Ethnic discrimination, asking for fair treatment, and poor self-rated health: a gender stratified analysis of 13,443 Korean Chinese waged workers in South Korea.

BACKGROUND: In South Korea, Korean Chinese workers experience ethnic discrimination although they share physical similarities and ethnic heritage with native-born Koreans. This study aimed to examine whether perceived ethnic discrimination is associated with poor self-rated health and whether the association differs by gender among Korean Chinese waged workers in South Korea. METHODS: We conducted a pooled cross-sectional analysis using data of 13,443 Korean Chinese waged workers from the Survey on Immigrants' Living Conditions and Labor Force conducted in 2018, 2020, and 2022. Based on perceived ethnic discrimination, asking for fair treatment, and subsequent situational improvement, respondents were classified into the following four groups: "Not experienced," "Experienced, not asked for fair treatment," "Experienced, asked for fair treatment, not improved," and "Experienced, asked for fair treatment, improved." Poor self-rated health was assessed using a single question "How is your current overall health?" We applied logistic regression to examine the association between perceived ethnic discrimination and poor self-rated health, with gender-stratified analyses. RESULTS: We found an association between ethnic discrimination and poor self-rated health among Korean Chinese waged workers. In the gender-stratified analysis, the "Experienced, not asked for fair treatment" group was more likely to report poor self-rated health compared to the "Not experienced" group, regardless of gender. However, gender differences were observed in the group stratified by situational improvements. For male workers, no statistically significant association was found in the "Experienced, asked for fair treatment, improved" group with poor self-rated health (odd ratios: 0.87, 95% confidence intervals: 0.30-2.53). Conversely, among female workers, a statistically significant association was observed (odd ratios: 2.63, 95% confidence intervals: 1.29-5.38). CONCLUSIONS: This study is the first to find an association between perceived ethnic discrimination and poor self-rated health, along with gender differences in the association between situational improvements after asking for fair treatment and poor self-rated health among Korean Chinese waged workers in South Korea.

Identifying Candidate Polyphenols Beneficial for Oxidative Liver Injury through Multiscale Network Analysis.

Oxidative stress, a driver of liver pathology, remains a challenge in clinical management, necessitating innovative approaches. In this research, we delved into the therapeutic potential of polyphenols for oxidative liver injury using a multiscale network analysis framework. From the Phenol-Explorer database, we curated a list of polyphenols along with their corresponding PubChem IDs. Verified target information was then collated from multiple databases. We subsequently measured the propagative effects of these compounds and prioritized a ranking based on their correlation scores for oxidative liver injury. This result underwent evaluation to discern its effectiveness in differentiating between known and unknown polyphenols, demonstrating superior performance over chance level in distinguishing these compounds. We found that lariciresinol and isopimpinellin yielded high correlation scores in relation to oxidative liver injury without reported evidence. By analyzing the impact on a multiscale network, we found that lariciresinol and isopimpinellin were predicted to offer beneficial effects on the disease by directly acting on targets such as CASP3, NR1I2, and CYP3A4 or by modulating biological functions related to the apoptotic process and oxidative stress. This study not only corroborates the efficacy of identified polyphenols in liver health but also opens avenues for future investigations into their mechanistic actions.

Change in employment status and its causal effect on suicidal ideation and depressive symptoms: A marginal structural model with machine learning algorithms.

OBJECTIVE: This study aimed to assess the causal effect of a change in employment status on suicidal ideation and depressive symptoms by applying marginal structural models (MSM) with machine-learning (ML) algorithms. METHODS: We analyzed data from the 8-15th waves (2013-2020) of the Korean Welfare Panel Study, a nationally representative longitudinal dataset. Our analysis included 13 294 observations from 3621 participants who had standard employment at baseline (2013-2019). Based on employment status at follow-up year (2014-2020), respondents were classified into two groups: (i) maintained standard employment (reference group), (ii) changed to non-standard employment. Suicidal ideation during the past year and depressive symptoms during the past week were assessed through self-report questionnaire. To apply the ML algorithms to the MSM, we conducted eight ML algorithms to build the propensity score indicating a change in employment status. Then, we applied the MSM to examine the causal effect by using inverse probability weights calculated based on the propensity score from ML algorithms. RESULTS: The random forest algorithm performed best among all algorithms, showing the highest area under the curve 0.702, 95% confidence interval (CI) 0.686-0.718. In the MSM with the random forest algorithm, workers who changed from standard to non-standard employment were 2.07 times more likely to report suicidal ideation compared to those who maintained standard employment (95% CI 1.16-3.70). A similar trend was observed in the analysis of depressive symptoms. CONCLUSIONS: This study found that a change in employment status could lead to a higher risk of suicidal ideation and depressive symptoms.

Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients.

Galectin-3 levels have been studied as a potential biomarker for predicting cardiovascular (CV) risk and mortality in hemodialysis (HD) patients. Recently, a close relationship between galectin-3 and vascular calcification (VC) has been reported. Here, we investigated the role of VC as a mediating factor in the association between galectin-3 and mortality. Serum galectin-3 and baseline aortic arch calcification (AoAC) score were measured in 477 incident HD patients. Mortality data were obtained at a median follow-up of 40 months. Causal mediation analysis was performed to examine the effect of vascular risk factors on galectin-3-related mortality. The prevalence of AoAC in HD patients was 57% (n = 272), and elevated galectin-3 levels were associated with a significantly increased risk of AoAC. When the galectin-3 level was divided by the median level of 37 ng/mL, a higher galectin group increased the risk of all-cause mortality by 1.71-fold (95% CI 1.02-2.92, p = 0.048), even after adjustment for multiple CV risk factors. Mediation analysis showed that both the direct effect of the galectin-3 on mortality (ß = 0.0368, bootstrapped 95% CI [0.0113-0.0622]) and the indirect effects were significant. AoAC score and high-sensitivity CRP levels significantly mediated the association between galectin-3 and mortality (total indirect effects: ß = 0.0188, bootstrapped 95% CI [0.0066-0.0352]). This study suggests that the association between high galectin-3 and mortality may be partially mediated by higher VC and inflammatory state in HD patients.

Necking Reduction at Low Temperature in Aspect Ratio Etching of SiO2 at CF4/H2/Ar Plasma.

This study investigated the effect of temperature on the aspect-ratio etching of SiO2 in CF4/H2/Ar plasma using patterned samples of a 200 nm trench in a low-temperature reactive-ion etching system. Lower temperatures resulted in higher etch rates and aspect ratios for SiO2. However, the plasma property was constant with the chuck temperature, indicated by the line intensity ratio from optical emission spectroscopy monitoring of the plasma. The variables obtained from the characterization of the etched profile for the 200 nm trench after etching were analyzed as a function of temperature. A reduction in the necking ratio affected the etch rate and aspect ratio of SiO2. The etching mechanism of the aspect ratio etching of SiO2 was discussed based on the results of the surface composition at necking via energy-dispersive X-ray spectroscopy with temperature. The results suggested that the neutral species reaching the etch front of SiO2 had a low sticking coefficient. The bowing ratio decreased with lowering temperature, indicating the presence of directional ions during etching. Therefore, a lower temperature for the aspect ratio etching of SiO2 could achieve a faster etch rate and a higher aspect ratio of SiO2 via the reduction of necking than higher temperatures.

Accuracy of zirconia crown manufactured using stereolithography and digital light processing.

OBJECTIVES: The aim of this study is to evaluate the accuracy of zirconia crowns fabricated using stereolithography (SLA) and digital light processing (DLP) and to compare their accuracy with those fabricated using the subtractive manufacturing (SM) method. METHODS: A typodont model with a prepared maxillary first molar was scanned, and the anatomical contour crown was designed using dental computer-aided-design (CAD) software. The designed file in standard tessellation language (STL) format was used to fabricate 10 crowns per group. The crowns were manufactured using a dental milling machine (Datron D5; MLC group), SLA (CERAMAKER 900; SLAC group), and DLP (ZIPRO; DLPC group) printers. The fabricated crowns were scanned using a dental laboratory scanner and saved in three parts: the external, intaglio, and marginal surfaces. For accuracy assessment, these parts were superimposed to the reference file. Root mean square (RMS) values were evaluated using three-dimensional analysis software (Geomagic Control X). Statistical significance was evaluated using a nonparametric Kruskal-Wallis test (α = 0.05) and a post-hoc Mann-Whitney U test with Bonferroni correction (α = 0.016). RESULTS: Trueness evaluation revealed the lowest RMS value in all areas in the MLC group, followed by that in the DLPC group. The precision evaluation revealed the lowest RMS value in all areas in the MLC group. Statistically significant differences were observed among the groups in the external, intaglio, and marginal surface (P < 0.05). CONCLUSIONS: Although the restorations fabricated using SM revealed higher accuracy, the crowns manufactured using SLA and DLP methods were considered clinically acceptable. CLINICAL SIGNIFICANCE: In the production of zirconia crowns, subtractive manufacturing continues to demonstrate significantly higher accuracy compared to additive manufacturing. However, crowns fabricated using the additive manufacturing method also demonstrated high accuracy.

Female workers with long working hours are more likely to have depressive symptoms when having family-to-work conflict.

PURPOSE: Workers' health can be influenced by risk factors from their family environments as well as their work environments. This paper sought to examine how the association between long working hours and depressive symptoms differs based on the level of FWC after being stratified by worker's gender. METHODS: We used the dataset of 20,384 full-time wage workers from the sixth Korean Working Conditions Survey (2020). Long working hours were defined as working 52 h or more per week. FWC was measured using a 2-item questionnaire, and depressive symptoms were measured using the WHO-5 well-being index. Applying modified Poisson regression, we evaluated how the association between long working hours and depressive symptoms differs by the level of FWC male and female workers separately. RESULTS: In the analysis of the female workers, long working hours were associated with depressive symptoms in the high FWC group (PR 1.35, 95% CI 1.17, 1.55) after adjusting for potential confounders whereas no association was observed in the low FWC group. Among the male workers, a statistically significant association was observed in both high FWC (PR 1.22, 95% CI 1.07, 1.38) and low FWC (PR 1.28, 95% CI 1.12, 1.47) groups. CONCLUSION: FWC may act as a workplace stressor that potentially amplifies the health impact of long working hours among female workers.

High-Performance Organic Electrochemical Transistors Achieved by Optimizing Structural and Energetic Ordering of Diketopyrrolopyrrole-Based Polymers.

For optimizing steady-state performance in organic electrochemical transistors (OECTs), both molecular design and structural alignment approaches must work in tandem to minimize energetic and microstructural disorders in polymeric mixed ionic-electronic conductor films. Herein, a series of poly(diketopyrrolopyrrole)s bearing various lengths of aliphatic-glycol hybrid side chains (PDPP-mEG; m = 2-5) is developed to achieve high-performance p-type OECTs. PDPP-4EG polymer with the optimized length of side chains exhibits excellent crystallinity owing to enhanced lamellar and backbone interactions. Furthermore, the improved structural ordering in PDPP-4EG films significantly decreases trap state density and energetic disorder. Consequently, PDPP-4EG-based OECT devices produce a mobility-volumetric capacitance product ([µC*]) of 702 F V-1 cm-1 s-1 and a hole mobility of 6.49 ± 0.60 cm2 V-1 s-1 . Finally, for achieving the optimal structural ordering along the OECT channel direction, a floating film transfer method is employed to reinforce the unidirectional orientation of polymer chains, leading to a substantially increased figure-of-merit [µC*] to over 800 F V-1 cm-1 s-1 . The research demonstrates the importance of side chain engineering of polymeric mixed ionic-electronic conductors in conjunction with their anisotropic microstructural optimization to maximize OECT characteristics.

The Fate of Pre-Existing L5-S1 Degeneration following Oblique Lumbar Interbody Fusion of L4-L5 and Above.

BACKGROUND: Previous studies have identified various risk factors for adjacent segment disease (ASD) at the L5-S1 level after fusion surgery, including preoperative sagittal imbalance, longer fusion, and preoperative disc degeneration. However, only a few studies have explored the risk factors for ASD at the L5-S1 level after oblique lumbar interbody fusion (OLIF) at the L4-L5 level and above. This study aimed to identify the risk factors for symptomatic ASD at the L5-S1 level in patients with pre-existing degeneration after OLIF at L4-L5 and above. METHODS: We retrospectively reviewed the data of patients who underwent OLIF at L4-L5 and above, with a minimum follow-up period of 2 years. Patients with central stenosis or Lee grade 2 or 3 foraminal stenosis at L5-S1 preoperatively were excluded. Patients were divided into ASD and non-ASD groups based on the occurrence of new-onset L5 or S1 radicular pain requiring epidural steroid injection (ESI). The clinical and radiological factors were analyzed. Logistic regression was used to identify the risk factors for ASD of L5-S1. RESULTS: A total of 191 patients with a mean age ± standard deviation of 68.6 ± 8.3 years were included. Thirty-four (21.7%) patients underwent ESI at the L5 root after OLIF. In the logistic regression analyses, severe disc degeneration (OR (95% confidence interval (CI)): 2.65 (1.16-6.09)), the presence of facet effusion (OR (95% CI): 2.55 (1.05-6.23)), and severe paraspinal muscle fatty degeneration (OR (95% CI): 4.47 (1.53-13.05)) were significant risk factors for ASD in L5-S1. CONCLUSIONS: In this study, the presence of facet effusion, severe disc degeneration, and severe paraspinal muscle fatty degeneration at the L5-S1 level were associated with the development of ASD at L5-S1 following OLIF at L4-L5 and above. For patients with these conditions, surgeons could consider including L5-S1 in the fusion when considering OLIF at the L4-L5 level and above.

Improvement of Thermodynamic Phase Stability and High-Rate Capability of Li Layered Oxides.

The use of elemental doping in lithium cobalt oxide (LCO) cathode material at high cutoff voltage is a widely adopted technique in the field of rechargeable batteries to mitigate multiple unfavorable phase transitions. However, there is still a lack of fundamental understanding regarding the rationality of each doping element implemented in this method, specifically considering the various thermodynamic stability and phase transitions. Herein, we investigated the effect of Ti doping on an O2 phase LCO (LCTO) cathode material that exhibited enhanced rate performance. We suggest that the incorporation of Ti into an O2 phase LCO results in the mitigation of multiple-phase transitions and the improvement of phase stability, thereby yielding a high-rate-capable cathode material. Through a combination of experimental and computational calculations, we demonstrate that Ti doping improves the thermodynamic stability and kinetics of Li-ions during the cycling process.

Peculiar transient behaviors of organic electrochemical transistors governed by ion injection directionality.

Despite the growing interest in dynamic behaviors at the frequency domain, there exist very few studies on molecular orientation-dependent transient responses of organic mixed ionic-electronic conductors. In this research, we investigated the effect of ion injection directionality on transient electrochemical transistor behaviors by developing a model mixed conductor system. Two polymers with similar electrical, ionic, and electrochemical characteristics but distinct backbone planarities and molecular orientations were successfully synthesized by varying the co-monomer unit (2,2'-bithiophene or phenylene) in conjunction with a novel 1,4-dithienylphenylene-based monomer. The comprehensive electrochemical analysis suggests that the molecular orientation affects the length of the ion-drift pathway, which is directly correlated with ion mobility, resulting in peculiar OECT transient responses. These results provide the general insight into molecular orientation-dependent ion movement characteristics as well as high-performance device design principles with fine-tuned transient responses.

Machine Learning-Based Measurement of Regional and Global Spinal Parameters Using the Concept of Incidence Angle of Inflection Points.

This study delves into the application of convolutional neural networks (CNNs) in evaluating spinal sagittal alignment, introducing the innovative concept of incidence angles of inflection points (IAIPs) as intuitive parameters to capture the interplay between pelvic and spinal alignment. Pioneering the fusion of IAIPs with machine learning for sagittal alignment analysis, this research scrutinized whole-spine lateral radiographs from hundreds of patients who visited a single institution, utilizing high-quality images for parameter assessments. Noteworthy findings revealed robust success rates for certain parameters, including pelvic and C2 incidence angles, but comparatively lower rates for sacral slope and L1 incidence. The proposed CNN-based machine learning method demonstrated remarkable efficiency, achieving an impressive 80 percent detection rate for various spinal angles, such as lumbar lordosis and thoracic kyphosis, with a precise error threshold of 3.5°. Further bolstering the study's credibility, measurements derived from the novel formula closely aligned with those directly extracted from the CNN model. In conclusion, this research underscores the utility of the CNN-based deep learning algorithm in delivering precise measurements of spinal sagittal parameters, and highlights the potential for integrating machine learning with the IAIP concept for comprehensive data accumulation in the domain of sagittal spinal alignment analysis, thus advancing our understanding of spinal health.

Role of neutrophil extracellular traps in vascular access thrombosis in hemodialysis patients.

BACKGROUND: A patent vascular access (VA) is a lifeline for hemodialysis (HD) patients. However, vascular access is prone to thrombosis, which, if left untreated, can lead to permanent VA loss and increased mortality. Neutrophil extracellular traps (NETs) are known to be involved in intravascular thrombosis. We evaluated the relationship between NETs and VA thrombosis and their impact on VA prognosis. METHODS: A total of 189 patients with VA flow problems were enrolled. Among these, 93 patients underwent percutaneous transluminal angioplasty (PTA) for stenosis, and 96 patients underwent PTA with thrombectomy for thrombosis. Plasma nucleosome, myeloperoxidase-DNA complex, and von Willebrand factor (vWF) were measured as markers of circulating NETs and thrombosis risk, respectively. The primary outcome was permanent VA loss and the secondary outcome was recurrent thrombotic occlusion within 6 months. In addition, the presence of NETs in thrombi was evaluated by histopathological analysis. RESULTS: Circulating nucleosome levels were closely associated with plasma vWF levels (r = 0.172, p = 0.025), and both were higher in thrombectomy cases than in PTA alone cases (nucleosome; 0.83 ± 0.70 vs. 0.35 ± 0.26, p < 0.001, vWF: 9.0 ± 7.6 vs. 7.3 ± 6.2, p = 0.038). The highest quartile of nucleosomes (Q4) was associated with an 18-fold increased rate of access thrombotic occlusion (p < 0.001). In addition, multivariate analysis showed that the rates of permanent access loss (HR 2.77, 95 % CI 1.35-5.77) and recurrent thrombosis (HR 2.35, 95 % CI 1.22-4.54) were much higher in patients with the Q4 nucleosome group than in those with Q1-3. In addition, higher neutrophil infiltration and NET expression in thrombi were also associated with poor VA prognosis. CONCLUSIONS: Higher levels of circulating NETs and the amount of NET expression in thrombi may be associated with VA thrombosis and poor VA outcomes.

Lack of compensation for COVID-19-related overtime work and its association with burnout among EMS providers in Korea.

OBJECTIVES: This study examined the association between lack of compensation for COVID-19-related overtime work (LCCOW) and burnout among emergency medical service (EMS) providers in Seoul, Korea. METHODS: We conducted a cross-sectional survey of 693 EMS providers in Seoul, Korea. Participants were classified into 3 groups according to their experience of coronavirus disease 2019 (COVID-19)-related overtime work and LCCOW: (1) "did not experience," (2) "experienced and was compensated," and (3) "experienced and was not compensated." Burnout was measured using the Korean version of the Copenhagen Burnout Inventory, which has 3 subdomains: personal burnout (PB), work-related burnout (WRB), and citizen-related burnout (CRB). Multiple linear regression was applied to examine whether LCCOW was associated with burnout after adjusting for potential confounders. RESULTS: In total, 74.2% of participants experienced COVID-19-related overtime work, and 14.6% of those who worked overtime experienced LCCOW. COVID-19-related overtime work showed a statistically non-significant association with burnout. However, the association differed by LCCOW. Compared to the "did not experience" group, the "experienced and was not compensated" group was associated with PB (ß=10.519; 95% confidence interval [CI], 3.455 to 17.584), WRB (ß=10.339; 95% CI, 3.398 to 17.280), and CRB (ß=12.290; 95% CI, 6.900 to 17.680), whereas no association was observed for the "experienced and was compensated" group. Furthermore, an analysis restricted to EMS providers who worked overtime due to COVID-19 showed that LCCOW was associated with PB (ß=7.970; 95% CI, 1.064 to 14.876), WRB (ß=7.276; 95% CI, 0.270 to 14.283), and CRB (ß=10.000; 95% CI, 3.435 to 16.565). CONCLUSIONS: This study suggests that LCCOW could be critical in worsening burnout among EMS providers who worked overtime due to COVID-19.

Enhanced Organic Electrochemical Transistor Performance of Donor-Acceptor Conjugated Polymers Modified with Hybrid Glycol/Ionic Side Chains by Postpolymerization Modification.

Emergent bioelectronic technologies are underpinned by the organic electrochemical transistor (OECT), which employs an electrolyte medium to modulate the conductivity of its organic semiconductor channel. Here we utilize postpolymerization modification (PPM) on a conjugated polymer backbone to directly introduce glycolated or anionic side chains via fluoride displacement. The resulting polymers demonstrated increased volumetric capacitances, with subdued swelling, compared to their parent polymer in p-type enhancement mode OECTs. This increase in capacitance was attributed to their modified side chain configurations enabling cationic charge compensation for thin film electrochemical oxidation, as deduced from electrochemical quartz crystal microbalance measurements. An overall improvement in OECT performance was recorded for the hybrid glycol/ionic polymer compared to the parent, owing to its low swelling and bimodal crystalline orientation as imaged by grazing-incidence wide-angle X-ray scattering, enabling its high charge mobility at 1.02 cm2·V-1·s-1. Compromised device performance was recorded for the fully glycolated derivative compared to the parent, which was linked to its limited face-on stacking, which hindered OECT charge mobility at 0.26 cm2·V-1·s-1, despite its high capacitance. These results highlight the effectiveness of anionic side chain attachment by PPM as a means of increasing the volumetric capacitance of p-type conjugated polymers for OECTs, while retaining solid-state macromolecular properties that facilitate hole transport.

The Influence of Regiochemistry on the Performance of Organic Mixed Ionic and Electronic Conductors.

Thiophenes functionalised in the 3-position are ubiquitous building blocks for the design and synthesis of organic semiconductors. Their non-centrosymmetric nature has long been used as a powerful synthetic design tool exemplified by the vastly different properties of regiorandom and regioregular poly(3-hexylthiophene) owing to the repulsive head-to-head interactions between neighbouring side chains in the regiorandom polymer. The renewed interest in highly electron-rich 3-alkoxythiophene based polymers for bioelectronic applications opens up new considerations around the regiochemistry of these systems as both the head-to-tail and head-to-head couplings adopt near-planar conformations due to attractive intramolecular S-O interactions. To understand how this increased flexibility in the molecular design can be used advantageously, we explore in detail the geometrical and electronic effects that influence the optical, electrochemical, structural, and electrical properties of a series of six polythiophene derivatives with varying regiochemistry and comonomer composition. We show how the interplay between conformational disorder, backbone coplanarity and polaron distribution affects the mixed ionic-electronic conduction. Ultimately, we use these findings to identify a new conformationally restricted polythiophene derivative for p-type accumulation-mode organic electrochemical transistor applications with performance on par with state-of-the-art mixed conductors evidenced by a µC* product of 267 F V-1 cm-1 s-1 .

Compound-level identification of sasang constitution type-specific personalized herbal medicine using data science approach.

Introduction: Sasang Constitutional Medicine (SCM) is a type of traditional Korean medicine where patients are classified as one of four Sasang constitution types (Sasang type) and medications consisting of medicinal herbs are prescribed according to the Sasang type. Despite the importance of personalized medicine, the operation mechanism is largely unknown. To gain a better understanding, we investigated the compound information that composes Sasang type-specific personalized herbal medicines on both multivariate and univariate levels. Methods: Five machine learning classifiers including extremely randomized trees (ERT) were trained to investigate whether the Sasang type can be explained by compound information at the multivariate level. Hierarchical clustering was conducted to determine whether compounds are processed distributedly or specifically. Taxonomic and biosynthetic analyses were conducted on these compounds. A univariate level statistical test was conducted to provide more robust Sasang type-specific compound information. Results: Using the trained ERT classifier, sixty important compounds were extracted. The sixty compounds were clustered into three groups, corresponding to each Sasang type-prominent compounds, suggesting that most compounds have specific preference for the Sasang type. Structural and biosynthetic characteristics of these Sasang type-prominent compounds were determined based on taxonomy and pathway analyses. Fourteen compounds showed statistically significant relevance with the Sasang type. Additionally, we predicted the Sasang type of unknown herbs, which were confirmed by their biological effects in functional assays. Conclusion: This study investigated the personalized herbal medicines of the SCM using compound information. This study provided information on the chemical characteristics of the compounds that are essential for classifying the Sasang type of medicinal herbs, as well as predictions regarding the Sasang type of the commonly used but unidentified medicinal herbs.

Striatal Dopaminergic Loss and Dysphagia in Parkinson Disease.

PURPOSE: To better understand the development of dysphagia in patients with Parkinson disease (PD) and to identify possible neuromodulatory target regions of dysphagia, we studied the striatal dopamine transporter (DAT) availability distribution by subtype of dysphagia. METHODS: In this retrospective cross-sectional study, patients with PD who underwent videofluoroscopic swallowing study and N-(3-[18F]fluoropropyl)-2ß-carbon ethoxy-3ß-(4-iodophenyl) nortropane (18F-FP-CIT) PET at intervals of less than 1 month were analyzed. The 14 binarized subitem scores of the Videofluoroscopic Dysphagia Scale were analyzed using a voxel-wise Firth's penalized binary logistic regression model, adjusting for age and disease duration at videofluoroscopic swallowing study. RESULTS: Sixty-five patients with PD were finally included. Striatal mapping showed association of decreased DAT availability with 5 subitems with 1 or more clusters surviving the statistical threshold: 1 oral phase and 4 pharyngeal phase subitems. The overlap maps created by superimposing clusters for all 5 statistically significant subitems revealed associations of dysphagia in PD with decreased DAT availability in the bilateral ventral striatum. Of these, 4 subitems belonging to the pharyngeal phase-specific dysphagia were additionally found to be related to dopaminergic degeneration of the bilateral anterior-to-posterior caudate and ventral striatum. CONCLUSIONS: These findings suggest that subitem/phase-specific striatal subregional dopaminergic depletion may explain the dysphagia of PD. This dopaminergic degeneration of striatal subregions specific to the phases of dysphagia may serve as a potential target for neuromodulatory brain stimulation through stimulation of cortices functionally connected.

Trueness of stereolithography ZrO2 crowns with different build directions.

This study aims to measure the trueness of zirconia crowns with different build directions of materials fabricated using the stereolithography (SLA) method. The anatomic contour crown of prepped maxillary right first molar was designed using CAD software to obtain the standard tessellation language (STL) file. Two different build directions were set for the crowns using Materialize Magics software. One group was built with a margin base platform, while the other group was built in the direction opposite to the occlusal surface base platform. The 20 crown-shaped parts were printed. The STL files of scanned printing zirconia crowns were superimposed each segment by the 3D analysis software. The two groups were statistically analyzed using t-tests. Significant differences were found in the marginal and internal discrepancies between the groups. The build direction had a significant influence on the accuracy of the zirconia crown. The results indicate the most effective build direction for manufacturing SLA 3D-printed crowns.

HYPOTENSION AT THE TIME OF SEPSIS RECOGNITION IS NOT ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS PATIENTS WITH NORMAL LACTATE LEVELS.

ABSTRACT: Background and Objective: Although sepsis is heterogeneous, data on sepsis patients with normal lactate levels are very limited. We explored whether hypotension at the time of sepsis recognition (i.e., time zero) was significant in terms of survival when lactate levels were normal in sepsis patients. Patients and Design: This was a prospective multicenter observational study conducted in 19 hospitals (20 intensive care units [ICUs]). Adult sepsis patients with normal lactate levels (≤2 mmol/L) admitted to ICUs were divided by the mean arterial pressure at time zero into hypotensive (<65 mm Hg) and nonhypotensive groups (≥65 mm Hg). Measurements and Results: Of 2,032 patients with sepsis (not septic shock), 617 with normal lactate levels were included in the analysis. The hypotensive group (n = 237) was characterized by higher rates of abdominal or urinary infections, and bacteremia, whereas the nonhypotensive group (n = 380) was characterized by higher rates of pulmonary infections and systemic inflammatory response. However, the Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment score (excluding the cardiovascular score) were not different between the groups. During sepsis resuscitation, the rates of antibiotic administration within 1, 3, and 6 h of time zero were higher in the hypotensive than nonhypotensive group ( P < 0.05 for all time points), and the amounts of pre-ICU fluids given were also higher in the hypotensive group. However, despite a higher rate of vasopressor use in the hypotensive group, ICU and in-hospital mortality rates were not different between the groups (12.7% vs. 13.9% [ P = 0.648] and 19.4% vs. 22.4% [ P = 0.382], respectively). In multivariable analysis, the use of appropriate antibiotics and early lactate measurement were significant risk factors for in-hospital mortality. Conclusions: In sepsis patients with normal lactate levels, neither hypotension nor vasopressor use adversely impacted the hospital outcome. Our results emphasize the importance of early interventions and appropriate use of antibiotics regardless of whether a patient is or is not hypotensive.