To assess the safety and reproducibility of a two-stage mid-peripheral approach for anterior capsulorhexis by the full moon capsulorhexis technique (FCT) for intumescent cataract. A retrospective analysis of clinical and surgical records for consecutive cases of intumescent cataract in which the FCT was used by a single surgeon during the study period (24 months). Eyes with pre-existing corneal opacity, phacodonesis, pseudo-exfoliation, capsular fibrosis, glaucoma, pre-existing ocular inflammation, inadequate mydriasis (a pupil diameter less than 6 mm), history of ocular trauma, and history of previous ocular surgery were excluded. Patient demographics (age, gender, comorbidities), size of primary capsulorhexis (PCC), size of secondary capsulorhexis (SCC), type of lenticular cortical fluid egress after initial nick of anterior capsule (F), complications, and surgical time were collected. Descriptive analysis (range (R), mean, standard deviation (SD)) of data was done. There were 110 eyes of FCT in the study period: male: n = 35 (31.82%), female: n = 75 (68.18%); mean age: 51.84 years (R: 25-65 years); comorbidities: n = 83 (75.45%) of hypertension (37.27%, n = 41), type 2 diabetes mellitus (20.90%, n = 23), or both (17.27%, n = 19). Mean PCC was 1.61 mm (R = 1-3 mm; SD = 0.66). Mean SCC was 5.22 mm (R = 4-6 mm; SD = 0.50). F was 'no fluid release': n = 64 (58.18%), 'minimal fluid release': n = 37 (33.64%), and 'profuse milky fluid release': n = 9 (8.18%). There were no complications in PCC or SCC creation. The mean surgical time was 5 minutes 6 seconds (R = 3 minutes 35 seconds to 7 minutes 15 seconds). The mid-peripheral approach for anterior capsulorhexis in intumescent cataract by the full moon capsulorhexis technique was safe and reproducible in this series of cases.
The South Pole-Aitken (SPA) basin-forming impact was a critical event in the Moon's history. Despite being the oldest and largest acknowledged basin, critical details including the impactor's size, nature, direction, and fate of the ejecta remain uncertain. Here, we simulate SPA's formation and resultant crustal structure. We find that SPA's observed shape of an ellipse tapered toward the south is best reproduced by a 260-km-diameter differentiated impactor striking with a north-to-south trajectory. In this scenario, the impact disperses lunar mantle materials in the cross-range and the downrange directions away from the lunar farside. Much of the mantle ejecta collapses into the basin interior, consistent with the distribution inferred from gravity. These results suggest that the Artemis landing sites near the lunar south pole should contain abundant SPA ejecta including mantle materials. Samples returned from these regions should therefore reveal the age of SPA and the composition of the lunar mantle.
Ganymede is the only known moon with an active dynamo today. Previous studies interpret Ganymede's dynamo as arising from convection in a metal core that formed billions of years ago. However, Ganymede likely accreted too cold to form with a metal core, which confounds interpretations of Ganymede's magnetic field as a constraint on the moon's broader history. Here, we reevaluate the thermal evolution of Ganymede's rock-metal interior from a cold start. Our models show that Ganymede's observed dynamo is consistent with ongoing core formation, a process not yet observed elsewhere. If Ganymede has an Fe-FeS core with a sub-eutectic composition, then gradual mantle warming may expel dense Fe melt onto the growing protocore and stir liquid metal, sustaining a dynamo for billions of years.
The extravasation of anticancer immune cells is a very important issue that must be understood to improve the anticancer effect of chimeric antigen receptor (CAR)-expressing anticancer immune cell therapy. To date, no study has been reported to quantitatively evaluate the degree of extravasation of anticancer immune cells escaping from tumor blood vessels to the tumor microenvironment (TME) at the microscopic level. In this study, for the first time, using tumor transparency imaging, the extent of extravasation of CAR-NK and NK cells in pancreatic tumors was determined. we used tumor transparency imaging, which preserves intact vasculature, to accurately measure the extravasation and infiltration of established MSLN-CAR-NK-92 cells and unmodified NK-92 cells in an NSG mouse model of pancreatic cancer. Extravasation was quantified by calculating the volume ratio of cells located inside versus outside tumor vessels. Following intravenous infusion, MSLN-CAR-NK-92 cells showed higher extravasation rates (85.3% vs. 57.4%), penetration depths (185 μm vs. 128 μm), and average extravasated cell counts (7,717 vs. 2,311) compared with NK-92 cells. Further measures of penetration and cytotoxicity also favored MSLN-CAR-NK-92 cells, with CPA50/CPD50 values of 6,887 cells at 88 μm versus 3,509 cells at 45 μm, and CDA50/CDD50 values of 6,350 cells at 102 μm versus 2,023 cells at 48 μm, respectively. These findings highlight the value of extravasation efficiency as a metric for assessing immune cell performance in solid tumors. Considering these results, the extravasation efficiency of anticancer immune cells can be regarded as a valuable indicator for evaluating the effectiveness of CAR constructs designed for NK cells target pancreatic cancer. In this study, we establish a quantitative extravasation imaging platform for evaluating CAR-NK cell trafficking in pancreatic and cholangiocarcinoma tumor models. This approach provides a structured framework for assessing immune cell delivery and therapeutic distribution within the tumor microenvironment.
Early open fracture management aims to minimise the risk of complications. For the most severe open fracture wounds, multiple irrigation and debridement surgeries are required to overcome severe wound contamination, to reassess the evolving tissue injury or to temporise and plan further surgery. When multiple irrigation and debridement surgeries are needed, uncertainty remains about how the open fracture wound should be managed to best minimise complications. The primary aim of this trial is to compare the antibiotic cement bead pouch vs negative pressure wound therapy in the management of patients with severe open tibia fracture wounds. BvV is a multicentre, pragmatic, parallel arm randomised controlled trial that aims to enrol 312 adult patients admitted to a participating centre with a severe open tibia fracture requiring multiple irrigation and debridement surgeries. Participants will be randomly allocated on a 1:1 basis to either antibiotic cement bead pouch or negative pressure wound therapy. The primary outcome will be a composite outcome to evaluate clinical status 6 months after randomisation. Using the win ratio approach, we will hierarchically assess the composite outcome in the following order: (i) all-cause mortality, (ii) injury-related amputation of the lower extremity, (iii) unplanned reoperation to manage wound complications, an infection or promote fracture healing and (iv) clinical fracture healing assessed using the Functional IndeX for Trauma (FIX-IT) instrument. The BvV trial has been approved by a central institutional review board (IRB) (Advarra) for clinical sites in the USA, the ethics board at the coordinating centre at McMaster University (Hamilton Integrated Research Ethics Board), and participating sites not using the central institutional IRB (Fraser Health Research Ethics Board, The University of British Columbia Clinical Research Ethics Board, Newfoundland and Labrador Health Research Ethics Board, University of Manitoba Biomedical Research Ethics Board). Additional clinical sites who are in the start-up phase, as well as any new selected clinical sites, will obtain local approvals prior to initiating trial activities. This will include a clinical site in the UK who is in the process of obtaining the necessary approvals. Recruitment began in November 2023. Both interventions are frequently used to manage severe open fracture wounds, ensuring that the trial results can be easily transitioned into clinical practice. The results of this trial will be disseminated to national and international partners through peer-reviewed publications, academic conferences and stakeholder engagement activities. NCT05615844.
We aimed to investigate the prevalence and clinical significance of pontine microtubular signal intensity (MSI), presumed dilated perivascular or perineural spaces, in patients with hemifacial spasm (HFS) using high-resolution MRI using proton density-weighted imaging (HR-PDI). We retrospectively analyzed 438 patients with unilateral HFS who underwent microvascular decompression (MVD) and preoperative HR-PDI. MSI was defined as a linear or curvilinear hyperintense lesion along the presumed course of the intraparenchymal facial nerve fascicles within the pons on HR-PDI. The presence and laterality of MSI were evaluated by consensus between two reviewers and classified according to their relationship to the symptomatic side of HFS as ipsilateral (same side as the facial spasm), contralateral (opposite side), or bilateral. Clinical characteristics, surgical findings, and postoperative outcomes were compared according to the presence of ipsilateral MSI. A control group of 307 subjects who underwent HR-PDI for non-central neurologic symptoms was included to assess the prevalence of MSI. Multivariable logistic regression analysis was performed to identify factors associated with immediate postoperative improvement after MVD. MSI was more frequently observed in patients with HFS than in controls after adjusting age and sex (OR, 3.78; 95% CI, 2.747-5.197; p < 0.001). Ipsilateral MSI was identified in 267 of 438 patients (61.0%). Patients with ipsilateral MSI showed a significantly higher frequency of contralateral MSI (p < 0.001) and vertebralartery-related compression (p = 0.002). Immediate postoperative improvement after MVD was less frequent in patients with ipsilateral MSI than in those without MSI (77.5% vs. 86.5%, p = 0.019). Multivariable logistic regression analysis demonstrated that ipsilateral MSI was independently associated with a lower likelihood of immediate postoperative improvement (OR, 0.411; 95% CI, 0.222-0.759; p = 0.005). However, long-term surgical outcomes were not significantly different according to the presence of MSI. Pontine MSI on HR-PDI is more frequently observed in patients with HFS and is associated with a lower likelihood of immediate postoperative improvement and a tendency toward delayed recovery after MVD but not with poorer long-term outcomes. These findings suggest that MSI may represent microstructural or neurofluidic alterations along the pontine facial nerve pathway and may serve as an imaging marker of delayed recovery dynamics.
Heparin-induced thrombocytopenia (HIT) in cardiac surgical patients presents unique diagnostic and management challenges due to universal perioperative heparin exposure, postoperative platelet kinetics, and the high prevalence of critical illness in this population. Current guidelines do not fully address these cardiac surgical-specific features, leading to practice variation in screening, diagnosis, anticoagulation management, and perioperative planning. Consolidated, practical, and evidence-based recommendations are needed that are tailored to cardiac surgery and to temporary mechanical circulatory support after cardiac surgery. The American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee convened a multidisciplinary panel of 16 experts in cardiac surgery, hematology, critical care, anesthesiology, perfusion, and pharmacology. A comprehensive literature review was performed with medical librarian support. Using a modified Delphi methodology, the panel evaluated the evidence, developed clinical statements, and assigned a class of recommendation and a level of evidence to each recommendation. Consensus was achieved for 32 recommendations across 5 domains: (1) epidemiology and natural history of HIT after cardiac surgery; (2) diagnostic evaluation, including appropriate Thrombocytopenia, Timing, Thrombosis, oTher cause (4Ts) score use, time-dependent platelet count patterns, and integration of immunoassay and functional testing; (3) therapeutic management with nonheparin anticoagulants, including the selection of direct thrombin inhibitors, factor Xa inhibitors, and adjunctive therapies; (4) perioperative management of patients with HIT who require cardiac surgery, including the timing of surgery, intraoperative anticoagulation strategy, and adjunctive therapies; and (5) screening, testing, and anticoagulation strategies for patients supported by extracorporeal membrane oxygenation or temporary mechanical circulatory support after cardiac surgery. Additional best practices are included for cardiopulmonary bypass circuit management for patients with HIT. This AATS expert consensus document provides practical, cardiac surgery-specific guidance for the diagnosis and management of HIT across the continuum of cardiac surgical care. By addressing the complexities unique to cardiac surgery, high-risk anticoagulation environments, and extracorporeal and temporary mechanical circulatory support, these recommendations aim to improve diagnostic accuracy, standardize care, reduce complications, and support safe heparin re-exposure or alternative anticoagulation strategies when surgery is required.
In this study, we designed and synthesized two novel oxygen-bridged boron-based thermally activated delayed fluorescence (TADF) emitters, 11-(9H-carbazol-9-yl)-16-phenyl-12-(3-(triphenylsilyl)phenyl)-16H-5,9-dioxa-16-aza-13b-boraindeno[1,2-a]naphtho[1,2,3-fg]anthracene (BOID-Cz-Si) and 9-(12-(3-(triphenylsilyl)phenyl)-5,9,16-trioxa-13b-boraindeno[1,2-a]naphtho[1,2,3-fg]anthracen-11-yl)-9H-carbazole (BOBF-Cz-Si). These compounds produce fluorescent emission through short-range and long-range charge transfer (CT) within the polycyclic aromatic hydrocarbon framework along with additional long-range CT between the donor and acceptor units of the emitter. Indole and benzofuran units were incorporated into the oxygen-bridged boron core as electron-donating moieties to modulate the long-range CT and enhance the multiple resonance (MR)-TADF properties. Furthermore, a bulky tetraphenylsilane group and an auxiliary carbazole unit were incorporated to suppress intermolecular interactions and enhance emission through long-range CT. Both emitters exhibited pure violet emission (peaks near 400 nm) with narrow full width at half-maximum values (approximately 25 nm) in the solution state and high photoluminescence quantum yields (up to 95%). Notably, the BOID-Cz-Si device showed a violet emission peak at 420 nm and a maximum external quantum efficiency of 22.7%, which is one of the highest efficiency values reported in the violet region. These results indicate the promising potential of hybridized oxygen-bridged boron scaffolds, which combine short- and long-range CT within the MR framework with rational donor engineering, as high-efficiency, high-color-purity MR-TADF emitters.
Pancreatic ductal adenocarcinoma (PDAC) carries an extremely poor prognosis, in part resulting from cellular heterogeneity that supports overall tumorigenicity. Cancer-associated fibroblasts (CAF) are key determinants of PDAC biology and response to systemic therapy, and multiple CAF subtypes have been defined. However, defining the effects of patient-specific CAF heterogeneity and plasticity on tumor cell behavior is required to better characterize the role of CAFs in PDAC. Here, we used multi-omic analyses to characterize the tumor microenvironment (TME) in tumors from patients undergoing curative-intent surgery for PDAC. In these same patients, matched tumor organoid and CAF lines were established to functionally validate the impact of CAFs on the tumor cells. CAFs promoted epithelial-mesenchymal transition (EMT) and a switch in tumor cell classification from classical to basal subtype. Furthermore, CAF-specific interleukin 8 (IL-8) functioned as a modulator of tumor cell subtype. Finally, neighborhood relationships between tumor cells and T cell subsets were defined, demonstrating a distinct spatial coordination among CAF and tumor cell subtypes. Overall, this study provides data supporting CAF signaling as a regulator of the cellular and behavioral heterogeneity in the PDAC TME. These findings can be used to explore rational approaches to improve therapies for this difficult-to-treat disease.
Cholangiocarcinoma (CCA) consists of a class of malignant tumors of the biliary system, with a rising incidence and carries a poor prognosis. Developing reliable animal models of CCA is crucial to elucidate the pathogenesis, identify novel therapeutic targets, and assess treatment efficacy. Among these models, the in situ primary cholangiocarcinoma model which closely mimics clinical reality, serves as a robust tool for evaluating drug efficacy, simulating tumor progression characteristics, and facilitates immunotherapy strategies. Although in situ primary CCA models have been utilized in preclinical research, they have inherent limitations that warrant attention and further refinement. This review article highlights the status of the most relevant experimental animal models in preclinical CCA studies. It further delineates the differences in the development of intrahepatic and extrahepatic bile ducts that influence CCA model construction. In addition, we review the advancements, strengths and weaknesses of CCA organoids, primary intrahepatic and extrahepatic CCA models, and examine the pivotal role of bile duct inflammation and biliary fibrosis in creating the invasive cancer models. We emphasize the innovative application and immense potential of single-cell sequencing technology in studying cancer models. Additionally, this article summarizes the progress of CCA-targeted therapies and associated clinical trials which offered relevant insights. With a comprehensive review of in situ primary CCA models, we aim to provide suggestions and recommendation for future development of more advanced and clinically relevant research in constructing CCA models.
Background and Objectives: We aimed to evaluate differences in PM exposure reduction behaviors among older adults and patients with chronic respiratory diseases, atrial fibrillation, and stroke and to identify associated determinants. Materials and Methods: This multicenter cross-sectional study included 717 participants from five cohorts: older adults (n = 255), chronic obstructive pulmonary disease (COPD, n = 145), asthma (n = 100), atrial fibrillation (n = 117), and stroke (n = 100). PM exposure reduction behaviors were assessed using a standardized 18-item questionnaire (total score range: 0-126) covering indoor, outdoor, and other behaviors (health-seeking actions, such as checking air quality and using purifiers). Results: In multivariable linear regression models, COPD (β = 11.09), asthma (β = 15.54), and atrial fibrillation (β = 14.29) were associated with significantly higher total behavior scores compared with the older adult cohort (adjusted mean 69.0), corresponding to an approximately 20% relative increase in the asthma cohort. The stroke cohort did not differ significantly from the primary cohort. Domain-specific analyses showed that indoor and other behavioral scores were consistently higher across all disease cohorts, whereas outdoor scores were significantly elevated only for asthma and atrial fibrillation. In a fully adjusted model that included all covariates simultaneously, the stroke cohort demonstrated a modest increase in the total score (β = 8.79). Increased age and higher educational attainment were independently associated with greater behavioral engagement. Conclusions: PM exposure reduction behavior scores differed across the clinical cohorts, and sociodemographic factors were independently associated with behavioral engagement. These findings support personalized disease-specific counseling and inform future digital health interventions for vulnerable populations.
Sex and gender shape disease presentation, diagnostic accuracy, treatment response and clinical outcomes in rheumatology, yet these dimensions remain insufficiently embedded in clinical practice. Owing to the markedly unbalanced sex prevalence ratios across many rheumatic diseases, the 'minority' sex is consistently under-represented in clinical studies, limiting the interpretation of long-term outcomes and treatment effectiveness. Sex-related differences in pain perception, inflammatory biomarkers and imaging patterns further complicate disease assessment, and treatment allocation and drug persistence also differ between women and men. Gender-related factors - including disparities in care-seeking behaviours, social roles and lifestyle factors - additionally modulate symptom burden and disease trajectories. Evidence remains particularly scarce for transgender, gender-diverse and intersex individuals, who are rarely captured in clinical cohorts, restricting the development of inclusive and generalizable evidence. Embedding sex-aware and gender-aware approaches into diagnostic reasoning, risk assessment and therapeutic decision-making is therefore essential for advancing precision, equity and truly personalized rheumatological care. Such integration enables clinicians to interpret disease signals more accurately, anticipate divergent multimorbidity trajectories and tailor treatment strategies to the biological and sociocultural contexts of each patient.
Polysomnography (PSG) is the gold standard for diagnosing sleep disorders. However, the subjectivity of manual scoring can lead to inter-scorer variability, undermining diagnostic accuracy and subsequent clinical decisions. This study aims to quantitatively assess scoring concordance among multiple scorers across various clinical subgroups to identify the factors that contribute to interpretive discrepancies. We conducted a retrospective analysis of overnight diagnostic PSG data from adult patients at a tertiary university hospital sleep center. Interrater reliability was evaluated by three independent expert scorers for 30 subjects selected through stratified random sampling. The polysomnographic data were independently and blindly scored according to the American Academy of Sleep Medicine criteria, focusing on sleep stages, arousals, respiratory events, and leg movements, all scored in 30 s epochs. Interrater agreement was measured using Fleiss' κ, along with 95% confidence intervals, and included subgroup analyses by diagnostic category. The analysis included a total of 28,291 epochs from 30 adults across normal, insomnia, obstructive sleep apnea (OSA) [mild-severe], and periodic limb movement (PLM) disorder subgroups. The overall interrater agreement for sleep staging among the three scorers was nearly perfect (Fleiss' κ = 0.932), with the highest concordance observed in stages W, N2, and R, and excellent agreement in stages N1 and N3. Respiratory events showed particularly high reliability, with near-perfect agreement for apnea (κ = 0.955) and substantial agreement for hypopnea, arousals, and PLMs. Pairwise analyses indicated the highest concordance between scorer 1 and scorer 3, while the agreement between scorer 1 and scorer 2 was lower, particularly for detecting arousals and limb movements. Subgroup analyses showed the highest and most stable agreement in moderate OSA, whereas severe OSA exhibited reduced reliability for sleep staging and arousal scoring, indicating increased scoring complexity with greater sleep fragmentation. Although expert PSG scoring demonstrates high overall reliability, significant variability persists in complex cases like severe OSA. These findings underscore the necessity for structured quality assurance and automated tools to improve diagnostic consistency in clinical practice.
Tuberculosis (TB) remains a major global health challenge, requiring standardized animal models to evaluate vaccine-induced immune responses. This study characterized time-dependent immune responses following Bacillus Calmette-Guérin (BCG) vaccination in BALB/c mice. BALB/c mice were vaccinated with BCG, and the immune responses and protective efficacy were evaluated at 4, 6, and 8 weeks post-immunization. The cytokine expression in serum, lung, and spleen tissues was analyzed using ELISA, quantitative PCR, and immunohistochemistry. Protective efficacy was assessed via colony-forming unit (CFU) enumeration and the immunohistochemical detection of Mycobacterium TB after aerosol challenge. The BCG vaccination induced time-dependent and tissue-specific cytokine responses. Pulmonary IL-1β and splenic IFN-γ levels were significantly increased four weeks post-vaccination. At 8 weeks, serum IL-2, pulmonary IL-2, and TNF-α were significantly increased, whereas no significant changes in cytokines were observed at 6 weeks. After the challenge, BCG-vaccinated mice exhibited reduced bacterial burdens compared with controls, but the differences among the 4-, 6-, and 8-week groups were modest. Immune responses became detectable starting four weeks after BCG vaccination, with temporal differences observed in cytokine expression. Week 8 may serve as a reference point for monitoring cytokine dynamics rather than as an optimal time for protection.
To evaluate the shear bond strength (SBS) of newly developed composite resin materials intended for dental splinting to enamel and to determine whether phosphoric acid etching alone provides reliable adhesion. Four experimental materials (G-Fix, Light Fix, Ortho Connect, and Ortho Connect Flow) were compared with conventional composite resins applied to phosphoric acid-etched enamel, with or without a universal adhesive. After thermocycling, SBS was measured and failure modes were assessed. Wettability was evaluated by contact angle measurement, and the resin-enamel interfacial microstructure was examined using atomic force microscopy. Across all materials, application of a universal adhesive did not increase SBS. SBS was significantly reduced for Light Fix and Ortho Connect Flow when the adhesive was used. When applied directly to etched enamel, all experimental materials achieved clinically acceptable SBS. Interfacial analyses supported that adhesion was predominantly mediated by functional monomer-driven chemical interactions rather than enhanced micromechanical retention. For the tested splinting composites, phosphoric acid etching followed by direct composite application provided reliable enamel adhesion, and the additional use of a universal adhesive was unnecessary and may be detrimental for selected materials. This simplified protocol may be suitable for clinical splinting procedures.
Background/Objectives: Cannabidiol (CBD) has emerged as a potential therapeutic agent for respiratory disorders, including asthma and chronic obstructive pulmonary disease. However, its clinical translation via pulmonary delivery is limited by poor aqueous solubility, chemical instability, and low local bioavailability. This study aimed to develop and optimize a sodium stearate (NaSt)-based spray-dried dry powder inhaler (DPI) formulation to enhance the aerosol performance, dissolution, and storage stability of CBD. Methods: CBD microparticles were prepared by spray drying using NaSt as the primary excipient. The feed preparation method, spray-drying parameters, and CBD:NaSt ratios were systematically optimized. The resulting powders were evaluated for aerodynamic properties using cascade impaction, dissolution behavior in simulated lung fluid, solid-state characteristics, and accelerated stability under stress conditions. Results: The optimized formulation, SD-4, a spray-dried CBD:NaSt formulation prepared at a 20:80 weight ratio using Process B, demonstrated excellent aerosolization performance, with a fine particle fraction (FPF) exceeding 50% and a mass median aerodynamic diameter (MMAD) of 5.08 ± 0.1 μm. Dissolution testing revealed more than a three-fold increase in drug release compared with raw CBD, attributed to amorphous dispersion within the NaSt matrix and surfactant-induced micellization. Accelerated stability studies confirmed improved retention of the amorphous state and drug content, while antioxidant incorporation further reduced oxidative degradation. Conclusions: The NaSt-based spray-dried formulation significantly improved aerosol deposition efficiency, dissolution rate, and physicochemical stability of CBD. This formulation strategy may provide a promising platform for pulmonary delivery of poorly water-soluble compounds.
We present an 8-λ local-area-network wavelength-division-multiplexing (LAN-WDM) transmitter optical subassembly (TOSA) for 800-Gb/s operation, using an epoxy-sealed, non-hermetic package for improved cost-effectiveness and manufacturability. To shorten packaging time and improve packaging yield, a ball-lens alignment scheme replaces a square lens, reducing per-lane alignment degrees of freedom from six to three. All eight wavelengths are locked to the LAN-WDM grid with a single thermoelectric cooler (TEC). In addition, inserting series DC-blocking capacitors in the electro-absorption-modulated laser (EML) radio-frequency (RF) path reduces the internal heat load, lowering the TEC input power from 1.294 W to 1.086 W (ΔP = 0.208 W; 16.1% reduction). Under 53.125-Gbaud PAM4 modulation (8 × 106.25 Gb/s), the TOSA delivers clear eye diagrams with transmitter and dispersion eye closure for PAM4 (TDECQ) ≤ 3.0 dB and outer extinction ratio (ER) ≥ 3.7 dB across all lanes. In link tests with a PIN-photodiode receiver optical subassembly (ROSA), per-lane receiver sensitivities of -11.2 to -7.7 dBm are achieved after 20-km transmission at BER = 2.4 × 10-4. These results indicate that the proposed non-hermetic 8-λ TOSA is a viable building block for ≥10-km intensity-modulated/direct-detect (IM/DD) 800-Gb/s deployments, with demonstrated operation over 20 km.
This study aimed to evaluate the incidence and severity of CA-AKI, and its predictive factors in trauma patients. Trauma patients from the Regional Korea Trauma Center who underwent iodixanol-enhanced CT and were monitored for 72 hours post-scan were included. Demographics, co-morbidities, and lab results were collected. CA-AKI was defined by the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Severity of CA-AKI was classified by the risk, injury, failure, loss of kidney function, and end-stage renal failure (RIFLE) criteria. Trauma severity was assessed by the injury severity score (ISS) category. Predictive factors of CA-AKI were evaluated by univariate and multivariate logistic regression. Of 1115 patients undergoing iodixanol-enhanced CT, 799 with complete data were included. Overall CA-AKI incidence was 3.80% (30/799) and severe renal failure occurred in 2.87% (23/799). CA-AKI incidence by ISS category was 1.52% (minor), 3.95% (moderate), 42.30% (serious), and 75.0% (severe). Upon univariate analysis, significant predictive factors of CA-AKI included hypertension [odds ratio (OR) 2.87], heart disease (OR 4.06), serious ISS (OR 47.50), and severe ISS (OR 194.33). Upon multivariate analysis, significant predictive factors were ISS serious category (OR 48.20), and ISS severe category (OR 245.22). In trauma patients who underwent iodixanol-enhanced CT, incidence of CA-AKI was considerably low at 3.8%, with trauma severity as a significant predictive factor. Iodixanol-enhanced CT demonstrates low CA-AKI incidence and favorable safety in trauma patients. These findings support its clinical utility in high-trauma cases where renal risk is elevated.
Background: The Global Positioning System (GPS) and wearable monitoring technologies are increasingly applied in sport science to quantify training load; however, data from female cross-country skiers in nations with emerging competitive programs remain scarce. This case series covering the complete national team roster analyzed the complete annual training cycle of the Korean women's national cross-country skiing team (KCF) using GPS and heart rate-based wearable sensors. Methods: All three national team members were monitored throughout the 2022-2023 season (52 weeks), structured into General Preparation Period 1 (April-July), General Preparation Period 2 (August-November), and Competition Period (December-March). Individualized five-zone intensity thresholds were established through graded exercise testing on a roller ski treadmill with ventilatory threshold and blood lactate determination, independently assessed by two exercise physiologists (PhD level). Results: The total annual training volume was 667.72 h, comprising roller/on-snow skiing (54.0%), running (23.3%), and strength training (22.7%). The endurance-only intensity distribution demonstrated a polarized pattern (Zones 1-2: 91.5%). The total annual training distance reached 4673.30 km. The mean FIS points were 108.46 ± 38.60, and the mean VO2max was 60.17 ± 6.11 mL·kg-1·min-1. Conclusions: When benchmarked against world-class female (WCF) standards (800-950 h annually), the overall training volume was approximately 18-30% lower. The relative strength training allocation (22.7%) exceeded typical WCF values (10-15%). These observations should be interpreted cautiously given the small sample size and cross-study comparison design, using published literature-based benchmarks.
Bacteriophages in natural environments play a critical role in microbial ecology by regulating bacterial populations, mediating nutrient cycling, and facilitating horizontal gene transfer. Aquaculture operations, particularly inland fish farms, are major sources of anthropogenic influence on freshwater ecosystems. Here, we present three viral metagenomic datasets derived from freshwater samples collected at an inland aquaculture effluent site and adjacent upstream and downstream locations along the Sung-am River in Jincheon County, South Korea. The datasets were generated using the Illumina HiSeq X sequencing platform, yielding approximately 10.0-11.2 Gbp per sample. Quality assessments confirmed minimal bacterial contamination, with negligible proportions of rRNA and bacterial marker genes. Assembly using metaSPAdes and MEGAHIT, application of Phables to resolve high-quality phage genomes (viral metagenome-assembled genomes; vMAGs), viral identification with VirSorter2, and clustering using Vclust, resulted in 2,837-3,156 virus operational taxonomic units (vOTUs; ≥10 kb) per sample. Each vOTU sequence is analyzed for taxonomic assignment and putative host prediction. These datasets provide a valuable resource for further studies on viral diversity and microbial ecology in freshwater ecosystems affected by aquaculture.