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We examined whether the intramedullary nailing (IMN) can be used as an alternative modality to the plate fixation (PF) in patients with distal fibular fracture with displaced fragments.The eligible patients of two treatment arms (IMN group: n=30 and the group: n=31) were evaluated at 3, 6, 9 and 12 months postoperatively, for which functional outcome measures include differences in the American Orthopaedic Foot and Ankle Society Scores (AOFAS) and the Olerud Molander Ankle Scores (OMAS) between the two groups. In addition, radiological outcome measures include differences in radiological outcome scores at 12 months between the two groups. Differences in the percentage of frequency of postoperative complications between the two groups served as safety outcome measures.At 3 months, the AOFAS and OMAS were significantly higher in the IMN group as compared with the PF group (p0.0001 and p=0.0177, respectively). At 6 months, the AOFAS were significantly higher in the IMN group as compared with the PF group (p=0.0255). But there were no significant differences in the OMAS between the two groups (p=0.1077). At 9 and 12 months, there were no significant differences in the AOFAS and OMAS between the two groups (p=0.4334 and 0.3227, respectively at 9 months and p=0.8731 and 0.7610, respectively, at 12 months). These results indicate that the IMN group achieved a faster recovery as compared with the PF group. At 12 months, the radiological outcome scores were 3.67±0.60 in the IMN group and 3.71±0.52 in the PF group (p=0.7816). All the patients of each group achieved a bony union at 12 months. At 12 months, the percentage of frequency of postoperative complications was significantly lower in the IMN group as compared with the PF group (p=0.0227).The IMN might be considered as an alternative surgical modality to the PF in patients with distal fibular fracture with displaced fragments. But further large-scale, multi-center studies are warranted to establish our results.

Air pollutants are in the spotlight because the human body can easily be exposed to them. Among air pollutants, the particulate matter (PM) represents one of the most serious toxicants that can enter the human body through various exposure routes. PMs have various adverse effects and classified as severe carcinogen by International Agency for Research on Cancer. Their physical and chemical characteristics are distinguished by their size. In this review, we summarized the published information on the physicochemical characteristics and adverse effects of PMs on the skin, including carcinogenicity. Through comparisons of biological networks constructed from relationships discussed in the previous scientific publications, we show it is possible to predict skin cancers and other disorders from particle-size-specific signaling alterations of PM-responsive genes. Our review not only helps to grasp the biological association between ambient PMs and skin diseases including cancer, but also provides new approaches to interpret chemical-gene-disease associations regarding the adverse effects of these heterogeneous particles.

PurposePulchronomics studies the economics of beauty. The purpose of this paper is to research CEO pulchronomics by examining whether a beauty premium exists in CEO compensation and whether this beauty premium is justified by differences in CEO performance.Design/methodology/approachThe authors calculate a facial attractiveness scores (FAS) based on facial symmetry, facial structure and the golden ratio. The authors then perform OLS regressions to examine the effect of CEO beauty on CEO compensation and firm performances.FindingsThe authors find that base salaries for attractive CEOs are higher than those for unattractive CEOs, but incentive pays for attractive CEOs are not different from those for unattractive CEOs. The latter is likely due to the fact that attractive CEOs do not outperform unattractive CEOs in operations, innovation, corporate social responsibility and financial reporting quality.Originality/valueSince the CEO beauty premium is not supported by the superior performance of attractive CEOs, this paper provides new evidence of appearance discrimination in CEO compensation.

Purpose: Few studies have demonstrated the clinical significance of pretreatment serum albumin and globulin in prostate cancer (PCa). This study evaluated the association between the pretreatment albumin to globulin ratio (AGR) and clinicopathologic characteristics of nonmetastatic PCa in a large multicenter setting in Korea. Materials and Methods: This study involved 742 patients with nonmetastatic PCa who underwent radical prostatectomy (RP) in seven institutions between January 2011 and December 2012. The AGR was calculated as follows: albumin/(total protein−albumin). Patients were divided into low and high AGR groups by a cutoff value from a receiver operating characteristic curve analysis. Results: The best cutoff for the AGR was set at 1.53. The area under the curve of the AGR was 0.624 (95% confidence interval, 0.557–0.671; p

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

PurposeThe study aims to understand the role of accountant in corporate social responsibility (CSR) practice.Design/methodology/approachIn this study, the authors examine whether and how chief financial officer (CFO) accounting expertise and previous work experience influence voluntary CSR disclosure, using textual analysis and natural language processing (NLP) techniques. The authors find that firms' CFOs with accounting expertise disclose more CSR issues in their 10-K reports. Overall, this study provides evidence of the impact of CFOs' professional and personal attributes on voluntary CSR disclosure in corporate annual reports. This study has important implications to investors and policy makers in the context of CSR disclosure regulations in annual reports.FindingsOverall, this study provides evidence of the impact of CFOs' professional and personal attributes on voluntary CSR disclosure in corporate annual reports. This study has important implications to practitioners and policy makers in the context of CSR disclosure regulations in annual reports.Research limitations/implicationsThere is an inherent limitation of textual analysis as the tool tries to read key words from the text.Practical implicationsThis finding is useful for policy maker and investors as CSR is known to have impact on the share price.Originality/valueThis paper is the first attempt to find out accountants' role in CSR activities, which has not been examined in the prior literature.

Background Recent reports show that the pre-operative or post-operative skeletal mass index (sarcopenia) affects survival rates for various cancers; however, the link between prostate cancer survival and sarcopenia is unclear. Therefore, this study examined the effect of the pre-operative internal obturator muscle (IOM) mass index on biochemical recurrence (BCR) of prostate cancer (PCa) patients who underwent radical prostatectomy. Methods In total, 222 patients, who underwent open, laparoscopic, or robot-assisted radical prostatectomy at seven centers in 2011 and were followed up for 5 years, were enrolled. BCR was examined in the context of pre-operative IOM mass index and BMI. Results The mean age of the patients was 67.82 ± 6.23 years, and the mean pre-operative prostate-specific antigen (PSA) level was 11.61 ± 13.22 ng/ml. There was no significant difference in baseline characteristics between the low and high IOM mass index groups (p > 0.05). Age, pre-op PSA level, ECE, and T-stage were associated with BCR (p = 0.049, p p = 0.001, p = 0.004, respectively). BMI, prostate volume, Gleason score, resection margin, N-stage, M-stage and IOM mass index was not associated with BCR (p > 0.05). Conclusions Pre-operative IOM mass index was not associated with BCR; however, long-term follow-up is necessary to evaluate cancer-specific and overall survival of PCa patients.

This article presents a black-sun readout scheme for CMOS image sensors (CISs) that utilizes the black-sun effect caused by a strong illumination condition. Based on the analysis of the black-sun phenomenon in CISs, the proposed CIS extracts the black-sun indication and its strength images while providing normal images without any degradation. By effectively utilizing the black-sun readout capability, a prototype CIS with the proposed readout scheme was identified as a useful solution to track the brightest source of light. In addition, the proposed black-sun readout scheme is reversible to the conventional readout scheme such that it can be used for various purposes in several electronic devices using CISs. The proposed readout scheme was verified in the typical CIS structure, and it shows the feasibility of utilizing it in sun tracking sensor applications for improving energy conversion efficiency. The prototype chip was implemented in a 0.11- $\mu \text{m}$ 1P4M CIS process with a 2.9- $\mu \text{m}$ pitch.

In January 2019, Koreans controlled 1,647 vessels and 76,701,517 deadweight, placing Korea as the world’s seventh largest shipowning country. In this article, the author reviews the contribution of the education of upper-class marine officers to the development of Korean shipping industry during the period 1948–1982. This study is organized into four main parts. In the first section, the role of human capital in economic development is reviewed, while Section 2 focuses on change in the education for merchant marine officers from 1948 to 1982. Section 3 analyzes the role of marine officers in the development of Korea’s shipping industry, while the final part considers the wider implications of the education of marine officers in the development of shipping.

Purpose Basal metabolic rate (BMR) is an indicator of overall body metabolism and may portend unique aberrations in urine physico-chemistry and stone recurrence. The present study examined the effect of predicted BMR on 24 hours urinary metabolic profiles and stone recurrence in obese stone patients. Materials and Methods Data from 308 obese patients (body mass index [BMI] ≥30 kg/m2) diagnosed with urinary stone disease between 2003 and 2015 were analyzed retrospectively. BMR was calculated using the Harris–Benedict equation, and patients were classified into two predicted BMR categories (, Graphical Abstract

To improve the efficiency of concentrated solar power devices and to reach a high conversion rate of the solar energy into heat, a rational design of new high temperature absorber materials is a challenge of prime importance. Ultra-high temperature ceramics can fit the requirements to act as absorber materials, provided that their chemical composition and their properties are finely tuned. Within this context, we investigated the optical selectivity of titanium carbide modified with B, N, O impurity atoms or carbon vacancies, by first principles simulations. By computing the dielectric function and the reflectivity spectra of each composition, we found that modifying TiC can have important consequence on the optical properties of the bulk material, leading in certain cases to an enhancement of the optical selectivity. Then, we assess the performance of nanocomposites made of the corresponding nanoparticles embedded in a silicon carbide media by using Mie scattering theory fed by our ab initio dielectric functions. In this case, we found that while carbon vacancies are detrimental to selectivity, alloying TiC with boron improves notably the performance of the composite material, with an increase in selectivity of about 50%.

As a lower middle-income nation, Cambodia has made significant improvements in basic health but hand surgery development continues to lag behind due to scarcity of trained and quality surgical manpower. Most of the hand surgery development locally has been due to surgical volunteers from Asia, Europe, and the United States. The introduction of a structured and systematic community-oriented hand surgery training over a 5-year period was successful in producing local surgeons to meet the basic needs of hand surgery patients. Brachial plexus surgery has benefited significantly, with local surgeons able to independently manage cases with minimal support. With the expansion of local surgical manpower and guidance, motivation, and assistance of regional hand surgeons, the future of hand surgery in Cambodia looks promising.

Very low periprosthetic distal femur fractures (PPDFFs) are rare injuries and often have a relatively high failure rate after single lateral locked plating. The double plating technique yields good outcomes in osteoporotic fractures of the distal femur. To date, there is limited information on double-locked plate fixation of very low PPDFFs. This study aimed to evaluate the outcomes and complications of surgically treated very low PPDFFs using double-locked plate fixation. Between January 2013 and December 2018, sixty-one consecutive patients with PPDFFs have been conducted. Only Su type III PPDFFs with double-locked plate fixation through a lateral minimally invasive approach and a medial subvastus approach to the distal femur were analyzed. Patients were encouraged to perform straight leg raising exercises and active knee motion on the second postoperative day. Assisted weight bearing from the early postoperative days was supported, and full weight-bearing was allowed after healing the fracture site. All patients were evaluated according to the time to union, limb alignment, range of knee motion, Knee Society Score, and presence of complications. Twenty one patients (17 females and 4 males, mean age 76 years, range 56–90) were included in the study. There were 10 of 33-A1, 6 of 33-A2 and 5 of 33 A3 fractures, according to the AO classification. Of 21 patients, 20 achieved union at an average of 14 weeks postoperatively. Postoperative limb alignment was satisfactory in all cases, with an average mechanical distal lateral femur angle of 89° and average mechanical posterior distal femur angle of 86°. All patients recovered the knee joint motion similar to that of the contralateral side, and daily life pre-injury. The average knee and function scores were 94 and 89, respectively. There were one case of non-union and three cases of superficial wound infection, which resolved after intravenous antibiotic therapy. Double locked plating showed excellent radiographic and functional outcomes with few complications in patients with very low PPDFFs. Based on these promising results, we propose the consideration of double-locked plate fixation in the treatment of very low PPDFFs.

BACKGROUND In this meta-analysis, we compared the risk of obtaining nondiagnostic results and the diagnostic accuracy for detection of salivary gland malignancy between core needle biopsy (CNB) and fine-needle aspiration (FNA). METHODS All published English-language studies comparing CNB and FNA diagnostic accuracy for salivary gland masses through December 2019 were searched. Pooled risk ratios (RRs) of nondiagnostic results, sensitivities, and specificities of CNB and FNA for salivary gland malignancy diagnosis were determined. Complication rates were compared. RESULTS Six studies (1924 procedures) were quantitatively analyzed. CNB yielded significantly fewer nondiagnostic results (P

The objective of this study was to provide more definitive information about the prognostic impact of perioperative blood transfusion (PBT) on patients with surgically treated renal cell carcinoma (RCC). A database of 4019 patients with clear cell RCC, all of whom underwent radical or partial nephrectomy as primary therapy as part of a multi-institutional Korean collaboration between 1988 and 2015, was analyzed retrospectively. PBT was defined as transfusion of allogeneic red blood cells during surgery or postsurgical period. Receipt of a PBT, as well as the amount and time of blood transfusion (BT), was compared. Overall, 335 (8.3%) patients received a PBT: 84 received postoperative BT, 202 received intraoperative BT, and 49 received both intraoperative and postoperative BT. Patients receiving a PBT had a poor preoperative immuno-nutritional status, and aggressive tumor characteristics. Multivariate analyses identified PBT as an independent predictor of recurrence-free survival and cancer-specific survival. Prognostic impact of PBT was restricted to those with locally advanced stage (pT3–4), and who underwent radical nephrectomy. Among patients who received a PBT, intraoperative (but not postoperative) BT was a prognostic factor for survival. Among patients who received intraoperative BT, those receiving three or more transfusion units had a significantly worse survival. Receipt of a PBT was an independent predictor of RFS and CSS in patients with surgically treated RCC, specifically locally advanced disease. Regarding the prognostic impact of timing or dose of PBT on survival, intraoperative BT and ≥ 3 pRBC units were associated with adverse oncological outcomes.

Virtual electrodes in neuromodulation can provide more delicate stimulation patterns with a limited number of physical electrodes in a confined area. Many researchers successfully verified the effectiveness of virtual electrodes in clinical trials, using current steering, which modulates electric fields produced by multi-polar stimulation. Still, it is questioned how these virtual electrodes are really generated in an electrolyte, especially in two dimensions. In order to answer this question, this work analyses the virtual electrode generation by comparing finite element analysis and in vitro evaluation of penta-polar stimulation. Penta-polar stimulation was realised using custom-designed integrated circuits and electrodes with an individual diameter of 450 μm and a centre-to-centre spacing of 800 μm. The customised test setup of electric field measurement estimated (i) the focused electric fields by the penta-polar stimulation and (ii) the optimum distance from the electrodes, at which virtual electrodes were most effectively generated. Compared with mono-polar stimulation, the penta-polar stimulation showed 0.594 and 0.545 times smaller electric field distribution areas, respectively, at a distance from the electrodes of 100 μm. Furthermore, the virtual electrodes showed the best performance at a distance from the electrodes of 150 μm, while the distance varied from 13 to 250 μm.

Northern Vietnam plays an important role in Vietnam's national economy. In recent years, the sea-port industry in the area has witnessed an impressive development and fierce competition especially among local container terminals. Under the pressure of competition, local container ports are competing through attractive handling charges. The paper applies a Bertrand-Nash game model to estimate the equilibrium handling charges and equilibrium market share of each container terminal in the area. The game can be divided into non-cooperative game and cooperative game. Under the cooperative game, three different scenarios are considered. The game results will verify the implication of price competition among local container terminals and present the outcome of each coalitional scenario for further discussion. Keywords: Northern Vietnam, Container terminals, Game theory, Handling charges

The Korean shipping industry has developed swiftly since the 1960s, and by 2018 Korea had become one of the world’s top seven shipowning countries. From 1945 to the 1960s, the Korea Shipping Corporation, as a national shipping company, played a crucial role in leading the development of the shipping industry. Since the privatization of this national shipping company in 1968, Korean shipping has been led by private companies. This article analyzes the forces that drove the rapid expansion of private shipping companies between 1960 and 1981, and contends that government policy and the entrepreneurship of merchant marine officers were the main causal factors.

Background Animal learning based on brain stimulation is an application in a brain-computer interface. Especially for birds, such a stimulation system should be sufficiently light without interfering with movements of wings. Objective We proposed a fully-implantable system for wirelessly navigating a pigeon. In this paper, we report a handheld neural stimulation controller for this avian navigation guided by remote control. Methods The handheld controller employs ZigBee to control pigeon's behaviors through brain stimulation. ZigBee can manipulate brain stimulation remotely while powered by batteries. Additionally, simple switches enable users to customize parameters of stimuli like a gamepad. These handheld and user-friendly interfaces make it easy to use the controller while a pigeon flies in open areas. Results An electrode was inserted into a nucleus (formatio reticularis medialis mesencephalic) of a pigeon and connected to a stimulator fully-implanted in the pigeon's back. Receiving signals sent from the controller, the stimulator supplied biphasic pulses with a duration of 0.080 ms and an amplitude of 0.400 mA to the nucleus. When the nucleus was stimulated, a 180-degree turning-left behavior of the pigeon was consistently observed. Conclusions The feasibility of remote avian navigation using the controller was successfully verified.

A composite B-pillar was designed and manufactured by design optimization combined with an impact analysis. A carbon-fiber-reinforced plastic (CFRP) was used for the reinforcement part of the B-pillar assembly to substitute the conventional steel materials for reducing the weight of vehicle. To maximize the impact performance by finite element method, the equivalent static loads method was used. The shape, stacking sequence, and thickness of the CFRP reinforcement were optimized to minimize the deflection profile for improving the crashworthiness while reducing the weight. The designed CFRP B-pillar was manufactured and its performance was evaluated by a drop weight test. As a result, the CFRP B-pillar exhibited an improved impact performance and reduced weight compared to those of the conventional steel B-pillar.

Objectives: To determine the diagnostic accuracy and complication rate of percutaneous transthoracic needle biopsy (PTNB) for subsolid pulmonary nodules and sources of heterogeneity among reported results. Methods: We searched PubMed, EMBASE, and Cochrane libraries (until November 7, 2020) for studies measuring the diagnostic accuracy of PTNB for subsolid pulmonary nodules. Pooled sensitivity and specificity of PTNB were calculated using a bivariate random-effects model. Bivariate meta-regression analyses were performed to identify sources of heterogeneity. Pooled overall and major complication rates were calculated. Results: We included 744 biopsies from 685 patients (12 studies). The pooled sensitivity and specificity of PTNB for subsolid nodules were 90% (95% confidence interval [CI]: 85–94%) and 99% (95% CI: 92–100%), respectively. Mean age above 65 years was the only covariate significantly associated with higher sensitivity (93% vs 85%, p = 0.04). Core needle biopsy showed marginally higher sensitivity than fine-needle aspiration (93% vs 83%, p = 0.07). Pooled overall and major complication rate of PTNB were 43% (95% CI: 25–62%) and 0.1% (95% CI: 0–0.4%), respectively. Major complication rate was not different between fine-needle aspiration and core needle biopsy groups (p = 0.25). Conclusion: PTNB had acceptable performance and a low major complication rate in diagnosing subsolid pulmonary nodules. The only significant source of heterogeneity in reported sensitivities was a mean age above 65 years. Advances in knowledge: This is the first meta-analysis attempting to systemically determine the cause of heterogeneity in the diagnostic accuracy and complication rate of PTNB for subsolid pulmonary nodules.

Acoustic-sensor-based soft error resilience is particularly promising, since it can verify the absence of soft errors and eliminate silent data corruptions at a low hardware cost. However, the state-of-the-art work incurs a significant performance overhead for in-order cores due to frequent structural/data hazards during the verification. To address the problem, this paper presents Turnpike, a compiler/architecture co-design scheme that can achieve lightweight yet guaranteed soft error resilience for in-order cores. The key idea is that many of the data computed in the core can bypass the soft error verification without compromising the resilience. Along with simple microarchitectural support for realizing the idea, Turnpike leverages compiler optimizations to further reduce the performance overhead. Experimental results with 36 benchmarks demonstrate that Turnpike only incurs a 0-14% run-time overhead on average while the state-of-the-art incurs a 29-84% overhead when the worst-case latency of the sensor based error detection is 10-50 cycles.

This letter presents a wide dynamic range (WDR) feature extraction (FE) readout scheme for machine vision applications using CMOS image sensors (CISs). The proposed scheme with the proposed pixel structure has two operating modes, the normal and WDR modes. In the normal operating mode, the proposed CIS captures a normal image with high sensitivity. In addition, as a unique function, a bi‐level image is obtained for real‐time FE even if a pixel is saturated in strong illumination conditions. Thus, compared to typical CISs for machine vison, the proposed CIS can reveal object features that are blocked by light in real time. In the WDR operating mode, the proposed CIS produces a WDR image with its corresponding bi‐level image. A prototype CIS was fabricated using a standard 0.35‐μm 2P4M CMOS process with a 320 × 240 format (QVGA) with 10‐μm pitch pixels. At 60 fps, the measured power consumption was 5.98 mW at 3.3 V for pixel readout and 2.8 V for readout circuitry. The dynamic range of 73.1 dB was achieved in the WDR operating mode.

Background We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels - the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

This study evaluated the accuracy of tangential axial radiography of the patellofemoral joints using an auxiliary device, which we named patellofemoral joint radiography (PJR). To compare the PJR and conventional radiography methods such as the Laurin, Merchant, and Settegast, the images taken by three methods were evaluated using a whole body phantom (PBU-31). Settegast was the radiographic method that had the smallest inclination of the patella and showed the best half lateral image of the patella, with a difference of 5.76% when compared with PJR (p = 0.001). PJR was the method that had the largest distance between the patellar and femoral joint spaces, with a difference of 14.54% when compared with the Merchant method (p = 0.001). PJR was the method in which the two bones were well overlapped (i.e., measured by the distance between the femoral trochlear groove and the tibial tuberosity), with a difference of 109.41% when compared with the Merchant method (p = 0.001). The Settegast method has the image with the smallest inclination of the patella, but the PJR has the image that best describes the patellofemoral joint and the least distortion of the image. when using PJR, bending the knee by 40° degree and setting a 140° angle between the long axis of the femur and the long axis of the lower leg were considered to be the most beneficial conditions. We propose the use of PJR for tangential axial radiography of the patellar and patellofemoral joints.

INTRODUCTION AND OBJECTIVE:Non–muscle-invasive bladder cancer (NMIBC) is clinically heterogeneous; thus many patients fail to respond to treatment and relapse. Here, we identified a molecular signa...

Simple Summary Approximately 80% of all new bladder cancer patients are diagnosed with non-muscle invasive bladder cancer. However, about 15% of them progress to muscle-invasive bladder cancer, which is associated with poor prognosis. As these diseases are highly heterogeneous, the identification of an accurate prognostic biomarker for them has been challenging. In the present study, our aims were to compare cancerous and normal adjacent bladder tissues excised from patients in various cohorts and endeavor to detect differentially expressed genes known to be upregulated exclusively in patients at high risk of bladder cancer progression. Through various molecular methods, we found that the expression level of the cell cycle-regulating SKA3 gene was markedly increased in patients with worse prognosis and high progression risk. Hence, SKA3 is a viable predictive marker for bladder cancer progression and its inhibition could constitute part of a novel therapy that improves the prognosis of this disease. Abstract Approximately 80% of all new bladder cancer patients are diagnosed with non-muscle invasive bladder cancer (NMIBC). However, approximately 15% of them progress to muscle-invasive bladder cancer (MIBC), for which prognosis is poor. The current study aimed to improve diagnostic accuracy associated with clinical outcomes in NMIBC patients. Nevertheless, it has been challenging to identify molecular biomarkers that accurately predict MIBC progression because this disease is complex and heterogeneous. Through integrative transcriptome profiling, we showed that high SKA3 expression is associated with poor clinical outcomes and MIBC progression. We performed RNA sequencing on human tumor tissues to identify candidate biomarkers in NMIBC. We then selected genes with prognostic significance by analyzing public datasets from multiple cohorts of bladder cancer patients. We found that SKA3 was associated with NMIBC pathophysiology and poor survival. We analyzed public single-cell RNA-sequencing (scRNA-seq) data for bladder cancer to dissect transcriptional tumor heterogeneity. SKA3 was expressed in an epithelial cell subpopulation expressing genes regulating the cell cycle. Knockdown experiments confirmed that SKA3 promotes bladder cancer cell proliferation by accelerating G2/M transition. Hence, SKA3 is a new prognostic marker for predicting NMIBC progression. Its inhibition could form part of a novel treatment lowering the probability of bladder cancer progression.

Snakebite-related injury is a serious public health issue. In Cambodia, it is estimated that up to 21,500 cases of envenoming occurs from snakebites annually. Musculoskeletal disability is a major long-term complication associated with the injury. In this study, we aim to describe surgical management and rehabilitation in snakebite-related musculoskeletal injuries at Children's Surgical Centre, Phnom Penh, Cambodia.We conducted a retrospective case series analysis of patients with snakebite-related injury who were treated between January 1, 2002 and December 31, 2018. Surgical patients were divided into the early and late presenting groups (= one year vs. one year, respectively) based on their time interval from snake bite to time of presentation.There were 88 patients who presented with snakebite-related musculoskeletal injury during the cohort study period. Majority of them were male (n = 62, 71%) and had a median age of 24 years old (IQR 17-44). The injuries were all in the upper and lower limbs though lower limb injury was more common in female patients (81% vs. 48%, Fisher's test p = 0.005). The median time interval from snakebite to time of treatment was 3 years (IQR 3 months-11 years). In this study, 65 patients received surgical interventions. An ulcerated wound was the most common symptom among the early presenting group (78% vs. 24%), while scar contracture was most common among the late group (76% vs. 22%) (Fisher's test p 0.0001). For management, surgical debridement was the most common primary intervention for the early group (52% vs. 19%), and contracture release was the most common for patients in the late group (62% vs. 15%) (Fisher's test p = 0.0004). Overall, the postoperative complication rate was highest in the late presenting group (34% vs. 3%, Fisher's test p = 0.005).More than half of the patients presented with musculoskeletal injury require surgical correction. Our study demonstrated that scar contracture is the most common complaint among the late presenting group and is associated with high postoperative complication rate.

This work proposes the data augmentation by molecular rotation, with consideration that the protein-ligand binding events are rotation-variant. As a proof-of-concept, known active (i. e., 1-labeled) ligands to human β-secretase 1 (BACE-1) are rotated for the generation of 0-labeled data, and the rotation-dependent prediction accuracy of 3D graph convolutional network (3DGCN) is investigated after data augmentation. The data augmentation makes the orientation-recognizing ability of 3DGCN improved significantly in the classification task for BACE-1/ligand binding. Furthermore, the data-augmented 3DGCN has a capability for predicting active ligands from a candidate dataset, via improved performance of orientation recognition, which would be applied to virtual drug screening and discovery.

Due to their optimal bandgap size and large defect tolerance, nitrides are becoming pivotal materials in several optoelectronic devices, photovoltaics, and photocatalysts. A computational method that can accurately predict their electronic structures is indispensable for exploring new nitride materials. However, the relatively small bandgap of nitrides, which stems from the subtle balance between ionic and covalent bond characteristics, makes conventional density functional theory challenging to achieve satisfactory accuracy. Here, we employed a self-consistent hybrid functional where the Hartree–Fock mixing parameter is self-consistently determined and thus the empiricism of the hybrid functional is effectively removed to calculate the bandgaps of various nitride compounds. By comparing the bandgaps from the self-consistent hybrid functional calculations with the available experimental and high-level GW calculation results, we found that the self-consistent hybrid functional can provide a computationally efficient approach for quantitative predictions of nitride electronic structures with an accuracy level comparable to the GW method. Additionally, we aligned the band edge positions of various nitride compounds using self-consistent hybrid functional calculations, providing material design principles for heterostructures of nitride-based optoelectronic devices. We anticipate the wide use of the self-consistent hybrid functional for accelerating explorations and predictions of new nitride-based functional materials in various photoactive applications.

Photopolymer composites filled with cellulose nanocrystal (CNC) and/or inorganic nanofillers were fabricated by using digital light processing (DLP) 3D printing. To investigate the effects of different CNC lyophilization concentrations and behaviors of CNC particles in the photopolymer composites, morphological and mechanical properties were analyzed. CNC loading levels affected the morphological and mechanical properties of the filled composites. Better CNC dispersion was seen at a lower lyophilization concentration, and the highest mechanical strength was observed in the 0.25 wt% CNC-filled composite. Furthermore, nano-precipitated calcium carbonate (nano-PCC) and nanoclay were added to photocurable resins, and then the effect of inorganic nanofillers on the morphological and mechanical properties of the composites were evaluated. By analyzing the morphological properties, the stress transfer mechanism of nano-PCC and nanoclay in the photopolymer composites was identified and related models were presented. These supported the improved mechanical strength of the composites filled with CNC, nano-PCC, and nanoclay. This study suggested a new approach using wood-derived cellulose nanomaterials and inorganic nanofillers as effective fillers for DLP 3D printing.

No study has evaluated the prognostic impact of the age-adjusted Charlson comorbidity index (AACI) in those with renal cell carcinoma (RCC). This study aimed to evaluate the utility of the AACI for predicting long-term survival in patients with surgically treated non-metastatic clear cell RCC (ccRCC). Data from 698 patients with non-metastatic ccRCC who underwent radical or partial nephrectomy as primary therapy from a multi-institutional Korean collaboration between 1988 and 2015 were retrospectively analyzed. Clinicopathological variables and survival outcomes of those with AACI scores ≤ 3 (n = 324), 4–5 (n = 292), and ≥ 6 (n = 82) were compared. Patients with a high AACI score were older and more likely to be female. They were also more likely to have diabetes or hypertension, a worse Eastern Cooperative Oncology Group performance status, and lower preoperative hemoglobin, albumin, serum calcium, and serum total cholesterol levels. Regarding pathologic features, a high AACI score was associated with advanced stage. Kaplan–Meier analyses revealed that AACI ≥ 6 was associated with shorter cancer-specific (log-rank test, P

Lateral locked plating is a standard treatment option for distal femur fractures. However, the unstable conditions after lateral locked plating are increasing. The objective of this study was to investigate the biomechanical strength of additional medial plate fixation over the unstable lateral locked plating of distal femur fractures.A distal femur fracture model (AO/OTA 33-A3) was created with osteotomies in the composite femur. Three study groups consisting of 6 specimens each were created for single-side lateral locked plating with 6 distal locking screws (LP-6), single-side lateral locked plating with 4 distal locking screws (LP-4), and additional medial locked plating on LP-4 construct (DP-4). A compressive axial load (10 mm/min) was applied in the failure test. Mode of failure, load to failure, and ultimate displacement were documented.All single-side lateral locked plating (LP-4 and LP-6) showed plate bending at the fracture gap, while none of the DP-4 showed plate bending at the fracture gap. Load to failure of DP-4 (mean 5522 N) was 17.1% greater than that of LP-6 (mean 4713.3 N, p 0.05) and 29.2% greater than that of LP-4 (mean 4273.2 N, p 0.05). Ultimate displacement of DP-4 (mean 5.6 mm) was significantly lower than that of LP-6 (mean 8.8 mm, p 0.05) and LP-4 (mean 9.1 mm, p 0.05).Additional fixation of medial plate significantly increased the fracture stability in distal femur fractures fixed with the lateral locked plating. Especially in the clinical situations where sufficient stability cannot be provided at the distal segment, the medial plate may be considered as a useful biomechanical solution to obtain adequate stability for fracture healing.

Vertical cavity surface emitting lasers (VCSELs) with a wavelength of 980 nm were applied to design a low-pressure chemical vapor deposition (LPCVD) reactor as a promising heat source of excellent irradiation uniformity, rapid power controllability, and extended spatial scalability. The average divergence angle of the laser beam emitted from a myriad of cells was estimated from a comparison of the VCSEL emission distribution obtained from ray-tracing calculation with experimental measurements using a power meter. This property was closely related to irradiation uniformity and spatial scalability. The experimental temperature distribution of silicon wafers exposed to high power VCSEL beams was used to verify the performance of commercial codes on three-dimensional simulation models including conduction, convection and thermal radiation. For LPCVD reactor design, this code was used to predict the optimal placement of the VCSEL module for uniform irradiation on 300 mm diameter wafers. The best-fit values of the factors for the Arrhenius equation describing the deposition process of polycrystalline silicon (poly-Si) thin-film using silane gas species were obtained from a comparison of deposition rates from numerical simulations with experimental observations available in the literature. Using these factors and the optical characteristics of the VCSEL and Si, the deposition process on the wafer with 300 mm in diameter was simulated under various operation conditions. Especially, instead of the uniform surface temperature condition, the heat flux distribution estimated from experimental irradiations on the wafer was used for the boundary condition at the bottom surface of the wafer in order to realize a practical deposition process. Simulation using the realistic heat flux boundary conditions showed that deposition rates in the wafer edge-region were significantly reduced due to the severe temperature drop in that region, compared to that using the ideal uniform temperature condition. In order to minimize this wafer exclusion area, the emission power of the VCSEL emitters affecting the wafer edge-region was adjusted to slightly increase, resulting in a more uniform distribution of the deposition rate.

Numerous studies document female scholars’ underrepresentation in political science publications and citations, yet few examine graduate syllabi. In this study, we assess the impact of instructors’ individual characteristics (i.e., race, gender, and age) on which readings they assign. We use what is—to our knowledge—the largest dataset of graduate readings to date: the GRaduate Assignments DataSet (GRADS), with 75,601 readings from 840 syllabi in 94 US PhD programs. We report several findings. First, overall, instructors infrequently assign female-authored scholarship relative to the rates at which women publish. Second, instructors who are women, people of color, and those from more gender-equal countries assign significantly more female-authored readings than white male instructors and those from less gender-equal countries. Third, among women—but not men—older instructors assign more female-authored work. We suggest that women’s underrepresentation on syllabi may contribute to “the leaky pipeline,” which describes women’s attrition from academic careers.

OBJECTIVE. The objective of our study was to compare the sensitivity of a deep learning (DL) algorithm with the assessments by radiologists in diagnosing osteonecrosis of the femoral head (ONFH) using digital radiography. MATERIALS AND METHODS. We performed a two-center, retrospective, noninferiority study of consecutive patients (≥ 16 years old) with a diagnosis of ONFH based on MR images. We investigated the following four datasets of unilaterally cropped hip anteroposterior radiographs: training (n = 1346), internal validation (n = 148), temporal external test (n = 148), and geographic external test (n = 250). Diagnostic performance was measured for a DL algorithm, a less experienced radiologist, and an experienced radiologist. Noninferiority analyses for sensitivity were performed for the DL algorithm and both radiologists. Subgroup analysis for precollapse and postcollapse ONFH was done. RESULTS. Overall, 1892 hips (1037 diseased and 855 normal) were included. Sensitivity and specificity for the temporal external test set were 84.8% and 91.3% for the DL algorithm, 77.6% and 100.0% for the less experienced radiologist, and 82.4% and 100.0% for the experienced radiologist. Sensitivity and specificity for the geographic external test set were 75.2% and 97.2% for the DL algorithm, 77.6% and 75.0% for the less experienced radiologist, and 78.0% and 86.1% for the experienced radiologist. The sensitivity of the DL algorithm was noninferior to that of the assessments by both radiologists. The DL algorithm was more sensitive for precollapse ONFH than the assessment by the less experienced radiologist in the temporal external test set (75.9% vs 57.4%; 95% CI of the difference, 4.5-32.8%). CONCLUSION. The sensitivity of the DL algorithm for diagnosing ONFH using digital radiography was noninferior to that of both less experienced and experienced radiologist assessments.

Purpose: To investigated the prognostic significance of the geriatric nutritional risk index (GNRI) in patients with surgically treated clear cell renal cell carcinoma (ccRCC).Patients and ...

Purpose of reviewRheumatoid arthritis is a systemic inflammatory disorder, which can involve many organs; among which, CNS involvement, as in rheumatoid meningitis (RM), is rare and difficult to recognize. Our goal is to present collective data of RM cases to better characterize this disease process and to start new discussions about pathophysiology, diagnosis, and treatment.Recent findingsSince Kato et al., 39 cases of RM have been reported. Approximately 59% were women, presenting with neurologic deficits (56%) and diagnosed by MRI findings, leptomeningeal enhancement (69%), after CSF analysis. Seventy-four percent were treated with corticosteroids, 64% as maintenance therapy, with 46% experiencing improvement or resolution in symptoms without relapse.SummaryDiagnosis and prognosis of RM has drastically changed since the year 2000. Early detection with CSF and MRI or biopsy findings, coupled with early treatment using corticosteroids and immunologic therapy, has reduced mortality in this population.

To determine the value of 24-h urine osmolality (UOsm) as a representative index of adequate hydration and predictor of stone recurrence in patients with urolithiasis. Medical records of consecutive patients presenting with renal or ureteric stones between 1994 and 2017 were retrospectively reviewed. Patients were grouped according to the results of 24-h UOsm (low ≤ 564 mOsm/kg H2O, high > 564 mOsm/kg H2O). Metabolic parameters and risk of stone recurrence were compared between the two groups. The low urine concentration group were more likely to be older, to be female, and to have a lower body mass index and higher glomerular filtration rate than the high concentration group (each P

Background Fracture-dislocation of the proximal interphalangeal (PIP) joint of the finger is challenging due to the high risk of stiffness. The purpose of this study is to evaluate the clinical and radiological results of a modified transosseous wiring technique for the management of chronic fracture-dislocations of the PIP joint. Methods Ten patients (nine men and one woman; mean age, 38.3 years; range, 21 to 69 years) with neglected fracture-dislocation of the PIP joint were included. The mean duration from injury to operation was 14.7 weeks (range, 3 to 66 weeks). The dorsolateral approach and extension block pinning were used to reduce dislocation. After thorough debridement of the scar tissues in the dorsal dead space and the fracture site, the reduction was maintained with transosseous wiring. Radiologic evaluations of bone union and arthritic changes and clinical evaluations (range of motion of the PIP joint and Disabilities of the Arm, Shoulder and Hand [DASH] score) were performed. The mean follow-up period was 12.9 months (range, 12 to 19 months). Results All patients demonstrated evidence of radiographic healing within a mean healing time of 6 weeks (range, 4 to 10 weeks); however, one had a widened gap and one had an early arthritic change. The mean range of motion in the PIP joint was 81° (range, 50° to 105°). The mean DASH score was 21.6 (range, 7.5 to 35.8). Conclusions For chronic fracture-dislocation of the PIP joint, transosseous wiring with direct curettage and optimal bone purchase can provide satisfying outcome.

In 2017, Koreans controlled 1,656 vessels with an aggregate tonnage of 80,976,874 deadweight (dwt), placing Korea as the world’s seventh largest shipowning country. Given that Korean-owned tonnage stood at just 1.3m dwt in 1970, this represented a remarkable rate of growth over less than half a century. This article focuses on the years from 1967 to 1999 and aims to prove that government policy was one of the key causal factors in the rapid increase in Korean shipping. The paper is organised into four main parts. In the first section, the role of the government in the development of the economy is assessed, while Section 2 focuses on state policies designed to promote the shipping industry in Korea. Section 3 highlights the rise of Korean shipping from 1967 to 1999, and the final part considers the wider implications of the role of government policy in the development of the shipping industry.