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Background: Endobronchial ultrasound (EBUS) is widely used to diagnose lung cancer. Monitored anesthesia care (MAC) can enhance patient comfort and procedural conditions during EBUS. EBUS under MAC is usually safe but can lead to various complications. Case: A 34-year-old male who had increased sputum for two months showed an enlarged paratracheal lymph node and planned for lymph node biopsy by EBUS. During EBUS under MAC, an unexpected oxygen saturation decline required intervention. After intubation, copious frothy fluid was suctioned from the bronchi, and oxygenation was recovered. A narrowed trachea and the EBUS bronchoscope might have resulted in upper airway obstruction, and suction performed under these conditions might have caused pulmonary edema. The patient received non-invasive ventilation and high-flow nasal cannula and recovered without complications. Conclusions: When there is an expected risk of upper airway obstruction during EBUS, careful preoperative evaluation and preparation are essential to prevent negative pressure pulmonary edema. [ABSTRACT FROM AUTHOR]

Background: Delayed emergence after general anesthesia may significantly affect a patient’s condition. We present the case of a patient who experienced prolonged delayed recovery of consciousness, language, and motor response due to catatonia after eight hours of total elbow arthroplasty under general anesthesia. Case: A 68-year-old woman with neuropsychiatric disorders and Parkinson’s disease did not respond adequately during recovery after more than eight hours of general anesthesia. Following the operation, the patient was semi-comatose and appeared to have nonconvulsive status epilepticus upon awakening from anesthesia. However, subsequent examinations did not reveal any organic causes. The patient was subsequently diagnosed with catatonia, treated, and discharged following gradual improvement. Conclusions: Although rare, patients taking psychiatric drugs for an extended period may experience delayed emergence after prolonged general anesthesia without identifiable causes. Catatonia should be considered in the differential diagnoses of these patients. [ABSTRACT FROM AUTHOR]

Background: COVID-19 and delayed hip surgery are well-known risk factors for thromboembolism in elderly patients. Case: We report the case of an 88-year-old female patient with COVID-19 and pulmonary thromboembolism (PTE) who underwent delayed hip surgery 21 days after the injury. Heparinization and inferior vena cava filters were used to treat and prevent PTE. Transesophageal echocardiography and extracorporeal membrane oxygenation (ECMO) sheaths were inserted as a precaution in case of emergencies during surgery; the procedure was performed without any specific event. Conclusions: COVID-19-infected patients suffering from a hip fracture have a high risk of thromboembolism, and therefore, require utmost attention for appropriate evaluation and prevention. [ABSTRACT FROM AUTHOR]

Oblique lumbar interbody fusion is a minimally invasive procedure for treating degenerative lumbar disease. Its advantages include correcting coronal and sagittal spinal alignment and indirect neural decompression. However, achieving a successful outcome is limited in some patients who need direct decompression for central canal lesions including hard stenotic lesions (endplate or facet articular osteophytes and ossification of posterior longitudinal ligaments) and sequestration of the disk. Biportal endoscopic spinal surgery is a minimally invasive technique, which directly decompresses the lesion. By taking advantage of two procedures, in a longlevel lumbar lesion, alignment correction and direct decompression can be both achieved. Herein, the authors introduce multilevel lumbar fusion through oblique lumbar interbody fusion and selective direct decompression through biportal endoscopic spinal surgery and discuss the surgical indications, surgical pitfalls, and recommendations for application. Consequently, it is regarded as a minimally invasive interbody fusion method for patients with multilevel lumbar degenerative degeneration. [ABSTRACT FROM AUTHOR]

Background: Although competency-based education (CBE) is becoming a popular form of medical education, it has not been used to train residents. Recently, the Korean Society of Anesthesiologists completed a pilot implementation and evaluation of a CBE program. This study aims to outline the experience. Methods: The chief training faculty from each hospital took a one-hour online course about CBE. Emails on the seven core competencies and their evaluation were sent ahead of a pilot core competency evaluation (CCE) to residents and faculty. The pilot CCE took place in late 2021, followed by a survey. Results: A total of 68 out of 84 hospitals participated in the pilot CCE. The survey response rate was 55.9% (38/68) for chief training faculty, 10.2% (91/888) for training faculty, and 30.2% (206/683) for residents. More than half of the training faculty thought that CCE was necessary for the education of residents. Residents’ and training faculty’s responses about CCE were generally positive, although their understanding of CCE criteria was low. More than 80% of the hospitals had a defibrillator and cardiopulmonary resuscitation manikin while the rarest piece of equipment was an ultrasound vessel model. Only defibrillators were used in more than half of the hospitals. Thoughts about CCE were related to various factors, such as length of employment, location of hospitals, and the number of residents per grade. Conclusions: This study’s results may be helpful in improving resident education quality to meet the expectations of both teaching faculty and residents while establishing CBE. [ABSTRACT FROM AUTHOR]

Unmanned aerial vehicle (UAV) autopilot flight requires a specific altitude when inspecting defective urban solar panels to avoid obstacles such as high-rise buildings, trees, and telegraph poles. Therefore, autopilot-based thermal imaging has severe data redundancy because the non-solar panel area occupies more than 99% of the ground target. We aim to explore the tracking capability of a UAV video stream for defective urban solar panels by comparing spatial and clustering patterns with autopilot-based photomosaics. The spatial patterns of distributions and clusters in defective solar panels have high similarity (80--100%) to those of autopilot-based photomosaics. The results of this study can serve as a valuable reference for video-stream-based thermal deficiency inspections of defective solar panels in urban areas. [ABSTRACT FROM AUTHOR]

Interdisciplinarity is a critical component of creating a more sustainable built environment and improving student learning outcomes. Yet, learning interdisciplinarity and measuring it in higher education is challenging. This study implemented a diagnostic tool that allowed educators to measure how both disciplinary and interdisciplinary skills, knowledge, and values would grow in courses related to sustainable built environments. One school containing four different disciplines devoted to the built environment, was selected as the study area to collect emprical data. Pre- and post-semester surveys were conducted. Among 286 students, interdisciplinarity grew most among students within the school's majors, while among students from outside the school majors interdisciplinary learning decreased. Though disciplinary learning outpaces interdisciplinary learning the closer students are to earning their bachelor's or higher degrees. The result showed that students' knowledge, values and skills differ depending on the majors, their affiliational context, and the year of classification. The result suggests that the timing of teaching interdisciplinary contents should be earlier. The diagnostic tool which measured pre- and post- course disciplinary and interdisciplinary knowledge, skills, and values related to sustainable built environment would also be applicable in other courses in higher education. [ABSTRACT FROM AUTHOR]

Background: Local anesthetics systemic toxicity (LAST) is a grave complication of regional anesthesia that usually occurs immediately after local anesthetics injection. Here, we report on rare late-onset toxicity cases after supraclavicular brachial plexus blocks. Case: Two patients underwent surgery for radius fractures. We used lidocaine 100 mg and ropivacaine 150 mg for blocking and infused dexmedetomidine for intraoperative sedation. The 63-year-old male patient’s blood pressure dropped to 87/60 mmHg after 3 h 15 min after blocking. Ventricular fibrillation occurred 10 min later. After five defibrillations, electrocardiography showed ventricular tachycardia that was normalized through one cardioversion. The 54-year-old female patient’s heart rate decreased to 35 beats/min 2 h 30 min after blocking. Her vital signs returned to normal after administering atropine, ephedrine, epinephrine, and lipid emulsion. Conclusions: Physicians should remember that LAST may occur long after local anesthetic injection and be aware of factors that may adversely affect the course of LAST. [ABSTRACT FROM AUTHOR]

Background: Giant lip hemangioma is a rare disease that may cause difficulty in preoxygenation and ventilation when using face masks and intubation during general anesthesia induction. Case: A laparoscopic cholecystectomy was planned for a 77-year-old woman. The patient had a giant lower lip hemangioma that was 12 × 5 × 5 cm, which made preoxygenation and ventilation through a face mask impossible and put her at risk of hemangioma rupture. We preoxygenated her through a high-flow nasal cannula (HFNC). Following propofol and succinylcholine administration, we intubated the patient with a video laryngoscope without desaturation, hemangioma rupture, or CO2 retention. Conclusions: HFNC is a useful tool when difficult intubation is expected in patients who have problems using conventional face masks. [ABSTRACT FROM AUTHOR]

Background: Postoperative pain control after the minimally invasive repair of pectus excavatum (MIRPE) is essential, but there is a controversy about a better analgesic method between epidural and intravenous (IV) analgesia. This systematic review and meta-analysis aimed to compare the effect of epidural versus IV analgesia following MIRPE. Methods: We searched PubMed, MEDLINE, Embase, Cochrane Central Register, and ClinicalTrials.gov for randomized controlled trials (RCTs) dated up to 31st May 2021. The primary outcome was the area under the curve (AUC) of the weighted mean visual analog scale (VAS) after MIRPE. The secondary outcomes were postoperative nausea, operation time, total operating room time, and postoperative length of hospital stay. Results: Four RCTs involving 243 patients were finally included in this meta-analysis. The AUC of the weighted mean VAS was 343.62 in the epidural group and 375.24 in the IV group. The epidural group showed lower VAS than the IV group at 12 to 48 h after the surgery. Postoperative nausea, operation time and length of hospital stay was not different between two groups. The epidural group had a significantly longer total operating room time due to epidural catheter insertion time. Conclusions: Epidural analgesia after the MIRPE had a better analgesic effect than IV analgesia. However, IV analgesia may also be a viable option, and physicians should wisely choose analgesic modalities after MIRPE. [ABSTRACT FROM AUTHOR]

The mammalian orthologue of ecdysoneless (ECD) protein is required for embryogenesis, cell cycle progression, and mitigation of endoplasmic reticulum stress. Here, we identified key components of the mRNA export complexes as binding partners of ECD and characterized the functional interaction of ECD with key mRNA export-related DEAD BOX protein helicase DDX39A. We find that ECD is involved in RNA export through its interaction with DDX39A. ECD knockdown (KD) blocks mRNA export from the nucleus to the cytoplasm, which is rescued by expression of full-length ECD but not an ECD mutant that is defective in interaction with DDX39A. We have previously shown that ECD protein is overexpressed in ErbB21 breast cancers (BC). In this study, we extended the analyses to two publicly available BC mRNA The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) data sets. In both data sets, ECD mRNA overexpression correlated with short patient survival, specifically ErbB21 BC. In the METABRIC data set, ECD overexpression also correlated with poor patient survival in triple-negative breast cancer (TNBC). Furthermore, ECD KD in ErbB21 BC cells led to a decrease in ErbB2 mRNA level due to a block in its nuclear export and was associated with impairment of oncogenic traits. These findings provide novel mechanistic insight into the physiological and pathological functions of ECD. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity and its comorbidities have become major public health challenges in the US. While previous studies have investigated the roles of land uses and transportation infrastructure on obesity, limited research has examined the influence of landscape spatial patterns. The purpose of this study was to examine the association between landscape spatial patterns and obesity in Hispanic children. Methods: Participants included 61 fourth- and fifth-grade Hispanic children from inner-city neighborhoods in Houston, TX. BMI z-scores were computed based on objectively-measured height and weight from each child. Parental and child surveys provided sociodemographic and physical activity data. Landscape indices were used to measure the quality of landscape spatial patterns surrounding each child's home by utilizing Geographic Information Systems and remote sensing analyses using aerial photo images. Results: After controlling for sociodemographic factors, in the half-mile airline buffer, more tree patches and well-connected landscape patterns were negatively correlated with their BMI z-scores. Furthermore, larger sizes of urban forests and tree patches were negatively associated with children's BMI z-scores in the half-mile network buffer assessment. Conclusions: This study suggests that urban greenery requires further attention in studies aimed at identifying environmental features that reduce childhood obesity. [ABSTRACT FROM AUTHOR]

Background: Responding to the growing interest in the environmental influences on physical activity, and the concerns about the limitations of self-report data, this study evaluates Global Positioning System (GPS) units for measuring outdoor physical activity. Methods: Four GPS models were selected to test their accuracy related to adherence to an actual route walked, variations based on position of unit on user's body, and variations against a known geodetic point. A qualitative assessment was performed using the following criteria: a) battery life, b) memory capacity, c) initial satellite signal acquisition time, d) ease of data transfer to other programs, e) wearability, f) ease of operation, g) suitability for specific study populations, and h) price. Results and Conclusions: The Garmin Forerunner provided the most accurate data for data points collected along a known route. Comparisons based on different body placement of units showed some variations. GlobalSat reported battery life of 24 hours, compared with 9-15 hours for the other units. The static test using ANOVA showed that the Garmin Foretrex's data points compared with a geodetic point was significantly more accurate than the other 3 models. GPS units appear promising as a tool to capture objective data on outdoor physical activities. [ABSTRACT FROM AUTHOR]

Background: Parents represent a key ecological component in influencing their child's physical activity. The aim of this exploratory study was to assess the relationship between maternal acculturation and physical activity in Hispanic children. Methods: 102 Hispanic mothers (mean age 36.2 yrs; +SD 7.3 yrs) and their children (mean age 10.0 yrs, +SD 0.8 yrs) participated. Most of the mothers (74%) were foreign-born, with 62% classified as low acculturated and 38% high acculturated. Demographic, acculturation, and anthropometric measures were completed by mothers and children. Physical activity was measured using accelerometers. Relationships between maternal acculturation and demographic variables and children's physical activity were examined using chi-square, Analysis of Variance, and simple regression. Results: Children had higher physical activity levels than their mothers (t(49) = -7.87, P < .000 1). Significant correlations between maternal and child's physical activity levels were observed in moderate (r² = 0.13, P = .001), vigorous (r² = 0.08, P = .05), and moderate-to-vigorous physical activity (r² = 0.17, P = .002). Low acculturated mothers were more likely to have active children compared with high acculturated mothers. Maternal BMI and other demographic characteristics were not significantly associated with child's physical activity. Conclusions: Findings from this study revealed an association among maternal acculturation, role modeling, and child's physical activity. [ABSTRACT FROM AUTHOR]

Background: Parents represent a key ecological component in influencing their child's physical activity. The aim of this exploratory study was to assess the relationship between maternal acculturation and physical activity in Hispanic children. Methods: 102 Hispanic mothers (mean age 36.2 yrs; +SD 7.3 yrs) and their children (mean age 10.0 yrs, +SD 0.8 yrs) participated. Most of the mothers (74%) were foreign-born, with 62% classified as low acculturated and 38% high acculturated. Demographic, acculturation, and anthropometric measures were completed by mothers and children. Physical activity was measured using accelerometers. Relationships between maternal acculturation and demographic variables and children's physical activity were examined using chi-square, Analysis of Variance, and simple regression. Results: Children had higher physical activity levels than their mothers (t(49) = -7.87, P < .0001). Significant correlations between maternal and child's physical activity levels were observed in moderate (r² = 0.13, P = .001), vigorous (r² = 0.08, P = .05), and moderate-to-vigorous physical activity (r² = 0.17, P = .002). Low acculturated mothers were more likely to have active children compared with high acculturated mothers. Maternal BMI and other demographic characteristics were not significantly associated with child's physical activity. Conclusions: Findings from this study revealed an association among maternal acculturation, role modeling, and child's physical activity. [ABSTRACT FROM AUTHOR]

Background: An Alveolar-pleural fistula is communication between the alveoli and the pleural space that may result in intractable pneumothorax, severe infection, respiratory failure, physical weakness, and even death. Case: A 70-year-old male underwent right hepatectomy with a cystic mass of the liver. During the operation, peak airway pressure abruptly increased and a serous fluid was regurgitated through the endotracheal tube. Lung isolation was immediately performed with a double-lumen endotracheal tube. Approximately 1,000 ml of exudate was drained through endotracheal tube. Thoracostomy was performed at right lung. Analysis of fluid from endotracheal tube and pleural effusion consistent with parapneumonic effusion. Conclusions: We presented a case of alveolar-pleural fistula caused by pneumonia presenting with massive exudate fluid regurgitated from the endotracheal tube that was managed with bronchial suction, lung isolation, and thoracostomy and improved without surgical repair of the fistula. [ABSTRACT FROM AUTHOR]

Background/Aims: In the ABC classification system, group A consists of seronegative subjects without gastric corpus atrophy. This study aimed to determine the prevalence and characteristics of pseudo group A subjects. Methods: Group A subjects were identified among consecutive Korean adults who underwent a serum anti-Helicobacter pylori immunoglobulin G (IgG) test and pepsinogen (PG) assay on the day of endoscopy. Past infection was defined as the presence of either eradication history or endoscopic findings suggesting past infection (i.e., gastric xanthoma, metaplastic gastritis, or advanced atrophy >closed-type 1). Results: Among 2,620 group A subjects, 448 (17.1%) had eradication history, and 133 (5.1%) showed endoscopic findings suggesting past infection. Older age (odds ratio [OR], 1.148; 95% confidence interval [CI], 1.067 to 1.236) and earlier year of birth (OR, 1.086; 95% CI, 1.009 to 1.168) were independent risk factors for classification into pseudo group A, with cutoff points at 50.5 years and birth year of 1959.5, respectively. Positive H. pylori test findings were found in 22 subjects (3.1%) among the 715 subjects who underwent the urea breath test or Giemsa staining on the same day. Current infection was positively correlated with PG I and PG II levels (p<0.001) but not with age, anti-H. pylori IgG titer, or classification into pseudo group A. Conclusions: Among the group A subjects, 22.2% had past infection. The risk was higher in subjects older than 50 years, especially those born before 1960. Furthermore, current infection was found in 3.1% of the subjects and was correlated with increased gastric secretory ability. [ABSTRACT FROM AUTHOR]

We derived a mouse model in which a mutant form of Nbn/Nbs1mid8 (hereafter Nbnmid8) exhibits severely impaired binding to the Mre11-Rad50 core of the Mre11 complex. The Nbnmid8 allele was expressed exclusively in hematopoietic lineages (in Nbn-/mid8vav mice). Unlike Nbnflox/floxvav mice with Nbn deficiency in the bone marrow, Nbn-/mid8vav mice were viable. Nbn-/mid8vav mice hematopoiesis was profoundly defective, exhibiting reduced cellularity of thymus and bone marrow, and stage-specific blockage of B cell development. Within 6 mo, Nbn-/mid8 mice developed highly penetrant T cell leukemias. Nbn-/mid8vav leukemias recapitulated mutational features of human T cell acute lymphoblastic leukemia (T-ALL), containing mutations in NOTCHI, TPSB, BCLS, BCOR, and IKZF1, suggesting that Nbnmid8 mice may provide a venue to examine the relationship between the Mre11 complex and oncogene activation in the hematopoietic compartment. Genomic analysis of Nbn-/mid8vav malignancies showed focal amplification of 9qA2, causing overexpression of MRE11 and CHK1. We propose that overexpression of MRE11 compensates for the metastable Mre11-Nbnmid8 interaction, and that selective pressure for overexpression reflects the essential role of Nbn in promoting assembly and activity of the Mre11 complex. [ABSTRACT FROM AUTHOR]

A 37-year-old male visited the hospital with multiple trauma after traffic accident. Fractures of ribs, left femur, and right humerus and spleen rupture with hemoperitoneum were founded on image studies. He was moved to operation room and general anesthesia was performed for splenectomy. During the operation, excessive high peak inspiratory pressure was observed. After abdominal closure, hypoxia, hypercapnia, and respiratory acidosis were worsened. Veno-venous extracorporeal membrane oxygenation (ECMO) was initiated after the operation. Status of the patient were improved after the application of ECMO. The patient was discharged without significant complication. Despite of several limitations in applying ECMO to patients with abdominal compartment syndrome (ACS) and multiple trauma, severe pulmonary dysfunction in ACS patients may be rescued without open abdomen treatment. [ABSTRACT FROM AUTHOR]

Background: Point-of-care (POC) arterial blood gas analysis (ABGA) is widely used for checking hemoglobin (Hb) level. However, there is the tendency of downward bias of conductivity-based POC ABGA Hb measurement compared with optical methods. Authors tried to correct that bias by linear regression equation. Methods: We retrospectively collected a total of 86 Hb result pairs during surgeries. Hb measured by the Sysmex XE-2100 in the laboratory was set as the gold standard and was compared with that measured by the GEM Premier 3500. Data were compared using the Bland-Altman analysis, the reliability of transfusion decision was assessed using three-zone error grid. The linear regression analysis was performed to find out the relation between the Hb results of POC ABGA and those of laboratory based test. Results: The bias of the Hb measured between Sysmex XE-2100 and GEM Premier 3500 was −0.9 g/dl (P < 0.001, 95% confidence interval, −1.038 to −0.665 g/dl). The percentage error was 16.4%. According to error grid methodology, zone A, B and C encompassed 89.5%, 10.5% and 0% of data pairs. After adjusting the POC ABGA Hb values, the bias of the Hb measured by two methods was 0 g/dl (P = 0.991). The percentage error was 18.2%. The zone A, B and C encompassed 91.9%, 8.1% and 0% of data pairs. Conclusions: Hb measurements obtained with reference to conductivity via a POC ABGA were significantly lower than those obtained via optical methods. This bias may deserve attention of anesthesiologists when POC ABGA Hb level is used as a transfusion guideline. [ABSTRACT FROM AUTHOR]

The article presents a study which identified certain vulnerabilities in cancers that express PGBD5, a DNA transposase. The study found that expression of PGBD5 is not tolerated by cells in mice and human beings which lack nonhomologous end joining DNA repair. Examination of cell survival and DNA damage was done using Western immunoblotting.

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A 25-year-old male patient who was infected with human immunodeficiency virus (HIV) underwent a condyloma excision under spinal anesthesia. The patient complained of suspicious postdural puncture headache. The patient did not respond to conservative management. Subsequently, the subdural hematoma (SDH) was found through magnetic resonance imaging. In response, an epidural blood patch was used to improve the symptoms and inhibit the enlargement of the SDH. The patient was discharged after it was confirmed that a headache had subsided without increasing SDH. Anesthesiologist should be aware of other causes of headaches after spinal anesthesia in HIV-infected patients and should carefully and accurately identify the cause. [ABSTRACT FROM AUTHOR]

We report a healthy patient with postpartum headache and neck stiffness which were diagnosed as symptoms of pseudoaneurysm of vertebral artery. She had received a Cesarean section under the spinal anesthesia, and complaint of headache and neck stiffness. Epidural blood patches were done twice, but symptoms persisted. Eight days later, she experienced sensory disturbance and emergent laminectomy was done. When persistent postpartum headache occurs after epidural blood patch, more precise differential diagnosis should be made and considering other possible pathologies. [ABSTRACT FROM AUTHOR]

Ecdysoneless (ECD) is an evolutionarily conserved protein whose germ line deletion is embryonic lethal. Deletion of Ecd in cells causes cell cycle arrest, which is rescued by exogenous ECD, demonstrating a requirement of ECD for normal mammalian cell cycle progression. However, the exact mechanism by which ECD regulates cell cycle is unknown. Here, we demonstrate that ECD protein levels and subcellular localization are invariant during cell cycle progression, suggesting a potential role of posttranslational modifications or protein-protein interactions. Since phosphorylated ECD was recently shown to interact with the PIH1D1 adaptor component of the R2TP cochaperone complex, we examined the requirement of ECD phosphorylation in cell cycle progression. Notably, phosphorylation-deficient ECD mutants that failed to bind to PIH1D1 in vitro fully retained the ability to interact with the R2TP complex and yet exhibited a reduced ability to rescue Ecd-deficient cells from cell cycle arrest. Biochemical analyses demonstrated an additional phosphorylation-independent interaction of ECD with the RUVBL1 component of the R2TP complex, and this interaction is essential for ECD's cell cycle progression function. These studies demonstrate that interaction of ECD with RUVBL1, and its CK2-mediated phosphorylation, independent of its interaction with PIH1D1, are important for its cell cycle regulatory function. [ABSTRACT FROM AUTHOR]

Increased demands for technological integration in higher education have resulted in new forms of course instruction. Under a flipped approach, students learn course materials outside the classroom while active learning methods are employed inside. This study focuses on the perceived effects of flipped instruction on knowledge acquisition in undergraduate students using information communication, accessibility, stimulation, interaction, and accumulation as measures. Undergraduate students indicated positive effects of flipped teaching and student's perceived learning improved as time spent using learning management systems increased. While knowledge acquisition tended to increase in most students, technological incompatibilities prevented the flipped approach from being fully accepted. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the major variables identified as important for considering the stabilization of slope revegetation based on hydroseeding applications and evaluate weights of each variable using the analytic hierarchy process (AHP) with both environmental experts and civil engineers. Twenty-five variables were selected by the experts' survey from a total of 65 from the existing literature, with each variable considered as an important factor for slope stabilization in South Korea. The final results from the AHP method showed that variables associated with the driving force of water resources showed higher values in all expert groups such as rain intensity, seepage water and drainage condition. Other important variables were related to plant growth such as vegetation community, vegetation coverage and quality of soil ameliorant produced in an artificial factory such as tensile strength, permeability coefficient, soil texture and organic matter. The five highest-ranked variables that satisfied both environmental experts and civil engineers were rain intensity, seepage water, slope angle, drainage condition and ground layer. The findings of this research could be helpful for developing a more accurate rating system to evaluate the stability of slope revegetation. [ABSTRACT FROM AUTHOR]

Slanted Cu nanopillars with uniform arrays were fabricated using slanted Si channel structures as templates. A slanted plasma etching technique was employed, utilizing a Faraday cage system for the formation of these slanted channel structures. The angle of the slanted channel structures was accurately controlled because ions entering the Faraday cage maintained their direction. After the slanted channel structures were formed, they were filled with Cu by electroless deposition. Chemical mechanical polishing was then used to remove the excess Cu film and the SiO2 masks. Finally, the remaining poly Si of the channel structures was removed by wet chemical etching. This work offers a novel method for the fabrication of slanted metal nanostructures with uniform arrays covering a large area. [ABSTRACT FROM AUTHOR]

Background: Simplified acute physiology score 3 (SAPS3) was developed in 2005 to evaluate intensive care unit (ICU) performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. Methods: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC) of the total scores and each subset were evaluated. Results: The ICC (95% confidence interval) of SAPS3 score was 0.89 (0.82-0.95), that of subset I was 0.90 (0.82-0.95), subset II was 0.54 (0.35-0.73), and subset III was 0.95 (0.91-0.97). The ICC of predicted mortality was 0.91 (0.85-0.96). Conclusions: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component. [ABSTRACT FROM AUTHOR]

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy. [ABSTRACT FROM AUTHOR]

We experienced a case of venous vessel wall entrapment between the introducer needle and the guide wire during an attempt to perform right internal jugular vein (IJV) catheterization. The guide wire was introduced with no resistance but could not be withdrawn. We performed ultrasonography and C-arm fluoroscopy to confirm the entrapment location. We assumed the introducer needle penetrated the posterior vessel wall during the puncture and that only the guide wire entered the vein; an attempt to retract the wire pinched the vein wall between the needle tip and the guide wire. Careful examination with various diagnostic tools to determine the exact cause of entrapment is crucial for reducing catastrophic complications and achieving better outcomes during catheterization procedures. [ABSTRACT FROM AUTHOR]

Various polybenzimidazole (PBI)-based ion-exchange films were prepared and thoroughly characterized by Fourier transform infrared (FT-IR) spectroscopy, proton conductivity, and water uptake for possible use as fuel cell membranes. Upon the increase in the flexibility of the PBI-based polymer films (e.g., poly(oxyphenylene benzimidazole) (OPBI) and sulfonated OPBI (s-OPBI)), the membranes exhibited slightly improved proton conductivity, but significantly increased dimensional changes. To reduce the dimensional changes (i.e., increase the stability), the cross-linking of the polymer films (e.g., cross-linked OPBI (c-OPBI) and sulfonated c-OPBI (sc-OPBI)) was accomplished using phosphoric acid. Interestingly, the sc-OPBI membrane possessed a greatly increased proton conductivity (0.082 S/cm), which is comparable to that of the commercially available Nafion membrane (0.09 S/cm), while still maintaining slightly better properties regarding the dimensional change and water uptake than those of the Nafion membrane. [ABSTRACT FROM AUTHOR]

Background: Propofol has been widely used for an induction and/or maintenance of general anesthesia, or for sedation for various procedures. Although it has many ideal aspects, there have been several cases of drug abuse and addiction. The authors investigated whether there are abuse liable groups among the general population. Methods: We surveyed 169 patients after gastric endoscopic examination, which used propofol as a sedative, with the Addiction Research Center Inventory (ARCI) questionnaire. Other characteristics of the patients, such as past history, smoking habits, depression, anxiety, alcohol abuse liability and sleep disturbance, were recorded by history taking and several questionnaires before the exam. Results: Propofol had a high Morphine-Benzedrine Group (MBG) score (representative value for euphoria) of 6.3, which is higher than marijuana, and a Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score (representative value of sedation) of 8.1, which is lower than most opioids. The MBG score showed no statistically significant correlation between any of the characteristics of the groups. In females, the PCAG score showed a correlation with age, and in males, it showed a correlation with a sleeping problem. Conclusions: Propofol had relatively high euphoria and low residual sedative effects. It had a more potent sedative effect in the female group who were young, and in the male group who had a low sleep quality index. There were differences in the abuse liability from a single exposure to propofol in the general population. Further study is needed to evaluate the abuse liability of repeated exposure. [ABSTRACT FROM AUTHOR]

This report describes the formation of gold-coated silver bimetallic nanoparticles prepared by the one-pot synthetic approach which involves the subsequent reduction of silver and gold ions at ambient conditions. The reduction of silver ions by excess L-ascorbic acid initially led to the formation of silver cores. This step was followed by the addition of gold ions into the preformed cores, resulting in the formation of silver-core gold-shell type bimetallic nanoparticles at room temperature. This process systematically allowed for the formation of various bimetallic nanoparticles which exhibited tunable absorption properties corresponding to the visible and near-IR regions. The thickness of the gold shells and the diameter of the silver-core nanoparticles were readily controlled; the morphological and structural properties of the resulting bimetallic nanoparticles were thoroughly analyzed by SEM/TEM, DLS, and UV-Vis spectrophotometry. The overall results demonstrated not only that these gold-coated silver nanoparticles were reliably prepared by our one-pot synthetic approach, but also that their optical properties were tunable in the visible and near- IR areas as a function of the core size and shell thickness. [ABSTRACT FROM AUTHOR]

Zeolites are potentially a robust desalination alternative, as they are chemically stable and possess the essential properties needed to reject ions. Zeolite membranes could desalinate "challenging" waters, such as saline secondary effluent, without any substantial pre-treatment, due to the robust mechanical properties of ceramic membranes. A novel MFI-type zeolite membrane was developed on a tubular α-Al2O3 substrate by a combined rubbing and secondary hydrothermal growth method. The prepared membrane was characterised by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and single gas (He or N2) permeation and underwent desalination tests with NaCl solutions under different pressures (0.7 MPa and 7 MPa). The results showed that higher pressure resulted in higher Na+ rejection and permeate flux. The zeolite membrane achieved a good rejection of Na+ (~82%) for a NaCl feed solution with a TDS (total dissolved solids) of 3000 mg•L-1 at an applied pressure of 7 MPa and 21 °C. To explore the opportunity for high salinity and high temperature desalination, this membrane was also tested with high concentration NaCl solutions (up to TDS 90,000 mg•L-1) and at 90 °C. This is the first known work at such high salinities of NaCl. It was found that increasing the salinity of the feed solution decreased both Na+ rejection and flux. An increase in testing temperature resulted in an increase in permeate flux, but a decrease in ion rejection. [ABSTRACT FROM AUTHOR]