Objectives: . Head and neck squamous cell carcinoma (HNSCC) exhibits high recurrence rates, particularly in cases of radioresistant HNSCC (RR-HNSCC). Non-thermal plasma (NTP) therapy effectively suppresses the progression of HNSCC. However, the therapeutic mechanisms of NTP therapy in treating RR-HNSCC are not well understood. In this study, we explored the regulatory role of NTP in the RR-HNSCC signaling pathway and identified its signature genes. Methods: . After constructing two RR-HNSCC cell lines, we prepared cell lysates from cells treated or not treated with NTP-activated media (NTPAM) and performed RNA sequencing to determine their mRNA expression profiles. Based on the RNA sequencing results, we identified differentially expressed genes (DEGs), followed by a bioinformatics analysis to identify candidate molecules potentially associated with NTPAM therapy for RR-HNSCC. Results: . NTPAM reduced RR-HNSCC cell viability in vitro. RNA sequencing results indicated that NTPAM treatment activated the reactive oxygen species (ROS) pathway and induced ferroptosis in RR-HNSCC cell lines. Among the 1,924 genes correlated with radiation treatment, eight showed statistical significance in both the cell lines and The Cancer Genome Atlas (TCGA) cohort. Only five genes—ABCC3, DUSP16, PDGFB, RAF1, and THBS1—showed consistent results between the NTPAM data sequencing and TCGA data. LASSO regression analysis revealed that five genes were associated with cancer prognosis, with a hazard ratio of 2.26. In RR-HNSCC cells, NTPAM affected DUSP16, PDGFB, and THBS1 as activated markers within 6 hours, and this effect persisted for 12 hours. Furthermore, enrichment analysis indicated that these three DEGs were associated with the extracellular matrix, transforming growth factor-beta, phosphoinositide 3-kinase/protein kinase B, and mesenchymal-epithelial transition factor pathways. Conclusion . NTPAM therapy exerts cytotoxic effects in RR-HNSCC cell lines by inducing specific ROS-mediated ferroptosis. DUSP16, PDGFB, and THBS1 were identified as crucial targets for reversing the radiation resistance induced by NTPAM therapy, providing insights into the mechanisms and clinical applications of NTPAM treatment in RR-HNSCC.

Objectives: . Head and neck squamous cell carcinoma (HNSCC) exhibits high recurrence rates, particularly in cases of radioresistant HNSCC (RR-HNSCC). Non-thermal plasma (NTP) therapy effectively suppresses the progression of HNSCC. However, the therapeutic mechanisms of NTP therapy in treating RR-HNSCC are not well understood. In this study, we explored the regulatory role of NTP in the RR-HNSCC signaling pathway and identified its signature genes. Methods: . After constructing two RR-HNSCC cell lines, we prepared cell lysates from cells treated or not treated with NTP-activated media (NTPAM) and performed RNA sequencing to determine their mRNA expression profiles. Based on the RNA sequencing results, we identified differentially expressed genes (DEGs), followed by a bioinformatics analysis to identify candidate molecules potentially associated with NTPAM therapy for RR-HNSCC. Results: . NTPAM reduced RR-HNSCC cell viability in vitro. RNA sequencing results indicated that NTPAM treatment activated the reactive oxygen species (ROS) pathway and induced ferroptosis in RR-HNSCC cell lines. Among the 1,924 genes correlated with radiation treatment, eight showed statistical significance in both the cell lines and The Cancer Genome Atlas (TCGA) cohort. Only five genes—ABCC3, DUSP16, PDGFB, RAF1, and THBS1—showed consistent results between the NTPAM data sequencing and TCGA data. LASSO regression analysis revealed that five genes were associated with cancer prognosis, with a hazard ratio of 2.26. In RR-HNSCC cells, NTPAM affected DUSP16, PDGFB, and THBS1 as activated markers within 6 hours, and this effect persisted for 12 hours. Furthermore, enrichment analysis indicated that these three DEGs were associated with the extracellular matrix, transforming growth factor-beta, phosphoinositide 3-kinase/protein kinase B, and mesenchymal-epithelial transition factor pathways. Conclusion . NTPAM therapy exerts cytotoxic effects in RR-HNSCC cell lines by inducing specific ROS-mediated ferroptosis. DUSP16, PDGFB, and THBS1 were identified as crucial targets for reversing the radiation resistance induced by NTPAM therapy, providing insights into the mechanisms and clinical applications of NTPAM treatment in RR-HNSCC.

Objectives: . Head and neck squamous cell carcinoma (HNSCC) exhibits high recurrence rates, particularly in cases of radioresistant HNSCC (RR-HNSCC). Non-thermal plasma (NTP) therapy effectively suppresses the progression of HNSCC. However, the therapeutic mechanisms of NTP therapy in treating RR-HNSCC are not well understood. In this study, we explored the regulatory role of NTP in the RR-HNSCC signaling pathway and identified its signature genes. Methods: . After constructing two RR-HNSCC cell lines, we prepared cell lysates from cells treated or not treated with NTP-activated media (NTPAM) and performed RNA sequencing to determine their mRNA expression profiles. Based on the RNA sequencing results, we identified differentially expressed genes (DEGs), followed by a bioinformatics analysis to identify candidate molecules potentially associated with NTPAM therapy for RR-HNSCC. Results: . NTPAM reduced RR-HNSCC cell viability in vitro. RNA sequencing results indicated that NTPAM treatment activated the reactive oxygen species (ROS) pathway and induced ferroptosis in RR-HNSCC cell lines. Among the 1,924 genes correlated with radiation treatment, eight showed statistical significance in both the cell lines and The Cancer Genome Atlas (TCGA) cohort. Only five genes—ABCC3, DUSP16, PDGFB, RAF1, and THBS1—showed consistent results between the NTPAM data sequencing and TCGA data. LASSO regression analysis revealed that five genes were associated with cancer prognosis, with a hazard ratio of 2.26. In RR-HNSCC cells, NTPAM affected DUSP16, PDGFB, and THBS1 as activated markers within 6 hours, and this effect persisted for 12 hours. Furthermore, enrichment analysis indicated that these three DEGs were associated with the extracellular matrix, transforming growth factor-beta, phosphoinositide 3-kinase/protein kinase B, and mesenchymal-epithelial transition factor pathways. Conclusion . NTPAM therapy exerts cytotoxic effects in RR-HNSCC cell lines by inducing specific ROS-mediated ferroptosis. DUSP16, PDGFB, and THBS1 were identified as crucial targets for reversing the radiation resistance induced by NTPAM therapy, providing insights into the mechanisms and clinical applications of NTPAM treatment in RR-HNSCC.

This guideline aims to promote the prudent use of antibacterial agents for managing carbapenem-resistant Enterobacterales (CRE) infections in clinical practice in Korea. The general section encompasses recommendations for the management of common CRE infections and diagnostics, whereas each specific section is structured with key questions that are focused on antibacterial agents and disease-specific approaches. This guideline covers both currently available and upcoming antibacterial agents in Korea.

Objective: To determine the clinical impact of the baseline sagittal imbalance severity in patients with adult spinal deformity (ASD). Methods: We retrospectively reviewed patients who underwent ≥ 5-level fusion including the pelvis, for ASD with a ≥ 2-year follow-up. Using the Scoliosis Research Society-Schwab classification system, patients were classified into 3 groups according to the severity of the preoperative sagittal imbalance: mild, moderate, and severe. Postoperative clinical and radiographic results were compared among the 3 groups. Results: A total of 259 patients were finally included. There were 42, 62, and 155 patients in the mild, moderate, and severe groups, respectively. The perioperative surgical burden was greatest in the severe group. Postoperatively, this group also showed the largest pelvic incidence minus lumbar lordosis mismatch, suggesting a tendency towards undercorrection. No statistically significant differences were observed in proximal junctional kyphosis, proximal junctional failure, or rod fractures among the groups. Visual analogue scale for back pain and Scoliosis Research Society-22 scores were similar across groups. However, severe group’s last follow-up Oswestry Disability Index (ODI) scores significantly lower than those of the severe group. Conclusion Patients with severe sagittal imbalance were treated with more invasive surgical methods along with increased the perioperative surgical burden. All patients exhibited significant radiological and clinical improvements after surgery. However, regarding ODI, the severe group demonstrated slightly worse clinical outcomes than the other groups, probably due to relatively higher proportion of undercorrection. Therefore, more rigorous correction is necessary to achieve optimal sagittal alignment specifically in patients with severe baseline sagittal imbalance.

Objective: This study aimed to examine the psychiatric impact of the Seoul Halloween crowd crush on individuals related to the victims compared to the general population. It also explores the moderating effect of resilience on the relationship between trauma exposure and psychiatric symptoms. Methods: In total, 2,220 participants completed various post-incident questionnaires (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Hwa-byung symptom scale, post-traumatic stress disorder checklist for DSM-5, and Brief Resilience Scale) 30 days after the incident. Moderation analyses were conducted using the PROCESS macro in the statistical package for the social sciences. Results: Individuals related to the victims exhibited higher symptom severity and a greater risk for clinically significant levels of depression, anxiety, anger, and post-traumatic stress disorder (PTSD) (odds ratio=3.28, 3.33, 1.51, and 4.39 respectively). The impact of relevance to victims on anxiety and PTSD symptoms was moderated by resilience, with a stronger effect observed for individuals with low resilience (β=3.51, 95% confidence interval [CI] 2.78–4.24 for anxiety and β=14.53, 95% CI 12.43–16.63 for PTSD) than for those with high resilience (β=1.69, 95% CI 0.72–2.65 for anxiety and β=8.33, 95% CI 5.56–11.09 for PTSD). Conclusion When related to the victims, it was found that not only PTSD, but also depression, anxiety, and anger could intensify. Resilience emerged as a potential buffer against these adverse effects, emphasizing its significance in mitigating the psychiatric impact of community trauma.

Purpose: This study explored the feasibility of utilizing a deep learning artificial intelligence (AI) model to detect ileocolic intussusception on grayscale ultrasound images. Methods: This retrospective observational study incorporated ultrasound images of children who underwent emergency ultrasonography for suspected ileocolic intussusception. After excluding video clips, Doppler images, and annotated images, 40,765 images from two tertiary hospitals were included (positive-to-negative ratio: hospital A, 2,775:35,373; hospital B, 140:2,477). Images from hospital A were split into a training set, a tuning set, and an internal test set (ITS) at a ratio of 7:1.5:1.5. Images from hospital B comprised an external test set (ETS). For each image indicating intussusception, two radiologists provided a bounding box as the ground-truth label. If intussusception was suspected in the input image, the model generated a bounding box with a confidence score (0-1) at the estimated lesion location. Average precision (AP) was used to evaluate overall model performance. The performance of practical thresholds for the modelgenerated confidence score, as determined from the ITS, was verified using the ETS. Results: The AP values for the ITS and ETS were 0.952 and 0.936, respectively. Two confidence thresholds, CTopt and CTprecision, were set at 0.557 and 0.790, respectively. For the ETS, the perimage precision and recall were 95.7% and 80.0% with CTopt, and 98.4% and 44.3% with CTprecision. For per-patient diagnosis, the sensitivity and specificity were 100.0% and 97.1% with CTopt, and 100.0% and 99.0% with CTprecision. The average number of false positives per patient was 0.04 with CTopt and 0.01 for CTprecision. Conclusion The feasibility of using an AI model to diagnose ileocolic intussusception on ultrasonography was demonstrated. However, further study involving bias-free data is warranted for robust clinical validation.

OBJECTIVES: This study aimed to examine the association between the food-based index of dietary inflammatory potential (FBDI) and the risk of mild cognitive impairment (MCI) in Korean older adults. METHODS: The subjects were 798 Korean adults aged 60 years and older. The FBDI was calculated based on the intake of 7 anti-inflammatory and 3 inflammatory food groups. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. A general linear model and multiple logistic regression were applied to assess the association between FBDI and the risk of MCI. RESULTS: As the FBDI increased, the intake of white rice, cookies/candies, and sweetened drinks tended to increase, but the intake of niacin, β-carotene, calcium, and potassium tended to decrease (p for trend<0.05). The highest FBDI group had a higher MCI risk (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.01 to 2.52) than the lowest FBDI group, adjusted for gender, age, and education level; and this trend was significant in a fully adjusted model (p for trend=0.039). No significant associations were found in men after adjusting for confounding factors. Among women, MCI risk increased as the FBDI increased (p for trend=0.007); and the highest FBDI group had a higher MCI risk (OR, 2.22; 95% CI, 1.04 to 4.74) than the lowest FBDI group in a fully adjusted model. CONCLUSIONS These results suggest that the appropriate intake of anti-inflammatory foods and nutrients may be associated with a reduced risk of MCI among older adults.

Objective: To determine the clinical impact of the baseline sagittal imbalance severity in patients with adult spinal deformity (ASD). Methods: We retrospectively reviewed patients who underwent ≥ 5-level fusion including the pelvis, for ASD with a ≥ 2-year follow-up. Using the Scoliosis Research Society-Schwab classification system, patients were classified into 3 groups according to the severity of the preoperative sagittal imbalance: mild, moderate, and severe. Postoperative clinical and radiographic results were compared among the 3 groups. Results: A total of 259 patients were finally included. There were 42, 62, and 155 patients in the mild, moderate, and severe groups, respectively. The perioperative surgical burden was greatest in the severe group. Postoperatively, this group also showed the largest pelvic incidence minus lumbar lordosis mismatch, suggesting a tendency towards undercorrection. No statistically significant differences were observed in proximal junctional kyphosis, proximal junctional failure, or rod fractures among the groups. Visual analogue scale for back pain and Scoliosis Research Society-22 scores were similar across groups. However, severe group’s last follow-up Oswestry Disability Index (ODI) scores significantly lower than those of the severe group. Conclusion Patients with severe sagittal imbalance were treated with more invasive surgical methods along with increased the perioperative surgical burden. All patients exhibited significant radiological and clinical improvements after surgery. However, regarding ODI, the severe group demonstrated slightly worse clinical outcomes than the other groups, probably due to relatively higher proportion of undercorrection. Therefore, more rigorous correction is necessary to achieve optimal sagittal alignment specifically in patients with severe baseline sagittal imbalance.

Objective: This study aimed to examine the psychiatric impact of the Seoul Halloween crowd crush on individuals related to the victims compared to the general population. It also explores the moderating effect of resilience on the relationship between trauma exposure and psychiatric symptoms. Methods: In total, 2,220 participants completed various post-incident questionnaires (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Hwa-byung symptom scale, post-traumatic stress disorder checklist for DSM-5, and Brief Resilience Scale) 30 days after the incident. Moderation analyses were conducted using the PROCESS macro in the statistical package for the social sciences. Results: Individuals related to the victims exhibited higher symptom severity and a greater risk for clinically significant levels of depression, anxiety, anger, and post-traumatic stress disorder (PTSD) (odds ratio=3.28, 3.33, 1.51, and 4.39 respectively). The impact of relevance to victims on anxiety and PTSD symptoms was moderated by resilience, with a stronger effect observed for individuals with low resilience (β=3.51, 95% confidence interval [CI] 2.78–4.24 for anxiety and β=14.53, 95% CI 12.43–16.63 for PTSD) than for those with high resilience (β=1.69, 95% CI 0.72–2.65 for anxiety and β=8.33, 95% CI 5.56–11.09 for PTSD). Conclusion When related to the victims, it was found that not only PTSD, but also depression, anxiety, and anger could intensify. Resilience emerged as a potential buffer against these adverse effects, emphasizing its significance in mitigating the psychiatric impact of community trauma.