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Background: Islet transplantation holds promise for treating selected type 1 diabetes mellitus patients, yet the scarcity of human donor organs impedes widespread adoption. Porcine islets, deemed a viable alternative, recently demonstrated successful longterm survival without zoonotic risks in a clinically relevant pig-to-non-human primate islet transplantation model. This success prompted the development of a clinical trial protocol for porcine islet xenotransplantation in humans.Methods: A single-center, open-label clinical trial initiated by the sponsor will assess the safety and efficacy of porcine islet transplantation for diabetes patients at Gachon Hospital. The protocol received approval from the Gachon Hospital Institutional Review Board (IRB) and the Korean Ministry of Food and Drug Safety (MFDS) under the Investigational New Drug (IND) process. Two diabetic patients, experiencing inadequate glycemic control despite intensive insulin treatment and frequent hypoglycemic unawareness, will be enrolled. Participants and their family members will engage in deliberation before xenotransplantation during the screening period. Each patient will receive islets isolated from designated pathogen-free pigs. Immunosuppressants and systemic infection prophylaxis will follow the program schedule. The primary endpoint is to confirm the safety of porcine islets in patients, and the secondary endpoint is to assess whether porcine islets can reduce insulin dose and the frequency of hypoglycemic unawareness.Conclusion: A clinical trial protocol adhering to global consensus guidelines for porcine islet xenotransplantation is presented, facilitating streamlined implementation of comparable human trials worldwide.

Background: Multimodal treatment approaches are often considered for patients with Lennox-Gastaut syndrome (LGS). Creating an algorithm that can guide healthcare providers in selecting treatment options for patients with LGS remains a challenge. Herein, we assessed the long-term seizure-free and neurodevelopmental outcomes of stepwise multimodal treatment in patients with LGS. Objective: Herein, we assess the long-term seizure-free and neurodevelopmental outcomes of stepwise multimodal treatment in patients with LGS. Methods: We retrospectively examined the data of 371 patients with LGS who underwent stepwise multimodal treatment, including antiseizure medication (ASM) therapy, dietary therapy (DT), resective epilepsy surgery (R-ES), and palliative epilepsy surgery (P-ES). The seizure-free outcome was considered to be the effect of the final treatment according to the treatment algorithm, and the percentage of patients who remained seizure-free in each treatment group was calculated. ASM treatment, DT, R-ES, and P-ES were applied to 371 (100%), 201 (54.2%), 112 (30.2%), and 115 (31.0%) patients with LGS, respectively. We evaluated the stepwise multimodal treatment outcomes in these patients. Results: One hundred sixty-eight patients (45.3%) remained seizure-free for at least 1 year (seizure-free-for-1-year group), 61 of whom (16.5%) remained seizure-free for more than 5 years (remained-seizure-free group). Among the patients treated with ASM therapy, DT, R-ES, and P-ES, 41 (11.1%), 53 (14.3%), 56 (15.1%), and 29 (7.8%), respectively, remained seizure-free for 1 year. In addition, 15 (4.1%), 15 (4.1%), 19 (5.1%), and 12 (3.2%) patients in the ASM, DT, R-ES, and P-ES treatment groups, respectively, remained seizure-free for more than 5 years. Both the seizure-free-for-1-year and remained-seizure-free groups showed significant improvement in electroencephalography findings and neurodevelopmental status following treatment. Conclusion: This study provides an update on the long-term seizure outcomes and neurodevelopmental improvements in a large cohort of patients with LGS following comprehensive multimodal treatment. We emphasize that the active combination of multiple ASMs, DT, and surgical treatment could provide long-term seizure-free outcomes and significant neurological benefits to patients with LGS.

Chronic lymphocytic leukaemia (CLL) exhibits differences between Asians and Caucasians in terms of incidence rate, age at onset, immunophenotype, and genetic profile. We performed genome-wide methylation profiling of CLL in an Asian cohort for the first time. Eight Korean patients without somatic immunoglobulin heavy chain gene hypermutations underwent methyl-CpG-binding domain sequencing (MBD-seq), as did five control subjects. Gene Ontology, pathway analysis, and network-based prioritization of differentially methylated genes were also performed. More regions were hypomethylated (2,062 windows) than were hypermethylated (777 windows). Promoters contained the highest proportion of differentially methylated regions (0.08%), while distal intergenic and intron regions contained the largest number of differentially methylated regions. Protein-coding genes were the most abundant, followed by long noncoding and short noncoding genes. The most significantly over-represented signalling pathways in the differentially methylated gene list included immune/cancer-related pathways and B-cell receptor signalling. Among the top 10 hub genes identified via network-based prioritization, four ( UBC , GRB2 , CREBBP , and GAB2 ) had no known relevance to CLL, while the other six ( STAT3 , PTPN6 , SYK , STAT5B , XPO1 , and ABL1 ) have previously been linked to CLL in Caucasians. As such, our analysis identified four novel candidate genes of potential significance to Asian patients with CLL.

The Internet of things (IoT) technology, which is currently considered the new growth engine of the fourth industrial revolution, affects our daily life and has been applied to various industrial fields. Studies on overcoming the limitations of scalability and stability in a centralized IoT operating environment by employing distributed blockchain technology have been actively conducted. However, the nature of IoT that ensures connectivity with multiple objects at any time and any place increases security threats. Further, it extends the influence of the cyber world into the physical domain, resulting in serious damage to human life and property. Therefore, we aim to study a method to increase the security of IoT devices and effectively extend them simultaneously. To this end, we analyze the authentication methods and limitations of traditional IoT devices and examine cases for improving IoT environments by using blockchain technology. Accordingly, we propose a framework that allows IoT devices to be securely connected and extended to other devices by automatically evaluating security using blockchain technology and the whitelist. The method proposed in this paper restricts the extension of devices vulnerable to security risks by imposing penalties and allows only devices with high security to be securely and quickly authenticated and extended without user intervention. In this study, we applied the proposed method to IoT network simulation environments and observed that the number of devices vulnerable to security was reduced by 48.5% compared with traditional IoT environments.

Purpose This paper aims to understand the relationships among calling, employee engagement, work-life balance and life satisfaction for executive chefs based on role theory and spillover theory. Design/methodology/approach Surveys were completed by members of the American Culinary Federation in North America, the Nevada Restaurant Association and attendees at the ChefConnect Annual Conference. The data were analysed with confirmatory factor analysis and structural equation modelling. Findings All relationships in the model were significantly positive except for calling to life satisfaction. Importantly work-life balance was a significant mediator between calling and life satisfaction as well as for employee engagement and life satisfaction. Research limitations/implications The research provides a more comprehensive framework for hospitality scholars to understand the outcomes of work as a calling through meaningfulness. The sample of executive chef limits generalizability. Practical implications The identification of a calling through in-depth interviews is recommended. Once recognized, managers should further foster chef’s passion through employee engagement facilitated by workplace autonomy and continuing education and work-life balance supported with human resource management practices including time off for critical life events. This will allow calling to flourish, increase life satisfaction and reduce the likelihood of turnover and burnout. Originality/value Outcomes reveal the complexity of the relationship between calling and life satisfaction. Contrary to previous findings, the presence of positive work-life balance was critical to attain life satisfaction, even when work was viewed as a calling.

Semantic mapping plays an important role in the mobile robotic area, helping robots to perform numerous complicated tasks in both industry and daily life. According to the semantic map, the robot can automatically operate some challenging tasks such as path-planning, place localization, and human-robot interaction. Also, the terminologies of a group of homogenous or heterogeneous robots that perform a general purpose to solve a heavy task with resource limitation become more popular in robot society. To build a multi-robot system, the communication protocol is an essential component to cooperate with a team of robots. Therefore, we propose a multi-robot mapping system, which adopts the P2P communication protocol to solve the mapping problem and map segmentation method from the given mapping or floor plan. The P2P network is constructed based on a centralized overlay network to be scalable and broadcast the control command from the base station to all robots. For generating a semantic map, there have been many works to cope with this task; however, they are still lack of performance. Thus, we perform both feature extraction and feature selection from Voronoi node to enhance the performance of map segmentation. Then to support vector machine (SVM) algorithm and artificial neural network (ANN) are adopted for classifying the segmented areas from Voronoi Graph. The experiment of SVM and ANN shows that they accomplish in map segmentation; however, the SVM algorithm has slightly higher accuracy.

The decline in blood donation rates and the ongoing shortage of blood products pose significant challenges to medical societies. One potential solution is to use porcine red blood cells (pRBCs) from genetically modified pigs as an alternative to human red blood cells (hRBCs). However, adverse immunological reactions remain a significant obstacle to their use. This study aimed to evaluate the compatibility of diverse genetically modified pRBCs with human serum. We acquired human complement-competent serum, complement 7 (C7)-deficient serum, and hRBCs from all ABO blood types. Additionally, we used leftover clinical samples from health checkups for further evaluation. pRBCs were collected from wild-type (WT) and genetically modified pigs: triple knockout (TKO), quadruple KO (QKO), and TKO/hCD55.hCD39 knockin (hCD55.hCD39KI). The extent of C3 deposition on RBCs was measured using flow cytometry after incubation in C7-deficient serum diluted in Ca ++ -enriched or Ca ++ -depleted and Mg ++ -enriched buffers. The binding of immunoglobulin (Ig) M/IgG antibody to RBCs after incubation in ABO-type human serum was evaluated using flow cytometry. Naïve human serum- or sensitized monkey serum-mediated hemolysis was also evaluated. Phagocytosis was assessed by incubating labeled RBCs with the human monocytic cell line THP-1 and measurement by flow cytometry. All three genetic modifications significantly improved the compatibility of pRBCs with human serum relative to that of WT pRBCs. The extent of IgM/IgG binding to genetically modified pRBCs was lower than that of WT pRBCs and similar to that of O-type hRBCs. Total and alternative pathway complement activation in all three genetically modified pRBCs was significantly weaker than that in WT pRBCs and did not differ from that in O-type hRBCs. The extent of serum-mediated hemolysis and phagocytosis of these genetically modified pRBCs was low and similar to that of O-type hRBCs. Sensitized monkey serum-mediated hemolysis in QKO and TKO/hCD55.hCD39KI pRBCs was higher than in O-type hRBCs but lower than in TKO pRBCs. The elimination of porcine carbohydrate antigens in genetically modified pigs significantly enhanced pRBC compatibility with naïve human sera, which was comparable to that of O-type hRBCs. These findings provide valuable insights into the development of pRBCs as potential alternatives to hRBCs.

Purpose – The purpose of this paper is to explore whether authentic leadership in hospitality is composed of four distinctive but related substantive components (i.e. self-awareness, relational transparency, balanced processing, and internalized moral); the impact of authentic leadership on employees’ organizational commitment (OC); the impact of employees’ OC on their turnover intention (TI); and the indirect effect of authentic leadership on employees’ TI via OC. Design/methodology/approach – The authors tested a sample of 236 students working as employees in hospitality in the USA, on the idea that authentic leadership increases OC which in turn decreases TI. The participants were asked to rate the manager’s leadership style and the frequency of their leadership behavior. Findings – Results of structural equation modeling provide support for the positive effect of authentic leadership on OC in the hospitality industry, and suggest that OC mediates reduced TI. Practical implications – The findings in the present study are extremely useful to managers, human resource managers, and organizations as a whole. Practitioners looking to increase employee OC and decrease TI can do so by augmenting the authentic leadership qualities of managers. Originality/value – The results of this study suggests a variety of significant theoretical contributions as well as critical leadership and organizational implications. The effects of authentic leadership were empirically tested on employees’ OC and the effects of that OC on TI.

Because there is a shortage of donor kidneys, researchers are exploring the possibility of using genetically modified pig kidneys for transplantation. Approaches involving knockout of carbohydrate genes or knockin of protective proteins have been attempted to determine the best gene modifications. In this study, we utilized GalT−/−;hCD39;hCD55 and GalT−/−;hCD39;hCD46;hCD55;thrombomodulin (TBM) pigs for transplantation in nonhuman primates (NHPs). The NHPs survived for 4 weeks after kidney transplantation (4 WAT) from the GalT−/−;hCD39;hCD55 pig and for 6 WAT from the GalT−/−;hCD39;hCD46;hCD55;TBM pig. However, messenger RNA (mRNA) sequencing and immunohistochemistry analysis revealed that the 6 WAT kidney exhibited more severe apoptosis, inflammation, loss of renal function, and renal fibrosis than the 4 WAT kidney. These results indicate that additional knockin of complement regulator (hCD46) and coagulation regulator (TBM) is not enough to prevent renal damage, suggesting that improved immune suppression is needed for more prolonged survival.