Publications by authors named "Minjae Kim"

112 Publications

Beach sand oil spills select for generalist microbial populations.

ISME J 2021 Jun 4. Epub 2021 Jun 4.

School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, USA.

The specialization-disturbance hypothesis predicts that, in the event of a disturbance, generalists are favored, while specialists are selected against. This hypothesis has not been rigorously tested in microbial systems and it remains unclear to what extent it could explain microbial community succession patterns following perturbations. Previous field observations of Pensacola Beach sands that were impacted by the Deepwater Horizon (DWH) oil spill provided evidence in support of the specialization-disturbance hypothesis. However, ecological drift as well as uncounted environmental fluctuations (e.g., storms) could not be ruled out as confounding factors driving these field results. In this study, the specialization-disturbance hypothesis was tested on beach sands, disturbed by DWH crude oil, ex situ in closed laboratory advective-flow chambers that mimic in situ conditions in saturated beach sediments. The chambers were inoculated with weathered DWH oil and unamended chambers served as controls. The time series of shotgun metagenomic and 16S rRNA gene amplicon sequence data from a two-month long incubation showed that functional diversity significantly increased while taxonomic diversity significantly declined, indicating a decrease in specialist taxa. Thus, results from this laboratory study corroborate field observations, providing verification that the specialization-disturbance hypothesis can explain microbial succession patterns in crude oil impacted beach sands.
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http://dx.doi.org/10.1038/s41396-021-01017-6DOI Listing
June 2021

Development of Brain Metastases in Patients With Non-Small Cell Lung Cancer and No Brain Metastases at Initial Staging Evaluation: Cumulative Incidence and Risk Factor Analysis.

AJR Am J Roentgenol 2021 May 26. Epub 2021 May 26.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

While established guidelines give indications for performing staging brain MRI at initial non-small cell lung cancer (NSCLC) diagnosis, guidelines are lacking for performing surveillance brain MRI in patients without brain metastases at presentation. To estimate the cumulative incidence of, and risk factors associated with, brain metastasis development in patients with NSCLC without brain metastases at initial presentation. This retrospective study included 1495 patients with NSCLC (mean age 65±10 years; 920 men, 575 women) without brain metastases at initial evaluation that included brain MRI. Follow-up brain MRI was ordered at referrer physicians' discretion. MRI examinations were reviewed in combination with clinical records for brain metastasis development; patients not undergoing MRI were deemed to have not developed metastases through last clinical follow-up. Cumulative incidence of brain metastases was determined with death as a competing risk and stratified by clinical stage group, cell type, and epidermal growth factor receptor (EGFR) status. Univariable and multivariable Cox proportional hazards regression analyses were performed. A total of 258/1495 (17.3%) patients underwent follow-up brain MRI, and 72/1495 (4.8%) developed brain metastases at a median of 12.3 months after initial NSCLC diagnosis. Among the 72 patients developing metastases, 44% had no neurologic symptoms, and 58% had stable primary thoracic disease. Cumulative incidence of brain metastases at 6, 12, 18, and 24 months was 0.6%, 2.1%, 4.2% and 6.8%, respectively. Cumulative incidence was higher (P<.001) in clinical stage III-IV (1.3%, 3.9%, 7.7%, and 10.9%) than I-II (0.0%, 0.8%, 1.2%, and 2.6%) disease, and higher (P<.001) in EGFR positive (0.7%, 2.5%, 6.3%, and 12.3%) than EGFR negative (0.4%, 1.8%, 2.9%, and 4.4%) adenocarcinoma. Among 1109 patients with adenocarcinoma, independent risk factors for brain metastasis development were clinical stage III-IV (hazard ratio [HR]=9.39; P<.001) and EGFR positivity (HR=1.78; P=.04). Brain metastasis incidence over the study interval was 8.7% in clinical stage III-IV disease and 8.6% in EGFR positive adenocarcinoma. Clinical stage III-IV and EGFR positive adenocarcinoma are independent risk factors for brain metastasis development. Surveillance brain MRI may be warranted 12 months after initial evaluation in clinical stage III-IV disease or EGFR-positive adenocarcinoma.
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http://dx.doi.org/10.2214/AJR.21.25787DOI Listing
May 2021

Postresection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma according to the 2010 World Health Organization classification: single-center experience of 168 patients.

Ann Surg Treat Res 2021 May 29;100(5):260-269. Epub 2021 Apr 29.

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) has wide histologic diversity. This study investigated the effects of cHCC-CC histology, according to the 2010 World Health Organization (WHO) classification, on patient prognosis.

Methods: The medical records of patients who underwent surgical resection for cHCC-CC at our institution between July 2012 and June 2019 were retrospectively evaluated.

Results: During the study period, 168 patients, 122 males (72.6%) and 46 females (27.4%), underwent surgical resection for cHCC-CC, including 159 patients (94.6%) who underwent R0 resection. Mean tumor diameter was 4.4 ± 2.8 cm, and 161 patients (95.8%) had solitary tumors. Histologically, 86 patients (51.2%) had classical type, and 82 (48.8%) had tumors with stem cell (SC) features, including 33 (19.6%) with intermediate-cell and 23 (13.7%) each with typical SC and cholangiolocellular features; 3 tumors (1.8%) were unclassifiable. At 1, 3, and 5 years, tumor recurrence rates were 31.9%, 49.6%, and 58.1%, respectively, and patient survival rates were 91.0%, 70.2%, and 60.3%, respectively. Univariate analysis showed that tumor size of >5 cm, microscopic and macroscopic vascular invasion, lymph node metastasis, 8th edition of the American Joint Committee on Cancer (AJCC) tumor stage, and 2010 WHO classification were significantly prognostic. Multivariate analysis showed that the 8th AJCC tumor stage and 2010 WHO histologic classification were independently prognostic for tumor recurrence and patient survival. There were no significant prognostic differences among the 3 SC subtypes.

Conclusion: Postresection outcomes are better in patients with SC-type than with classical-type cHCC-CC.
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http://dx.doi.org/10.4174/astr.2021.100.5.260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103158PMC
May 2021

Combination of automated brain volumetry on MRI and quantitative tau deposition on THK-5351 PET to support diagnosis of Alzheimer's disease.

Sci Rep 2021 May 14;11(1):10343. Epub 2021 May 14.

Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, South Korea.

Imaging biomarkers support the diagnosis of Alzheimer's disease (AD). We aimed to determine whether combining automated brain volumetry on MRI and quantitative measurement of tau deposition on [18F] THK-5351 PET can aid discrimination of AD spectrum. From a prospective database in an IRB-approved multicenter study (NCT02656498), 113 subjects (32 healthy control, 55 mild cognitive impairment, and 26 Alzheimer disease) with baseline structural MRI and [18F] THK-5351 PET were included. Cortical volumes were quantified from FDA-approved software for automated volumetric MRI analysis (NeuroQuant). Standardized uptake value ratio (SUVR) was calculated from tau PET images for 6 composite FreeSurfer-derived regions-of-interests approximating in vivo Braak stage (Braak ROIs). On volumetric MRI analysis, stepwise logistic regression analyses identified the cingulate isthmus and inferior parietal lobule as significant regions in discriminating AD from HC and MCI. The combined model incorporating automated volumes of selected brain regions on MRI (cingulate isthmus, inferior parietal lobule, hippocampus) and SUVRs of Braak ROIs on [18F] THK-5351 PET showed higher performance than SUVRs of Braak ROIs on [18F] THK-5351 PET in discriminating AD from HC (0.98 vs 0.88, P = 0.033) but not in discriminating AD from MCI (0.85 vs 0.79, P = 0.178). The combined model showed comparable performance to automated volumes of selected brain regions on MRI in discriminating AD from HC (0.98 vs 0.94, P = 0.094) and MCI (0.85 vs 0.78; P = 0.065).
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http://dx.doi.org/10.1038/s41598-021-89797-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121780PMC
May 2021

Diagnostic value of diffusion-weighted brain magnetic resonance imaging in patients with sporadic Creutzfeldt-Jakob disease: a systematic review and meta-analysis.

Eur Radiol 2021 May 12. Epub 2021 May 12.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Objective: To evaluate the diagnostic yield and performance of DWI in patients with sporadic CJD (sCJD).

Methods: A systematic literature search of the MEDLINE and EMBASE databases was performed, since their inception up to July 28, 2020. Pooled diagnostic yield of diffusion-weighted imaging was calculated using DerSimonian-Laird random-effects model. Pooled diagnostic performance of DWI (sensitivity, specificity, and area under the curve) in diagnosing sCJD among patients with rapidly progressive dementia was calculated using a bivariate random-effects model. Subgroup analysis and meta-regression were performed.

Results: Fifteen original articles with a total of 1144 patients with sCJD were included. The pooled diagnostic yield was 91% (95% confidence interval [CI], 86 to 94%); summary sensitivity, 91% (95% CI, 84 to 95%); and specificity, 97% (95% CI, 94 to 99%). The area under the hierarchical summary receiver operating characteristic curve was 0.99 (95% CI, 0.97-0.99). Simultaneous involvement of the neocortex and striatum was the most common finding, and the neocortex was the most common site to be involved on DWI followed by striatum, thalamus, and cerebellum. Subgroup analysis and meta-regression demonstrated significant heterogeneity among the studies associated with the reference standards used for diagnosis of sCJD.

Conclusions: DWI showed excellent diagnostic value in diagnosis of sporadic Creutzfeldt-Jakob disease among patients with rapidly progressive dementia. Simultaneous involvement of the neocortex and striatum was the most common finding, and the neocortex was the most common site to be involved on diffusion-weighted imaging followed by striatum, thalamus, and cerebellum.

Key Points: • The pooled diagnostic yield of diffusion-weighted imaging in sporadic Creutzfeldt-Jakob disease was 91%. • The diagnostic performance of diffusion-weighted imaging for predicting sporadic Creutzfeldt-Jakob disease among patients with rapidly progressive dementia was excellent, with pooled sensitivity, 91%, and specificity, 97%. • Simultaneous involvement in the neocortex and striatum was most commonly seen on diffusion-weighted imaging (60%), followed by the neocortex without striatum (30%), thalamus (21%), cerebellum (8%), and striatum without neocortex (7%).
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http://dx.doi.org/10.1007/s00330-021-08031-4DOI Listing
May 2021

Cytochrome P450-epoxygenated fatty acids inhibit Müller glial inflammation.

Sci Rep 2021 May 6;11(1):9677. Epub 2021 May 6.

Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, USA.

Free fatty acid dysregulation in diabetics may elicit the release of inflammatory cytokines from Müller cells (MC), promoting the onset and progression of diabetic retinopathy (DR). Palmitic acid (PA) is elevated in the sera of diabetics and stimulates the production of the DR-relevant cytokines by MC, including IL-1β, which induces the production of itself and other inflammatory cytokines in the retina as well. In this study we propose that experimental elevation of cytochrome P450 epoxygenase (CYP)-derived epoxygenated fatty acids, epoxyeicosatrienoic acid (EET) and epoxydocosapentaenoic acid (EDP), will reduce PA- and IL-1β-induced MC inflammation. Broad-spectrum CYP inhibition by SKF-525a increased MC expression of inflammatory cytokines. Exogenous 11,12-EET and 19,20-EDP significantly decreased PA- and IL-1β-induced MC expression of IL-1β and IL-6. Both epoxygenated fatty acids significantly decreased IL-8 expression in IL-1β-induced MC and TNFα in PA-induced MC. Interestingly, 11,12-EET and 19,20-EDP significantly increased TNFα in IL-1β-treated MC. GSK2256294, a soluble epoxide hydrolase (sEH) inhibitor, significantly reduced PA- and IL-1β-stimulated MC cytokine expression. 11,12-EET and 19,20-EDP were also found to decrease PA- and IL-1β-induced NFκB-dependent transcriptional activity. These data suggest that experimental elevation of 11,12-EET and 19,20-EDP decreases MC inflammation in part by blocking NFκB-dependent transcription and may represent a viable therapeutic strategy for inhibition of early retinal inflammation in DR.
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http://dx.doi.org/10.1038/s41598-021-89000-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102485PMC
May 2021

Metagenome-Assembled Genome Sequences of Novel Prokaryotic Species from the Mercury-Contaminated East Fork Poplar Creek, Oak Ridge, Tennessee, USA.

Microbiol Resour Announc 2021 Apr 29;10(17). Epub 2021 Apr 29.

Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA

We sequenced two metagenomes of sediments from the East Fork Poplar Creek in the Oak Ridge Reservation (Oak Ridge, TN), a natural stream that has been contaminated with Hg from upstream sources, and we reconstructed 28 metagenome-assembled genomes of novel prokaryotic species.
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http://dx.doi.org/10.1128/MRA.00153-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086206PMC
April 2021

Using Naturalistic Driving Data to Predict Mild Cognitive Impairment and Dementia: Preliminary Findings from the Longitudinal Research on Aging Drivers (LongROAD) Study.

Geriatrics (Basel) 2021 Apr 23;6(2). Epub 2021 Apr 23.

Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA.

Emerging evidence suggests that atypical changes in driving behaviors may be early signals of mild cognitive impairment (MCI) and dementia. This study aims to assess the utility of naturalistic driving data and machine learning techniques in predicting incident MCI and dementia in older adults. Monthly driving data captured by in-vehicle recording devices for up to 45 months from 2977 participants of the Longitudinal Research on Aging Drivers study were processed to generate 29 variables measuring driving behaviors, space and performance. Incident MCI and dementia cases (n = 64) were ascertained from medical record reviews and annual interviews. Random forests were used to classify the participant MCI/dementia status during the follow-up. The F score of random forests in discriminating MCI/dementia status was 29% based on demographic characteristics (age, sex, race/ethnicity and education) only, 66% based on driving variables only, and 88% based on demographic characteristics and driving variables. Feature importance analysis revealed that age was most predictive of MCI and dementia, followed by the percentage of trips traveled within 15 miles of home, race/ethnicity, minutes per trip chain (i.e., length of trips starting and ending at home), minutes per trip, and number of hard braking events with deceleration rates ≥ 0.35 g. If validated, the algorithms developed in this study could provide a novel tool for early detection and management of MCI and dementia in older drivers.
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http://dx.doi.org/10.3390/geriatrics6020045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167558PMC
April 2021

Post-resection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma cannot be predicted by the 2019 World Health Organization classification.

Asian J Surg 2021 Mar 22. Epub 2021 Mar 22.

Department of Surgery and Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address:

Background: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CCA) has wide histologic diversity. This study investigated the prognostic impacts of cHCC-CCA histology according to the 2019 World Health Organization (WHO) classification.

Methods: This retrospective observational study included 153 patients who underwent surgical resection for cHCC-CCA at Asan Medical Center between August 2012 and July 2019.

Results: During the study period, 153 patients, 112 (73.2%) men and 41 (26.8%) women with a mean age of 56.4 ± 10.8 years, underwent R0 resection for cHCC-CCA. Mean tumor diameter was 4.2 ± 2.6 cm, and 147 (96.1%) patients had solitary tumors. According to 2019 WHO classification, 111 (72.5%) patients had cHCC-CCA alone, and 29 of them (26.1%) showed stem cell features. cHCC-CCA-intermediate cell carcinoma and cHCC-CCA-cholangiolocellular carcinoma were identified in 27 (17.6%) and 15 (9.8%), respectively. The 1-, 3-, and 5-year tumor recurrence and patient survival rates were 31.8% and 92.1%, 49.8% and 70.9%, and 59.0% and 61.7%, respectively. Univariate analyses revealed that significant prognostic factors were tumor size >5 cm, microscopic and macroscopic vascular invasion, lymph node metastasis, 8th American Joint Committee on Cancer (AJCC) tumor stage, and status of stem cell features. Multivariate analysis revealed 8th AJCC tumor stage and status of stem cell features as independent prognostic factors. 2019 WHO classification was not associated with post-resection prognosis.

Conclusions: 2019 WHO classification was not associated with post-resection prognosis, thus was considered as simplified histologic classification requiring prognostic validation. We suggest that stem cell features should be included as an essential component of the pathology report for cHCC-CCA.
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http://dx.doi.org/10.1016/j.asjsur.2021.03.002DOI Listing
March 2021

Reproducibility of radiomic features in SENSE and compressed SENSE: impact of acceleration factors.

Eur Radiol 2021 Mar 17. Epub 2021 Mar 17.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 33, Seoul, 05505, Republic of Korea.

Objectives: To investigate the impact of acceleration factors on reproducibility of radiomic features in sensitivity encoding (SENSE) and compressed SENSE (CS), compare between SENSE and CS, and identify reproducible radiomic features.

Methods: Three-dimensional turbo spin echo T1-weighted imaging was performed in 14 healthy volunteers (mean age, 57 years; range, 33-67 years; 7 men) under SENSE and CS with accelerator factors of 5.5, 6.8, and 9.7. Eight anatomical locations (brain parenchyma, salivary glands, masseter muscle, tongue, pharyngeal mucosal space, eyeballs) were evaluated. Reproducibility of radiomic features was evaluated by calculating concordance correlation coefficient (CCC) in reference to the original image (SENSE with acceleration factor of 3.5). Reproducibility of radiomic features among acceleration factors and between SENSE and CS was compared.

Results: Proportion of radiomic features with CCC > 0.85 in reference to the original image was lower with higher acceleration factors in both SENSE and CS across all anatomical locations (p < .001). Proportion of radiomic features with CCC > 0.85 in reference to the original image was higher in SENSE compared with CS (SENSE, 6.7-7.3% vs CS, 4.4-5.0%; p < .001). Run percentage of gray-level run-length matrix (GLRLM) with wavelet D showed CCC > 0.85 in reference to the original image in both SENSE and CS at acceleration factor of 9.7 in the highest number of anatomical locations.

Conclusions: Higher acceleration factors resulted in lower reproducibility of radiomic features in both SENSE and CS, and SENSE showed higher reproducibility of radiomic features than CS in reference to the original image. Run percentage of GLRLM with wavelet D was identified as the most reproducible feature.

Key Points: • Reproducibility of radiomic features in reference to the original image was lower with higher acceleration factors in both sensitivity encoding (SENSE) and compressed SENSE (CS) across all anatomical locations (p < .001). • SENSE showed higher proportions of radiomic features with CCC > 0.85 in reference to the original image (SENSE, 6.7-7.3% vs CS, 4.4-5.0%; p < .001) compared with CS. • Run percentage of gray-level run-length matrix (GLRLM) with wavelet D showed CCC > 0.85 in reference to the original image in both SENSE and CS with the highest acceleration factor.
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http://dx.doi.org/10.1007/s00330-021-07760-wDOI Listing
March 2021

Patency of Hemashield grafts versus ringed Gore-Tex grafts in middle hepatic vein reconstruction for living donor liver transplantation.

Ann Hepatobiliary Pancreat Surg 2021 Feb;25(1):46-53

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Backgrounds/aims: Owing to the short supply of homologous vein allografts, we previously used ringed Gore-Tex vascular grafts for middle hepatic vein (MHV) reconstruction in living donor liver transplantation. When ringed Gore-Tex grafts became unavailable, we used Hemashield vascular grafts. This study aimed to compare the patency and complication rates of Hemashield and ringed Gore-Tex grafts.

Methods: This retrospective two-arm study compared the study group that received Hemashield grafts (n=157) and the propensity score-matched control group that received ringed Gore-Tex grafts (n=157).

Results: In the Hemashield and Gore-Tex groups, the recipient age was 54.7±9.4 and 53.3±6.3 years; Model for End-stage Liver Disease scores were 15.9±9.2 and 16.9±8.3; and graft-recipient weight ratios were 1.07±0.24 and 1.10±0.23, respectively. In the Hemashield group, V5 reconstruction was performed using single (n=113, 72.0%), double (n=39, 24.8%), and triple (n=3, 1.9%) anastomoses. The proportion of double and triple anastomoses for V5 and V8 was higher in the Hemashield group than in the Gore-Tex group. Two (1.3%) patients required MHV conduit stenting owing to early thrombosis of the Hemashield graft. There was no difference in conduit occlusion- free patient survival rates between groups (=0.91). The incidence of accidental conduit migration in the Hemashield and Gore-Tex groups was 0 (0%) and 2 (1.3%), respectively.

Conclusions: Hemashield grafts used in MHV reconstruction demonstrated acceptably high short- and mid-term patency rates, no incidences of conduit migration, easy handling, and good flexibility for length adjustment. Therefore, we suggest that the Hemashield graft is the preferentially suitable prosthetic material for MHV reconstruction.
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http://dx.doi.org/10.14701/ahbps.2021.25.1.46DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952673PMC
February 2021

Molecular basis of ice-binding and cryopreservation activities of type III antifreeze proteins.

Comput Struct Biotechnol J 2021 19;19:897-909. Epub 2021 Jan 19.

Department of Chemistry and Research Institute of Natural Science, Gyeongsang National University, Gyeongnam 52828, Republic of Korea.

Antifreeze proteins (AFPs) can inhibit the freezing of body fluid at subzero temperatures to promote the survival of various organisms living in polar regions. Type III AFPs are categorized into three subgroups, QAE1, QAE2, and SP isoforms, based on differences in their isoelectric points. We determined the thermal hysteresis (TH), ice recrystallization inhibition (IRI), and cryopreservation activity of three isoforms of the notched-fin eelpout AFP and their mutant constructs and characterized their structural and dynamic features using NMR. The QAE1 isoform is the most active among the three classes of III AFP isoforms, and the mutants of inactive QAE2 and SP isoforms, QAE2 and SP, displayed the full TH and IRI activities with resepect to QAE1 isoform. Cryopreservation studies using mouse ovarian tissue revealed that the QAE1 isoform and the active mutants, QAE2 and SP, more effectively preserved intact follicle morphology and prevented DNA double-strand break damage more efficiently than the inactive isoforms. It was also found that all active AFPs, QAE1, QAE2, and SP, formed unique H-bonds with the first 3 helix, an interaction that plays an important role in the formation of anchored clathrate water networks for efficient binding to the primary prism and pyramidal planes of ice crystals, which was disrupted in the inactive isoforms. Our studies provide valuable insights into the molecular mechanism of the TH and IRI activity, as well as the cryopreservation efficiency, of type III AFPs.
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http://dx.doi.org/10.1016/j.csbj.2021.01.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851773PMC
January 2021

Spatiotemporal habitats from multiparametric physiologic MRI distinguish tumor progression from treatment-related change in post-treatment glioblastoma.

Eur Radiol 2021 Feb 10. Epub 2021 Feb 10.

Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Objectives: We aimed to develop multiparametric physiologic MRI-based spatial habitats and to evaluate whether temporal changes in these habitats help to distinguish tumor progression from treatment-related change in post-treatment glioblastoma.

Methods: This retrospective, single-institution study included patients with glioblastoma treated by concurrent chemoradiotherapy who had newly developed or enlarging, measurable contrast-enhancing mass. Contrast-enhancing mass was divided into three spatial habitats by K-means clustering of voxel-wise ADC and CBV values. Temporal changes of these habitats between two consecutive examinations prior to the diagnosis of tumor progression or treatment-related change were assessed. Predictors were selected using logistic regression and the performance was measured with an area under the receiver operating characteristics curve (AUC). Spatiotemporal habitats were further analyzed for correlation with the site of tumor progression.

Results: There were 75 patients (mean, 58 years; range, 26-81 years; 43 men) with 48 cases of tumor progression and 39 cases of treatment-related change including 12 patient overlaps at different time points. Three spatial habitats of hypervascular cellular, hypovascular cellular, and nonviable tissue were identified. Increase in the hypervascular cellular (OR 4.55, p = .002) and hypovascular cellular habitat (OR 1.22, p < .001) was predictive of tumor progression. Combination of spatiotemporal habitats yielded a high diagnostic performance with an AUC of 0.89 (95% CI, 0.87-0.92). An increase in hypovascular cellular habitat predicted the site of tumor progression in 84% [21/25] of cases with tumor progression.

Conclusions: Temporal changes in spatial habitats derived from multiparametric physiologic MRI provided diagnostic value in distinguishing tumor progression from treatment-related change and predicted site of tumor progression in post-treatment glioblastoma.

Key Points: • In post-treatment glioblastoma, three spatial habitats of hypervascular cellular, hypovascular cellular, and nonviable tissue were identified, and an increase in the hypervascular cellular (OR 4.55, p = .002) and hypovascular cellular habitat (OR 1.22, p < .001) was predictive of tumor progression. • Combination of spatiotemporal habitats yielded a high diagnostic performance with an AUC of 0.89 (95% CI, 0.87-0.92). • An increase in hypovascular cellular habitat predicted the site of tumor progression in 84% (21/25) of cases with tumor progression.
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http://dx.doi.org/10.1007/s00330-021-07718-yDOI Listing
February 2021

Diagnostic performance of loss of nigral hyperintensity on susceptibility-weighted imaging in parkinsonism: an updated meta-analysis.

Eur Radiol 2021 Jan 15. Epub 2021 Jan 15.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 33, Seoul, 05505, Republic of Korea.

Objectives: To evaluate diagnostic performance of loss of nigral hyperintensity on SWI in differentiating idiopathic Parkinson's disease (IPD) or primary parkinsonism (including IPD and Parkinson-plus syndrome) from healthy/disease controls.

Methods: MEDLINE/PubMed and EMBASE databases were searched to identify original articles investigating the diagnostic performance of loss of nigral hyperintensity for differentiating IPD or primary parkinsonism from healthy/disease control, up to April 3, 2020. Pooled sensitivity and specificity were calculated using a bivariate random-effects model. The proportion of nondiagnostic scan, inter- and intrareader agreement, and the proportion of concordance between clinical laterality and imaging asymmetry were also pooled.

Results: Nineteen articles covering 2125 patients (1097 with primary parkinsonism, 1028 healthy/disease controls) were included. For discrimination between IPD and healthy/disease controls, pooled sensitivity and specificity were 0.96 (95% CI, 0.91-0.98) and 0.95 (95% CI, 0.92-0.97). For discrimination between primary parkinsonism and healthy/disease controls, pooled sensitivity and specificity were 0.87 (95% CI, 0.75-0.94) and 0.93 (95% CI, 0.85-0.97). The pooled proportion of non-diagnostic scans on random-effects modeling was 4.2% (95% CI, 2.5-6.9%). The inter- and intrareader agreements were almost perfect, with the pooled coefficients being 0.84 (95% CI, 0.78-0.89) and 0.96 (95% CI, 0.89-0.99), respectively. The pooled proportion of concordant cases was 69.3% (95% CI, 58.4-78.4%).

Conclusions: Loss of nigral hyperintensity on SWI can differentiate IPD or primary parkinsonism from a healthy/disease control group with high accuracy. However, the proportion of non-diagnostic scans is not negligible and must be taken into account.

Key Points: • For discrimination between idiopathic Parkinson's disease and healthy/disease controls, pooled sensitivity and specificity of loss of nigral hyperintensity were 0.96 and 0.95. • For discrimination between primary parkinsonism and healthy/disease controls, pooled sensitivity and specificity of loss of nigral hyperintensity were 0.87 and 0.93. • The pooled proportion of non-diagnostic scans on random-effects modeling was 4.2%.
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http://dx.doi.org/10.1007/s00330-020-07627-6DOI Listing
January 2021

Diagnostic performance and interobserver agreement of the callosal angle and Evans' index in idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis.

Eur Radiol 2021 Jan 6. Epub 2021 Jan 6.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Olympic-ro 33, Seoul, 05505, Republic of Korea.

Objective: To evaluate the diagnostic performance and interobserver agreement of the callosal angle and Evans' index in idiopathic normal pressure hydrocephalus (iNPH).

Methods: A systematic search of MEDLINE and EMBASE was performed to find studies assessing the diagnostic performance or interobserver agreement of the callosal angle and Evans' index in iNPH. Pooled sensitivity and specificity of the two radiologic indices were calculated. The area under the curve (AUC) was obtained based on a hierarchical summary receiver operating characteristic curve. The diagnostic performances of both radiologic indices were compared in subgroup analysis. To evaluate interobserver agreement, the pooled correlation coefficient was calculated.

Results: Ten original articles (874 patients) were included. The pooled sensitivity and specificity of the callosal angle in the diagnosis of iNPH were 91% (95% CI, 86-94%) and 93% (95% CI, 89-96%), respectively. The pooled sensitivity and specificity of Evans' index were 96% (95% CI, 47-100%) and 83% (95% CI, 77-88%), respectively. Subgroup analysis demonstrated a significant higher specificity of the callosal angle than that of Evans' index (p < 0.01). The AUC of the callosal angle and Evans' index were 0.97 (95% CI, 0.95-0.98) and 0.87 (95% CI, 0.84-0.90), respectively. The pooled correlation coefficients for the callosal angle and Evans' index were 0.92 (95% CI, 0.82-0.96) and 0.92 (95% CI, 0.83-0.97), respectively.

Conclusions: Our meta-analysis demonstrated a high performance of the callosal angle in the diagnosis of iNPH. Evans' index showed reasonable diagnostic performance with high sensitivity but low specificity. Interobserver agreements were excellent in both radiologic indices.

Key Points: • Callosal angle showed high diagnostic performance in idiopathic normal pressure hydrocephalus. • Evans' index showed reasonable diagnostic performance with high sensitivity but low specificity. • Interobserver agreements were excellent in both callosal angle and Evans' index.
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http://dx.doi.org/10.1007/s00330-020-07555-5DOI Listing
January 2021

Copper-Catalyzed Enantiotopic-Group-Selective Allylation of -Diborylalkanes.

J Am Chem Soc 2021 01 4;143(2):1069-1077. Epub 2021 Jan 4.

Department of Chemistry, Pohang University of Science and Technology (POSTECH), Pohang 37673, Republic of Korea.

We report a copper-catalyzed enatiotopic-group-selective allylation of -diborylalkanes with allyl bromides. The combination of copper(I) bromide and H-BINOL derived phosphoramidite ligand proved to be the most effective catalytic system to provide various enantioenriched homoallylic boronate esters, containing a boron-substituted stereogenic center that is solely derived from -diborylalkanes, in good yields with high enantiomeric ratios under mild conditions. Experimental and theoretical studies have been conducted to elucidate the reaction mechanism, revealing how the enatiotopic-group-selective transmetalation of -diborylalkanes with chiral copper complex occurs to generate chiral α-borylalkyl-copper species for the first time. Additional synthetic applications to the synthesis of various chiral building blocks are also included.
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http://dx.doi.org/10.1021/jacs.0c11750DOI Listing
January 2021

Simultaneous liver-kidney transplantation: A single-center experience in Korea.

Ann Hepatobiliary Pancreat Surg 2020 Nov;24(4):454-459

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Seoul, Korea.

Backgrounds/aims: Simultaneous liver and kidney transplantation (SLKT) has been established as the treatment of choice for patients with concurrent end-stage liver and end-stage kidney diseases. The objective of this study was to analyze the nationwide incidence of SLKT in Korea and the outcomes of SLKT in a high-volume transplant center.

Methods: Databases of the Korean Network for Organ Sharing (KONOS) and Asan Medical Center from 2000 to 2019 were retrospectively reviewed to determine the incidence of SLKT.

Results: During 20 years from 2000 to 2019, deceased donor SLKT was performed for 38 cases in the KONOS database. The proportion of deceased donor SLKT was 0.6% (20 of 3333) before adoption of MELD score, which was significantly increased to 1.2% (18 of 1524) after the adoption of MELD score (=0.034). In our institution, there were 11 cases of SLKT (2 cases with deceased donors and 9 cases with living donors). SLKT accounted for 0.2% (11 of 6468) of total liver transplantation volume. During follow-up, five patients died due to hepatocellular carcinoma recurrence (n=2), infection (n=2), or unknown cause (n=1). The 1-year and 10-year overall patient survival rates were 90.9% and 81.8%, respectively.

Conclusions: Results of this study revealed that the incidence of deceased donor SLKT was very low. An increase of such incidence is not anticipated unless the number of deceased donors is markedly increased. Currently, sequential living donor liver transplantation and kidney transplantation with deceased or living donors are mainstays of transplantation rather than SLKT in our institution.
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http://dx.doi.org/10.14701/ahbps.2020.24.4.454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691209PMC
November 2020

Simultaneous liver-kidney transplantation: A single-center experience in Korea.

Ann Hepatobiliary Pancreat Surg 2020 Nov;24(4):454-459

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Seoul, Korea.

Backgrounds/aims: Simultaneous liver and kidney transplantation (SLKT) has been established as the treatment of choice for patients with concurrent end-stage liver and end-stage kidney diseases. The objective of this study was to analyze the nationwide incidence of SLKT in Korea and the outcomes of SLKT in a high-volume transplant center.

Methods: Databases of the Korean Network for Organ Sharing (KONOS) and Asan Medical Center from 2000 to 2019 were retrospectively reviewed to determine the incidence of SLKT.

Results: During 20 years from 2000 to 2019, deceased donor SLKT was performed for 38 cases in the KONOS database. The proportion of deceased donor SLKT was 0.6% (20 of 3333) before adoption of MELD score, which was significantly increased to 1.2% (18 of 1524) after the adoption of MELD score (=0.034). In our institution, there were 11 cases of SLKT (2 cases with deceased donors and 9 cases with living donors). SLKT accounted for 0.2% (11 of 6468) of total liver transplantation volume. During follow-up, five patients died due to hepatocellular carcinoma recurrence (n=2), infection (n=2), or unknown cause (n=1). The 1-year and 10-year overall patient survival rates were 90.9% and 81.8%, respectively.

Conclusions: Results of this study revealed that the incidence of deceased donor SLKT was very low. An increase of such incidence is not anticipated unless the number of deceased donors is markedly increased. Currently, sequential living donor liver transplantation and kidney transplantation with deceased or living donors are mainstays of transplantation rather than SLKT in our institution.
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http://dx.doi.org/10.14701/ahbps.2020.24.4.454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691209PMC
November 2020

Thin-Slice Pituitary MRI with Deep Learning-based Reconstruction: Diagnostic Performance in a Postoperative Setting.

Radiology 2021 01 3;298(1):114-122. Epub 2020 Nov 3.

From the Department of Radiology and Research Institute of Radiology (M.K., H.S.K., H.J.K., J.E.P., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.Y.P.), and Department of Neurosurgery (Y.H.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-Gu, Seoul 05505, South Korea; GE Healthcare Korea, Seoul, Korea (J.L.); GE Healthcare Canada, Calgary, Canada (M.R.L.); and Department of Radiology, University of Calgary, Calgary, Canada (M.R.L.).

Background Achieving high-spatial-resolution pituitary MRI is challenging because of the trade-off between image noise and spatial resolution. Deep learning-based MRI reconstruction enables image denoising with sharp edges and reduced artifacts, which improves the image quality of thin-slice MRI. Purpose To assess the diagnostic performance of 1-mm slice thickness MRI with deep learning-based reconstruction (DLR) (hereafter, 1-mm MRI+DLR) compared with 3-mm slice thickness MRI (hereafter, 3-mm MRI) for identifying residual tumor and cavernous sinus invasion in the evaluation of postoperative pituitary adenoma. Materials and Methods This single-institution retrospective study included 65 patients (mean age ± standard deviation, 54 years ± 10; 26 women) who underwent a combined imaging protocol including 3-mm MRI and 1-mm MRI+DLR for postoperative evaluation of pituitary adenoma between August and October 2019. Reference standards for correct diagnosis were established by using all available imaging resources, clinical histories, laboratory findings, surgical records, and pathology reports. The diagnostic performances of 3-mm MRI, 1-mm slice thickness MRI without DLR (hereafter, 1-mm MRI), and 1-mm MRI+DLR for identifying residual tumor and cavernous sinus invasion were evaluated by two readers and compared between the protocols. Results The performance of 1-mm MRI+DLR in the identification of residual tumor was comparable to that of 3-mm MRI (area under the receiver operating characteristic curve [AUC], 0.89-0.92 vs 0.85-0.89, respectively; ≥ .09). In the identification of cavernous sinus invasion, the diagnostic performance of 1-mm MRI+DLR was higher than that of 3-mm MRI (AUC, 0.95-0.98 vs 0.83-0.87, respectively; ≤ .02). Conventional 1-mm MRI (AUC, 0.82-0.83) showed comparable diagnostic performance to 3-mm MRI (AUC, 0.83-0.87) ( ≥ .38). With 1-mm MRI+DLR, residual tumor was diagnosed in 20 patients and cavernous sinus invasion was diagnosed in 14 patients, in whom these diagnoses were not made with 3-mm MRI. Conclusion In the postoperative evaluation of pituitary adenoma, 1-mm slice thickness MRI with deep learning-based reconstruction showed higher diagnostic performance than 3-mm slice thickness MRI in the identification of cavernous sinus invasion and comparable diagnostic performance to 3-mm slice thickness MRI in the identification of residual tumor. © RSNA, 2020
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http://dx.doi.org/10.1148/radiol.2020200723DOI Listing
January 2021

Ultra-High Energy Density Hybrid Supercapacitors Using MnO/Reduced Graphene Oxide Hybrid Nanoscrolls.

Nanomaterials (Basel) 2020 Oct 16;10(10). Epub 2020 Oct 16.

School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju 61005, Korea.

Manganese oxide (MnO) is a promising material for supercapacitor applications, with a theoretical ultra-high energy density of 308 Wh/kg. However, such ultra-high energy density has not been achieved experimentally in MnO-based supercapacitors because of several practical issues, such as low electrical conductivity of MnO, incomplete utilization of MnO, and dissolution of MnO The present study investigates the potential of MnO/reduced graphene oxide (rGO) hybrid nanoscroll (GMS) structures as electrode material for overcoming the difficulties and for developing ultra-high-energy storage systems. A hybrid supercapacitor, comprising MnO/rGO nanoscrolls as anode material and activated carbon (AC) as a cathode, is fabricated. The GMS/AC hybrid supercapacitor exhibited enhanced energy density, superior rate performance, and promising Li storage capability that bridged the energy-density gap between conventional Li-ion batteries (LIBs) and supercapacitors. The fabricated GMS/AC hybrid supercapacitor demonstrates an ultra-high lithium discharge capacity of 2040 mAh/g. The GMS/AC cell delivered a maximum energy density of 105.3 Wh/kg and a corresponding power density of 308.1 W/kg. It also delivered an energy density of 42.77 Wh/kg at a power density as high as 30,800 W/kg. Our GMS/AC cell's energy density values are very high compared with those of other reported values of graphene-based hybrid structures. The GMS structures offer significant potential as an electrode material for energy-storage systems and can also enhance the performance of the other electrode materials for LIBs and hybrid supercapacitors.
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http://dx.doi.org/10.3390/nano10102049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603058PMC
October 2020

Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study.

JMIR Mhealth Uhealth 2020 10 16;8(10):e22080. Epub 2020 Oct 16.

Graduate Program in Speech-Language Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Background: Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults.

Objective: The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults.

Methods: We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant's progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention.

Results: Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed.

Conclusions: Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted.

International Registered Report Identifier (irrid): RR2-10.2196/19585.
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http://dx.doi.org/10.2196/22080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600016PMC
October 2020

Prognosis of Split Liver Transplantation Compared with Whole Liver Transplantation in Adult Patients: Single-center Results under the Korean MELD Score-based Allocation Policy.

J Korean Med Sci 2020 Sep 21;35(37):e304. Epub 2020 Sep 21.

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: Split liver transplantation (SLT) has been occasionally performed in Korea. This study compared the incidence and prognosis of SLT with whole liver transplantation (WLT) in adult patients.

Methods: Between June 2016 and November 2019, 242 adult patients underwent a total of 256 deceased donor liver transplantation operations. SLT was performed in 7 patients (2.9%).

Results: The mean age of SLT donors was 29.7 ± 7.4 years, and the mean age of recipients was 55.7 ± 10.6 years, with the latter having a mean model for end-stage liver disease score of 34.6 ± 3.1. Mean split right liver graft weight was 1,228.6 ± 149.7 g and mean graft-recipient weight ratio was 1.97 ± 0.39. Of the seven SLT recipients, Korean Network for Organ Sharing (KONOS) status was one in status 1, one in status 2 and five in status 3. The graft ( = 0.72) and patient ( = 0.84) survival rates were comparable in the SLT and WLT groups. Following propensity score matching, graft ( = 0.61) and patient ( = 0.91) survival rates remained comparable in the two groups. Univariate analysis showed that pretransplant ventilator support and renal replacement therapy were significantly associated with patient survival, whereas KONOS status category and primary liver diseases were not. Multivariate analysis showed that pretransplant ventilator support was an independent risk factor for patient survival.

Conclusion: Survival outcomes were similar in adult SLT and WLT recipients, probably due to selection of high-quality grafts and low-risk recipients. Prudent selection of donors and adult recipients for SLT may expand the liver graft pool for pediatric patients without affecting outcomes in adults undergoing SLT.
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http://dx.doi.org/10.3346/jkms.2020.35.e304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505731PMC
September 2020

Theory of Mind Following the Violation of Strong and Weak Prior Beliefs.

Cereb Cortex 2021 Jan;31(2):884-898

Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA 02467, USA.

Recent work in psychology and neuroscience has revealed differences in impression updating across social distance and group membership. Observers tend to maintain prior impressions of close (vs. distant) and ingroup (vs. outgroup) others in light of new information, and this belief maintenance is at times accompanied by increased activity in Theory of Mind regions. It remains an open question whether differences in the strength of prior beliefs, in a context absent social motivation, contribute to neural differences during belief updating. We devised a functional magnetic resonance imaging study to isolate the impact of experimentally induced prior beliefs on mentalizing activity. Participants learned about targets who performed 2 or 4 same-valenced behaviors (leading to the formation of weak or strong priors), before performing 2 counter-valenced behaviors. We found a greater change in activity in dorsomedial prefrontal cortex (DMPFC) and right temporo-parietal junction following the violation of strong versus weak priors, and a greater change in activity in DMPFC and left temporo-parietal junction following the violation of positive versus negative priors. These results indicate that differences in neural responses to unexpected behaviors from close versus distant others, and ingroup versus outgroup members, may be driven in part by differences in the strength of prior beliefs.
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http://dx.doi.org/10.1093/cercor/bhaa263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786349PMC
January 2021

Theory of Mind Following the Violation of Strong and Weak Prior Beliefs.

Cereb Cortex 2021 Jan;31(2):884-898

Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA 02467, USA.

Recent work in psychology and neuroscience has revealed differences in impression updating across social distance and group membership. Observers tend to maintain prior impressions of close (vs. distant) and ingroup (vs. outgroup) others in light of new information, and this belief maintenance is at times accompanied by increased activity in Theory of Mind regions. It remains an open question whether differences in the strength of prior beliefs, in a context absent social motivation, contribute to neural differences during belief updating. We devised a functional magnetic resonance imaging study to isolate the impact of experimentally induced prior beliefs on mentalizing activity. Participants learned about targets who performed 2 or 4 same-valenced behaviors (leading to the formation of weak or strong priors), before performing 2 counter-valenced behaviors. We found a greater change in activity in dorsomedial prefrontal cortex (DMPFC) and right temporo-parietal junction following the violation of strong versus weak priors, and a greater change in activity in DMPFC and left temporo-parietal junction following the violation of positive versus negative priors. These results indicate that differences in neural responses to unexpected behaviors from close versus distant others, and ingroup versus outgroup members, may be driven in part by differences in the strength of prior beliefs.
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http://dx.doi.org/10.1093/cercor/bhaa263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786349PMC
January 2021

Diagnostic Yield of Staging Brain MRI in Patients with Newly Diagnosed Non-Small Cell Lung Cancer.

Radiology 2020 11 25;297(2):419-427. Epub 2020 Aug 25.

From the Department of Radiology and Research Institute of Radiology (M.K., C.H.S., S.M.L., H.S.K.) and Department of Pulmonology and Critical Care Medicine (H.C.K.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, Seoul 05505, Republic of Korea; Department of Radiation Oncology (A.A.A.) and Division of Neuroradiology (J.P.G., R.Y.H.), Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Mass; Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (T.K.Y.); and Department of Diagnostic Imaging, Rhode Island Hospital and Warren Alpert Medical School of Brown University, Providence, RI (H.X.B.).

Background Existing guidelines are inconsistent regarding the indications for staging brain MRI in patients with newly diagnosed, early-stage non-small cell lung cancer (NSCLC). Purpose To evaluate the diagnostic yield of staging brain MRI in the initial evaluation of lung cancer. Materials and Methods This retrospective, observational, single-institution study included patients with newly diagnosed NSCLC who underwent staging chest CT and staging brain MRI from November 2017 to October 2018. Diagnostic yield was defined as the proportion of patients with brain metastases among all patients. Yield was stratified into clinical stage groups per the eighth edition of the American Joint Committee on Cancer staging guidelines, based on staging chest CT and in adenocarcinoma with epidermal growth factor receptor gene mutation and anaplastic lymphoma kinase gene rearrangement. Subgroup analyses were performed on the basis of cell types and molecular markers. The χ test was performed to compare the diagnostic yields, and Bonferroni correction was used to account for multiple testing between stage groups. Results A total of 1712 patients (mean age, 64 years ± 10 [standard deviation]; 1035 men) were included. The diagnostic yield of staging brain MRI in newly diagnosed NSCLC was 11.9% (203 of 1712; 95% confidence interval [CI]: 10.4%, 13.5%). In clinical stage IA, IB, and II disease, the diagnostic yields were 0.3% (two of 615; 95% CI: 0.0%, 1.2%), 3.8% (seven of 186; 95% CI: 1.5%, 7.6%), and 4.7% (eight of 171; 95% CI: 2.0%, 9.0%), respectively. The diagnostic yield was higher in patients with adenocarcinoma (13.6%; 176 of 1297; 95% CI: 11.8%, 15.6%) than squamous cell carcinoma (5.9%; 21 of 354; 95% CI: 3.7%, 8.9%) and in patients with mutation-positive adenocarcinoma (17.5%; 85 of 487; 95% CI: 14.2%, 21.1%) than with mutation-negative adenocarcinoma (10.6%; 68 of 639; 95% CI: 8.4%, 13.3%) ( < .001 for both). Conclusion The diagnostic yield of staging brain MRI in clinical stage IA non-small cell lung cancer was low, but staging brain MRI had a higher diagnostic yield in clinical stage IB and epidermal growth factor receptor mutation-positive adenocarcinoma. © RSNA, 2020
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http://dx.doi.org/10.1148/radiol.2020201194DOI Listing
November 2020

Development of an Ultrasonic Doppler Sensor-Based Swallowing Monitoring and Assessment System.

Sensors (Basel) 2020 Aug 13;20(16). Epub 2020 Aug 13.

Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang 37673, Korea.

Existing swallowing evaluation methods using X-ray or endoscopy are qualitative. The present study develops a swallowing monitoring and assessment system (SMAS) that is nonintrusive and quantitative. The SMAS comprises an ultrasonic Doppler sensor array, a microphone, and an inertial measurement unit to measure ultrasound signals originating only from swallowing activities. Ultrasound measurements were collected for combinations of two viscosity conditions (water and yogurt) and two volume conditions (3 mL and 9 mL) from 24 healthy participants (14 males and 10 females; age = 30.5 ± 7.6 years) with no history of swallowing disorders and were quantified for 1st peak amplitude, 2nd peak amplitude, peak-to-peak (PP) time interval, duration, energy, and proportion of two or more peaks. The peak amplitudes and energy significantly decreased by viscosity and the PP time interval and duration increased by volume. The correlation between the time measures were higher ( = 0.78) than that of the amplitude measures ( = 0.30), and the energy highly correlated with the 1st peak amplitude ( = 0.86). The proportion of two or more peaks varied from 76.8% to 87.9% by viscosity and volume. Further research is needed to examine the concurrent validity and generalizability of the ultrasonic Doppler sensor-based SMAS.
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http://dx.doi.org/10.3390/s20164529DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472343PMC
August 2020

Heterologous Gene Expression System Using the Cold-Inducible Promoter in .

J Microbiol Biotechnol 2020 Nov;30(11):1777-1784

Department of Life Science, Research Institute for Natural Sciences, Hanyang University, Seoul 04763, Republic of Korea.

To increase the availability of microalgae as producers of valuable compounds, it is necessary to develop novel systems for gene expression regulation. Among the diverse expression systems available in microalgae, none are designed to induce expression by low temperature. In this study, we explored a cold-inducible system using the antifreeze protein (AFP) promoter from a polar diatom, . A vector containing the promoter () was generated to regulate nuclear gene expression, and reporter genes ( luciferase () and mVenus fluorescent protein ()) were successfully expressed in the model microalga, . In particular, under the control of , the expression of these genes was increased at low temperature, unlike , a promoter that is widely used for gene expression in . Promoter truncation assays showed that cold inducibility was still present even when was shortened to 600 bp, indicating the presence of a low-temperature response element between -600 and -477 bp. Our results show the availability of new heterologous gene expression systems with cold-inducible promoters and the possibility to find novel low-temperature response factors in microalgae. Through further improvement, this cold-inducible promoter could be used to develop more efficient expression tools.
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http://dx.doi.org/10.4014/jmb.2007.07024DOI Listing
November 2020

Intraoperative Data Enhance the Detection of High-Risk Acute Kidney Injury Patients When Added to a Baseline Prediction Model.

Anesth Analg 2021 02;132(2):430-441

From the Department of Anesthesiology, Columbia University Medical Center, New York, New York.

Background: Aspects of intraoperative management (eg, hypotension) are associated with acute kidney injury (AKI) in noncardiac surgery patients. However, it is unclear if and how the addition of intraoperative data affects a baseline risk prediction model for postoperative AKI.

Methods: With institutional review board (IRB) approval, an institutional cohort (2005-2015) of inpatient intra-abdominal surgery patients without preoperative AKI was identified. Data from the American College of Surgeons National Surgical Quality Improvement Program (preoperative and procedure data), Anesthesia Information Management System (intraoperative data), and electronic health record (postoperative laboratory data) were linked. The sample was split into derivation/validation (70%/30%) cohorts. AKI was defined as an increase in serum creatinine ≥0.3 mg/dL within 48 hours or >50% within 7 days of surgery. Forward logistic regression fit a baseline model incorporating preoperative variables and surgical procedure. Forward logistic regression fit a second model incorporating the previously selected baseline variables, as well as additional intraoperative variables. Intraoperative variables reflected the following aspects of intraoperative management: anesthetics, beta-blockers, blood pressure, diuretics, fluids, operative time, opioids, and vasopressors. The baseline and intraoperative models were evaluated based on statistical significance and discriminative ability (c-statistic). The risk threshold equalizing sensitivity and specificity in the intraoperative model was identified.

Results: Of 2691 patients in the derivation cohort, 234 (8.7%) developed AKI. The baseline model had c-statistic 0.77 (95% confidence interval [CI], 0.74-0.80). The additional variables added to the intraoperative model were significantly associated with AKI (P < .0001) and the intraoperative model had c-statistic 0.81 (95% CI, 0.78-0.83). Sensitivity and specificity were equalized at a risk threshold of 9.0% in the intraoperative model. At this threshold, the baseline model had sensitivity and specificity of 71% (95% CI, 65-76) and 69% (95% CI, 67-70), respectively, and the intraoperative model had sensitivity and specificity of 74% (95% CI, 69-80) and 74% (95% CI, 73-76), respectively. The high-risk group had an AKI risk of 18% (95% CI, 15-20) in the baseline model and 22% (95% CI, 19-25) in the intraoperative model.

Conclusions: Intraoperative data, when added to a baseline risk prediction model for postoperative AKI in intra-abdominal surgery patients, improves the performance of the model.
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http://dx.doi.org/10.1213/ANE.0000000000005057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855510PMC
February 2021

Do Antifibrinolytic Agents Reduce the Risk of Blood Transfusion in Children Undergoing Spinal Fusion?: A Propensity Score-matched Comparison Using a National Database.

Spine (Phila Pa 1976) 2020 Aug;45(15):1055-1061

Anesthesiology, Columbia University Medical Center, New York, NY.

Study Design: Retrospective cohort.

Objective: To evaluate the effectiveness and safety of antifibrinolytic (AF) agents in reducing perioperative blood transfusion in pediatric patients undergoing spinal fusion.

Summary Of Background Data: The potential for AF to decrease bleeding and reduce exposure to allogenic transfusions has led to widespread off-label use in a number of major pediatric surgical procedures. Recent reviews call for improving the body of evidence for their effectiveness and safety in pediatric spinal fusion.

Methods: Children undergoing spinal fusion were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP-P) 2016 and 2017 databases. Univariate analyses of patient and perioperative characteristics informed the creation of a propensity score model predicting treatment with AF, followed by 1:1 matching to allow comparison of allogenic red blood cell transfusion rates and secondary outcomes between treated and untreated patients.

Results: Of 6626 total patients, 5434 (81%) received AF and 1533 (23%) received a blood transfusion. Analysis of data for 1192 propensity score-matched pairs revealed that treatment with AF was associated with a statistically nonsignificant 16% reduction in perioperative transfusion (OR 0.84, 95% confidence interval 0.68-1.05, P = 0.119) and a statistically significant 43% reduction in postoperative transfusion (OR 0.57, 95% confidence interval 0.39-0.81, P = 0.002). No differences in the incidences of postoperative seizure or thrombosis were observed, with overall rates of 7.5 and 22.5 events per 10,000 patients, respectively.

Conclusion: AF agents appear to reduce postoperative allogenic transfusion in children undergoing spinal fusion surgery. Adverse drug effects such as thromboembolic complications and seizure were extremely rare and warrant continued monitoring, though this is the largest study to date providing evidence for the safety profile of these drugs.

Level Of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000003455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120993PMC
August 2020

Integrated Omics Elucidate the Mechanisms Driving the Rapid Biodegradation of Deepwater Horizon Oil in Intertidal Sediments Undergoing Oxic-Anoxic Cycles.

Environ Sci Technol 2020 08 5;54(16):10088-10099. Epub 2020 Aug 5.

Department of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta 30332-0002, Georgia, United States.

Crude oil buried in intertidal sands may be exposed to alternating oxic and anoxic conditions but the effect of this tidally induced biogeochemical oscillation remains poorly understood, limiting the effectiveness of remediation and managing efforts after oil spills. Here, we used a combination of metatranscriptomics and genome-resolved metagenomics to study microbial activities in oil-contaminated sediments during oxic-anoxic cycles in laboratory chambers that closely emulated in situ conditions. Approximately 5-fold higher reductions in the total petroleum hydrocarbons were observed in the oxic as compared to the anoxic phases with a relatively constant ratio between aerobic and anaerobic oil decomposition rates even after prolonged anoxic conditions. Metatranscriptomics analysis indicated that the oxic phases promoted oil biodegradation in subsequent anoxic phases by microbially mediated reoxidation of alternative electron acceptors like sulfide and by providing degradation-limiting nitrogen through biological nitrogen fixation. Most population genomes reconstructed from the mesocosm samples represented uncultured taxa and were present typically as members of the rare biosphere in metagenomic data from uncontaminated field samples, implying that the intertidal communities are adapted to changes in redox conditions. Collectively, these results have important implications for enhancing oil spill remediation efforts in beach sands and coastal sediments and underscore the role of uncultured taxa in such efforts.
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http://dx.doi.org/10.1021/acs.est.0c02834DOI Listing
August 2020