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Background We aimed to assess if quantitative radiomic features can predict programmed death ligand 1 (PD‐L1) expression in advanced stage lung adenocarcinoma. Methods This retrospective study included 153 patients who had advanced stage (>IIIA by TNM classification) lung adenocarcinoma with pretreatment thin section computed tomography (CT) images and PD‐L1 expression test results in their pathology reports. Clinicopathological data were collected from electronic medical records. Visual analysis and radiomic feature extraction of the tumor from pretreatment CT were performed. We constructed two models for multivariate logistic regression analysis (one based on clinical variables, and the other based on a combination of clinical variables and radiomic features), and compared c‐statistics of the receiver operating characteristic curves of each model to identify the model with the higher predictability. Results Among 153 patients, 53 patients were classified as PD‐L1 positive and 100 patients as PD‐L1 negative. There was no significant difference in clinical characteristics or imaging findings on visual analysis between the two groups (P > 0.05 for all). Rad‐score by radiomic analysis was higher in the PD‐L1 positive group than in the PD‐L1 negative group with a statistical significance (−0.378 ± 1.537 vs. −1.171 ± 0.822, P = 0.0008). A prediction model that uses clinical variables and CT radiomic features showed higher performance compared to a prediction model that uses clinical variables only (c‐statistic = 0.646 vs. 0.550, P = 0.0299). Conclusions Quantitative CT radiomic features can predict PD‐L1 expression in advanced stage lung adenocarcinoma. A prediction model composed of clinical variables and CT radiomic features may facilitate noninvasive assessment of PD‐L1 expression. Key points Significant findings of the study Quantitative CT radiomic features can help predict PD‐L1 expression, whereas none of the qualitative imaging findings is associated with PD‐L1 positivity. What this study adds A prediction model composed of clinical variables and CT radiomic features may facilitate noninvasive assessment of PD‐L1 expression.

Background Although the Mini Nutritional Assessment (MNA) is recognized as a useful tool for evaluating nutritional status in patients with various diseases, its applicability in patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) remains undetermined. Methods We designed a prospective cross-sectional study to investigate whether the MNA Short-Form (MNA-SF) score can serve as a screening tool to assess the nutritional status of patients with NTM-PD. The MNA-SF was conducted upon patient enrollment, and correlation analyses were performed to compare MNA-SF scores with other nutritional measurements and disease severity. Multivariable logistic regression analyses were conducted to evaluate the association between MNA-SF scores and NTM-PD severity. Results The 194 patients with NTM-PD included in the analysis had a median age of 65.0 (59.0–69.0) years; 59.3% ( n  = 115) had low MNA-SF scores (< 12). The low MNA-SF group exhibited a lower body mass index (19.7 vs. 22.4 kg/m 2 , p  < 0.001) and fat-free mass index (14.7 vs. 15.6 kg/m 2 , p  < 0.001) than the normal MNA-SF group, as well as higher incidences of sarcopenia (20.0% vs. 6.3%, p  = 0.008) and adipopenia (35.7% vs. 5.1%, p  < 0.001). However, no significant differences in calorie and protein intakes were observed between the two groups. Low MNA-SF scores were associated with radiographic severity (adjusted odds ratio 2.72, 95% confidence interval 1.38–5.36) but not with forced vital capacity. Conclusions The MNA-SF can effectively assess the nutritional status of patients with NTM-PD and can serve as an important clinical indicator in NTM-PD where treatment timing is determined by clinical judgment.

BackgroundHeadache disorder is not only a common complaint but also a global burden. Pharmacotherapeutic and non-pharmacotherapeutic approaches have been developed for its treatment and prophylaxis. The present study included a systematic review of psychological treatments for primary headache disorder accessible in Korea.MethodsWe included English and Korean articles from EMBASE, MEDLINE, Cochrane library database, SCOPUS, ScienceDirect, Web of Science, CINAHL, PsycArticles and Korean database, KoreaMed and KMBASE which studied primary headache and medication-overuse headache. The primary efficacy measure was the number of headache days per month, while secondary efficacy measures were the number of headache attacks per week, headache index, treatment response rate, and migraine disability assessment. The meta-analysis was performed using R 3.5.1. to obtain pooled mean difference and pooled relative risk with 95% confidence interval (CI) for continuous data and dichotomous data, respectively.ResultsFrom 12,773 identified articles, 27 randomized clinical trials were identified. Primary outcome showed significant superiority of psychological treatments (pooled mean difference = − 0.70, 95% CI [− 1.22, − 0.18]). For the secondary outcomes, the number of headache attacks (pooled mean difference = − 1.15, 95% CI [− 1.63, − 0.67]), the headache index (pooled mean difference = − 0.92, 95% CI [− 1.40 to − 0.44]) and the treatment response rate (pooled relative risk = 3.13, 95% CI [2.24, 4.37]) demonstrated significant improvements in the psychological treatment group over the control group.ConclusionPsychological treatments for primary headache disorder reduced headache frequency and the headache index. Future research using standardized outcome measures and strategies for reducing bias is needed.

Mycobacterium avium complex pulmonary disease (MAC-PD) requires prolonged multidrug therapy. However, treatment outcomes remain suboptimal due to limited antibiotic efficacy, disease chronicity, and frequent early treatment interruption (ETI). Despite its clinical significance, data on the prevalence, risk factors, and long-term outcomes of ETI remain limited. Therefore, this study aims to identify factors associated with ETI and its impact on mortality. A retrospective cohort study of 420 patients treated with MAC-PD was conducted between 2010 and 2023. Patients were categorized into ETI (treatment duration < 12 months) and standard groups (treatment duration ≥ 12 months). Logistic regression was used to identify risk factors for ETI, whereas multivariate Cox proportional hazards regression was employed to evaluate factors associated with mortality. ETI occurred in 30% of patients. Low prognostic nutritional index (PNI) (adjusted odds ratio [aOR]: 0.92; 95% confidence Interval [CI]: 0.87-0.99) and grade 2 or higher adverse drug reactions (ADRs) (aOR: 5.65; 95% CI: 2.45-15.00) increased the risk of ETI. ETI was associated with higher mortality (adjusted hazard ratio: 2.86; 95% CI: 1.51-5.40). Additionally, low PNI scores indicated increased mortality risk. ETI is prevalent in MAC-PD and is strongly associated with ADRs and poor nutrition, both of which also predict higher long-term mortality. Early ADR monitoring and nutritional support are essential for improving treatment adherence and patient outcomes.

Cardiac magnetic resonance (CMR) imaging is widely used in various medical fields related to cardiovascular diseases. Rapid technological innovations in magnetic resonance imaging in recent times have resulted in the development of new techniques for CMR imaging. T1 and T2 image mapping sequences enable the direct quantification of T1, T2, and extracellular volume fraction (ECV) values of the myocardium, leading to the progressive integration of these sequences into routine CMR settings. Currently, T1, T2, and ECV values are being recognized as not only robust biomarkers for diagnosis of cardiomyopathies, but also predictive factors for treatment monitoring and prognosis. In this study, we have reviewed various T1 and T2 mapping sequence techniques and their clinical applications.

The structural and functional characteristics of left atrial appendage (LAA) in patients with atrial fibrillation (AF) with previous stroke remain incompletely elucidated. This study investigated whether a larger LAA orifice is related to decreased LAA flow velocity and stroke in nonvalvular AF. The dimension, morphology, and flow velocity of LAA were compared in patients with nonvalvular AF with (stroke group, n = 67, mean age 66 ± 9 years) and without ischemic stroke (no-stroke group, n = 151, mean age 56 ± 10 years). Compared with no-stroke group, the stroke group had larger LA dimension (4.7 ± 0.8 vs 4.2 ± 0.6 cm, p <0.001), larger LAA orifice area (4.5 ± 1.5 vs 3.0 ± 1.1 cm2, p <0.001), and slower LAA flow velocity (36 ± 19 vs 55 ± 20 cm/s, p <0.001). LAA flow velocity was negatively correlated with LAA orifice size (R = −0.48, p <0.001). After adjustment for multiple potential confounding factors including CHA2DS2-VASc score, persistent AF, and LA dimension, large LAA orifice area (odds ratio 6.16, 95% confidence interval 2.67 to 14.18, p <0.001) and slow LAA velocity (odds ratio 3.59, 95% confidence interval 1.42 to 9.08, p = 0.007) were found to be significant risk factors of stroke. In patients with LAA flow velocity <37.0 cm/s, patients with large LAA orifice (>3.5 cm2) had greater incidence of stroke than those with LAA orifice of ≤3.5 cm2 (75% vs 23%, p <0.001). In conclusion, LAA orifice enlargement was related to stroke risk in patients with nonvalvular AF even after adjustment for other risk factors, and it could be the cause of decreased flow velocity in LAA.

It is unknown whether the thinner slice reconstruction has added value relative to 3 mm reconstructions in predicting major adverse cardiac events (MACEs). This retrospective study included 550 asymptomatic individuals who underwent cardiac CT. Coronary artery calcium (CAC) scores and severity categories were assessed from 1.5 and 3 mm scans. CAC scores obtained from 1.5 and 3 mm scans were compared using Wilcoxon signed-rank tests. Cox proportional hazard models were developed to predict MACEs based on the degree of coronary artery stenosis on coronary CT angiography and the presence of CAC on both scans. Model performances were compared using the time-dependent ROC curve and integrated area under the curve (iAUC) methods. The CAC scores obtained from 1.5 mm scans were significantly higher than those from 3 mm scans (median, interquartile range 4.5[0-71] vs. 0[0-48.4]; p < 0.001). Models showed no difference in predictive accuracy of the presence of CAC between 1.5 and 3 mm scans (iAUC, 0.625 vs. 0.672). In conclusion, CAC scores obtained from 1.5 mm scans are significantly higher than those from 3 mm scans, but do not provide added prognostic value relative to 3 mm scans.

Background Growth factors (GFs) are signaling proteins that affect cellular processes such as growth, proliferation, and differentiation. GFs are used as cosmeceuticals, exerting anti-wrinkle, anti-aging, and whitening effects, and also as pharmaceuticals to treat wounds, growth failure, and oral mucositis. However, in mammalian and bacterial cells, low productivity and expression in inclusion bodies, respectively, of GFs does not satisfy the consumer demand. Here, we aimed to develop a bacterial expression system that produces high yields of soluble GFs that can be purified in their native forms. Results We present Fh8, an 8-kDa peptide from Fasciola hepatica with an N-terminal hexa-histidine (6HFh8), as a fusion partner for enhanced human GF production in recombinant Escherichia coli . The fusion partner harboring a tobacco etch virus (TEV) protease cleavage site was fused to the N-terminus of 10 human GFs: acidic and basic fibroblast growth factors (aFGF and bFGF, respectively), epidermal growth factor (EGF), human growth hormone (hGH), insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor 165 (VEGF165), keratinocyte growth factor 1 (KGF-1), placental growth factor (PGF), stem cell factor (SCF), and tissue inhibitor of metalloproteinase 1 (TIMP-1). The fusion proteins were expressed in E. coli under the control of T7 promoter at three temperatures (25 °C, 30 °C, and 37 °C). All individual fusion proteins, except for SCF and TIMP-1, were successfully overexpressed in cytoplasmic soluble form at more than one temperature. Further, the original aFGF, IGF-1, EGF, and VEGF165 proteins were cleaved from the fusion partner by TEV protease. Five-liter fed-batch fermentation approaches for the 6HFh8-aFGF (lacking disulfide bonds) and 6HFh8-VEGF165 (a cysteine-rich protein) were devised to obtain the target protein at concentrations of 9.7 g/l and 3.4 g/l, respectively. The two GFs were successfully highly purified (> 99% purity). Furthermore, they exerted similar cell proliferative effects as those of their commercial equivalents. Conclusions We demonstrated that 6HFh8-GF fusion proteins could be overexpressed on a g/l scale in the cytoplasm of E. coli , with the GFs subsequently highly purified and maintaining their biological activity. Hence, the small protein 6HFh8 can be used for efficient mass-production of various GFs.

Quantitative body composition affects the prognosis of patients with Mycobacterium avium complex pulmonary disease (MAC-PD). However, whether the qualitative body composition obtained indirectly through computed tomography (CT) affects their prognosis is debatable. We retrospectively analyzed patients with MAC-PD who underwent non-contrast CT at MAC-PD diagnosis. The cross-sectional area of the erector spinae muscle (ESM area), the Hounsfield unit of the erector spinae muscle (ESM HU), and the cross-sectional area of subcutaneous fat (SQF area) were measured at the level of the first lumbar vertebra. Myosteatosis were defined below the median value of ESM HU for each sex. Of 377 patients, 45 (11.9%) died during the follow-up. Patients who died were older and had a lower ratio of females (33.3%). In body compositions, SQF area and ESM HU were lower in the patients who died. In multivariable analysis, a low ESM HU was associated with increased mortality (ESM HU adjusted hazard ratio [aHR] 0.95, 95% confidence interval [CI] 0.93–0.97) through body composition. SQF area revealed protective effects in MAC-PD patients with body mass index ≥ 18.5 kg/m 2 (aHR 0.98, 95% CI 0.95–1.00). In conclusion, the decrease in ESM HU, which indirectly reflects myosteatosis, is associated with mortality in patients with MAC-PD.

Advanced metering infrastructure (AMI) is becoming increasingly popular as an efficient means of energy demand management. By collecting energy data through AMI, it is possible to provide users with information that can induce them to change their behavior. To ensure that AMI continues to expand and to encourage the use of energy data, it is important to increase consumer participation and analyze their preferred service attributes. This study utilized a choice experiment to analyze consumer preferences for and acceptance of smart energy services based on AMI data. The results of a mixed logit model estimation show that consumers prefer the electricity information service for individual households and the social safety-net service among convergence services. A scenario analysis confirms that monetary compensation to offset any additional charges is important to maintain the level of consumer acceptance. These empirical findings offer insights for policymakers and companies seeking to develop policies and similar services.