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An inappropriate thermal environment negatively impacts workers, causing mental stress and safety accidents. Unskilled workers are more vulnerable to industrial accidents and thermal stress compared with skilled workers due to suboptimal and unfamiliar work. Previous studies have focused on individual characteristics (such as gender, age, and race), with limited emphasis on the thermal comfort sensation. This study identified the preferred thermal environment according to work experience and how mental stress differed between unskilled and skilled workers by examining their thermal comfort sensation. Predicted mean vote (PMV) was used as an indicator of the thermal environment, and five environments were constructed for PMV: −2, −1, 0, 1, and 2. Participants were recruited among current workers and the public. Mental stress and thermal comfort sensation were assessed using heart rate variability and thermal comfort vote, respectively. This study demonstrated that the skilled group experienced higher mental stress and a lower thermal comfort sensation. Contrastingly, in the sensitivity analysis, the unskilled group exhibited greater sensitivity to changes in the thermal environment. Through a comprehensive analysis, this study derived an optimal PMV range for each group. The findings can provide a reference for configuring the optimal thermal environment of the workplace. [ABSTRACT FROM AUTHOR]

Background: Endoscopic resection (ER) is a minimally invasive therapeutic approach for early gastric cancer (EGC), particularly for cases with a low risk of lymph node metastasis (LNM). Tumor budding (TB) has gained attention as a potential prognostic indicator for LNM in EGC. Case Presentation: We report two cases—a 73-year-old and an 81-year-old male patient—who presented with gastric adenocarcinoma. Both patients had small-sized, differentiated, and intramucosal adenocarcinomas. However, high-grade TBs per high-power field under ×200 magnification at the invasive front and LNMs were found in both cases. Conclusions: These cases conformed to the post-ER observation guidelines of the current treatment protocol, yet demonstrated LNMs. We found that TB could serve as an effective prognostic marker for LNM compared to traditional risk factors. The aim of this study is to re-examine the ability of TB to predict LNM in EGC, thereby providing an impetus for reconsideration and potential revision of the current treatment guidelines for EGC. [ABSTRACT FROM AUTHOR]

Granulomatous gastritis (GG) is a rare condition, with incidence between 0.08 and 0.35% in gastric biopsies. Various infectious and non-infectious aetiologies can be considered to cause granulomatous gastritis. Foreign bodies are a rare aetiology of GG and may result from foods, suture materials, or medications. We report a 59-year-old woman who had eaten large amounts of peanuts for more than 10 years and presented with epigastric discomfort. Esophagogastroduodenoscopy revealed multiple nodular lesions with ulcer scars at the stomach, which was diagnosed as GG probably caused by chronic peanut ingestion on endoscopic mucosal resection. [ABSTRACT FROM AUTHOR]

This paper presents a real-time implementation of model predictive control (MPC) for HVAC systems in an ice-cream factory building. The target building consists of two large open spaces served by two HVAC systems. We developed four artificial neural network (ANN) models that predict the thermal states of the supply air and indoor air of the two thermal zones and prove to be accurate enough (MBE = 2.65, CVRMSE = 9.43). The control variables employed in this study are the number of operating chillers, frequency of supply-air fan inverter and outdoor-air intake ratio. The objective function minimizes total energy use, and a constraint was set to maintain average indoor air temperatures close to set points. Real-time MPC was implemented at a sampling time of 20 min from 3 August to 30 August 2021 and could save approximately 31.7% of electricity when compared to the existing simple rule-based control. [ABSTRACT FROM AUTHOR]

A decrease in dynamic balance ability (DBA) in the elderly is closely associated with aging. Various studies have investigated different methods to quantify the DBA in the elderly through DBA evaluation methods such as the timed up and go test (TUG) and the six-minute walk test (6MWT), applying the G-Walk wearable system. However, these methods have generally been difficult for the elderly to intuitively understand. The goal of this study was thus to generate a regression model based on machine learning (ML) to predict the age of the elderly as a familiar indicator. The model was based on inertial measurement unit (IMU) data as part of the DBA evaluation, and the performance of the model was comparatively analyzed with respect to age prediction based on the IMU data of the TUG test and the 6MWT. The DBA evaluation used the TUG test and the 6MWT performed by 136 elderly participants. When performing the TUG test and the 6MWT, a single IMU was attached to the second lumbar spine of the participant, and the three-dimensional linear acceleration and gyroscope data were collected. The features used in the ML-based regression model included the gait symmetry parameters and the harmonic ratio applied in quantifying the DBA, in addition to the features of description statistics for IMU signals. The feature set was differentiated between the TUG test and the 6MWT, and the performance of the regression model was comparatively analyzed based on the feature sets. The XGBoost algorithm was used to train the regression model. Comparison of the regression model performance according to the TUG test and 6MWT feature sets showed that the performance was best for the model using all features of the TUG test and the 6MWT. This indicated that the evaluation of DBA in the elderly should apply the TUG test and the 6MWT concomitantly for more accurate predictions. The findings in this study provide basic data for the development of a DBA monitoring system for the elderly. [ABSTRACT FROM AUTHOR]

This paper presents an integrated lighting control that employs a daylit illuminance prediction model for a large, open-spaced factory building in which interactions between multiple luminaires and points of the workplane exist. The prediction model was developed with Radiance and consists of daylight and electric lighting prediction components. Both components showed reliable accuracy after calibration with measured illuminance (daylighting: MBE = 4.9%, CVRMSE = 24%; electric lighting: MBE = 3.7%, CVRMSE = 7.7%). An optimal policy trained by the deep deterministic policy gradient determines the dimming levels of multiple luminaire groups. The policy is developed with an artificial neural network model whose input is the current state (daylight distribution) and whose output is an action (lighting control variables). The model could provide an appropriate amount of electric lighting that meets the target illuminance and uniformity, while only 54% of the average consumption power (7,292 W) was needed compared with that of the existing rule-based control (13,629 W). [ABSTRACT FROM AUTHOR]

To assess the apparent diffusion coefficient (ADC) values and the T1 and T2 values derived from nonenhanced (NE) and contrast-enhanced (CE) magnetic resonance fingerprinting (MRF) in the prostate gland and to evaluate differences in values among prostate cancer, the normal peripheral zone (PZ) and the normal transition zone (TZ). Fifty-seven patients (median age, 73 years; range, 48–86) with prostate cancer who underwent multiparametric MRI including NE and CE MRF were included in this study. T1 and T2 values were extracted from NE and CE MRF, respectively. Five quantitative values (the ADC, NE T1, NE T2, CE T1 and CE T2 values) were measured in three areas: prostate cancer, PZ and TZ. We compared the values among the three areas and evaluated the differences between NE MRF and CE MRF values. ADC values and MRF-derived values were significantly higher in PZ than prostate cancer or TZ (p < 0.001). TZ had a significantly lower CE T1 but significantly higher values of the other variables than prostate cancer (p < 0.001). The T1 values in all three areas and the T2 values in prostate cancer and TZ were significantly lower on CE MRF than on NE MRF (p < 0.001). Quantitative analysis of NE and CE MRI can be conducted by using the MRF technique. The ADC value and the T1 and T2 values from CE MRF and NE MRF were found to be significantly different between prostate cancer and normal prostate tissue. The T1 and T2 values from contrast-enhanced MR fingerprinting are significantly different between prostate cancer and normal prostate tissue. [ABSTRACT FROM AUTHOR]

This research explores the social mechanism of luxury hotel membership programs and extends current loyalty program literature that has mainly examined membership programs from a mental-accounting perspective. By building upon the social identity theory, this study posits that luxury hotel membership programs provide social platforms, allowing members to construct a collective identity and collective self-esteem. Consequently, collective self-esteem is proposed as an antecedent of customer–brand relationship constructs, such as commitment, switching resistance, and word of mouth. Members from two South Korean luxury hotel membership programs were recruited to participate in a survey to test these constructs' relationship, and findings demonstrate that membership programs' effectiveness in cultivating a robust customer–brand relationship is contingent upon members' collective self-esteem with the program. This correlation involves the four dimensions of collective self-esteem: membership esteem, private esteem, public esteem, and importance to identity. This study is preeminent to the current literature by identifying a critical psychological mechanism, which luxury hotel brand managers can leverage to successfully launch a membership program that ultimately cultivates enduring customer–brand relationships. The results of this study also suggest several managerial implications for hotel marketers to effectively design and manage membership programs by considering collective self-esteem's four dimensions. [ABSTRACT FROM AUTHOR]

Ladder training is a form of multidirectional lower limb plyometric training utilized by coaches and athletes in a variety of sports. The purpose of this study was to examine the effects of ladder training (LT) on sprint (20-m) and change of direction (COD) (L-drill) kinematics. Fourteen NCAA D-2 Basketball players were matched on baseline performance rankings and randomly assigned to a LT (n = 7) or conventional training (CT) (n = 7) group. The LT group performed all the CT exercises with the addition of 25-35 minutes of LT performed 3 times per week, for 4 weeks. Within-group analyses showed significant improvements (p < 0.001) in 20-m sprint performance from pretest to posttest in LT (+6.71%) and CT (+2.16%). No statistically significant difference was found in COD performance. Significant enhancements (p < 0.005) were found in stride frequency from pretest to posttest for 20-m sprint and COD as a result of LT (+13.58%, and +12.26%) and CT (+0.97%, and -2.33%), respectively. LT resulted in substantially better results (between-group changes) in both the 20-m sprint (ES = 1.45) and COD test (ES = 0.97). Furthermore, LT resulted in substantially greater enhancements in stride frequency (ES = 2.43, 1.65), and ground contact time (ES = 1.82, 1.25) in the 20-m sprint and COD performance respectively. LT may be more effective than CT in improving performance and kinematics. LT should be implemented as a warm up or neural priming exercise to induce improvements in stride frequency and ground contact time. [ABSTRACT FROM AUTHOR]

Alicea, SK, Parrott, AD, Manos, TM, and Kwon, YS. Comparison of the affective responses to continuous training and high-intensity interval training protocols: application of the dual-mode model. J Strength Cond Res 35(11): 3069–3075, 2021—High-intensity interval training (HIIT) is time-efficient and has physiological benefits similar to or greater than that of continuous training (CT); however, there are mixed results regarding how HIIT protocols influence affect. The purpose of this study was to compare acute affective responses between HIIT and CT protocols over time using the Dual-Mode Model (DMM) as a theoretical framework. Subjects included 12 healthy women (aged 19–28 years) who completed a HIIT protocol consisting of a 2-minute work interval (100% V̇ o 2max) followed by a 2-minute rest interval (∼55% V̇ o 2max), and a CT protocol set at the workrate corresponding to their respiratory compensation point (RCP; ∼80% V̇ o 2max). Protocols were matched for average intensity, total duration, and energy expenditure. After blood pressure, anthropometrics, body composition, and V̇ o 2max measurements were taken, responses were recorded for affect (Feeling Scale [FS]), arousal (Felt Arousal Scale [FAS]), and rate of perceived exertion (RPE) before each protocol, during the last 10 seconds of every 2 minutes during the protocol, and at time points 2, 5, and 10 minutes after the protocol. Heart rate was also monitored continuously, and exercise enjoyment was measured before and after exercise. A repeated-measures analysis of variance revealed no significant differences in affect between CT (M = 2.5, SD = 2.1) and HIIT (M = 2.6, SD = 2.1) protocols over the duration of the exercise. There were no significant differences in mean RPE between CT (M = 12.9, SD = 2.7) and HIIT (M = 13.0, SD = 1.9) protocols (t = 0.333, p = 0.745) or in enjoyment between CT (M = 2.3, SD = 1.1) and HIIT (M = 2.0, SD = 0.9) protocols (t = −0.288, p = 0.492). In addition, based on visual inspection, the general patterning of the mean FS and FAS values between HIIT and CT was similar within the circumplex model, supporting the DMM. In conclusion, a HIIT protocol at V̇ o 2max and 1:1 exercise:rest interval did not result in a different affect response, perceived exertion, or enjoyment level when compared with a CT protocol at RCP. [ABSTRACT FROM AUTHOR]

Hernandez, DJ, Healy, S, Giacomini, ML, and Kwon, YS. Effect of rest interval duration on the volume completed during a high-intensity bench press exercise. J Strength Cond Res 35(11): 2981–2987, 2021—Between-set rest intervals (RIs) are one of the most important variables in resistance training; however, no known research has investigated the effects of RIs greater than 5 minutes during high-intensity strength training. The purpose of this research was to examine the effects of 3 different RIs on repetition sustainability and training volume (sets × reps × resistance) during a high-intensity bench press exercise. Fifteen resistance-trained male subjects (mean ± SD , age = 25.5 ± 4.5 years, and bench press 1 repetition maximum [1RM] ratio [1RM/body mass] = 1.39 ± 0.1) completed 3 experimental sessions, during which 4 sets of the bench press were performed with 85% of 1RM load. Subjects performed the bench press using 3 different RIs in a random counterbalanced design. Data were analyzed using both a one- and two-way analysis of variance with repeated measures. As sets progressed, repetitions were significantly different (p < 0.05) between all RIs, and only the 8-minute RI (p < 0.05) allowed for the complete sustainability of repetitions over 4 consecutive sets. Subjects attained the greatest training volume (p < 0.05) using an 8-minute RI between sets compared with a 2- or 5-minute RI. Similarly, a significantly greater training volume was achieved using the 5-minute RI compared with the 2-minute RI. Resistance-trained men, with the goal of greater volume during strength training, would benefit from longer RIs, specifically using an 8-minute RI between 4 consecutive sets of a bench press exercise. [ABSTRACT FROM AUTHOR]

Purpose: Sarcopenia is a symptom in which muscle mass decreases due to decreasing in the number of muscle fibers and muscle cross-sectional area as aging. This study aimed to develop a machine learning classification model for predicting sarcopenia through a inertial measurement unit (IMU)-based physical performance measurement data of female elderly. Patients and Methods: Seventy-eight female subjects from an elderly population (aged: 78.8± 5.7 years) volunteered to participate in this study. To evaluate the physical performance of the elderly, the experiment conducted timed-up-and-go test (TUG) and 6-minute walk test (6mWT) with worn a single IMU. Based on literature review, 132 features were extracted from collected data. Feature selection was performed through the Kruskal–Wallis test, and features datasets were constructed according to feature selection. Three major machine learning-based classification algorithms classified the sarcopenia group in each dataset, and the performance of classification models was compared. Results: As a result of comparing the classification model performance for sarcopenia prediction, the k-nearest neighborhood algorithm (kNN) classification model using 40 major features of TUG and 6mWT showed the best performance at 88%. Conclusion: This study can be used as a basic research for the development of self-monitoring technology for sarcopenia. [ABSTRACT FROM AUTHOR]

In this paper, we analyze the radar cross section (RCS) of an integrated mast and present the optimized mast shape for RCS reduction. The RCS is simulated using commercial electromagnetic (EM) software based on the shooting and bouncing rays (SBR) method and the diffraction fields at the edges are also considered. Threat frequencies, threat regions and cardinal points are first defined considering the operational environments of a naval vessel. We calculate and analyze the RCS of the integrated mast in terms of the threat frequencies, the shapes of the integrated mast and the direction and polarization of the incident waves. The shape of the integrated mast is optimized based on the shaping technique. The optimized mast has low RCS properties in the primary threat sectors except for the exceptional angle regions. [ABSTRACT FROM AUTHOR]

Objective : Infection is one of most devastating complications in ventriculoperitoneal (VP) shunt surgery. Preoperative hair removal has traditionally been performed to reduce infectious complications. We performed VP shunt surgeries and evaluated the prevalence of infection in patients who were shaved and those who were unshaven. Methods : A retrospective analysis was conducted of 82 patients with hydrocephalus of various pathologies who underwent VP shunt surgery, with or without having the head shaved, between March 2010 and March 2017. For patients in the non-shaved group (n=36), absorbable suture materials were used for wound closure, and Nylon sutures or staples were used in the shaved group (n=46). We evaluated the infection outcomes of patients in the two groups. Results : There was no difference in the average age of patients in the two groups. In the non-shaved group, there were no infections, while two patients in the shaved group required revision because of shunt infection. Conclusion : Non-shaved shunt surgery may be safe and effective, with no increase of infection rate. We recommend that shunt procedures could be performed without shaving the hair, which may increase patients' satisfaction without increasing infection risk. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate ways in which hotel loyalty programs can be designed to enhance customer's identification with a hotel brand and develop a sustainable customer-brand relationship. Design/methodology/approach: The study adopted a cross-sectional design survey questionnaire for data collection and used structural equation modeling data analysis to test the conceptual model. Findings: The three loyalty program experiences proposed (member-to-member similarity, memorable loyalty program experience and loyalty program social benefits) exerted significant positive effects on customer-brand identification (CBI), which, in turn, influences customer-brand relationship elements, including trust, commitment and switching resistance. Originality/value: This study expands the scope of CBI literature, which previously focused substantially on brand level experiences, by being the first to explore a new set of CBI antecedents with a focus on loyalty program experiences. Furthermore, the current study's findings delineate specific strategies to uphold the social and experiential aspects of loyalty programs that can develop sustainable customer-brand relationships. [ABSTRACT FROM AUTHOR]

Objective To determine whether modified constraint-induced movement therapy (mCIMT) with continuous restraint is feasible and effective in improving the use of the paretic arm in the real world among infants and toddlers with unilateral cerebral palsy (CP). Design Single-blind randomized controlled trial. Setting Tertiary hospital. Participants Children aged 7 to 36 months with unilateral CP (N = 24; 16 boys, 8 girls). Intervention The experimental group received 2-hour clinic-based mCIMT sessions (5 days per week for 3 weeks), and a continuous restraint was applied. Main Outcome Measures Standardized assessments were conducted. Peabody Developmental Motor Scales-2 (PDMS-2), Gross Motor Function Measure-66, Pediatric Motor Activity Log (PMAL), and Pediatric Evaluation of Disability Inventory were measured pre- and postintervention. Children who agreed to participate in the accelerometer study additionally wore accelerometers on both their wrists for 3 days before and after the intervention. Results The mCIMT group exhibited greater improvement in PMAL-how often (p = 0.048; ηp2 = 0.173), PMAL-how well (p = 0.008; ηp2 = 0.289), and PDMS-2 visual motor integration (p = 0.014; ηp2 = 0.256) posttreatment than the control group. The percentage of time in moderate-to-vigorous physical activity (z = –2.24; p = 0.03) and vector magnitude average counts (z = –2.52; p = 0.01) significantly increased in children in who wore accelerometers (N = 8) after the 3-week mCIMT protocol. Conclusion mCIMT with continuous restraint applied to infants and toddlers with unilateral CP appeared to have a positive effect on paretic hand use in the real world. Clinical Trial Registration Number NCT03418519 [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incidence and presentation of osteoporotic sequential bilateral hip fractures (SBHF) in Center for Joint Disease, Chonnam National University Hwasun Hospital as there are limited studies with variable results reported in Korea. Materials and Methods: Records of 507 patients aged >60 years old presenting with osteoporotic hip fractures between 2009 and 2015 were retrospectively reviewed to document the occurrence and presentation of sequential hip fractures; mean post-treatment follow-up was 48 months. Additionally, any correlations between sequential fractures and initial fracture and risk factors were assessed. Bone mineral density (BMD) was measured before and after sequential hip fracture for comparison. Results: There were 246 femoral neck (Group A) and 261 intertrochanteric (Group B) fractures. The cumulative incidence of SBHF was 8.2% (42 patients total; 29 in Group A and 13 in Group B). Average interval of SBHF for Group A and Group B were 37.4 months and 29.9 months, respectively. There was significant correlation between the initial fracture type and sequential fractures, particularly the trochanteric and subgroup of those with neck fractures. Hypertension as a co-morbidity and female sex have been identified as risk factors for SBHF. No significant findings were noted regarding BMD and risk factors in both groups. Conclusion: The clinical presentations of SBHF noted here concur with other worldwide studies and may guide efforts to develop relevant programs to prevent SBHF. [ABSTRACT FROM AUTHOR]

Background: Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective: Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods: Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results: Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions: Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations. [ABSTRACT FROM AUTHOR]

In this study, we aimed to provide the recommended occupational exposure limits (OELs) for multi-walled carbon nanotubes (MWCNTs) and graphene nanomaterials based on data from a subchronic inhalation toxicity study using a lung dosimetry model. We used a no observed adverse effect level (NOAEL) of 0.98 mg m−3 and 3.02 mg m−3 in rats for MWCNTs and graphene, respectively. The NOAELs were obtained from a 13-week inhalation study in rats. The deposition fractions of MWCNTs and graphene in the respiratory tract of rats and humans were calculated by using the multi-path particle dosimetry model (MPPD model, v3.04). The deposition fraction in the alveolar region was 0.0527 and 0.0984 for MWCNTs and 0.0569 and 0.1043 for graphene in rats and human lungs, respectively. Then, the human equivalent exposure concentrations (HECs) of MWCNTs and graphene were calculated according to the method by the National Institute for Occupational Safety and Health (NIOSH). The HEC was estimated to be 0.17 mg m−3 for MWCNTs and to be 0.54 mg m−3 for graphene, which was relevant to the rat NOAEL of 0.98 mg m−3 and 3.02 mg m−3 for MWCNTs and graphene, respectively. Finally, we estimated the recommended OELs by applying uncertainty factors (UFs) to the HEC as follows: an UF of 3 for species differences (rats to humans), 2 for an experimental duration (subchronic to chronic), and 5 for inter-individual variations among workers. Thus, the OEL was estimated to be 6 μg m−3 for MWCNTs and 18 μg m−3 for graphene. These values could be useful in preventing the adverse health effects of nanoparticles in workers. [ABSTRACT FROM AUTHOR]

The article presents a case of a 47-year-old male who was presented to a hospital due to a left nasal obstruction for six months to discuss cholesterol granuloma of the maxillary sinus presenting as antrochoanal polyp (ACP). Also cited are the possible causes of the condition like drainage impairment, hemorrhage and disturbed ventilation,

Intracranial arterial stenosis usually occurs due to atherosclerosis and is considered the most common cause of stroke worldwide. Although the effectiveness of bypass surgery for ischemic stroke is controversial, the superficial temporal artery to the middle cerebral artery bypass for ischemic stroke is a common procedure. In our report, a 50-year-old man presented with sudden-onset left side weakness and dysarthria. An angiogram showed significant stenosis in the junction of the right cavernous- supraclinoid internal carotid artery and right pericallosal artery. Symptoms altered between improvement and deterioration. Magnetic resonance imaging showed a repeated progression of anterior cerebral artery (ACA) infarction despite maximal medical therapy. We performed a STA-ACA bypass with contralateral STA interposition. Postoperative course was uneventful with no further progression of symptoms. Thus, bypass surgery may be considered in patients with symptomatic stenosis or occlusion of the ACA, especially when patients present progressive symptoms despite maximal medical therapy [ABSTRACT FROM AUTHOR]

The parallel combination of a switching and a linear amplifier in the supply modulator for RF power amplifiers (PAs) has the potential to enhance energy efficiency while achieving wider bandwidth and lower ripple output voltage. In this paper, a linear amplifier that features a buffered-switching Class-AB bias scheme is presented for the supply modulator in polar-transmitter structures achieving 500 MHz of small-signal 3-dB bandwidth at a 1.2-V supply. The linear amplifier absorbs and cancels up to 60 mA of ripple current from the switching amplifier. As such, the ripple in the output voltage of the hybrid linear-switching supply modulator is less than 7.5 mVpp. The switching amplifier provides most of the signal current for greatest efficiency owing to a proposed rail-to-rail current-sensing circuit. Current feedback in the switching amplifier achieves 1.68-MHz unity-gain bandwidth at 6-MHz switching frequency. Harmonic distortion in the output voltage of the supply modulator is below 40 dBc at 0.8 Vpp sinusoidal input up to 9 MHz. The peak efficiency is 87.7% for a 8.25- $\Omega $ load, while the maximum output power is 23.6 dBm for a 4.99- $\Omega $ load. The chip measures 1.35 mm2 in a 65-nm standard bulk CMOS process. [ABSTRACT FROM AUTHOR]

In this paper, a fully integrated digitally assisted low-dropout regulator (LDO) for a NAND flash memory system is proposed and verified using 500 nm I/O CMOS transistors. By combining an amplifier (AMP)-based LDO with a comparator (CMP)-based LDO, the proposed LDO achieves both fast load response in the transient state and accurate regulation in the steady state, which are advantages of the CMP-based LDO and AMP-based LDO, respectively. Moreover, loop frequency stability is satisfied in a wide range of load currents between 0 and 150 mA by using the simple structure of the gm-boost cell to insert an auxiliary path. For an input voltage range of 2.3–3 V and an output voltage of 2.1 V, the measured output droop is 225 mV for a 150 mA load step in the load transition time of 20 ns with the total bias current of 81\,\mu \rmA. The fabricated prototype chip occupies 160\,\times \,610\,\mu \rmm^2 with an on-chip output capacitor of 2 nF. [ABSTRACT FROM AUTHOR]

Spindle cell ductal carcinoma in situ (DCIS) is a recently recognized subtype of DCIS, which is associated with a very rare and unique morphology. Although the histologic features have been relatively well described in a few reports, the cytologic features have not. Even though the distinction of this lesion from usual DCIS is not crucial clinically, it should be noted that this lesion might simulate the features of metaplastic carcinoma on fine needle aspiration cytology. Here, we report a case of spindle cell DCIS in a 45-year-old female, with the detailed cytologic features, both on conventional and liquid-based preparations, along with some useful immunohistochemical staining markers for the differential diagnosis. [ABSTRACT FROM AUTHOR]

Background: In this study, the growth and reproductive response of seedlings, grown in plastic pots with sand, to moisture and nutrients were analyzed in order to study the environmental conditions required to create an alternative habitat for Epilobium hirsutum L., an endangered plant. Results: Vegetative and reproductive growths of Epilobium hirsutum L. are accelerated with increase in moisture and organic matter content in the soil. Among vegetative organs, the number of runners related to asexual reproduction was the highest when the moisture content was over 25% and nutrient content between 7 and 14% in the soil. But the number of flowers related to flowering responses, among reproductive organs, was the highest when the moisture content was maintained at 75% and when nutrient content was 21% in the soil. The number of seeds, related to sexual reproduction, was the highest when the moisture content was over 25% and nutrient content between 14 and 21%. Conclusions: The study results show that a place with high moisture and nutrient content in the soil is advantageous to asexual and sexual reproduction of Epilobium hirsutum L. Therefore, we must serve periodically nutrient and seeds to sustain population in in situ conservation. Furthermore, it is advisable to create in riverside where abundant nutrient content have, making alternative habitat of Epilobium hirsutum L. Also, we must find species that have high contribution degree index through vegetation survey. [ABSTRACT FROM AUTHOR]

Cadmium (Cd) is the most potent nephrotoxic heavy metal and may affect bone; it also has a long biological half-life in the human body. This study was designed to assess the effect of environmental low-level Cd exposure on kidney function and bone in the general population. The subjects of this cross-sectional study were 1907 healthy Korean adults who had not been exposed to Cd occupationally. We analyzed the concentrations of Cd in the urine, markers of renal tubule damage, such as β-microglobulin (β-MG) and N-acetyl-β-D-glucosaminidase (NAG) activity in the urine, calculated the estimated glomerular filtration rate (eGFR) using serum creatinine, and measured bone mineral density (BMD). Also, we analyzed malondialdehyde (MDA) levels in the urine. The geometric mean concentration of Cd in urine was higher in women (1.36 μg/g creatinine) than in men (0.82 μg/g creatinine). Urinary Cd was significantly positively correlated with urinary β-MG and NAG activity, whereas it was negatively correlated with eGFR and BMD. The risk of renal tubule damage was significantly associated with urine Cd level, and the association remained significant after controlling for various confounding variables. However, no association was observed between urinary Cd level and glomerular dysfunction or bone damage. The concentration of MDA was increased with urinary Cd level in a dose-dependent manner. These findings suggest that low-level environmental Cd exposure may cause microscopic damage to renal tubules through oxidative stress but might not impair kidney glomeruli or bones. [ABSTRACT FROM AUTHOR]

The dual microcatheter technique is an alternative treatment for stent-assisted coiling in acutely ruptured wide-necked aneurysms because of no antiplatelet therapy. We assessed the safety and efficacy of this technique in ruptured wide-necked aneurysms. Between March 2008 and March 2016, 56 acutely ruptured aneurysms were treated with the dual microcatheter technique. The angiographic results, treatment-related complications, and clinical outcome were documented. Angiographic follow-up was available in 37 patients at a mean of 20.6 months (6 to 81 months). On the postembolization angiograms, 27 (48.2%) aneurysms showed complete occlusion (Raymond 1), 15 (26.8%) showed neck remnant (Raymond 2), and 14 (25.0%) showed body remnant (Raymond 3). Treatment-related complications occurred in seven patients (12.5%) and six patients remained asymptomatic. The permanent complication rate was 1.8% (1/56). A good outcome (modified Rankin Scale (mRS) score, 0-2) was observed in 64.3% of patients at the time of discharge. Five patients had died, all of the sequelae of subarachnoid hemorrhage. The overall mortality rate was 8.9% (5/56); however, the treatment-related mortality rate was 0%. Of the 37 aneurysms for which angiographic follow-up was available, 21 (56.8%) aneurysms demonstrated recanalization. Five aneurysms with recanalization were retreated endovascularly. There was one aneurysm re-rupture on follow-up and it rebled 21 months after the initial procedure. The dual microcatheter technique is a safe and effective treatment for acutely ruptured wide-necked aneurysms due to low treatment-related complication and mortality rate. However, the high rate of postembolization incomplete occlusion and recanalization remains as the main challenge. [ABSTRACT FROM AUTHOR]

Multiloculated hydrocephalus (MLH) is a condition in which patients have multiple, separate abnormal cerebrospinal fluid collections with no communication between them. Despite technical advancements in pediatric neurosurgery, neurological outcomes are poor in these patients and the approach to this pathology remains problematic especially given individual anatomic complexity and cerebrospinal fluid (CSF) hydrodynamics. A uniform surgical strategy has not yet been developed. Current treatment options for MLH are microsurgical fenestration of separate compartments by open craniotomy or endoscopy, shunt surgery in which multiple catheters are placed in the compartments, and combinations of these modalities. Craniotomy for fenestration allows better visualization of the compartments and membranes, and it can offer easy fenestration or excision of membranes and wide communication of cystic compartments. Hemostasis is more easily achieved. However, because of profound loss of CSF during surgery, open craniotomy is associated with an increased chance of subdural hygroma and/or hematoma collection and shunt malfunction. Endoscopy has advantages such as minimal invasiveness, avoidance of brain retraction, less blood loss, faster operation time, and shorter hospital stay. Disadvantages are also similar to those of open craniotomy. Intraoperative bleeding can usually be easily managed by irrigation or coagulation. However, handling of significant intraoperative bleeding is not as easy. Currently, endoscopic fenestration tends to be performed more often as initial treatment and open craniotomy may be useful in patients requiring repeated endoscopic procedures.q [ABSTRACT FROM AUTHOR]

Arteriovenous graft for hemodialysis vascular access is a widely used technique with many advantages. However, it has crucial complications with graft thrombosis and infection. We recently experienced an unusual case of arteriovenous graft complication involving graft thrombosis related to fistula formation between the graft and the natural vein with infection. We diagnosed this condition using Doppler ultrasound and computed tomography angiography. Successful surgical treatment including partial graft excision and creation of a secondary arteriovenous fistula using an inadvertently dilated cephalic vein was performed. The dialysis unit staff should keep this condition in mind and try to prevent this complication. [ABSTRACT FROM AUTHOR]

Background: The elderly have been reported to show anatomical and physiologic changes in the upper airway, which might affect the supraglottic airway (SGA) performance in geriatric populations. This study aimed to evaluate the clinical efficacy of the classic laryngeal mask airway (LMA-C) in the elderly compared with young adult patients. Methods: Fifty patients aged 65-85 years (elderly group) and 50 patients aged 20-40 years (young group) who were scheduled for surgery using the LMA-C for general anesthesia were enrolled in this prospective, non-randomized, comparative study. Manipulations required during insertion, success rate, insertion time, oropharyngeal leak pressure, gastric insufflation, and intraoperative inadequate ventilation with the LMA-C were assessed. Fiberoptic evaluation was used to determine the position of the LMA-C. Results: In the elderly group, the insertion success rate on the first attempt was significantly lower than that in the young group (84 vs. 96%, P = 0.02). The insertion time in the elderly group was significantly longer than that in the young group (28.5 ± 19.6 vs. 22.2 ± 6.4 seconds, P = 0.001). However, there was no difference in oropharyngeal leak pressure or fiberoptic grade between the two groups after proper placement of the LMA-C. During the surgery, inadequate ventilation events occurred more frequently in the elderly group than in the young group (31.3 vs. 4.0%, P < 0.001). Conclusions: The clinical efficacy of the LMA-C in elderly patients was inferior to that in young adult patients. Therefore, further studies are required to determine the type of SGA that can provide excellent clinical efficacy in the geriatric population. [ABSTRACT FROM AUTHOR]

This study examined whether palm cooling (PC) could reduce heat strain, measured through changes in core, mean skin, mean body temperatures, and thermal sensation in resting hyperthermic subjects wearing chemical protective garments. Ten male subjects performed three exercise bouts (6.1 km h(-1), 2-4% grade) in a hot, dry environment [mean (SD) air temperature 42.2 (0.5 degrees C), relative humidity 36.5 (1%)] until core temperature reached 38.8 degrees C. Subjects then simulated transport in an armoured vehicle by resting in a seated position for 50 min with either no cooling (NC), (PC at 10 degrees C) or palm cooling with vacuum application around the hand (PCVAC, 10 degrees C, 7.47 kPa negative pressure). Core, skin, and mean body temperatures with PC and PCVAC were lower (P < 0.05) than NC from 15 to 50 min of cooling, and thermal sensation was lower (P < 0.05) from 30 to 50 min, with no differences in any variables between PC and PCVAC. Maximal heat extraction averaged 42 (12 W), and core temperature was reduced by 0.38 (0.21 degrees C) after 50 min of PC. Heat extraction with PC was modest compared to other cooling approaches in the literature. [ABSTRACT FROM AUTHOR]