Objective: Prolonged fasting has been reported to have a negative effect on patient outcomes. Although fasting is routinely practiced in the emergency department (ED), there is limited evidence on the current status and appropriateness of fasting in the ED. This study examined the status and appropriateness of fasting in the ED and identified the characteristics of patients who experienced unnecessary fasting. Methods: A retrospective observational study was performed at an urban ED in Seoul, Korea. The fasting status and characteristics of adult patients who visited the ED and were admitted or discharged between April 1 and April 30, 2022, were analyzed. A checklist for discontinuing fasting in the ED was used to screen for unnecessary fasting. Results: Among 2,292 patients who met the study inclusion criteria, all patients were instructed to begin fasting upon ED arrival. Fasting was discontinued by the physician’s order in 300 patients (13.1%). Patients remained fasting for 92.0%±23.2% of their total ED length of stay. Of the 1,577 patients eligible for fasting discontinuation according to the checklist, 249 patients (15.8%) were ordered to discontinue fasting, and 1,328 patients (84.2%) experienced unnecessary fasting. Conclusion ED patients spent significant time fasting during their ED length of stay. A high prevalence of unnecessary fasting was identified in the ED.

Objective: To improve our understanding of EPEC, this study focused on analyzing and comparing the genomic characteristics of EPEC isolates from humans and companion animals in Korea. Methods: The whole genome of 26 EPEC isolates from patients with diarrhea and 20 EPEC isolates from companion animals in Korea were sequenced using the Illumina HiSeq X (Illumina, USA) and Oxford Nanopore MinION (Oxford Nanopore Technologies, UK) platforms. Results: Most isolates were atypical EPEC, and did not harbor the bfpA gene. The most prevalent virulence genes were found to be ompT (humans: 61.5%; companion animals:60.0%) followed by lpfA (humans: 46.2%; companion animals: 60.0%). Although pangenome analyses showed no apparent correlation among the origin of the strains, virulence profiles, and antimicrobial resistance profiles, isolates included in clade A obtained from both humans and companion animals exhibited high similarity. Additionally, all the isolates included in clade A encoded the ompT gene and did not encode the hlyE gene. The two isolates from companion animals harbored an incomplete bundle-forming pilus region encoding bfpA and bfpB. Moreover, the type IV secretion system-associated genes tra and trb were found in the bfpA-encoding isolates from humans. Conclusions and Relevance: Whole-genome sequencing enabled a more accurate analysis of the phylogenetic structure of EPEC and provided better insights into the understanding of EPEC epidemiology and pathogenicity.

Objective: To improve our understanding of EPEC, this study focused on analyzing and comparing the genomic characteristics of EPEC isolates from humans and companion animals in Korea. Methods: The whole genome of 26 EPEC isolates from patients with diarrhea and 20 EPEC isolates from companion animals in Korea were sequenced using the Illumina HiSeq X (Illumina, USA) and Oxford Nanopore MinION (Oxford Nanopore Technologies, UK) platforms. Results: Most isolates were atypical EPEC, and did not harbor the bfpA gene. The most prevalent virulence genes were found to be ompT (humans: 61.5%; companion animals:60.0%) followed by lpfA (humans: 46.2%; companion animals: 60.0%). Although pangenome analyses showed no apparent correlation among the origin of the strains, virulence profiles, and antimicrobial resistance profiles, isolates included in clade A obtained from both humans and companion animals exhibited high similarity. Additionally, all the isolates included in clade A encoded the ompT gene and did not encode the hlyE gene. The two isolates from companion animals harbored an incomplete bundle-forming pilus region encoding bfpA and bfpB. Moreover, the type IV secretion system-associated genes tra and trb were found in the bfpA-encoding isolates from humans. Conclusions and Relevance: Whole-genome sequencing enabled a more accurate analysis of the phylogenetic structure of EPEC and provided better insights into the understanding of EPEC epidemiology and pathogenicity.

Objective: To improve our understanding of EPEC, this study focused on analyzing and comparing the genomic characteristics of EPEC isolates from humans and companion animals in Korea. Methods: The whole genome of 26 EPEC isolates from patients with diarrhea and 20 EPEC isolates from companion animals in Korea were sequenced using the Illumina HiSeq X (Illumina, USA) and Oxford Nanopore MinION (Oxford Nanopore Technologies, UK) platforms. Results: Most isolates were atypical EPEC, and did not harbor the bfpA gene. The most prevalent virulence genes were found to be ompT (humans: 61.5%; companion animals:60.0%) followed by lpfA (humans: 46.2%; companion animals: 60.0%). Although pangenome analyses showed no apparent correlation among the origin of the strains, virulence profiles, and antimicrobial resistance profiles, isolates included in clade A obtained from both humans and companion animals exhibited high similarity. Additionally, all the isolates included in clade A encoded the ompT gene and did not encode the hlyE gene. The two isolates from companion animals harbored an incomplete bundle-forming pilus region encoding bfpA and bfpB. Moreover, the type IV secretion system-associated genes tra and trb were found in the bfpA-encoding isolates from humans. Conclusions and Relevance: Whole-genome sequencing enabled a more accurate analysis of the phylogenetic structure of EPEC and provided better insights into the understanding of EPEC epidemiology and pathogenicity.

Objective: To improve our understanding of EPEC, this study focused on analyzing and comparing the genomic characteristics of EPEC isolates from humans and companion animals in Korea. Methods: The whole genome of 26 EPEC isolates from patients with diarrhea and 20 EPEC isolates from companion animals in Korea were sequenced using the Illumina HiSeq X (Illumina, USA) and Oxford Nanopore MinION (Oxford Nanopore Technologies, UK) platforms. Results: Most isolates were atypical EPEC, and did not harbor the bfpA gene. The most prevalent virulence genes were found to be ompT (humans: 61.5%; companion animals:60.0%) followed by lpfA (humans: 46.2%; companion animals: 60.0%). Although pangenome analyses showed no apparent correlation among the origin of the strains, virulence profiles, and antimicrobial resistance profiles, isolates included in clade A obtained from both humans and companion animals exhibited high similarity. Additionally, all the isolates included in clade A encoded the ompT gene and did not encode the hlyE gene. The two isolates from companion animals harbored an incomplete bundle-forming pilus region encoding bfpA and bfpB. Moreover, the type IV secretion system-associated genes tra and trb were found in the bfpA-encoding isolates from humans. Conclusions and Relevance: Whole-genome sequencing enabled a more accurate analysis of the phylogenetic structure of EPEC and provided better insights into the understanding of EPEC epidemiology and pathogenicity.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by fat accumulation in the liver. MASLD encompasses both steatosis and MASH. Since MASH can lead to cirrhosis and liver cancer, steatosis and MASH must be distinguished during patient treatment. Here, we investigate the genomes, epigenomes, and transcriptomes of MASLD patients to identify signature gene set for more accurate tracking of MASLD progression. Methods: Biopsy-tissue and blood samples from patients with 134 MASLD, comprising 60 steatosis and 74 MASH patients were performed omics analysis. SVM learning algorithm were used to calculate most predictive features. Linear regression was applied to find signature gene set that distinguish the stage of MASLD and to validate their application into independent cohort of MASLD. Results: After performing WGS, WES, WGBS, and total RNA-seq on 134 biopsy samples from confirmed MASLD patients, we provided 1,955 MASLD-associated features, out of 3,176 somatic variant callings, 58 DMRs, and 1,393 DEGs that track MASLD progression. Then, we used a SVM learning algorithm to analyze the data and select the most predictive features. Using linear regression, we identified a signature gene set capable of differentiating the various stages of MASLD and verified it in different independent cohorts of MASLD and a liver cancer cohort. Conclusions We identified a signature gene set (i.e., CAPG, HYAL3, WIPI1, TREM2, SPP1, and RNASE6) with strong potential as a panel of diagnostic genes of MASLD-associated disease.

Background: The Korea Expert Committee on Immunization Practices (KECIP) is a key advisory body the government to develop guidelines and provide technical advisory activities on immunization policies in Korea. A recent policy study, inspired by global best practices, aims to enhance KECIP's functionality for providing timely and transparent recommendations in the face of evolving vaccine science and emerging infectious diseases like COVID-19. Methods: This study reviewed the current status of KECIP and collected expert opinions through surveys and consultations. Among the 40 panel members who were surveyed, 19 responded to a questionnaire specifically designed to assess the potential areas of improvement within KECIP. Results: The majority of respondents favored maintaining the current member count and emphasized the need for a subcommittee. Opinions varied on issues such as the length of KECIP’s term, the representation of vaccine manufacturers’ perspectives, and the chairperson’s role. However, there was a consensus on the importance of expertise, transparency, and fair proceedings within the committee. Conclusion This study underscores the pivotal role of KECIP in shaping national immunization policies, emphasizing the necessity for informed guidance amidst evolving vaccine science and emerging infectious diseases. Furthermore, it stressed the importance of enhancing KECIP’s capacity to effectively address evolving public health challenges and maintain successful immunization programs in South Korea.

Purpose: This study aimed to improve the antioxidant activities of sweet persimmon peel extracts using supercritical carbon dioxide (SFE-CO2 ) as a green extraction (GE) technology, as part of upcycling efforts. It also aimed to demonstrate the effectiveness of GE as an ecofriendly extraction method by comparing it with conventional extraction (CE) techniques. Methods: Sweet persimmon peel extracts were obtained using CE (hot water at 80°C for 6 h or 95% ethanol at room temperature for 24 hours) and SFE-CO2 extraction (50°C for 2 hours, with pressures ranging from 100 to 250 bar). Antioxidant activities (2,2-diphenyl-1-picrylhydrazyl [DPPH] radical scavenging activity and tannin content) were analyzed to evaluate and compare the antioxidant extraction efficiency across different extraction methods. Results: In the CE extraction method, the 95% ethanol extract exhibited 1.2 times higher DPPH radical scavenging activity and 1.5 times higher tannin content than that of the hot water extract. In the SFE-CO2 extraction method, antioxidant activities increased with increasing pressure (100–250 bar), as higher pressures enhanced antioxidant activities and extraction efficiency. At 250 bar, the SFE-CO2 extracts demonstrated 1.6 times higher DPPH radical scavenging activity and 2.0 times higher tannin content than that of the hot water extract, and 1.3 times higher DPPH scavenging activity and tannin content than that of the 95% ethanol extract. These findings highlight the superior efficiency of extraction using the SFE-CO2 method. Conclusion This study demonstrated that SFE-CO2 was an efficient and eco-friendly method for extracting antioxidants from sweet persimmon peels, surpassing conventional methods.It underscores the potential of SFE-CO2 for the sustainable upcycling of sweet persimmon byproducts and the promotion of green technologies to enhance antioxidant activities.

Purpose: This study aimed to improve the antioxidant activities of sweet persimmon peel extracts using supercritical carbon dioxide (SFE-CO2 ) as a green extraction (GE) technology, as part of upcycling efforts. It also aimed to demonstrate the effectiveness of GE as an ecofriendly extraction method by comparing it with conventional extraction (CE) techniques. Methods: Sweet persimmon peel extracts were obtained using CE (hot water at 80°C for 6 h or 95% ethanol at room temperature for 24 hours) and SFE-CO2 extraction (50°C for 2 hours, with pressures ranging from 100 to 250 bar). Antioxidant activities (2,2-diphenyl-1-picrylhydrazyl [DPPH] radical scavenging activity and tannin content) were analyzed to evaluate and compare the antioxidant extraction efficiency across different extraction methods. Results: In the CE extraction method, the 95% ethanol extract exhibited 1.2 times higher DPPH radical scavenging activity and 1.5 times higher tannin content than that of the hot water extract. In the SFE-CO2 extraction method, antioxidant activities increased with increasing pressure (100–250 bar), as higher pressures enhanced antioxidant activities and extraction efficiency. At 250 bar, the SFE-CO2 extracts demonstrated 1.6 times higher DPPH radical scavenging activity and 2.0 times higher tannin content than that of the hot water extract, and 1.3 times higher DPPH scavenging activity and tannin content than that of the 95% ethanol extract. These findings highlight the superior efficiency of extraction using the SFE-CO2 method. Conclusion This study demonstrated that SFE-CO2 was an efficient and eco-friendly method for extracting antioxidants from sweet persimmon peels, surpassing conventional methods.It underscores the potential of SFE-CO2 for the sustainable upcycling of sweet persimmon byproducts and the promotion of green technologies to enhance antioxidant activities.

Purpose: This study aimed to improve the antioxidant activities of sweet persimmon peel extracts using supercritical carbon dioxide (SFE-CO2 ) as a green extraction (GE) technology, as part of upcycling efforts. It also aimed to demonstrate the effectiveness of GE as an ecofriendly extraction method by comparing it with conventional extraction (CE) techniques. Methods: Sweet persimmon peel extracts were obtained using CE (hot water at 80°C for 6 h or 95% ethanol at room temperature for 24 hours) and SFE-CO2 extraction (50°C for 2 hours, with pressures ranging from 100 to 250 bar). Antioxidant activities (2,2-diphenyl-1-picrylhydrazyl [DPPH] radical scavenging activity and tannin content) were analyzed to evaluate and compare the antioxidant extraction efficiency across different extraction methods. Results: In the CE extraction method, the 95% ethanol extract exhibited 1.2 times higher DPPH radical scavenging activity and 1.5 times higher tannin content than that of the hot water extract. In the SFE-CO2 extraction method, antioxidant activities increased with increasing pressure (100–250 bar), as higher pressures enhanced antioxidant activities and extraction efficiency. At 250 bar, the SFE-CO2 extracts demonstrated 1.6 times higher DPPH radical scavenging activity and 2.0 times higher tannin content than that of the hot water extract, and 1.3 times higher DPPH scavenging activity and tannin content than that of the 95% ethanol extract. These findings highlight the superior efficiency of extraction using the SFE-CO2 method. Conclusion This study demonstrated that SFE-CO2 was an efficient and eco-friendly method for extracting antioxidants from sweet persimmon peels, surpassing conventional methods.It underscores the potential of SFE-CO2 for the sustainable upcycling of sweet persimmon byproducts and the promotion of green technologies to enhance antioxidant activities.