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Objective This study was aimed to compare the oncologic outcomes of patients with non-endometrioid endometrial cancer who underwent minimally invasive surgery with the outcomes of patients who underwent open surgery. Method This is a retrospective, multi-institutional study of patients with non-endometrioid endometrial cancer who were surgically staged by either minimally invasive surgery or open surgery. Oncologic outcomes of the patients were compared according to surgical approach. Results 113 patients met the inclusion and exclusion criteria. 57 underwent minimally invasive surgery and 56 underwent open surgery. Patients who underwent minimally invasive surgery had smaller tumors (median size, 3.3 vs. 5.2%, p = 0.0001) and a lower lymphovascular space invasion rate (29.8% vs. 48.2%, p = 0.045). In the overall population, the numbers and rate of recurrence were significantly higher in the open surgery group (p = 0.016). In multivariate analysis, disease stage and tumor size were associated with DFS in contrast to surgical procedure. Conclusion Minimally invasive surgery showed similar survival outcomes when compared to open surgery in non-endometrioid endometrial cancer patients, irrespective of disease stage. When minimally invasive surgery is managed by expert surgeons, non-endometrioid histological subtypes should not be considered a contraindication for minimally invasive surgery.

Human bone marrow-derived mesenchymal stem cells (hBM-MSCs) have been studied for their application to manage various neurological diseases, owing to their anti-inflammatory, immunomodulatory, paracrine, and antiapoptotic ability, as well as their homing capacity to specific regions of brain injury. Among mesenchymal stem cells, such as BM-MSCs, adipose-derived MSCs, and umbilical cord MSCs, BM-MSCs have many merits as cell therapeutic agents based on their widespread availability and relatively easy attainability and in vitro handling. For stem cell-based therapy with BM-MSCs, it is essential to perform ex vivo expansion as low numbers of MSCs are obtained in bone marrow aspirates. Depending on timing, before hBM-MSC transplantation into patients, after detaching them from the culture dish, cell viability, deformability, cell size, and membrane fluidity are decreased, whereas reactive oxygen species generation, lipid peroxidation, and cytosolic vacuoles are increased. Thus, the quality and freshness of hBM-MSCs decrease over time after detachment from the culture dish. Especially, for neurological disease cell therapy, the deformability of BM-MSCs is particularly important in the brain for the development of microvessels. As studies on the traditional characteristics of hBM-MSCs before transplantation into the brain are very limited, omics and machine learning approaches are needed to evaluate cell conditions with indepth and comprehensive analyses. Here, we provide an overview of hBM-MSCs, the application of these cells to various neurological diseases, and improvements in their quality and freshness based on integrated omics after detachment from the culture dish for successful cell therapy.

Background Dyspnea is a common symptom in patients presenting to the emergency department. It has a variety of causes that range from non-urgent to life-threatening. One episode of dyspnea in a healthy young person is easy to overlook. However, if the symptoms occur after physically or emotionally stressful events, careful evaluation needs to be undertaken because it may be associated with Takotsubo syndrome, which is rarely expected but can be fatal. Herein, we report the case of Takotsubo syndrome in a healthy young woman who arrived at the emergency department after experiencing a short single episode of dyspnea following a minor surgery. Case presentation A 23-year old woman with no underlying chronic disease underwent closed reduction surgery for a nasal bone fracture under general anesthesia (with sevoflurane as the anesthetic). Approximately 5 h later, she presented to the emergency department with dyspnea, which improved soon upon arrival at the emergency department. There were no other symptoms. The dyspnea occurred about 5 h after being discharged on observation, with an uneventful postoperative course. Her electrocardiogram and chest X-ray findings were unremarkable. On testing, troponin I and creatine kinase myocardial band levels were elevated at 6.122 ng/mL and 11.2 µg/L (reference ranges: 0.000–0.046 ng/mL and 0.0–5.0 µg/L), respectively. Bedside echocardiography revealed an ejection fraction of 25%, with mid-ventricular and apical akinesia and basal hyperkinesia. The pulmonary and coronary angiographic computed tomographic scans were unremarkable. Hence, apical Takotsubo syndrome was suspected. A follow-up echocardiogram taken 5 days after admission showed full recovery with a normalized ejection fraction (60%) and no regional wall motion abnormality. The patient was discharged on the sixth day with no other complications. Conclusion When atypical symptoms, such as transient dyspnea, manifest, it becomes necessary to suspect and diagnose Takotsubo syndrome to ensure timely and appropriate medical management, especially when a preceding stressful event, such as minor surgery has occurred. It might be helpful to perform bedside point-of-care echocardiography to check for regional wall motion abnormalities that are typically associated with Takotsubo syndrome.

Left subclavian venous access increases the risk of vascular damage and thrombosis based on the catheter course and location of the catheter tip. We investigated the accuracy of tip positioning with conventional landmarks using transesophageal echocardiography. The carina as a radiological landmark and the right third intercostal space as a topographical landmark were selected for tip positioning within the target zone, defined as 2 cm above and 1 cm below the right atrial junction. A total of 120 participants were randomized into two groups. The catheter insertion depth was determined as 1.5 cm more than the distance between the venous insertion point and the carina via the right first intercostal space in the radiological group, and between the venous insertion point and the right third intercostal space via the right first intercostal space in the topographical group. The determined insertion depth and actual distance to the right atrial junction of the radiological and topographical groups were 19.5 cm and 20.5 cm, and 19.8 cm and 20.4 cm, respectively. Acceptable positioning was more frequent in the topographical group (96.4% vs. 85.7%; p = 0.047). The catheter tip is more accurately positioned in the distal superior vena cava using topographical landmarks than radiological landmarks.

We aimed to evaluate the efficacy of using airway ultrasonography to select the correct tracheal tube size and insertion depth in pediatric patients who underwent cleft repair surgery as a way to decrease airway complications and adverse events during perioperative periods. Fifty-one patients (age P = 0.045). The number of complications and adverse events was significantly higher in the conventional group than in the ultrasound group (32.1% vs 4.3%, P = 0.013). Airway ultrasound application could reduce airway-related complications and adverse events by determining the appropriate tracheal tube size and insertion depth.

Point-of-care ultrasound (POCUS) is a powerful diagnostic tool and provides treatment guidelines in acute critical settings. However, the limitation of using POCUS is operator dependent. Appropriate and validated training for acquiring and using skills in practice must be conducted before using POCUS in clinical settings in order to keep patients safe. Simulation education models have been introduced as a way to solve and overcome these concerns. However, the commercial simulator with sufficiently secured fidelity is expensive and not always available. This review focused on the inexpensive and easily made simulators for education on POCUS in critical specific situations related to the airway, breathing, circulation, and disability. We introduced the simulators that used non-infectious materials, with easily transportable features, and that had a sonographic appearance reproducibility similar to human tissue. We also introduced the recipe of each simulator in two parts: Materials surrounding disease simulators (surrounding materials) and specific disease simulators themselves (target simulators). This review article covered the following: endotracheal or oesophageal intubation, lung (A-lines, B-lines, lung sliding, and pleural effusions such as hemothorax), central vein access, pericardial fluid (cardiac tamponade), the structure related to the eyes, soft tissue abscess, nerve (regional nerve block), and skull fracture simulators.

Disease caused by Pepper yellow leaf curl virus (PepYLCV) is one of the greatest threats to pepper (Capsicum spp.) cultivation in the tropics and subtropics. Resistance to PepYLCV was previously identified in a few Capsicum accessions, but no resistance QTLs have been mapped. This study aimed to elucidate the genetics of PepYLCV resistance in C. annuum L. Augmented inoculation by the viruliferous whitefly Bemisia tabaci was used to evaluate parental lines and an F2 segregating population derived from a cross between resistant C. annuum line LP97 and susceptible C. annuum line ECW30R. Final evaluation was performed six weeks after inoculation using a standardized 5-point scale (0 = no symptoms to 4 = very severe symptoms). A high-density linkage map was constructed using genotyping-by-sequencing (GBS) to identify single-nucleotide polymorphism (SNP) markers associated with PepYLCV resistance in the F2 population. QTL analysis revealed three QTLs, peplcv-1, peplcv-7, and peplcv-12, on chromosomes P1, P7, and P12, respectively. Candidate genes associated with PepYLCV resistance in the QTL regions were inferred. In addition, single markers Chr7-LCV-7 and Chr12-LCV-12 derived from the QTLs were developed and validated in another F2 population and in commercial varieties. This work thus provides not only information for mapping PepYLCV resistance loci in pepper but also forms the basis for future molecular analysis of genes involved in PepYLCV resistance.

Objective: We aim to describe our experience of multidisciplinary surgical resection of retroperitoneal sarcoma (RPS), including intra- and extrapelvic approaches.Method: Multidisciplinary surgery is an anatomical approach combining intra- and extraperitoneal access within the same surgery to achieve complete RPS removal. This retrospective review of the records of patients who underwent multidisciplinary surgery for RPS analyzed surgical and survival outcomes.Result: Eight patients underwent 10 intra- and extrapelvic surgical resection and their median mass size was 12.75 cm (range, 6–45.5 cm). Using an intrapelvic approach, laparoscopy-assisted surgery was performed in 4 cases and laparotomy surgery in 6 cases. Using an extrapelvic approach, ilioinguinal and posterior approaches were used in 4 cases each, prone position and midline skin incision were shared in 1 case. All patients’ RPS masses were removed completely and 4 patients achieved R0 resection through intra- and extrapelvic surgery. Additionally, pelvic lymph node dissections or prophylactic fixation or revision of structures were conducted. The median estimated blood loss was 2000 mL (range, 300–20 000 mL) and the median hospitalization was 12.6 days (range, 9–69 days). Reoperation was needed in 2 patients (one for wound necrosis, the other for bowel perforation and wound necrosis). The median overall survival rate and median progression-free survival were 64.6 months and 13.7 months, respectively.Conclusion: RPS are therapeutically challenging based on their locations and high risk of recurrence. Considering that, intra- and extrapelvic surgical approach could improve the macroscopic security of the surgical margin.

We propose a piezoelectric energy harvesting technology installed in a roadway speed bump. We have installed a module that can charge mobile phones utilizing a speed bump piezoelectric harvester (SBPH), which is easy to apply to roads. A highly integrated module with 40 piezo-generators was fixed and installed at the center of the speed bump. When a medium-sized vehicle passed the module at a speed of 30 km/h, an output voltage of 144 Vmax, output current of 45.2 mAmax, and output power of 4086.08 mWmax (6.81 W/m2) were measured at a load resistance of 2 kΩ. When the vehicle passed over the SBPH nine times, it charged a capacitor (10,000 μF) to provide 6 V for about 200 s, and the charged electrical energy was enough to operate a cellphone. The self-controlled battery charging system via electricity generated by the piezoelectric module could be applied to a speed bump installed on an actual road.

The power generated by the designed piezoelectric energy harvester replaces the standby power that is constantly used in sensors and driving circuits in commercial LED shoes; the harvester thus reduces battery consumption. LED shoes incorporating a piezoelectric energy harvester are designed for night workers who work near roads. The piezoelectric energy harvester, composed of a piezoelectric device (PZT ceramic), which is inserted under the insoles of shoes, converts mechanical energy generated by motion of user into electrical energy. The designed harvester has an area of 6 × 4 mm and height of 3 mm (pressed state); it weighs 14 g. Because of its small size and light weight, device is suitable for real workers’ shoes. This piezoelectric energy harvester produces 800 μW at a resistive matching point of 400 kΩ; it is used as a sensor to control an LED switching circuit, allowing the LEDs to blink based on user movements. By applying the piezoelectric energy harvester to LED shoes, battery usage time can be doubled compared to LED shoes that are turned on continuously.

Piezoelectric energy harvesting technology can be used for a wide range of purposes through the design of road energy harvesting devices. For the roadway piezoelectric energy harvester (RPEH) developed here, a piezoelectric energy harvester (PEH) is fixed at both ends to increase the tolerable load and a module durable against harsh highway environments were developed using aluminum plates, steel plates, and polypropylene bars. A maximum voltage of 66 V, maximum current of 30.37 mA and maximum output power of 830 mW were measured with 2 mm of displacement at 15 Hz using the RPEH (50 cm × 20 cm) with 80 PEH units connected in parallel. On an actual high-speed road, measurements from a medium-sized vehicle which passes the RPEH at a speed of 90 km/h record an output voltage of 46.52 Vmax, output current of 93.04 mAmax, and power of 4.3 Wmax (power density: 43.0 W/m2) at a load resistance level of 0.5 kΩ. In an actual roadway environment, the electrical energy generated by the RPEH is sufficient to operate a temperature sensor and to transmit data wirelessly.

The purpose of this research was to demonstrate a road-compatible piezoelectric energy harvester (RPEH) that uses the energy to power self-powered sensors and vehicle indicators. The demonstrated RPEH (20 × 50 × 10 cm3) with 80 piezoelectric devices can efficiently convert mechanical energy stemming from the small vertical displacement (1.45 mm) from vehicles into electrical power. The maximum voltage is 113.5 V, the maximum current is 25.71 mA, and the maximum power is 661 mW (6.61 W/m2) at an impedance resistance level of 0.9 kΩ under a z-axial load. The high-power RPEH was initially installed at a highway rest area. The measured output performances of the installed module on the actual roadway in the test setup area were a maximum voltage of 196 V and output power of 2080 mW (20.79 W/m2) at a vehicle speed of 30 km/h. Tests of the RPEH module demonstrate its ability to measure temperature, strain, and leakage values in real time and the generated energy provides sufficient power to illuminate LED indicators. It was also found that the z-axial loaded piezoelectric devices with a two-end fixed beam provide high output power with low levels of vertical displacement, making it highly efficient and durable for actual highway energy-harvesting applications.

Tip positioning of a wire-driven catheter tube is a great challenge during surgeries and it is a significant problem. In order to successfully position the tip to the desired location, a reliable simulation has to be developed. With simulation, determining the required tension force to accurately position the tip of the tube is possible. We examined the general structure of a wire-driven catheter tube. The equations for analyzing the nonlinear large deformation of the tube were derived based on the Euler-Bernoulli law. The Matlab simulation of the deflected catheter tube was developed according to the derived equations. An experiment capturing the actual shape of deflected catheter under various pull wire tensions of up to about 11 N involved measuring the displacement of the pre-selected five points along the catheter tube. The location of the points was compared to the location of the corresponding points of the simulation results. Both shapes resulted in similar curve shapes with maximum error around 3 mm, which corresponds to 1 % error. Thus, the simulation reliability was verified.

For the development and application of wearable electronics, a transparent and flexible piezoelectric sensor (TFPS) system is an important component considering the physical motion energy of the human body. This work newly proposes a transparent and biocompatible boron nitride nanosheet (BNNS) material with a TFPS device. The TFPS device is based on BNNS as a piezoelectric active component and PDMS as a flexible element. The device is able to generate electrical energy from mechanical push force and human movement; it has an output voltage of 22 V, output current of 75 nA, output power of 40 µW (power density: 106 μW/cm3), and energy conversion efficiency of 12.6%. In addition, the TFPS device based on BNNS (1.0 wt%) is proposed as a significant step toward devices which are self-powered by the biomechanical movement of the human foot, neck, wrist, and knee, converted into electric energy in various signal forms. It will be deployed as a body-movement sensor.

A pilot-operated solenoid valve is used to control ultra-high pressure vessels. However, it is difficult to understand its dynamic behavior because the valve operates under ultra-high pressure conditions and the driving unit moves in a multi-step fashion in a tight hidden space. This study aims to identify the system coefficient, especially the damping coefficient, required to analyze the dynamic behavior of a solenoid driving unit. Experiments to measure the dynamic behavior of the driving unit are conducted using two laser sensors and one accelerator. The damping coefficient is estimated using Matlab Simulink, by varying the damping coefficient to match the experimental results. The obtained system coefficients are modeled as equations of motion. It is verified that the valve motion consists of two sequential movements—Phase 1 by pilot plunger and Phase 2 by main plunger, pilot plunger, and the valve initiation time is as fast as 9.9 ms. The damping coefficient of each phase is estimated 0.001 N ∙ s/mm for Phase 1, 0.004 N ∙ s/mm for Phase 2.

Herbal drugs are widely used for the auxiliary treatment of diseases. The pharmacokinetics of a drug may be altered when it is coadministered with herbal drugs that can affect drug absorption. The effects of herbal drugs on absorption must be evaluated. In this study, we investigated the effects of Rumex acetosa (R. acetosa) extract on fexofenadine absorption. Fexofenadine was selected as a model drug that is a substrate of P-glycoprotein (P-gp) and organic anion transporting polypeptide 1A2 (OATP1A2). Emodine&mdash, the major component of R. acetosa extract&mdash, showed P-gp inhibition in vitro and in vivo. Uptake of fexofenadine via OATP1A2 was inhibited by R. acetosa extract in OATP1A2 transfected cells. A pharmacokinetic study showed that the area under the plasma concentration&ndash, time curve (AUC) of fexofenadine was smaller in the R. acetosa extract coadministered group than in the control group. R. acetosa extract also decreased aqueous solubility of fexofenadine HCl. The results of this study suggest that R. acetosa extract could inhibit the absorption of certain drugs via intervention in the aqueous solubility and the drug transporters. Therefore, R. acetosa extract may cause drug interactions when coadministered with substrates of drug transporters and poorly water-soluble drugs, although further clinical studies are needed.

Herbal drugs are widely used for the auxiliary treatment of diseases. The pharmacokinetics of a drug may be altered when it is coadministered with herbal drugs that can affect drug absorption. The effects of herbal drugs on absorption must be evaluated. In this study, we investigated the effects of Rumex acetosa (R. acetosa) extract on fexofenadine absorption. Fexofenadine was selected as a model drug that is a substrate of P-glycoprotein (P-gp) and organic anion transporting polypeptide 1A2 (OATP1A2). Emodine—the major component of R. acetosa extract—showed P-gp inhibition in vitro and in vivo. Uptake of fexofenadine via OATP1A2 was inhibited by R. acetosa extract in OATP1A2 transfected cells. A pharmacokinetic study showed that the area under the plasma concentration–time curve (AUC) of fexofenadine was smaller in the R. acetosa extract coadministered group than in the control group. R. acetosa extract also decreased aqueous solubility of fexofenadine HCl. The results of this study suggest that R. acetosa extract could inhibit the absorption of certain drugs via intervention in the aqueous solubility and the drug transporters. Therefore, R. acetosa extract may cause drug interactions when coadministered with substrates of drug transporters and poorly water-soluble drugs, although further clinical studies are needed.

Objective To identify the incidence and clinical course of septic shock combined with neutropenia during chemotherapy in gynecological cancer patients. Methods We retrospectively reviewed the medical records of all gynecological cancer patients who received intravenous chemotherapy between March 2009 and March 2018. Patients diagnosed with neutropenic septic shock (NSS) during the course of chemotherapy were identified. We calculated the overall incidence and mortality rate of NSS, and analyzed risk factors and clinical course. Results A total of 1,009 patients received 10,239 cycles of chemotherapy during the study period. Among these, 30 (3.0%) patients had 32 NSS events, of which 12 (1.2%) died. With respect to patient age during the first course of chemotherapy, the incidence of NSS after the age of 50 was significantly higher than that in patients under 50 (3.9% vs. 1.4%, p=0.034). As the number of chemotherapy courses increased, the incidence of NSS increased, and linear-by-linear association analysis showed a positive correlation (p=0.004). NSS events occurred on average 7.8 days after the last cycle of chemotherapy, and the median duration of vasopressor administration was 23.3 hours. The median age (64.0 vs. 56.5, p=0.017) and peak heart rate (149.5 min-1 vs. 123.5 min-1, p=0.015) were significantly higher in the group of patients who subsequently died of NSS than in those who survived. Conclusion The overall incidence of NSS in gynecological cancer patients receiving chemotherapy was 3.0%, which is higher than previously estimated. Peak heart rate during NSS events may be an indicator for predicting survival.

Changing a time-varying magnetic field induces an electromotive force (EMF) in non-magnetic conductive materials, resulting in an eddy current across the conductor. Thus, electromagnetic damping can be used as viscous damping. This study theoretically and experimentally investigates the electromagnetic damping characteristics of a bobbin-wounded coil with an attached cantilever beam floating over a permanent magnet, the beam is balanced by electromagnetic force compensation (EMFC) instead of applied weight. System identification is carried out for the mass (m), damping coefficient (c), and spring constant (k) values. The presence of a back EMF seen in either conductive or non-conductive material responses in the experiments includes the step input and corresponding output responses to measure the electromagnetic damping force with and without a voice-coil actuator (VCA). The results were validated using bobbins of conductive (aluminum) and non-conductive (plastic) materials. The experimental results for the conductive material show that the electromagnetic damping force is 10 times greater than that of the non-conductive material, the opposite was true in the case without a VCA, where the force was almost zero for the non-conductive material. In conclusion, conductivity is directly related to the electromagnetic damping force, which affects the performance of a VCA.

A self-powered energy harvester for real roads to predict and detect black ice formation and pinpoint dangerous road sections was developed. An open-type piezoelectric device was developed for a high-efficiency module to achieve uniform stress distribution for enhanced energy harvesting performance by free-fixed-end type central strike mechanism. The output performance of the open-type device was 80% higher than that of the closed-type device. A uniform stress distribution road piezoelectric generator (URPG) with 120 open-type devices was installed on real roads. The URPG showed output power performance of up to 2.38 mW/cm3 when a vehicle passed once under the condition of being buried 2.5 cm below the road surface. The URPG can operate a wireless temperature sensor monitoring system for 83 s and charge a cellphone battery for 53 s. The developed self-powered energy harvesters can be used to reduce accidents caused by black ice on real roads.

Listeriosis is a rare foodborne infection caused by Listeria monocytogenes. It is 12-20 times more prevalent in pregnant women compared to the general population, with a 20-40% mortality rate in neonates. Early treatment with appropriate antimicrobial agents is critical for pregnancy outcomes; however, the infection is difficult to control because the nonspecific clinical manifestations and rarity of the disease often preclude early diagnosis. We encountered 2 cases of pregnancy-associated listeriosis that occurred at 29 and 37 weeks of gestation. Both neonates were delivered by emergent cesarean section due to fetal condition, and one of the preterm infants died immediately after birth. Pregnancy-associated listeriosis should be considered in the management of unexplained fever or inflammatory conditions in pregnant women.

One factor in the energy management of smart home is based upon the location of the home occupants. This location information then can be used to control various electrical and electronic devices and appliances. A floor tile is presented which can be used at different locations in the home and can generate enough energy to wirelessly transmit the information to electrical appliance when a person steps on it. In this work, a novel piezoelectric material system of 0.72Pb(Zr0.47Ti0.53)O3-0.28Pb[(Zn0.45Ni0.55)1/3Nb2/3]O3 + x mol% CuO (PZNxC) was designed, and the energy harvesting characteristics were tailored through composition driven phase boundary evolution. The rhombohedral-tetragonal phase boundary is the best performance area in terms of energy harvesting, which exhibits an obvious advantage in regards to stable energy harvesting. When a person steps on the floor tile, the peak output voltage and current of 42 V and 11 μA, was generated. This energy is then utilized to power a wireless sensor node which can control the power on and off function of home appliances in a real-time.

A smart lighting system can be controlled using a smartphone and/or human activated wireless remote switches. We designed a wireless remote switch using a cantilever type piezoelectric energy harvester to make a battery-less IoT node device that has high output power but a small tip displacement through frequency up-conversion. The purpose of this design is to overcome the conventional volume problem of the piezoelectric cantilever beam. In order to apply the high resonance frequency to the model at constant displacement, we set the limiting conditions of maximum vertical displacement of the cantilever beam to be 1 mm and a human input pressing force of 5–8 N, the force generally required when a human presses a switch button. In these limiting conditions, different shapes of steel substrate were used to find the optimal harvester that meets the limiting conditions and generates about 65 μJ of energy at 5 kΩ resistive loads under free vibration. Using this harvester, we designed a wireless remote switch with an impact type mechanical mechanism with two cantilever type energy harvesters to generate 140 μJ of energy, requiring no impedance matching circuit. This energy was then used to power a microcontroller to transmit data packets using ZigBee Green Power communication. Three identical data packets were transmitted by the wireless remote control switch to ensure data reception by the smart LED bulb and to toggle the bulb on or off state. Finally, this study successfully contributed to elevating the possibility of commercialization of the piezoelectric harvester based wireless remote switch for IoT.

In this paper, the small magnetic field from a small magnet is analyzed. It describes the measurement and utilization of the magnetic field signals generated by the movement of small magnets. After analyzing the signal, we find clues to find out the location of the magnet. Small magnets can be attached to the end of the catheter, a medical instrument that is inserted into the body. Positional tracking allow the catheter to be directed to the desired point when inserted into the body.

As the fourth industrial revolution emerged in the manufacturing industry, the importance of automation of various measurement systems is emphasized. In particular, a weight checker with high speed and good accuracy among the various methods of weighing becomes important. There are two types of checkweighers: load cell types and electromagnetic force compensation(EMFC) types. EMFC has higher accuracy but slower speed than the load cell type. In this paper, a simple mck modeling is performed for the Voice Coil Actuator(VCA) balance type checkweigher in EMFC. Determine the desired spring coefficient and proceed with system identification considering the effect of the electromagnetic damping coefficient generated by VCA.

Tip positioning of steerable catheters is important for a successful surgery. The catheter should bend in a flat plane and a quantitative method for pulling the pull wires must be established for accurate tip positioning. This paper presents a design of catheter tube and the proximal handle that enhances tip positioning of the catheter. The tube design facilitates tube to bend precisely along a flat plane. The handle design which includes a servo motor allows pulling the pull wire according to the quantitative standard.

Piezoelectric energy harvesting has gained attention owing to its effectiveness at harvesting electrical energy from various energy sources. Especially, with the increasing demand for smart highways, piezoelectric energy harvesting from road traffic has been increasingly studied. However, existing piezoelectric road-energy harvesters have limitations of low electrical output and low durability. A novel piezoelectric energy harvester was designed and fabricated to overcome these limitations. The proposed harvester had a maximum output power of 3.93 mW at a load resistance of 130 kΩ under an input displacement of 2.5 mm. The proposed harvester had 4.2 times more output power than the existing vibration-type road energy harvesters and was much less susceptible to destruction-in contrast to existing impact-type road-energy harvesters. The proposed road-energy harvester can be used as a power source for wireless sensor networks in smart highways.

In this study, a nonlinear piezoelectric energy harvester (PEH) with a ball tip mass was designed and fabricated for broadband energy harvesting. The proposed nonlinear PEH exhibits two resonant frequencies (5 and 15 Hz) and can harvest a considerable amount of electrical energy, whereas a conventional PEH with a rigid tip mass only exhibits one (15 Hz). The minimum acceleration that can induce nonlinearity in the proposed PEH was determined to be 3 m s –2 . In order to maximize the electrical output of the proposed PEH, 0.1 mm was selected as the optimal vibration amplitude of the ball among three options (0.1, 0.5, and 1.0 mm). The maximum output power of the proposed PEH was measured as 13.5 mW at 15 Hz and at a load resistance of 30 kΩ, which is the matching load resistance calculated and verified with the experimental result. The output power of the proposed PEH was measured to be 1.8 mW at 5 Hz and 45 kΩ, whereas that of the conventional PEH at 5 Hz was 0.03 mW, implying that the proposed PEH possesses one additional resonant frequency over the conventional PEH. In addition, the proposed PEH performs significantly better than the conventional PEH in terms of broadband energy harvesting. At a power level of 100 μW, the proposed PEH at 3 m s –2 provides a bandwidth of 20 Hz, which is more than 133% wider than the 15 Hz provided by the conventional PEH. By utilizing the nonlinearity with a ball tip mass, the PEH vibration is capable of harvesting considerable electrical energy from more than two resonant frequencies.

Piezoelectric energy harvesting generally demonstrates low output power because its output current is low compared to its high output voltage. The low current and high impedance limit the applications of piezoelectric energy harvesting systems. Thus, it is necessary to increase the output current and reduce the internal impedance. This study presents the fabrication of multilayer piezoelectric thick films with high output currents. Single-layer and five-layer piezoelectric devices are prepared using the tape-casting process. The material properties of each lead zirconate titanate (PZT) ceramic are measured using an impedance analyzer and a d33 meter. The electrical properties of the piezoelectric devices were evaluated by a controllable strain module using vibration exciter. The capacitance of the single-layer device was 7.33 nF and that of the five-layer device was 241.04 nF, which was 32.88 times higher than that of the single-layer device. The open circuit voltage of the five-layer device decreased 6.09 times compared to the single-layer, but the short circuit current increased 5.30 times. The impedance matching load of the five layer device for maximum power transfer was averagely 34.05 times smaller than that of single-layer. Under maximum power transfer conditions, the current of the five-layer PZT device was 6.61 times larger than the single-layer, even though the output power of both devices was similar. Because of this capacitance and current increase, the energy stored in the 220 μF capacitor for 10 s using the five-layer device was 920% larger compared to the energy stored using a single-layer.

Objective Adult appendicitis (AA) with equivocal computed tomography (CT) findings remains a diagnostic challenge for physicians. Herein we evaluated the diagnostic performance of several clinical scoring systems in adult patients with suspected appendicitis and equivocal CT findings. Methods We retrospectively evaluated 189 adult patients with equivocal CT findings. Alvarado, Eskelinen, appendicitis inflammatory response, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA), and adult appendicitis score (AAS) scores were evaluated, receiver operating characteristic analysis was conducted, and the optimal, low, and high cut-off values were determined for patient classification into three groups: low, intermediate, or high. Results In total, 61 patients were included in the appendicitis group and 128 in the non-appendicitis group. There were no significant differences between the area under the curve of the clinical scoring systems in the final diagnosis of AA for equivocal appendicitis on CT (Alvarado, 0.698; Eskelinen, 0.710; appendicitis inflammatory response, 0.668; RIPASA, 0.653; AAS, 0.726). A RIPASA score greater than 7.5 had a high positive predictive value (90.9) and an AAS score less than or equal to 5 had a high negative predictive value (91.7) in the diagnosis of AA. Conclusion The accuracy of clinical scoring systems in the diagnosis of AA with equivocal CT findings was moderate. Therefore, a high RIPASA score may assist in the diagnosis of AA in patients with equivocal CT findings, and a low AAS score may be used as a criterion for patient discharge. Most patients presented with intermediate scores. The patients with equivocal CT findings may be considered as a third diagnostic category of AA.

ObjectiveSubcutaneous local anaesthetic injection can be painful to patients in the ED. We evaluated the effect of cryotherapy by application of an ice cube to the injection site prior to injection in patients with simple lacerations.MethodsWe conducted a prospective, randomised, controlled trial in consented patients with simple lacerations needing primary repair at a single emergency centre from April to July 2016. We randomly assigned patients undergoing repair for simple lacerations to either the cryotherapy group or the control group (standard care; no cryotherapy or other pretreatment of the injection site). In cryotherapy group subjects, we applied an ice cube (size: 1.5×1.5×1.5 cm) placed inside a sterile glove on the wound at the anticipated subcutaneous lidocaine injection site for 2 min prior to injection. The primary outcome was a subjective numeric rating (0–10 scale) of the perceived pain from the subcutaneous local anaesthetic injections. Secondary outcomes were (a) perceived pain on a numeric scale for cryotherapy itself, that is, pain from contact of the ice cube/glove with the skin and (b) the rate of complications after primary laceration repair.ResultsFifty patients were enrolled, consented and randomised, with 25 in the cryotherapy group and 25 in the control group. The numeric rating scale for subcutaneous anaesthetic injections was median, IQR, 95% CI 2.0 (1 to 3.5), 1.81 to 3.47, respectively, in the cryotherapy group and 5.0 (3 to 7), 3.91 to 6.05 in the control group (Mann-Whitney U=147.50, p=0.001). No wound complications occurred in either group. The numeric rating scale for cryotherapy itself was median, IQR, 95% CI: 2.0 (1 to 3.5), 1.90 to 3.70.ConclusionPre-emptive topical injection site cryotherapy lasting 2 min before subcutaneous local anaesthetic injections can significantly reduce perceived pain from subcutaneous local anaesthetic injections in patients presenting for simple laceration repair.Trial registration numberKCT0001990.

We designed hydro electromagnetic and piezoelectric energy harvesters to power a smart water meter system. Usually, in water pipes, a water meter is necessary for checking water flow conditions within the pipe. However, supplying electrical energy to the water meter is a critical problem. The use of batteries or a direct connection to a power socket for this purpose causes other problems such as requiring regular replacement of the batteries and potential electric shock caused by water leakages. Furthermore, flow rate is checked at a specific location, typically the basement of the building. By constructing a smart water meter system which is self-powered by the energy harvesters and can transmit flow rate data wirelessly, time and effort could be saved. In addition, the proposed smart water meter system can detect water leakages in the pipes. In this paper, a turn-buckle type stainless steel waterwheel with a diameter of 90 mm and two pole magnets was proposed, as turn-buckle type waterwheels do not require any hole in the pipe unlike other self-powered water meters that use DC motor-based energy generation. In addition, by designing non-contact energy harvesters using magnets, the proposed energy harvesters are semi-permanent. The performance of the manufactured energy harvesters was analyzed under experimental conditions in a flowing water setup composed of a PVC pipe and a water pump. The electrical output power of the energy harvesters was measured under various load resistance conditions. The maximum root mean square (RMS) output power of the electromagnetic and the piezoelectric energy harvesters were 648 mW at 200 Ω and 0.196 mW at 10 kΩ, respectively. The generated electrical energy works differently. The energy harvested by the electromagnetic energy harvester is used to be a power source for the smart water meter system while the energy harvested by the piezoelectric energy harvester is used to be a water leakage detector for the water leakage warning system.

Background Intra-articular corticosteroid injection is a commonly used therapy for adhesive capsulitis, but not enough studies exist on the optimal timing of the injection. Objective To determine whether intra-articular corticosteroid injection has better outcomes in patients with earlier stage than later stage of adhesive capsulitis. Study Design Retrospective longitudinal study Setting University-affiliated tertiary care hospital. Participants Primary adhesive capsulitis patients (n=339) who were unresponsive to at least 1 month of conservative treatment and who had ultrasound-guided corticosteroid injection. Interventions Not applicable. Main Outcome Measurements Visual analogue scale, Shoulder Pain and Disability Index, and passive range of motion (flexion, abduction, external rotation, and internal rotation and extension) were evaluated at pretreatment, month 1 and 12 after the first injection. Results The result of the multiple regressions, which considered the main and the interaction effect of confounding variables, showed that the differences of all outcomes in both short-term effect at month 1 and long-term effect at month 12 are greater when the duration of pain prior to injection is shorter. Among the confounders, the injection number in the difference of internal rotation and extension between month 0 and 12 (IRE Δ(0-12)) was statistically significant. IRE Δ(0-12) was also greater when the pain duration was shorter, though the decrease in IRE Δ(0-12) differed depending on the number of injections. Conclusions Early injection improves outcomes of adhesive capsulitis at both short- and long-term follow-ups. If pain persists despite non-invasive and conservative treatments, early injection may be considered to shorten its natural history. Level of Evidence III