Effect of aerobic exercise and particulate matter exposure duration on the diversity of gut microbiota.

Inhalation of ambient particulate matter (PM) can disrupt the gut microbiome, while exercise independently influences the gut microbiome by promoting beneficial bacteria. In this study, we analyzed changes in gut microbial diversity and composition in response to combined interventions of PM exposure and aerobic exercise, extending up to 12 weeks. This investigation was conducted using mice, categorized into five groups: control group (Con), exercise group (EXE), exercise group followed by 3-day exposure to PM (EXE + 3-day PM), particulate matter exposure (PM), and PM exposure with concurrent treadmill exercise (PME). Notably, the PM group exhibited markedly lower alpha diversity and richness compared to the Con group and our analysis of beta diversity revealed significant variations among the intervention groups. Members of the Lachnospiraceae family showed significant enhancement in the exercise intervention groups (EXE and PME) compared to the Con and PM groups. The biomarker Lactobacillus, Coriobacteraceae, and Anaerofustis were enriched in the EXE group, while Desulfovibrionaceae, Mucispirillum schaedleri, Lactococcus and Anaeroplasma were highly enriched in the PM group. Differential abundance analysis revealed that Paraprevotella, Bacteroides, and Blautia were less abundant in the 12-week PM exposure group than in the 3-day PM exposure group. Moreover, both the 3-day and 12-week PM exposure groups exhibited a reduced relative abundance of Bacteroides uniformis, SMB53, and Staphylococcus compared to non-PM exposure groups. These findings will help delineate the possible roles and associations of altered microbiota resulting from the studied interventions, paving the way for future mechanistic research.

The effect of age on alpha rhythms in the human brain derived from source localized resting-state electroencephalography.

With increasing age, peak alpha frequency (PAF) is slowed, and alpha power is reduced during resting-states with eyes closed. These age-related changes are evident across the whole scalp but remained unclear at the source level. The purpose of this study was to determine whether age impacts the power and frequency of the dominant alpha rhythm equally across source generators or whether the impact of age varies across sources. A total of 28 young adults and 26 elderly adults were recruited. High-density EEG was recorded for 10 mins with eyes closed. Single dipoles for each independent component were localized and clustered based on their anatomical label, resulting in 36 clusters. Meta-analyses were then conducted to assess effect sizes for PAF and power at PAF for all 36 clusters. Subgroup analyses were then implemented for frontal, sensorimotor, parietal, temporal, and occipital regions. The results of the meta-analyses showed that the elderly group exhibited slower PAF and less power at PAF compared to the young group. Subgroup analyses revealed age effects on PAF in parietal (g = 0.38), temporal (g = 0.65), and occipital regions (g = 1.04), with the largest effects observed in occipital regions. For power at PAF, age effects were observed in sensorimotor (g = 0.84) and parietal regions (g = 0.80), with the sensorimotor region showing the largest effect. Our findings show that age-related slowing and attenuation of the alpha rhythm manifests differentially across cortical regions, with sensorimotor and occipital regions most susceptible to age effects.

Temporal variations in the gut microbial diversity in response to high-fat diet and exercise.

High-fat diet-induced obesity is a pandemic caused by an inactive lifestyle and increased consumption of Western diets and is a major risk factor for diabetes and cardiovascular diseases. In contrast, exercise can positively influence gut microbial diversity and is linked to a decreased inflammatory state. To understand the gut microbial variations associated with exercise and high-fat diet over time, we conducted a longitudinal study to examine the effect of covariates on gut microbial diversity and composition. Young mice were divided into four groups: Chow-diet (CHD), high-fat diet (HFD), high-fat diet + exercise (HFX), and exercise only (EXE) and underwent experimental intervention for 12 weeks. Fecal samples at week 0 and 12 were collected for DNA extraction, followed by 16S library preparation and sequencing. Data were analyzed using QIIME 2, R and MicrobiomeAnalyst. The Bacteroidetes-to-Firmicutes ratio decreased fivefold in the HFD and HFX groups compared to that in the CHD and EXE groups and increased in the EXE group over time. Alpha diversity was significantly increased in the EXE group longitudinally (p < 0.02), whereas diversity (Shannon, Faith's PD, and Fisher) and richness (ACE) was significantly reduced in the HFD (p < 0.005) and HFX (p < 0.03) groups over time. Beta diversity, based on the Jaccard, Bray-Curtis, and unweighted UniFrac distance metrics, was significant among the groups. Prevotella, Paraprevotella, Candidatus arthromitus, Lactobacillus salivarius, L. reuteri, Roseburia, Bacteroides uniformis, Sutterella, and Corynebacterium were differentially abundant in the chow-diet groups (CHD and EXE). Exercise significantly reduced the proportion of taxa characteristic of a high-fat diet, including Butyricimonas, Ruminococcus gnavus, and Mucispirillum schaedleri. Diet, age, and exercise significantly contributed to explaining the bacterial community structure and diversity in the gut microbiota. Modulating the gut microbiota and maintaining its stability can lead to targeted microbiome therapies to manage chronic and recurrent diseases and infections.

Effects of Particulate Matter Inhalation during Exercise on Oxidative Stress and Mitochondrial Function in Mouse Skeletal Muscle.

Particulate matter (PM) has deleterious consequences not only on the respiratory system but also on essential human organs, such as the heart, blood vessels, kidneys, and liver. However, the effects of PM inhalation on skeletal muscles have yet to be sufficiently elucidated. Female C57BL/6 or mt-Keima transgenic mice were randomly assigned to one of the following four groups: control (CON), PM exposure alone (PM), treadmill exercise (EX), or PM exposure and exercise (PME). Mice in the three-treatment group were subjected to treadmill running (20 m/min, 90 min/day for 1 week) and/or exposure to PM (100 µg/m3). The PM was found to exacerbate oxidative stress and inflammation, both at rest and during exercise, as assessed by the levels of proinflammatory cytokines, manganese-superoxide dismutase activity, and the glutathione/oxidized glutathione ratio. Furthermore, we detected significant increases in the levels of in vivo mitophagy, particularly in the PM group. Compared with the EX group, a significant reduction in the level of mitochondrial DNA was recorded in the PME group. Moreover, PM resulted in a reduction in cytochrome c oxidase activity and an increase in hydrogen peroxide generation. However, exposure to PM had no significant effect on mitochondrial respiration. Collectively, our findings in this study indicate that PM has adverse effects concerning both oxidative stress and inflammatory responses in skeletal muscle and mitochondria, both at rest and during exercise.

Lower individual alpha frequency in individuals with chronic low back pain and fear of movement.

ABSTRACT: Significant progress has been made in linking measures of individual alpha frequency (IAF) and pain. A lower IAF has been associated with chronic neuropathic pain and with an increased sensitivity to pain in healthy young adults. However, the translation of these findings to chronic low back pain (cLBP) are sparse and inconsistent. To address this limitation, we assessed IAFs in a cohort of 70 individuals with cLBP, implemented 3 different IAF calculations, and separated cLBP subjects based on psychological variables. We hypothesized that a higher fear movement in cLBP is associated with a lower IAF at rest. A total of 10 minutes of resting data were collected from 128 electroencephalography channels. Our results offer 3 novel contributions to the literature. First, the high fear group had a significantly lower peak alpha frequency. The high fear group also reported higher pain and higher disability. Second, we calculated individual alpha frequency using 3 different but established methods; the effect of fear on individual alpha frequency was robust across all methods. Third, fear of movement, pain intensity, and disability highly correlated with each other and together significantly predicted IAF. Our findings are the first to show that individuals with cLBP and high fear have a lower peak alpha frequency.

Dribble Accuracy and Arm Coordination Pattern According to Motor Expertise and Tempo.

Skilled movements in motor learning result from efficiently controlling the many degrees of freedom in human movement. To acquire motor skills, harmonious coordination of body segments in time and space is crucial for accurate and consistent performance. The purpose of this study was to compare dribbling accuracy, consistency, and coordination patterns of body segments according to motor expertise and tempo. To achieve this, we had eight basketball experts and eight beginners perform static dribbling at three different speeds for 20 s. Force plates measured radial error while motion capture equipment measured the angular data of the right arm's fingers, wrist, and elbow. The measurements obtained from the force plate were used to analyze the participants' dribbling performance, including accuracy, consistency, and coordination patterns. The research results showed that there was no significant difference in dribbling accuracy according to skill level, but skilled players showed higher consistency in the anterior-posterior (AP) direction (p < 0.001). In the comparative analysis of coordination patterns, skilled players showed an in-phase structure, whereas beginners showed an anti-phase structure (elbow-wrist: p < 0.05; wrist-finger: p < 0.001; elbow-finger: p < 0.001). This study suggests that achieving proficiency in basketball dribbling requires a strategy that involves coordination of movements with an in-phase pattern for stability in performance.

The effect of chronic low back pain on postural control during quiet standing: A meta-analysis.

Low back pain (LBP) has been associated with altered body sway during quiet standing, but the pattern of results is inconsistent. The purpose of this meta-analysis is to examine the effects of vision (eyes open, eyes closed) and changing the support surface (foam surface, firm surface) on postural sway during quiet standing in individuals with chronic LBP (cLBP). Five electronic databases were searched on March 27th, 2022. Of 2,856, 16 studies (n = 663) were included. Across all conditions, we found a positive and medium effect size (g = 0.77 [0.50, 1.04]) that represented greater body sway in individuals with cLBP. Subgroup analyses revealed medium effects during eyes open conditions (firm surface: g = 0.60 [0.33, 0.87]; foam surface: g = 0.68 [0.38, 0.97]), and large effects during eyes closed conditions (firm surface: g = 0.97 [0.60, 1.35]; foam surface: g = 0.89 [0.28, 1.51]). We quantified effects of self-reported pain and found a moderate effect during eyes closed plus firm surface conditions (Q = 3.28; p = 0.070). We conclude that cLBP is associated with increased postural sway, with largest effect sizes evident when vision is removed and when self-reported pain intensity is higher.

Time-efficient implantable catheters for draining malignant ascites in terminal cancer patients.

BACKGROUND: There is a need for an improved version of the implantable catheter for malignant ascites in the abdominal cavity. OBJECTIVE: New implantable catheters have been developed that drain ascites from the abdominal cavity to the bladder by applying pressure. Based on pigtail catheters, these newly designed catheters have silicone membranes and apertures. METHODS: Experimental instruments controlled flow rates and water level to observe changes of the activation pressure and its cycle time along flow rates and turns of catheters. Furthermore, various normality tests, difference tests and non-parametric tests were investigated to observe statistical validity. RESULTS: Cycle times were significantly affected by flow rate (3/4 cases of p< 0.05). The effects of flow rate on activation pressure, however, were not significant (1/4 case of p< 0.05). Cycle times were not significantly affected by the number of turns of the catheter (3/8 cases of p< 0.05). In contrast, the effects of the turns on activation pressure were significant (5/8 cases of p< 0.05). CONCLUSION: Overall, there was no significant difference between cycle times for 1.5 turns and 2.0 turns of catheters. In addition, catheters with 1.5 turns have a lower activation pressure than catheters with 2.0 turns. It is possible to customize catheters based on the ascites excretion and urination rates of various terminal patients.

Comparison of Osseointegration of Dental Implants Placed in Rabbit Tibia Using Two Dental Laser and Implant Handpiece Systems.

The present study aimed to confirm the usefulness of a multi-laser handpiece system currently under development. Implants were placed in the tibia of rabbits using a conventional separate laser-implant handpiece system (control group; SurgicPro+; NSK, Kanuma, Japan and Epic 10; Biolase, Irvine, CA, USA) and a multi-laser handpiece system (experimental group; BLP 10; Saeshin, Daegu, Korea). Implants were placed in left and right tibias of five rabbits using a conventional laser-implant handpiece system and a multi-laser handpiece system (N = 5 per group). Subsequently, micro-computed tomography (micro-CT; bone-to-implant contact evaluation), implant stability quotient (ISQ) measurement, and histological evaluations were performed to confirm the implant placement results. The independent t-test and the paired t-test were used to compare the ISQ values and the results of the two implant-laser handpiece groups (α = 0.05), respectively. No statistically significant difference in micro-CT, ISQ, and histological evaluations was observed between implant placement by the two systems (p > 0.05) except implant initial stability. The use of the multi-laser handpiece system is expected to produce the same results as a conventional separate laser-implant handpiece system with the higher implant initial stability. Additionally, it will potentially make the clinical environment more pleasant and will provide convenience for the clinicians.

Long-Term Survival Rate of Autogenous Tooth Transplantation: Up to 162 Months.

Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.

Current status and trends of pulmonary rehabilitation in South Korea: National level data analysis using Health Insurance Review and Assessment Service (HIRA) database from 2016 to 2018.

In South Korea, there are few studies to understand the current status of pulmonary rehabilitation in clinical practice and develop it. This study aimed to assess the current status and annual changes in the number and pattern of prescriptions for pulmonary rehabilitation before and after its insurance coverage. The trends of pulmonary rehabilitation before and after its insurance coverage commencement were evaluated using the data of 24,380 patients during the 3-year period from 2016 to 2018 that were archived by the National Health Information Database of the Health Insurance Review and Assessment Service in South Korea. The annual total number of patients who received pulmonary rehabilitation was stratified by the type of prescription, sex, age, type of insurance, medical institution, and region. In addition, the frequencies of pulmonary rehabilitation for various diagnoses were investigated using the major codes of the Korean Standard Classification of Disease. The patients who received pulmonary rehabilitation increased by approximately 2 times from 5936 in 2016 (before insurance coverage) to 10,474 in 2019. Before 2017, most patients underwent simple pulmonary rehabilitation coded as MM290. However, since the insurance coverage of rehabilitation exercise for pulmonary disease (MM440), the proportions of patients receiving them increased. Men underwent pulmonary rehabilitation more often than women, and >70% of the patients were aged >60 years. Most patients received pulmonary rehabilitation at tertiary hospitals in Seoul. In 2016, pulmonary rehabilitation was prescribed more frequently for cerebral infarction; after 2017, it was prescribed more frequently for lung cancer. This study summarized the current status and trends of pulmonary rehabilitation in South Korea before and after National Health Insurance Service coverage, which commenced on January 1, 2017. A significant increase in the number of pulmonary rehabilitations was confirmed after the insurance coverage.

Diet Is a Stronger Covariate than Exercise in Determining Gut Microbial Richness and Diversity.

Obesity is a common metabolic disorder caused by a sedentary lifestyle, and a high-fat and a high-glucose diet in the form of fast foods. High-fat diet-induced obesity is a major cause of diabetes and cardiovascular diseases, whereas exercise and physical activity can ameliorate these disorders. Moreover, exercise and the gut microbiota are known to be interconnected, since exercise can increase the gut microbial diversity and contribute to the beneficial health effects. In this context, we analyzed the effect of diet and exercise on the gut microbiota of mice, by next-generation sequencing of the bacterial V4 region of 16S rRNA. Briefly, mice were divided into four groups: chow-diet (CD), high-fat diet (HFD), high-fat diet + exercise (HFX), and exercise-only (EX). The mice underwent treadmill exercise and diet intervention for 8 weeks, followed by the collection of their feces and DNA extraction for sequencing. The data were analyzed using the QIIME 2 bioinformatics platform and R software to assess their gut microbial composition, richness, and diversity. The Bacteroidetes to Firmicutes ratio was found to be decreased manifold in the HFD and HFX groups compared to the CD and EX groups. The gut microbial richness was comparatively lower in the HFD and HFX groups and higher in the CD and EX groups (ACE, Chao1, and observed OTUs). However, the Shannon alpha diversity index was higher in the HFD and HFX groups than in the CD and EX groups. The beta diversity based on Jaccard, Bray-Curtis, and weighted UniFrac distance metrics was significant among the groups, as measured by PERMANOVA. Paraprevotella, Desulfovibrio, and Lactococcus were the differentially abundant/present genera based on the intervention groups and in addition to these three bacteria, Butyricimonas and Desulfovibrio C21c20 were differentially abundant/present based on diet. Hence, diet significantly contributed to the majority of the changes in the gut microbiota.

Glymphatic system function in patients with newly diagnosed focal epilepsy.

INTRODUCTION: The aim of this study was to analyze the glymphatic system function and its relationship with clinical characteristics, global diffusion tensor imaging (DTI) parameters, and global structural connectivity in treatment-naïve patients with newly diagnosed focal epilepsy. METHODS: This retrospective single-center study investigated patients with focal epilepsy and healthy controls. All participants underwent routine brain magnetic resonance imaging and DTI. DTI analysis along the perivascular space (DTI-ALPS) was used to evaluate glymphatic system function. We also calculated the measures of global DTI parameters, including whole-brain fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), and performed a graph theoretical network analysis to measure global structural connectivity. RESULTS: A total of 109 patients with focal epilepsy and 88 healthy controls were analyzed. There were no significant differences in the DTI-ALPS index (1.67 vs. 1.68, p = 0.861) between the groups. However, statistically significant associations were found between the DTI-ALPS index and age (r = -0.242, p = 0.01), FA (r = 0.257, p = 0.007), MD (r = -0.469, p < 0.001), AD (r = -0.303, p = 0.001), RD (r = -0.434, p < 0.001), and the assortative coefficient (r = 0.230, p = 0.016) in patients with focal epilepsy. CONCLUSION: The main finding of this study is that DTI-ALPS index is significantly correlated with global DTI parameters and structural connectivity measures of the brain in patients with focal epilepsy. In addition, DTI-ALPS index decreases with age in these patients. We conclude that the DTI-ALPS index can be used to investigate glymphatic system function in patients with focal epilepsy.

The development process and significance of the 3rd National Climate Change Adaptation Plan (2021-2025) of the Republic of Korea.

The Republic of Korea has developed its 3rd National Climate Change Adaptation Plan (2021-2025) through joint work between government departments in 2020. This follows the Framework Act on Low Carbon, Green Growth, which was enacted in 2010. In this paper, we presented the development process, main contents, significance, and limitations of the 3rd Adaptation Plan as a helpful case for the international community to consult in formulating their national adaptation plans. The plan aims to implement a climate-safe nation with the people, and its development process features a scientific evidence basis and participation of various parties. It systematically and organically recommends 232 measures to be implemented by the Korean government and related departments for the next five years to enhance the adaptive capacity to 84 climate risks. Through expert forums, working council on climate change adaptation, adaptation governance forums, online public hearings, and discussion on preparing public-oriented countermeasures, 41 representative public-oriented tasks in eight sectors were selected. The plan consists of measures to resolve national climate risks constructed based on scientific evidence. All adaptation parties participated in the entire process of establishing the adaptation plan and evaluating its implementation. Significantly, the 3rd Adaptation Plan attempts to overcome the limitations of the 2nd adaptation plan by planning for the operation of a citizen evaluation group. However, the plan's limitations have been identified as insufficient willingness to monitor and implement measures, differences in the spectrum of adaptation measures by a government department, and lack of publicity in the English language. The measures to deal with these shortcomings are being sought.

Affective Change With Variations in Zumba Fitness Intensity as Measured by a Smartwatch.

In this study we investigated affective changes during Zumba fitness program exercise with varied intensity, as measured by a smartwatch. Sixteen college students (4 males and 12 females) participated in two single-session Zumba fitness programs at low and moderate intensities separated by a one-week interval. During exercise, participants' heart rate (HR) and their responses to the Felt Arousal Scale (FAS) and the Feeling Scale (FS) were measured seven times (pre-exercise, warm-up, merengue, reggaeton, salsa, cumbia, and cool-down) using tailor-made applications on a smartwatch. Additionally, pre- and post-exercise affect was measured by the PANAS-X, which showed enhanced positive affect and reduced negative affect following exercise. Feelings and arousal during exercise were activated, irrespective of exercise intensity, but positive effects were more prominent at the higher (moderate) exercise intensity level. By adopting wearable technology, we were able to measure real-time affect changes during exercise, and we demonstrated the particular affective benefits of a moderate intensity Zumba Fitness program.

Aerobic Exercise Mediates Neural Inefficiency Among Adolescents At Risk for Suicide.

This study examined the electroencephalograpy (EEG) coherence and working memory performance effects of a 9-week exercise program on a small group of adolescents at high suicide risk. We randomly assigned 26 adolescents at high suicide risk (based on their scores on the Adolescents Mental Health Inventory- AMHI) into equal sized exercise and no-exercise groups. Before and after the 9-week exercise program, all participants performed the Sternberg working memory task, during which we recorded their EEGs, with electrodes placed at F3, F4, C3, C4, P3, P4, T3, T4, O1, and O2 regions (using the International 10-20 system of EEG electrode placement). We measured working memory performance and inter-hemispheric (F3-F4, C3-C4, T3-T4, P3-P4, O1-O2) and intra-hemispheric (F3-C3, F3-T3, F3-P3, F3-O1, F4-C4, F4-T4, F4-P4, F4-O2) EEG coherence as an index of the participants' underlying neural efficiency. While we found no significant group differences in working memory performances, the exercise group, relative to the no-exercise group, exhibited lower inter- and intra-hemispheric EEG coherence while performing the working memory task. These EEG differences may reflect a mediating effect of aerobic exercise on these participants' neural efficiency.

Effect of Aerobic Exercise on Oxidative Stress and Inflammatory Response During Particulate Matter Exposure in Mouse Lungs.

Regular exercise provides several health benefits that can improve the cardiovascular and musculoskeletal systems, but clear evidence on the effect of exercise-induced hyperventilation in particulate matter (PM) exposure is still lacking. This study aimed to investigate the effects of exercise in PM exposure on reactive oxygen species (ROS) generation, inflammatory response, and mitochondrial integrity in human lung epithelial cells (A549), as well as in mouse lung tissue. In in vitro experiments, PM treatment was shown to significantly increased ROS production, and reduced cell viability and mitochondrial function in A549 cells. The mice were divided into four groups for an in vivo exercise experiment: control (CON), PM inhalation (PI), PM inhalation during exercise (PIE), and exercise (EX) groups. The PI and PIE groups were exposed to 100 µg/m3 of PM for 1 h per day for a week. The PIE and EX groups performed treadmill exercises every day for 1 h at 20 m/min for a week. The levels of pro-inflammatory markers (IL-6 and TNF-α) were significantly higher in the PI group than in the CON group (P < 0.001 and P < 0.01, respectively). The carbonyl protein level was decreased in EX vs. PI (P < 0.001). Mitochondrial fission (Drp1) content was significantly decreased in the EX vs. CON group (P < 0.01), but anti-mitochondrial fission (P-Drp1 Ser637) was increased in the EX vs. PI group (P < 0.05). Mitochondrial autophagy (mitophagy), which is an assessment of mitochondrial integrity, was markedly increased in PI vs. CON (P < 0.001), but the level was reversed in PIE (P < 0.05). Lung fibrosis was increased in PI vs. CON group (P < 0.001), however, the cells were rescued in the PIE (P < 0.001). The number of apoptotic cells was remarkably increased in the PI vs. CON group (P < 0.001), whereas the level was decreased in the PIE (P < 0.001). Taken together, these results showed that short-term exposure to PM triggers oxidative stress, pro-inflammatory responses, and apoptosis in the lungs, but the PM-induced adverse effects on the lung tissue are not exacerbated by exercise-induced PM hyperventilation but rather has a protective effect.

Unilateral pleuroparenchymal fibroelastosis as a rare form of idiopathic interstitial pneumonia: A case report.

BACKGROUND: Pleuroparenchymal fibroelastosis (PPFE) is a rare idiopathic interstitial pneumonia characterized by predominantly upper lobe involvement with pleural fibrosis and subjacent parenchymal fibrosis. Recently, there have been increasing reports of PPFE, and PPFE might coexist with other interstitial lung diseases in the lower lobe and upper lobe. However, cases of unilateral PPFE are scarce. CASE SUMMARY: A 75-year-old Korean male presented to our hospital with chronic dry cough and exertional dyspnea. The patient's symptoms started 6 mo previously and had been gradually worsening. At the time of presentation, he felt dyspnea when walking at his own pace. Radiologic findings suggested PPFE, but the lesion was localized in the upper lobe of the right lung. After multidisciplinary discussion, a transbronchial lung biopsy in the right upper lobe revealed collapsed alveoli with parenchymal fibroelastosis, and elastic van Gieson staining demonstrated septal elastosis with intra-alveolar collagenosis, which met the histopathologic criteria of definite PPFE. After multidisciplinary discussion in an experienced interstitial lung disease center, we confirmed the diagnosis of unilateral PPFE. Furthermore, we confirmed the progression of PPFE on radiologic findings during the follow-up period. CONCLUSION: Clinicians should consider PPFE, even in cases with unilateral, predominantly upper lung involvement in interstitial lung disease patients through multidisciplinary discussion.

A Supervised Machine Learning Approach to Detect the On/Off State in Parkinson's Disease Using Wearable Based Gait Signals.

Fluctuations in motor symptoms are mostly observed in Parkinson's disease (PD) patients. This characteristic is inevitable, and can affect the quality of life of the patients. However, it is difficult to collect precise data on the fluctuation characteristics using self-reported data from PD patients. Therefore, it is necessary to develop a suitable technology that can detect the medication state, also termed the "On"/"Off" state, automatically using wearable devices; at the same time, this could be used in the home environment. Recently, wearable devices, in combination with powerful machine learning techniques, have shown the potential to be effectively used in critical healthcare applications. In this study, an algorithm is proposed that can detect the medication state automatically using wearable gait signals. A combination of features that include statistical features and spatiotemporal gait features are used as inputs to four different classifiers such as random forest, support vector machine, K nearest neighbour, and Naïve Bayes. In total, 20 PD subjects with definite motor fluctuations have been evaluated by comparing the performance of the proposed algorithm in association with the four aforementioned classifiers. It was found that random forest outperformed the other classifiers with an accuracy of 96.72%, a recall of 97.35%, and a precision of 96.92%.

Safety of early orthopedic surgery in patients with intermediate/low- or low-risk pulmonary embolism.

BACKGROUND: Preoperative pulmonary embolism (PE) is one of the comorbidities in patients with hip fracture. However, previous studies have not identified the optimal timing of surgery in these patients, who might require early surgery. This study aimed to investigate the safety and clinical feasibility of early surgery in patients with hip fracture and acute PE. METHODS: The medical records of 156 patients with hip fracture, who were suspected to have PE and underwent pulmonary computed tomography angiography at Asan Medical Center from January 2008 to December 2017, were retrospectively reviewed. After excluding patients who were diagnosed with PE during the postoperative period, the baseline characteristics and clinical course were compared between patients preoperatively diagnosed with PE (PE group) and patients without PE during the hospital stay (non-PE group). Adverse outcomes were evaluated during 3 months postoperatively. RESULTS: The baseline characteristics were not different between the PE group (n=90) and the non-PE group (n=50). All patients in the PE group were classified as having an intermediate/low or low risk according to the European Society of Cardiology guidelines and underwent surgery within 30 days after the PE diagnosis (median duration: 2 days). None of the patients in both groups developed symptomatic venous thromboembolism (VTE) during the follow-up. Moreover, there were no statistically significant differences in major bleeding, clinically relevant nonmajor (CRNM) bleeding, transfusion amount, bleeding site, and length of hospital stay between the PE and non-PE groups. CONCLUSIONS: Our results suggest that early surgery might be a reasonable treatment option in patients with hip fracture and acute PE.