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Various measurement campaigns and studies have been conducted on the sub-THz frequency band (above 100 GHz) for potential future mobile communication use. However, collecting sufficient measurement data is challenging due to the high pathloss, and there is also a possibility that the measurement data is biased from measurement equipment outages. This letter proposes a ray-tracing simulation to complement measurements of the 159 GHz band in an urban street-canyon. Using virtual measurement points generated by a ray-tracing simulator, the pathloss exponent of the 159 GHz band is estimated after checking some results against the measurement data. In the censored environment, the pathloss estimation result is compared with the ray-tracing using the Tobit Maximum Likelihood (ML) estimation. The results show that the pathloss exponent estimated by ray tracing simulation with virtual measurement points matches the result of the ML estimation method. Based on these, small scale channel parameters such as a delay spread and angular spreads were also estimated, and they can be used for 159 GHz channel simulation.

ObjectivesThe effect of subclinical leaflet thrombosis, characterised by hypoattenuated leaflet thickening (HALT), on the valve haemodynamic function and durability of the bioprosthetic valve, is not yet determined. We determined the impact of HALT on valve haemodynamics after transcatheter aortic valve replacement (TAVR) and the predictors of haemodynamic structural valve deterioration (SVD).MethodsThe Anticoagulation vs Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization after Transcatheter Aortic Valve Replacement(ADAPT-TAVR) trial is a multicenter, randomised trial that compared edoxaban and dual antiplatelet therapy in patients who had undergone successful TAVR. The presence of HALT was evaluated by four-dimensional CT at 6 months and serial echocardiography performed at baseline, immediately post-TAVR and after 6 months. SVD was defined as at least one of the following: (1) mean transprosthetic gradient ≥20 mm Hg, (2) change in the mean gradient ≥10 mm Hg from baseline, or (3) new or increase in intraprosthetic aortic regurgitation of at least ≥1 grade, resulting in moderate or greater regurgitation.ResultsAt 6 months, HALT was found in 30 of 211 (14.2%) patients. The presence of HALT did not significantly affect aortic valve mean gradients (with vs without HALT; 14.0±4.8 mm Hg vs 13.7±5.5 mm Hg; p=0.74) at 6 months. SVD was reported in 30 of 206 patients (14.6%) at 6-month follow-up echocardiography. Older age (OR: 1.138; 95% CI: 1.019 to 1.293; p=0.033), use of aortic valve size ≤23 mm (OR: 6.254; 95% CI: 2.230 to 20.569; p=0.001) and mean post-TAVR pressure gradient (OR: 1.233; 95% CI: 1.123 to 1.371; p<0.001) were independent predictors of haemodynamic SVD; however, the presence of HALT was not identified as a predictor of SVD.ConclusionsIn patients who had undergone successful TAVR, aortic valve haemodynamic status was not influenced by the presence of HALT. Although HALT was not a predictor of haemodynamic SVD at 6 months, it warrants further longer-term follow-up to evaluate the effect on long-term valve durability.Trial registration numberNCT03284827(https://www.clinicaltrials.gov).

The ongoing COhort for Childhood Origin of Asthma and allergic diseases (COCOA) study is a prospective birth cohort investigating the origin and natural courses of childhood allergic diseases, including atopic dermatitis, food allergy, allergic rhinitis and asthma, with long-term prognosis. Initiated under the premise that allergic diseases result from a complex interplay of immune development alterations, environmental exposures, and host susceptibility, the COCOA study explores these dynamic interactions during prenatal and postnatal periods, framed within the hygiene and microbial hypotheses alongside the developmental origins of health and disease (DOHaD) hypothesis. The scope of the COCOA study extends to genetic predispositions, indoor and outdoor environmental variables affecting mothers and their offsprings such as outdoor and indoor air pollution, psychological factors, diets, and the microbiomes of skin, gut, and airway. We have embarked on in-depth investigations of diverse risk factors and the pathophysiological underpinnings of allergic diseases. By employing multi-omics approaches—proteomics, transcriptomics, and metabolomics—we gain deeper insights into the distinct pathophysiological processes across various endotypes of childhood allergic diseases, incorporating the exposome using extensive resources within the COCOA study. Integration with large-scale datasets, such as national health insurance records, enhances robustness and mitigates potential limitations inherent to birth cohort studies. As part of global networks focused on childhood allergic diseases, the COCOA study fosters collaborative research across multiple cohorts. The findings from the COCOA study are instrumental in informing precision medicine strategies for childhood allergic diseases, underpinning the establishment of disease trajectories.

IMPORTANCE: The NIFTY trial demonstrated the benefit of treatment with second-line liposomal irinotecan (nal-IRI) plus fluorouracil (FU) and leucovorin (LV) for patients with advanced biliary tract cancer (BTC). OBJECTIVE: To report the updated efficacy outcomes from the NIFTY trial with extended follow-up of 1.3 years with reperformed masked independent central review (MICR) with 3 newly invited radiologists. DESIGN, SETTING, AND PARTICIPANTS: The NIFTY trial was a randomized, multicenter, open-label, phase 2b clinical trial conducted between September 5, 2018, and December 31, 2021, at 5 tertiary referral centers in South Korea. Patients with advanced BTC whose disease progressed while receiving first-line gemcitabine plus cisplatin with at least 1 measurable lesion per Response Evaluation Criteria in Solid Tumors, version 1.1, were eligible. Data analysis was completed on May 9, 2022. INTERVENTIONS: Patients were randomized 1:1 to receive LV, 400 mg/m2, bolus and FU, 2400 mg/m2, for a 46-hour infusion intravenously every 2 weeks with or without nal-IRI, 70 mg/m2, before LV intravenously. Patients were treated until disease progression or unacceptable toxic effects. MAIN OUTCOMES AND MEASURES: Primary end point was progression-free survival (PFS) as assessed by MICR. Secondary end points were PFS as assessed by the investigator, overall survival, and objective response rate. RESULTS: A total of 178 patients (75 women [42.1%]; median [IQR] age, 64 [38-84] years) were randomly assigned, and 174 patients were included in the full analysis set (88 patients [50.6%] in the nal-IRI plus FU/LV group vs 86 patients [49.4%] in the FU/LV alone group). In this updated analysis, the median MICR-assessed PFS was 4.2 months (95% CI, 2.8-5.3) for the nal-IRI plus FU/LV group and 1.7 months (95% CI, 1.4-2.6) for the FU/LV alone group (hazard ratio, 0.61; 95% CI, 0.44-0.86; P = .004), in contrast to the 7.1 and 1.4 months reported in the previous study, respectively. The discordance rate for tumor progression date between the MICR and investigators was 17.8% (vs 30% in the previous study). CONCLUSIONS AND RELEVANCE: The NIFTY randomized clinical trial demonstrated significant improvement in PFS with treatment with nal-IRI plus FU/LV compared with FU/LV alone for patients with advanced BTC after progression to gemcitabine plus cisplatin. The combination of nal-IRI plus FU/LV could be considered as a second-line treatment option for patients with previously treated advanced BTC. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT03524508

Personalized survival prediction is important in gastric cancer patients after gastrectomy based on large datasets with many variables including time‐varying factors in nutrition and body morphometry. One year after gastrectomy might be the optimal timing to predict long‐term survival because most patients experience significant nutritional change, muscle loss, and postoperative changes in the first year after gastrectomy. We aimed to develop a personalized prognostic artificial intelligence (AI) model to predict 5 year survival at 1 year after gastrectomy. From a prospectively built gastric surgery registry from a tertiary hospital, 4025 gastric cancer patients (mean age 56.1 ± 10.9, 36.2% females) treated gastrectomy and survived more than a year were selected. Eighty‐nine variables including clinical and derived time‐varying variables were used as input variables. We proposed a multi‐tree extreme gradient boosting (XGBoost) algorithm, an ensemble AI algorithm based on 100 datasets derived from repeated five‐fold cross‐validation. Internal validation was performed in split datasets (n= 1121) by comparing our proposed model and six other AI algorithms. External validation was performed in 590 patients from other hospitals (mean age 55.9 ± 11.2, 37.3% females). We performed a sensitivity analysis to analyse the effect of the nutritional and fat/muscle indices using a leave‐one‐out method. In the internal validation, our proposed model showed AUROC of 0.8237, which outperformed the other AI algorithms (0.7988–0.8165), 80.00% sensitivity, 72.34% specificity, and 76.17% balanced accuracy. In the external validation, our model showed AUROC of 0.8903, 86.96% sensitivity, 74.60% specificity, and 80.78% balanced accuracy. Sensitivity analysis demonstrated that the nutritional and fat/muscle indices influenced the balanced accuracy by 0.31% and 6.29% in the internal and external validation set, respectively. Our developed AI model was published on a website for personalized survival prediction. Our proposed AI model provides substantially good performance in predicting 5 year survival at 1 year after gastric cancer surgery. The nutritional and fat/muscle indices contributed to increase the prediction performance of our AI model.

This letter presents our 159 GHz measurements collected in an urban microcellular (UMi) environment and provides synthesized beamwidth-related propagation characteristics. Our directional antenna measurements include line-of-sight (LoS) scenarios (distances up to 170 m) and non-LoS (NLoS) (distances up to 97 m). To validate the synthesized beamwidth characteristics, an omnidirectional antenna was also used. So far, to the best of our knowledge, two organizations (NYU and USC) have reported their measurement-based propagation characteristics for UMi, especially including NLoS, at frequencies above 100 GHz. We compare our data with the two organizations’ data as well as the frequency-extrapolated 3GPP model.

In this paper, we propose an accurate and rapid non-rigid registration method between blood vessels in temporal 3D cardiac computed tomography angiography images of the same patient. This method provides auxiliary information that can be utilized in the diagnosis and treatment of coronary artery diseases. The proposed method consists of the following four steps. First, global registration is conducted through rigid registration between the 3D vessel centerlines obtained from temporal 3D cardiac CT angiography images. Second, point matching between the 3D vessel centerlines in the rigid registration results is performed, and the corresponding points are defined. Third, the outliers in the matched corresponding points are removed by using various information such as thickness and gradient of the vessels. Finally, non-rigid registration is conducted for hierarchical local transformation using an energy function. The experiment results show that the average registration error of the proposed method is 0.987 mm, and the average execution time is 2.137 s, indicating that the registration is accurate and rapid. The proposed method that enables rapid and accurate registration by using the information on blood vessel characteristics in temporal CTA images of the same patient.

Overexpression of the BCL2 protein has been reported as a poor prognostic factor for diffuse large B-cell lymphoma (DLBCL). However, there are currently no standardized criteria for evaluating BCL2 protein expression. We aimed to evaluate the prognostic value of BCL2 expression determined by immunohistochemistry (IHC), incorporating both the staining intensity and proportion, in patients with de novo DLBCL who received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as first-line treatment. We defined tumors with BCL2 expression in nearly all tumor cells with a uniformly strong intensity by IHC as BCL2 super-expressor. The BCL2 super-expressors (n= 35) showed significantly worse event-free survival (EFS; HR, 1.903; 95% CI, 1.159–3.126, P= 0.011) and overall survival (OS; HR, 2.467; 95% CI, 1.474–4.127, P= 0.001) compared with the non-BCL2 super-expressors (n= 234) independent of the international prognostic index (IPI), cell of origin (COO), and double expressor status in the training set (n= 269). The adverse prognostic impact of BCL2 super-expression was confirmed in the validation set (n= 195). When the survival outcomes were evaluated in the entire cohort (n= 464), BCL2 super-expressor group was significantly associated with inferior EFS and OS regardless of IPI, COO, MYC expression, and stages. BCL2 super-expressors had genetic aberrations enriched in the NOTCHand TP53signaling pathways. This study suggests that the BCL2 super-expressor characterizes a distinct subset of DLBCL with a poor prognosis and warrants further investigation as a target population for BCL-2 inhibitors.

Owing to the difficulties associated with conducting millimeter‐wave (mmWave) field measurements, especially in high‐speed train (HST) environments, most propagation channels for mmWave HST have been studied using methods based on simulation rather than measurement. In this study, considering a linear cell layout in which base stations are installed along a railway, measurements were performed at 28 GHz with a speed up to 170 km/h in two prevalent HST scenarios: viaduct and tunnel scenarios. By observing the channel impulse responses, we could identify single‐ and double‐bounced multipath components (MPCs) caused by railway static structures such as overhead line equipment. These MPCs affect the delay spread and Doppler characteristics significantly. Moreover, we observed distinct path loss behaviors for the two scenarios, although both are considered line‐of‐sight (LoS) scenarios. In the tunnel scenario, the path loss exponent (PLE) is 1.3 owing to the waveguide effect, which indicates that the path loss is almost constant with respect to distance. However, the LoS PLE in the viaduct scenario is 2.46, which is slightly higher than the free‐space loss.

Despite central nervous system (CNS) relapse occurring in >10% of high-risk diffuse large B-cell lymphoma (DLBCL) patients, the role of CNS-directed prophylaxis is controversial in the absence of randomized controlled trials. In this retrospective study, we aimed to evaluate the safety and efficacy of prophylactic high-dose methotrexate (HD-MTX) on CNS relapse and survival outcomes in 258 newly diagnosed R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)–treated high-risk DLBCL patients, based on the initial treatment intent (ITT) of the physician on the use of prophylactic HD-MTX. Patients were classified into an ITT HD-MTX group (n = 128) and a non-ITT HD-MTX group (n = 130). The CNS relapse rate was not significantly different between these groups, with 2-year CNS relapse rates of 12.4% and 13.9%, respectively (P = 0.96). Three-year progression-free survival and overall survival rates in the ITT HD-MTX and non-ITT HD-MTX groups were 62.4% vs 64.5% (P = 0.94) and 71.7% vs 71.4% (P = 0.7), respectively. Also, propensity score–matched analyses showed no significant differences in the time-to-CNS-relapse, progression-free survival, or overall survival. The ITT HD-MTX group showed a higher incidence of grade ≥ 3 oral mucositis and elevated alanine aminotransferase. Prophylactic HD-MTX does not improve CNS relapse rate or survival outcomes in high-risk DLBCL patients, and it is accompanied by increased toxicities.

Purpose:Microvascular invasion (MVI) is an important prognostic factor in patients with hepatocellular carcinoma (HCC). However, the reported results of magnetic resonance imaging (MRI) features for predicting MVI of HCC are variable and conflicting. Therefore, this meta-analysis aimed to identify the significant MRI features for MVI of HCC and to determine their diagnostic value. Methods:Original studies reporting the diagnostic performance of MRI for predicting MVI of HCC were identified in MEDLINE and EMBASE up until January 15, 2020. Study quality was assessed using QUADAS-2. A bivariate random-effects model was used to calculate the meta-analytic pooled diagnostic odds ratio (DOR) and 95% confidence interval (CI) for each MRI feature for diagnosing MVI in HCC. The meta-analytic pooled sensitivity and specificity were calculated for the significant MRI features. Results:Among 235 screened articles, we found 36 studies including 4,274 HCCs. Of the 15 available MRI features, 7 were significantly associated with MVI: larger tumor size (>5 cm) (DOR = 5.2, 95% CI [3.0–9.0]), rim arterial enhancement (4.2, 95% CI [1.7–10.6]), arterial peritumoral enhancement (4.4, 95% CI [2.8–6.9]), peritumoral hypointensity on hepatobiliary phase imaging (HBP) (8.2, 95% CI [4.4–15.2]), nonsmooth tumor margin (3.2, 95% CI [2.2–4.4]), multifocality (7.1, 95% CI [2.6–19.5]), and hypointensity on T1-weighted imaging (T1WI) (4.9, 95% CI [2.5–9.6]). Both peritumoral hypointensity on HBP and multifocality showed very high meta-analytic pooled specificities for diagnosing MVI (91.1% [85.4–94.8%] and 93.3% [74.5–98.5%], respectively). Conclusions:Seven MRI features including larger tumor size, rim arterial enhancement, arterial peritumoral enhancement, peritumoral hypointensity on HBP, nonsmooth margin, multifocality, and hypointensity on T1WI were significant predictors for MVI of HCC. These MRI features predictive of MVI can be useful in the management of HCC.

Data suggest that various dietary interventions slow kidney disease progression and improve clinical outcomes for those with chronic kidney disease (CKD). However, the association between plant protein intake and incident CKD has been uncertain.

Overexpression of the BCL2 protein has been reported as a poor prognostic factor for diffuse large B-cell lymphoma (DLBCL). However, there are currently no standardized criteria for evaluating BCL2 protein expression. We aimed to evaluate the prognostic value of BCL2 expression determined by immunohistochemistry (IHC), incorporating both the staining intensity and proportion, in patients with de novo DLBCL who received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as first-line treatment. We defined tumors with BCL2 expression in nearly all tumor cells with a uniformly strong intensity by IHC as BCL2 super-expressor. The BCL2 super-expressors (n= 35) showed significantly worse event-free survival (EFS; HR, 1.903; 95% CI, 1.159–3.126, P= 0.011) and overall survival (OS; HR, 2.467; 95% CI, 1.474–4.127, P= 0.001) compared with the non-BCL2 super-expressors (n= 234) independent of the international prognostic index (IPI), cell of origin (COO), and double expressor status in the training set (n= 269). The adverse prognostic impact of BCL2 super-expression was confirmed in the validation set (n= 195). When the survival outcomes were evaluated in the entire cohort (n= 464), BCL2 super-expressor group was significantly associated with inferior EFS and OS regardless of IPI, COO, MYC expression, and stages. BCL2 super-expressors had genetic aberrations enriched in the NOTCHand TP53signaling pathways. This study suggests that the BCL2 super-expressor characterizes a distinct subset of DLBCL with a poor prognosis and warrants further investigation as a target population for BCL-2 inhibitors.

Measuring the diffraction loss for high frequencies, long distances, and large diffraction angles is difficult because of the high path loss. Securing a well‐controlled environment to avoid reflected waves also makes long‐range diffraction measurements challenging. Thus, the prediction of diffraction loss at millimeter‐wave frequency bands relies on theoretical models, such as the knife‐edge diffraction (KED) and geometrical theory of diffraction (GTD) models; however, these models produce different diffraction losses even under the same environment. Our observations revealed that the KED model underestimated the diffraction loss in a large Fresnel‐Kirchhoff diffraction parameter environment. We collected power‐delay profiles when millimeter waves propagated over a building rooftop at millimeter‐wave frequency bands and calculated the diffraction losses from the measurements while eliminating the multipath effects. Comparisons between the measurements and the KED and GTD diffraction‐loss models are shown. Based on the measurements, an approximation model is also proposed that provides a simple method for calculating the diffraction loss using geometrical parameters.

The overall incidence of pseudoprogression is 6% and less than 10% in subgroups according to the definition of pseudoprogression, cancer type, and drug type.

Although previous studies had reported an important role of interleukin 13 (IL13) and its genetic polymorphisms in atopic dermatitis (AD), many of these previous reports focused on the missense variant rs20541 (Gln144Arg) without fine mapping of the gene region.

Assuming omnidirectional antenna reception, the ITU‐R recently developed a new propagation model on building entry loss (BEL) for 5G millimeter‐wave frequency sharing and compatibility studies, which is a simplified outdoor‐to‐indoor path loss model. Considering the utilization of high‐gain narrow‐beamwidth beamforming, the omnidirectional‐based ITU‐R BEL model may not be appropriate to predict propagation characteristics for directional beamforming scenarios. This paper studies the effects of beamwidth on the ITU‐R BEL model. This study is based on field measurements collected with four different beamwidth antennas: omnidirectional, 10° horn, 30° horn, and 60° horn. The measurement campaigns were conducted at two types of building sites: traditional and thermally efficient buildings. These sites, as well as the measurement scenarios, were carefully chosen to comply with the ITU‐R BEL measurement guidelines and the ITU‐R building types. We observed the importance of accurate beam alignment from the BEL variation range. We were able to quantify the beamwidth dependency by fitting to a model that is inversely proportional to the beamwidth.

Mold exposure in early life may be associated with development of atopic dermatitis; however, studies of this link are inconclusive and evidence for the underlying mechanism(s) is lacking. This study identified the association between the time of mold exposure and development of atopic dermatitis and investigated the underlying mechanisms.

In gastrectomy for gastric cancer, oncologic safety including secure resection margin is considered important while less attention is given to maximizing remnant stomach volume (RSV). Nutrition and body composition are important postoperative factors for patient well-being. In this prospective observational study, we investigated the effects of RSV and anastomosing method on nutrition, anemia, and body composition change.

Immune checkpoint inhibitors (ICIs) have become an effective therapeutic option for colorectal cancer and studies on these drugs have therefore increased greatly. Efficacy assessments of ICIs in preclinical orthotopic colorectal cancer using MRI have not been reported however due to the difficulties in conducting colorectal imaging. The purpose of this present study was to investigate the feasibility of using magnetic resonance colonography (MRC) to evaluate the efficacy of an ICI, an anti-PD-L1 antibody, in an orthotopic colorectal cancer mouse model. The mouse model was generated by the engraftment of colorectal cancer cells into the submucosal layer of the colon. Anti-cancer efficacy was assessed by tumor volume and metastatic tumor number analyses, and these values were significantly lower in the PD-L1 antibody-treated group compared to the controls. Histological analyses using H&E and Ki-67 immunohistochemical staining confirmed a highly efficacious tumor growth inhibition and enhanced infiltration by CD4+ and CD8+ lymphocytes in the PD-L1 antibody-treated group. We conclude that MRC has the potential to be used for ICI efficacy assessments against orthotopic colorectal cancer mouse model.

Background: Surgically resected grade 1–2 (G1-2) pancreatic neuroendocrine tumors (PanNETs) exhibit diverse clinical outcomes, highlighting the need for reliable prognostic biomarkers. Our study aimed to develop and validate CT-based radiomics model for predicting postsurgical outcome in patients with G1-2 PanNETs, and to compare its performance with the current clinical staging system. Methods: This multicenter retrospective study included patients who underwent dynamic CT and subsequent curative resection for G1–2 PanNETs. A radiomics-based model (R-score) for predicting recurrence-free survival (RFS) was developed from a development set (441 patients from one institution) using least absolute shrinkage and selection operator-Cox regression analysis. A clinical model (C-model) consisting of age and tumor stage according to the 8th American Joint Committee on Cancer staging system was built, and an integrative model combining the C-model and the R-score (CR-model) was developed using multivariable Cox regression analysis. Using an external test set (159 patients from another institution), the models’ performance for predicting RFS and overall survival (OS) was evaluated using Harrell’s C-index. The incremental value of adding the R-score to the C-model was evaluated using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results: The median follow-up periods were 68.3 and 59.7 months in the development and test sets, respectively. In the development set, 58 patients (13.2%) experienced recurrence and 35 (7.9%) died. In the test set, tumors recurred in 14 patients (8.8%) and 12 (7.5%) died. In the test set, the R-score had a C-index of 0.716 for RFS and 0.674 for OS. Compared with the C-model, the CR-model showed higher C-index (RFS, 0.734 vs. 0.662, p= 0.012; OS, 0.781 vs. 0.675, p= 0.043). CR-model also showed improved classification (NRI, 0.330, p&lt; 0.001) and discrimination (IDI, 0.071, p&lt; 0.001) for prediction of 3-year RFS. Conclusions: Our CR-model outperformed the current clinical staging system in prediction of the prognosis for G1–2 PanNETs and added incremental value for predicting postoperative recurrence. The CR-model enables precise identification of high-risk patients, guiding personalized treatment planning to improve outcomes in surgically resected grade 1–2 PanNETs.

In the present study, we experimentally investigated the aerosol-particle sustaining features of a porous-walled rubber foam tube model according to outlet humidity and temperature variations. An oleic acid aerosol is used as the inlet working fluid and the embedded particle diameters are in the range of 6–10 μm. To analyze particle size distribution, a wide-ranging particle spectrometer is employed, and particle sizes are measured at the inlet and outlet of the tube. Variance analysis is performed to evaluate the significance level of various tube-wall conditions, including dry and moist aerosol conditions at room and body temperatures. For the cases of larger particle sizes, the sustaining rates are increased when the porous wall condition is moist and at body temperature.

Prenatal antibiotic exposure and delivery mode may affect the gut microbiome in early life and influence the development of childhood asthma, but the combined effect of these two factors is unknown.

A specially designed internally cooled directional electrode can allow creation of a sufficient ablation zone in the desired direction, and use of it can reduce thermal injury to the adjacent organs at hepatic radiofrequency ablation.

Background The actions of glucocorticoids in target tissues depend on the local metabolism of glucocorticoids catalyzed by 11β hydroxysteroid dehydrogenase (HSD) 1 and 2. Glucocorticoids are the most effective anti-inflammatory drugs in the treatment of nasal polyps. However, the mechanisms that underlie the anti-inflammatory effects are unclear.Objective The present study analyzed the expression of 11β-HSD1, 11β-HSD2, and steroidogenic enzymes (cytochrome P450, family 11, subfamily B, polypeptide 1 [CYP11B1]; cytochrome P450, family 11, subfamily A, polypeptide 1 [CYP11A1]) in nasal polyp tissues, and endogenous cortisol levels in nasal polyp–derived epithelial cells.Methods The expression levels and distribution pattern of 11β-HSD1, 11β-HSD2, CYP11B1, and CYP11A1 were determined in nasal polyp tissues or nasal polyp–derived epithelial cells by using real-time polymerase chain reaction, Western blot, and immunohistochemistry testing. The expression levels of cortisol by using enzyme-linked immunosorbent assay were determined in cultured polyp–derived epithelial cells treated with adrenocorticotrophic hormone (ACTH), 11β-HSD1 inhibitor, or small interfering ribonucleic acid technique. The effect of glucocorticoids on the expression levels of these enzymes was investigated in cultured cells.Results Expressed in nasal polyp tissues and nasal polyp–derived epithelial cells were 11β-HSD1, 11β-HSD2, CYP11B1, and CYP11A1. Cortisol production in cultured epithelial cells was decreased in cells treated with 11β-HSD1 small interfering ribonucleic acid or inhibitor, compared with nontreated cells. Cultured cells treated with adrenocorticotropic hormone induced increased cortisol production. 11β-HSD1 expression levels were upregulated in cells treated with glucocorticoid.Conclusions Analysis of these results indicated that 11β-HSD1 expressed in polyp-derived epithelial cells may be involved in the anti-inflammatory function of glucocorticoid in the treatment of nasal polyps, which contributes to increased levels of endogenous cortisol.

Purpose:To compare the efficacy of radiofrequency ablation (RFA) and laser ablation (LA) for treatment of benign solid thyroid nodules, using a systematic review including traditional pooling and Bayesian network meta-analysis.Materials and Methods:A comprehensive literature search in PubMed-MEDLINE, EMBASE, and the Cochrane Library databases identified prospective studies evaluating the percentage mean change [absolute mean change (mL)] in nodule volume after RFA or LA. Studies from January 1, 2000, to November 1, 2013, were included. Review of 128 potential papers, including a full-text review of 33, identified 10 eligible papers covering a total of 184 patients for meta-analysis. The percentage mean change [absolute mean change] in nodule volume over a 6-month follow-up was compared between RFA and LA.Results:Based on the traditional frequentist approach, the pooled percentage mean changes (95% confidence interval) of RFA and LA were 76.1% (70.1–82.1) and 49.9% (41.4–58.5), respectively, and the pooled absolute mean changes (95% confidence interval) of RFA and LA were 8.9 mL (6.6–11.2) and 5.2 mL (4.3–6.1), respectively. Based on the Bayesian network meta-analysis, RFA achieved a larger pooled percentage mean change (95% credible interval) and absolute mean change (95% credible interval) compared to LA [77.8% (67.7–88.0) vs 49.5% (26.7–72.4), and 9.2 mL (5.8–11.9) vs 5.3 mL (2.1–8.5), respectively]. The RFA group has the highest probability of having the most efficacious treatment (98.7%). There were no major complications after either RFA or LA.Conclusions:RFA appears to be superior to LA in reducing benign solid thyroid nodule volume, despite the smaller number of treatment sessions without major side effects.

Baffles are frequently used to reduce flow speed and to change fluid passages by directly blocking oncoming flow. This study employed multi-stacked porous baffle obstructions to enhance the flow relaxations of water-soluble buoyant gases inside an odor removing basin system. We performed qualitative flow visualization by using tracing particles in working fluid to evaluate the effects of porous baffles. Particle image velocimetry technique was also employed to quantitatively analyze the flow field around the baffle regime. As a result, oncoming two-phase bubbly flow from the basin bottom regime was bent, passing the edge of a porous baffle plate. The main stream speed and momentum were effectively reduced by the installed porous flow obstruction devices.

A tape spring hinge is one of the most typical deployment devices and is frequently used in miniaturized satellite due to its simplicity, lightweight, low cost and high deployment reliability. But a tape spring hinge mechanism has limited performance due to the performance trade-off between deployed stiffness and latch-up shock.In this study, to improve a conventional tape spring hinge mechanism, SMA damped tape spring hinge is proposed so that a satellite solar array can be quasi-statically deployed. The test result shows the feasibility of the proposed concept.

Tumor stage, node metastasis, tumor size, vascular invasion, and perineural invasion are the most important prognostic factors that might be determined by preoperative multidetector computed tomography (MDCT) in pancreatic cancer. The purpose of our study is to investigate diagnostic accuracy of MDCT for determining these prognostic factors.

Mushroom fly, Lycoriella mali(Diptera: Sciaridae), is the primary pest in imported mushrooms. The amount of Tricholoma matsutakeimported from China increases every fall when it is harvested. When importing T. matsutake,disinfestation using methyl bromide (MB) or phosphine (PH3) is performed to prevent the introduction of L. mali. However, MB will be phased out due to ozone-depletion, chronic toxicity to workers, and residual issues. PH3fumigation in mushroom disinfestation requires a long exposure time (24 h). In this study, we used ethyl formate (EF), which can replace MB and reduce exposure time. The efficacy of EF, PH3 and EF + PH3 on L. maliwas evaluated. Using 4-h EF fumigation at 5 °C, the 3rd and 4th instar was the most tolerant stage in terms of 99% killed lethal concentration × time products (LCt99%). When 4-h EF fumigation at 5 °C was applied on all stages of L. mali, the LCt99%values of EF were 73.1 g h/m3to the 1st and 2nd instar, 112.9 g h/m3to the 3rd and 4th instar, 68.9 g h/m3to pupae, and 20.1 g h/m3to adult. It was confirmed that combination treatment with EF + PH3had a synergistic effect on L. mali. The LCt99%of EF + 0.5 g/m3of PH3to the 3rd and 4th instar was 48.3 g h/m3. When only 140 g/m3of EF was applied for 4 h at > 5 °C and 35 g/m3of EF + 0.5 g/m3of PH3for 4 h at > 5 °C in commercial trials containing T. matsutake, proven efficacy (100%) on L. maliwas confirmed. In the case of EF treatment only, phytotoxic damage occurred due to high Ct products, and there was no phytotoxic damage in combination treatment with EF + PH3. This study provides a new guideline for EF + PH3combination treatment within a shorter exposure time (4 h) than existing PH3treatment (24 h) and replacement of MB use.

The flow structure inside a water basin that, serves as a water tank of a modeled washer system with an immersed coiled heater and air supply nozzle is investigated experimentally. To obtain the flow velocity field, particle image velocimetry is employed, and different view-point sections are analyzed. A large-scale vertical flow structure, which is attributed to the strong air jet flow enhancement, causes the development of a 3D mixing layer in the entire flow regime. Although a coiled heater can provide buoyancy to the working fluid, the bubbly flow structure significantly dominates this stage by supplying air from the bottom nozzles.

A tube furnace is a heat treatment device in which a specimen is heated in the presence of an inert gas using electric heating coils embedded in a thermally insulating matrix. Heat flux and temperature gradients of sample during heat treatment in a tube furnace depend on the gas and wire velocities. These parameters were used in this paper for a 2-D axisymmetric numerical study to determine an optimized relationship between the temperature and the sample wire motion. The results show that wire velocity considerably affected the wire temperature distribution and increased the gas temperature to some extent. The phenomenon resulted in the shifting of the heating zone on the wire surface and occurrence of an inner convection heat transfer.

With the recent dramatic advances in diagnostic modalities, the diagnosis of hepatocellular carcinoma (HCC) is primarily based on imaging. Ultrasound (US) plays a crucial role in HCC surveillance. Dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI) are the standard diagnostic methods for the noninvasive diagnosis of HCC, which can be made based on hemodynamic features (arterial enhancement and delayed washout). The technical development of MDCT and MRI has made possible the fast scanning with better image quality and resolution, which enables an accurate CT hemodynamic evaluation of hepatocellular tumor, as well as the application of perfusion CT and MRI in clinical practice. Perfusion CT and MRI can measure perfusion parameters of tumor quantitatively and can be used for treatment response assessment to anti-vascular agents. Besides assessing the hemodynamic or perfusion features of HCC, new advances in MRI can provide a cellular information of HCC. Liver-specific hepatobiliary contrast agents, such as gadoxetic acid, give information regarding hepatocellular function or defect of the lesion, which improves lesion detection and characterization. Diffusion-weighted imaging (DWI) of the liver provides cellular information of HCC and also has broadened its role in lesion detection, lesion characterization, and treatment response assessment to chemotherapeutic agents. In this article, we provide an overview of the state-of-the art imaging techniques of the liver and their clinical role in management of HCC.

This paper presents a novel hinge mechanism for deployment of spacecraft subsystems such as antennas, solar arrays. By using Axiomatic design theory, the conceptual design of the hinge mechanism is suggested, which has not only high deployed stiffness and low deployment shock but also does not require lubrication and accurate fabrication. That is, optimization of deployment torque and maximization of the deployed stiffness can be possible since this suggested hinge mechanism is decoupled design. And the suggested hinge mechanism is fabricated and tested to evaluate the feasibility. Quasi-static analysis is performed to optimize deployment torque for low deployment shock by using FEM. Also, the bending stiffness is measured by 4 point bending test.

This paper presents a novel hinge mechanism for deployment of spacecraft subsystems such as antennas, solar arrays. By using Axiomatic design theory, the conceptual design of the hinge mechanism is suggested, which has not only high deployed stiffness and low deployment shock but also does not require lubrication and accurate fabrication. That is, optimization of deployment torque and maximization of the deployed stiffness can be possible since this suggested hinge mechanism is decoupled design. And the suggested hinge mechanism is fabricated and tested to evaluate the feasibility. Quasi-static analysis is performed to optimize deployment torque for low deployment shock by using FEM. Also, the bending stiffness is measured by 4 point bending test.

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To evaluate the in vivo efficiency of 2 multiple-electrode radiofrequency (RF) systems to create confluent areas of coagulation in porcine liver, compared with consecutive overlapping ablation.

AbstractBackground: Ghrelin has been reported to be the natural ligand of growth hormone (GH) secretagogue receptor, and it is known that exogenous ghrelin administration strongly stimulates GH release in humans. However, the effects of endogenous ghrelin on GH secretion and changes in ghrelin levels during dynamic changes in GH levels are not well understood. Methods: Therefore, we measured circulating acylated ghrelin concentrations during oral glucose tolerance tests (OGTTs) in patients with active acromegaly (AA, n = 9) and in age/sex/BMI-matched group A controls (n = 12), and during insulin tolerance testing (ITT) in patients with GH deficiency (GHD, n = 10) and in group B controls (n = 10). Plasma acylated ghrelin, serum GH, insulin and glucose levels were measured during each test. Results: Fasting plasma ghrelin levels correlated negatively with serum insulin levels in both group A and B controls (r = –0.665; p < 0.05) but not in patients with AA or GHD. During OGTTs, circulating ghrelin levels decreased significantly with a nadir at 30 min in both patients with AA (p < 0.05) and group A controls (p < 0.01). Also, ITTs were followed by a significant decrease in circulating ghrelin levels with a nadir at 30 min in patients with GHD (p < 0.05) and in group B controls (p < 0.05). Conclusion: The results of the study show that at baseline acylated ghrelin levels do not differ with respect to the GH status (GH excess or GH deficiency) and, furthermore, the suppression of acylated ghrelin levels during OGTT or ITT is independent of the GH response to the tests.Copyright © 2007 S. Karger AG, Basel