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Background: Gastric conduit is most widely used method for esophageal reconstruction. Despite its popularity, certain complications, such as anastomotic leakage and strictures, remain to be resolved. In the present study, we reviewed the outcomes of narrow gastric conduit compared to wide gastric conduit reconstruction. Methods: We retrospectively reviewed 493 patients with esophageal cancer who received esophagectomy with reconstruction in Taichung Veteran General Hospital, Taiwan between January 2010 and December 2019. We performed gastric conduit reconstruction with two different methods, narrow gastric conduit made of multistaples (more than four staples) and wide gastric conduit made of two or three staples. Among the 493 patients, 170 patients underwent wide gastric conduit formation and 323 patients underwent narrow gastric conduit. After propensity score matching, 140 patients from each group were matched by 1:1. Results: The average anastomotic leakage rate is 80 of 493 (16.23%). The leakage rate, length of hospital stay, intensive care unit (ICU) admission, and ICU stay were significantly lower in the narrow gastric conduit group than in the wide gastric conduit group. The need for postoperation dilatation was significantly higher in wide gastric conduit group (19.41% vs 11.76%, p = 0.0217), and the time to first dilatation was similar in both groups (p = 0.9808). Similar results were observed even after propensity score matching. In univariate analysis, the narrow gastric conduit, circular stapler, video-assisted thoracic surgery, and laparoscopic surgery were associated with a reduced risk of anastomotic leakage. However, these factors are not statistically significant in a multivariate logistic regression analysis. Conclusion: The narrow gastric conduit is not inferior to the wide gastric conduit and can be considered an alternative option for gastric conduit preparation. [ABSTRACT FROM AUTHOR]

Background: Free flap monitoring is essential for postmicrosurgical management and outcomes but traditionally relies on human observers; the process is subjective and qualitative and imposes a heavy burden on staffing. To scientifically monitor and quantify the condition of free flaps in a clinical scenario, we developed and validated a successful clinical transitional deep learning (DL) model integrated application. Material and Methods: Patients from a single microsurgical intensive care unit between 1 April 2021 and 31 March 2022, were retrospectively analyzed for DL model development, validation, clinical transition, and quantification of free flap monitoring. An iOS application that predicted the probability of flap congestion based on computer vision was developed. The application calculated probability distribution that indicates the flap congestion risks. Accuracy, discrimination, and calibration tests were assessed for model performance evaluations. Results: From a total of 1761 photographs of 642 patients, 122 patients were included during the clinical application period. Development (photographs =328), external validation (photographs =512), and clinical application (photographs = 921) cohorts were assigned to corresponding time periods. The performance measurements of the DL model indicate a 92.2% training and a 92.3% validation accuracy. The discrimination (area under the receiver operating characteristic curve) was 0.99 (95% CI: 0.98-1.0) during internal validation and 0.98 (95% CI: 0.97-0.99) under external validation. Among clinical application periods, the application demonstrates 95.3% accuracy, 95.2% sensitivity, and 95.3% specificity. The probabilities of flap congestion were significantly higher in the congested group than in the normal group (78.3 (17.1)% versus 13.2 (18.1)%; 0.8%; 95% CI, P<0.001). Conclusion: The DL integrated smartphone application can accurately reflect and quantify flap condition; it is a convenient, accurate, and economical device that can improve patient safety and management and assist in monitoring flap physiology. [ABSTRACT FROM AUTHOR]

The term “abandoned Japanese” refers to those Japanese left in China for various reasons in the wake of World War II. Most lived in Manchuria, and during the Chinese civil war they experienced life and death situations and many changed their identities to become Chinese. In the 1970s, when Japan and the China restored diplomatic relations, some of the “abandoned Japanese” reclaimed their original identities and returned to Japan, becoming marginal people of “two motherlands.”This article explores the identity of “abandoned Japanese” from the perspectives of war, memory, and gender. The first part of this article analyzes the meaning of war memory itself. The “abandoned Japanese” not only became a pawn in the Cold War era of diplomatic “war” but also their “Manchurian experience” became a site of the search for war responsibility. The second part analyzes their memories of a variety of experiences, including the frustration they felt at the bottom of society, as well as the terror of the “Manchurian experience” as they faced life and death situations at the conclusion of the war. Finally, gender differences played an important role in determining their choices about their future plans. It is clear that “abandoned Japanese” as marginal people produced by a particular time and place reflect the tragedy of war and possess complex identities. [ABSTRACT FROM AUTHOR]

The purpose of this study was based on our WiiRemote system study results to improve the human-machine interface and to develop the tangible augmented reality system for the learning effects on museum artifacts. The system prototype of tangible augmented reality system for butterfly's specimens was examined in National Museum of Natural Science. Through the research method of questionnaire, interview and observation, we gathered the different aspects of the data and the information from visitors of National Museum of Natural Science. Based on the analysis of research data, the important conclusions are as follows: 1. All visitors highly satisfied with the tangible augmented reality system and met their needs of use: high interaction, easy to use and enjoyment; 2. The system usability impacted the system utility. Furthermore both of system usability and system utility affected the users' attention in tangible augmented reality system. [ABSTRACT FROM AUTHOR]

This study presents two reversible data hiding schemes based on the coefficient shifting (CS) algorithm. The first scheme uses the CS algorithm with a mean predictor in the spatial domain to provide a large payload while minimizing distortion. To guard against manipulations, the second scheme uses a robust version of the CS algorithm with feature embedding implemented in the integer wavelet transform domain. Simulations demonstrate that both the payload and peak signal-tonoise ratio generated by the CS algorithm with a mean predictor are better than those generated by existing techniques. In addition, the marked images generated by the variant of the CS algorithm are robust to various manipulations created by JPEG2000 compression, JPEG compression, noise additions, (edge) sharpening, low-pass filtering, bit truncation, brightness, contrast, (color) quantization, winding, zigzag and poster edge distortion, and inversion. [ABSTRACT FROM AUTHOR]