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Objectives. This study investigated age-related differences in nasal morphometry and the degree of changes within an individual over at least a 10-year period by pairing previous and recent three-dimensional reconstructed computed tomography (CT) images. Methods. Forty-eight adult Korean patients who underwent at least two CT scans of the nasal region with an interval of at least 10 years were selected. Patients were categorized into six subgroups according to sex and age (20–39 years, 40–49 years, and ≥50 years) at the time of initial imaging. Eight nasal parameters were measured on the initial and recent images, and paired comparisons between the two images were performed based on the data. The differences in the degree of change by age were also analyzed. Results. Over an average image interval of 12 years, men exhibited an increase in the nasofrontal angle (3.2°±5.4°, P=0.041), profile nasal length (1.7±1.7 mm, P=0.002), and nasal bridge height (1.2±1.6 mm, P=0.002). Conversely, they showed a decrease in the nasofacial angle (–2.3°±2.9°, P=0.010). Women also demonstrated an increase in the nasofrontal angle (2.5°±5.2°, P=0.010), profile nasal length (1.4±1.9 mm, P

Abstract The alpha–beta filter algorithm has been widely researched for various applications, for example, navigation and target tracking systems. To improve the dynamic performance of the alpha–beta filter algorithm, a new prediction learning model is proposed in this study. The proposed model has two main components: (1) the alpha–beta filter algorithm is the main prediction module, and (2) the learning module is a feedforward artificial neural network (FF‐ANN). Furthermore, the model uses two inputs, temperature sensor and humidity sensor data, and a prediction algorithm is used to predict actual sensor readings from noisy sensor readings. Using the novel proposed technique, prediction accuracy is significantly improved while adding the feed‐forward backpropagation neural network, and also reduces the root mean square error (RMSE) and mean absolute error (MAE). We carried out different experiments with different experimental setups. The proposed model performance was evaluated with the traditional alpha–beta filter algorithm and other algorithms such as the Kalman filter. A higher prediction accuracy was achieved, and the MAE and RMSE were 35.1%–38.2% respectively. The final proposed model results show increased performance when compared to traditional methods.

Abstract Aims The long‐term effect of angiotensin receptor–neprilysin inhibitor (ARNI) remains uncertain in patients who have experienced improvements in left ventricular (LV) systolic function or significant LV reverse remodelling following a certain period of treatment. It is also unclear how ARNI performs in patients who have not shown these improvements. This study aimed to assess the impact of prolonged ARNI use compared with angiotensin‐converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) in patients with and without significant treatment response after 1 year of heart failure (HF) treatment. Methods and results The present study enrolled patients with HF with reduced ejection fraction (HFrEF) who were treated with either ARNI or ACEIs/ARBs within 1 year of undergoing index echocardiography. After 1 year of treatment, patients were reclassified into the following groups: (i) patients with HF with improved ejection fraction and persistent HFrEF and (ii) patients with and without LV reverse remodelling based on the follow‐up echocardiography. The effect of ARNI versus that of ACEIs/ARBs in each group was assessed from the time of categorizing into new groups using the composite event of all‐cause mortality and HF hospitalization. A total of 671 patients with HFrEF (age, 66.4 ± 14.1 years; males, 66.8%) were included, and 133 (19.8%) composite events of death and rehospitalization for HF were observed during the follow‐up (median follow‐up, 44 [interquartile range, 34–51] months). ARNI had a significantly lower event rate than ACEIs/ARBs in patients with HF with improved ejection fraction (7.0% vs. 30.4%, P = 0.020) and those with persistent HFrEF (17.6% vs. 49.7%, P

Red ginseng (RG) is a popular ingredient in traditional Korean medicine that has various health benefits. It is commonly taken orally as a dietary supplement; however, its potential interactions with concomitantly administered drugs are unclear. In this study, we examined the pharmacokinetic interaction between furosemide and RG in equine plasma. Liquid chromatography with tandem mass spectrometry analysis was performed to evaluate ginsenosides in the plasma of horses after feeding them RG and furosemide and validate the results. A single bolus of furosemide (0.5 mg/kg) was administered intravenously to female horses that had consumed RG (600 mg/kg/day) every morning for 3 weeks (experimental group), and blood samples were collected from 0 to 24 h, analyzed, and compared with those from female horses that did not consume RG (control group). Four (20s)-protopanaxadiol ginsenosides (Rb1, Rb2, Rc, and Rd) were detected in the plasma. Rb1 and Rc individually showed a high concentration distribution in the plasma. The Cmax, AUC0−t, and AUC0−∞ of furosemide was significantly increased in the experimental group (p

With the global advancement of maritime autonomous surface ships (MASS), the critical task of verifying their key technologies, particularly in challenging conditions, becomes paramount. This study introduces a synthetic maritime traffic generation system (S-MTGS) designed for the efficient and safe verification of these technologies. The S-MTGS encompasses a maritime traffic generator integrating a generator based on absolute position (GAP) and a generator based on relative position (GRP). This innovative system leverages historical maritime data to create various scenarios or generate virtual ships based on their interactions with and proximity to other ships. The virtual ships adeptly navigate and perform collision avoidance maneuvers with nearby vessels enabled by the integrated collision avoidance algorithm. The S-MTGS’s ability to generate a wide range of maritime traffic information mirroring actual maritime conditions is pivotal for thoroughly verifying the performance of MASS technology under both standard and extreme situations. The development of the S-MTGS represents a significant advancement in maritime safety and technology. It can evaluate collision avoidance and navigation systems in MASS, featuring a virtual environment for realistic scenario testing and an intelligent navigation system focused on route tracking and collision avoidance.

Purpose Despite the promising palliative effects of radiation treatment, few reports have studied the role of palliative tumor surgery (PTS) in patients with unresectable head and neck cancer (HNC). Thus, we aimed to present the outcomes of PTS in HNC, and suggest a possible surgical indication for PTS. Methods We retrospectively reviewed the medical records of 18 patients who underwent PTS for HNC between 2002 and 2017. PTS was defined as surgical debulking of tumor or surgery of loco-regionaltumors in patients with distant metastasis. As functional outcomes, we evaluated changes in pain, diet, respiration, and wound care before and after PTS. Results Squamous cell carcinoma was the common cancer type (72.2%), followed by salivary gland cancers and others. The median overall survival time was 17 months (95% confidence interval, 7.3 to 26.7). PTS significantly reduced the pain score (P= 0.013), and improved cancer-related wounds (P=0.003 in wound infection). Oral swallowing and respiration status did not change after PTS. The recurrent tumor at the operation bed was clinically detected at post-operative 1 to 2 months with intact skin (without wound problems). Of note, further chemotherapy or other additional cancer treatments was possible in 66.7% of patients with PTS (P=0.002). Conclusion PTS could provide a meaningful benefit to selected patients with incurable HNC, in terms of pain control and cancer wound management. Thus, PTS is a considerable option for selected HNC patients, based on the accurate evaluation of tumor extent along with multi-disciplinary consultation as well as patient counseling.

Recent projections from marine transportation experts highlight an uptick in maritime traffic, attributed to the fourth industrial revolution’s technological strides and global economic rebound. This trend underscores the need for enhanced systems for maritime accident prediction and traffic management. In this study, to analyze the flow of maritime traffic macroscopically, spatiality and continuity reflecting the output of ships are considered. The course–speed (CS) model used in this study involved analyzing COG, ROT, speed, and acceleration, which can be obtained from the ship’s AIS data, and calculating the deviation from the standard plan. In addition, spatiality and continuity were quantitatively analyzed to evaluate the smoothness of maritime traffic flow. A notable finding is that, in the target sea area, the outbound and inbound CS indices are measured at 0.7613 and 0.7501, suggesting that the outbound ship flows are more affected than inbound ship flows to the liquidity of maritime traffic flow. Using the CS model, a detailed quantitative evaluation of the spatiality and continuity of maritime traffic is presented. This approach facilitates robust comparisons over diverse scales and periods. Moreover, the research advances our understanding of factors dictating maritime traffic flow based on ship attributes. The study insights can catalyze the development of a novel index for maritime traffic management, enhancing safety and efficiency.

Abstract Background Anticoagulant therapy has been important for stroke prevention in patients with atrial fibrillation (AF). However, it was not recommended due to its relatively higher risk of bleeding than its lower risk of stroke in patients with a CHA2DS2‐VASc score of 0. Hypothesis This study aimed to evaluate the predictors of stroke in AF patients with very low risk of stroke. Methods Between 1990 and 2020, 542 patients with non‐valvular AF (NVAF) with a CHA2DS2‐VASc score of 0 followed up for at least 6 months were enrolled. Patients with only being woman as a risk factor were included as a CHA2DS2‐VASc score of 0 in this study. The primary outcome was stroke or systemic embolism. Results The primary outcome rate was 0.78%/year. In Cox hazard model, age of ≥50 years at diagnosis (hazard ratio [HR] 6.710, 95% confidence interval [CI] 1.811–24.860, p = .004), LVEDD of ≥46 mm (HR 4.513, 95% CI 1.038–19.626, p = .045), and non‐paroxysmal AF (HR 5.575, 95% CI 1.621–19.175, p = .006) were identified as independent predictors of stroke or systemic embolism. Patients with all three independent predictors had a higher risk of stroke or systemic embolism (4.21%/year), whereas those without did not have a stroke or systemic embolism. Conclusion The annual stroke or systemic embolism rate in NVAF patients with CHA2DS2‐VASc score of 0 was 0.78%/year, and age at AF diagnosis, LVEDD, and non‐paroxysmal AF were independent predictors of stroke or systemic embolism in patients considered to have a very low risk of stroke.

Traumatic coronary artery dissection resulting from blunt trauma, is a relatively rare and life-threatening event. We present a case report of a 42-year-old male who presented with electrocardiogram abnormality and cardiac enzyme elevation following a fall from a height of 3 m. The patient was misdiagnosed with stress-induced cardiomyopathy because of the absence of clinical signs of acute coronary syndrome. The patient was subsequently diagnosed with traumatic coronary artery dissection using coronary angiography, and the relevance of the trauma was confirmed using intravascular ultrasonography (IVUS). Herein, we highlight that trauma team should maintain a high suspicion of traumatic coronary artery dissection, although the early recognition of traumatic coronary artery dissection can be difficult. Additionally, the importance of coronary angiography with IVUS modalities for the evaluation of traumatic coronary artery dissection is highlighted.

Abstract Background Early detection and diagnosis of parotid gland cancer (PGC) are essential to improve clinical outcomes, because Tumor-Node-Metastasis stage at diagnosis is a very strong indicator of prognosis in PGC. Nevertheless, some patients still present with large parotid mass, maybe due to the unawareness or ignorance of their disease. In this study, we aimed to present the clinical outcomes of bulky PGC (defined by a 4 cm cutoff point for T3–4 versus T1–2 tumors), to emphasize the necessity of a self-examination tool for parotid gland tumor. Methods We retrospectively reviewed 60 consecutive cases with bulky (equal to and greater than 4 cm in the longest diameter, determined radiologically) malignant tumors arising from the parotid gland from 1995 to 2016. The clinical and pathological factors were analyzed to identify risk factors for poor outcomes using Cox proportional hazard models. In addition, we designed a self-examination tool for parotid gland tumors, similar to breast self-examination for breast cancer detection. Results Patients with bulky parotid cancer showed 48.9% 5-year and 24.5% 10-year overall survival rates and a 47.9% risk of high-grade malignancy. The common pathological diagnoses were carcinoma ex pleomorphic adenoma (18.3%), adenocarcinoma (16.7%), mucoepidermoid carcinoma (16.7%), salivary duct carcinoma (16.7%), and adenoid cystic carcinoma (11.7%). Survival analyses revealed that tumor size (hazard ratio, HR = 1.262 upon increase of 1 cm, 95% confidence interval, 95%CI 1.059–1.502), lymph node metastasis (HR = 2.999, 95%CI 1.048–8.583), and high tumor grade (HR = 4.148, 95%CI 1.215–14.154) were independent prognostic factors in multivariable analysis. Functional preservation of the facial nerve was possible only in less than half of patients. Conclusion In bulky PGC, lymph node metastasis at diagnosis and high tumor grade indicated poor survival outcomes, and functional outcomes of the facial nerve were suboptimal. Thus, a public effort seems to be necessary to decrease these patients with bulky PGC, and to increase patients’ self-awareness of their disease. As a way of early detection, we proposed a parotid self-examination tool to detect parotid gland tumors at an early stage, which is similar to breast self-examination.

Functional paraganglioma is a rare tumor that secretes the catecholamine which is able to cause secondary hypertension. Surgical resection is the only curative treatment modality for this tumor, which can correct the secondary hypertension. The pterygopalatine fossa is a small retromaxillary space which contains a neurovascular bundle that crosses the middle cranial fossa to the nasal cavity, nasal septum, and oral cavity. To our knowledge, two cases have been reported for functional paraganglioma involving the pterygopalatine fossa removed by surgery. We present a patient who had a catecholamine-secreting paraganglioma in the pterygopalatine fossa, which is the first case successfully resected with an endoscopic approach.

Recently, marine development plans such as offshore wind farms and marina port facilities have been established to use Korean coastal waters, and research on the development of operational ships such as autonomous ships and water-surface flying ships is being rapidly promoted. Since the marine traffic in Korean coastal waters is expected to increase, the government intends to construct a coastal maritime transportation network that connects Korean coastal waters to guarantee safe ship navigation. Therefore, this study used automatic-identification-system data analysis to obtain quantitative evaluation results on maritime traffic distribution characteristics and utilization levels for the entire Korean coastal waters in grid cell for greater consistency and compatibility. The characteristics of marine traffic distribution at a certain site in coastal Korean waters can be quantitatively examined using the findings of this study, and they may be used as grid-cell-type data-based information. Moreover, the vessel traffic index allows for extensive research while quickly understanding the present level of use of the passing ships by the sea area. In this regard, the findings of this study are expected to be useful for the future development of maritime transportation networks in Korean coastal waters.

The recent emergence of futuristic ships is the result of advances in information and communication technology, big data, and artificial intelligence. They are generally autonomous, which has the potential to significantly improve safety and drastically reduce operating costs. However, the commercialization of Maritime Autonomous Surface Ships requires the development of appropriate technologies, including intelligent navigation systems, which involves the identification of the current maritime traffic conditions and the prediction of future maritime traffic conditions. This study aims to develop an algorithm that predicts future maritime traffic conditions using historical data, with the goal of enhancing the performance of autonomous ships. Using several datasets, we trained and validated an artificial intelligence model using long short-term memory and evaluated the performance by considering several features such as the maritime traffic volume, maritime traffic congestion fluctuation range, fluctuation rate, etc. The algorithm was able to identify features for predicting maritime traffic conditions. The obtained results indicated that the highest performance of the model with a valid loss of 0.0835 was observed under the scenario with all trends and predictions. The maximum values for 3, 6, 12, and 24 days and the congestion of the gate lines around the analysis point showed a significant effect on performance. The results of this study can be used to improve the performance of situation recognition systems in autonomous ships and can be applied to maritime traffic condition recognition technology for coastal ships that navigate more complex sea routes compared to ships navigating the ocean.

Groundwater level (GWL) refers to the depth of the water table or the level of water below the Earth’s surface in underground formations. It is an important factor in managing and sustaining the groundwater resources that are used for drinking water, irrigation, and other purposes. Groundwater level prediction is a critical aspect of water resource management and requires accurate and efficient modelling techniques. This study reviews the most commonly used conventional numerical, machine learning, and deep learning models for predicting GWL. Significant advancements have been made in terms of prediction efficiency over the last two decades. However, while researchers have primarily focused on predicting monthly, weekly, daily, and hourly GWL, water managers and strategists require multi-year GWL simulations to take effective steps towards ensuring the sustainable supply of groundwater. In this paper, we consider a collection of state-of-the-art theories to develop and design a novel methodology and improve modelling efficiency in this field of evaluation. We examined 109 research articles published from 2008 to 2022 that investigated different modelling techniques. Finally, we concluded that machine learning and deep learning approaches are efficient for modelling GWL. Moreover, we provide possible future research directions and recommendations to enhance the accuracy of GWL prediction models and improve relevant understanding.

Abstract Background The reported incidence of facial weakness immediately after parotid tumor surgery ranges from 14 to 65%. The purpose of this study was to evaluate the incidence of postoperative facial weakness related to parotidectomy with use of preoperative computed tomography (CT), intraoperative facial nerve monitoring, and surgical magnification. Also, we sought to elucidate additional information about risk factors for postoperative facial weakness in parotid tumor surgery, particularly focusing on the tumor subsites. Methods We retrospectively reviewed 794 cases with parotidectomy for benign and malignant tumors arising from the parotid gland (2009–2016). Patients with pretreatment facial palsy were excluded from the analyses. Tumor subsites were stratified based on their anatomical relations to the facial nerve as superficial, deep, or both. Multivariable logistic regression analyses were conducted to identify risk factors for postoperative facial weakness. Results The overall incidences of temporary and permanent (more than 6 months) facial weakness were 9.2 and 5.2% in our series utilizing preoperative CT, intraoperative facial nerve monitoring, and surgical magnification. Multivariable analysis revealed that old age, malignancy, and recurrent tumors (revision surgery) were common independent risk factors for both temporary and permanent postoperative facial weakness. In addition, tumor subsite (tumors involving superficial and deep lobe) was associated with postoperative facial weakness, but not tumor size. Extent of surgery was strongly correlated with tumor pathology (malignant tumors) and tumor subsite (tumors involving deep lobe). Conclusion Aside from risk factors for facial weakness in parotid tumor surgery such as old age, malignant, or recurrent tumors, the location of tumors was found to be related to postoperative facial weakness. This study result may provide background data in a future prospective study and up-to-date information for patient counseling.

One of the primary factors that affect the safe maritime navigation is the insufficient experience and skill of an apprentice officer, which may be improved using simulation-based training by ensuring operational efficiency. This study aims to determine appropriate factors for achieving effective and intensive simulation-based training of apprentice officers and present the guidelines for such a training scheme. Initially, a marine traffic risk model, which interprets and accurately measures the risk of collision with other vessels, is analyzed to derive the most influential factors in safe navigation. Subsequently, simulation experiments are conducted by applying machine learning to verify the required safe navigation factors for effectively training the apprentice officers. As a result of the above analysis, it was confirmed that the factor affecting safe maritime navigation was the distance from other vessels. Finally, the differences between these distances in the simulations are analyzed for both the apprentice officers and the experienced officers, and the guidelines corresponding to both these cases are presented. This study has the limitation because of the difference between the ship maneuver simulation and the actual ship navigation. This can be resolved based on the results of this study, in combination with the actual navigation data.

Abstract Background Skin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft. To improve the success rate of oral skin graft, we proposed a novel and simple dressing technique for intraoral skin graft to control saliva accumulation, in comparison with the conventional bolster dressing. Methods We retrospectively reviewed 31 patients reconstructed with skin graft in their intraoral defect. The patients were divided into two groups; conventional bolster group (n = 21) and modified bolster group (n = 10). In the modified bolster group, a polyvinyl alcohol sponge was designed to fit the skin graft and a suction drain was inserted with tagging suture to apply continuous suction. We analyzed the success rate, the size of the skin grafts and clinical variables of each method. Results The overall success rate of oral skin graft was not different between the two groups (90.0 and 90.5%). However, partial necrosis in the engrafted skin was observed frequently in the control group (57.1% versus 20.0%). The relative engrafted area was significantly higher in the modified bolster group (55.0 ± 11.6% versus 23.0 ± 18.7%, p = 0.015). The duration of bolster dressing and the time to start an oral diet were shorter in the modified bolster group. Conclusions Our modified method could be easily applied for removing saliva accumulation under a skin graft and for enhancing skin engraftment of an oral cavity wound.

This research expands the traditional triple bottom line (people, profit, and planet) by splitting profit based on benefits from resource savings or productivity enhancements. In the context of corporate real estate, the suggested quadruple bottom line (PPPP) is defined as general environmental goals (planet), employees' productivity (people), the tenant firm's profitability (profit T), and landlord's profit (profit L). Tenants' perspectives on specific sustainability categories and the relative importance of PPPP are examined through a survey of over 700 tenants in U.S. office buildings. The findings suggest that different ways of evaluating the direction of profit is warranted, because tenants' attitudes toward profit diverge significantly when landlord profit and tenant profit are considered separately based on lease structure. The results also suggest that while planet, or resource conservation, is a major priority for tenant respondents, detailed analysis of sustainability components shows that people, a proxy for occupant well-being and productivity gains, are the highest priority. This is of particular importance in sustainable real estate as new products and developments are considered.

The aim of this study is to apply a collision warning algorithm for a small fishing vessel in a fishing waterway to verify its alarm operation and to validate its feasibility. For this purpose, a scenario-based real ship test was conducted, and cases extracted from real sea data (Vpass data) were applied. Moreover, zones with frequent alarms and high-risk waters were compared. First, we installed millimeter-wave communication terminals in three small fishing vessels and applied our algorithm based on two scenarios. Furthermore, we applied the collision warning algorithm by extracting two cases encountered by multiple ships from the Vpass data. The results show that the algorithm triggered alarms continuously under risky situations. This study also compares waterway risk levels as assessed by maritime risk-assessment tools (potential assessment of risk model, environment stress model, and International Association of Marine Aids to Navigation and Lighthouse Authorities Waterway Risk Assessment Program MkII) and the locations having frequent alarms based on Vpass data collected for 7 days. Not only did the eastern sea of Yeongheung Island indicate that more alarms were triggered, but we found high-risk results from the risk-level assessment, indicating that the risky zones and the frequent alarm zones were identical. Additional research is necessary to develop an algorithm based on qualitative evaluation by actual ship operators. In addition, since fishing vessels navigate differently from general navigation methods during fishing, it is necessary to develop additional algorithms for this.

Structural heterogeneity results in different spatial distributions of microcrustaceans. Thus, in ecosystems with excessive macrophyte development, it may be difficult to determine the microcrustacean species composition. Given the importance of microcrustaceans in the food web, the elucidation of microcrustacean diversity is essential. In vegetated habitats, bluegill sunfish can prey on microcrustaceans, and therefore have a potential role as microcrustacean monitoring agents. In the present study, we compared microcrustacean species compositions in the field with those in the guts of bluegill, in Jangcheok Lake, South Korea. Our results showed that the number of microcrustacean species was higher in bluegill guts than in the field. Further, microcrustacean species, such as Daphnia galeata, Graptoleveris testudinaria, Leydigia leydigii, Rhynchotalona sp., and Simocephalus exponisus, were found only in bluegill guts. Our findings verify the validity of the fish gut analysis to monitor microcrustacean species compositions and to clarify spatial distributions of microcrustacean species in structurally heterogeneous ecosystems with excessive macrophyte development.

Maritime transportation, a cornerstone of global trade, faces increasing safety challenges due to growing sea traffic volumes. This study proposes a novel approach to vessel trajectory prediction utilizing Automatic Identification System (AIS) data and advanced deep learning models, including Long Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), Bidirectional LSTM (DBLSTM), Simple Recurrent Neural Network (SimpleRNN), and Kalman Filtering. The research implemented rigorous AIS data preprocessing, encompassing record deduplication, noise elimination, stationary simplification, and removal of insignificant trajectories. Models were trained using key navigational parameters: latitude, longitude, speed, and heading. Spatiotemporal aware processing through trajectory segmentation and topological data analysis (TDA) was employed to capture dynamic patterns. Validation using a three-month AIS dataset demonstrated significant improvements in prediction accuracy. The GRU model exhibited superior performance, achieving training losses of 0.0020 (Mean Squared Error, MSE) and 0.0334 (Mean Absolute Error, MAE), with validation losses of 0.0708 (MSE) and 0.1720 (MAE). The LSTM model showed comparable efficacy, with training losses of 0.0011 (MSE) and 0.0258 (MAE), and validation losses of 0.2290 (MSE) and 0.2652 (MAE). Both models demonstrated reductions in training and validation losses, measured by MAE, MSE, Average Displacement Error (ADE), and Final Displacement Error (FDE). This research underscores the potential of advanced deep learning models in enhancing maritime safety through more accurate trajectory predictions, contributing significantly to the development of robust, intelligent navigation systems for the maritime industry. [ABSTRACT FROM AUTHOR]