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Background/Aims: The optimal treatment for acute malignant obstruction of the proximal colon (MOPC, proximal to the splenic flexure) remains challenging. Emergency resection, the traditional modality for MOPC, has shown significantly high mortality and morbidity rates, according to recent studies. This study aimed to investigate the clinical outcomes of stent vs stoma as a bridge to curative surgery for MOPC.Methods: This retrospective cohort study included 72 patients who underwent endoscopic placement of a self-expanding metallic stent (SEMS) or loop ileostomy for MOPC at six referral centers between January 2011 and July 2021. Clinical and pathological characteristics, procedure-related complications, and long-term mortality rates after curative surgery were analyzed.Results: During a mean follow-up period of 32 months, 30 patients (41.7%) underwent ileostomy preferentially for more proximal cancer, complete obstruction, and advanced tumor stage compared to the SEMS group. No difference was found in procedure-related complications, but five deaths were observed after ileostomy. Survival analysis for 5-year mortality after curative surgery showed no significant difference between the bridge modalities (log-rank p = 0.253).Conclusions: In this study, SEMS as a bridge to surgery showed relatively safe results in terms of post-procedural mortality. However, these results should be considered when performing ileostomy in patients with more advanced malignant obstruction.

Evaluate per-patient diagnostic performance of a wireless dual-sensor system (ANNE sleep) compared with reference standard polysomnography (PSG) for the diagnosis of moderate and severe obstructive sleep apnea (OSA) with a minimum prespecified threshold of 80% for both sensitivity and specificity.A multicenter clinical trial was conducted to evaluate ANNE sleep vs PSG to diagnose moderate and severe OSA in individuals 22 years or older. For each testing approach, apnea-hypopnea index (AHI) was manually scored and averaged by 3 registered sleep technologists blinded to the other system. Average variations15% were adjudicated by a sleep medicine physician.In a total of n = 225 participants (mean age 53 years, range 22-88 years), PSG diagnosed 30% (n = 68) of participants with moderate or severe OSA (AHI ≥ 15 events/h) compared to 29% (n = 65) diagnosed by ANNE sleep (Using PSG as the gold standard, ANNE sleep demonstrated high sensitivity and specificity for the diagnosis of moderate or severe OSA.Registry: ClinicalTrials.gov; Name: Comparative Study of the ANNE™ One System to Diagnose Obstructive Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/NCT04643782; Identifier: NCT04643782.Davies C, Lee JY, Walter J et al. A single-arm, open-label, multicenter, and comparative study of the ANNE sleep system vs polysomnography to diagnose obstructive sleep apnea.

Endoscopic submucosal dissection is a widely used treatment for gastric epithelial neoplasms. Accurate delineation of the horizontal margins is necessary for the complete resection of gastric epithelial neoplasms. Recently, image-enhanced endoscopy has been used to evaluate horizontal margins of gastric epithelial neoplasms. The aim of this study was to investigate whether I-SCAN-optical enhancement (I-SCAN-OE) is superior to chromoendoscopy in evaluating the horizontal margin of gastric epithelial neoplasms.This was a multicenter, prospective, and randomized trial. The participants were divided into two groups: I-SCAN-OE and chromoendoscopy. For both groups, we first evaluated the horizontal margins of early gastric cancer or high-grade dysplasia using white-light imaging, and then evaluated, the horizontal margins using I-SCAN-OE or chromoendoscopy. We devised a unique scoring method based on the pathological results obtained after endoscopic submucosal dissection to accurately evaluate the horizontal margins of gastric epithelial neoplasms. The delineation scores of both groups were compared, as were the ratios of positive/negative horizontal margins.In total, 124 patients were evaluated for gastric epithelial neoplasms, of whom 112 were enrolled in the study. A total of 112 patients participated in the study, and 56 were assigned to each group (1:1). There was no statistically significant difference in the delineation scores between the groups (chromoendoscopy, 7.80±1.94; I-SCAN-OE, 8.23±2.24; p=0.342).I-SCAN-OE did not show superiority over chromoendoscopy in delineating horizontal margins of gastric epithelial neoplasms.

Vocal fatigue is a measurable form of performance fatigue resulting from overuse of the voice and is characterized by negative vocal adaptation. Vocal dose refers to cumulative exposure of the vocal fold tissue to vibration. Professionals with high vocal demands, such as singers and teachers, are especially prone to vocal fatigue. Failure to adjust habits can lead to compensatory lapses in vocal technique and an increased risk of vocal fold injury. Quantifying and recording vocal dose to inform individuals about potential overuse is an important step toward mitigating vocal fatigue. Previous work establishes vocal dosimetry methods, that is, processes to quantify vocal fold vibration dose but with bulky, wired devices that are not amenable to continuous use during natural daily activities; these previously reported systems also provide limited mechanisms for real-time user feedback. This study introduces a soft, wireless, skin-conformal technology that gently mounts on the upper chest to capture vibratory responses associated with vocalization in a manner that is immune to ambient noises. Pairing with a separate, wirelessly linked device supports haptic feedback to the user based on quantitative thresholds in vocal usage. A machine learning-based approach enables precise vocal dosimetry from the recorded data, to support personalized, real-time quantitation and feedback. These systems have strong potential to guide healthy behaviors in vocal use.

With the everyday use of big data technology, using big data resources effectively has become a key area of research. Media consumption creates enormous amounts of data in people’s digital lives. This data is not only very valuable to the company, but it also presents a number of concerns, including privacy breaches and data exploitation. Along with the continuous improvement of blockchain technology, the rational use of big data resources has become possible. Blockchain technology has expanded from the initial Bitcoin to the financial field and has become more widely used in the legal and media industries. This study catches the actual cases of blockchain technology in the media industry through Qingbo Big Data, analyzes the current global blockchain and media industry’s overall development status and the existing problems, and puts forward corresponding countermeasures to accelerate the integration and development of blockchain and media industry in the context of big data. The results show that the technical features of blockchain can solve the painful problems of copyright risk, algorithmic black box, and weak trust mechanism in the media industry, and the combination of the two can form a new burst of media productivity. The article discusses the broad application prospects of blockchain in the media industry, which is essential for big data and blockchain research. This paper composes the pioneering literature on the blockchain, catches the information on blockchain by keywords, analyzes the application prospect of blockchain in the media industry, and promotes the research and application of blockchain technology.

본 연구는 2019년 일본의 한국 수출품 규제로 인한 일본 제품 불매운동에 있어서 일본산 일반 제품에 대한 불매의도와 일본산 콘텐츠 제품에 대한 불매의도가 각각 달라질 수 있다는 가설에서 출발한다. 국내 소비자들을 대상으로 설문조사를 한 결과 진보적인 성향의 소비자가 일본제품 불매운동에 더 적극적인 것으로 나타났다. 미디어 이용에 있어서는 일본제품 불매에 대한 뉴스를 많이 시청하는 사람들이 일본제품 불매운동에 더 적극적으로 참여한 것으로 나타났다. 반면에 SNS이용은 유의미한 영향을 미치지 못하는 것으로 나타났다. 일본에 대한 친숙도에 있어서 친숙도가 높은 사람들은 일본제품 불매운동 참여율이 낮게 나타났다. 마지막으로 일본제품에 대한 태도에서 기능적인 태도와 쾌락적인 태도 모두 일본제품 불매운동에 부정적인 영향을 미치는 것으로 나타났다. 콘텐츠 불매운동에서는 결과가 다소 차이를 보였다. 일본제품 불매운동과 마찬가지로 소비자의 뉴스이용은 콘텐츠에 대한 불매를 높이는 것으로 나타났다. SNS이용은 유의미한 영향을 미치지 않았으며 일본에 대한 국가 친숙도는 콘텐츠제품에 대한 불매의도를 감소시키는 것으로 나타났다. 다만, 정치성향에 따라 미치는 영향성이 제한적으로 나타났고 일본제품에 대한 쾌락적인 태도가 콘텐츠 불매운동에 미치는 영향성은 검증되지 않았다. 이러한 결과는 소비자의 불매운동에 대한 학문적인 이해를 높여주고, 위기상황에서의 국가브랜드관리 차원에 있어서 실무적인 시사점을 제공할 것이다.

Background and Study Aims Endoscopic submucosal dissection (ESD) is the most effective treatment for early gastric cancer or gastric adenoma . However, ESD results in iatrogenic ulcers and postoperative bleeding from ulcers. This study aimed to evaluate the effect of using a proton pump inhibitor (PPI) alone, a PPI + rebamipide combination therapy, and an H2 receptor antagonist (H2RA) + rebamipide combination therapy on ulcer healing after ESD. Patients and Methods A total of 204 patients who underwent ESD from April 2014 to July 2017 at Dong-A University Hospital were randomly assigned to the following groups: PPI-alone group, PPI + rebamipide combination therapy group, and H2RA + rebamipide combination therapy group. However, only 156 patients were studied since we excluded those who were lost to follow-up or had diseases other than early gastric cancer or gastric adenoma. Twenty-eight days after ESD, we evaluated the ulcer residual ratio, S stage rates, ulcer bleeding ratio, and gastric pH. Results This study included 156 patients (PPI-alone group: 52 patients; PPI + rebamipide group: 52 patients; H2RA + rebamipide group: 52 patients). The ulcer residual ratios were 24.3 ± 14.2%, 17.0 ± 12.1%, and 21.0 ± 13.8% in the PPI alone, PPI + rebamipide, and H2RA + rebamipide groups, respectively (P = 0.048). Conclusions PPI + rebamipide was more effective in reducing the ulcer residual ratio after ESD. There was no statistical difference in ulcer stage and delayed bleeding after ESD among the groups. These findings showed that PPI + rebamipide had limited benefits after ESD.

Background: The optimal treatment for acute malignant right-sided colonic obstruction (RSCO) remains challenging. Emergency resection, the traditional modality for RSCO, has shown significantly high mortality and morbidity rates according to recent studies. Initial bowel decompression by stent placement or stoma creation has been established for distal colonic obstruction. This study aimed to compare the clinical outcomes of these two procedures as a bridge to curative surgery for RSCO.Methods: This retrospective cohort study included 85 patients (46 men, mean age: 73 ± 16 years) who underwent loop ileostomy or endoscopic placement of a self-expanding metallic stent (SEMS) for RSCO at six referral centers between January, 2011 and July, 2021. Clinicopathologic characteristics, procedure-related complications, surgical outcomes, and risk factors for short-term mortality were analyzed.Results: During a median follow-up period of 26 months (range: 0.5–60 months), 40 patients (47.1%) underwent ileostomy preferentially in clinical situations with tumor in ascending colon/hepatic flexure, complete obstruction, and more advanced tumor stage compared to SEMS group. No significant differences were found in procedure-related complications. Multivariate Cox regression analysis revealed that ileostomy as a bridge treatment was associated with increased likelihood of 1-year mortality (hazard ratio, 17.805; 95% confidence interval, 1.924–164.788; P = 0.011).Conclusions: In this study, ileostomy as a bridge to surgery showed a significantly higher mortality rate than stent placement. However, these results should be considered when performing ileostomy in patients with more advanced malignant obstruction of the right colon.

Temporary postoperative cardiac pacing requires devices with percutaneous leads and external wired power and control systems. This hardware introduces risks for infection, limitations on patient mobility, and requirements for surgical extraction procedures. Bioresorbable pacemakers mitigate some of these disadvantages, but they demand pairing with external, wired systems and secondary mechanisms for control. We present a transient closed-loop system that combines a time-synchronized, wireless network of skin-integrated devices with an advanced bioresorbable pacemaker to control cardiac rhythms, track cardiopulmonary status, provide multihaptic feedback, and enable transient operation with minimal patient burden. The result provides a range of autonomous, rate-adaptive cardiac pacing capabilities, as demonstrated in rat, canine, and human heart studies. This work establishes an engineering framework for closed-loop temporary electrotherapy using wirelessly linked, body-integrated bioelectronic devices.

Cecal intubation is essential during colonoscopy, and observation of the terminal ileum is performed in most clinical practices. However, data on terminal ileal (TI) ulcers observed incidentally during colonoscopy are rare. We aimed to identify the characteristics and clinical course of TI ulcers observed incidentally during colonoscopy. Between January 2008 and December 2018, medical records from multi-centers reporting asymptomatic subjects who underwent biopsy on TI ulcers during colonoscopy were retrospectively reviewed. The characteristics of endoscopic findings and clinical course of TI ulcers were analyzed, and the factors affecting the clinical course of TI ulcers were evaluated. The median follow-up durations from first to second colonoscopy and from second to third colonoscopy were 20 months (interquartile range, 12–36) and 24 months (interquartile range, 12–34), respectively. A total of 134 subjects were included in the analysis. The histopathologic findings of TI ulcers were mostly chronic or active ileitis/inflammation (92.7%). On the second colonoscopy, 59 (44.0%) patients had no ulcers, 38 (28.4%) showed a decrease in size or number, and 37 (27.6%) patients showed no change in ulcers. Among 62 subjects who underwent a third colonoscopy, 14 (10.4%) had decreased size or number, 10 (7.5%) had no ulcer change, and two (1.5%) had increased ulcer size or number. In multivariate logistic regression analysis, a star shape was the only factor affecting continuation without improvement of incidental TI ulcers. Most TI ulcers observed incidentally showed no unusual findings on biopsy and improved on follow-up colonoscopy without treatment.

During COVID-19, many renowned galleries and art fairs used Virtual Reality (VR) exhibitions for art information dissemination and online displays. To avoid the risks of offline viewing of exhibitions, users can access a web-based VR exhibition platform for remote appreciation of artworks, gaining a rich art experience and thus contributing to physical and mental health. The reasons affecting users’ continued usage intentions are not clear enough in the existing studies of VR exhibitions. Therefore, further studies are needed. This paper explores the relationship between users’ escapist experience, aesthetic experience, presence, emotional responses, and continued usage intention through a survey of VR exhibition users. The survey data were collected from 543 users who had experienced the VR exhibition through an online survey website. The study results show that users’ continued usage intentions are influenced by escapist experience and aesthetic experience. Presence plays a mediating role in the influence of escapist experiences and aesthetic experiences on continued usage intention. Emotional responses play a moderating role in the impact of user experience on continued usage intention. This paper provides a theoretical reference for the study of the impact mechanism of continued usage intention of VR exhibitions from the perspective of mental health. In addition, this study enables VR exhibition platforms to better understand the emotional state of users during art experiences to create and share healthy aesthetic information that can contribute to the management and enhancement of mental health. At the same time, it provides valuable and innovative guidance solutions for the future development of VR exhibitions.

Colonoscopy is a safe and extremely popular diagnostic and therapeutic procedure. The most common complications are bleeding and perforation. Hemoperitoneum is a rare complication after a colonoscopy and is usually associated with splenic injury or solid organ pathology. This is potentially serious and can be life threatening. With the increasing number of colonoscopies performed, there has also been an increasing trend in reports of rare complications, such as pneumothorax, pneumomediastinum, appendicitis, small bowel perforation, septicemia, mesenteric tear, retroperitoneal abscess, and hemoperitoneum. This paper reports a unique case of hemoperitoneum after a recent colonoscopy without a splenic rupture or intra-abdominal abnormality, or external trauma. Most hemoperitoneum occurs within 48 hours after the inciting colonoscopy. In the present case, however, hemoperitoneum appeared 10 days after the colonoscopy. This case emphasizes that physicians should consider hemoperitoneum in a differential diagnosis of abdominal pain in patients after colonoscopy.

This paper examines the relationship between consumer loneliness, boredom, telepresence, influencer-brand image congruence and purchase intention by investigating consumers of live commerce during the COVID-19 period. With the help of an online survey website, survey data was gathered on 550 Chinese customers who experienced live commerce shopping in China. Although previous studies have shown that consumer boredom and loneliness have an impact on purchase intention, the mechanism of influence remains unclear. As a result, additional research is needed to study the link between boredom and loneliness and customer purchase intention. Consumers’ purchase intention was influenced by their feelings of loneliness and boredom. Telepresence played a mediating role in the impact of loneliness and boredom on purchase intention. Influencer-brand image congruence played a moderating role in the impact of consumers’ boredom on purchase intention. The study results contribute to the research of factors impacting consumers’ purchase intention. In addition, this study can help live commerce merchants better understand the impact factors of consumers’ purchase intention and contribute to the development of live commerce.

Adenoma detection rate (ADR) is an important quality indicator of colonoscopy. High-definition (HD) colonoscopy has been reported to increase ADR compared to standard-definition (SD) colonoscopy. Although there are few reports comparing the latest generation and the previous generation of HD colonoscopy equipment, there are reports that the latest generation colonoscopy equipment improves ADR. However, there are no reports on the impact of the latest generation HD colonoscopy on the ADR of trainee endoscopists. The aim of this study was to investigate whether the latest generation HD colonoscopy increases the ADR of trainee endoscopists compared with the previous generation HD colonoscopy. We conducted a retrospective review of medical records of patients aged 40–79 years old, who underwent screening or surveillance colonoscopy performed by nine gastroenterology fellows at Dong-A University Hospital from March 2019 to February 2020. We calculated the overall ratios of the ADR: the ADRs of the group using the older generation HD colonoscopy equipment and the group using the latest HD colonoscopy equipment. Polyp detection rate (PDR), sessile serrated polyp detection rate (SSPDR), and advanced neoplasia detection rate (ANDR) were calculated for each group. Factors related to adenoma detection were identified using logistic regression analysis. Altogether, 2189 patients were included in the study (the older HD colonoscopy group comprising 1183 and the latest HD colonoscopy group comprising 1006). We found that PDR (45.98 vs. 51.69%, p = 0.008) and ADR (35.67 vs. 40.85%, p = 0.013) were significantly higher in the latest generation HD colonoscopy group. The generational differences were not statistically significant for SSPDR (1.94 vs. 2.78%, p = 0.195) or ANDR (4.65 vs. 4.97%, p = 0.726). In the multivariate regression analysis, age, male sex, the latest generation HD colonoscopy, and long withdrawal time were the most significant factors affecting adenoma detection. The latest generation HD colonoscopy improved PDR and ADR by trainee endoscopists. These findings suggest that latest generation, higher-resolution colonoscopy equipment can improve the quality of colonoscopy for less experienced endoscopists.

Standard clinical care in neonatal and pediatric intensive-care units (NICUs and PICUs, respectively) involves continuous monitoring of vital signs with hard-wired devices that adhere to the skin and, in certain instances, can involve catheter-based pressure sensors inserted into the arteries. These systems entail risks of causing iatrogenic skin injuries, complicating clinical care and impeding skin-to-skin contact between parent and child. Here we present a wireless, non-invasive technology that not only offers measurement equivalency to existing clinical standards for heart rate, respiration rate, temperature and blood oxygenation, but also provides a range of important additional features, as supported by data from pilot clinical studies in both the NICU and PICU. These new modalities include tracking movements and body orientation, quantifying the physiological benefits of skin-to-skin care, capturing acoustic signatures of cardiac activity, recording vocal biomarkers associated with tonality and temporal characteristics of crying and monitoring a reliable surrogate for systolic blood pressure. These platforms have the potential to substantially enhance the quality of neonatal and pediatric critical care. Soft electronic patches worn on the skin of infants or children in intensive-care units have a wide range of capabilities in aiding critical care, including monitoring of hemodynamic parameters, cardiac activity, movement and crying.

Important insights into human health can be obtained through the non-invasive collection and detailed analysis of sweat, a biofluid that contains a wide range of essential biomarkers. Skin-interfaced microfluidic platforms, characterized by soft materials and thin geometries, offer a collection of capabilities for in situ capture, storage, and analysis of sweat and its constituents. In ambulatory uses cases, the ability to provide real-time feedback on sweat loss, rate and content, without visual inspection of the device, can be important. This paper introduces a low-profile skin-interfaced system that couples disposable microfluidic sampling devices with reusable 'stick-on' electrodes and wireless readout electronics that remain isolated from the sweat. An ultra-thin capping layer on the microfluidic platform permits high-sensitivity, contactless capacitive measurements of both sweat loss and sweat conductivity. This architecture avoids the potential for corrosion of the sensing components and eliminates the need for cleaning/sterilizing the electronics, thereby resulting in a cost-effective platform that is simple to use. Optimized electrode designs follow from a combination of extensive benchtop testing, analytical calculations and FEA simulations for two sensing configurations: (1) sweat rate and loss, and (2) sweat conductivity, which contains information about electrolyte content. Both configurations couple to a flexible, wireless electronics platform that digitizes and transmits information to Bluetooth-enabled devices. On-body field testing during physical exercise validates the performance of the system in scenarios of practical relevance to human health and performance.

BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain, abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease. CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication. CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease. Thus, thorough history-taking and clinical suspicion of parasitic infection are important.

Hydrophilic polyamide copolymers were successfully synthesized based on Nylon 6 and Nylon 46. This study aims to synthesize hydrophilic polyamides with moisture regain ability comparable to that of cotton. Random copolymers of nylon 6 and nylon 46 did not exhibit moisture regain rates higher than 6 %. A limited introduction of trifunctional monomer, diethylenetriamine (TA) produced the polyamides with higher mechanical strengths but failed to enhance the moisture regain. The incorporation of poly(ethylene oxide) oligomer with amine end groups increased the moisture regain but resulted in poor hydro-thermal and mechanical strength. A synergic effect was observed for copolymers which contain both nylon 46 units and PEO oligomer in regards to moisture regain capacity. Furthermore, the poor hydro-thermal and mechanical strength of Nylon/PEO segmented polyamides were drastically improved by the introduction of diethylenetriamine (TA). This study demonstrated that the polyamide copolymers comprising both PEO oligomer and TA unit record tensile moduli over 3 GPa and moisture regain rates of 8–10 wt%.

Background: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Healthcare workers are at a higher risk for exposure to COVID-19 infection than the general population. During the COVID-19 pandemic, endoscopists are recommended to wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission. However, to the best of our knowledge, there are no reports on the impact of face shields on the quality of colonoscopy. This study aimed to determine whether the use of PPE, including face shields, affects the quality of colonoscopy during the COVID-19 pandemic.Methods: We retrospectively reviewed the medical records of patients who underwent screening or surveillance colonoscopy performed at Dong-A University Hospital between June 2020 and March 2021 during the COVID-19 pandemic. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists additionally wore face shields. Therefore, we compared the colonoscopy quality indicators during the 5 months without the use of face shields and the 5 months with the use of face shields. We calculated the overall adenoma detection rates (ADRs) of the group using face shields and the group not using face shields. Further, the polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), polyp per colonoscopy, and adenoma per colonoscopy were calculated for each group.Results: In total, 1,359 patients were included in the study; the face shield and non-face shield groups comprised 679 and 680 patients, respectively. We found no statistically significant differences in the PDR (49.04 vs. 52.50%, p=0.202), ADR (38.59 vs. 38.97%, p=0.884) SSPDR (1.91 vs. 1.32%, p=0.388), and ANDR (3.98 vs. 3.97%, p=0.991) between the groups. In both the experienced endoscopist group and trainee endoscopist group, there was no difference in the colonoscopy quality indicators between the groups of patients examined by endoscopists with and without face shields.Conclusions: The quality indicators of colonoscopy were not affected by face shields during the COVID-19 pandemic.

Significance Monitoring vital signs for laboring women and their fetuses is foundational to the delivery of obstetrical care; however, monitoring platforms for pregnancy have undergone little innovation over the last several decades with many low-income settings lacking basic access. We report a new time-synchronized, flexible, and wireless sensor system applicable across the entire continuum of antepartum and postpartum care that provides continuous, comprehensive, and noninvasive monitoring (heart rate, respiratory rate, and pulse oxygenation) compatible with a wide range of mobile devices. This system offers advanced features such as continuous blood pressure, uterine electrohysterography, and automated body position classification. We further demonstrate the performance of this new system among pregnant individuals (n = 576) in both high-resource settings and low-resource care settings., Vital signs monitoring is a fundamental component of ensuring the health and safety of women and newborns during pregnancy, labor, and childbirth. This monitoring is often the first step in early detection of pregnancy abnormalities, providing an opportunity for prompt, effective intervention to prevent maternal and neonatal morbidity and mortality. Contemporary pregnancy monitoring systems require numerous devices wired to large base units; at least five separate devices with distinct user interfaces are commonly used to detect uterine contractility, maternal blood oxygenation, temperature, heart rate, blood pressure, and fetal heart rate. Current monitoring technologies are expensive and complex with implementation challenges in low-resource settings where maternal morbidity and mortality is the greatest. We present an integrated monitoring platform leveraging advanced flexible electronics, wireless connectivity, and compatibility with a wide range of low-cost mobile devices. Three flexible, soft, and low-profile sensors offer comprehensive vital signs monitoring for both women and fetuses with time-synchronized operation, including advanced parameters such as continuous cuffless blood pressure, electrohysterography-derived uterine monitoring, and automated body position classification. Successful field trials of pregnant women between 25 and 41 wk of gestation in both high-resource settings (n = 91) and low-resource settings (n = 485) demonstrate the system’s performance, usability, and safety.

Sparganosis is a parasitic infestation caused by sparganum, a plerocercoid tapeworm larva of the genus Spirometra. Since the first case of human sparganosis reported in 1908, sparganosis has been a global disease, and is common in China, Japan, and Southeast Asian countries. Consumption of raw snakes, frogs, fish, or drinking contaminated beverages are sources of human infections. Human sparganosis usually manifests in subcutaneous fat in areas such as the abdomen, genitourinary tract, and limbs. Breast sparganosis cases are rare, representing less than 2% of total cases of human infections. Complete surgical extraction of the sparganum is the treatment of choice. Because of the rarity of the disease, clinical suspicion is vital to reach the diagnosis of breast sparganosis. Here we report 2 rare cases of breast sparganosis presenting with a painless breast lump, both treated with surgical excision and sparganum extraction.

This study assessed the impact of the artistic program of the Winter Olympics opening ceremony event on international spectators’ national image branding of the host country and their intention to ...

Significance Continuous measurements of health status can be used to guide the care of patients and to manage the spread of infectious diseases. Conventional monitoring systems cannot be deployed outside of hospital settings, and existing wearables cannot capture key respiratory biomarkers. This paper describes an automated wireless device and a data analysis approach that overcome these limitations, tailored for COVID-19 patients, frontline health care workers, and others at high risk. Vital signs and respiratory activity such as cough can reveal early signs of infection and quantitate responses to therapeutics. Long-term trials on COVID-19 patients in clinical and home settings demonstrate the translational value of this technology., Capabilities in continuous monitoring of key physiological parameters of disease have never been more important than in the context of the global COVID-19 pandemic. Soft, skin-mounted electronics that incorporate high-bandwidth, miniaturized motion sensors enable digital, wireless measurements of mechanoacoustic (MA) signatures of both core vital signs (heart rate, respiratory rate, and temperature) and underexplored biomarkers (coughing count) with high fidelity and immunity to ambient noises. This paper summarizes an effort that integrates such MA sensors with a cloud data infrastructure and a set of analytics approaches based on digital filtering and convolutional neural networks for monitoring of COVID-19 infections in sick and healthy individuals in the hospital and the home. Unique features are in quantitative measurements of coughing and other vocal events, as indicators of both disease and infectiousness. Systematic imaging studies demonstrate correlations between the time and intensity of coughing, speaking, and laughing and the total droplet production, as an approximate indicator of the probability for disease spread. The sensors, deployed on COVID-19 patients along with healthy controls in both inpatient and home settings, record coughing frequency and intensity continuously, along with a collection of other biometrics. The results indicate a decaying trend of coughing frequency and intensity through the course of disease recovery, but with wide variations across patient populations. The methodology creates opportunities to study patterns in biometrics across individuals and among different demographic groups.

Smartphone-compatible, wireless, battery-free hydration sensors can monitor skin diseases in any environment., Present-day dermatological diagnostic tools are expensive, time-consuming, require substantial operational expertise, and typically probe only the superficial layers of skin (~15 μm). We introduce a soft, battery-free, noninvasive, reusable skin hydration sensor (SHS) adherable to most of the body surface. The platform measures volumetric water content (up to ~1 mm in depth) and wirelessly transmits data to any near-field communication–compatible smartphone. The SHS is readily manufacturable, comprises unique powering and encapsulation strategies, and achieves high measurement precision (±5% volumetric water content) and resolution (±0.015°C skin surface temperature). Validation on n = 16 healthy/normal human participants reveals an average skin water content of ~63% across multiple body locations. Pilot studies on patients with atopic dermatitis (AD), psoriasis, urticaria, xerosis cutis, and rosacea highlight the diagnostic capability of the SHS (PAD = 0.0034) and its ability to study impact of topical treatments on skin diseases.

Capabilities in continuous monitoring of key physiological parameters of disease have never been more important than in the context of the global COVID-19 pandemic. Soft, skin-mounted electronics that incorporate high-bandwidth, miniaturized motion sensors represent a powerful class of technology for digital, wireless measurements of mechano-acoustic (MA) signatures of both core vital signs (heart rate, respiratory rate, and temperature) and underexplored biomarkers (coughing count) with high fidelity and immunity to ambient noises. Here, we introduce an effort that integrates such an MA sensor, a cloud data infrastructure and data analytics approaches based on digital filtering and convolutional neural networks for comprehensive monitoring of COVID-19 infections in sick and healthy individuals in a population, both in the hospital and the home. This hardware/software system extracts diverse signatures of health status in an automated fashion from a single device and time series data stream. Unique features are in quantitative measurements of coughing and other vocal events, as indicators of both disease and infectiousness. Systematic imaging studies demonstrate direct correlations between the time and intensity of coughing, speaking and laughing and the total droplet production, as an approximate indicator of the probability for disease spread. The sensors, deployed on COVID-19 patients along with healthy controls in both inpatient and home settings, record coughing frequency and intensity continuously, along with a comprehensive collection of other biometrics, with recording times for individuals of more than a month after disease diagnosis. These pilot studies include 3,111 hours of data spanning 363 days from 37 COVID-19 patients (20 females, 17 males) with 27,651 coughs detected in total along with continuous measurements of heart rate, respiratory rate, physical activity, and skin temperature. Manual labeling of randomly sampled 10,258 vocal events from 11 COVID-19 patients (6 females, 5 males) suggests a sensitivity of 85% and a specificity of 96% in cough detection using automated algorithms. The collective results indicate a decaying trend of coughing frequency and intensity through the course of disease recovery, but with wide variations across patient populations. The methodology also opens opportunities to study patterns in biometrics across individuals and among different demographic groups.

Important insights into human health can be obtained through the non-invasive collection and detailed analysis of sweat, a biofluid that contains a wide range of essential biomarkers. Skin-interfaced microfluidic platforms, characterized by soft materials and thin geometries, offer a collection of capabilities for in situ capture, storage, and analysis of sweat and its constituents. In ambulatory uses cases, the ability to provide real-time feedback on sweat loss, rate and content, without visual inspection of the device, can be important. This paper introduces a low-profile skin-interfaced system that couples disposable microfluidic sampling devices with reusable 'stick-on' electrodes and wireless readout electronics that remain isolated from the sweat. An ultra-thin capping layer on the microfluidic platform permits high-sensitivity, contactless capacitive measurements of both sweat loss and sweat conductivity. This architecture avoids the potential for corrosion of the sensing components and eliminates the need for cleaning/sterilizing the electronics, thereby resulting in a cost-effective platform that is simple to use. Optimized electrode designs follow from a combination of extensive benchtop testing, analytical calculations and FEA simulations for two sensing configurations: (1) sweat rate and loss, and (2) sweat conductivity, which contains information about electrolyte content. Both configurations couple to a flexible, wireless electronics platform that digitizes and transmits information to Bluetooth-enabled devices. On-body field testing during physical exercise validates the performance of the system in scenarios of practical relevance to human health and performance.

Precise form-fitting of prosthetic sockets is important for the comfort and well-being of persons with limb amputations. Capabilities for continuous monitoring of pressure and temperature at the skin-prosthesis interface can be valuable in the fitting process and in monitoring for the development of dangerous regions of increased pressure and temperature as limb volume changes during daily activities. Conventional pressure transducers and temperature sensors cannot provide comfortable, irritation-free measurements because of their relatively rigid construction and requirements for wired interfaces to external data acquisition hardware. Here, we introduce a millimeter-scale pressure sensor that adopts a soft, three-dimensional design that integrates into a thin, flexible battery-free, wireless platform with a built-in temperature sensor to allow operation in a noninvasive, imperceptible fashion directly at the skin-prosthesis interface. The sensor system mounts on the surface of the skin of the residual limb, in single or multiple locations of interest. A wireless reader module attached to the outside of the prosthetic socket wirelessly provides power to the sensor and wirelessly receives data from it, for continuous long-range transmission to a standard consumer electronic device such as a smartphone or tablet computer. Characterization of both the sensor and the system, together with theoretical analysis of the key responses, illustrates linear, accurate responses and the ability to address the entire range of relevant pressures and to capture skin temperature accurately, both in a continuous mode. Clinical application in two prosthesis users demonstrates the functionality and feasibility of this soft, wireless system.

Healthcare systems have increased patients’ exposure to their own health materials to enhance patients’ health levels, but this has been impeded by patients’ lack of understanding of their health material. We address potential barriers to their comprehension by developing a context-aware text simplification system for health material. Given the scarcity of annotated parallel corpora in healthcare domains, we design our system to be independent of a parallel corpus, complementing the availability of data-driven neural methods when such corpora are available. Our system compensates for the lack of direct supervision using a biomedical lexical database: Unified Medical Language System (UMLS). Compared to a competitive prior approach that uses a tool for identifying biomedical concepts and a consumer-directed vocabulary list, we empirically show the enhanced accuracy of our system due to improved handling of ambiguous terms. We also show the enhanced accuracy of our system over directly-supervised neural methods in this low-resource setting. Finally, we show the direct impact of our system on laypeople’s comprehension of health material via a human subjects’ study (n=160).

Small, wireless dosimeters with light-adaptive, ultralow power consumption continuously monitor personalized light exposure., Exposure to electromagnetic radiation (EMR) from the sun and from artificial lighting systems represents a modifiable risk factor for a broad range of health conditions including skin cancer, skin aging, sleep and mood disorders, and retinal damage. Technologies for personalized EMR dosimetry could guide lifestyles toward behaviors that ensure healthy levels of exposure. Here, we report a millimeter-scale, ultralow-power digital dosimeter platform that provides continuous EMR dosimetry in an autonomous mode at one or multiple wavelengths simultaneously, with time-managed wireless, long-range communication to standard consumer devices. A single, small button cell battery supports a multiyear life span, enabled by the combined use of a light-powered, accumulation mode of detection and a light-adaptive, ultralow-power circuit design. Field studies demonstrate single- and multimodal dosimetry platforms of this type, with a focus on monitoring short-wavelength blue light from indoor lighting and display systems and ultraviolet/visible/infrared radiation from the sun.