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In the field of food and agriculture, fuel cell-based energy supply technology is gaining much attention for sustainable food systems with carbon neutrality by 2050. Previous studies have focused on the electricity balance using polymer electrolyte fuel cells (PEMFCs) without considering the temperature quality to maintain the environmental conditions required in smart farms. However, this study proposes a system that can provide all four energy sources (electricity, cooling, heating, and CO2) required by smart farms by using solid oxide fuel cells (SOFC), which can utilize high-quality heat. To confirm the feasibility of the proposed idea, we demonstrate the world's first 10 kW-class SOFC-based integrated system for a smart farm in Jinju, South Korea. The system's core components consist of a SOFC system, a hot thermal storage system, a cold thermal storage system, and a CO2 supply system. In this study, the applicability of the proposed system is verified by the experimental results of the effective production of cold and hot heat required by smart farms. In addition, the technical problems encountered during the demonstration are presented. In doing so, we suggest the direction of more economical and sustainable SOFC technology development for smart farm applications.

Purpose: To minimize ultrasound power use and surgical phaco time in illuminated chop cataract surgery.Methods: The charts of patients who underwent senile cataract surgery by a single surgeon were reviewed retrospectively. A conventional intracameral endoilluminator was used in a Stop & Chop group (n = 45), while an illuminated chopper was used in an illuminated chop (I-Chop) group (n = 71). EFX, a unitless value that roughly correlates with ultrasound energy during phacoemulsification, surgical phaco time, and changes in endothelial cell count were compared between the two groups and the ratio of zero phacoemulsification in the I-Chop group was evaluated.Results: EFX of the Stop & Chop and I-Chop groups was 18.08 ± 16.15 and 0.82 ± 3.53, respectively (p = 0.001), while the surgical phaco time was 185.08 ± 41.42 and 162.04 ± 49.65 seconds (p = 0.01). However, the endothelial loss did not differ in the two groups (7.03 ± 7.89 vs. 7.13 ± 9.47%, p = 0.76). In the I-Chop group, 56 (86%) eyes had zero phaco energy and patients with EFX >1 (n = 6) had more severe nuclear sclerosis grading (2.90 ± 0.71 vs. 4.5 ± 1.0; p = 0.001).Conclusions: The I-Chop group had lower EFX and shorter surgical phaco time than the Stop & Chop group. Illuminated chop using an illuminated chopper is one way to attain minimal phacoemulsification.

The rest duration between sets is one of the most essential resistance training variables; however, research on the effects of rest intervals between sets has shown inconsistencies on whether short or long rest intervals significantly increase overall performance during resistance training. This literature review aimed to investigate how different rest intervals between sets affect the maintenance of repetitions, training volume, and overall strength gains from resistance exercises in both trained and non-trained individuals. Fifteen original investigations and three textbooks involving the effect of between set rest intervals during resistance training are summarized in this review. The results for the studies interested in repetition maintenance suggested longer rest intervals significantly increased the number of repetitions and helped repetitions stay more consistent throughout sets. Longer rest intervals were also determined to increase training volume but had no significant effect on overall strength gains. Biochemical substrates that provide the catalyst for energy creation can take up to eight minutes to fully resynthesize; therefore, more research is needed on longer rest intervals to see if there are further increases in resistance training performance.

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.

Objective To evaluate the effect of combined hyperbaric oxygen therapy (HBOT) and steroid therapy in severe idiopathic sudden sensorineural hearing loss (ISSNHL). Methods Between January 2010 and July 2017, we evaluated 218 patients with ISSNHL and divided them into 2 groups: those with hearing loss greater than 80 dB and those with hearing loss of 60-79 dB. Each group was further divided into 3 groups according to the treatment method: oral steroids alone (PO), PO+intratympanic injection (IT), and PO+IT+HBOT. The treatment effect was evaluated for improvement in hearing thresholds at mid-term (3 weeks later) and final term (2 months later). Results When comparing the 3 treatment groups within the group that had a hearing loss greater than 80 dB, no differences were observed in the gaps in hearing thresholds and in the duration of improvement (P = .0764 and .2938, respectively). However, in the group with 60-79 dB hearing loss, the gaps in hearing thresholds at mid-term were 27.50 dB in the PO group, 38.13 dB in the PO+IT group, and 51.25 dB in the PO+IT+HBOT group. The treatment was more effective and faster in the initial period in the PO+IT+HBOT group than in the other groups. In addition, the results of frequency analysis showed greatest treatment efficacy at low frequencies of hearing. Conclusion Patients with ISSNHL above 80 dB are less likely to recover hearing even after PO+IT+HBOT. However, this treatment initially accelerates recovery in patients with a hearing loss below 80 dB. Therefore, the appropriate indication for HBOT benefits in patients with severe or profound ISSNHL should be reviewed.

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.

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.

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 XX(X): 000-000, 2020-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.

Jeong Bae Ko,1,&ast; Kwang Bok Kim,1,&ast; Young Sub Shin,1 Hun Han,1 Sang Kuy Han,2 Duk Young Jung,3 Jae Soo Hong1 1Digital Health Care R&D Department, Korea Institute of Industrial Technology, Cheonan, Chuncheongnam-do, South Korea; 2Robotics R&D Department, Korea Institute of Industrial Technology, Ansan, Gyeonggi-do, South Korea; 3Seongnam Senior Experience Complex, Eulji University, Seongnam, Gyeonggi-do, South Korea&ast;These authors contributed equally to this workCorrespondence: Jae Soo HongDigital Health Care R&D Department, Korea Institute of Industrial Technology, Cheonan, Chuncheongnam-do, South KoreaTel +82 41-589-8412Fax +82 41-589-8413Email jshong94@kitech.re.krDuk Young JungSeongnam Senior Experience Complex, Eulji University, Seongnam, Gyeonggi-do, South KoreaTel +82 41-589-8412Email dyjung@eulji.ac.krPurpose: 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.Keywords: sarcopenia, physical activity, machine learning, inertial measurement unit

While safety is a high priority for our community during the Covid-19 pandemic, exercise is essential to improve and maintain a healthy lifestyle (ACSM, 2018). Fitness centers are reopening across the county with various safety precautions including masks and social distancing. Although the Centers for Disease Control and Prevention (CDC, 2020) recommends all people to wear a mask (except for children younger than 2 years old, anyone who has trouble breathing, and anyone who is unconscious, incapacitated, or otherwise unable to remove the cloth face-covering without assistance), wearing a mask may not be possible in every situation. For example, during outdoor exercises, wearing a mask contributes to issues of potential breathing restrictions (lower the oxygen gas concentration levels in the recirculated air). This column concerns views on wearing masks while exercising, especially when doing it outdoors.

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 XX(X): 000-000, 2020-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% V[Combining Dot Above]O2max) followed by a 2-minute rest interval (∼55% V[Combining Dot Above]O2max), and a CT protocol set at the workrate corresponding to their respiratory compensation point (RCP; ∼80% V[Combining Dot Above]O2max). Protocols were matched for average intensity, total duration, and energy expenditure. After blood pressure, anthropometrics, body composition, and V[Combining Dot Above]O2max 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 V[Combining Dot Above]O2max 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.

Smart farm is a breakthrough technology that can maximize crop productivity and economy through efficient utilization of space regardless of external environmental factors. This study was conducted to investigate the optimal growth and physiological conditions of Chinese matrimony vine (Lycium chinense) with LED light sources in a smart farm. The light source was composed of red+blue and red+blue+white mixed light using a LED system. In the red+blue mixed light, red and blue colored LEDs were mixed at ratios of 1:1, 2:1, 5:1, and 10:1, with duty ratios varied to 100%, 99%, and 97%. The experimental results showed that the photosynthetic rate according to the types of light sources did not show statistically significant differences. Meanwhile, the photosynthetic rate according to the mixed ratio of the red and the blue light was highest with the red light and blue LED ratio of 1:1 while the water use efficiency was highest with the red and blue LED ratio of 2:1. The photosynthetic rate according to duty ratio was highest with the duty ratio of 99% under the mixed light condition of red+blue+white whereas the water use efficiency was highest with the duty ratio of 97% under the mixed light of red+blue LED. The results indicate that the light source and light quality for the optimal growth of Lycium chinense in the smart farm using the LED system are the mixed light of red+blue (1:1) and the duty ratio of 97%.

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.

Objective This study aimed to develop and verify an endometriosis self-assessment tool (ESAT).Methods A non-experimental, descriptive, correlational study design was used. Candidate items were developed based on a conceptual framework constructed using the results of in-depth interviews and an integrative literature review. The construct validity of the developed tool was also examined. One-hundred and forty-two participants (117 patients with endometriosis and 25 patients without endometriosis) were included in the validity and reliability tests. The data were collected between August and December 2018. Nomological validity was verified based on significant correlations between the ESAT and the quality-of-life scores.Results A 21-item ESAT was developed, and its construct validity was supported. Exploratory factor analysis indicated that the tool consisted of four components (gastrointestinal symptoms, dysmenorrhea, usual symptoms, and the amount and characteristics of menstrual bleeding) with a variance of 61.6%. The variance in quality-of-life scores, as explained by the ESAT scores, was relatively high. Receiver operator characteristics curve analysis indicated that ESAT scores significantly differentiated endometriosis from non-endometriosis with fair discriminatory power at a cut-off score of 50 (sensitivity, 0.76; specificity, 0.72; area under the curve, >0.75; P50 points were more likely to have endometriosis. Thus, the reliability of the ESAT was confirmed.Conclusion The devised tool appears valid and reliable. This tool may allow women to determine their risk of endometriosis by distinguishing between normal and pathological menstruation-related symptoms.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic disrupted the emergency medical care system worldwide. We analyzed the changes in the management of intracerebral hemorrhage (ICH) and compared the pre-COVID-19 and COVID-19 eras. MATERIALS AND METHODS: From March to October of the COVID-19 era (2020), 83 consecutive patients with ICH were admitted to four comprehensive stroke centers. We retrospectively reviewed the data of patients and compared the treatment workflow metrics, treatment modalities, and clinical outcomes with the patients admitted during the same period of pre-COVID-19 era (2017-2019). RESULTS: Three hundred thirty-eight patients (83 in COVID-19 era and 255 in pre-COVID-19 era) were included in this study. Symptom onset/detection-to-door time [COVID-19; 56.0 min (34.0-106.0), pre-COVID-19; 40.0 min (27.0-98.0), p=0.016] and median door to-intensive treatment time differed between the two groups [COVID-19; 349.0 min (177.0-560.0), pre-COVID-19; 184.0 min (134.0-271.0), p

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.

Objective: To evaluate the clinicopathological characteristics of grade group 1 (GG1) prostate cancer in Korean populations.Methods: We retrospectively analyzed 492 consecutive radical prostatectomy specimens from our institution, which included those from 322 men with clinical GG1 and 170 with clinical GG2 tumors between years 2009 and 2018. The incidence of Gleason score (GS) upgrading, extraprostatic extension (EPE), and seminal vesicle invasion (SVI) were evaluated in patients with clinical GG1. In pathological GG1 cases, the distribution of adverse pathological features including EPE, lymphovascular invasion (LVI), perineural invasion (PNI), and biochemical recurrence (BCR) was analyzed.Results: Altogether, 78 (24.2%) out of 322 men in the clinical GG1 group demonstrated upgrading of GS, including 19 men with pathological Gleason score 4 + 3 = 7 and 6 with ≥ pathological Gleason score 4 + 4 = 8 cases. EPE was found in 37 (11.5%) and 22 (8.9%) men in clinical GG1 and pathological GG1 group, respectively. The incidence of LVI and PNI in the pathological GG1 cases was 2.8% (n = 7) and 28.6% (n = 71), respectively. BCR was observed in 4 men in pathological GG1 T2 (n = 226) and 2 men in GG1 T3 (n = 22) group. When we compared the pathological features between pathological GG1 T3 vs. GG2 T2, there was no statistical differences in the incidence of LVI and PNI between the two groups.Conclusions: Contrary to the current concept that GG1 is almost always clinically insignificant, it seems that GG1 still possess its respectable position as a group of cancer with aggressiveness. These findings should be kept in mind when deciding on treatment options for prostate cancer patients in the Asian populations.

The objectives of this study were to determine the clinical and radiologic outcome after headless compression screw fixation through the transolecranon approach in patients who had sustained Dubberley type 2 and 3 articular surface fractures of the distal humerus. Twenty-seven patients were included in the study. There were 23 Dubberley type 2 and 4 type 3 fractures. All patients were available for a minimum of 24 months of follow-up. The evaluation was performed using the VAS, the DASH score, and the MEPS. The outcome was excellent in 18 patients, and 9 patients had a good result by the MEPS. The average range of flexion was 132° (range 110°-140°). The mean extensor lag was 7.9° (range 0°-30°). The main advantages of the transolecranon approach are direct fracture visualization, ease of joint inspection, help in reduction, and ease of correct perpendicular fracture fixation.

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

We developed a slim double-skin window (SDSW) with the aim of reducing building energy consumption for heating and cooling, thereby reducing the impact of buildings on climate change. The developed SDSW is a slim structure with an air cavity thickness of 20 mm, i.e., thinner than that of a traditional double-skin facade (DSF). We analyzed changes in the thermal properties and cooling and heating energy consumption of the SDSW as well as the effects of the thin air cavity on window performance. A testbed was constructed to analyze the seasonal temperature properties of the glass and the cooling and heating energy consumption. We also compared the long-term effects of the air cavity on the difference between outdoor and indoor glass surface temperatures under similar conditions for the SDSW and traditional DSF. The SDSW temperature was 3 °C lower than that of the traditional DSF, and the cooling and heating energy consumption dropped by 6.5%. Although the performance of the developed SDSW was comparable to that of traditional DSF, the life-cycle cost was reduced by 47%.