Case report of laryngeal infection by Clinostomum complanatum 24 days after ingestion of raw fish.

RATIONALE: Clinostomum complanatum is a laryngeal fluke whose hosts include birds and mammals.[1] In humans, infection occurs accidentally during the consumption of raw freshwater fish.[1,2]. PATIENT CONCERNS: A 59-year-old female presented to our hospital with throat pain and globus sensation. The patient had been prescribed Proton Pump Inibitor for 3 weeks at another hospital. The patient continued the medication, but the discomfort persisted, and she was admitted to our hospital for further examination. The patient had eaten raw fish 24 days before, and the symptoms occurred after eating the raw fish. Endoscopy under sedation showed a fluke, with an approximate length of 8.0 mm and width of 3.2 mm, on the interaryepiglottic fold, with active motility on the mucosa. DIAGNOSIS INTERVENTIONS: It was extracted from the larynx using biopsy forceps and identified as C complanatum. OUTCOMES: After the fluke was removed, symptoms improved, and the patient was discharged. The globus symptoms completely resolved at the last follow-up visit. LESSONS: To the best of our knowledge, this is an endoscopically diagnosed and treated case of human infection by C complanatum in Korea after the longest period of infection. This suggests that C complanatum can survive for up to 3 weeks or more in the gastrointestinal tract. Endoscopy is a useful tool for the diagnosis and treatment of patients with atypical extraesophageal symptoms who do not respond to Proton Pump Inibitors.

High-Speed Magnetic Tweezers for Nanomechanical Measurements on Force-Sensitive Elements.

Single-molecule magnetic tweezers (MTs) have served as powerful tools to forcefully interrogate biomolecules, such as nucleic acids and proteins, and are therefore poised to be useful in the field of mechanobiology. Since the method commonly relies on image-based tracking of magnetic beads, the speed limit in recording and analyzing images, as well as the thermal fluctuations of the beads, has long hampered its application in observing small and fast structural changes in target molecules. This article describes detailed methods for the construction and operation of a high-resolution MT setup that can resolve nanoscale, millisecond dynamics of biomolecules and their complexes. As application examples, experiments with DNA hairpins and SNARE complexes (membrane-fusion machinery) are demonstrated, focusing on how their transient states and transitions can be detected in the presence of piconewton-scale forces. We expect that high-speed MTs will continue to enable high-precision nanomechanical measurements on molecules that sense, transmit, and generate forces in cells, and thereby deepen our molecular-level understanding of mechanobiology.

Association of the etiology and peak level of markedly elevated aminotransferases with mortality: a multicenter study.

BACKGROUND: Markedly elevated aminotransferase levels are commonly encountered among hospitalized patients. However, data regarding the trajectory of enzyme elevation and disease-specific prognosis are limited. METHODS: This study included 3237 patients with at least one episode of aspartate aminotransferase or alanine aminotransferase level being higher than 400 U/L between January 2010 and December 2019 at 2 centers. Patients were classified into 5 groups comprising 13 diseases according to etiology. Factors associated with 30-day mortality were evaluated using a logistic regression analysis. RESULTS: The most common disease leading to markedly elevated aminotransferase level was ischemic hepatitis (33.7%), followed by pancreatobiliary disease (19.9%), DILI (12.0%), malignancy (10.8%), and viral hepatitis (7.0%). The 30-day all-cause mortality rate was 21.6%. The mortality rate for patients from the pancreatobiliary, hepatocellular, extrahepatic, malignancy, and ischemic hepatitis groups was 1.7%, 3.2%, 13.8%, 39.9%, and 44.2%, respectively. Age, etiology, and peak aminotransferase levels were independently associated with 30-day mortality. CONCLUSIONS: In patients with markedly elevated liver enzymes, the etiology and peak AST level are significantly associated with mortality.

Synthesis and Electrochemical Performance of Microporous Hollow Carbon from Milkweed Pappus as Cathode Material of Lithium-Sulfur Batteries.

Microtube-like porous carbon (MPC) and tube-like porous carbon-sulfur (MPC-S) composites were synthesized by carbonizing milkweed pappus with sulfur, and they were used as cathodes for lithium-sulfur batteries. The morphology and uniformity of these materials were characterized using X-ray powder diffraction, Raman spectroscopy, scanning electron microscopy, transmission electron microscopy with an energy-dispersive X-ray analyzer, thermogravimetric analysis, and X-ray photoelectron spectrometry. The electrochemical performance of the MPC-S cathodes was measured using the charge/discharge cycling performance, C rate, and AC impedance. The composite cathodes with 93.8 wt.% sulfur exhibited a stable specific capacity of 743 mAh g-1 after 200 cycles at a 0.5 C.

Clinical Features of Hepatitis C Virus-related Acute-on-chronic Liver Failure in a Korean Population.

Background/Aims: Acute-on-chronic liver failure (ACLF) is a widely recognized concept in which acute decompensation (AD) in patients with cirrhosis results in organ failure and high short-term mortality. On the other hand, few studies reflecting the various etiologies of cirrhosis are available. This study examined the clinical features of patients with hepatitis C virus (HCV)-related ACLF. Methods: Between January 2005 and December 2018, 109 HCV-related cirrhosis patients hospitalized for AD (ascites, hepatic encephalopathy, gastrointestinal hemorrhage, and bacterial infection) were enrolled for ACLF defined by the European Association for the Study of the Liver (EASL). Results: ACLF developed in 35 patients (32.1%) on admission. Eight, eight, and 19 patients had ACLF grades 1, 2, and 3, respectively. The 28-day and 90-day mortality rates were very low (2.7% and 5.4%, respectively) in patients without ACLF and very high (60.0% and 74.3%, respectively) in those with ACLF. In patients with HCV-related ACLF, compared to previous studies on hepatitis B virus-related ACLF and alcohol-related ACLF, the prevalence of liver failure was very low (17.1%), whereas that of kidney failure was very high (71.4%). Compared with all other prognostic scores, the Chronic liver failure Consortium Organ Failure score predicted the 90-day mortality most accurately, with an area under the receiver operator characteristic of 0.921. Conclusions: HCV-related ACLF has unique clinical characteristics distinct from hepatitis B virus-related and alcohol-related ACLF. ACLF defined by EASL can be useful for predicting the short-term mortality in HCV-related cirrhosis.

Healing Ion-Implanted Semiconductors by Hybrid Microwave Annealing: Activation of Nitrogen-Implanted TiO2.

In order to recover the damaged structure of a nitrogen-implanted TiO2 (N-I-TiO2) photoanode, hybrid microwave annealing (HMA) is proposed as an alternative postannealing process instead of conventional thermal annealing (CTA). Compared to CTA, HMA provides distinctive advantages: (i) facile transformation of the interstitial N-N states into substitutional N-Ti states, (ii) better preservation of the ion-implanted nitrogen in TiO2, and (iii) effective alleviation of lattice strain and reconstruction of the broken bonds. As a result, the HMA-activated photoanode improves the photocurrent density by a factor of ∼3.2 from 0.29 to 0.93 mA cm-2 at 1.23 VRHE and the incident photon-to-current conversion efficiency (IPCE) from ∼2.9% to ∼10.5% at 430 nm relative to those of the as-prepared N-I-TiO2 photoanode in photoelectrochemical water oxidation, which are much better than those of the CTA-activated photoanode (0.58 mA cm-2 at 1.23 VRHE and IPCE of 5.7% at 430 nm), especially in the visible light region (≥420 nm).

Evolutionary balance between foldability and functionality of a glucose transporter.

Despite advances in resolving the structures of multi-pass membrane proteins, little is known about the native folding pathways of these complex structures. Using single-molecule magnetic tweezers, we here report a folding pathway of purified human glucose transporter 3 (GLUT3) reconstituted within synthetic lipid bilayers. The N-terminal major facilitator superfamily (MFS) fold strictly forms first, serving as a structural template for its C-terminal counterpart. We found polar residues comprising the conduit for glucose molecules present major folding challenges. The endoplasmic reticulum membrane protein complex facilitates insertion of these hydrophilic transmembrane helices, thrusting GLUT3's microstate sampling toward folded structures. Final assembly between the N- and C-terminal MFS folds depends on specific lipids that ease desolvation of the lipid shells surrounding the domain interfaces. Sequence analysis suggests that this asymmetric folding propensity across the N- and C-terminal MFS folds prevails for metazoan sugar porters, revealing evolutionary conflicts between foldability and functionality faced by many multi-pass membrane proteins.

High-Resolution Single-Molecule Magnetic Tweezers.

Single-molecule magnetic tweezers deliver magnetic force and torque to single target molecules, permitting the study of dynamic changes in biomolecular structures and their interactions. Because the magnetic tweezer setups can generate magnetic fields that vary slowly over tens of millimeters-far larger than the nanometer scale of the single molecule events being observed-this technique can maintain essentially constant force levels during biochemical experiments while generating a biologically meaningful force on the order of 1-100 pN. When using bead-tether constructs to pull on single molecules, smaller magnetic beads and shorter submicrometer tethers improve dynamic response times and measurement precision. In addition, employing high-speed cameras, stronger light sources, and a graphics programming unit permits true high-resolution single-molecule magnetic tweezers that can track nanometer changes in target molecules on a millisecond or even submillisecond time scale. The unique force-clamping capacity of the magnetic tweezer technique provides a way to conduct measurements under near-equilibrium conditions and directly map the energy landscapes underlying various molecular phenomena. High-resolution single-molecule magnetic tweezerscan thus be used to monitor crucial conformational changes in single-protein molecules, including those involved in mechanotransduction and protein folding.

Markedly Elevated Aspartate Aminotransferase from Non-Hepatic Causes.

There have been no reports on mortality in patients with markedly elevated aspartate aminotransferase (AST) levels from non-hepatic causes to date. This study aimed to determine the etiologies of markedly elevated AST levels > 400 U/L due to non-hepatic causes and to investigate the factors associated with mortality in these cases. This retrospective study included 430 patients with AST levels > 400 U/L unrelated to liver disease at two centers between January 2010 and December 2021. Patients were classified into three groups according to etiology: skeletal muscle damage, cardiac muscle damage, and hematologic disorder. Binary logistic regression analysis was performed to evaluate the factors associated with 30-day mortality. The most common etiology for markedly elevated AST levels was skeletal muscle damage (54.2%), followed by cardiac muscle damage (39.1%) and hematologic disorder (6.7%). The 30-day mortality rates for the skeletal muscle damage, cardiac muscle damage, and hematologic disorder groups were 14.2%, 19.5%, and 65.5%, respectively. The magnitude of the peak AST level significantly correlated with 30-day mortality, with rates of 12.8%, 26.7%, and 50.0% for peak AST levels < 1000 U/L, <3000 U/L, and ≥3000 U/L, respectively. In the multivariate analysis, cardiac muscle damage (odds ratio [OR] = 2.76, 95% confidence interval [CI] = 1.31−5.80), hematologic disorder (OR = 9.47, 95% CI = 2.95−30.39), peak AST < 3000 U/L (OR = 2.94, 95% CI = 1.36−6.35), and peak AST ≥ 3000 U/L (OR = 9.61, 95% CI = 3.54−26.08) were associated with increased 30-day mortality. Our study revealed three etiologies of markedly elevated AST unrelated to liver disease and showed that etiology and peak AST level significantly affected the survival rate.

Analyzing climate change impacts on health, energy, water resources, and biodiversity sectors for effective climate change policy in South Korea.

This study analyzes how climate change affects the economy, society, and environment in South Korea. Then, the study explores the ways to strengthen capabilities that can alleviate climate change impacts. To find them, the study employs a system dynamics simulation method and builds a model with several sectors including the urban, rural, population, and social-environmental sectors. The study compares the size of climate change damages in rural and urban areas. The results with representative concentration path (RCP) 8.5 show that the size of climate change damage will continue to increase by 2050. The projected damages from the reduced industrial outputs in urban areas will be larger than that in rural areas. The results also show that the service sector will face stronger impacts from climate change than the manufacturing and agricultural sectors. However, the total size of damage in the rural areas will be bigger than that of the urban areas. It is because the size of reduced industrial outputs per capita in the rural areas is twice bigger than that of the urban areas. The climate change damage in the social and environmental sectors (including a loss of biodiversity and an increase in health costs) account for the largest part of the total damage. The study finally provides suggestions and policies that can improve the capabilities to reduce the climate change damages. One of the major suggestions of this study is that the increase in the climate change budget corresponding to the GDP growth can minimize the size of climate change impacts.

Publisher Correction: Distinct handedness of spin wave across the compensation temperatures of ferrimagnets.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Distinct handedness of spin wave across the compensation temperatures of ferrimagnets.

Antiferromagnetic spin waves have been predicted to offer substantial functionalities for magnonic applications due to the existence of two distinct polarizations, the right-handed and left-handed modes, as well as their ultrafast dynamics. However, experimental investigations have been hampered by the field-immunity of antiferromagnets. Ferrimagnets have been shown to be an alternative platform to study antiferromagnetic spin dynamics. Here we investigate thermally excited spin waves in ferrimagnets across the magnetization compensation and angular momentum compensation temperatures using Brillouin light scattering. Our results show that right-handed and left-handed modes intersect at the angular momentum compensation temperature where pure antiferromagnetic spin waves are expected. A field-induced shift of the mode-crossing point from the angular momentum compensation temperature and the gyromagnetic reversal reveal hitherto unrecognized properties of ferrimagnetic dynamics. We also provide a theoretical understanding of our experimental results. Our work demonstrates important aspects of the physics of ferrimagnetic spin waves and opens up the attractive possibility of ferrimagnet-based magnonic devices.

Leaching behaviors and mechanisms of vitrified forms for the low-level radioactive solid wastes.

Leaching behaviors and mechanisms of commercialized glass wasteforms to sequester low-level solid-wastes were investigated: SG glass for resin waste and DG-2 glass for dry active waste. After ANS 16.1 leaching test, leachabilities of the nuclides, Co, Cs, and Sr, were all lager than 14, which met the requirement of the US-Nuclear Regulatory Commission. Holes of diameters 5-10 µm remained on the surface of the SG and crevices of lengths 10-50 µm were observed on the surface of the DG-2. We analyzed elemental compositions of the SG and the DG-2 with depths. For the SG, Si, Al, Ca, and Mg were accumulated and Na was depleted up to nearly 1.5 µm compared to an internal glass. For the DG-2, concentrations of B, Na, Al, Ca and Sr started to decrease from 2.5 µm even though other minor elements are still remained their concentrations. We suggested leaching mechanisms: alkali elements including H would diffuse through the holes on the SG, while most of the elements including Si and Al would diffuse through the crevices on the DG-2.

Risk factors of postoperative major adverse cardiac events after radical cystectomy: implication of diastolic dysfunction.

Radical cystectomy, which is a standard treatment of muscle invasive and high-grade non-invasive bladder tumour, is accompanied with high rates of postoperative complications including major adverse cardiac events (MACE). Diastolic dysfunction is associated with postoperative complications. We evaluated perioperative risk factors including diastolic dysfunction related with MACE within 6 months after radical cystectomy. The 546 patients who underwent elective radical cystectomy were included. Diastolic dysfunction was defined as early transmitral flow velocity (E)/early diastolic mitral annulus velocity (e') > 15. Logistic regression analysis, Kaplan-Meier survival analysis and log-rank test were performed. MACE within 6 months after radical cystectomy developed in 43 (7.9%) patients. MACE was related with female (odds ratio 2.546, 95% confidence interval 1.166-5.557, P = 0.019) and diastolic dysfunction (odds ratio 3.077, 95% confidence interval 1.147-8.252, P = 0.026). The 6-month mortality were significantly higher in the MACE group, and hospital stay and intensive care unit stay were significantly longer in the MACE group compared to the non-MACE group. Accordingly, preoperative diastolic dysfunction (E/e' > 15) was related with postoperative MACE and MACE was related with 6-month survival after radical cystectomy. These results suggest that preoperative diastolic dysfunction can provide useful information on postoperative complications.

Tuning the Ionomer Distribution in the Fuel Cell Catalyst Layer with Scaling the Ionomer Aggregate Size in Dispersion.

With the demands for better performance of polymer electrolyte membrane fuel cells, studies on controlling the distribution of ionomers have recently gained interest. Here, we present a tunable ionomer distribution in the catalyst layer (CL) with dipropylene glycol (DPG) and water mixtures as the ionomer dispersion medium. Dynamic light scattering and molecular dynamics simulation demonstrate that, by increasing the DPG content in the dispersion, the size of the ionomer aggregates in the dispersion is exponentially reduced because of the higher affinity of DPG for Nafion ionomers. The ionomer distribution of the resulting CLs dictates the dimensional feature of the ionomer dispersion. Although the ionomer distribution becomes more uniform with increasing the DPG content, an optimal power performance is obtained at a DPG content of 50 wt % regardless of feed humidity because of balanced proton and mass transports. As a guide for tuning the ionomer distribution, we suggest that the ionomer aggregates in the dispersion with a size close to that of the Pt/C aggregates form a highly connected ionomer network and maintain a porosity in the catalyst/ionomer aggregate, resulting in high power performance.

Fast-switching optically isotropic liquid crystal nano-droplets with improved depolarization and Kerr effect by doping high k nanoparticles.

We proposed and analyzed an optically isotropic nano-droplet liquid crystal (LC) doped with high k nanoparticles (NPs), exhibiting enhanced Kerr effects, which could be operated with reduced driving voltages. For enhancing the contrast ratio together with the light efficiencies, the LC droplet sizes were adjusted to be shorter than the wavelength of visible light to reduce depolarization effects by optical scattering of the LC droplets. Based on the optical analysis of the depolarization effects, the influence of the relationship between the LC droplet size and the NP doping ratio on the Kerr effect change was investigated.

Ultrathin Nafion-filled porous membrane for zinc/bromine redox flow batteries.

In this work, we present a 16 µm-thick Nafion-filled porous membrane for Zn/Br redox flow batteries (ZBBs). By using molecular dynamics simulation and dynamic light scattering analysis, we rationally design Nafion solution for Nafion impregnation into a porous polypropylene (PP) separator. A void-free Nafion/PP membrane is successfully fabricated by using NMP as a solvent for the Nafion solution. The resulting membrane shows a smaller area specific resistance in comparison with 600 µm-thick, commercial SF-600 porous membrane. Due to its dense morphology, Br2 diffusivity of the Nafion/PP membrane is two orders of magnitude lower than that of SF-600, resulting in a comparable Br2 crossover in spite of 37.5 times smaller membrane thickness. As a result, the ZBB based on the Nafion/PP membrane exhibits a higher energy efficiency, demonstrating that ion exchange membrane can outperform the conventional porous membrane by reducing the membrane thickness with inexpensive porous substrate.

Bioequivalence Study of a New Fixed-dose Combination Tablet Containing S-Amlodipine Nicotinate and Olmesartan Medoxomil in Healthy Korean Male Subjects.

PURPOSE: A fixed-dose combination (FDC) pill of amlodipine (relatively old calcium channel blocker as dihydropyridine) and olmesartan (relatively new angiotensin II receptor blocker) is used for hypertension that is not adequately controlled with a single-formulation drug. Because the FDC is a one-pill formulation, and amlodipine and olmesartan have different mechanisms of action, it is expected to improve patients' medication compliance and have an increased blood pressure-lowering efficacy. The purpose of this study was to assess the safety profile and the bioequivalence of two different FDC formulations [amlodipine besylate/olmesartan medoxomil 10/40 mg (reference product) and S-amlodipine nicotinate/olmesartan medoxomil 5/40 mg (test product)]. METHODS: A randomized, open-label, single-dose, 2-treatment, 2-way, and 2-period crossover study, including a 3-week washout period, was performed in 32 healthy Korean male volunteers. To analyze the concentration of S-amlodipine or olmesartan, plasma samples were collected up to 144 hours after the dose for S-amlodipine and 48 hours after the dose for olmesartan. Pharmacokinetic parameters, including the Cmax and the area under the curve from time 0 to the last measurable concentration (AUC0-last) for the time versus concentration plot, were calculated. Analysis of variance for bioequivalence was conducted using Cmax and AUC0-last converted to log scale, and the mean ratios and 90% CIs were determined. Safety data included analysis of adverse events (AEs), vital signs, physical examinations, clinical laboratory test, and 12-lead ECGs. FINDINGS: Of the 32 enrolled participants, 29 healthy volunteers completed the study. For both S-amlodipine and olmesartan, the main pharmacokinetic parameters were all within the acceptable range for regulatory bioequivalence. The 90% CIs for the geometric mean ratios of Cmax and AUC0-last were 0.8766 to 0.9760 and 0.8288 to 0.9224, respectively, for S-amlodipine and 0.9097 to 1.1229 and 0.8904 to 1.0407, respectively, for olmesartan. Hypotension was the most frequent AE, and it was observed in 4 volunteers with the test product and 7 volunteers with the reference product. Both the test and reference formulations were well tolerated. IMPLICATIONS: The present study demonstrates that the newly developed FDC product (test drug) and the conventional FDC product (reference drug) have comparable pharmacokinetic characteristics in healthy adult male volunteers. Both the test and reference products indicated good tolerance in this population, and no serious AEs were observed.

Combined Treatment with Low Concentrations of Aqueous and Gaseous Chlorine Dioxide Inactivates Escherichia coli O157:H7 and Salmonella Typhimurium Inoculated on Paprika.

Combined treatment with gaseous and aqueous chlorine dioxide (ClO2) was performed to improve the microbiological safety and quality of paprika. A single treatment of 50 ppmv ClO2 gas for 30 min decreased the populations of Escherichia coli O157:H7 and Salmonella Typhimurium by 2.33 and 2.91 log CFU/g, respectively. In addition, a single treatment of aqueous ClO2 (50 ppm) for 5 min decreased these populations by 1.86 and 1.37, respectively. The most dramatic effects were achieved by combined treatment of 50 ppm aqueous and gaseous ClO2 for 30 min, which decreased populations of E. coli O157:H7 and S. Typhimurium by 4.11 and 3.61 log CFU/g, respectively. With regard to the qualities of paprika, no adverse effects were elicited by the combined treatment. Thus, combined treatment with aqueous and gaseous ClO2 is a suitable approach that can be used to improve the microbial safety and quality of paprika.

Nitrogen ion implantation into various materials using 28 GHz electron cyclotron resonance ion source.

The installation of the 28 GHz electron cyclotron resonance ion source (ECRIS) ion implantation beamline was recently completed at the Korea Basic Science Institute. The apparatus contains a beam monitoring system and a sample holder for the ion implantation process. The new implantation system can function as a multipurpose tool since it can implant a variety of ions, ranging hydrogen to uranium, into different materials with precise control and with implantation areas as large as 1-10 mm(2). The implantation chamber was designed to measure the beam properties with a diagnostic system as well as to perform ion implantation with an in situ system including a mass spectrometer. This advanced implantation system can be employed in novel applications, including the production of a variety of new materials such as metals, polymers, and ceramics and the irradiation testing and fabrication of structural and functional materials to be used in future nuclear fusion reactors. In this investigation, the first nitrogen ion implantation experiments were conducted using the new system. The 28 GHz ECRIS implanted low-energy, multi-charged nitrogen ions into copper, zinc, and cobalt substrates, and the ion implantation depth profiles were obtained. SRIM 2013 code was used to calculate the profiles under identical conditions, and the experimental and simulation results are presented and compared in this report. The depths and ranges of the ion distributions in the experimental and simulation results agree closely and demonstrate that the new system will enable the treatment of various substrates for advanced materials research.