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In breast cancer radiation therapy, minimizing radiation-related risks and toxicity is vital for improving life expectancy. Tailoring radiotherapy techniques and treatment positions can reduce radiation doses to normal organs and mitigate treatment-related toxicity. This study entailed a dosimetric comparison of six different external beam whole-breast irradiation techniques in both supine and prone positions. We selected fourteen breast cancer patients, generating six treatment plans in both positions per patient. We assessed target coverage and organs at risk (OAR) doses to evaluate the impact of treatment techniques and positions. Excess absolute risk was calculated to estimate potential secondary cancer risk in the contralateral breast, ipsilateral lung, and contralateral lung. Additionally, we analyzed the distance between the target volume and OARs (heart and ipsilateral lung) while considering the treatment position. The results indicate that prone positioning lowers lung exposure in X-ray radiotherapy. However, particle beam therapies (PBTs) significantly reduce the dose to the heart and ipsilateral lung regardless of the patient's position. Notably, negligible differences were observed between arc-delivery and static-delivery PBTs in terms of target conformity and OAR sparing. This study provides critical dosimetric evidence to facilitate informed decision-making regarding treatment techniques and positions. [ABSTRACT FROM AUTHOR]

Purpose Short bowel syndrome is a malabsorptive condition that occurs due to surgical removal or a congenital absence of a significant portion of the small intestine. Patients with short bowel syndrome often rely on parenteral support for extended periods or even their entire lives. Teduglutide, a glucagon-like peptide-2 analog, has shown promising results in reducing dependency on parenteral support in these patients by promoting intestinal adaptation and enhancing nutrient absorption. However, the long-term safety of teduglutide remains a concern, particularly with respect to its potential for the development of hyperamylasemia and hyperlipasemia. Methods This study involved patients who received teduglutide from December 2012 to December 2022 at Boston Medical Center. We evaluated outcomes and adverse events, focusing on hyperamylasemia and hyperlipasemia, through chart review. Results Thirteen eligible patients were identified who had used teduglutide. Of these, the majority (84.6%) experienced a reduction in parenteral support. A high incidence (72.7%) of nonpathological pancreatic enzyme elevation was observed in patients treated with teduglutide. These elevations were often dose dependent and were not associated with any clinical signs of acute pancreatitis or abnormal imaging findings. Conclusion This study highlights the need for further investigations into the long-term safety of teduglutide and the importance of closely monitoring amylase and lipase levels in patients undergoing treatment with teduglutide. [ABSTRACT FROM AUTHOR]

Research on molecular crystals exhibiting light‐driven actuation has made remarkable progress through the development of various molecules and the identification of driving mechanisms. However, crystals developed to date have been driven mainly by ultraviolet (UV) or blue light irradiation, and driving by red or near‐infrared (NIR) light has not been attempted yet. Herein, a broad‐wavelength light‐driven molecular crystals that exhibit high‐speed bending by photothermal effect is developed. Titanium carbide (Ti3C2Tx) MXene nanosheets are integrated into salicylideneaniline crystals to extend the wavelength range that causes photothermally driven bending to UV, visible, and NIR light. In addition, unlike the thin pristine molecular crystals that show slow photoisomerization‐induced bending only under UV light, the MXene layer enables the molecular crystals to be actuated rapidly regardless of their thickness over a wide range of wavelengths. The hybridization of molecular crystals with MXene, which exhibits strong biocompatibility as well as NIR light‐driven photothermal effect, allows for the bending of the hybrid crystals inside agar phantoms mimicking biological tissue. Last, it is confirmed that MXene hybridization can be extended to common molecular crystals including various salicylideneaniline and anisole derivatives. [ABSTRACT FROM AUTHOR]

Canopy coverage-based crop growth monitoring is highly dependent on the performance of crop segmentation algorithms. Under field conditions, crop segmentation for unmanned aerial vehicle (UAV) imagery should be sophisticated considering geometric distortion of images by wind and illumination variations. Under Korean cultivation conditions, a plastic mulch used to restrict weeds and prevent cold weather damage increases the complexity of the image background. In particular, on-site monitoring of onion and garlic growth has been limited by their morphology because they have long narrow leaves. The ultimate goal of this study was to quantify the growth parameters of onion and garlic at multiple growth stages using red, green, and blue (RGB) imagery obtained with UAVs. Canopy coverage and plant height were used as predictor variables to develop mathematical models to estimate the fresh weights of onion and garlic. The use of a CIE L*a*b* color space and mean shift (MS) algorithm enhanced the extraction of the canopy coverage of onion and garlic from complex backgrounds, including plastic mulch, soil, and shadows under varying illumination conditions. Multiple linear regression models consisting of the a* band-based vegetation fraction (VF) and structure from motion (SfM)-based plant height (PH) fitted the fresh weight data of onion and garlic well with high coefficients of determination (R2) ranging from 0.82 to 0.92. The validation results showed an almost 1:1 slope with highly linear relationships (R2 > 0.82) between the onion and garlic fresh weights obtained with the UAV RGB imagery and actual fresh weights, confirming that the UAV-RGB imagery based on the use of the a*band and PH can be used to quantify the spatial and temporal variability of onion and garlic growth parameters during the growing season. [ABSTRACT FROM AUTHOR]

Abies koreana, a plant species endemic to Korea, is sensitive to climate change. However, little is known about the molecular mechanisms underlying its environmental stress response. Here, we characterized the effects of exogenous abscisic acid (ABA) concentration, application method, and application duration on the expression of ABA-responsive genes in A. koreana. The expression level of AkNAC19 was significantly higher in ABA (0.2, 0.4, 0.8 mM)-treated leaves (needles) than in non-treated samples, indicating the role of ABA in the induction of gene expression. In addition, 0.2 mM ABA was found to be optimal for gene regulation. When assessing the efficacies of ABA application methods, the dipping method was slightly more effective in inducing gene expression than the pressure method. Therefore, leaves were further treated with 0.2 mM ABA using the dipping method to investigate the expression levels of multiple ABA-responsive genes, including AkNAC19, AkMPK6, AkERF4, AkNAC2, AkbHLH, AkEFP, AkHSP17.6, and AkMYB123. The expression levels of all genes, except AkMPK6, were significantly higher in ABA-treated leaves than in non-treated leaves. However, the optimal treatment duration for gene expression induction varied with the gene type. Overall, these results suggest that A. koreana responds to abiotic stress by upregulating the expression of ABA-responsive genes. [ABSTRACT FROM AUTHOR]

Eslicarbazepine acetate (ESL) is a new antiseizure medication (ASM) approved as an adjunctive therapy or monotherapy for focal onset seizures. We performed this study to explore the potential efficacy and safety of ESL oral loading in selected patients with epilepsy. Thirty adult patients with status epilepticus or acute repetitive seizures were enrolled, and ESL was administered at a single loading dosage of 30 mg/kg. Plasma levels of an active metabolite of ESL, monohydroxy derivative (MHD), were measured at 2, 4, 6, 12, and 24 h after ESL oral loading. Two thirds of the patients reached a therapeutic level of MHD 2 h after ESL loading, and most of the patients achieved a therapeutic range within 12 h after loading. Plasma MHD levels did not rise above the supratherapeutic level in any patient throughout the study. The reported adverse effects included one patient with gaze‐evoked nystagmus and another patient with a rash. No serious adverse events leading to drug discontinuation occurred. There was no discernible difference in sodium levels before and after ESL oral loading. Our study findings suggest that ESL oral loading could be a useful therapeutic option for patients with epilepsy who need rapid elevations in the therapeutic levels of ASMs. [ABSTRACT FROM AUTHOR]

The genus Hapalochlaena, including the blue-lined octopus Hapalochlaena fasciata (H. fasciata), is highly toxic. Venomous, blue-lined octopuses were recently found in Korea, but their toxicity, toxin composition, and distribution remain largely unknown. Here we estimated the geographic distribution of the organisms along the Korean coast and clarified their toxicity. Tetrodotoxin (TTX) was present in all three specimens of H. fasciata examined, although the toxicity varied largely between individuals. The mean TTX concentration in the whole body of the three specimens was 6.5 ± 2.2 μg/g (range 3.3–8.5 μg/g). Among the body parts examined, the salivary glands exhibited the highest concentration (22.4 ± 9.7 μg/g). From 2012 to 2021, 26 individuals were obtained nearly every month from different regions of the Korean coast. A non-fatal case of a blue-lined octopus bite was reported along the Korean coast in June 2015. This is the first report on the widespread distribution of blue-lined octopuses on the Korean coast and TTX detection. The widespread distribution of the TTX-bearing H. fasciata along the Korean coast within the temperate zone indicates that the species may soon become a serious health issue in Korea. The toxicity of this species is also a potentially significant human health risk. [ABSTRACT FROM AUTHOR]

A novel method for tool wear estimation in milling using infrared (IR) laser vision and a deep-learning algorithm is proposed and demonstrated. The measurement device employs an IR line laser to irradiate the tool focal point at angles of −7.5°, 0.0°, and +7.5° to the vertical plane, and three cameras are placed at 45° intervals around the tool to collect the reflected IR light at different locations. For the processing materials and methods, a dry processing method was applied to a 100 mm × 100 mm × 40 mm SDK-11 workpiece through end milling and downward cutting using a TH308 insert. This device uses the diffused light reflected off the surface of a rotating tool roughened by flank wear, and a polarization filter is considered. As the measured tool wear images exhibit a low dynamic range of exposure, high dynamic range (HDR) images are obtained using an exposure fusion method. Finally, tool wear is estimated from the images using a multi-view convolutional neural network. As shown in the results of the estimated tool wear, a mean absolute error (MAE) of prediction error calculated was to be 9.5~35.21 μm. The proposed method can improve machining efficiency by reducing the downtime for tool wear measurement and by increasing tool life utilization. [ABSTRACT FROM AUTHOR]

Ever since research attention was first paid to phenomics, it has mainly focused on the use of high throughput phenotyping for characterizing traits in an accurate and fast manner. It was recently realized that its use has huge potential in precision agriculture. However, the focus so far has mainly been on "obtain large data set", not on "how to analyze them". Here, the expanded application of high throughput phenotyping combined with special dependence analysis is demonstrated to reveal the hidden field heterogeneity, using a kenaf field. Based on the method used in the study, the results showed that the growth of kenaf in the field was grouped into two, which led to a large variation of sources among replications. This method has potential to be applied to detect hidden heterogeneity, to be utilized and applied in plant breeding not only for better analysis, but also for better management of fields in precision agriculture. [ABSTRACT FROM AUTHOR]

CRISPR/Cas9 and Cas12a belonging to the Class II CRISPR system are characterized by a single-component effector protein. Despite unique features of Cas12a like DNA cleavage with 5′ staggered ends and a single crRNA, Cas12a has not been adopted in biotechnological applications to the similar extent as Cas9. To better understand the CRISPR/Cas12 systems, we selected two candidates, designated mgCas12a-1 and mgCas12a-2, from an analysis of the human microbiome metagenome (mg) and provided biochemical characterization. These new Cas12a proteins shared about 37% identity in amino acid sequences and shared the same direct repeat sequences in the crRNA with FnCas12a from Francisella novicida. The purification yield of the recombinant proteins was up to 3.6-fold greater than that of FnCas12a. In cell-free DNA cleavage assays, both mgCas12a proteins showed the higher cleavage efficiencies when Mn2+ was provided with KCl (< 100 mM) than tested other divalent ions. They were able to tolerate ranges of pH points and temperature, and showed the highest cleavage efficiencies at pH 8.0 and 50 °C. In addition, mgCas12a proteins showed 51% less crRNA-independent and 56% less crRNA-dependent non-specific nuclease activity upon prolonged incubation than did FnCas12a. Considering their greater yield in protein preparation and reduced non-specific nuclease activity, our findings may expedite the use of Cas12a especially when genome editing needs to be practiced with the form of ribonucleoproteins. [ABSTRACT FROM AUTHOR]

Objectives: To determine risk factors for transient severe motion (TSM) artifact on arterial phase of gadoxetic acid–enhanced MRI using a large cohort. Methods: A total of 2230 patients who underwent gadoxetic acid–enhanced MRI was consecutively included. Two readers evaluated respiratory motion artifact on arterial phase images using a 5-point grading scale. Clinical factors including demographic data, underlying disease, laboratory data, presence of ascites and pleural effusion, and previous experience of gadoxetic acid–enhanced MRI were investigated. Univariable and multivariable logistic regression analyses were performed to determine significant risk factors for TSM. Predictive value of TSM was calculated according to the number of significant risk factors. Results: Overall incidence of TSM was 5.0% (111/2230). In the multivariable analysis, old age (≥ 65 years; odds ratio [OR] = 2.01 [95% CI, 1.31–3.07]), high body mass index (≥ 25 kg/m2; OR = 1.76 [1.18–2.63]), chronic obstructive pulmonary disease (OR = 6.11 [2.32–16.04]), and moderate to severe pleural effusion (OR = 3.55 [1.65–7.65]) were independent significant risk factors for TSM. Presence of hepatitis B (OR = 0.66 [0.43–0.99]) and previous experience of gadoxetic acid–enhanced MRI (OR = 0.52 [0.33–0.83]) were negative risk factors for TSM. When at least one of the significant factors was present, the predictive risk was 5.7% (109/1916), whereas it was 16.3% (17/104) when at least four factors were present. Conclusion: Knowing risk factors for transient severe motion artifact on gadoxetic acid–enhanced MRI can be clinically useful for providing diagnostic strategies more tailored to individual patients. Key Points: • Old age, high body mass index, chronic obstructive pulmonary disease, and moderate to severe pleural effusion were independent risk factors for transient severe motion artifact on gadoxetic acid–enhanced MRI. • Patients with hepatitis B or previous experience of gadoxetic acid–enhanced MRI were less likely to show transient severe motion artifact. • As the number of risk factors for transient severe motion artifact increased, the predicted risk for it also showed a tendency to increase. [ABSTRACT FROM AUTHOR]

Besides their extremely useful properties as solvent, ionic liquids (ILs) are now considered to be highly instructive tools for enhancing the rates of chemical reactions. The ionic nature of the IL anion and cation seems to be the origin of this fascinating function of ILs as organocatalyst/promoter through their strong Coulombic forces on other ionic species in the reaction and also through the formation of hydrogen bonds with various functional groups in substrates. It is now possible to tailor-make ILs for specific purposes as solvent/promoters in a variety of situations by carefully monitoring these interactions. Despite the enormous potentiality, it seems that the application of ILs as organocatalysts/promoters for chemical reactions have not been fully achieved so far. Herein, we review recent developments of ILs for promoting the nucleophilic reactions, focusing on fluorination. Various aspects of the processes, such as organocatalytic capability, reaction mechanisms and salt effects, are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To determine the diagnostic performance of the liver surface nodularity (LSN) score for assessment of hepatic fibrosis. Methods: Major databases were searched to identify studies reporting the diagnostic performance of the LSN score published from January 2011 to April 2021. The pooled sensitivity and specificity of the LSN score in the diagnosis of significant fibrosis (F2–4), advanced fibrosis (F3–4), and liver cirrhosis (F4) were calculated using a bivariate random-effects model, and the summary areas under the hierarchical summary receiver operating characteristics curve (AUC) for each were calculated. Subgroup analysis was performed to explore the causes of study heterogeneity. Results: Of 168 screened studies, six were included in the analysis. The pooled sensitivity, specificity, and AUC of the LSN score were 68% (95% confidence interval [CI], 45–84%), 89% (95% CI, 83–93%), and 0.90 (95% CI, 0.87–0.92), respectively, for the diagnosis of significant fibrosis; 88% (95% CI, 60–97%), 78% (95% CI, 57–90%), and 0.89 (95% CI, 0.86–0.91), respectively, for the diagnosis of advanced fibrosis; and 83% (95% CI, 71–91%), 80% (95% CI, 72–85%), and 0.87 (95% CI, 0.83–0.89), respectively, for the diagnosis of liver cirrhosis. Cutoff values of the LSN score affected study heterogeneity in the diagnosis of advanced fibrosis (p = 0.03) and liver cirrhosis (p = 0.01). Imaging modality (p = 0.01) and reference standard (p = 0.01) affected study heterogeneity in the diagnosis of liver cirrhosis. Conclusions: The LSN score showed good diagnostic performance in assessing the hepatic fibrosis stage. Additional investigations are needed to improve and standardize the LSN score. Key Points • The liver surface nodularity (LSN) score showed overall good diagnostic performance in assessing hepatic fibrosis. • The pooled sensitivity of the LSN score was highest in the diagnosis of advanced fibrosis (88%; 95% confidence interval [CI], 60–97%), and the pooled specificity was highest in the diagnosis of significant fibrosis (89%; 95% CI, 83–93%). • The diagnostic performance of the LSN score differed according to the cutoff value, imaging modality, and reference standard. [ABSTRACT FROM AUTHOR]

Motivation Improvements in next-generation sequencing have enabled genome-based diagnosis for patients with genetic diseases. However, accurate interpretation of human variants requires knowledge from a number of clinical cases. In addition, manual analysis of each variant detected in a patient's genome requires enormous time and effort. To reduce the cost of diagnosis, various computational tools have been developed to predict the pathogenicity of human variants, but the shortage and bias of available clinical data can lead to overfitting of algorithms. Results We developed a pathogenicity predictor, 3Cnet, that uses recurrent neural networks to analyze the amino acid context of human variants. As 3Cnet is trained on simulated variants reflecting evolutionary conservation and clinical data, it can find disease-causing variants in patient genomes with 2.2 times greater sensitivity than currently available tools, more effectively discovering pathogenic variants and thereby improving diagnosis rates. Availability and implementation Codes (https://github.com/KyoungYeulLee/3Cnet/) and data (https://zenodo.org/record/4716879#.YIO-xqkzZH1) are freely available to non-commercial users. Supplementary information Supplementary data are available at Bioinformatics online. [ABSTRACT FROM AUTHOR]

Objectives: To develop a prediction model of spontaneous ureteral stone passage (SSP) using machine learning and logistic regression and compare the performance of the two models. Indications for management of ureteral stones are unclear, and the clinician determines whether to wait for SSP or perform active treatment, especially in well-controlled patients, to avoid unwanted complications. Therefore, suggesting the possibility of SSP would help make a clinical decision regarding ureteral stones. Methods: Patients diagnosed with unilateral ureteral stones at our emergency department between August 2014 and September 2018 were included and underwent non-contrast-enhanced computed tomography 4 weeks from the first stone episode. Predictors of SSP were applied to build and validate the prediction model using multilayer perceptron (MLP) with the Keras framework. Results: Of 833 patients, SSP was observed in 606 (72.7%). SSP rates were 68.2% and 75.6% for stone sizes 5–10 mm and <5 mm, respectively. Stone opacity, location, and whether it was the first ureteral stone episode were significant predictors of SSP. Areas under the curve (AUCs) for receiver operating characteristic (ROC) curves for MLP, and logistic regression were 0.859 and 0.847, respectively, for stones <5 mm, and 0.881 and 0.817, respectively, for 5–10 mm stones. Conclusion: SSP prediction models were developed in patients with well-controlled unilateral ureteral stones; the performance of the models was good, especially in identifying SSP for 5–10-mm ureteral stones without definite treatment guidelines. To further improve the performance of these models, future studies should focus on using machine learning techniques in image analysis. [ABSTRACT FROM AUTHOR]

Cold stress is one of the main abiotic stresses that cause major damage to plant growth and development. Plants activate a number of response mechanisms to increase tolerance to environmental stresses. To investigate the important components of cold stress signaling in plants, we identified a novel Arabidopsis thaliana gene, which encodes an leucine-rich repeat-only protein, AtLRRop2 (At2g20210), and demonstrated its role in the cold stress response. Amino acid sequence analysis of AtLRRop2 revealed the presence of four leucine-rich repeat (LRR) motifs that mediate protein–protein interactions. To determine the function of AtLRRop2 in cold stress response, we identified three independent T-DNA insertion mutants, atlrrop2-1, atlrrop2-2, and atlrrop2-3, and examined the transcript levels by reverse transcription PCR (RT-PCR). The results revealed that atlrrop2-1 and atlrrop2-2 are knockout mutants, while atlrrop2-3 is a knockdown mutant. All three mutants were more sensitive to cold stress than the wild type (Col-0), although atlrrop2-3 mutant plants were less sensitive to chilling and freezing temperatures than atlrrop2-1 and atlrrop2-2 plants. Taken together, these results suggest that AtLRRop2 plays an important role in cold stress signaling in Arabidopsis. [ABSTRACT FROM AUTHOR]

What is known and Objective: Extended‐release topiramate (TPM‐XR) was recently approved for the treatment of epilepsy, but there is only limited real‐world information on the clinical usefulness of TPM‐XR in epilepsy patients. We investigated the usefulness of TPM‐XR in clinical practice by analysing the retention of TPM‐XR in adult epilepsy patients. Methods: We performed a single‐centre retrospective study covering two years. Epilepsy patients taking TPM‐XR were included in the study and classified into one of three groups: the monotherapy group, in which patients took only TPM‐XR; the adjunctive therapy group, in which patients took TPM‐XR concomitant with other AEDs; and the switching AED regimen group, in which patient's AED was switched from immediate‐release TPM (TPM‐IR) to TPM‐XR. We evaluated the retention rates of TPM‐XR and analysed the differences in retention rate among the three patient groups. Results and discussion: We included 164 epilepsy patients who received TPM‐XR for the treatment of epilepsy. The overall retention rate of TPM‐XR was generally favourable: 79.1% after one year and 77.7% after two years. The switching AED regimen group had a better retention rate than the other two groups (p = 0.04), with a one‐year retention rate of 90.6% and a two‐year retention rate of 88.1%. What is new and conclusion: The favourable retention rate of TPM‐XR shows that TPM‐XR can be an effective treatment option for epilepsy patients, as either a monotherapy or as an adjunctive therapy. Additionally, switching AED regimen to TPM‐XR from TPM‐IR can be considered in selected epilepsy patients with poor adherence to TPM‐IR. [ABSTRACT FROM AUTHOR]

Objectives: To develop and evaluate a deep learning–based model capable of detecting primary hepatic malignancies in multiphase CT images of patients at high risk for hepatocellular carcinoma (HCC). Methods: A total of 1350 multiphase CT scans of 1280 hepatic malignancies (1202 HCCs and 78 non-HCCs) in 1320 patients at high risk for HCC were retrospectively analyzed. Following the delineation of the focal hepatic lesions according to reference standards, the CT scans were categorized randomly into the training (568 scans), tuning (193 scans), and test (589 scans) sets. Multiphase CT information was subjected to multichannel integration, and livers were automatically segmented before model development. A deep learning–based model capable of detecting malignancies was developed using a mask region–based convolutional neural network. The thresholds of the prediction score and the intersection over union were determined on the tuning set corresponding to the highest sensitivity with < 5 false-positive cases per CT scan. The sensitivity and the number of false-positives of the proposed model on the test set were calculated. Potential causes of false-negatives and false-positives on the test set were analyzed. Results: This model exhibited a sensitivity of 84.8% with 4.80 false-positives per CT scan on the test set. The most frequent potential causes of false-negatives and false-positives were determined to be atypical enhancement patterns for HCC (71.7%) and registration/segmentation errors (42.7%), respectively. Conclusions: The proposed deep learning–based model developed to automatically detect primary hepatic malignancies exhibited an 84.8% of sensitivity with 4.80 false-positives per CT scan in the test set. Key Points: • Image processing, including multichannel integration of multiphase CT and automatic liver segmentation, enabled the application of a deep learning–based model to detect primary hepatic malignancy. • Our model exhibited a sensitivity of 84.8% with a false-positive rate of 4.80 per CT scan. [ABSTRACT FROM AUTHOR]

Stretchable electronics has emerged over the past decade and is now expected to bring form factor‐free innovation in the next‐generation electronic devices. Stretchable devices have evolved with the synthesis of new soft materials and new device architectures that require significant deformability while maintaining the high device performance of the conventional rigid devices. As the mismatch in the mechanical stiffness between materials, layers, and device units is the major challenge for stretchable electronics, interface control in varying scales determines the device characteristics and the level of stretchability. This article reviews the recent advances in interface control for stretchable electronic devices. It summarizes the design principles and covers the representative approaches for solving the technological issues related to interfaces at different scales: i) nano‐ and microscale interfaces between materials, ii) mesoscale interfaces between layers or microstructures, and iii) macroscale interfaces between unit devices, substrates, or electrical connections. The last section discusses the current issues and future challenges of the interfaces for stretchable devices. [ABSTRACT FROM AUTHOR]

• The number of patients who died from COVID-19 according to the elapsed date of death was the most common in 20 patients who died the next day after the initial diagnosis. • Survival rates were low, and the risk of death was higher in people in older age groups and with chronic diseases. • It is believed that early diagnosis and timely treatment are necessary for the elderly and those with chronic diseases. This study aimed to identify the survival rate and explore factors affecting survival among early COVID-19 patients in South Korea. Data reported by the Korea Disease Control and Prevention Agency (KDCA), up to 15 July, when COVID-19 was confirmed were used as research data in connection with the National Health Insurance Service's (NHIS) national health information database. The final analysis targets were 12,646 confirmed patients and 303 deaths. The survival rate of patients with COVID-19 was estimated through Kaplan-Meier survival analysis. Cox proportional hazard regression analysis was performed to search for factors affecting survival. When looking at the survival rate by age group for men and women, the 28-day survival rate for men aged >80 years was 77% and 73% at 42 days, while 83% and 81% for women. Men had a worse survival rate than women. For chronic diseases, the highest risk of mortality was observed in malignant neoplasms of the respiratory and urogenital systems, followed by diseases of the urinary system and diabetes. The number of COVID-19 deaths was highest the next day after initial diagnosis. The case fatality rate was high in males, older age, and chronic diseases. [ABSTRACT FROM AUTHOR]

Nitrogen addition is known to be one of the most effective ways of strengthening austenitic stainless steels while maintaining good properties of the steels. This study investigates Nb addition as an additional strategy to strengthen a high nitrogen austenitic stainless steel. It was found that Nb-containing steels developed Z -phase precipitates during homogenization and hot-rolling. Their fraction and size hardly changed by subsequent aging at 1050 °C. They effectively delayed grain coarsening and fine grains were maintained throughout the aging. The yield strengths of Nb-containing steels were always higher than those of Nb-free steel by 30–83 MPa. Quantitative analyses revealed that the major strengthening mechanism was grain boundary strengthening. The contribution from precipitation hardening was small because the precipitates were not sufficiently fine and the negative contribution from solid solution strengthening due to N consumption by the precipitation was also insignificant. • Nb addition generated Z -phase and suppressed grain coarsening. • Z-phase formation slightly weakened solid solution strengthening. • Precipitation hardening by Z-phase was insignificant due to its size. • Nb contribution to yield strength of austenitic stainless steel was quantified. • Nb addition increased yield strength mostly by grain boundary strengthening. [ABSTRACT FROM AUTHOR]

Recently, with the increase in the population of hearing impaired people, various types of hearing aids have been rapidly developed. In particular, a fully implantable middle ear hearing device (F-IMEHD) is developed for people with sensorineural hearing loss. The F-IMEHD system comprises an implantable microphone, a transducer, and a signal processor. The signal processor should have a small size and consume less power for implantation in a human body.In this study, we designed and fabricated a signal-processing chip using the modified FFT algorithm. This algorithm was developed focusing on eliminating time delay and system complexity in the transform process. The designed signal-processing chip comprises a 4-channel WDRC, a fitting memory, a communication 1control part, and a pulse density modulator. Each channel is separated using a 64-point fast Fourier transform (FFT) method and the gain value is matched using the fitting table in the fitting memory. The chip was designed by Verilog-HDL and the designed HDL codes were verified by Modelsim-PE 10.3 (Mentor graphics, USA). The chip was fabricated using a 0.18 μm CMOS process (SMIC, China). Experiments were performed on a cadaver to verify the performance of the fabricated chip. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the image quality and accuracy of axial vs coronal contrast-enhanced magnetic resonance cholangiography (CE-MRC) for assessing bile duct anatomy. Data from 313 healthy donors who underwent axial and coronal CE-MRC before liver donation were retrospectively analyzed. Motion artifacts and bile duct visibility were assessed using 4-point scales, with scores ≥3 considered interpretable. The sensitivity and specificity of axial and coronal CE-MRC for diagnosing anatomic variations were compared, as were the proportions of correctly categorized biliary anatomic types. Axial CE-MRC provided better image quality than coronal CE-MRC in terms of both motion artifacts (3.83 vs 3.17; P <.001) and duct visibility (3.50 vs 3.17, P <.001), resulting in more interpretable images with axial than coronal CE-MRC (92.7% vs 82.1%; P <.001). Among 249 donors with interpretable images, coronal CE-MRC performed significantly better for identifying duct anatomic variation than axial CE-MRC (sensitivity, 96.9% vs 80.4%, P <.001; specificity, 100% vs 96.7%, P =.025). Coronal CE-MRC was significantly better than axial CE-MRC at correctly categorizing anatomic types of right posterior hepatic duct into left hepatic duct and accessory duct with incomplete right hepatic duct. With interpretable image quality, coronal CE-MRC performed better than axial CE-MRC for evaluating bile duct anatomy. [ABSTRACT FROM AUTHOR]

Intersigmoid hernia is a rare form of internal hernia presenting with symptoms of bowel obstruction. A 32-year-old male visited the emergency department with chief complaint of abrupt onset of abdominal pain without any history of prior abdominal surgery. The initial abdominal X-ray and computed tomography (CT) scan exhibited mild distension of small bowel and paralytic ileus with no definitive obstruction site. However, a 12-h follow-up abdominal X-ray showed manifestations of newly appeared step-ladder sign and the CT scan displayed mechanical obstruction in the left lower quadrant area. Upon laparoscopic examination, herniation of small bowel was observed through the intersigmoid recess. Reduction was performed for about 5 cm of incarcerated ileum, and there was no sign of necrosis or lasting damage. The patient was discharged without complications. Laparoscopic management of intersigmoid hernia is possible with early surgical management of mechanical obstruction. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effect of accumulated doses on radio-photoluminescence glass dosimeters (RPLGDs) from measurements involving mega-voltage photons. Methods: Forty-five commercially available RPLGDs were irradiated to estimate their dose responses. Photon beams of 6, 10, and 15 MV were irradiated onto the RPLGDs inside a phantom, which were divided into five groups with different doses and energies. Groups 1 and 2 were irradiated at 1, 5, 10, 50, and 100 Gy in a sequential manner; Group 3 was irradiated 10 times with a dose of 10 Gy; and Groups 4 and 5 followed the same method as that of Group 3, but with doses of 50 Gy and 100 Gy, respectively. Each device was subjected to a measurement reading procedure each time irradiation. Results: For the annealed Group 1, RPLGD exhibited a linearity response with variance within 5%. For the non-annealed Group 2, readings demonstrated hyperlinearity at 6 MV and 10 MV, and linearity at 15 MV. Following the 100 Gy irradiation, the readings for Group 2 were 118.7 ± 1.9%, 112.2 ± 2.7%, and 101.5 ± 2.3% at 6, 10, and 15 MV, respectively. For Groups 3, 4, and 5, the responsiveness of the RPLGDs gradually decreased as the number of repeated irradiations increased. The percentage readings for the 10th beam irradiation with respect to the readings for the primary beam irradiation were 84.6 ± 1.9%, 87.5 ± 2.4%, and 93.0 ± 3.0% at 6 MV, 10 MV, and 15 MV, respectively. Conclusions: The non-annealed RPLGD response to dose was hyperlinear for the 6 MV and 10 MV photon beams but not for the 15 MV photon beam. Additionally, the annealed RPLGD exhibited a fading phenomenon when the measurement was repeated several times and demonstrated a relatively large fading effect at low energies than at high energies. [ABSTRACT FROM AUTHOR]

Functional group−activity relationships of pyrene‐tagged ionic liquid (PTIL)‐based organocatalysts for nucleophilic fluorination using alkali metal fluorides (MFs) are described, which demonstrate that the pyrene, oligoether and alcohol moieties on the imidazolium ring are vital for efficient catalysis. Further investigation of these findings led to the discovery of new strategy, which showed superior catalyst separation process, i.e., catalyst is effortlessly separated from the reaction mixture using reduced graphene oxide. The catalytic efficiency of the PTIL as a phase transfer catalyst was demonstrated by the high conversion of the reactants up to 98% fluorinated yield using MFs in CH3CN or t‐amyl alcohol. Importantly, the catalyst not only enhanced the reactivity of bimolecular nucleophilic substitutions (SN2) within a short reaction time and reduces the formation of by‐products but also affords high yield with easy isolation and separation under mild conditions. [ABSTRACT FROM AUTHOR]

What is known and objective: Thrombocytopenia is a common laboratory abnormality among critically ill patients under neurological intensive care unit (NCU) care. Valproic acid (VPA), a widely used antiepileptic drug, is one of the common causes of drug‐induced thrombocytopenia. The purpose of this study was to estimate the incidence and risk factors of thrombocytopenia after intravenous VPA therapy among the patients admitted to NCU. Methods: We retrospectively reviewed the medical records of patients who were treated with intravenous VPA during their NCU stay between January 2014 and December 2018. We studied the frequency of thrombocytopenia and further evaluated the risk of thrombocytopenia in these patients. Results: Among the 283 patients (181 male [64.0%], mean age: [61.0 ± 14.9] years) who were treated with intravenous VPA, thrombocytopenia was observed in 104 patients (36.7%). Thrombocytopenia was associated with several risk factors, including lower baseline platelet counts (<200 × 109/L); aetiologies other than intracranial or subarachnoid haemorrhage; longer use of VPA (more than 3 days); higher daily dose of VPA (more than 1000 mg/d); concurrent use of VPA with other antiepileptic drugs; infection; and the use of mechanical ventilation. Multivariate analysis found several independent risk factors of thrombocytopenia with intravenous VPA therapy, including lower baseline platelet counts, aetiologies other than intracranial or subarachnoid haemorrhage, use of VPA for more than 3 days and infection. What is new and conclusion: Thrombocytopenia is common in NCU patients. Because several clinical and laboratory factors are associated with thrombocytopenia, careful use of VPA should be considered in patients with these risk factors. [ABSTRACT FROM AUTHOR]

Background: The development of deep learning (DL) algorithms is a three-step process—training, tuning, and testing. Studies are inconsistent in the use of the term "validation", with some using it to refer to tuning and others testing, which hinders accurate delivery of information and may inadvertently exaggerate the performance of DL algorithms. We investigated the extent of inconsistency in usage of the term "validation" in studies on the accuracy of DL algorithms in providing diagnosis from medical imaging. Methods and findings: We analyzed the full texts of research papers cited in two recent systematic reviews. The papers were categorized according to whether the term "validation" was used to refer to tuning alone, both tuning and testing, or testing alone. We analyzed whether paper characteristics (i.e., journal category, field of study, year of print publication, journal impact factor [JIF], and nature of test data) were associated with the usage of the terminology using multivariable logistic regression analysis with generalized estimating equations. Of 201 papers published in 125 journals, 118 (58.7%), 9 (4.5%), and 74 (36.8%) used the term to refer to tuning alone, both tuning and testing, and testing alone, respectively. A weak association was noted between higher JIF and using the term to refer to testing (i.e., testing alone or both tuning and testing) instead of tuning alone (vs. JIF <5; JIF 5 to 10: adjusted odds ratio 2.11, P = 0.042; JIF >10: adjusted odds ratio 2.41, P = 0.089). Journal category, field of study, year of print publication, and nature of test data were not significantly associated with the terminology usage. Conclusions: Existing literature has a significant degree of inconsistency in using the term "validation" when referring to the steps in DL algorithm development. Efforts are needed to improve the accuracy and clarity in the terminology usage. [ABSTRACT FROM AUTHOR]

It has been recognized that systemic inflammatory markers (SIMs) are associated with patient survival in various types of cancer. This study aimed to determine the optimal cut-off values, and to evaluate the prognostic performance of SIMs for oral squamous cell carcinoma (OSCC) within the framework of the American Joint Committee of Cancer (AJCC) cancer staging manual, 8th edition. Records were collected for a total 291 patients who had had a peripheral blood test within 1 week prior to surgery and had undergone the surgical resection of OSCC in a single institution between 2005 and 2018. The cut-off values of SIMs were obtained, and the survival analyses for overall survival (OS) and disease-free survival (DFS) were performed. Multivariate analyses incorporating other clinicopathologic factors were performed to verify the independent risk factors for survival. The cut-off values of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were 2.23, 135.14 for OS and 2.16, 131.07 for DFS, respectively, demonstrating a significant association for OS and DFS in OSCC. AJCC pathologic regional lymph node category (pN) (P < 0.001), perineural invasion (PNI) (P < 0.001) and NLR (P < 0.001) were independent predictors for OS. Meanwhile, for DFS, AJCC pN (P = 0.018) and NLR (P = 0.015) were shown to be independent predictors. Before the curative surgery, NLR and PLR could be auxiliary parameters for OS and DFS in OSCC. And based on the 8th edition of AJCC staging system, elevated NLR will be a potential indicator of the worse OS or DFS along with pN or PNI in OSCC. [ABSTRACT FROM AUTHOR]

In this article, versatile video coding, the next-generation video coding standard, is combined with a deep convolutional neural network to achieve state-of-the-art image compression efficiency. The proposed hierarchical grouped residual dense network exhaustively exploits hierarchical features in each architectural level to maximize the image quality enhancement capability. The basic building block employed for hierarchical grouped residual dense network is residual dense block which exploits hierarchical features from internal convolutional layers. Residual dense blocks are then combined into a grouped residual dense block exploiting hierarchical features from residual dense blocks. Finally, grouped residual dense blocks are connected to comprise a hierarchical grouped residual dense block so that hierarchical features from grouped residual dense blocks can also be exploited for quality enhancement of versatile video coding intra-coded images. Various non-architectural and architectural aspects affecting the training efficiency and performance of hierarchical grouped residual dense network are explored. The proposed hierarchical grouped residual dense network respectively obtained 10.72% and 14.3% of Bjøntegaard-delta-rate gains against versatile video coding in the experiments conducted on two public image datasets with different characteristics to verify the image compression efficiency. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the efficacy and safety of perampanel added to monotherapy in patients with focal‐onset seizures, with or without secondarily generalized tonic‐clonic seizures. Materials & Methods: In this multicentre, open‐label trial, enrolled patients were treated with perampanel monotherapy. During a 12‐week titration period, perampanel was incrementally increased by 2 mg/d over ≥2‐week intervals. Patients then entered a 24‐week maintenance period. The primary objective was to investigate the 50% responder rate in total seizure frequency, with 75% and 100% responder rates as secondary objectives. Treatment‐emergent adverse events (TEAEs) and adverse drug reactions were recorded. A post hoc analysis was performed to investigate the effect of titration speed and different concomitant AEDs on the efficacy and safety of perampanel. Results: Of the 85 patients analysed, seizure reductions of 50%, 75% and 100% were observed in 80.0% (95% confidence interval [CI]: 69.9‐87.9), 71.8% (95% CI: 61.0‐81.0) and 47.1% (95% CI: 36.1‐58.2) during the maintenance period, respectively. The 50%, 75% and 100% response rates in patients with secondarily generalized tonic‐clonic seizures were 87.5% (95% CI: 61.7‐98.5), 87.5% (95% CI: 61.7‐98.5) and 75.0% (95% CI: 47.6‐92.7), respectively. The most common TEAEs were dizziness (50.0%), somnolence (9.8%) and headache (8.8%). The efficacy outcomes and safety profile of perampanel were more favourable with slow titration and relatively consistent when stratified by concomitant AEDs. Conclusions: Perampanel was effective and well tolerated as a first add‐on to monotherapy in patients with focal‐onset seizures, with or without secondarily generalized seizures. [ABSTRACT FROM AUTHOR]

Background: It is unclear if it is appropriate for people with Parkinson's disease (PD) to wear activity monitors on the wrist because of the potential influence of impairments on the data. Objective: The objective of this study was to determine (1) whether activity monitor data collected from devices worn at the wrist and waist are comparable and (2) the contribution of PD impairments to any differences in step and activity counts at the wrist and waist. Methods: A total of 46 community‐dwelling people with PD wore an accelerometer at the wrist and waist simultaneously for 1 week. Motor impairments (rigidity, bradykinesia, tremor, dyskinesia) were assessed using the Movement Disorders Society Unified Parkinson's Disease Rating Scale part III (motor examination) and part IV (motor complications). Results: Higher values were recorded by the wrist monitor for steps/day (wrist, 9236 [standard deviation (SD) 3812]; waist, 5324 [SD 2800]; difference 3912; P < 0.001) and activity counts/day (wrist, 872,590 [SD 349,148]; waist, 186,491 [SD 101,989]; difference 686,099; P < 0.001). However, the wrist and waist values were strongly correlated (steps, r = 0.89; counts, r = 0.74; P ≤ 0.001). Increased tremor and dyskinesia explained 19% of the variation in the difference in average steps/day, and these variables plus reduced bradykinesia explained 24% of the variation in the difference in average activity counts/day. Conclusion: Wrist monitors are likely to overestimate activity, particularly in people with tremor and dyskinesia. Nonetheless, activity monitors can be worn on the wrist if the aim is to monitor change rather than accurately record activity. [ABSTRACT FROM AUTHOR]

The shielding parameters can vary depending on the geometrical structure of the linear accelerators (LINAC), treatment techniques, and beam energies. Recently, the introduction of O-ring type linear accelerators is increasing. The objective of this study is to evaluate the shielding parameters of new type of linac using a dedicated program developed by us named ORSE (O-ring type Radiation therapy equipment Shielding Evaluation). The shielding evaluation was conducted for a total of four treatment rooms including Elekta Unity, Varian Halcyon, and Accuray Tomotherapy. The developed program possesses the capability to calculate transmitted dose, maximum treatable patient capacity, and shielding wall thickness based on patient data. The doses were measured for five days using glass dosimeters to compare with the results of program. The IMRT factors and use factors obtained from patient data showed differences of up to 65.0% and 33.8%, respectively, compared to safety management report. The shielding evaluation conducted in each treatment room showed that the transmitted dose at every location was below 1% of the dose limit. The results of program and measurements showed a maximum difference of 0.003 mSv/week in transmitted dose. The ORSE program allows for the shielding evaluation results to the clinical environment of each institution based on patient data. [ABSTRACT FROM AUTHOR]

In this study, we compared ultrasound (US) features between normal parotid parenchyma (NPP) and incidental diffuse parotid disease (DPD). From January 2008 to December 2017, 180 patients underwent neck US before parotid surgery at our hospital. From these, 82 were excluded because of the lack of histopathological data concerning the parotid parenchyma or inadequate US images. A single radiologist blinded to the clinicoserological data and histopathological results, retrospectively investigated all US features and categorizations for the parotid glands using a picture archiving and communication system. Retrospective histopathological analysis of the parotid parenchyma was performed by a single pathologist. On the basis of the histopathological analyses, the 98 patients were divided into NPP (n = 70) and DPD (n = 28) groups. Among US features, parenchymal echogenicity and echotexture showed statistically significant differences between the two groups (p < 0.0001), whereas the gland size, margin, and vascularity showed no significant differences (p > 0.05). The US-based categorization significantly differentiated between NPP and DPD (p < 0.0001), and receiver operating characteristic curve analysis revealed that US categorization based on ≥2 abnormal US features showed the best diagnostic performance for detecting DPD. Thus, US can aid in differentiating DPD from NPP. [ABSTRACT FROM AUTHOR]

Abstract In this study, silver nanoparticles (AgNPs) were loaded onto commercial filter paper using a simple "suspending-discharging-washing" process. Nanosecond pulse dielectric barrier discharge (NP-DBD) plasma was used to perform the in-situ reduction-loading process in a plate-to-plate DBD reactor during the five-minute fabrication process. Gaseous ethanol was used as the reducing agent under an argon gas plasma treatment. There was no thermal treatment, which prefers the formation of small nanoparticles. Transmission electron microscopy showed that the synthesized AgNPs were well-dispersed over the surface of the filter paper. The synthesized nanoparticles were hemispherical and crystalline. Fourier transform infrared spectroscopy showed that the cellulose skeletons had been mostly maintained after the plasma discharge. The catalytic activity of the AgNPs paper was evaluated by the reduction reaction of methylene blue (MB) with sodium borohydride (NaBH 4) using a straightforward filtration process. Graphical abstract Unlabelled Image Highlights • No toxic chemical reagents or thermal treatment are used. • Commercial filter paper is used as the support and no more treatments on the filter paper is necessary. • The fabrication is realized by a simple "suspending-discharging-washing" process. • The use of filter paper allows the liquid-phase reaction to be catalyzed through a straightforward filtering process. [ABSTRACT FROM AUTHOR]

Objective: To assess the technical performance (proportion of technical failure and unreliable measurements) of shear wave elastography (SWE) for assessing liver stiffness in pediatric and adolescent patients.Methods: We searched Ovid-MEDLINE and EMBASE databases for eligible studies and selected original articles investigating transient elastography (TE), point shear wave elastography (pSWE), or two-dimensional SWE (2D-SWE) for measuring liver stiffness in pediatric and adolescent patients. A quantitative synthesis of studies reporting technical failures and/or unreliable measurements of TE, pSWE, or 2D-SWE is presented. Meta-analytic pooling was conducted using the random effects model. Meta-regression analysis was conducted to explore potential causes of heterogeneity.Results: Forty of 69 studies (58%) provided technical performance information. Technical failure data were reported in 3 TE, 6 pSWE, and 8 2D-SWE studies. Unreliable measurement data were provided in 21 TE, 4 pSWE, and 1 2D-SWE study. The pooled proportion of unreliable measurements of TE was 12.1%. Meta-regression analysis showed that the study population size and readers' blinding to pathologic results affected the study's heterogeneity. The pooled proportions of technical failure during pSWE and 2D-SWE were 4.1% and 2.2%, respectively, demonstrating no significant difference between the techniques.Conclusions: We reviewed the technical performance of SWE, especially the rate of unreliable measurements from TE studies and rates of technical failure from pSWE and 2D-SWE studies. Considering the importance of technical performance for clinical validation of SWE, numbers of and reasons for technical failure and unreliable measurements should be reported in future studies. Further efforts are necessary to standardize SWE reliability criteria.Key Points: • Most TE studies reported rate of unreliable measurements, whereas pSWE and 2D-SWE studies were likely to report rates of technical failure. • The pooled proportion of unreliable measurements of TE was 12.1%. • The pooled proportions of technical failure during pSWE and 2D-SWE were 4.1% and 2.2%, respectively, demonstrating no significant difference between the techniques. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Anatase TiO 2 -Graphene was synthesized by thermal plasma, DBD and heat treatment. • Conversion ratio of TiC to TiO 2 depends on the heat treatment time. • TiO 2 -Graphene consist of well-dispersed TiO 2 particles and 5–10 layers of graphene. Abstract Herein, we introduce a facile method for synthesis of anatase TiO 2 -Graphene nanocomposites using a series of thermal plasma, dielectric barrier discharge (DBD) and heat treatment. The synthesis proceeded in two steps: (1) synthesizing TiC-Graphene nanocomposites from titanium isopropoxide using thermal plasma; (2) converting TiC to anatase TiO 2 using DBD plasma and heat treatment. Experiments were conducted under various conditions and the optimized conditions were found to be DBD treatment for 1 min and heat treatment at 643 K for 2 h. The produced TiO 2 -Graphene nanocomposites consisted of well-dispersed anatase TiO 2 nanoparticles below 50 nm and 5–10 layers of graphene nanosheets. [ABSTRACT FROM AUTHOR]

Background: Previous studies on elderly epilepsy included only patients with new‐onset disease, but there are many patients who developed epilepsy earlier and aged. Aim: We compared the characteristics of new‐onset and persistent epilepsy in the elderly. Methods: We performed a 10‐year retrospective analysis of elderly patients with epilepsy divided into two groups according to the onset of seizure: new‐onset epilepsy (onset age ≥65) and persistent epilepsy (onset age<65). Results: Nearly half (78/172, 45.3%) of patients in the new‐onset group presented as status epilepticus, and one‐fourth of these (19/78, 24.4%) died during the initial treatment for status epilepticus. Patients in the new‐onset epilepsy group presented more frequently as status epilepticus (59/153 vs 12/78, P < 0.001) and had a past history of status epilepticus (63/153 vs 20/78, P = 0.02). History of stroke (81/153 vs 30/78, P = 0.04), hypertension (83/153 vs 29/78, P = 0.01), and dyslipidemia (53/153 vs 17/78, P = 0.05) was more common in the new‐onset group, but patients in the persistent group used more antiepileptic drugs (AEDs; P = 0.036) and total AED drug loads (P = 0.028). Conclusions: Our study shows that new‐onset epilepsy has a higher incidence of status epilepticus and more stroke‐related risk factors but may require fewer AEDs for epilepsy control. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the feasibility of indocyanine green (ICG) fluorescent method for sentinel lymph node detection in early gastric cancer.Methods: Between December 2012 and December 2014, 28 cases of pilot examination were performed at Seoul National University Bundang Hospital. Advanced version of multispectral fluorescence organoscope was used to identify sentinel node by quantitative estimation of ICG fluorescent signal intensity. Sensitivity, specificity, false positive value were analyzed and compared with dual tracer method.Results: A total of 443 lymph nodes in 28 cases were examined and 184 sentinel nodes (41.5%) were identified by dual tracer method. The sensitivity using near-infrared ICG method was 98.9%. The specificity was 76.0% and false positive rate was 25.4% compared with dual tracer method. The adequate threshold for sentinel node detection was considered as 10% of maximum signal intensity.Conclusion: New near-infrared ICG fluorescent method could be a promising protocol for sentinel node navigation surgery in early gastric cancer. [ABSTRACT FROM AUTHOR]

Background: Dexamethasone is widely used in cancer patients despite the concern that perioperative glucocorticoids may potentially cause immunosuppression. However, studies on the influence of dexamethasone on cancer recurrence after curative surgery have produced conflicting results. The goal of our study was to compare postoperative recurrence-free survival and overall survival between patients with breast cancer who received perioperative dexamethasone and those who did not.Methods: The medical records of 2729 patients who underwent breast cancer surgery between November 2005 and December 2010 were reviewed. These patients were followed up until December 2015. The patients were categorised according whether they received a single dose of intravenous dexamethasone perioperatively or not. Cox regression analyses were conducted to evaluate any associations between dexamethasone usage with postoperative recurrence and mortality. Additionally, we performed a sensitivity test with propensity score matching to adjust for selection bias.Results: Among the 2628 patients, 236 (8.5%) received perioperative dexamethasone. No increasing risk for recurrence (hazard ratio [HR], 1.442; 95% confidence interval [CI], 0.969-2.145; P = 0.071) or mortality (HR, 1.256; 95% CI, 0.770-2.047; P = 0.361) after breast cancer surgery were identified in patients who received dexamethasone. Similarly, propensity score matching did not show significant associations in postoperative recurrence (HR, 1.389; 95% CI, 0.904-2.132; P = 0.133) or mortality (HR, 1.506; 95% CI, 0.886-2.561; P = 0.130) in patients who received dexamethasone.Conclusions: We found that a perioperative single dose of dexamethasone is not associated with increased recurrence or mortality after curative surgery in breast cancer patients. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • The DBD reactor having segmented electrodes was introducing to decompose toluene. • The plasma characteristics was improved by introducing the segmented electrode. • The ozone generation performance increased by the increased plasma characteristics. • The ozone consumption was not proportional to the increase of ozone generation. • The increased current affected the decomposition of toluene absorbed on absorbent. Abstract The effect of the segmented electrode structure of the dielectric barrier discharge reactor on toluene decomposition adsorbed on bare-zeolite surface was investigated. The three types electrodes, divided into 1, 2 and 4 parts, respectively, but equal in their total length, were introduced to increase decomposition efficiency without any assistance of catalyst. The experimental results showed that introducing the segmented electrode could improve both the plasma characteristics and the performance of toluene decomposition. As the number of segments of electrodes increased, the plasma current increased so that the specific input energy density could be increased at the same applied voltage. It led to the increase of the ozone generation which is expected to increase also the amount of ozone consumption because ozone has a significant effect on the decomposition of toluene. However, the increase of ozone consumption was not proportional to the decomposition of toluene. Nevertheless, the mineralization and the CO 2 selectivity increased as the plasma current increased. Herein, the decomposition of toluene is considered to occur by reaction path affected by the increased plasma current as well as ozone. In conclusion, the mechanisms for toluene decomposition in the dielectric barrier discharge with introducing the segmented electrode are suggested. [ABSTRACT FROM AUTHOR]

Objective: To assess the diagnostic performance of CT for pediatric patients with suspected appendicitis in various clinical settings and the proportion of acute appendicitis on final diagnosis among equivocal CT findings.Methods: MEDLINE and EMBASE databases were searched until October 21, 2017, for studies investigating diagnostic performance of CT for acute appendicitis in pediatric patients confirmed by histopathologic findings and/or clinical follow-up. Pooled estimates of sensitivity and specificity were calculated using a hierarchical logistic regression modeling. The proportion of true appendicitis among patients with inconclusive CT results was obtained using fixed and random effects meta-analyses.Results: Twenty-two articles with 3396 patients were included. The pooled sensitivity and specificity were 95% (95% CI, 93-97%) and 94% (95% CI, 90-96%), respectively, and the area under the hierarchical summary receiver operating characteristic (HSROC) curve was 0.98 (95% CI, 0.96-0.99). Subgroup analyses revealed a comparable diagnostic performance in the low-dose CT group (sensitivity, 97%; specificity, 96%) and the unenhanced group (sensitivity, 95%; specificity, 95%). Other subgroups (publication year, study design, enrolled population, true appendicitis proportion, CT channel number, and slice thickness) also showed good diagnostic performance. Six studies reporting the true appendicitis proportion among patients with equivocal CT findings had pooled proportion of 17% (95% CI, 9-29%).Conclusions: CT showed good performance for suspected appendicitis in pediatric patients under various clinical settings, including in cases with dose reduction or absence of IV contrast. The prevalence of true appendicitis among patients with equivocal appendicitis results on CTs was not low; therefore, clinical attention should not be disregarded in this population. [ABSTRACT FROM AUTHOR]

This study aimed to assess the diagnostic performance of computed tomography (CT) for differentiating diffuse thyroid disease (DTD) from normal thyroid parenchyma (NTP) using multicenter data. Between January 2016 and June 2016, 229 patients underwent preoperative neck CT and subsequent thyroid surgery at five participating institutions. The neck CT images of each patient were retrospectively reviewed and classified into the following four categories: no DTD, indeterminate, suspicious for DTD, and DTD. The results of the CT image evaluations were compared with the histopathological results to determine the diagnostic accuracy of CT at each institution. According to the histopathological results, there were NTP (n = 151), Hashimoto thyroiditis (n = 24), non-Hashimoto lymphocytic thyroiditis (n = 47), and diffuse hyperplasia (n = 7). The CT categories of the 229 patients were “no DTD” in 89 patients, “indeterminate” in 40 patients, “suspicious for DTD” in 42 patients, and “DTD” in 58 patients. The presence of two or more CT features of DTD, which was classified as “suspicious for DTD” by all radiologists, had the largest area under the receiver-operating characteristic curve (Az = 0.820; 95% confidence interval: 0.764, 0.868), with sensitivity of 85.9% and specificity of 78.2%. However, no statistical significance between readers’ experience and their diagnostic accuracy was found. In conclusion, evaluations of CT images are helpful for differentiating DTD from NTP. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Ag coated Ni particle was prepared by ball-mill followed by thermal plasma process. • Silver attached nickel particle was obtained through the ball mill process. • The dense silver layer was obtained by melting the attached silver using the plasma. Abstract Recently, reducing noble metals in electric devices has been identified as a key factor to lower product cost. Among these, noble metal coated particles are considered an alternative with the potential to dramatically reduce the usage of noble metals. A dense coating of noble metals over all surfaces is desirable for maintaining the properties of noble metal. However, our previous research showed that coated surfaces onto which the nanoparticles were attached were non-uniform because of evaporation of the raw materials. Therefore, in this study, we improved the coverage ratio of silver coated nickel particles using thermal plasma processing followed by ball mill pre-treatment. Silver and nickel particles were mixed using a ball mill, then injected into the thermal plasma jet. The silver particles were subsequently attached onto the surface of the nickel particles through ball mill processing, after which the silver attached nickel particles were melted through thermal plasma processing to produce silver coated nickel spherical particles. The cross section of the as-prepared particles showed a dense silver shell and nickel core, while the sintered body of the as-prepared particles showed the net-like silver covering over the nickel cores. These findings suggest that attachment of silver on nickel could lead to complete silver coatings by limiting the formation of nanoparticles. [ABSTRACT FROM AUTHOR]

Abstract Introduction The aim of this study was to build and validate five types of machine learning models that can predict the occurrence of BRONJ associated with dental extraction in patients taking bisphosphonates for the management of osteoporosis. Patients & methods A retrospective review of the medical records was conducted to obtain cases and controls for the study. Total 125 patients consisting of 41 cases and 84 controls were selected for the study. Five machine learning prediction algorithms including multivariable logistic regression model, decision tree, support vector machine, artificial neural network, and random forest were implemented. The outputs of these models were compared with each other and also with conventional methods, such as serum CTX level. Area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the results. Results The performance of machine learning models was significantly superior to conventional statistical methods and single predictors. The random forest model yielded the best performance (AUC = 0.973), followed by artificial neural network (AUC = 0.915), support vector machine (AUC = 0.882), logistic regression (AUC = 0.844), decision tree (AUC = 0.821), drug holiday alone (AUC = 0.810), and CTX level alone (AUC = 0.630). Conclusions Machine learning methods showed superior performance in predicting BRONJ associated with dental extraction compared to conventional statistical methods using drug holiday and serum CTX level. Machine learning can thus be applied in a wide range of clinical studies. Highlights • Machine learning models that can predict the occurrence of BRONJ associated with dental extraction was built and validated. • The machine learning predictions were superior to methods such as the length of drug holiday and serum CTX levels. • Random forest model yielded the best performance (AUC = 0.973). • Drug holiday alone (AUC = 0.810), and CTX level alone (AUC = 0.630) were the least accurate predictors. [ABSTRACT FROM AUTHOR]

Background: Tuberous sclerosis complex (TSC) is an autosomal dominant multisystem disorder, caused by a loss‐of‐function of either TSC1 or TSC2 gene. However, in 10%–15% TSC patients there is no pathogenic variant identified in either TSC1 or TSC2 genes based on standard clinical testing. Methods: In this study, genome sequencing was performed for families with clinical diagnosis of TSC with negative results from TSC1 and TSC2 single‐gene tests. Results: Herein, we report a family presenting a classical TSC phenotype with an unusual, complex structural variant involving the TSC1 gene: an intrachromosomal inverted insertion in the long arm of chromosome 9. We speculate that the inverted 9q33.3q34.13 region was inserted into the q31.2 region with the 3′‐end of the breakpoint of the inversion being located within the TSC1 gene, resulting in premature termination of TSC1. Conclusions: In this study, we demonstrate the utility of genome sequencing for the identification of complex chromosomal rearrangement. Because the breakpoints are located within the deep intronic/intergenic region, this copy‐neutral variant was missed by the TSC1 and TSC2 single‐gene tests and contributed to an unknown etiology. Together, this finding suggests that complex structural variants may be underestimated causes for the etiology of TSC. [ABSTRACT FROM AUTHOR]

Introduction: Lymph node metastasis of nonfunctioning pancreatic neuroendocrine neoplasms (pNENs) potentially leads to poor survival. Given the contradictory results in the literature regarding factors associated with lymph node metastasis of nonfunctioning pNENs, we conducted a systematic review and meta-analysis to determine the preoperative predictors of lymph node metastasis. Methods: Original studies reporting factors associated with lymph node metastasis in patients with nonfunctioning pNENs were identified in PubMed, EMBASE, and Cochrane Library databases, and data from eligible studies were analyzed using random-effects meta-analysis to obtain pooled estimates of odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Eleven studies were included. Tumor size (>2 cm or >2.5 cm; OR, 5.80 [95% CI, 4.07–8.25]) and pancreatic head location (OR, 1.75 [95% CI, 1.05–2.94]) were significant preoperative predictors of lymph node metastasis. Old age (OR, 1.07 [95% CI, 0.68–1.68]) and male sex (OR, 1.12 [95% CI, 0.74–1.70]) were not significantly associated with lymph node metastasis. Conclusions: A large tumor size and pancreatic head location can be useful for planning optimal treatment in patients with nonfunctioning pNENs. [ABSTRACT FROM AUTHOR]