Mass Spectrometric Sampling of a Liquid Surface by Nanoliter Droplet Generation from Bursting Bubbles and Focused Acoustic Pulses: Application to Studies of Interfacial Chemistry

The complex chemistry occurring at the interface between liquid and vapor phases contributes significantly to the dynamics and evolution of numerous chemical systems of interest, ranging from damage to the human lung surfactant layer to the aging of atmospheric aerosols. This work presents two methodologies to eject droplets from a liquid water surface and analyze them via mass spectrometry. In bursting bubble ionization (BBI), droplet ejection is achieved via the formation of a jet following bubble rupture at the surface of a liquid to yield 250 μm diameter droplets (10 nL volume). In interfacial sampling by an acoustic transducer (ISAT), droplets are produced by focusing pulsed piezoelectric transducer-generated acoustic waves at the surface of a liquid, resulting in the ejection of droplets of 100 μm in diameter (500 pL volume). In both experimental methodologies, ejected droplets are aspirated into the inlet of the mass spectrometer, resulting in the facile formation of gas-phase ions. We demonstrate the ability of this technique to readily generate spectra of surface-active analytes, and we compare the spectra to those obtained by electrospray ionization. Charge measurements indicate that the ejected droplets are near-neutral (<0.1% of the Rayleigh limit), suggesting that gas-phase ion generation occurs in the heated transfer capillary of the instrument in a mechanism similar to thermospray or sonic spray ionization. Finally, we present the oxidation of oleic acid by ozone as an initial demonstration of the ability of ISAT-MS to monitor heterogeneous chemistry occurring at a planar water/air interface

Technology-based self-management interventions for women with breast cancer: a systematic review

Purpose Since technology-based interventions can facilitate convenient access to healthcare for women with breast cancer, it is crucial to understand innovative approaches to maintaining the effectiveness of these interventions. Therefore, we conducted a systematic review of technology-based self-management interventions for women with breast cancer in six countries. We analyzed the characteristics of these interventions and examined their diverse health outcomes. Methods Six databases were systematically searched to extract research articles using the keywords “breast cancer,” “technology,” and “self-management.” The search was carried out up until June 12, 2023. From the 1,288 studies retrieved from the database search, 10 eligible papers were identified based on inclusion/exclusion criteria. Two authors independently extracted and compared the data from these articles, resolving any discrepancies through discussion. Results Most of the 10 studies utilized web- or mobile-based technology, and one used artificial intelligence-based technology. Among the 12 health-related outcome variables, quality of life and symptom distress were the most frequently mentioned, appearing in six articles. Furthermore, an analysis of the intervention programs revealed a variety of common constructs and the involvement of managers in the self-management intervention. Conclusion Incorporating key components such as self-management planning, diary keeping, and communication support in technology-based interventions could significantly improve the self-management process for breast cancer survivors. The practical application of technology has the potential to empower women diagnosed with breast cancer and improve their overall quality of life, by providing timely and sustainable interventions, and by leveraging available resources and tools

Validation of the ECOS-16 Questionnaire in Koreans with Osteoporosis

Study DesignProspective study.PurposeTo evaluate the reliability and validity of the adapted Korean version of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (ECOS-16).Overview of LiteratureThe validity of the Korean version of ECOS-16 has not been completely demonstrated.MethodsTranslation/retranslation of the English version of ECOS-16, and full cross-cultural adaptation were performed. The Korean version of a visual analog scale measure of pain, and the Korean versions of ECOS-16 and of the previously validated short form-36 (SF-36) were mailed to 158 consecutive patients with osteoporosis. Factor analysis and reliability assessment using kappa statistics of agreement for each item, intraclass correlation coefficient, and Cronbach's α were done. Construct validity was evaluated by comparing responses to ECOS-16 with responses to SF-36 using Pearson's correlation coefficient.ResultsFactor analysis extracted three factors. All items had a kappa statistics of agreement >0.6. The ECOS-16 showed good test/re-test reliability (0.8469) and internal consistency of Cronbach's α (0.897). The Korean version of ECOS-16 showed significant correlation with SF-36 total scores and with single SF-36 domains scores.ConclusionsThe adapted Korean version of the ECOS-16 was successfully translated and showed acceptable measurement properties. It is considered suitable for outcome assessments in Korean patients with osteoporosis

Characteristics of interval gastric neoplasms detected within two years after negative screening endoscopy among Koreans

Background In Korea, where gastric cancer is highly prevalent, biennial endoscopy is recommended among individuals over 40. Even under regular screening, some are still diagnosed at advanced stages. We aimed to identify characteristics of interval gastric neoplasms (IGNs) with rapid progression. Results Newly-diagnosed gastric neoplasms detected in screening endoscopy between January 2004 and May 2016 were reviewed. Among them, those who had previous endoscopy within 2 years were enrolled. Endoscopic findings, family history of gastric cancer, smoking, and H. pylori status were analysed. Totally, 297 IGN cases were enrolled. Among them, 246 were endoscopically treatable IGN (ET-IGN) and 51 were endoscopically untreatable IGNs (EUT-IGN) by the expanded criteria for endoscopic submucosal dissection. Among EUT-IGNs, 78% were undifferentiated cancers (40/51) and 33% showed submucosal invasion (13/40). They were median 2.0 cm in size and more commonly located in the proximal stomach than ET-IGNs (70.6% vs. 41.9%, p < 0.001). EUT-IGN was independently related with age < 60 (OR, 2.09; 95%CI, 1.03–4.26, p = 0.042), H. pylori (OR, 2.81; 95%CI, 1.20–6.63, p = 0.018), and absent/mild gastric atrophy (OR, 2.67; 95%CI, 1.25–5.72, p = 0.011). Overall and disease-specific survival were not significantly different between the two groups, however EUT-IGN tended to have short disease-specific survival (overall survival, p = 0.143; disease-specific survival, p = 0.083). Conclusions Uniform screening endoscopy with two-year interval seems not enough for rapid-growing gastric neoplasms, such as undifferentiated cancers. They tended to develop in adults younger than 60 with H. pylori infection without severe gastric atrophy. More meticulous screening, especially for proximal lesions is warranted for adults younger than 60 with H. pylori infection before development of gastric atrophy

The serum vitamin D level is inversely correlated with nonalcoholic fatty liver disease

Background/Aims:A low vitamin D level has been associated with metabolic syndrome and diabetes. However, an association between a low vitamin D level and nonalcoholic fatty liver disease (NAFLD) has not yet been definitively established. This study aimed to characterize the relationship between a vitamin D level and NAFLD in Korea. Methods:A cross-sectional study involving 6,055 health check-up subjects was conducted. NAFLD was diagnosed on the basis of typical ultrasonographic findings and a history of alcohol consumption. Results:The subjects were aged 51.7±10.3 years (mean±SD) and 54.7% were female. NAFLD showed a significant inverse correlation with the vitamin D level after adjusting for age and sex [odds ratio (OR)=0.85, 95% confidence interval (CI)=0.75–0.96]. The age- and sex-adjusted prevalence of NAFLD decreased steadily with increasing vitamin D level [OR=0.74, 95% CI=0.60–0.90, lowest quintile (≤14.4 ng/mL) vs highest quintile (≥28.9 ng/mL), p for trend 20 ng/mL) [OR=0.86, 95% CI=0.75-0.99] and the quintiles of the vitamin D level in a dose-dependent manner (p for trend=0.001). Conclusions:The serum level of vitamin D, even when within the normal range, was found to be inversely correlated with NAFLD in a dose-dependent manner. Vitamin D was found to be inversely correlated with NAFLD independent of known metabolic risk factors. These findings suggest that vitamin D exerts protective effects against NAFLD

Lean or diabetic subtypes predict increased all-cause and disease-specific mortality in metabolic-associated fatty liver disease

Background Metabolic-associated fatty liver disease (MAFLD) encompasses diverse disease groups with potentially heterogeneous clinical outcomes. We investigated the risk of all-cause and disease-specific mortality in MAFLD subgroups. Methods Using the Korean National Health Insurance Service database, participants were divided into four subgroups: no MAFLD, MAFLD-diabetes, MAFLD-overweight/obese, and MAFLD-lean. Hazard ratios (HRs) and 95% confidence interval (CI) values for all-cause and disease-specific mortality according to MAFLD subgroups were analyzed using Cox proportional hazards models. Results Among 9,935,314 participants, those with MAFLD-diabetes showed the highest risk of all-cause and disease-specific mortality. The HRs (95% CI) for all-cause mortality were 1.61 (1.59–1.63), 1.36 (1.34–1.38), and 1.19 (1.18–1.20) in the MAFLD-diabetes, MAFLD-lean, and MAFLD-overweight/obese groups, respectively. The magnitude of cardiovascular disease and cancer-related risk showed the same pattern. The risk of liver-related mortality in the MAFLD-lean group (HR: 2.84, 95% CI: 2.72–2.97) was comparable with that in the MAFLD-diabetes group (HR: 2.85, 95% CI: 2.75–2.95). When stratified by body mass index, liver-related mortality was the highest in MAFLD-lean individuals in the underweight group (HR, 5.03, 95% CI: 4.23–5.97). Conclusions The MAFLD-lean and MAFLD-diabetes groups had a higher risk of all-cause and disease-specific mortality than did the MAFLD-overweight/obese group. Classifying MAFLD subgroups based on metabolic phenotypes might help risk stratification of patients with MAFLD.This work was supported in part by grants from the Seoul National University Hospital (04–2022-3140 and 30–2022-0340) and the Liver Research Foundation of Korea (Bio Future Strategies Research Project)

The association of fatty liver index and BARD score with all-cause and cause-specific mortality in patients with type 2 diabetes mellitus: a nationwide population-based study

Background Type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) commonly coexist. However, NAFLD’s effect on mortality in Asian patients with type 2 diabetes awaits full elucidation. Therefore, we examined NAFLD-related all-cause and cause-specific mortality in a nationwide Asian population with type 2 diabetes. Methods We included patients who had undergone general health checkups between 2009 and 2012 using the National Health Insurance Service database linked to death-certificate data. Hepatic steatosis was defined as a fatty liver index (FLI) ≥ 60, and advanced hepatic fibrosis was determined using the BARD score. Findings During the follow-up period of 8.1 years, 222,242 deaths occurred, with a mortality rate of 14.3/1000 person-years. An FLI ≥ 60 was significantly associated with increased risks of all-cause and cause-specific mortality including cardiovascular disease (CVD)-, cancer-, and liver disease (FLI ≥ 60: hazard ratio [HR] = 1.02, 95% confidence interval [CI] 1.01–1.03 for all-cause; 1.07, 1.04–1.10 for CVD; 1.12, 1.09–1.14 for cancer; and 2.63, 2.50–2.77 for liver disease). Those with an FLI ≥ 60 and fibrosis (BARD ≥ 2) exhibited increased risks of all-cause (HR, 95% CI 1.11, 1.10–1.12), CVD- (HR, 95% CI 1.11, 1.09–1.14), cancer- (HR, 95% CI 1.17, 1.15–1.19), and liver disease-related (HR, 95% CI 2.38, 2.29–2.49) mortality. Conclusion Hepatic steatosis and advanced fibrosis were significantly associated with risks of overall and cause-specific mortality in patients with type 2 diabetes. Our results provide evidence that determining the presence of hepatic steatosis and/or fibrosis potentially plays a role in risk stratification of mortality outcomes in patients with type 2 diabetes mellitus.This work was supported by grants from the Seoul National University Hospital Research Fund (06‑2020‑4150) and from Liver Research Foundation of Korea as part of the Bio Future Strategies Research Project