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Recently, automated detection has been a new approach to address the risks posed by prescribing errors. This study focused on prescription errors and utilized real medical data to supplement the Drug Utilization Review (DUR)-based rules, the current prescription error detection method. We developed a new hybrid method through artificial intelligence for prescription error prediction by utilizing actual detection accuracy improvement to reduce ‘warning fatigue’ for doctors and improve medical care quality. This study was conducted in the Department of Pediatrics, targeting children sensitive to drugs to develop a prescription error detection system. Based on the DUR prescription history, 15,281 patient-level observations of children from Konyang University Hospital (KYUH)’s common data model (CDM) and DUR were collected and analyzed retrospectively. Among the CDM data, inspection information was interlocked with DUR and reflected as standard information for model development; this included outpatient prescriptions from January 1 to December 31, 2018. Through consultation with pediatric clinicians, rule definitions and model development were conducted for 35 drugs, with 137,802 normal and 1609 prescription errors. We developed a novel hybrid method of error detection in the form of an advanced rule-based deep neural network (ARDNN), which showed the expected performance (precision: 72.86, recall: 81.01, F1 score: 76.72) and reduced alarm pop-up alert fatigue to below 10%. We also created an ARDNN-based comprehensive dashboard that allows doctors to monitor prescription errors with alarm pop-ups when prescribing medications. These results can advance the existing rule-based model by developing a prescription error detection model using deep learning. This method can improve overall medical efficiency and service quality by reducing doctors’ fatigue.

BACKGROUND Mannitol is a hyperosmolar agent and the combination of mannitol and furosemide is a widely used treatment for intracranial pressure control. Considering the hypertonic properties of mannitol to move water out of intracellular spaces, we hypothesized that mannitol combined with furosemide could relieve focal tissue swelling in refractory lymphedema. CASE SUMMARY A 90-year-old female had been diagnosed with intracranial hemorrhage and received a combination of mannitol and furosemide for intracranial pressure control. Independent of the intracranial hemorrhage, she had refractory lymphedema of the left lower extremity since 1998. Remarkably, after receiving the mannitol and furosemide, the patient’s lower extremity lymphedema improved dramatically. After the mannitol and furosemide were discontinued, the lymphedema worsened in spite of complete decongestive therapy (CDT) and intermittent pneumatic compression treatment (IPC). To identify the presumed effect of mannitol and furosemide on the lymphedema, these agents were resumed, and the lymphedema improved again. CONCLUSION The present case raises the possibility that a combination of mannitol and furosemide might be considered another effective therapeutic option for refractory lymphedema when CDT and IPC are ineffective.

BACKGROUND Herpes zoster is a painful infectious disease caused by the varicella zoster virus. Herpes zoster radiculopathy, which is a type of segmental zoster paresis, can complicate the disease and cause motor weakness. This complication should be considered when a patient with a rash complains of acute-onset motor weakness, and the diagnosis can be verified via electrodiagnostic study. CASE SUMMARY A 64-year-old female with a history of asthma presented to the emergency department with stabbing pain, an itching sensation, and a rash on the right anterior shoulder that had begun 5 d prior. Physical examination revealed multiple erythematous grouped vesicles in the right C4-5 and T1 dermatome regions. Because herpes zoster was suspected, the patient immediately received intravenous acyclovir. On the third hospital day, she complained of motor weakness in the right upper extremity. Magnetic resonance imaging of the cervical spine revealed mild intervertebral disc herniation at C4-C5 without evidence of nerve root compression. On the 12th hospital day, electrodiagnostic study revealed right cervical radiculopathy, mainly in the C5/6 roots. Six months later, monoparesis resolved, and follow-up electrodiagnostic study was normal. CONCLUSION This case emphasizes that clinicians should consider the possibility of post-herpetic paresis, such as herpes zoster radiculopathy, and that electrodiagnostic study is useful for diagnosis and follow-up.

Background Extracorporeal shock wave therapy (ESWT) can be applied to various musculoskeletal conditions including calcific tendinitis. Muscle injuries can lead to hematomas, and unabsorbed hematomas sometimes cause pain. We report a case of painful hematoma successfully treated with ESWT. To our knowledge, this is the first reported case of painful intramuscular hematoma treated with ESWT. Case summary A 65-year-old man visited the outpatient department for left calf pain with swelling that had persisted since he slipped two weeks prior. The calf pain had persisted and was rated visual analog scale 7. On physical examination, there was a localized, stiff, ovoid mass on his left upper posterior calf. The pain was aggravated by dorsiflexion of the left ankle or weight-bearing on the left foot. Initial diagnostic ultrasonography showed a hematoma in the left gastrocnemius muscle; its texture was firm with low heterogeneity. We applied ESWT to the hematoma. His pain decreased immediately to a visual analog scale 3, and the mass was softened. The texture of the hematoma became more heterogeneous on ultrasonography. Due to planned overseas travel, he returned three months after the initial visit to report that the pain and swelling were dramatically relieved after ESWT. Conclusion We propose that painful hematomas could be a new indication for ESWT. Further investigation on the effects of ESWT for hematomas is needed.

This study proposes a parameter-free model predictive current control (MPCC) for synchronous machines controlled by a high-frequency (HF) signal injection sensorless. In electric machine drives, correct rotor position and machine parameters information are crucial for vector control. This approach does not require any machine parameters information and the position sensor. The proposed method estimates the electrical machine parameters by a recursive least-square (RLS) in real-time. The estimated parameters are used for the deadbeat MPCC and the HF signal injection sensorless control. This work proposes a HF signal injection sensorless method suitable for deadbeat MPCC, ensuring stable motor drives in the low-speed regions without the position sensor. Simulation and experimental results are conducted to verify the performance of the proposed method.

Exercise intensity of exoskeleton-assisted walking in patients with spinal cord injury (SCI) has been reported as moderate. However, the cardiorespiratory responses to long-term exoskeleton-assisted walking have not been sufficiently investigated. We investigated the cardiorespiratory responses to 10 weeks of exoskeleton-assisted walking training in patients with SCI. Chronic nonambulatory patients with SCI were recruited from an outpatient clinic. Walking training with an exoskeleton was conducted three times per week for 10 weeks. Oxygen consumption and heart rate (HR) were measured during a 6-min walking test at pre-, mid-, and post-training. Exercise intensity was determined according to the metabolic equivalent of tasks (METs) for SCI and HR relative to the HR reserve (%HRR). Walking efficiency was calculated as oxygen consumption divided by walking speed. The exercise intensity according to the METs (both peak and average) corresponded to moderate physical activity and did not change after training. The %HRR demonstrated a moderate (peak %HRR) and light (average %HRR) exercise intensity level, and the average %HRR significantly decreased at post-training compared with mid-training (31.6 ± 8.9% to 24.3 ± 7.3%, p = 0.013). Walking efficiency progressively improved after training. Walking with an exoskeleton for 10 weeks may affect the cardiorespiratory system in chronic patients with SCI.

Background Spinal cord injury (SCI) is a serious clinical condition that impacts a patient's physical, psychological, and socio-economic status. The aim of this pilot study was to evaluate the effects of training with a newly developed powered wearable exoskeleton (Hyundai Medical Exoskeleton [H-MEX]) on functional mobility, physiological health, and quality of life in non-ambulatory SCI patients. Methods Participants received 60 minutes of walking training with a powered exoskeleton 3 times per week for 10 weeks (total 30 sessions). The 6-minute walking test (6MWT) and timed-up-and-go test (TUGT) were performed to assess ambulatory function. The physiological outcomes of interest after exoskeleton-assisted walking training were spasticity, pulmonary function, bone mineral density, colon transit time, and serum inflammatory markers. Effects of walking training on subjective outcomes were estimated by the Korean version of the Falls Efficacy Scale—International and the 36-Item Short-Form Health Survey version 2. Results Ten participants finished 30 sessions of training and could ambulate independently. No severe adverse events were reported during the study. After training, the mean distance walked in the 6MWT (49.13 m) was significantly enhanced compared with baseline (20.65 m). The results of the TUGT also indicated a statistically significant improvement in the times required to stand up, walk 3 m and sit down. Although not statistically significant, clinically meaningful changes in some secondary physiological outcomes and/or quality of life were reported in some participants. Conclusion In conclusion, this study demonstrated that the newly developed wearable exoskeleton, H-MEX is safe and feasible for non-ambulatory SCI patients, and may have potential to improve quality of life of patients by assisting bipedal ambulation. These results suggest that the H-MEX can be considered a beneficial device for chronic non-ambulatory SCI patients. Trial Registration ClinicalTrials.gov Identifier: NCT04055610, Graphical Abstract

Recently, the necessity of the autonomous mobile robot is empha sized in order to enlarge the scope of activity and actively cope with the change of work environment. This paper p roposes the algorithm which enables the mobile robot to avoid obstacles and lead it to the destination by the shortest path. And we verify the usability by a simulation. We made the algorithm with micro-GA and λ-geometry MRA. The area of simulation is limited to 320(width)X200(length) pixels and one pixel is one centimeter. When we planned the path with only λ-geometry MRA, we could find the direction for path planning but could not find the shortest path. But when we planned the path with λ-geometry MRA and micro-GA, we could find the shortest path. So the algorithm enables us to find the direction for path planning and the shortest path. Key Words : Micro-GA, λ-Geometry MRA, Optimal path planning, Collision avoidance 1. 서 론 과거 산업 현장에서 응용되고 있는 대부분의 로봇은 매니플레이터(manipulator)방식으로서 한정된 공간 안에서 제한된 작업을 수행하였지만, 최근 들어 로봇은 산업 현장뿐만 아니라 병원, 사무실, 가정, 전시장과 같은 여러 환경에서 각각의 목적에 맞는 기능을 수행하고 있다. 이에 따라 로봇은 넓은 활동 범위를 수용하고 작업 환경의 변화에 능동적으로 대처할 수 있어야 한다. 즉 작업 공간의 제한성을 해결하고 더 많은 작업 능력을 갖기 위하여 자율 이동 로봇(autonomous mobile robot)에 대한 필요성이 높아지고 있고 이와 관련된 여러 가지 연구가 진행되고 있다.자율 이동 로봇의 지능화란 어떤 임무가 주어졌을 때 자기 스스로 감지기(sensor)로 주변의 환경과 자신의 위치나 상태를 파악해서 이동하고자하는 경로 계획(path planning)을 해야 하며 이러한 경로는 주행 시간, 소모되는 에너지, 안정성에 대한 고려가 되어야 하고 계산된 경로를 따라가기 위한 경로 추종(path tracking) 제어기가 있어야 한다. 그리고 경로 계획은 크게 두 부분으로 나뉘어지는데 먼저 오프라인(off-line)으로 이미 알려진 환경의 지도나 모델을 이용하는 광역 경로 계획(global path planning)과 실시간으로 바뀌어가는 환경에 적응하기 위해 온라인(on-line)으로 상황을 판단하는 국지적 경로 계획(local path planning)이 있다.즉 이동 로봇을 실용화하기 위해서는 로봇의 위치 추정 및 장애물 회피를 위한 경로 계획 그리고 센서를 이용한 제어 기술이 요구된다. 경로 계획은 장애물이 존재하는 작업 환경 내에서 로봇의 위치로부터 목표점까지 장애물을 피해 최적 경로로 이동하는 것을 목적으로 하는데, 이러한 목적을 이루기 위해서 이동 로봇은 외부에서 획득한 환경 정보

Colloidal quantum dots (CQD) are now making their entry to full-color displays, endowed by their brightness and single-material base. By contrast, many obstacles have been encountered in their use towards lasers. We demonstrate here optically pumped distributed feedback (DFB) lasers, based on close-packed, solid films self-assembled from type-I CQDs. Notably, the single mode CQD-DFB lasers could reach such a low threshold as to be pumpable with a compact pulsed source in a quasi-continuous wave regime. Our results show the spatially and temporally coherent laser beam outputs with power of 400 μW and a quantum efficiency of 32%. Accepted version

We demonstrate ultrafast all-optical control of terahertz (THz) radiation through nanoresonators, slot antennas with a hundred micron length but submicron width in thin gold layers, fabricated on vanadium dioxide (VO2) thin films. Our THz nanoresonators show almost perfect transmission at resonance. By virtue of phase transition of VO2 from insulating to metallic state, induced in subpicosecond time scale by moderate optical pump, ultrafast control of THz transmission is enabled. This is compared to bare VO2 films where no switching dynamics are observed under similar conditions.