Plasma cell-free RNA signatures of inflammatory syndromes in children.

Inflammatory syndromes, including those caused by infection, are a major cause of hospital admissions among children and are often misdiagnosed because of a lack of advanced molecular diagnostic tools. In this study, we explored the utility of circulating cell-free RNA (cfRNA) in plasma as an analyte for the differential diagnosis and characterization of pediatric inflammatory syndromes. We profiled cfRNA in 370 plasma samples from pediatric patients with a range of inflammatory conditions, including Kawasaki disease (KD), multisystem inflammatory syndrome in children (MIS-C), viral infections, and bacterial infections. We developed machine learning models based on these cfRNA profiles, which effectively differentiated KD from MIS-C-two conditions presenting with overlapping symptoms-with high performance [test area under the curve = 0.98]. We further extended this methodology into a multiclass machine learning framework that achieved 80% accuracy in distinguishing among KD, MIS-C, viral, and bacterial infections. We further demonstrated that cfRNA profiles can be used to quantify injury to specific tissues and organs, including the liver, heart, endothelium, nervous system, and the upper respiratory tract. Overall, this study identified cfRNA as a versatile analyte for the differential diagnosis and characterization of a wide range of pediatric inflammatory syndromes.

Trifunctional Graphene-Sandwiched Heterojunction-Embedded Layered Lattice Electrocatalyst for High Performance in Zn-Air Battery-Driven Water Splitting.

Zn-air battery (ZAB)-driven water splitting holds great promise as a next-generation energy conversion technology, but its large overpotential, low activity, and poor stability for oxygen reduction reaction (ORR), oxygen evolution reaction (OER), and hydrogen evolution reaction (HER) remain obstacles. Here, a trifunctional graphene-sandwiched, heterojunction-embedded layered lattice (G-SHELL) electrocatalyst offering a solution to these challenges are reported. Its hollow core-layered shell morphology promotes ion transport to Co3S4 for OER and graphene-sandwiched MoS2 for ORR/HER, while its heterojunction-induced internal electric fields facilitate electron migration. The structural characteristics of G-SHELL are thoroughly investigated using X-ray absorption spectroscopy. Additionally, atomic-resolution transmission electron microscopy (TEM) images align well with the DFT-relaxed structures and simulated TEM images, further confirming its structure. It exhibits an approximately threefold smaller ORR charge transfer resistance than Pt/C, a lower OER overpotential and Tafel slope than RuO2, and excellent HER overpotential and Tafel slope, while outlasting noble metals in terms of durability. Ex situ X-ray photoelectron spectroscopy analysis under varying potentials by examining the peak shifts and ratios (Co2+/Co3+ and Mo4+/Mo6+) elucidates electrocatalytic reaction mechanisms. Furthermore, the ZAB with G-SHELL outperforms Pt/C+RuO2 in terms of energy density (797 Wh kg-1) and peak power density (275.8 mW cm-2), realizing the ZAB-driven water splitting.

Recurrent neural network-aided processing of incomplete free induction decays in 1H-MRS of the brain.

In the case of limited sampling windows or truncation of free induction decays (FIDs) for artifact removal in proton magnetic resonance spectroscopy (1H-MRS) and spectroscopic imaging (1H-MRSI), metabolite quantification needs to be performed on incomplete FIDs. Given that FIDs are naturally time-domain sequential data, we investigated the potential of recurrent neural network (RNN)-types of neural networks (NNs) in the processing of incomplete human brain FIDs with or without FID restoration prior to quantitative analysis at 3.0T. First, we employed an RNN encoder-decoder and developed it to restore incomplete FIDs (rRNN) with different amounts of sampled data. The quantification of metabolites from the rRNN-restored FIDs was achieved by using LCModel. Second, we modified the RNN encoder-decoder and developed it to convert incomplete brain FIDs into incomplete metabolite-only FIDs without restoration, followed by linear regression using a metabolite basis set for quantitative analysis (cRNN). In consideration of the practical benefit of the FID restoration with respect to pure zero-filling, development and analysis of the NNs were focused particularly on the incomplete FIDs with only the first 64 data points retained. All NNs were trained on simulated data and tested mainly on in vivo data acquired from healthy volunteers (n = 27). Strong correlations were obtained between the NN-derived and ground truth metabolite content (LCModel-derived content on fully sampled FIDs) for myo-inositol, total choline, and total creatine (normalized to total N-acetylaspartate) on the in vivo data using both rRNN (R = 0.83-0.94; p ≤ 0.05) and cRNN (R = 0.86-0.91; p ≤ 0.05). RNN-types of NNs have potential in the quantification of the major brain metabolites from the FIDs with substantially reduced sampled data points. For the metabolites with low to medium SNR, the performance of the NNs needs to be further improved, for which development of more elaborate and advanced simulation techniques would be of help, but remains challenging.

Hemp sprout-derived exosome-like nanovesicles as hepatoprotective agents attenuate liver fibrosis.

Non-alcoholic fatty liver disease (NAFLD) is a form of hepatic steatosis in which more than 5% of the liver's weight is fat, primarily due to the overconsumption of soft drinks and a Western diet. In this study, we investigate the potential of plant-derived exosome-like nanovesicles (PENs) to prevent liver fibrosis and leaky gut resulting from NAFLD. Specifically, we examine whether hemp sprout-derived exosome-like nanovesicles (HSNVs) grown on smart farms could exert protective effects against NAFLD by inhibiting liver fibrosis. HSNVs ranging from 100-200 nm were measured using nanoparticle tracking analysis (NTA). HSNVs (1 mg kg-1) were orally administered for 5 weeks to mice with NAFLD induced by feeding them a Western diet (WD; a fat- and cholesterol-rich diet) and fat-, fructose-, and cholesterol-rich (FFC) diet for 8 weeks. Importantly, the administration of HSNVs markedly reduced oxidative stress and fibrosis marker proteins in NAFLD mouse models and LX2 cells. Furthermore, treatment with HSNVs prevented a significant decrease in the quantity of gut barrier proteins and endotoxin levels in NAFLD mouse models. For the first time, these results demonstrate that HSNVs can exhibit a hepatoprotective effect against gut leakiness and WD/FFC-induced liver fibrosis by inhibiting oxidative stress and reducing fibrosis marker proteins.

Unveiling crystal orientation-dependent interface property in composite cathodes for solid-state batteries by in situ microscopic probe.

A critical bottleneck toward all-solid-state batteries lies in how the solid(electrode)-solid(electrolyte) interface is fabricated and maintained over repeated cycles. Conventional composite cathodes, with crystallographically distinct electrode/electrolyte interfaces of random particles, create complexities with varying (electro)chemical compatibilities. To address this, we employ an epitaxial model system where the crystal orientations of cathode and solid electrolyte are precisely controlled, and probe the interfaces in real-time during co-sintering by in situ electron microscopy. The interfacial reaction is highly dependent on crystal orientation/alignment, especially the availability of open ion channels. Interfaces bearing open ion paths of NCM are more susceptible to interdiffusion, but stabilize with the early formed passivation layer. Conversely, interfaces with closed ion pathway exhibit stability at intermediate temperatures, but deteriorate rapidly at high temperature due to oxygen evolution, increasing interfacial resistance. The elucidation of these distinct interfacial behaviors emphasizes the need for decoupling collective interfacial properties to enable rational design in solid-state batteries.

Atomic-Scale Scanning of Domain Network in the Ferroelectric HfO2 Thin Film.

Ferroelectric HfO2-based thin films have attracted much interest in the utilization of ferroelectricity at the nanoscale for next-generation electronic devices. However, the structural origin and stabilization mechanism of the ferroelectric phase are not understood because the film is typically nanocrystalline with active yet stochastic ferroelectric domains. Here, electron microscopy is used to map the in-plane domain network structures of epitaxially grown ferroelectric Y:HfO2 films in atomic resolution. The ferroelectricity is confirmed in free-standing Y:HfO2 films, allowing for investigating the structural origin for their ferroelectricity by 4D-STEM, high-resolution STEM, and iDPC-STEM. At the grain boundaries of <111>-oriented Pca21 orthorhombic grains, a high-symmetry mixed-(R3m, Pnm21) phase is induced, exhibiting enhanced polarization due to in-plane compressive strain. Nanoscale Pca21 orthorhombic grains and their grain boundaries with mixed-(R3m, Pnm21) phases of higher symmetry cooperatively determine the ferroelectricity of the Y:HfO2 film. It is also found that such ferroelectric domain networks emerge when the film thickness is beyond a finite value. Furthermore, in-plane mapping of oxygen positions overlaid on ferroelectric domains discloses that polarization is suppressed at vertical domain walls, while it is active when domains are aligned horizontally with subangstrom domain walls. In addition, randomly distributed 180° charged domain walls are confined by spacer layers.

Effectiveness of a multi-component intervention to promote physical activity among Japanese remote workers: a pilot open-label randomized controlled trial.

OBJECTIVES: Remote work (i.e., teleworking) may adversely affect physical activity (PA) among workers, while no strategies have been effectively implemented to curb this issue. We aimed to test whether a multi-component intervention program could promote the PA of remote workers. METHODS: This study was an 8-week pilot open-label randomized controlled trial. Fifty-one participants (19 women) aged 23-58 years were recruited via an information technology company in Tokyo, Japan, and randomly assigned to the control (n = 26) or intervention (n = 25) group. The intervention group was provided a multi-component intervention that comprised individual (lecture, print material, goal setting, feedback, and posters), socio-cultural (supportive atmosphere and team building), and organizational (encouraging message from an executive) strategies. The control group only received posters. The primary outcome was an 8-week change in objectively measured moderate-to-vigorous PA (MVPA). The secondary outcomes were changes in light PA, moderate PA, vigorous PA, steps, and sedentary time. We also conducted sub-domain analyses divided into working and non-working days. RESULTS: No significant difference was observed in MVPA changes between the two groups. However, the intervention group showed significant improvement in light PA by +14.0 min/day [95% confidence interval (CI), 1.7 to 26.2]. Sub-domain analyses also showed no significant differences in MVPA changes between the two groups. However, MVPA in the intervention group significantly increased by +9.4 min/day [95% CI, 2.5 to 16.2] in working days. CONCLUSION: The present multi-component intervention was feasible for remote workers, while some revisions are necessary to enhance the effect size. TRIAL REGISTRATION: This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000046638).

Effect of intensive seasonal pumping and recharge on sulfur biogeochemistry in groundwater of agricultural riparian zones.

Physico-chemical characteristics of groundwater are often impacted by agricultural practices such as land use, fertilizer types, and groundwater pumping. This study aimed to identify contaminant sources and redox processes controlling the hydrogeochemistry of groundwater in riparian zones influenced by intensive agricultural activities, focusing on sulfur species. Groundwater samples were collected bimonthly from March 2014 to March 2015 from groundwater wells in two zones in South Korea with different agricultural systems. The water isotopic compositions of the groundwater indicated that all groundwater originated from the same meteoric water. Groundwater samples affected by periodic groundwater pumping exhibited wide variations in Mn2+ (47.8 ± 18.2 µM) and Fe2+ (123 ± 61.0 µM) and elevated SO42-, while NO3- was below the detection limit. Groundwater chemistry was affected by fertilizer and manure, and denitrification. The oxidation of reduced sulfur compounds by oxygen and nitrate did not fully account for the elevated SO42- concentrations and isotopic composition of sulfate (δ34S and δ18O) in the investigated aquifers. Therefore, we postulate that water level change due to periodic groundwater pumping and recharge enabled oxidants (MnO2 and Fe3+) to also contribute to oxidation of reduced sulfur. Additionally, fertilizers with distinct δ34S values and bacterial sulfate reduction (BSR) affected groundwater chemistry and its sulfur species, including δ34SSO4 and δ18OSO4. Removal of sulfate from the aquifer during pumping limited BSR. Consequently, the agricultural practices may further increase sulfate concentrations in the groundwater. This environmental impact should be thoroughly managed because high sulfate concentrations in drinking water cause ingestion problems in humans.

A Prospective Clinical Trial of Radiofrequency Ablation in Patients with Low-Risk Unifocal Papillary Thyroid Microcarcinoma Favoring Active Surveillance Over Surgery.

Background: Active surveillance (AS) of papillary thyroid microcarcinomas (PTMC) is emerging as an alternative to immediate surgery. While thermal ablation has also shown promise for low-risk PTMC, it has not been prospectively studied in patients appropriate for AS. This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for tumor control and quality of life (QoL) management in patients with PTMC who favored AS over immediate surgery. Methods: This prospective clinical trial was conducted at a single tertiary referral hospital from 2018 to 2021. Of 227 adult patients aged ≤60 years with low-risk unifocal PTMC favoring AS over immediate surgery, 100 patients underwent RFA for their management. The primary endpoint was the disease progression rate, and secondary endpoints were technical success, volume reduction rate (VRR), complication rates, and QoL. Results: The median age of the study population was 42 years (range, 27-59 years), and 83% (83/100, [CI: 66.1-100]) were female. The median follow-up was 30 months (range, 12-56 months). All 100 patients underwent RFA with technical success. Most of the ablation zones showed continuous volume reduction, and 95.9% (94/98, [CI: 77.5-100.0]) showed complete disappearance at the last follow-up. The median VRR was 100.0% at 1-year follow-up and persisted throughout the last follow-up. The cumulative disease progression rate among 98 patients who underwent at least 1-year follow-up was 3.1% (3/98, [CI: 0.6-9.0]); one patient had lymph node metastasis (treated with surgery), and two patients had new PTMC (1 treated with RFA, 1 ongoing AS). Major complications were not observed. Psychological (baseline vs. last follow-up, 7.3 vs. 8.0, p = 0.002) and social (8.0 vs. 8.7, p = 0.005) QoL scores significantly improved during follow-up without compromising physical QoL (8.6 vs. 8.5, p = 0.99). Conclusions: RFA can be a reasonable strategy for effectively and safely controlling tumors and improving QoL in non-elderly patients with low-risk PTMC appropriate for AS. Clinical Trial registration: This trial is registered with ClinicalTrials.gov: NCT03432299.

Metabolic responses of the marine mussel Mytilus galloprovincialis after exposure to microplastics of different shapes and sizes.

Microplastics (MP) are ubiquitous pollutants with diverse shapes, sizes, and characteristics that pose critical risks to marine organisms and the environment. In this study, we used the Mediterranean mussel Mytilus galloprovincialis as a marine benthic organism model to investigate the metabolic consequences of exposure to different polyethylene terephthalate MP sizes and shapes: round (27-32 µm), small fibers (200-400 µm), large fibers (3000 µm), small fragments (20 µm), medium fragments (45-75 µm), and large fragments (>150 µm). After exposure to high concentrations (100 mg L-1) of MP for 14 days, round and small fiber-type MP were highly accumulated in mussels. Metabolomic analysis revealed that exposure to round and small fiber-type MP induced significant changes in 150 metabolites. Partial least squares-discriminate analysis (PLS-DA) showed that the round and small fiber MP treatment groups displayed similar cluster patterns that differed from those of the control group. In addition, only 22 annotated metabolites related to histidine, valine, leucine, and isoleucine degradation/biosynthesis and vitamin B6 and aminoacyl-tRNA biosynthesis were significantly affected by round or small fiber-type MP. Among the histidine metabolites, round and small fiber-type MP upregulated the levels of L-histidine, L-glutamate, carnosine, imidazole-4-acetaldehyde, 4-imidazolone-5-propanoate, and methylimidazole acetaldehyde and downregulated methylimidazole acetic acid and N-formimino-L-glutamate. These results suggest novel insights into the potential pathways through which MP of specific sizes and shapes affect metabolic processes in mussels.

Giant chiral amplification of chiral 2D perovskites via dynamic crystal reconstruction.

Chiral hybrid perovskites show promise for advanced spin-resolved optoelectronics due to their excellent polarization-sensitive properties. However, chiral perovskites developed to date rely solely on the interaction between chiral organic ligand cations exhibiting point chirality and an inorganic framework, leading to a poorly ordered short-range chiral system. Here, we report a powerful method to overcome this limitation using dynamic long-range organization of chiral perovskites guided by the incorporation of chiral dopants, which induces strong interactions between chiral dopants and chiral cations. The additional interplay of chiral cations with chiral dopants reorganizes the morphological and crystallographic properties of chiral perovskites, notably enhancing the asymmetric behavior of chiral 2D perovskites by more than 10-fold, along with the highest dissymmetry factor of photocurrent (gPh) of ~1.16 reported to date. Our findings present a pioneering approach to efficiently amplify the chiroptical response in chiral perovskites, opening avenues for exploring their potential in cutting-edge optoelectronic applications.

Implementation of a Numerically Stable Algorithm for Capillary Hysteresis in Gas Hydrate Deposits.

We develop a numerically stable algorithm of intrinsic capillary hysteresis for numerical simulation of gas hydrate deposits where cyclic drainage and imbibition processes occur. The algorithm is motivated by the elastoplastic return mapping, and it is an extension of the recently developed algorithm of two-phase immiscible flow, which provides numerical stability with the fully implicit method. We consider the effective gas and aqueous saturations normalized by total fluid phase saturation implicitly affected by the dynamic formation and dissociation of hydrates. Specifically, gas saturation is additively decomposed into the reversible and irreversible parts, and the algorithm computes the reversible and irreversible parts dynamically during the evolution of gas saturation. We perform numerical tests, including a field-scale case, by implementing the code of the capillary hysteresis in a gas hydrate flow simulator. We find that the developed algorithm is stable and robust for repeated drainage and imbibition processes in gas hydrate systems. Since cyclic depressurization is one of the promising production scenarios for gas production from marine gas hydrate deposits, the developed algorithm and code will provide robust and high-fidelity simulation in the forward simulation of multiphase flow.

Role of induction chemotherapy in advanced-stage olfactory neuroblastoma.

OBJECTIVES: To evaluate the treatment outcomes in patients with advanced-stage olfactory neuroblastoma (ONB) who received induction chemotherapy (IC). MATERIALS AND METHODS: The clinical data of 38 patients with advanced-stage ONB who received initial IC were retrospectively analyzed. The response was defined using the Response Evaluation Criteria in Solid Tumors version 1.1. Patients with complete remission or partial remission were defined as responders. RESULTS: Seventeen (44.7%) patients responded to IC. The response rate was higher in patients with high Hyams grade tumor (III/IV) compared to those with low-grade tumors (I/II) (60% vs. 22.2%, p = 0.038). Overall, the 5-year cancer-specific survival (CSS) rate was 76.0%. Among nonresponders to IC, a significant difference in 5-year CSS rates was observed between surgery with adjuvant radiotherapy (RT) (100%) versus definitive RT or chemoradiotherapy (CRT) (68.6%) (log-rank p = 0.006). However, for responders, there was no significant difference in 5-year CSS rates between surgery with adjuvant therapy (75%) and definitive RT or CRT (51.1%) (log-rank p = 0.536). When only high-grade tumors were considered among responders, the 5-year CSS rate was significantly higher in patients who received RT or CRT (51.4%) compared to those who underwent surgery with adjuvant therapy (0%) (log-rank p = 0.008). CONCLUSION: In advanced-stage ONB, RT or CRT may be preferable for high-grade tumor responding to IC. Higher response rate and a potential role for induction IC in determining the optimal definitive treatment modality suggest a positive role for advanced-stage high-grade ONB.

Role of the circadian nuclear receptor REV-ERBα in dorsal raphe serotonin synthesis in mood regulation.

Affective disorders are frequently associated with disrupted circadian rhythms. The existence of rhythmic secretion of central serotonin (5-hydroxytryptamine, 5-HT) pattern has been reported; however, the functional mechanism underlying the circadian control of 5-HTergic mood regulation remains largely unknown. Here, we investigate the role of the circadian nuclear receptor REV-ERBα in regulating tryptophan hydroxylase 2 (Tph2), the rate-limiting enzyme of 5-HT synthesis. We demonstrate that the REV-ERBα expressed in dorsal raphe (DR) 5-HTergic neurons functionally competes with PET-1-a nuclear activator crucial for 5-HTergic neuron development. In mice, genetic ablation of DR 5-HTergic REV-ERBα increases Tph2 expression, leading to elevated DR 5-HT levels and reduced depression-like behaviors at dusk. Further, pharmacological manipulation of the mice DR REV-ERBα activity increases DR 5-HT levels and affects despair-related behaviors. Our findings provide valuable insights into the molecular and cellular link between the circadian rhythm and the mood-controlling DR 5-HTergic systems.

Angiotensin Receptor Blockers Versus Angiotensin Converting Enzyme Inhibitors in Acute Myocardial Infarction Without Heart Failure.

BACKGROUND: Whether angiotensin II receptor blockers (ARBs) can be an alternative to angiotensin-converting enzyme inhibitors (ACEIs) in patients without heart failure (HF) after acute myocardial infarction (MI) remains controversial. The aim of this study was to compare clinical outcomes between initial ARB and ACEI therapy in patients with MI without HF. METHODS: Between 2010 and 2016, a total of 31,013 patients who underwent coronary revascularization for MI with prescription of ARBs or ACEIs at hospital discharge were enrolled from the Korean nationwide medical insurance data. Patients who had HF at index MI were excluded. The primary outcome was all-cause death. The secondary outcomes included recurrent MI, hospitalization for new heart HF, stroke, and a composite of each outcome. RESULTS: Of 31,013 patients, ARBs were prescribed in 12,685 (40.9%) and ACEIs in 18,328 (59.1%). Patients receiving ARBs had a lower discontinuation rate compared with those receiving ACEIs (28.2% vs 43.5%, adjusted hazard ratio [HR] 0.34; 95% confidence interval [CI] 0.31-0.37; P < .01). During a median follow-up of 2.2 years, 2480 patients died. The incidence rate of all-cause death in patients receiving ARBs and those receiving ACEIs was 27.7 and 22.9 per 1000 person-years, respectively (adjusted HR 1.04; 95% CI 0.95-1.13; P = .40). There were no significant differences in the secondary outcomes between patients receiving ARBs and those receiving ACEIs, except stroke (19.2 vs 13.6 per 1000 person-years; adjusted HR 1.17; 95% CI 1.04-1.32; P = .01). In a subgroup analysis, a higher mortality was observed with ARBs compared with ACEIs in patients with diabetes. CONCLUSIONS: In this nationwide cohort, there was no significant difference in the incidence of all-cause death between ARBs and ACEIs as discharge medications in patients with myocardial infarction without heart failure. Angiotensin II receptor blockers would be an alternative to ACEIs for those intolerant to ACEI therapy.

Effect of endocrine-disrupting chemicals on the expression of a calcium ion channel receptor (ryanodine receptor) in the mud crab (Macrophthalmus japonicus).

Endocrine-disrupting chemicals (EDCs) are toxic pollutants generated by artificial activities. Moreover, their hormone-like structure induces disturbances, such as mimicking or blocking metabolic activity. Previous studies on EDCs have focused on the adverse effect of the endocrine system in vertebrates, with limited investigations conducted on ion channels in invertebrates. Thus, in this study, we investigated the potential adverse effects of exposure to bisphenol-A (BPA) and di-(2-ethylhexyl) phthalate (DEHP) at the molecular level on the ryanodine receptor (RyR), a calcium ion channel receptor in Macrophthalmus japonicus. In the phylogenetic analysis, the RyR amino acid sequences in M. japonicus clustered with those in the Crustacean and formed separated branches for RyR in insects and mammals. When exposed to 1 µg L-1 BPA, a significant increase in RyR mRNA expression was observed in the gills on day 1, although a similar level to the control group was observed from day 4 to day 7. However, the RyR expression due to DEHP exposure decreased on days 1 and 4, although it increased on day 7 following exposure to 10 µg L-1. The RyR expression pattern in the hepatopancreas increased for up to 4 days, depending on the BPA concentration. However, there was a tendency for the expression to decrease gradually after the statistical significance increased during the early stage of DEHP exposure (D1). Hence, the transcriptional alterations in the M. japonicus RyR gene observed in the study suggest that exposure toxicities to EDCs, such as BPA and DEHP, have the potential to disrupt calcium ion channel signaling in the gills and hepatopancreas of M. japonicus crabs.

Minimally Invasive Approach versus Sternotomy for Cardiac Surgery in Jehovah's Witness Patients.

OBJECTIVE: To evaluate the outcomes of minimally invasive cardiac surgery (MICS) compared with the sternotomy approach for Jehovah's Witness (JW) patients who cannot receive blood transfusions DESIGN: This was a retrospective observational study. SETTING: The study was conducted at a specialized cardiovascular intervention and surgery institute. PARTICIPANTS: The study cohort comprised JW patients undergoing cardiac surgery between September 2016 and July 2022. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Patients (n = 63) were divided into MICS (n = 19) and sternotomy (n = 44) groups, and clinical outcomes were analyzed. There was no difference in types of operation except coronary bypass grafting (n = 1 [5.3%] in the MICS group v n = 20 [45.5%] in the sternotomy group; p = 0.005). There were no between-group differences in early mortality and morbidities. Overall survival did not differ significantly during the follow-up period (mean, 43.9 ± 24.4 months). The amount of chest tube drainage was significantly lower in the MICS group on the first postoperative day (mean, 224.0 ± 122.7 mL v 334.0 ± 187.0 mL in the sternotomy group; p = 0.022). The mean hemoglobin level was significantly higher in the MICS group on the day of operation (11.7 ± 1.3 mg/dL v 10.6 ± 2.0 mg/dL in the sternotomy group; p = 0.042) and the first postoperative day (12.3 ± 1.8 mg/dL v 11.2 ± 1.9 mg/dL; p = 0.032). CONCLUSIONS: MICS for JW patients showed favorable early outcomes and mid-term survival compared to conventional sternotomy. MICS may be a viable option for JW patients who decline blood transfusions.

Quantification method of ctDNA using cell-free DNA methylation profile for noninvasive screening and monitoring of colon cancer.

BACKGROUND: Colon cancer ranks as the second most lethal form of cancer globally. In recent years, there has been active investigation into using the methylation profile of circulating tumor DNA (ctDNA), derived from blood, as a promising indicator for diagnosing and monitoring colon cancer. RESULTS: We propose a liquid biopsy-based epigenetic method developed by utilizing 49 patients and 260 healthy controls methylation profile data to screen and monitor colon cancer. Our method initially identified 901 colon cancer-specific hypermethylated (CaSH) regions in the tissues of the 49 cancer patients. We then used these CaSH regions to accurately quantify the amount of circulating tumor DNA (ctDNA) in the blood samples of these same patients, utilizing cell-free DNA methylation profiles. Notably, the methylation profiles of ctDNA in the blood exhibited high sensitivity (82%) and specificity (93%) in distinguishing patients with colon cancer from the control group, with an area under the curve of 0.903. Furthermore, we confirm that our method for ctDNA quantification is effective for monitoring cancer patients and can serve as a valuable tool for postoperative prognosis. CONCLUSIONS: This study demonstrated a successful application of the quantification of ctDNA among cfDNA using the original cancer tissue-derived CaSH region for screening and monitoring colon cancer.

Mid-term outcomes of tricuspid annuloplasty using the Tri-Ad Adams tricuspid annuloplasty ring.

OBJECTIVES: The Tri-Ad Adams tricuspid annuloplasty ring is a recent innovative prosthesis characterized by a semi-rigid central component and fully flexible extremities. The goal of this study was to assess the short-term and mid-term results following implantation of the Tri-Ad Adams ring. METHODS: A retrospective analysis was conducted on patients who underwent tricuspid annuloplasty using the Tri-Ad Adams ring between August 2016 and October 2021. RESULTS: Our study enrolled a total of 248 participants. The median age was 64.0 (interquartile range: 56.0-71.5) years. The median EuroSCORE II was 4.3% (2.7-7.5%), with 37 patients (14.9%) having a history of cardiac operations. Tricuspid regurgitation of grade 2-3 was observed in 63.7% of cases, and the median tricuspid annular diameter was 3.3 (2.8-3.6) cm. Concurrent procedures included mitral valve replacement (n = 160, 64.5%), mitral valve repair (n = 75, 30.2%), aortic valve replacement (n = 72, 29.0%) and the maze procedure (n = 170, 68.5%). Immediate postoperative tricuspid regurgitation≥moderate was present in 1 patient (0.4%). Early death occurred in 14 patients (5.6%). Major complications included low cardiac output syndrome (n = 18, 0.3%), acute kidney injury (n = 14, 5.6%) and permanent pacemaker placement (n = 15, 6.0%). According to the Kaplan-Meier analysis, the 4-year rates of freedom from overall mortality and moderate-to-severe tricuspid regurgitation were 96.9% and 91.6%, respectively. There were no incidents of tricuspid valve reoperations, ring detachment or significant tricuspid stenosis (trans-tricuspid valve gradient ≥ 5 mmHg). CONCLUSIONS: Tricuspid annuloplasty utilizing the Tri-Ad Adams ring demonstrated favourable outcomes in both the early and midterm periods. Further studies are warranted to confirm the long-term results.

Strategy to Simultaneously Manipulate Direct Zn Nucleation and Hydrogen Evolution via Surface Modifier Hydrolysis for High-Performance Zn-Ion Batteries.

The demand for safer batteries is growing rapidly due to fire incidents in electronic devices that use Li-ion batteries. Zn-ion batteries are among the most promising candidates to replace Li-ion batteries because they use a water-based electrolyte and are not explosive. However, Zn-ion batteries suffer from persistent corrosion and dendritic crystal formation during the charge-discharge process, which decrease their reversibility and hinder their commercial usage. Extensive research has been conducted to address these issues, but there are significant limitations due to high process and time costs. In this study, the modulation of the Zn-electrolyte interface to overcome these challenges is attempted using acetamide-derived thioacetamide (TAA), a surface modifier used in electroplating. TAA undergoes hydrolysis in an aqueous solution and produces weakly acidic byproducts and sulfide ions. These species are adsorbed onto the Zn metal surface, which induces uniform Zn2+ deposition, facilitates the formation of a stable interfacial layer, and inhibits side reactions due to the reduced water activity. Consequently, the symmetric cell with TAA achieves a low polarization of 50 mV and stable cycling for 700 h at 1 mA cm-2. Additionally, a Zn|V6O13 full cell exhibits electrochemical reversibility, maintaining a capacity retention of 64% over 300 cycles. Therefore, this study offers useful insights into the development of a simple manufacturing process to ensure the competitiveness of Zn-ion batteries for practical applications using functional electrolyte additives.