathode was applied in an AEMWE single cell, the device achieved a high current density of up to 0.9 A cm-2 at a cell potential of 2.0 V.

Evaluation of public's perception of scar cosmesis after thyroidectomy: results of a survey of Turkish versus South Korean individuals.

Purpose: Visible scars on the neck caused by thyroid surgery give rise to significant aesthetic, functional, and psychosocial problems. The objective of this study is to comparatively investigate the public perception of neck scar cosmesis in Turkish and South Korean populations. Methods: This survey was prepared to collect participants' demographic and socioeconomic data and determine their perception of scar cosmesis on the neck and consisted of 15 questions. One thousand thirty-nine individuals who did not undergo thyroid surgery completed the survey. The P-values of <0.05 were deemed to indicate statistical significance. Results: There were 1,039 respondents, of whom 525 (50.5%) were Turkish and 514 (49.5%) were South Korean. South Korean respondents stated that they would be significantly more uncomfortable with the thought of having a scar due to thyroid surgery, compared to the Turkish respondents (P < 0.001). The South Korean respondents stated that they would be significantly more concerned about the scar's length, thickness, and darkening color, compared to the Turkish respondents (P < 0.001 for all cases). Conclusion: Patients' expectations, which are affected by various sociodemographic factors and cultural characteristics, are as important as the medical condition when deciding on the type of thyroid surgery. The study findings clearly indicated that the South Korean population would be significantly more uncomfortable with having a scar on the neck, compared to the Turkish population. Therefore, in selected cases, a scarless thyroidectomy approach, such as transoral endoscopic thyroidectomy, vestibular approach may be preferable for societies like South Korea.

Twenty Years of Anti-Vascular Endothelial Growth Factor Therapeutics in Neovascular Age-Related Macular Degeneration Treatment.

Neovascular age-related macular degeneration (nAMD) is the primary disastrous retinal disease that leads to blindness in the elderly population. In the early 2000s, nAMD resulted in irreversible vision loss and blindness with no available treatment options. However, there have been breakthrough advances in the drug development of anti-angiogenic biological agents over the last two decades. The primary target molecule for treating nAMD is the vascular endothelial growth factor (VEGF), and there are currently several anti-VEGF drugs such as bevacizumab, ranibizumab, and aflibercept, which have made nAMD more manageable than before, thus preventing vision loss. Nevertheless, it should be noted that these anti-VEGF drugs for nAMD treatment are not effective in more than half of the patients, and even those who initially gain visual improvements lose their vision over time, along with potential deterioration in the geography of atrophy. As a result, there have been continuous endeavors to improve anti-VEGF agents through better efficacy, fewer doses, expanded intervals, and additional targets. This review describes past and current anti-VEGF therapeutics used to treat nAMD and outlines future directions to improve the effectiveness and safety of anti-VEGF agents.

Enhanced ultra high frequency EMI shielding with controlled ITO nano-branch width via different tin material types.

The development of technologies for electromagnetic wave contamination has garnered attention. Among the various electromagnetic wave frequencies, for high frequencies such as those in the K and Ka ranges, there is a limitation of using only the properties of a single material. Therefore, it is necessary to improve the absorption coefficients by increasing the path of electromagnetic waves through internal scattering at an interface or a structure inside the material. Here, we accurately demonstrated the role of Sn in the growth of an indium tin oxide (ITO) nano-branch structure and grew high-density ITO nano-branches with the lowest thickness possible. Consequently, we obtained shielding efficiencies of 21.09 dB (K band) and 17.81 dB (Ka band) for a film with a thickness of 0.00364 mm. Owing to the significantly high specific shielding efficiency and low thickness and weight, it is expected to be applied in various fields.

Korean guidelines for the management of gout.

Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.

RoBANS 2: A Revised Risk of Bias Assessment Tool for Nonrandomized Studies of Interventions.

Assessment of the risk of bias is an essential component of any systematic review. This is true for both nonrandomized studies and randomized trials, which are the main study designs of systematic reviews. The Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) was developed in 2013 and has gained wide usage as a risk-of-bias assessment tool for nonrandomized studies. Four risk-of-bias assessment experts revised it by reviewing existing assessment tools and user surveys. The main modifications included additional domains of selection and detection bias susceptible to nonrandomized studies of interventions, a more detailed consideration of the comparability of participants, and more reliable and valid outcome measurements. A psychometric assessment of the revised RoBANS (RoBANS 2) revealed acceptable inter-rater reliability (weighted kappa, 0.25 to 0.49) and construct validity in which intervention effects of studies with an unclear or high risk of bias were overestimated. The RoBANS 2 has acceptable feasibility, fair-to-moderate reliability, and construct validity. It provides a comprehensive framework for allowing authors to assess and understand the plausible risk of bias in nonrandomized studies of interventions.

Korean guidelines for the management of gout.

Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.