Search

The frozen elephant trunk (FET) technique can be applied to extensive aortic pathology, including lesions in the aortic arch and proximal descending thoracic aorta. FET is useful for tear-oriented surgery in dissections, managing malperfusion syndrome, and promoting positive aortic remodeling. Despite these benefits, complications such as distal stent-induced new entry and spinal cord ischemia can pose serious problems with the FET technique. To prevent these complications, careful sizing and planning of the FET are crucial. Additionally, since the FET technique involves total arch replacement, meticulous surgical skills are essential, particularly for young surgeons. In this article, we propose several techniques to simplify surgical procedures, which may lead to better outcomes for patients with extensive aortic pathology. In the era of precision medicine, the next-generation FET device could facilitate the treatment of complex aortic diseases through a patient- tailored approach.

Abstract Aortic surgery is one of the most challenging types of surgeries, which is possibly related to cognitive sequelae. We aimed to investigate the changes in resting-state functional connectivity (rsFC) associated with intraoperative circulatory arrest (CA) in aortic surgery, exploring the relationship between the altered connectivity and postoperative cognitive functions. Thirty-eight patients participated in this study (14 with CA, 24 without). Functional magnetic resonance imaging was scanned on the fifth day after surgery or after the resolution of delirium if it was developed. We assessed the differences in the development of postoperative cognitive changes and rsFC between patients with and without CA. The occurrence of postoperative delirium and postoperative cognitive dysfunction was not significantly different between the patients with and without the application of CA. However, patients with CA showed increased in posterior cingulate cortex-based connectivity with the right superior temporal gyrus, right precuneus, and right hippocampus, and medial prefrontal cortex-based connectivity with the dorsolateral prefrontal cortex. The application of moderate hypothermic CA with unilateral antegrade cerebral perfusion is unlikely to affect aspects of postoperative cognitive changes, whereas it may lead to increased rsFC of the default mode network at a subclinical level following acute brain insults.

Background: Chylothorax after congenital heart surgery is not an uncommon com-plication, and it is associated with significant morbidity. However, consensus treatment guidelines are lacking. To improve the treatment outcomes of patients with postoperative chylothorax, we implemented a standardized management protocol at Severance Hospi-tal in September 2014.Methods: A retrospective review of patients treated at a single center was done. All cor-rective and palliative operations for congenital heart disease performed at our institution between January 2008 and April 2018 were reviewed. The incidence and treatment out-comes of postoperative chylothorax were analyzed.Results: The incidence of chylothorax was 1.9%. Sixty-one percent of the patients could be managed with a low-fat diet, while 28% of the patients required complete restriction of enteral feeding. Thoracic duct embolization was performed in 2 patients and chest tube drainage decreased immediately after the procedure. No patient required thoracic duct ligation or pleurodesis. After implementation of the institutional management protocol, the number of chest tube drainage days decreased (median, 24 vs. 14 days; p=0.45).Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice proto-col helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax.

Cerebral air embolism combined with cardiomyopathy secondary to pulmonary barotrauma is rare. Here, we report an unusual case of cerebral air embolism combined with transient cardiomyopathy secondary to large bulla rupture during a pulmonary function test after lung cancer surgery. The patient experienced loss of consciousness. Computed tomography and magnetic resonance imaging suggested a cerebral air embolism. Electrocardiography showed ST-segment elevation and abnormally high plasma levels of cardiac enzymes. Echocardiography and coronary angiography suggested cardiomyopathy. The patient was discharged with no sequelae.

We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol.

BackgroundResveratrol (RSV) is a polyphenolic phytoalexin that has many effects on metabolic diseases such as diabetes and obesity. Given the importance of brown adipose tissue (BAT) for energy expenditure, we investigated the effects of RSV on brown adipocytes.MethodsFor the in vitro study, interscapular BAT was isolated from 7-week-old male Sprague Dawley rats. For the in vivo study, 7-week-old male Otsuka Long Evans Tokushima Fatty (OLETF) rats were divided into four groups and treated for 27 weeks with: standard diet (SD); SD+RSV (10 mg/kg body weight, daily); high fat diet (HFD); HFD+RSV. RSV was provided via oral gavage once daily during the in vivo experiments.ResultsRSV treatment of primary cultured brown preadipocytes promoted mitochondrial activity, along with over-expression of estrogen receptor α (ER-α). In OLETF rats, both HFD and RSV treatment increased the weight of BAT and the differentiation of BAT. However, only RSV increased the mitochondrial activity and ER-α expression of BAT in the HFD-fed group. Finally, RSV improved the insulin sensitivity of OLETF rats by increasing the mitochondrial activity of BAT, despite having no effects on white adipocytes and muscles in either diet group.ConclusionRSV could improve insulin resistance, which might be associated with mitochondrial activity of brown adipocyte. Further studies evaluating the activity of RSV for both the differentiation and mitochondrial activity of BAT could be helpful in investigating the effects of RSV on metabolic parameters.

Bacteria associated with plants play crucial roles in promoting plant growth and health by aiding in nutrient acquisition, including phosphorus. This study presents the isolation and genomic characterization of a potentially new bacterial strain, Lelliottia sp. JS-SCA-14, which exhibits significant plant growth-promoting effects through phosphorus solubilization. A comparative phylogenomic analysis of the complete genome of strain JS-SCA-14 and its closely related strains revealed a unique genomic profile, suggesting it could be a novel species. Genomic identity calculations indicated that JS-SCA-14 significantly deviates from strains belonging to closely related genera, such as Buttiauxella, Citrobacter, Enterobacter, Leclercia, and Lelliottia. A biochemical assay comparing JS-SCA-14 and a closely related strain, Lelliottia jeotgali PFL01T, showed differing patterns in carbon source utilization and enzyme activities. To assess the plant growth-promoting capabilities of strain JS-SCA-14, tests were conducted to evaluate its siderophore-producing and phosphate-solubilizing abilities. Seed germination assays demonstrated an improvement in germination, seedling length, and vigor compared to untreated controls. Notably, the phosphate-dissolving strain JS-SCA-14 led to a significant increase of 34.4% in fresh weight and 35.4% in dry weight of tomato plants compared to the negative control. These findings underscore the significant potential of strain JS-SCA-14 in solubilizing phosphate, thereby enhancing phosphorus availability in the rhizosphere and promoting plant growth and development. This study contributes to our understanding of plant-microbe interactions and suggests the potential application of strain JS-SCA-14 as a bioinoculant for sustainable agriculture and plant nutrient management strategies.

Background/Objectives: Neuroinflammation is associated with the progression of various brain diseases, and the management of neuroinflammation-induced neural damage is a crucial aspect of treating neurological disorders. This study investigated the anti-inflammatory efficacy of photobiomodulation therapy (PBMT) using 660 nm phototherapy in a rat model with lipopolysaccharide (LPS)-induced neuroinflammation. Methods: We induced inflammation in rat brains via intraperitoneal injection of LPS and subjected the treatment group to 660 nm phototherapy to examine its protective effect against hippocampal damage based on pathological, histological, and immunohistochemical tissue analyses. Results: The 660 nm treated rats showed a significant decrease in hippocampal structural damage and cell death compared to the LPS-treated group. We observed reduced expression of the inflammation markers GFAP, TNF-α, and IL-1β in the hippocampus of the treatment group, and an increase in SIRT1 expression across all hippocampal regions. Conclusions: This study presents a promising method for controlling neuroinflammation and providing neuroprotection and inflammation relief. PBMT represents a non-invasive therapeutic approach with minimal side effects ensured through the proper control of light irradiation.

This study proposes a two-degree-of-freedom PID controller design and tuning method based on a simple pole placement approach to enhance servo and regulatory performance while ensuring the stability of diesel engines. In the modeling of the control target, the actuator is analytically modeled. In contrast, the type of model for the diesel engine is derived analytically, and its parameter estimation uses operational data from naval ships. The proposed controller consists of a PID controller to improve regulatory performance and a set-point filter to enhance servo response. PID controller parameters consist of the parameters of the controlled plant model and a single tuning variable. At the same time, the set-point filter comprises the controller parameters and a single weighting factor. To ensure the robust stability of the controller, the controller parameters are tuned based on the maximum sensitivity. To verify the effectiveness of this study, simulations for the speed control of a diesel engine with inherent nonlinearity were conducted under three scenarios. Performance was quantitatively analyzed using the integral of time-weighted absolute error, 2% settling time, 2% recovery time, specified maximum sensitivity, and maximum peak response value, and was compared with Skogestad’s IMC and Lee’s IMC. Based on evaluation indices, the proposed controller demonstrated superior performance in both servo and regulatory responses compared to the two existing control techniques while ensuring stability.

The need for antibiotics in commercial laying hens is increasing owing to intensive farming systems. Amoxicillin trihydrate (AMX), an aminopenicillin β-lactam antibiotic, exerts broad bactericidal activity. However, its short half-life necessitates frequent administration to ensure efficacy, thus limiting its use. Herein, we investigated the effect of concurrent administration of bromhexine hydrochloride (BRM), a mucolytic agent, on AMX pharmacokinetics, performing a comparative pharmacokinetic analysis of AMX administration alone and in combination with BRM. AMX (50 mg/kg) was administered by oral gavage once daily for three days alone or in combination with 10 mg/kg BRM. Plasma and egg samples were collected to evaluate pharmacokinetic profiles and egg residues. The area under the curve and maximum plasma concentration values were significantly higher in the AMX + BRM group than the AMX only group. However, there were no significant differences in AMX half-life in the elimination phase (T1/2), elimination rate constant (kel), or apparent clearance (CL/F) values. In the egg residue study, the withdrawal period for AMX was 5 days in both groups, with no significant difference when using the maximum residue limit (MRL) of 10 μg/kg. The concentration of BRM in the eggs remained at 100 μg/kg up to the fourth day following drug administration. Conclusion: These results confirmed that BRM co-administration increased systemic exposure to AMX, with a negligible residual impact of amoxicillin in eggs.

Photonic therapy is emerging as a promising method in neuroscience for addressing Alzheimer’s disease (AD). This study uses computational simulations to investigate the impact of specific wavelengths emitted by photodiodes on the light absorption rates in brain tissue for brain implant sensors. Additionally, it presents a novel methodology that enhances light absorption via multi-parameter optimization. By adjusting the angle and wavelength of the incident light, the absorption rate was significantly enhanced using four photodiodes, each emitting at 660 nm with a power input of 3 mW. Notably, an incident angle of 20 degrees optimized light absorption and minimized thermal effects on brain tissue. The findings indicate that photodiodes within the near-infrared spectrum are suitable for low-temperature therapeutic applications in brain tissues, affirming the viability of non-invasive and safe photonic therapy. This research contributes foundational data for advancing brain implant photonic sensor design and therapeutic strategies. Furthermore, it establishes conditions for achieving high light absorption rates with minimal heat generation, identifying optimal parameters for efficient energy transfer.

Purpose The efficacy of standard chemotherapy or radical cystectomy in patients who have urothelial tumors with variant histology (VH) is very limited in terms of their prognosis. This study aimed to investigate the prognosis of bladder cancer (BC) patients with VH who underwent radical cystectomy (RC). Materials and Methods We retrospectively evaluated 327 BC patients who underwent RC at Pusan National University Yangsan Hospital between February 2010 and June 2021. VH was categorized into less and more aggressive types according to the patient’s mortality risk relative to pure urothelial carcinoma (PUC). More aggressive types included micropapillary, plasmacytoid, and sarcomatoid variants. Less aggressive types comprised other variant types, including squamous differentiation, glandular differentiation, lipoid, and nested. Small cell carcinoma, pure adenocarcinoma, pure squamous cell carcinoma, and lymphoma BC were excluded from analysis. The progression-free survival (PFS) and overall survival (OS) rates were evaluated using Kaplan-Meier analysis and Cox regression. Results After the exclusion of nonurothelial tumors, data from 299 patients were available for analysis. We identified 244 (74.6%) and 55 patients (16.8%) with PUC and urothelial carcinoma with VH, respectively. VH patients were categorized as having less aggressive (n=35) and more aggressive (n=20) types. Univariate analysis identified significant differences in PFS (p=0.031) between patients with PUC (n=244) and more aggressive VH (n=20). Multivariate analysis showed that more aggressive VH was significantly associated with OS and PFS. In the Kaplan-Meier analysis, a statistically significant difference was observed between PUC and more aggressive VH in OS and PFS. Conclusions VH patients with more aggressive types showed more advanced TNM stages at presentation than PUC patients. Pathological upstaging after RC was more common in VH patients. Among VH patients, the presence of a more aggressive VH type can be an independent predictor of progression after RC, with a worse prognosis than that of PUC patients.

The heart is a very crucial organ of the body. Concerted efforts are constantly put forward to provide adequate monitoring of the heart. A heart disorder is reported to cause a lot of hidden ailments resulting in numerous deaths. Early heart monitoring using an electrocardiogram (ECG) through the advancement of computer-aided diagnostic (CAD) systems is widely used. Meanwhile, the use of human reading of ECG results are faced with many challenges of inaccurate and unreliable interpretations. Over two decades, studies provided artificial intelligence (AI) technique using machine learning (ML) algorithms as a fast and reliable technique for ECG heartbeat classification. Moreover, in recent times, deep learning (DL) techniques have been focused on providing automatic feature extraction and better classification performance. On the other hand, the challenge with the ECG data is its imbalance nature. Therefore, this paper proposes a cost-based dual convolutional attention transfer DL model for ECG classification. The proposed model uses PhysionNet-MIT-BIH and Physikalisch-Technische Bundesanstalt (PTB) Diagnostics datasets. The first part uses the MIT-BIH for ECG categorization, while representations learned from the first classifier are used for PTB analysis through transfer learning (TL). The proposed model is evaluated and compared with well-performing conventional ML models based on their F1-score and accuracy scores. Our experimental finding show that the proposed model outperformed the well-performing ML models as well as competitive with past studies for both the classification and TL part, having obtained 98.45% for both F1-score and accuracy. The proposed model is applicable to real-life trials and experiments for ECG heartbeat and other similar domains.

Currently, the settlement of soft ground is measured using instruments operated by on-site workers. However, this method is expensive and inefficient in terms of data consistency, costeffectiveness, and utility. On the other hand, surveying using unmanned aerial vehicle (UAV) light detection and ranging (LiDAR) is used in various fields. However, studies on its utility in soft ground are insufficient. Therefore, in this study, we examined the optimal method for creating digital elevation models (DEMs) for estimating the settlement of soft ground using UAV LiDAR survey data. This method involved selecting a coastal construction site as the study area and acquiring data through UAV LiDAR surveying. The acquired data were used to create DEMs through preprocessing and postprocessing. Settlement measurements obtained from onsite instruments and settlement estimates derived from DEMs created using various interpolation methods and grid sizes were compared and analyzed. Additionally, the utility of the created time-series DEMs in the settlement estimation of soft ground was evaluated. We proposed the optimal method for creating DEMs for estimating the settlement of soft ground and suggested methods to utilize the proposed time-series DEMs. Our research results show that the use of UAV LiDAR survey data can lead to the economical and efficient settlement estimation of soft ground. [ABSTRACT FROM AUTHOR]

Introduction: Sweetpotato faces breeding challenges due to physiological and genomic issues. Gamma radiation is a novel approach for inducing genetic variation in crops. We analyzed the transcriptomic changes in gamma rayinduced sweetpotato mutants with altered stem development compared with those in the wild-type 'Tongchaeru' cultivar. Methods: RNA sequencing analyses were performed to identify changes in the expression of genes related to stem development. Results: Transcriptomic analysis identified 8,931 upregulated and 6,901 downregulated genes, including the upregulation of the auxinresponsive SMALL AUXIN UP RNA (SAUR) and three PHYTOCHROME INTERACTING FACTOR 4 (PIF4) genes. PIF4 is crucial for regulating the expression of early auxin-responsive SAUR genes and stem growth in Arabidopsis thaliana. In the mutant, several genes related to stem elongation, including PIF4 and those involved in various signaling pathways such as auxin and gibberellin, were upregulated. Discussion: Our results suggest that gamma ray-induced mutations influence auxin-dependent stem development by modulating a complex regulatory network involving the expression of PIF4 and SAUR genes, and other signaling pathways such as gibberellin and ethylene signaling genes. This study enhances our understanding of the regulatory mechanisms underlying stem growth in sweetpotato, providing valuable insights for genomics-assisted breeding efforts. [ABSTRACT FROM AUTHOR]

Purpose: For the treatment of locally advanced rectal cancer (LARC), research on primary lesions with mesorectal fascia (MRF) involvement is lacking. This study analyzed the clinical outcomes and efficacy of dose-escalated neoadjuvant concurrent chemoradiotherapy (NCRT) to patients with LARC involving MRF. Materials and Methods: We retrospectively reviewed 301 patients who were diagnosed with LARC involving MRF and underwent NCRT followed by total mesorectal excision (TME). Patients who received radiotherapy (RT) doses of =50.4 Gy were defined as the non-boost group, while =54.0 Gy as the boost group. Pathological tumor response and survival outcomes, including intrapelvic recurrence-free survival (IPRFS), distant metastases-free survival (DMFS) and overall survival (OS), were analyzed. Results: A total of 269 patients (89.4%) achieved a negative pathological circumferential resection margin and 104 (34.6%) had good pathological tumor regression grades. With a median follow-up of 32.4 months, IPRFS, DMFS, and OS rates at 5-years were 88.6%, 78.0%, and 91.2%, respectively. In the subgroup analysis by RT dose, the boost group included more advanced clinical stages of patients. For the non-boost group and boost group, 5-year IPRFS rates were 90.3% and 87.0% (p = 0.242), 5-year DMFS rates were 82.0% and 71.3% (p = 0.105), and 5-year OS rates were 93.0% and 80.6% (p = 0.439), respectively. Treatment related toxicity was comparable between the two groups (p = 0.211). Conclusion: Although this retrospective study failed to confirm the efficacy of dose-escalated NCRT, favorable IPRFS and pathological complete response was achieved with NCRT followed by TME. Further studies combining patient customized RT dose with systemic therapies are needed. [ABSTRACT FROM AUTHOR]

COVID-19-motivated social distancing made online concerts common practice in 2020 and 2021, with millions logging into streaming sites to see their favorite artists perform in realtime. For some fans, watching alone at home may have been enough, but concert-concurrent surges of social media activity suggest many virtual performance attendees are doing more. To understand why fans would turn their attention from these precious performance streams to social media, we explored Twitter engagement during four live streamed concerts performed by the Kpop group BTS in 2021. In public Tweets sampled by either concert hashtag or a predefined stream of users and keywords, we evaluated patterns in posting rates in relation to concert program events and investigated the content patterns in 1,200 Tweets sampled from four ranges of popularity (number of Retweets during the concert). Across concerts, short "Shout" Tweets surged at the start of songs, while the rate of retweets often fell during musical performances and shot up when BTS was off stage. Content analysis on the subsample found the materials most widely shared were informational or featured concert visuals, mimicking how fans use their phones at in-person concerts. Most original posts received fewRetweets and weremore personal and expressive of admiration for the performers. Comparison between the samples (concert hashtag vs. stream) also suggests users were strategic in using or omitting official concert hashtags with the strongest differences in the most widely disseminated content. Postings on Twitter during these performances seemed principally directed to fellow fans and audiencemembers, by individuals choosing to share their own excitement and check in with others. By leveraging their existing social media networks, these concert attendees constructed a collective and interactive concert space, connecting with friends and strangers in the crowd and helping each other capture a richer experience than any broadcasting platform currently supports. [ABSTRACT FROM AUTHOR]

Purpose: The ability to concentrate urine becomes an important index in determining nocturnal enuresis (NE) treatment. The aim of our study was to investigate first-morning urine osmolality (Uosm) changes at the end of treatment compared to before treatment in children with NE. Methods: A total of 71 children with NE were divided into two groups according to the level of first-morning Uosm before treatment: high group (=800 mOsm/kg) and low group (<800 mOsm/kg). Baseline parameters were obtained from uroflowmetry, frequency volume charts for at least 2 days, and a questionnaire for lower urinary tract symptoms. All patients were basically treated with standard urotherapy and medication. The first-morning Uosm was measured twice, before treatment and at the end of treatment. Results: The response rate was higher in the low group after 3 months of treatment than in the high group (P=0.041). However, there was no difference between the two groups at the end of the treatment. In the high group, the first-morning Uosm at the end of treatment did not show a significant change compared to before treatment. In contrast, the first-morning Uosm increased in the low group at the end of treatment (P<0.001). However, it was still lower than that of the high group (P=0.007). Conclusions: The ability to concentrate nocturnal urine improved at the end of treatment compared to before treatment in the low Uosm NE children. In addition, NE improved faster in the low Uosm group before treatment than in the high group. [ABSTRACT FROM AUTHOR]

We investigated the effect of Cr thin film deposition on the thermal stability and corrosion resistance of hot-dip aluminized steel. A high-quality Cr thin film was deposited on the surface of the Al-9 wt. % Si-coated steel sheets by physical vapor deposition. When the Al-Si coated steel sheets were exposed to a high temperature of 500°C, Fe from the steel substrate diffused into the Al-Si coating layer resulting in discoloration. However, the highly heat-resistant Cr thin film deposited on the Al-Si coating prevented diffusion and surface exposure of Fe, improving the heat and corrosion resistances of the Al-Si alloy coated steel sheet. [ABSTRACT FROM AUTHOR]

Stock prediction is prominent in the field of Artificial Intelligence. Stock prediction problems are handled either as a regression or classification task. Studies in the literature have also shown success for hybrid learning to stock prediction. But little attention is paid to finding out the effect of spatial feature extraction/distortion over the temporal effect of the deep neural network and vice versa for the problem under study. The paper, therefore, proposes a hybrid long short-term memory (LSTM) network over a convolutional neural network (CNN) called LSTM-CNN as against the popular CNN-LSTM model. The daily price movement of the S&P 500 index data is utilized. A sliding window technique is considered to obtain a balanced data of 20-days window data from the S&P 500. The proposed stock prediction model is investigated further for an optimal set of hyperparameters using the Bayesian optimization (Bo) technique. In addition, the proposed model is compared with optimized CNN, LSTM, and CNN-LTSM models. The optimized LSTM-CNN model is found to outperform the other models with accuracy, precision, and recall values of 0.9741, 0.9684, and 0.9800, respectively. The proposed model is established to provide a better stock trend prediction. [ABSTRACT FROM AUTHOR]