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Background/Aims: The effect of proton pump inhibitors (PPIs) on the lower gastrointestinal (GI) tract is uncertain, with potential to worsen damage. This study aimed to find the best method for protecting the entire GI tract from mucosal damage. Methods: A retrospective cohort study at Samsung Medical Center (2002-2019) included 195,817 patients prescribed GI mucosa-damaging agents. The primary goal was to assess the effectiveness of GI protective agents in preventing significant hemoglobin drops (>2 g/dL), indicating overall GI mucosal damage. Self-controlled case series and landmark analysis were used to address biases in real-world data. Results: The incidence rate ratios for rebamipide, PPI, and histamine-2 receptor antagonist (H2RA) were 0.34, 0.33, and 0.52, respectively. Rebamipide showed a significantly lower incidence rate than H2RA and was comparable to PPIs. Landmark analysis revealed significant reductions in hemoglobin drop risk with rebamipide and H2RA, but not with PPI. Conclusions: Rebamipide, like PPIs, was highly effective in preventing blood hemoglobin level decreases, as shown in real-world data. Rebamipide could be a comprehensive strategy for protecting the entire GI tract, especially when considering PPIs' potential side effects on the lower GI tract.

Background Knee joint injury is a common military training injury, which seriously affects the combat effectiveness of soldiers. In recent years, the prevention and treatment of military training injury becomes more and more important. Ultrasound therapy and Qingpeng ointment are commonly used to treat sports training injuries. However, the protective effectiveness of ultrasound combined with the external use of Qingpeng ointment for knee injury in sports training injury patients is less reported. Objective To comprehensively assess the clinical efficacy of Qingpeng ointment combined with ultrasound therapy in the treatment of knee injuries caused by military training. Methods Fifty-six patients with knee injury who were treated in the Fifth Pentry Outpatient Clinic, the General Hospital of the Western Theater Command PLA from May to July 2022 were selected and randomly grouped into control group (4 cases fell off during the study, n=24) and treatment group (n=28) using IBM-SPSS 25.0 statistical software to generate random numbers. The control group was given ordinary coupling agent ultrasonic therapy, and the treatment group was given Qingpeng ointment ultrasonic therapy, once a day, 10 times a course, a total of 2 courses. The Lysholm knee joint score, VAS score, Hamilton Depression Scale-17 (HAMD-17), and knee range of motion were compared between the two groups after a twenty-minute intervention. Results Before treatment, there was no significant difference in Lysholm knee joint score, VAS score, HAMD-17 score and knee joint motion between the two groups (P>0.05). After 2 courses of treatment, the passive joint motion of the knee in the treatment group was better than that in the control group (P

Abstract Infliximab (IFX) has transformed the management of inflammatory bowel diseases (IBD). While intravenous (IV) IFX has been effective, a subcutaneous (SC) formulation offers advantages in convenience and cost. However, there is lack of evidence regarding the transition from IV to SC-IFX, especially for patients with inadequate responses. This study investigates the effectiveness of switching from IV to SC-IFX in patients with inadequate responses during IV maintenance therapy. A retrospective study enrolled IBD patients who transitioned to SC-IFX after demonstrating inadequate responses during IV maintenance therapy. The study collected data of demographics of patients and dose and therapies administered prior to the IV-IFX. Primary outcomes included improvements in C-reactive protein (CRP) or fecal calprotectin (FC) levels. This study evaluated the trough levels and its differences between pre- and post-switching. Among 44 patients included, 10 exhibited CRP elevation before the switch, with 6 showing normalization post-switch. Similarly, 42 patients had elevated FC levels pre-switch, with 26 experiencing reductions post-switch. Trough levels increased after the switch. However, there were no significant differences between responders and non-responders. This study is the first study to investigate the transition therapy of IV to SC-IFX in patients with inadequate response. This suggests that SC-IFX could be a viable alternative in the management of IBD. However, further research is necessary to evaluate its efficacy in a larger population of patients who exhibit inadequate responses during IV-IFX maintenance therapy.

Abstract Many insects utilise optical information in linearly polarised light for navigation, with the degree of linear polarisation (DoLP) determining whether the ‘visibility’ of such optical information is available to them. However, changes in degree of linear polarisation in response to increased atmospheric levels of fine particulate matter (PM2.5) are poorly understood. We present analyses based on both ground-based monitoring and particulate matter modelling, establishing a quantitative relationship between PM2.5 mass concentration and the DoLP. We apply this relationship to a global PM2.5 projection for 2050 and estimate the increase in number and spatial extent of low visibility days for honeybees. We find an increase by up to 20% in the geographical extent of low visibility days in 2050, with an augmented frequency of low visibility days across an area exceeding 0.75 million km2 in India and 2 million km2 in China. More frequent and widespread low visibility conditions can reduce the ability of insects to navigate, especially in hotspot regions.

Abstract Limited research has been performed to determine if histologic improvement serves as a prognosticator for endoscopic remission, a key therapeutic target for ulcerative colitis (UC). The primary aim of the study was to evaluate if histological activity could predict endoscopic remission in UC patients with Mayo endoscopic subscores (MES) of 0 or 1. In addition, we compared the clinical outcomes between histologic improvement group and active group. This research encompassed 492 individuals with UC with MES of 0 or 1, who underwent histological assessment as per the established protocol of Samsung Medical Center between January 2018 and December 2020. Participants were categorized into two cohorts based on the degree of histological activity: those showing histologic improvement and those with ongoing histologic activity. The endoscopic activity was assessed during follow-up, and the primary outcome was endoscopic remission according to histologic activity. Out of the total participants, endoscopic activity was scrutinized in 435 patients during the colonoscopic follow-up and in 146 during the subsequent one. The histologic improvement group at the index colonoscopy was more likely achieve endoscopic remission than the histologic active group. Clinical relapse was more likely in the histologic active group than in the histologic improvement group.

Physicochemical analysis, headspace-solid phase microextraction (HS-SPME) combined with gas chromatography-mass spectrometry (GC-MS) and high-throughput sequencing were used to investigate the potential relationship between the microecology of different flavor types of Daqu and their physicochemical indexes and characteristic flavor compounds. The results showed that the highest saccharification power and fermentation power were found in Fen-flavor Daqu, the highest esterification power and starch content in Luzhou-flavor Daqu, and the highest acidity were found in Maotai-flavor Daqu. In the three types of Daqu, the dominant bacterial genera were Saccharopolyspora, Weissella and Bacillus, and the dominant fungal genera were Saccharomycopsis, Aspergillus and Thermomyces. Correlation analysis showed that Bacillus was positively correlated with saccharification power, liquefaction power, fermentation power, ethyl caprate and phenyl ethanol. Thermomyces was positively correlated with ethyl caproate, isoamyl alcohol, ethyl lactate, acetic acid and ligustrazine.

The purpose of this systematic review and meta-analysis is to perform a systematic review and meta-analysis of previous studies on minimally invasive scoliosis surgery (MISS) in adolescents with idiopathic scoliosis (AIS). Some data on MISS in AIS compared with conventional open scoliosis surgery (COSS) are conflicting. A systematic literature search was conducted in Medline, Embase, and Cochrane Library, including studies reporting outcomes for MISS in AIS. The meta-analysis compared the operative, radiological, and clinical outcomes and complications between MISS and COSS in patients with AIS. Of the 208 records identified, 15 nonrandomized studies with 1,369 patients (reviews and case reports are excluded) were included in this systematic review and meta-analysis. The mean scale was 6.1, and eight of the 15 included studies showed satisfactory quality using the Newcastle-Ottawa scale. For operative outcomes, MISS had significant benefits in terms of estimated blood loss (standard mean difference [SMD], −1.87; 95% confidence interval [CI], −2.94 to −0.91) and hospitalization days (SMD, −2.99; 95% CI, −4.45 to −1.53) compared with COSS. However, COSS showed significantly favorable outcomes for operative times (SMD, 1.71; 95% CI, 0.92–2.51). No significant differences were observed in radiological outcomes, including Cobb’s angle of the main curve and thoracic kyphosis. For clinical outcomes, MISS showed significant benefits on the visual analog scale score (SMD, −0.91; 95% CI, −1.36 to −0.47). The overall complication rates of MISS were similar to those of COSS (SMD, 0.96; 95% CI, 0.61–1.52). MISS using the posterior approach provides equivalent radiological and clinical outcomes and complication rates compared with COSS. Considering the lower estimated blood loss, shorter hospitalization days, and longer operative times in MISS, COSS is still the mainstay of surgical treatment in AIS; however, MISS using the posterior approach is also one of the surgical options of choice in the case of moderate AIS.

Abstract The rapid urbanization and population growth in major cities have given rise to enduring urban challenges, prompting local governments to assess urban development performance and customize urban planning strategies to meet these challenges. This study aims to formulate an evaluation framework for the comprehensive efficiency of major cities, centering on governance, Information and Communication Technology (ICT), and sustainability as fundamental aspects. Distinct from prior research, the framework employs the network slack-based measure (SBM) to unravel efficiency, concurrently scrutinizing input/output slack and link efficiency. Utilizing the network SBM model, the study assesses the comprehensive operational efficiencies of 38 major Chinese cities spanning from 2015 to 2019. The application of the Kruskal–Wallis test discerns differences in comprehensive efficiency between coastal and inland areas. The results indicate that governance, ICT, and sustainability significantly influence the comprehensive operations of cities. In addition to general and short-term policies, the implementation of the National New-Type Urbanization Plan by the Chinese central government has led to an increase in the number of cities demonstrating sustainable efficiency. Despite fluctuations in the efficiency gap during the study period, coastal cities consistently outperform their inland counterparts in terms of efficiency. Persistent geographical disparities underscore the imperative for balanced development. While acknowledging positive strides in sustainable urbanization, the study emphasizes the ongoing necessity to address the adverse impacts of urban development, positioning governance, ICT, and sustainability as indispensable elements in confronting the multifaceted challenges inherent in urban development. The research findings contribute significantly to the field of urban efficiency evaluation, accentuating the collaborative impact of governance, ICT, and sustainability.

Receiver and transmitter monolithic microwave integrated circuit (MMIC) multifunction chips (MFCs) for active phased-array antennas for Ka-band satellite communication (SATCOM) terminals have been designed and fabricated using a 0.15-μm GaAs pseudomorphic high-electron mobility transistor (pHEMT) process. The MFCs consist of four-channel radio frequency (RF) paths and a 4:1 combiner. Each channel provides several functions such as signal amplification, 6-bit phase shifting, and 5-bit attenuation with a 44-bit serial-to-parallel converter (SPC). RF pads are implemented on the bottom side of the chip to remove the parasitic inductance induced by wire bonding. The area of the fabricated chips is 5.2 mm X 4.2 mm. The receiver chip exhibits a gain of 18 dB and a noise figure of 2.0 dB over a frequency range from 17 GHz to 21 GHz with a low direct current (DC) power of 0.36 W. The transmitter chip provides a gain of 20 dB and a 1-dB gain compression point (P1dB) of 18.4 dBm over a frequency range from 28 GHz to 31 GHz with a low DC power of 0.85 W. The P1dB can be increased to 20.6 dBm at a higher bias of +4.5 V.

Abstract Akkermansia muciniphila has received great attention because of its beneficial roles in gut health by regulating gut immunity, promoting intestinal epithelial development, and improving barrier integrity. However, A. muciniphila-derived functional molecules regulating gut health are not well understood. Microbiome-secreted proteins act as key arbitrators of host-microbiome crosstalk through interactions with host cells in the gut and are important for understanding host-microbiome relationships. Herein, we report the biological function of Amuc_1409, a previously uncharacterised A. muciniphila-secreted protein. Amuc_1409 increased intestinal stem cell (ISC) proliferation and regeneration in ex vivo intestinal organoids and in vivo models of radiation- or chemotherapeutic drug-induced intestinal injury and natural aging with male mice. Mechanistically, Amuc_1409 promoted E-cadherin/β-catenin complex dissociation via interaction with E-cadherin, resulting in the activation of Wnt/β-catenin signaling. Our results demonstrate that Amuc_1409 plays a crucial role in intestinal homeostasis by regulating ISC activity in an E-cadherin-dependent manner and is a promising biomolecule for improving and maintaining gut health.

The distinct advantages of low power consumption and hardware compactness make SAR ADCs especially appealing in scaled CMOS technologies, garnering significant attention. The residue left on the capacitor digital-to-analog converter (CDAC) after conversion in the SAR ADC negates the need for complex residue extraction circuits. This crucial feature has inspired numerous SAR-assisted architectural variations, employed in a range of applications from high resolution to high speed. This article introduces several energy-efficient hybrid ADC architectures that incorporate SAR ADCs as their sub blocks, including the following: SAR-assisted subranging SAR, which saves DAC switching power and can detect skew errors for time-interleaved ADCs; SAR-flash hybrid for energy-efficient high-speed conversion; SAR-assisted dual-residue pipelined ADC, which eliminates the stringent requirement for residue gain accuracy; and SAR-assisted delta–sigma modulator (DSM) with digital-domain noise coupling, which reduces the number of required analog integrators.

Abstract We aimed to determine the effect of optic disc tilt on deep learning-based optic disc classification. A total of 2507 fundus photographs were acquired from 2236 eyes of 1809 subjects (mean age of 46 years; 53% men). Among all photographs, 1010 (40.3%) had tilted optic discs. Image annotation was performed to label pathologic changes of the optic disc (normal, glaucomatous optic disc changes, disc swelling, and disc pallor). Deep learning-based classification modeling was implemented to develop optic-disc appearance classification models with the photographs of all subjects and those with and without tilted optic discs. Regardless of deep learning algorithms, the classification models showed better overall performance when developed based on data from subjects with non-tilted discs (AUC, 0.988 ± 0.002, 0.991 ± 0.003, and 0.986 ± 0.003 for VGG16, VGG19, and DenseNet121, respectively) than when developed based on data with tilted discs (AUC, 0.924 ± 0.046, 0.928 ± 0.017, and 0.935 ± 0.008). In classification of each pathologic change, non-tilted disc models had better sensitivity and specificity than the tilted disc models. The optic disc appearance classification models developed based all-subject data demonstrated lower accuracy in patients with the appearance of tilted discs than in those with non-tilted discs. Our findings suggested the need to identify and adjust for the effect of optic disc tilt on the optic disc classification algorithm in future development.

Background/Aims: The newly derived simplified magnetic resonance index of activity (MARIAs) has not been verified in comparison to balloon-assisted enteroscopy (BAE) for patients with small bowel Crohn’s disease (CD). We studied the correlation of MARIAs with simple endoscopic scores for CD (SES-CD) of the ileum based on magnetic resonance enterography (MRE) and BAE in patients with small bowel CD. Methods: Fifty patients with small bowel CD who underwent BAE and MRE concurrently within 3 months from September 2020 to June 2021 were enrolled in the study. The primary outcome was the correlation between the active score of ileal SES-CD (ileal SES-CDa)/ileal SES-CD and MARIAs based on BAE and MRE. The cutoff value for MARIAs identifying endoscopically active/severe disease, defined as ileal SES-CDa/ileal SES-CD of 5/7 or more, was analyzed. Results: Ileal SES-CDa/ileal SES-CD and MARIAs showed strong associations (R=0.76, p

BackgroundDue to recent advances in artificial intelligence (AI), language model applications can generate logical text output that is difficult to distinguish from human writing. ChatGPT (OpenAI) and Bard (subsequently rebranded as “Gemini”; Google AI) were developed using distinct approaches, but little has been studied about the difference in their capability to generate the abstract. The use of AI to write scientific abstracts in the field of spine surgery is the center of much debate and controversy. ObjectiveThe objective of this study is to assess the reproducibility of the structured abstracts generated by ChatGPT and Bard compared to human-written abstracts in the field of spine surgery. MethodsIn total, 60 abstracts dealing with spine sections were randomly selected from 7 reputable journals and used as ChatGPT and Bard input statements to generate abstracts based on supplied paper titles. A total of 174 abstracts, divided into human-written abstracts, ChatGPT-generated abstracts, and Bard-generated abstracts, were evaluated for compliance with the structured format of journal guidelines and consistency of content. The likelihood of plagiarism and AI output was assessed using the iThenticate and ZeroGPT programs, respectively. A total of 8 reviewers in the spinal field evaluated 30 randomly extracted abstracts to determine whether they were produced by AI or human authors. ResultsThe proportion of abstracts that met journal formatting guidelines was greater among ChatGPT abstracts (34/60, 56.6%) compared with those generated by Bard (6/54, 11.1%; P

Abstract A knowledgebase (KB) transition of a clinical decision support (CDS) system occurred at the study site. The transition was made from one commercial database to another, provided by a different vendor. The change was applied to all medications in the institute. The aim of this study was to analyze the effect of KB transition on medication-related orders and alert patterns in an emergency department (ED). Data of patients, medication-related orders and alerts, and physicians in the ED from January 2018 to December 2020 were analyzed in this study. A set of definitions was set to define orders, alerts, and alert overrides. Changes in order and alert patterns before and after the conversion, which took place in May 2019, were assessed. Overall, 101,450 patients visited the ED, and 1325 physicians made 829,474 prescription orders to patients during visit and at discharge. Alert rates (alert count divided by order count) for periods A and B were 12.6% and 14.1%, and override rates (alert override count divided by alert count) were 60.8% and 67.4%, respectively. Of the 296 drugs that were used more than 100 times during each period, 64.5% of the drugs had an increase in alert rate after the transition. Changes in alert rates were tested using chi-squared test and Fisher’s exact test. We found that the CDS system knowledgebase transition was associated with a significant change in alert patterns at the medication level in the ED. Careful consideration is advised when such a transition is performed.

Primary liver cancer (PLC) is one of the common malignant tumors and the main causes of tumor death in China. Although the diagnosis and treatment technology of PLC in China has made great progress in recent years, its morbidity and mortality have been decreasing year by year, but the low early diagnosis rate and 5-year survival rate of PLC are major public health problems that need to be solved urgently in the field of chronic disease prevention and control. Effective implementation of early screening, detection, diagnosis and treatment of PLC is an important measure to improve the rates of radical treatment and survival. The combination of serum alpha-fetoprotein (AFP) and liver ultrasound is a routine method for screening hepatocellular carcinoma (HCC) in patients with chronic liver disease; the combination of AFP and AFP-L3 and/or abnormal prothrombin can improve the early diagnosis rate of early-stage HCC; the early diagnosis rate of small hepatocellular carcinoma can be improved by Gd-EOB-DTPA-enhanced magnetic resonance imaging or its combination with computerized tomography. With the continuous promotion of hierarchical medical system and improvement of primary medical resources allocation and health service capacity in China, primary care institutions have become an important force for early screening of many cancers. Based on this context, this paper mainly discusses the development opportunities, risk challenges and future thinking of surveillance for liver cancer in primary care institutions in China, in order to provide new ideas and direction guidance for it in the future.

Abstract Malnutrition might play a key role in the prognosis of patients with Crohn’s disease (CD). The aim of this study was to explore the impact of weight loss from diagnosis of CD to one-year post-diagnosis on disease prognosis in terms of surgery. Patients who were diagnosed with CD at Samsung Medical Center between 1995 to 2020 were included in this study. The study defined the “group with weight loss” as patients with weight loss in one year after diagnosis and the “group without body weight loss” as patients without weight loss in one year after diagnosis. Their data such as demographics, laboratory findings, and medical interventions were collected retrospectively. The primary outcome was confirmation of the difference in the incidence of surgery associated with CD between the group with weight loss and the group without body weight loss. We further analyzed factors associated with surgery outcomes. A total of 165 patients were analyzed in this study. Forty-one patients (24.8%) had body weight loss whereas 124 patients (75.2%) had no body weight loss. Body change at one year showed no significant association with direct surgical incidence. However, the patients with weight loss tended to undergo surgery earlier than patients without body weight loss. Among factors associated with outcomes of Crohn’s surgery, the albumin was the only significant factor. Patients with weight loss had no statistically significant increase in the risk of surgery than patients without weight loss, although they tended to undergo surgery earlier than patients without body weight loss. A prospective study is needed to determine serial body weight changes during follow-up for patients with CD.

This article presents a novel vision-based autonomous landing method utilizing a multirotor and a gimbal camera, which is designed to be applicable from any initial position within a broad space by addressing the problems of a field of view and singularity to ensure stable performance. The proposed method employs a two-step controller based on integrated dynamics for the multirotor and the gimbal camera, where the multirotor approaches the landing site horizontally in the first step and descends vertically in the second step. The multirotor and the camera converge simultaneously to the desired configuration because we design the stabilizing controller for the integrated dynamics of the multirotor and the gimbal camera. The controller requires only one feature point and decreases unnecessary camera rolling. The effectiveness of the proposed method is demonstrated through simulation and real environment experiments.

Abstract There are limited studies on the endoscopic assessment of disease activity using balloon-assisted enteroscopy (BAE) and its predictive role for long-term outcomes of patients with small bowel Crohn’s disease (CD). We sought to investigate the value of BAE as a predictor of long-term outcomes in patients with small-bowel CD. A total of 111 patients with small-bowel CD whose endoscopic disease activity was assessed using BAE based on the small-bowel simple endoscopic score for Crohn’s disease (small-bowel SES-CD) at Samsung Medical Center were retrospectively selected from January 2014 to August 2020. The outcome was an evaluation of the risk of surgery according to a small-bowel SES-CD of 0–6 vs. ≥ 7 and endoscopic findings (presence of any ulcer and degree of stricture) using the Cox proportional hazards model. The risk of surgery was significantly increased in patients with a small-bowel SES-CD of ≥ 7 compared to a small-bowel SES-CD of 0–6 [hazard ratio (HR) 6.31; 95% confidence interval (CI) 1.48–26.91; p = 0.013]. In addition, the risk of surgery was significantly increased in patients with stenosis with “cannot be passed” compared to the cases without stenosis (HR 12.34; 95% CI 1.66–91.92; p = 0.014), whereas there was no significance in any ulcer. The present study demonstrated the role of BAE in the endoscopic assessment of disease activity and its predictive value for the risk of surgery in small-bowel CD patients. Further optimization of BAE utilization for the assessment of disease activity is warranted in clinical practice.

Objective Osteotomies are required for the mobilization of spinal segments in patients with revisional scoliosis surgery with a fusion mass; however, only a few techniques have shown efficacy and safety, and their mid- and long-term outcomes remain unelucidated. This study aimed to analyze long-term outcomes of the posterior multilevel crack osteotomy (PMCO) technique for revisional surgery for scoliosis with a fusion mass. Methods Data from 18 patients who underwent revisional scoliosis surgery using PMCO between 2009 and 2015 and had more than 5-year follow-up were retrospectively reviewed. The Cobb angle and coronal and sagittal balance parameters were examined preoperatively, postoperatively, and during the final follow-up. Perioperative parameters and complications were also assessed. Results Preoperative and postoperative Cobb angles were 60.5° and 29.9°, respectively (p < 0.001); this improvement was maintained until the final follow-up (33.4°, p = 0.058). The difference in preoperative and postoperative coronal balance was statistically significant (15.9 mm and 9.2 mm, respectively; p < 0.001); this was maintained until the final follow-up (p = 0.071). There was no change in sagittal balance parameters over the 3 measurement periods. Only 1 patient showed PMCO-related motor weakness, but he spontaneously recovered 3 months after postsurgery. Pseudarthrosis was not observed during the follow-up period. Conclusion Incomplete osteotomy using PMCO provided satisfactory deformity correction without severe complications during revisional surgery for scoliosis with a fusion mass. It may be a less invasive procedure that maintains cortical continuity, preserves soft tissues, and provides sufficient mobility for the correction of spinal segments.

The lithology and hardness of the coal seam roof are directly related to the stability and water permeability of the roadway and the safe production of the coal mine. It has become a common method to predict gas content based on AVO inversion, but the conventional AVO inversion formula is a simplified approximation of Zoeppritz equation in different degrees under certain conditions, which affects the inversion accuracy to some extent. On the basis of petrophysical analysis of the roof, the pre-stack inversion of quasi-linear Zoeppritz equation with the smallest overall angle error was employed to lithology and hardness prediction of coal seam roof in Yangquan Mining Area, Shanxi Province. The results show that the expression of quasi-linear Zoeppritz equation is simple, and through the AVO characteristic analysis of different Zoeppritz approximate formulas, found that the precision of quasi-linear Zoeppritz equation is the highest, second only to that of accurate Zoeppritz equation. The analysis of rock mechanics characteristics shows that Young’s modulus multiplied by density is the most sensitive to hardness, and pseudo-gamma P-wave velocity can effectively reflect roof lithology. The lithology and hardness characterization parameters obtained from inversion are combined with the parameter well data and geological data to comprehensively evaluate the roof stability, provide geological evidence for roadway excavation and reduce the coal mine production risk.

Abstract Background This study aimed to determine short-term and long-term outcomes according to time intervals after stenting and compared them with those of emergency surgery (ES) in colorectal cancer (CRC) with malignant obstruction. Methods CRC with malignant obstructions was reviewed retrospectively between January 2008 and July 2018. Of a total of 539 patients who visited the emergency room and underwent ES, 133 were enrolled in the ES group. Of a total of 567 patients who initially received stenting and subsequently underwent elective surgery, 220 were enrolled in the SEMS group. The interval between SEMS placement and elective surgery was classified as 17 days. Results For those who received SEMS (n = 220), those with a time interval of 11–17 days (n = 97) had fewer hospital days than those with a time interval of 17 days (n = 55) (1.0% vs. 14.6%). Multivariable analysis revealed a decreased risk of death for the group with a time interval of 11–17 days (20.6%) compared to the ES group (31.6%) (hazard ratio: 0.48; 95% confidence interval: 0.24–0.97). Disease-free survival was comparable between the SEMS and ES groups regardless of the time interval (log-rank p = 0.52). Conclusions The time interval of 11–17 days after stenting to elective surgery appeared to be associated with the most favorable outcomes.

Background During the containment of COVID-19, the traditional face-to-face interventions conducted at the rehabilitation center were plagued by many limitations, while internet-based interventions can overcome the limitations of geographic location, working hours and transportation, with less medical costs. Objective To examine the effects of internet-based interventions on knowledge, attitude/belief and practice (KAP) toward rehabilitation exercises, physical activity (PA) level, and exercise compliance inpatients after PCI. Methods The subjects were 76 patients who received their first PCI in Department of Cardiology, Tangshan Gongren Hospital from November 2021 to June 2022. They were randomly and equally divided into two groups to receive either internet-based intervention with routine nursing (experimental group) or routine nursing (control group) . Before and three months after the intervention, the Rehabilitation Exercise Knowledge-Belief-Practice Scale for Patients with Coronary Heart Disease (REKBPCHD) , the International Physical Activity Questionnaire-Short Form (IPAQ-SF) , and Patients' Exercise Log were used to assess the KAP level, PA level, and exercise adherence, respectively. The impact of network intervention on exercise adherence in patients after PCI by univariate Logistic regression analysis. Results After 3 months of intervention, a significant increase was found in the average total score of REKBPCHD, and the average scores of the knowledge dimension, attitude dimension and practice dimension of the scale in the experimental group (P

Abstract The aim of this study was to address the issue of differentiating between Mayo endoscopic subscore (MES) 0 and MES 1 using a deep learning model. A dataset of 492 ulcerative colitis (UC) patients who demonstrated MES improvement between January 2018 and December 2019 at Samsung Medical Center was utilized. Specifically, two representative images of the colon and rectum were selected from each patient, resulting in a total of 984 images for analysis. The deep learning model utilized in this study consisted of a convolutional neural network (CNN)-based encoder, with two auxiliary classifiers for the colon and rectum, as well as a final MES classifier that combined image features from both inputs. In the internal test, the model achieved an F1-score of 0.92, surpassing the performance of seven novice classifiers by an average margin of 0.11, and outperforming their consensus by 0.02. The area under the receiver operating characteristic curve (AUROC) was calculated to be 0.97 when considering MES 1 as positive, with an area under the precision-recall curve (AUPRC) of 0.98. In the external test using the Hyperkvasir dataset, the model achieved an F1-score of 0.89, AUROC of 0.86, and AUPRC of 0.97. The results demonstrate that the proposed CNN-based model, which integrates image features from both the colon and rectum, exhibits superior performance in accurately discriminating between MES 0 and MES 1 in patients with UC.

Optoelectronic devices with organic semiconductors, such as organic light-emitting diodes (OLEDs), have received much attention because they offer ease of processing and device flexibility. However, practical application of these devices is still hindered by relatively poor device performance and lack of cost-effective fabrication process, which represent properties largely determined by the molecular dipole moments of the organic molecules. In this study, we designed and prepared novel quinoxaline-phosphine oxide small molecules (QPSMs) as the electron transport layer (ETL) for the solution-processable OLEDs by tuning the end functional group of the aromatic QPSMs. A key design criterion was controlling the dipole moments of QPSMs, which confers (1) convenient deposition on the emission layer without further annealing through solubility in isopropanol and (2) improved electron injection/transport behavior through effective band level matching of the devices. In particular, the optimized OLEDs with (4-(2,3-bis(4-methoxyphenyl)quinoxalin-5-yl)phenyl)diphenylphosphine oxide (MQxTPPO1) exhibit external quantum efficiency (EQE) of 6.12%. Our results demonstrate the potential application of QPSMs as next-generation ETLs in organic semiconductors.

Abstract Pelvic fixation is performed to obtain proper coronal and sagittal alignment when the pelvic obliquity is more than 15º in patients with neuromuscular scoliosis (NMS). Since many NMS patients were wheelchair or bed-ridden status, there has been controversy on the effect of pelvic fixation. Therefore, the purpose of this study is to analyze the effects of pelvic fixation on correction of spinal deformity and quality of life (QoL) in NMS patients. A total of 77 NMS patients who underwent deformity correction were divided into three groups and retrospectively analyzed preoperatively, postoperatively, and at 2-year follow-up: pelvic fixation group (Group A, n = 16), fixed to S1 (Group B, n = 33), and fixed to L5 (Group C, n = 28). The correction rate of scoliosis was 60.0%, 58.0%, and 56.7% in groups A, B, and C, respectively, with no statistical difference (P > 0.05). The correction rate of pelvic obliquity was 61.3%, 42.8%, and 57.5% in respective groups A, B, and C, with no significance (P > 0.05). The correction loss of scoliosis and pelvic obliquity showed no statistical significance between three groups for 2-year follow-up (all Ps > 0.05). There were no significant differences regarding clinical outcomes and postoperative complications among the three groups (all Ps > 0.05). Therefore, pelvic fixation using iliac screws is not substantially influencing radiological and clinical outcomes in the patients with NMS.

The development of efficient biomarkers and probes for monitoring and treating cancer, specifically metastatic cancer, is a critical research area that can have a significant impact on both patient outcomes and drug discovery. In this context, TiNIR has been developed to detect tumor-initiating cells (TICs), with heme oxygenase 2 (HO2) as a promising therapeutic biomarker for tumor-initiating cells. In this study, TiNIR has demonstrated its effectiveness as an in vivo metastatic lung cancer tracker, highlighting its potential as a valuable tool in cancer research and therapy. The development of innovative approaches that selectively target metastatic cancers represents a promising avenue for improving survival rates and enhancing the quality of life of cancer patients.

Study Design Retrospective observational study. Purpose This study aimed to investigate the impact of plating on postoperative serial segmental motion and its correlation with clinical outcomes in single-level anterior cervical discectomy and fusion (ACDF) for up to 1 year. Overview of Literature The advantages and disadvantages of using cervical plating in ACDF have been well discussed; however, few studies compared the early serial segmental motions at the postoperative level between plating and non-plating. Methods In retrospectively collected data, 149 patients who underwent single-level ACDF for degenerative disease were enrolled and divided into non-plating (n=66) and plating (n=83). Interspinous motion (ISM) at the arthrodesis segment, Numeric Rating Scale (NRS) for neck pain, and Neck Disability Index (NDI) were serially evaluated at 3, 6, and 12 months postoperatively. Predictable factors for fusion, including age, sex, plating, diabetes, smoking, and type of grafts, were investigated, and fusion was defined as ISM

This study compared the differences in the growth and metabolism of Clostridium celerecrescens JSJ-1, a strain able to produce caproic acid, and Clostridium tyrobutyricum D-1, a stain able to produce butyric acid, when cultured separately or co-cultured in different systems (solid medium, and liquid medium with or without use of dialysis bag). Furthermore, this study investigated the effect and mechanism of co-culture with C. tyrobutyricum on caproic acid metabolism in caproic acid-producing bacteria by culturing JSJ-1 alone in the presence of butyric acid or sodium butyrate at different concentrations. The results showed that when co-cultured on a composite solid medium containing glucose in anaerobic conditions at 34 ℃, D-1 grew better than JSJ-1, and could preferentially utilize glucose for growth. The generation time of caproic acid was three days earlier when D-1 and JSJ-1 were co-cultured in a liquid medium than when JSJ-1 was cultured alone under the same conditions, and the concentration of caproic acid was 9.93 and 9.79 g/L on the 12th day in the two cases, respectively. Glucose had a strong inhibitory effect on the production of caproic acid by JSJ-1, which could be relieved by preferential utilization of by D-1 upon co-culture. The co-culture in the liquid medium with and without use of dialysis bag were compared, revealing that whether there was direct contact between JSJ-1 and D-1 had no effect on the yield of caproic acid. By purely culturing JSJ-1 in the presence of butyric acid or sodium butyrate, it was found that butyric acid generated by D-1 at pH 6–6.5 could promote the synthesis of caproic acid by JSJ-1. During co-culture, the preferential utilization of glucose by D-1 could relieve the inhibitory effect of glucose on the production of caproic acid, and butyric acid produced by D-1 could promote the synthesis of caproic acid.

Background Parkinson's disease (PD) is frequently accompanied with anxiety, depression, sleep disorders, autonomic dysfunction, cognitive impairment, and other non-motor symptoms, among which autonomic dysfunction and cognitive impairment severely impair the quality of life. The relationship between autonomic dysfunction and cognitive impairment in PD is still controversial. Objective To analyze the characteristic of autonomic dysfunction and its correlation with cognitive impairment in PD patients. Methods A total of 156 patients with idiopathic PD admitted to Henan Provincial People's Hospital between September 2018 and November 2020 were enrolled. General data of patients, including age, sex, duration of disease, age of onset and years of education, were collected. According to the prevalence and duration of autonomic dysfunction, they were divided into autonomic dysfunction group (AutD group, n=107) and non-autonomic dysfunction group (NAutD group, n=49) . The part Ⅲ of the Unified Parkinson's Disease Rating Scale (UPDRS-Ⅲ) was used to assess motor symptoms. The Hoehn-Yahr (H-Y) scale was used to assess the severity of PD. The non-motor symptoms were assessed by the Non-motor Symptoms Scale (NMSS) . The Hamilton Anxiety Scale (HAMA) and Hamilton Rating Scale for Depression 24-item (HAMD-24) were used to evaluate anxiety and depression symptoms, respectively. The 39-item Parkinson's Disease Questionnaire (PDQ-39) was used to evaluate PD-specific health related quality of life. Autonomic function was evaluated by Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) . Cognitive function was evaluated by Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) . Spearman correlation analysis was used to explore the correlation between autonomic function (assessed using the SCOPA-AUT score) and cognitive function (assessed using the MMSE score and MoCA score) . Results Among the 156 patients, 83 were male and 73 were female, with a mean age of (63.9±0.7) years. AutD group had greater mean age (t=-4.391, P

Chemical warfare agents pose a serious threat due to their extreme toxicity, necessitating swift the identification of chemical gases and individual responses to the identified threats. Fourier transform infrared (FTIR) spectroscopy offers a method for remote material analysis, particularly in detecting colorless and odorless chemical agents. In this paper, we propose a deep neural network utilizing a semi-supervised autoencoder (SSAE) for the classification of chemical gases based on FTIR spectra. In contrast to traditional methods, the SSAE concurrently trains an autoencoder and a classifier attached to a latent vector of the autoencoder, enhancing feature extraction for classification. The SSAE was evaluated on laboratory-collected FTIR spectra, demonstrating a superior classification performance compared to existing methods. The efficacy of the SSAE lies in its ability to generate denser cluster distributions in latent vectors, thereby enhancing gas classification. This study established a consistent experimental environment for hyperparameter optimization, offering valuable insights into the influence of latent vectors on classification performance.

Gas source localization is vital in emergency scenarios to enable swift and effective responses. In this study, we introduce a gas source localization model leveraging the video vision transformer (ViViT). Utilizing synthetic time series diffusion data, the source grid is predicted by classifying the grid with the highest probability of gas occurrence within the diffusion data coverage. Through extensive experimentation using the NBC-RAMS simulator, we generate large datasets of gas diffusion under varied experimental conditions and meteorological environments, enabling comprehensive model training and evaluation. Our findings demonstrate that the ViViT outperforms other deep learning models in processing time series gas data, showcasing a superior estimation performance. Leveraging a transformer architecture, the ViViT exhibits a robust classification performance even in scenarios influenced by weather conditions or incomplete observations. Furthermore, we conduct an analysis of accuracy and parameter count across various input sequence lengths, revealing the ability of the ViViT to maintain high computational efficiency while achieving accurate source localization. These results underscore the effectiveness of the ViViT as a model for gas source localization, particularly in situations demanding a rapid response in real-world environments, such as gas leaks or attacks.

BackgroundExudative age-related macular degeneration (AMD), one of the leading causes of blindness, requires expensive drugs such as anti–vascular endothelial growth factor (VEGF) agents. The long-term regular use of effective but expensive drugs causes an economic burden for patients with exudative AMD. However, there are no studies on the long-term patient-centered economic burden of exudative AMD after reimbursement of anti-VEGFs. ObjectiveThis study aimed to evaluate the patient-centered economic burden of exudative AMD for 2 years, including nonreimbursement and out-of-pocket costs, compared with nonexudative AMD using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). MethodsThis retrospective cohort study was conducted using the OMOP CDM, which included 2,006,478 patients who visited Seoul National University Bundang Hospital from June 2003 to July 2019. We defined the exudative AMD group as patients aged >50 years with a diagnosis of exudative AMD and a prescription for anti-VEGFs or verteporfin. The control group was defined as patients aged >50 years without a diagnosis of exudative AMD or a prescription for anti-VEGFs or verteporfin. To adjust for selection bias, controls were matched by propensity scores using regularized logistic regression with a Laplace prior. We measured any medical cost occurring in the hospital as the economic burden of exudative AMD during a 2-year follow-up period using 4 categories: total medical cost, reimbursement cost, nonreimbursement cost, and out-of-pocket cost. To estimate the average cost by adjusting the confounding variable and overcoming the positive skewness of costs, we used an exponential conditional model with a generalized linear model. ResultsWe identified 931 patients with exudative AMD and matched 783 (84.1%) with 2918 patients with nonexudative AMD. In the exponential conditional model, the total medical, reimbursement, nonreimbursement, and out-of-pocket incremental costs were estimated at US $3426, US $3130, US $366, and US $561, respectively, in the first year and US $1829, US $1461, US $373, and US $507, respectively, in the second year. All incremental costs in the exudative AMD group were 1.89 to 4.25 and 3.50 to 5.09 times higher in the first and second year, respectively, than those in the control group (P

Objective The safety and clinical usefulness of minimally invasive scoliosis surgery (MISS) has been reported in various studies. However, freehand pedicle screwing in MISS remains technically challenging. The purpose of this study is to evaluate the accuracy and safety of pedicle screw placement using the freehand technique in adolescent idiopathic scoliosis (AIS) patients treated with MISS compared to conventional open scoliosis surgery (COSS). Methods We included 76 patients who underwent deformity correction for AIS. Computed tomography scans were used to assess screw violations divided into 2 groups according to the surgical technique: MISS or COSS. Anterior violations were classified into grade 0, 1 (no contact with internal organs), and 2 (contact with internal organs). Medial and lateral violations were classified into grade 0, 1 ( < 2 mm), and 3 ( ≥ 2 mm). grade 2 were considered critical violations. Results A total of 630 and 1,174 pedicle screws were inserted in the MISS and COSS groups, respectively. The overall critical violation rates of the MISS and COSS groups were 16.8% (106 screws) and 14.0% (165 screws) (p = 0.116). Medial critical violations on the left side in the middle thoracic region frequently occurred in the MISS group compared to the COSS group (p = 0.003). There were no statistical differences in the complications. Conclusion Pedicle screw placement using the freehand technique in MISS for AIS patients provided similar accuracy and safety compared to COSS. Pedicle screws inserted on the left side of the middle thoracic region, exhibited more medial critical violations in the MISS group.