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• We investigated the therapeutic outcomes of CyberKnife-based fractionated stereotactic radiotherapy (CKFRT) in patients with cerebral arteriovenous malformations (AVMs). • Our data revealed that the overall cumulative probability of complete obliteration at 3 years was 47% with a median time to complete obliteration of 39 months. • Also, the complete obliteration rate of AVM was associated with the radiosurgery-based AVM score, which consisted of AVM volume and location and patients' age. • Only one (2%) patient had a hemorrhage during the follow-up period. To explore the therapeutic outcomes of CyberKnife based fractionated stereotactic radiotherapy (CKFRT) for patients with cerebral arteriovenous malformations (AVM). Between January 2008 and October 2020, 45 patients underwent CKFRT for cerebral AVMs as a first treatment. The delineation of AVM targets included AVM nidus. The mean target volume was 4.07 cm3, and 9 lesions (20%) were larger than 10.0 cm3. The mean marginal dose was 24 Gy (range, 20–35 Gy). CKFRT was delivered in median 3 fractions (range, 2 ∼ 5 fractions). AVM obliteration following CKFRT was confirmed by magnetic resonance imaging or angiography. During a median follow-up of 47 (5–148) months, complete obliteration and partial obliteration of AVM after CKFRT were obtained in 23 (51%) and 13 (29%) patients, respectively. Median time to complete obliteration was 39 (15–63) months. The cumulative probability of complete obliteration rate at 3 years was 47%. Complete obliteration rate of AVM was associated with Radiosurgery-based AVM score, which was consisted of AVM volume, patients age, and AVM location. One (2%) patient had hemorrhage during the follow-up period. CKFRT is an effective primary treatment for patients with cerebral AVMs with a low hemorrhage risk. [ABSTRACT FROM AUTHOR]

Glucagon-like peptide-1 receptor agonist (GLP-1 RA) is used to treat obesity or type 2 diabetes mellitus (DM). We compared weight loss and side-effects between patients with and without DM using GLP-1 RA. This was a retrospective cohort study based on electronic medical records. Patients were categorized into three groups: liraglutide without DM (LiRa_NL), liraglutide with DM (LiRa_DM), and lixisenatide with DM (LiXi_DM). Six-month outcomes were evaluated for weight loss, side-effect types, and onset discontinuation of GLP-1 RA. We enrolled 356 (190 LiRa_NL, 95 LiRa_DM, and 71 LiXi_DM) patients (women, 72.5 %; mean age, 43.7 ± 12.7 years; mean body mass index, 30.7 ± 5.2 kg/m2). The mean glycated hemoglobin (HbA1c) participants were 7.7 ± 2.1 %. Average weight loss was 2.9 ± 0.3 kg. The change in HbA1c was lower in the LiXi_DM group than in the LiRa_DM group (− 1.1 ± 0.2 % vs. − 0.4 ± 0.1 %, P < 0.05). The LiRa_DM group showed a more effective weight loss (− 3.0 ± 0.4 kg) than the LiXi_DM group (− 0.9 ± 0.4 kg) (P < 0.05). Approximately 30 % of the patients reported experiencing side-effects, with gastrointestinal side-effects being the most frequent (20.5 %). The median side-effect onset was 1.9 ± 0.1 months from first treatment. The rate of GLP-1 RA discontinuation was 72.8 %. Discontinuation rates due to side-effects were 75.7 %, 68.9 %, and 64.4 % in the LiRa_NL, LiRa_DM, and LiXi_DM groups, respectively. The LiRa_NL group showed the most weight loss, although the discontinuation rate was high. Most side-effects occurred at 1–2 months. When prescribing GLP-1 RA, education concerning side-effects and discontinuation is needed to enhance treatment adherence. • We compared weight loss and side-effects in DM and non-DM patients using GLP-1 RA. • Six-month outcomes were evaluated for weight loss and side-effect types. • The liraglutide without DM (LiRa_NL) group showed the most weight loss. • Discontinuation rate was high, and most side-effects occurred at 1–2 months. • Education concerning side-effect and discontinuation is needed to enhance adherence. [ABSTRACT FROM AUTHOR]

Global reaction mechanisms (GRMs) are widely used in combustion engineering. However, it is difficult to find GRMs commonly available for various mixtures of H 2 , CO, and CH 4 (with air), which are likely to be the primary fuels in the future. In this study, a series of GRMs were optimized to follow the results of the five detailed reaction mechanisms (GRI 3.0, USC II, San Diego, FFCM-1, CRECK) for the essential fuels (H 2 , CO, CH 4) and their mixtures (at 300 K and 1 bar). At first, a 1-step GRM of H 2 +air (R1) and another of CO + air (R2), were optimized to reproduce their respective laminar burning velocities (LBVs). After that, an additional water-gas shift reaction (R3) was suggested to improve the prediction for the H 2 +CO + air mixture. Similarly, a 1-step GRM (M1) was developed for the fuel-lean mixtures of CH 4 +air, and a 2-step GRM (R1+M1) was proposed for the fuel-lean mixtures of H 2 +CH 4 +air. In the case of the mixture of H 2 +CO + CH 4 +air, an additional methane oxidation reaction (M1L) producing H 2 and CO was suggested, and a 4-step GRM (R1+R2+R3+M1L) showed reliable results in the fuel-lean conditions. However, to get reliable LBVs over all equivalence ratios, two additional reactions (M2+M3) were proposed to reflect the endothermic reaction. Furthermore, the pre-exponential factor of the methane oxidation reaction (M1R) varied as a function of the hydrogen concentration in the fuel. Conclusively, acceptable LBVs could be obtained for the H 2 +CO + CH 4 +air mixtures in a moderate temperature range (300 K–600 K). • Global reaction mechanisms (GRMs) were determined for H 2 +CO + CH 4 +air mixtures. • Laminar burning velocities from the detailed reaction mechanisms were compared. • 1-step GRMs were improved for the individual fuels H 2 , CO, and CH 4. • Additional multi-step GRMs were proposed for fuels of various compositions. • Optimized GRMs were proposed for various mixtures of H 2 +CO + CH 4 +air. [ABSTRACT FROM AUTHOR]

We investigated the long-term effects of bone cement-augmented instrumentation in multilevel lumbar fusions in a retrospective cohort study. The use of cement-augmented screws is one of the techniques used to reduce early mechanical failure in treating multilevel lumbar fusion, especially in the elderly. However, little information is available regarding the long-term effects. A total of 51 patients who had undergone ≥3 levels of lumbar fusion were divided into two groups according to the use of bone cement-augmented screw fixation involving the upper instrumented vertebra: 22 patients in the cement-augmented group (group I) and 29 patients in the non–cement-augmented group (group II). Analysis of radiographic adjacent disc segment degeneration (ASD) revealed patients with lumbosacral fusion with a similar degree of osteoporosis. Radiologic ASD was defined as progression of >2 UCLA (University of California, Los Angeles) grades at 2 years postoperatively. Other sagittal parameters and the preoperative magnetic resonance imaging Pfirrmann grades at the adjacent levels, possibly related to ASD, were also analyzed. No significant differences were present in the preoperative demographic and radiographic parameters between the 2 groups. However, the postoperative kyphotic changes at 3 months were greater for the non–cement-augmented group. In terms of the long-term effects, the incidence of radiologic ASD (group I, n = 20 [95.2%]; vs group II, n = 15 [53.6%]) was significantly higher in the cement-augmented group. Logistic regression analysis of radiologic ASD, including other clinical and radiologic parameters, postoperative pelvic incidence–lumbar lordosis mismatch (odds ratio, 5.201; 95% confidence interval, 1.123–24.090; P = 0.035), and cement augmentation (odds ratio, 20.193; 95% confidence interval, 2.195–185.729; P = 0.008) showed a significant correlation with the development of radiologic ASD at 2 years postoperatively. Although bone cement-augmented screw implantation can prevent kyphotic deformation at the proximal junction of upper instrumented vertebra in the early postoperative stages of multilevel lumbar fusion, a careful selection of patients is required because of possibly accelerated degeneration of adjacent segments. [ABSTRACT FROM AUTHOR]

Although monitoring greenhouse gases (GHG) is of crucial significance in addressing global climate change, contemporary GHG measuring equipment is expensive, bulky, and installed in only a few areas, leading to several limitations for responding in real-time. Besides, there are difficulties in measuring atmospheric constitutions in living spaces due to problems caused by the detection method that is used in measuring devices and the limits of observation incurred by spatial and operational contingencies. Here, we report a graphene-based photoelectric detector that provides low-cost and high-precision monitoring of GHGs, irrespective of the contiguity of the gas to the sensor unit. The graphene photodetection materials, laminated under high temperature and pressure conditions, were designed as three-dimensional elements in order to optimally absorb light energy passed through the GHG layers. As a result, the photoelectric detector indicated accurate responsivity to 216 ppm of carbon dioxide, 0.06 ppm of carbon monoxide, and 0.88 ppm of mixed methane and carbon dioxide gas. Of greater interest, it showed a high responsivity of 45% when 12 μW/cm2 of incident light passed through 1.09 ppm of carbon monoxide atmosphere. Our study is at the cornerstone of building high-density GHG monitoring networks within cities and metropolitan areas. [Display omitted] [ABSTRACT FROM AUTHOR]

• The incidence of sacral insufficiency fractures after lumbosacral fusion was 1.2%. • Three fracture patterns were identified. • Unilateral vertical fractures were successfully managed nonsurgically. • Bilateral vertical and horizontal sacral fracture showed sagittal malalignment. • Bilateral vertical or horizontal sacral fracture needed surgical treatment. The purpose of this study was to report the characteristics of SIFs after ILSF and discuss its management focusing on pelvic deformation. We retrospectively reviewed all consecutive patients who underwent ILSF for degenerative disc diseases during the period between 2000 and 2017 and were diagnosed as SIF at our institute. The clinical and radiographic data were reviewed on their medical charts. Treatment outcomes for SIF were also investigated. Eight patients (all females) were included in this study. Mean age at SIF diagnosis was 72 years, and the mean follow-up period was 3.8 years (range 1–7 years). SIF developed average 7.5 years (range 1 month−17 years) after the index ILSF. Fracture patterns were unilateral vertical in four, bilateral vertical in three, and horizontal in 1 patient. Unlike patients with unilateral vertical SIF, patients with bilateral vertical or horizontal SIF showed a marked increase of pelvic incidence (PI) by mean 17.0°±5.0° and sagittal vertical axis (SVA) by mean 4.5 ± 2.2 cm, compared to the respective values before the onset of abrupt pain. All patients with unilateral vertical SIF were treated favorably by conservative management, however sacropelvic fixation was inevitable in patients with bilateral vertical or horizontal SIF. Bilateral vertical or horizontal SIF showed marked changes on sagittal radiographic parameters including PI and SVA. Although unilateral vertical SIF has benign courses that responded well to conservative management, bilateral vertical or horizontal SIF is likely to need surgical treatment. Treatment plan should be determined depending on fracture pattern and pelvic deformation. [ABSTRACT FROM AUTHOR]

Aims Vitamin D is associated with diabetes mellitus (DM) occurrence by affecting insulin secretion and resistance. However, variations exist due to differences in vitamin D sensitivity among individuals. We investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] status and various indices of DM in a Korean population without DM. Methods Large-scaled population-based analysis was conducted from the Korea National Health and Nutrition Examination Survey data (2010–2012) were analyzed. Adult survey participants >20 years without diabetes (n = 15,169) were included. Results The mean 25(OH)D levels were lower in females, subjects aged 20–39 years, and subjects with body mass index <21.1 kg/m 2 and less physical activity (p < 0.001). Further, the mean 25(OH)D levels tended to be lower in subjects with FBG >126 mg/dL. After adjustment for potential confounders, 25(OH)D was not correlated with FBG (p = 0.925) or HbA1c (p = 0.336); however, fasting insulin ( β = −0.072, p = 0.011) and homeostasis model assessment of β-cell function ( β = −0.007, p < 0.001) showed significant negative correlations with 25(OH)D levels. Conclusion Although 25(OH)D status was not significantly associated with FBG or HbA1c, low 25(OH)D levels were associated with compensative insulin increase and ongoing increase in insulin resistance. Thus, vitamin D deficiency is assumed to influence DM occurrence. [ABSTRACT FROM AUTHOR]

Summary The aim of this study was to determine the relationships between free flap complications and old age or comorbidities. In a PubMed and Scopus search, the search terms (1) free flap OR microvascular anastomosis AND (2) elderly OR old age AND (3) complications OR comorbidity OR co-morbidity were used. Among the 62 full-text articles from 241 abstracts, 31 papers without sufficient content were excluded and 10 mined papers were added. Subsequently, 41 papers were reviewed. Overall complication rates of free flap increased significantly with age ( p < 0.001; y = 0.457 x + 13.464; 40.9% at 60 years, 45.5% at 70 years, and 50.0% at 80 years). Flap survival rates increased significantly ( p < 0.001; y = 0.025 x + 93.876). Donor site complication rates also increased significantly with age ( p < 0.001; y = 1.238 x − 63.700; 10.9% at 60 years, 23.0% at 70 years, and 35.3% at 80 years). The Kaplan–Feinstein index (KFI, OR = 7.944, 9.563), the Adult Comorbidity Evaluation-27 (ACE-27, OR = 5.854), the American Society of Anesthesiologists score (ASA, OR = 4.397), and the Index of Coexistent Diseases score (ICED, OR = 3.584) had statistically significant impacts on flap survival ( p < 0.05). Diabetes (OR = 4.562) and chronic obstructive pulmonary disease (OR = 2.300) had statistically significant negative impacts on the flap survival rate ( p < 0.05). Elderly patients had significantly higher Charlson Comorbidity Index (CCI) and ASA scores ( p < 0.001). Similarly, elderly patients exhibited a significantly higher prevalence of dementia ( p < 0.001) and use of aspirin at the time of surgery ( p < 0.001). On the basis of these results, we suggest that the incidence of complications is directly related to the preoperative medical condition of an individual patient rather than to age. [ABSTRACT FROM AUTHOR]

The purpose of this study is to gain understanding of the flow and evaporation characteristics inside a water droplet, on a hydrophobic surface that is vertically vibrated by an external force. To predict the resonance frequencies of a droplet, two theoretical equations on natural frequency (Lamb’s and Strani and Sabetta’s) are used. This study assesses the validity of one of these equations, which yields results that are closer to the experimentally measured values by comparing them with the calculated values. With the use of a high-speed camera, macro-lens and continuous laser, visualisation of the shape and the modal frequencies of a droplet were generated, and the results show that a droplet attains various shapes at different modes, resulting in complicated vortices inside the droplet. In the visualisation, the flow moves upwards starting from the bottom centre of the droplet along the symmetric axis. It then moves closer to the three-phase contact line along the surface of the upper part of the droplet. The resulting flow visualisation indicates a Y-shaped bifurcation flow pattern from a bottom surface at the second and fourth modal frequencies, while a large-sized oval shape is presented at the sixth and eighth modal frequencies. The flow velocity is the fastest at the fourth modal frequency. Correspondingly, the velocities at the eighth, sixth and second modal frequencies appear smaller than the fourth modal frequency, in that order. The evaporation rate is faster at the resonant frequency than at the rates of other neighbouring frequencies. [ABSTRACT FROM AUTHOR]

Recently, an annular-stepwise-diverging-tube (ASDT) was developed to investigate the length-scale effects on the flame propagation velocity (FPV), and the overall FPV of a specific fuel was described as a continuous surface in the physical domain of the concentration-length-velocity. In this study, the ASDT burner was improved in three aspects. First, all flame images taken during the experiment were analyzed to improve the experimental resolution and reliability. Second, an appropriate condition for the flow rate reduction was determined. Third, the thickness of the step-unit was reduced from 10 mm to 3 mm. Precise FPV values depending on the length-scale could be obtained using a compact ASDT burner. [ABSTRACT FROM AUTHOR]

Background We recently introduced an optical sensor, termed photothermal spectral-domain optical coherence reflectometer (PT SD-OCR), capable of direct measurement of hemoglobin concentration ([Hb]) without chemicals and pre-processing of blood. PT SD-OCR measures [Hb] by quantifying refractive index changes of blood samples due to photothermal effect under the irradiation of 532-nm light. We evaluated diagnostic accuracy and precision of PT SD-OCR in anemic patients. Methods We used PT SD-OCR to measure [Hb] in 50 anemic patients, and examined its accuracy against a hematology analyzer (ADVIA® 2120i, Siemens AG). Its precision was assessed by examining the SD and CV based on 20 repeated measurements on 3 blood samples. Its performance was also compared with a hemoglobinometer (HemoCue® 201 +, HemoCue®). Results The PT SD-OCR demonstrated good correspondence with the hematology analyzer with a Pearson's correlation coefficient of 0.992 and a bias of − 0.055 g/dl. Standard deviation and CV were measured to be < 0.25 g/dl and < 2.05%. Conclusions Simple and chemical-free operation of PT SD-OCR enabled rapid and accurate measurement of [Hb] in anemic patients. The sensor is expected to facilitate clinical procedures related to blood-related disorders in patient care. [ABSTRACT FROM AUTHOR]

The increasing average life expectancy is simultaneously increasing the incidence of chronic diseases and the number of healthy elderly people, consequently leading to an increased demand for healthcare management methods that do not involve hospital visits. The development of health management services involving mobile phones will change the focus of medical services from hospital visits and treatments to managing the health decisions made by individuals in their daily lives. However, the elderly may experience specific difficulties in adapting to constantly evolving services. This study reviews various health-related devices such as mobile phones that are available for providing healthcare to the elderly, and the different ways of using them. As the use of mobile phone increases, it is expected that elderly mobile phone users will also be able to regularly check their health status at any time and place. The issues of an ageing population pertain to the entire society rather than only to the elderly, which make mobile-phone-based medical informatics as a health management service a worthy goal. [ABSTRACT FROM AUTHOR]

Abstract: LiNiO2 was prepared by solid state reaction, and LiNiO2 was mixed with 1-, 2-, or 5wt% TiO2 or ZnO for the preparation of cathodes for a lithium ion battery. The electrochemical properties of the cathodes were investigated and the effects of the addition of TiO2 or ZnO were discussed. The voltage vs. capacity curves for charge and discharge at different numbers of cycles for LiNiO2, 2wt% TiO2-added LiNiO2, and 2wt% ZnO2-added LiNiO2 showed that in all the samples the first discharge capacity is much smaller than the first charge capacity. The addition of TiO2 or ZnO decreased the discharge capacities, but improved the cycling performance. The discharge capacities of LiNiO2 and 2wt% TiO2-added LiNiO2 decreased as the number of cycles increased. However, the discharge capacity of 2wt% ZnO-added LiNiO2 increased overall as the number of cycles increased. The −dx/|dV| vs. voltage curves for the 1st and 2nd cycles of 0, 1-, 2-, or 5wt% TiO2 or ZnO-added LiNiO2 showed that all the samples underwent four phase transitions during charging and discharging. [Copyright &y& Elsevier]

Abstract: The aim of this study was to investigate the clinical outcomes after gamma knife surgery (GKS) or surgery as the first treatment for brain metastases in colorectal cancer (CRC). Of the 4350 patients diagnosed with CRC at our institution identified from 1987 to 2009, 27 patients who underwent GKS (GKS group) and 11 who underwent surgery (surgery group) were included. The oncologic outcomes were compared between the two groups. Local control was significantly better in the surgery group than in the GKS group (90% versus [vs.] 71.4%, respectively; p =0.006). The rate of symptom relief after 3months was significantly higher in the surgery group than in the GKS group (72.7 vs.18.5%, respectively; p =0.005). The median survival after GKS was 5.6months and surgery was 16.2months. In multivariate analysis, controlled primary tumor (p =0.038) and solitary metastasis (p =0.028) were correlated with prolonged overall survival, whereas surgery (p =0.034) was associated with longer local control. Surgery for brain metastasis from CRC is more advantageous in local control and neurologic symptom palliation than GSK. In multivariate analysis, overall survival was associated with controlled primary tumor and solitary metastasis. [Copyright &y& Elsevier]

Abstract: Escherichia coli K12 cells suspended in apple cider were treated by manothermosonication (MTS, 400kPa/59°C), thermosonication (TS, 100kPa/59°C), and manosonication (MS, 400kPa/55°C) for up to 4min. A 5-log reduction was achieved in 1.4min by MTS, 3.8min by TS, and 2.5min by MS. The inactivation curves of the E. coli exhibited a fast initial reduction followed by a slow inactivation section. The Weibull, log–logistic, and biphasic linear models showed a good fit of the inactivation data. Quality analyses were conducted with raw apple cider (control), thermally-pasteurized (TP), and MTS-, TS-, and MS-treated cider samples over a 3-week period at refrigeration temperature. Titratable acidity and pH did not differ among any of the samples. During storage, the turbidity value of the control was the highest, followed by TP, TS, MTS and MS. All color parameters of the TP sample were significantly different from those receiving the other treatments. The control and sonicated samples showed similar color parameters during storage. In total, 97 aroma compounds were identified in the control, TS-, MS-, and MTS-treated cider samples, while 95 aroma compounds were found in the TP at Week 0. Among all the aroma compounds, 9 key ones were identified in all samples, including ethyl 2-methylbutanoate, butyl acetate, 1-butanol, ethyl hexanoate, 1-hexanol, butanoic acid, β-damascenone, hexanoic acid, and octanoic acid. The profiles of the key aroma compounds in all sonicated samples were more similar to the control than the TP sample at Weeks 0 and 3. [Copyright &y& Elsevier]