Nitrate Formation Mechanisms Causing High Concentration of PM2.5 in a Residential City with Low Anthropogenic Emissions during Cold Season.

During the cold season in South Korea, NO3‒ concentrations are known to significantly increase, often causing PM2.5 to exceed air quality standards. This study investigated the formation mechanisms of NO3‒ in a suburban area with low anthropogenic emissions. The average PM2.5 was 25.3 µg m‒3, with NO3‒ identified as the largest contributor. Ammonium-rich conditions prevailed throughout the study period, coupled with low atmospheric temperature facilitating the transfer of gaseous HNO3 into the particulate phase. This result indicates that the formation of HNO3 played a crucial role in determining particulate NO3‒ concentration. Nocturnal increases in NO3‒ were observed alongside increasing ozone (O3) and relative humidity (RH), emphasizing the significance of heterogeneous reactions involving N2O5. NO3‒ concentrations at the study site were notably higher than in Seoul, the upwind metropolitan area, during a high concentration episode. This difference could potentially attributed to lower local NO concentrations, which enhanced the reaction between O3 and NO2, to produce NO3 radicals. High concentrations of Cl‒ and dust were also identified as contributors to the elevated NO3‒ concentrations.

Prevalence and clinical implications of sarcopenia in breast cancer: a systematic review and meta-analysis.

PURPOSE: The impact of sarcopenia in oncology is increasingly recognized, yet little is known about its clinical implications in breast cancer. This systematic review and meta-analysis estimates the overall prevalence of sarcopenia in breast cancer, quantifies skeletal muscle index (SMI), and comprehensively evaluates sarcopenia's impact on clinical outcomes. METHODS: We systematically searched primary original research published before June 2023 in four databases: the Cochrane Library via Wiley, CINAHL Plus with Full Text, Embase via Elsevier Excerpta Medica, and Medline via Ovid. Standardized mean SMI and 95% confidence interval (CI) were calculated by applying the random-effects model. The methodological quality of the included studies was assessed using the National Institutes of Health quality assessment checklist. RESULTS: The systematic review included 17 studies with a total of 9863 patients; the meta-analysis included 12 of these studies. The mean prevalence of sarcopenia in breast cancer (stages I-III) was 32.5%. The mean SMI assessed by CT was 43.94 cm2/m2 (95% CI 42.87, 45.01; p < .01). Overall, low muscle mass was associated with chemotherapy toxicities, dose reductions, dose delays, or treatment discontinuation. Low muscle mass was generally associated with poor survival, but in some studies, this association was not significant or reversed direction. CONCLUSION: Sarcopenia is not just a state of muscle mass loss, but an influencing factor on therapeutic effects and survival rates in oncology. It is thus necessary to recognize the risk of sarcopenia throughout the trajectory of cancer treatment, identify low muscle mass early, and manage it from a prehabilitation perspective.

Characterization of SsHog1 and Shk1 Using Efficient Gene Knockout Systems through Repeated Protoplasting and CRISPR/Cas9 Ribonucleoprotein Approaches in Sclerotinia sclerotiorum.

Sclerotinia sclerotiorum is the causal agent of sclerotinia stem rot in over 400 plant species. In a previous study, the group III histidine kinase gene of S. sclerotiorum (Shk1) revealed its involvement in iprodione and fludioxonil sensitivity and osmotic stress. To further investigate the fungicide sensitivity associated with the high-osmolarity glycerol (HOG) pathway, we functionally characterized SsHog1, which is the downstream kinase of Shk1. To generate knockout mutants, split marker transformation combined with a newly developed repeated protoplasting method and CRISPR/Cas9 ribonucleoprotein (RNP) delivery approach were used. The pure SsHog1 and Shk1 knockout mutants showed reduced sensitivity to fungicides and increased sensitivity to osmotic stress. In addition, the SsHog1 knockout mutants demonstrated reduced virulence compared to Shk1 knockout mutants and wild-type. Our results indicate that the repeated protoplasting method and RNP approach can generate genetically pure homokaryotic mutants and SsHog1 is involved in osmotic adaptation, fungicide sensitivity, and virulence in S. sclerotiorum.

Variations of oxidative potential of PM2.5 in a medium-sized residential city in South Korea measured using three different chemical assays.

Although it is evident that PM2.5 has serious adverse health effects, there is no consensus on what the biologically effective dose is. In this study, the intrinsic oxidative potential (OPm) and the extrinsic oxidative potential (OPv) of PM2.5 were measured using three chemical assays including dithiothreitol (DTT), ascorbic acid (AA), and reduced glutathione (GSH), along with chemical compositions of PM2.5 in South Korea. Among the three chemical assays, only OPmAA showed a statistically significant correlation with PM2.5 while OPmGSH and OPmDTT were not correlated with PM2.5 mass concentration. When the samples were categorized by PM2.5 mass concentrations, the variations in the proportion of Ni, As, Mn, Cd, Pb, and Se to PM2.5 mass closely coincided with changes in OPm across all three assays, suggesting a potential association between these elements and PM2.5 OP. Multiple linear regression analysis identified the significant PM components affecting the variability in extrinsic OPv. OPvAA was determined to be significantly influenced by EC, K+, and Ba while OC and Al were common significant factors for OPvGSH and OPvDTT. It was also found that primary OC was an important variable for OPvDTT while secondary OC significantly affected the variability of OPvGSH.

Health Behavior Adherence in a Metropolitan-Based Metabolic Syndrome Management Program during the COVID-19 Pandemic.

Background: The COVID-19 pandemic increased the worldwide prevalence of metabolic syndrome. The purpose of this study was to assess health behavior adherence during the pandemic in adults who had engaged in a metabolic syndrome management program for at least six months. This assessment included an evaluation of health behavior changes, factors influencing adherence, and clinical parameters. The city-wide program was operated by the Seoul Metropolitan Government. Methods: Baseline and follow-up data were compared in 116 participants who engaged in the program for at least 6 months prior to the pandemic. Health behaviors and clinical parameters were examined. Generalized estimating equation analysis was used to identify sociodemographic variables influencing health behavior adherence over time. Results: Systolic blood pressure, waist circumference, and blood glucose improved (all P<0.05), and risk factors decreased (P<0.001) from baseline to follow-up (mean±standard deviation, 1.13±0.91 years). All six health behaviors, physical activity and weight control, eating habits, alcohol consumption and smoking, stress management, sleep and rest, and medication compliance and medical examination improved (all P<0.001) from baseline to follow-up (2.37±1.05 years). Smoking and employment negatively influenced adherence to health behaviors (P<0.05). Participants felt the most beneficial part of the program was receiving sequential medical examination results with follow-up consultations by public health professionals without charge. Conclusion: Our study demonstrated the durability of the impact of the Seoul Program on all six targeted health behaviors as well as clinical parameters. Findings encourage participation in such broad-based programs and development of novel approaches to facilitate success for smokers and employed participants.

Exploring the characteristics and health outcomes of working from home: Analysis of 2021 California Health Interview Survey data.

BACKGROUND: Working from home (WFH) may affect health behaviors and mental health. The coronavirus disease-2019 (COVID-19) pandemic saw many US employees transition to WFH, which has persisted in various job sectors and significantly impacted employees. However, its effects on health outcomes have remained unclear. We aimed to explore the characteristics and health outcomes of, and health-related differences between, WFH and not-WFH groups. METHODS: Using the 2021 California Health Interview Survey data, we analyzed health behaviors (smoking, alcohol consumption, and fruit-related nutrition) and the mental health status of 12,438 individuals using descriptive statistics, Pearson's χ2 test, and regressions. RESULTS: A total of 39% were WFH and 61% were not-WFH. Overall, the WFH group had worse health behaviors and mental health than the not-WFH group. Age was associated with smoking in both groups (WFH: b = 0.37; not-WFH: b = 0.35), but with fruit-related nutrition only in the WFH group. Household income and occupation were associated with alcohol consumption in both groups. Age (WFH: b = -1.58; not-WFH: b = -1.39), household income (WFH: b = -0.75; not-WFH: b = -0.34), and job duration (WFH: b = -0.34; not-WFH: b = -0.40) were associated with mental health in both groups; those who were younger and had lower household incomes and job durations had worse mental health. CONCLUSION: Health management is a clear necessity for the WFH group. Irrespective of WFH status, young workers with shorter than 5 years' job duration reported mental distress, highlighting a need for distress assessment and management for the young workforce.

Comprehensive lifestyle modification interventions for metabolic syndrome: A systematic review and meta-analysis.

INTRODUCTION: Previous systematic reviews and meta-analyses have mainly focused on improvements in the number of metabolic syndrome risk factors and individual changes in each risk factor, making it challenging to examine the impact of comprehensive lifestyle modification interventions on adherence to recommended health behaviors. To address this gap, we conducted a systematic and meta-analysis aimed at identifying clinical parameter levels associated with lifestyle modification outcomes and adherence to recommended health behaviors for individuals with metabolic syndrome. METHODS: A total of seven studies retrieved from four databases (CINAHL, Medline via PubMed, American Psychological Association PsycINFO, and Embase) were included in the review. The selected studies, which demonstrated improvements in health behaviors, all included diet and exercise as main factors of comprehensive lifestyle modification in home settings. RESULTS: Our findings suggest that a 6-month comprehensive intervention including diet and exercise can be effective in decreasing glucose levels and systolic blood pressure. However, given the limited available data, further studies investigating the efficacy of interventions of varying durations are needed. DISCUSSION: Although our review included a small number of studies, comprehensive lifestyle modifications consisting of at least two components (primarily diet and exercise) can improve health behaviors and some clinical parameters among individuals with metabolic syndrome. Future studies are needed to investigate the long-term effects of lifestyle modifications on health behavior adherence and explore effective interventions to address certain clinical parameters, such as high-density lipoprotein levels. Also, we recommend using objective and quantifiable measure to compare adherence to recommended lifestyle modifications across studies. CLINICAL RELEVANCE: This research provides empirical evidence of the effectiveness of comprehensive lifestyle modification and emphasizes the need to develop long-term nursing strategies in public health that can be used to effectively manage metabolic syndrome.

A human-machine collaborative approach measures economic development using satellite imagery.

Machine learning approaches using satellite imagery are providing accessible ways to infer socioeconomic measures without visiting a region. However, many algorithms require integration of ground-truth data, while regional data are scarce or even absent in many countries. Here we present our human-machine collaborative model which predicts grid-level economic development using publicly available satellite imagery and lightweight subjective ranking annotation without any ground data. We applied the model to North Korea and produced fine-grained predictions of economic development for the nation where data is not readily available. Our model suggests substantial development in the country's capital and areas with state-led development projects in recent years. We showed the broad applicability of our model by examining five of the least developed countries in Asia, covering 400,000 grids. Our method can both yield highly granular economic information on hard-to-visit and low-resource regions and can potentially guide sustainable development programs.

Effects of Transcutaneous Trigeminal Electrical Stimulation and Sound Therapy in Patients with Tinnitus.

PURPOSE: Tinnitus is one of the most common health conditions worldwide. Although various methods of treatment have been used, the condition is still difficult to manage or cure. This study aimed to evaluate the therapeutic effects of transcutaneous trigeminal electrical stimulation (TTES) combined with notched sound therapy (NST) on patients with tinnitus. MATERIALS AND METHODS: A clinical trial was conducted prospectively from September 2020 to September 2021 at a single center in South Korea. In total, 14 patients took part in this trial. Periodic visits and tele-monitoring were used to assess treatment compliance and collect data, including electroencephalography (EEG), photoplethysmography (PPG), tinnitus handicap inventory (THI), tinnitus magnitude index, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36-item short-form survey (SF-36) results. RESULTS: Changes after intervention were analyzed with paired t-test. This study showed that alpha waves in the left hemisphere measured by EEG (p=0.024), autonomic nervous system balance (p=0.007), and stress level (p=0.022) measured by PPG significantly changed after intervention. Also, THI scores especially emotional symptoms (p=0.029) and catastrophic symptoms (p=0.043) decreased after treatment. The SF-36 score, both mental component summary and physical component summary score (each p<0.001), increased significantly, whereas the PSQI score (p<0.001) and BDI score (p<0.001) decreased after TTES and NST. CONCLUSION: Based on the results of our study, we could confirm that TTES combined with NST can significantly improve tinnitus, catastrophic symptoms, and the overall quality of life of patients.

The Monitoring and Management of an Operating Environment to Enhance the Safety of a Container-Type Energy Storage System.

The implementation of an energy storage system (ESS) as a container-type package is common due to its ease of installation, management, and safety. The control of the operating environment of an ESS mainly considers the temperature rise due to the heat generated through the battery operation. However, the relative humidity of the container often increases by over 75% in many cases because of the operation of the air conditioner which pursues temperature-first control. Humidity is a major factor which can cause safety issues such as fires owing to insulation breakdown caused by condensation. However, the importance of humidity control in ESS is underestimated compared to temperature control. In this study, temperature and humidity monitoring and management issues were addressed for a container-type ESS by building sensor-based monitoring and control systems. Furthermore, a rule-based air conditioner control algorithm was proposed for temperature and humidity management. A case study was conducted to compare the conventional and proposed control algorithms and verify the feasibility of the proposed algorithm. The results showed that the proposed algorithm reduced the average humidity by 11.4% compared to the value achieved with the existing temperature control method while also maintaining the temperature.

Efficient disruption of CmHk1 using CRISPR/Cas9 ribonucleoprotein delivery in Cordyceps militaris.

Cordyceps militaris, an entomopathogenic ascomycete, produces edible medicinal mushrooms known to have medicinal and therapeutic functions. To develop the genetic transformation system in C. militaris, green fluorescent protein (GFP) mutants of C. militaris were generated by PEG-mediated protoplast transformation. The CRISPR/Cas9 ribonucleoprotein (RNP) targeting the class III histidine kinase of C. militaris (CmHk1) was then delivered into protoplasts of C. militaris through the transformation system. Mutations induced by the RNP in selected mutants were detected: 1 nt deletion (6 mutants), 3 nt deletion with substitution of 1 nt (1 mutant), insertion of 85 nts (1 mutant), 41 nts (2 mutants), and 35 nts (5 mutants). An in vitro sensitivity assay of the mutants indicated that knockout of CmHk1 reduced sensitivity to two fungicides, iprodione and fludioxonil, but increased sensitivity to osmotic stresses compared to the wild type. Summing up, the CRISPR/Cas9 RNP delivery system was successfully developed, and our results revealed that CmHk1 was involved in the fungicide resistance and osmotic stress in C. militaris.

High Visceral-To-Subcutaneous Fat Ratio Is Associated with an Increased Risk of Gastroesophageal Reflux Disease in Nonobese Adults.

INTRODUCTION: Abdominal obesity increases the risk of gastroesophageal reflux disease (GERD). This study aimed to determine the association between GERD and abdominal fat area quantified by computed tomography (CT). METHODS: We analyzed the effect of abdominal fat area on gastroesophageal reflux symptoms and erosive esophagitis using logistic regression models in 5,338 participants who underwent abdominal fat measurement CT and screening esophagogastroduodenoscopy. RESULTS: Participants with reflux symptoms and erosive esophagitis were diagnosed in 1,168 (21.9%) and 671 (12.5%), respectively. Multivariate analysis showed that subcutaneous and visceral fat areas were significantly associated with reflux symptoms and erosive esophagitis. The adjusted odds ratio (OR) in the fourth quartile of visceral fat area compared with that in the lowest quartile was 1.98 (95% confidence interval (CI) 1.63-2.39) for reflux symptoms and 2.33 (95% CI 1.80-3.01) for erosive esophagitis. Visceral fat area had a stronger effect in the younger age-group. In the group <50 years, the adjusted OR in fourth quartile of visceral fat area was 2.70 (95% CI 1.86-3.94) for reflux symptoms and 3.59 (95% CI 2.22-5.80) for erosive esophagitis. High visceral-to-subcutaneous fat ratio (VSR) increased the risk of reflux symptoms and erosive esophagitis in participants with body mass index <25 kg/m2 and normal waist circumference. CONCLUSION: Subcutaneous and visceral fat areas were associated with an increased risk of reflux symptoms and erosive esophagitis. High VSR increased the risk of reflux symptoms and erosive esophagitis in participants with normal body weight and waist circumference.

Challenges of interprofessional geriatric practice in home care settings: an integrative review.

This integrative review identified challenges for interprofessional home care and provided recommendations for improving geriatric home care. A search of six databases identified 982 articles; 11 of them met the review's eligibility criteria and were included in the review. Quality appraisal of the included studies was performed using two tools (Critical Appraisal Skills Program for Qualitative Research and Mixed Methods Appraisal Tool), and their overall methodological quality was found to be satisfactory. After applying D'Amour et al.'s framework, four "challenge" themes emerged: (1) lack of sharing, (2) lack of partnership, (3) limited resources and interdependency, and (4) power issues. Recommendations included providing practical multidisciplinary training guided by a standardized model, establishing streamlined communication protocols and a communication platform reflecting the actual needs of users by involving them in its design, and asking interprofessional team members to commit to home care planning and to cultivate a collaborative culture and organizational support.

Community-based death preparation and education: A scoping review.

The COVID-19 pandemic revealed a need for people and communities for death preparation. Few studies have examined community-level interventions for death preparation and education. This scoping review scrutinized the relevant literature following PRISMA 2018 guidelines. Six databases were searched for articles published between 2010 and 2020. We found that cultural, socioeconomic, and individual values affected death preparation and that online courses and life-death education were effective preparation methods. Additional research is needed to identify the population-specific effectiveness of interventions. To fully investigate death preparation and education at the community level, theory-based studies employing quantitative and qualitative methods are also needed.

Cross-cultural differences and similarities in nurses' experiences during the early stages of COVID-19 in Korea and the United States: A qualitative descriptive study.

Background: At the onset of the COVID-19 pandemic, governmental responses varied worldwide, which resulted in healthcare professionals and organizations having different experiences. As threats of global infectious disease and disasters increase, it is important to examine the collective experiences of nurses to leverage support across international settings and systems and to tailor specific policies to their local nursing workforce. Objective: To compare and contrast nurses' experiences working in hospitals at the onset of COVID-19 in South Korea and the United States. Method: This was a qualitative descriptive study. Nurses in South Korea and the United States were recruited through social media using snowball sampling between April and May 2020. Semi-structured telephone interviews were audio-recorded, transcribed, and translated as needed. The transcripts were analyzed thematically, and each theme was compared and synthesized using NVivo 12. Results: A total of 43 nurses from South Korea (n = 21) and the United States (n = 22) participated in the study. The majority of the participants were female and working as staff nurses in both countries. The work settings were similar between the participants from two countries. However, the participants in South Korea provided less direct care to patients with COVID-19 compared to the participants in the United States. Despite cultural and infrastructure differences, the nurses shared similar experiences. Conclusion: The overlapping similarities of nurses' experience highlight the need for national and global policies for a safe work environment and psychological well-being. The differences between the two countries also emphasize that specific policies and practice implications for the local contexts are needed in addition to global policies.

Idiopathic Nonsurgical Pneumoperitoneum in Healthy Individuals after Endoscopy: Coincidence or Consequence?

Idiopathic pneumoperitoneum has an unknown etiology despite exploratory laparotomy. However, it may occur without definite abdominal symptoms; thus, adequate management could be in clinical dilemma. We experienced three cases of idiopathic nonsurgical pneumoperitoneum in healthy individuals during a health check-up. Their cases were not accompanied by any relevant etiology or definite abdominal symptoms. All of the three cases exhibited a benign clinical course. The three patients underwent an abdominal computed tomography (CT) scan as part of a health check-up program, which incidentally revealed free air in the right paracolic gutter without evidence of visceral perforation or inflammation. Among the three cases, two patients underwent colonoscopy before abdominal CT, whereas one patient did not. Two cases were completely asymptomatic and were observed without any treatment in the outpatient clinic. Only the third case with minimal symptoms was treated conservatively for a short time. If a small amount of free air typically located in the right paracolic gutter is detected in the absence of perforation during colonoscopy, close observation without unnecessary treatment would be sufficient.

Wireless graphene-based thermal patch for obtaining temperature distribution and performing thermography.

Thermal imaging provides information regarding the general condition of the human body and facilitates the diagnosis of various diseases. Heat therapy or thermotherapy can help in the treatment of injuries to the skin tissue. Here, we report a wearable thermal patch with dual functions of continuous skin temperature sensing and thermotherapy for effective self-care treatment. This system consists of a graphene-based capacitive sensor, a graphene thermal pad, and a flexible readout board with a wireless communication module. The wearable sensor continuously monitors the temperature variation over a large area of the skin (3 × 3cm2) with high resolution and sensitivity and performs thermotherapy via the graphene-based heater mounted at the bottom of the device. Animal studies prove that the proposed system can be used to diagnose various diseases. This technology could be useful in the development of convenient and wearable health care devices.