Explore the vast range of titles available.

The efficacy of decompressive craniectomy (DC) for traumatic brain injury (TBI) have been investigated in two recent randomized clinical trials (RCTs) and DC is recommended as an optional treatment for improving overall survival compared to medical treatment. However, the two RCTs enrolled extremely young adults, and the efficacy of DC in older adults remains questionable. Therefore, to identify the efficacy of DC in older adults, we compared patients who received medical care with those who underwent DC after propensity score matching (PSM). From the Korea Multi-center Traumatic Brain Injury Database, 443 patients identified as having intracranial hypertension and a necessity of DC were retrospectively enrolled. The patients were classified into the DC (n = 375) and non-DC (n = 68) groups according to operation records. The PSM was conducted to match the patients in the DC group with those receiving medical care (non-DC). After PSM, the newly matched group (DC, n = 126) was compared with patients without DC (non-DC, n = 63). The mean difference in the logit of the propensity scores (LPS) was 0.00391 and the mean age of enrolled patients were 65 years. The results of the comparative analyses after PSM showed that the 6-month mortality rate of the non-DC group was higher than that of the DC group (61.9% vs. 51.6%, p = 0.179). In terms of favorable outcomes (modified Rankin Scale [mRS] score < 4), the DC group showed a lower rate of favorable mRS scores (11.9% vs. 17.5%, p = 0.296) than the non-DC group.

The retrieval of continuous snow water equivalent (SWE) directly from passive microwave observations is hampered by ambiguity, which can potentially be mitigated by incorporating knowledge on snow hydrological processes. In this paper, we present a data assimilation (DA)-based SWE retrieval framework coupling the QCA-Mie scattering (DMRT-QMS) model (a dense medium radiative transfer (RT) microwave scattering model) and a one-dimensional column-based multiple-layer snow hydrology model. The snow hydrology model provides realistic estimates of the snowpack physical parameters required to drive the DMRT-QMS model. This paper devises a strategy to specify those internal parameters in the snow hydrology and RT models that lack observational records. The modeled snow depth is updated by assimilating brightness temperatures (Tbs) from the X, Ku, and Ka bands using an ensemble Kalman filter (EnKF). The updated snow depth is then used to predict the SWE. The proposed framework was tested using the European Space Agency’s Nordic Snow Radar Experiment (ESA NoSREx) dataset for a snow field experiment from 2009 to 2012 in Sodankylä, Finland. The achieved SWE retrieval root mean square error of 34.31 mm meets the requirements of NASA and ESA snow missions and is about 70% less than the open-loop SWE. In summary, this paper introduces a novel SWE retrieval framework that leverages the combined strengths of a snow hydrology model and a radiative transfer model. This approach ensures physically realistic retrievals of snow depth and SWE. We investigated the impact of various factors on the framework’s performance, including observation time intervals and combinations of microwave observation channels. Our results demonstrate that a one-week observation interval achieves acceptable retrieval accuracy. Furthermore, the use of multi-channel and multi-polarization Tbs is preferred for optimal SWE retrieval performance.

This paper presents methods of monitoring river basin development and water variability for the transboundary river in North and South Korea. River basin development, such as dams and water infrastructure in transboundary rivers, can be a potential factor of tensions between upstream and downstream countries since dams constructed upstream can adversely affect downstream riparians. However, because most of the information related to North Korea has been limited to the public, the information about dams constructed and their locations were inaccurate in many previous studies. In addition, water resources in transboundary rivers can be exploited as a political tool. Specifically, due to the unexpected water release from the Hwanggang Dam, upstream of the transboundary Imjin River in North and South Korea, six South Koreans died on 6 September 2009. The Imjin River can be used as a political tool by North Korea, and seven events were reported as water conflicts in the Imjin River from 2001 to 2016. In this paper, firstly, we have updated the information about the dams constructed over the Imjin River in North Korea using multi-temporal images with a high spatial resolution (15-30 cm) obtained from Google Earth. Secondly, we analyzed inter- and intra-water variability over the Hwanggang Reservoir using open-source images obtained from the Global Surface Water Explorer. We found a considerable change in water surface variability before and after 2008, which might result from the construction of the Hwanggang Dam. Thirdly, in order to further investigate intra-annual water variability, we present a method monitoring water storage changes of the Hwanggang Reservoir using the area-elevation curve (AEC), which was derived from multi-sensor Synthetic Aperture Radar (SAR) images (Sentinel-1A and -1B) and the Shuttle Radar Topography Mission (SRTM) Digital Elevation Model (DEM). Since many previous studies for estimating water storage change have depended on satellite altimetry dataset and optical images for deriving AEC, the method adopted in this study is the only application for such inaccessible areas since no altimetry ground track exists for the Hwanggang Reservoir and because clouds can block the study area for wet seasons. Moreover, this study has newly proven that unexpected water release can occur in dry seasons because the water storage in the Hwanggang Reservoir can be high enough to conduct a release that can be used as a geopolitical tool. Using our method, potential risks can be mitigated, not in response to a water release, but based on pre-event water storage changes in the Hwanggang Reservoir.

This work presents a novel design model of a magnetorheological (MR) fluid-based shock absorber (MR shock absorber in short) that can be applied to an aircraft landing gear system. When an external force acts on an MR shock absorber, pressure loss occurs at the flow path while resisting the fluid flow. During the flow motion, two pressure losses occur: the major loss, which is proportional to the flow rate, and the minor loss, which is proportional to the square of the flow rate. In general, when an MR shock absorber is designed for low stroke velocity systems such as an automotive suspension system, the consideration of the major loss only for the design model is well satisfied by experimental results. However, when an MR shock absorber is applied to dynamic systems that require high stroke velocity, such as aircraft landing gear systems, the minor loss effect becomes significant to the pressure drop. In this work, a new design model for an MR shock absorber, considering both the major and minor pressure losses, is proposed. After formulating a mathematical design model, a prototype of an MR shock absorber is manufactured based on the design parameters of a lightweight aircraft landing gear system. After establishing a drop test for the MR shock absorber, the results of the pressure drop versus stroke/stroke velocity are investigated at different impact energies. It is shown from comparative evaluation that the proposed design model agrees with the experiment much better than the model that considers only the major pressure loss.

Background An open‐label single‐arm phase 2 study was conducted to evaluate the role of levetiracetam as a sensitizer of concurrent chemoradiotherapy (CCRT) for patients with newly diagnosed glioblastoma. This study aimed to determine the survival benefit of levetiracetam in conjunction with the standard treatment for glioblastoma. Methods Major eligibility requirements included histologically proven glioblastoma in the supratentorial region, patients 18 years or older, and Eastern Cooperative Oncology Group (ECOG) performance status of 0–2. Levetiracetam was given at 1,000–2,000 mg daily in two divided doses during CCRT and adjuvant chemotherapy thereafter. The primary and the secondary endpoints were 6‐month progression‐free survival (6mo‐PFS) and 24‐month overall survival (24mo‐OS), respectively. Outcomes of the study group were compared to those of an external control group. Results Between July 2016 and January 2019, 76 patients were enrolled, and 73 patients were included in the final analysis. The primary and secondary outcomes were improved in the study population compared to the external control (6mo‐PFS, 84.9% vs. 72.3%, p = 0.038; 24mo‐OS, 58.0% vs. 39.9%, p = 0.018), but the differences were less prominent in a propensity score‐matched analysis (6mo‐PFS, 88.0% vs. 76.9%, p = 0.071; 24mo‐OS, 57.1% vs. 38.8%, p = 0.054). In exploratory subgroup analyses, some results suggested that patients with ages under 65 years or unmethylated MGMT promoter might have a greater survival benefit from the use of levetiracetam. Conclusions The use of levetiracetam during CCRT in patients with newly diagnosed glioblastoma may result in improved outcomes, but further investigations are warranted. Patients aged less than 65 years exhibited better outcomes with levetiracetam. Patients with unmethylated MGMT promoter possibly have greater benefits from levetiracetam.

Agricultural drought is triggered by a depletion of moisture content in the soil, which hinders photosynthesis and thus increases carbon dioxide (CO2) concentrations in the atmosphere. The aim of this study is to analyze the relationship between soil moisture (SM) and vegetation activity toward quantifying CO2 concentration in the atmosphere. To this end, the MODerate resolution imaging spectroradiometer (MODIS), an optical multispectral sensor, was used to evaluate two regions in South Korea for validation. Vegetation activity was analyzed through MOD13A1 vegetation indices products, and MODIS gross primary productivity (GPP) product was used to calculate the CO2 flux based on its relationship with respiration. In the case of SM, it was calculated through the method of applying apparent thermal inertia (ATI) in combination with land surface temperature and albedo. To validate the SM and CO2 flux, flux tower data was used which are the observed measurement values for the extreme drought period of 2014 and 2015 in South Korea. These two variables were analyzed for temporal variation on flux tower data as daily time scale, and the relationship with vegetation index (VI) was synthesized and analyzed on a monthly scale. The highest correlation between SM and VI (correlation coefficient (r) = 0.82) was observed at a time lag of one month, and that between VI and CO2 (r = 0.81) at half month. This regional study suggests a potential capability of MODIS-based SM, VI, and CO2 flux, which can be applied to an assessment of the global view of the agricultural drought by using available satellite remote sensing products.

The surge in global plastic production, reaching 400.3 million tons in 2022, has exacerbated environmental pollution, with only 11% of plastic being recycled. Catalytic recycling, particularly through hydrogenolysis and hydrocracking, offers a promising avenue for upcycling polyolefin plastic, comprising 55% of global plastic waste. This study investigates the influence of water on polyolefin depolymerization using Ru catalysts, revealing a promotional effect only when both metal and acid sites, particularly Brønsted acid site, are present. Findings highlight the impact of Ru content, metal-acid balance, and their proximity on this interaction, as well as their role in modulating the isomerization process, affecting product selectivity. Additionally, the interaction facilitates the suppression of coke formation, ultimately enhancing catalyst stability. A comprehensive techno-economic and life cycle assessment underscores the viability and environmental benefits of the process, particularly in the presence of water. These insights advance understanding and offer strategies for optimizing polyolefin plastic recycling processes. Catalytic hydrogenolysis and hydrocracking present a promising approach for upcycling polyolefin plastics. Here, the authors highlight the role of water in catalytic plastic upcycling, emphasizing that catalysts with an optimal metal-acid balance significantly improve polyethylene depolymerization when water is present.

Diffuse-type gastric cancer (DGC), characterized by poorly cohesive cells within fibrotic stroma, is associated with advanced disease and poor prognosis. Here, to identify distinct biomarkers for DGC compared with intestinal-type gastric cancer, we constructed a comprehensive large-scale signaling network using RNA-sequencing data from three genomic databases (The Cancer Genome Atlas, GSE62254 and GSE26253), developed a mathematical model and conducted simulation analyses. For validation, we used tissue microarray blocks of gastric cancers with immunohistochemical staining, single-cell RNA sequencing, primary cultures of cancer-associated fibroblasts (CAFs) and organoids, and a co-culture system involving CAFs and cancer cells. Signaling network analysis identified six differentially activated signaling components across the database, including BIRC5 , TTK , NEK2 , FHL1 , NR2F1 and FBLN5 . Among the differentially activated signaling components, high tumoral expression of fibulin-5 protein encoded by FBLN5 correlated with poor overall and disease-specific survival rates in patients with DGC, even after adjusting for the tumor, node, metastases (TNM) stage. Fibulin-5, derived from CAFs within DGC stroma, promoted organoid growth and epithelial–mesenchymal transition (EMT) in DGC cell lines via the cAMP response element-binding protein (CREB) pathway in a CAF co-culture system. FBLN5 knockdown in CAFs reduced the aggressive phenotype of co-cultured DGC cells, while CREB inhibitors reversed EMT. Furthermore, levels of secreted FBLN5 in patient blood samples correlated with its expression in primary tumors. In summary, fibulin-5 secreted by CAFs and interacted with DGC cells promotes EMT and is clinically associated with poor patient outcomes. These findings suggest fibulin-5 as a potential prognostic marker and therapeutic target in patients with DGC. Fibulin-5 identified as key marker in diffuse gastric cancer Gastric cancer is a major health concern worldwide, with two main types: intestinal and diffuse. Diffuse gastric cancer (DGC) is less common but more aggressive. Here researchers used advanced computer models to study the complex networks of genes and proteins in DGC. They focused on the protein fibulin-5 (FBLN5), which was found to be more active in DGC than in intestinal-type cancer. The study involved analyzing data from 1,139 patients and conducting experiments with cancer tissues and cells. They discovered that FBLN5, produced by cells called cancer-associated fibroblasts, helps cancer cells spread by promoting the epithelial–mesenchymal transition process. High levels of FBLN5 were linked to worse survival rates in patients with DGC. The authors concluded that FBLN5 could be a useful marker for predicting patient outcomes and a potential target for new treatments. This summary was initially drafted using artificial intelligence, then revised and fact-checked by the author.

Previously, transcriptomic profiling studies have shown distinct molecular subtypes of glioblastomas. It has also been suggested that the recurrence of glioblastomas could be achieved by transcriptomic reprograming of tumors, however, their characteristics are not yet fully understood. Here, to gain the mechanistic insights on the molecular phenotypes of recurrent glioblastomas, gene expression profiling was performed on the 43 cases of glioblastomas including 15 paired primary and recurrent cases. Unsupervised clustering analyses revealed two subtypes of G1 and G2, which were characterized by proliferation and neuron-like gene expression traits, respectively. While the primary tumors were classified as G1 subtype, the recurrent glioblastomas showed two distinct expression types. Compared to paired primary tumors, the recurrent tumors in G1 subtype did not show expression alteration. By contrast, the recurrent tumors in G2 subtype showed expression changes from proliferation type to neuron-like one. We also observed the expression of stemness-related genes in G1 recurrent tumors and the altered expression of DNA-repair genes (i.e., AURK, HOX, MGMT, and MSH6) in the G2 recurrent tumors, which might be responsible for the acquisition of drug resistance mechanism during tumor recurrence in a subtype-specific manner. We suggest that recurrent glioblastomas may choose two different strategies for transcriptomic reprograming to escape the chemotherapeutic treatment during tumor recurrence. Our results might be helpful to determine personalized therapeutic strategy against heterogeneous glioma recurrence.

In this multi-center, assessor-blinded pilot study, the diagnostic efficacy of cCeLL-Ex vivo, a second-generation confocal laser endomicroscopy (CLE), was compared against the gold standard frozen section analysis for intraoperative brain tumor diagnosis. The study was conducted across three tertiary medical institutions in the Republic of Korea. Biopsy samples from newly diagnosed brain tumor patients were categorized based on location and divided for permanent section analysis, frozen section analysis, and cCeLL-Ex vivo imaging. Of the 74 samples from 55 patients, the majority were from the tumor core (74.3%). cCeLL-Ex vivo exhibited a relatively higher diagnostic accuracy (89.2%) than frozen section analysis (86.5%), with both methods showing a sensitivity of 92.2%. cCeLL-Ex vivo also demonstrated higher specificity (70% vs. 50%), positive predictive value (PPV) (95.2% vs. 92.2%), and negative predictive value (NPV) (58.3% vs. 50%). Furthermore, the time from sample preparation to diagnosis was notably shorter with cCeLL-Ex vivo (13 min 17 s) compared to frozen section analysis (28 min 28 s) ( p -value < 0.005). These findings underscore cCeLL-Ex vivo's potential as a supplementary tool for intraoperative brain tumor diagnosis, with future studies anticipated to further validate its clinical utility.