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The study aimed to investigate comorbidities, major adverse respiratory events, and mortality in patients with idiopathic pulmonary fibrosis (IPF). We established an IPF cohort and a comparative cohort matched for sex, age, and the date of IPF diagnosis. We recorded the most frequent comorbidities, the proportions, and time durations to the episode of major adverse respiratory events and death. Both cohorts were followed up to the end of 2016. We included 921 patients in the IPF cohort and 3,677 individuals in the comparative cohort. Comorbidities associated with IPF included pulmonary hypertension, chronic obstructive pulmonary disease, heart failure, asthma, and gastroesophageal reflux disease. The IPF cohort was more likely to have pneumonia (47.6 vs 12.0%), acute respiratory failure (17.8 vs 4.30%), chronic respiratory failure (4.23 vs 0.63%), and death (36.3 vs 15.0%) than the comparative cohort. The time durations to the first episode of pneumonia, acute respiratory failure, chronic respiratory failure, and death were 2.09 ± 2.98, 3.12 ± 3.62, 3.20 ± 4.03, and 3.27 ± 3.03 years in the IPF cohort. In conclusion, patients with IPF had significant comorbidities, particularly pulmonary and cardiovascular comorbidities. The duration from diagnosis to the major adverse respiratory events or death was short.

Background: In spinal revision surgery, previous pedicle screws (PS) may need to be replaced with new implants. Failure to accurately identify the brand of PS‐based instrumentation preoperatively may increase the risk of perioperative complications. This study aimed to develop and validate an optimal deep learning (DL) model to identify the brand of PS‐based instrumentation on plain radiographs of spine (PRS) using anteroposterior (AP) and lateral images. Methods: A total of 529 patients who received PS‐based instrumentation from seven manufacturers were enrolled in this retrospective study. The postoperative PRS were gathered as ground truths. The training, validation, and testing datasets contained 338, 85, and 106 patients, respectively. YOLOv5 was used to crop out the screws' trajectory, and the EfficientNet‐b0 model was used to develop single models (AP, Lateral, Merge, and Concatenated) based on the different PRS images. The ensemble models were different combinations of the single models. Primary outcomes were the models' performance in accuracy, sensitivity, precision, F1‐score, kappa value, and area under the curve (AUC). Secondary outcomes were the relative performance of models versus human readers and external validation of the DL models. Results: The Lateral model had the most stable performance among single models. The discriminative performance was improved by the ensemble method. The AP + Lateral ensemble model had the most stable performance, with an accuracy of 0.9434, F1 score of 0.9388, and AUC of 0.9834. The performance of the ensemble models was comparable to that of experienced orthopedic surgeons and superior to that of inexperienced orthopedic surgeons. External validation revealed that the Lat + Concat ensemble model had the best accuracy (0.9412). Conclusion: The DL models demonstrated stable performance in identifying the brand of PS‐based instrumentation based on AP and/or lateral images of PRS, which may assist orthopedic spine surgeons in preoperative revision planning in clinical practice. [ABSTRACT FROM AUTHOR]

Simple Summary: Radiotherapy is the main local treatment for head and neck cancer. Radiation oncologists and patients should be alert to late carotid artery stenosis and brain necrosis after treatment. Objective: This study aims to examine whether radiation therapy doses are related to incidences of carotid artery stenosis and brain necrosis in a large-scale real-world database. Methods: We identified a cohort of HNC patients from the catastrophic illness patient dataset using ICD-9 or ICD-10 to compare the incidence and risks of carotid artery stenosis (CAS) and brain necrosis (RIBN) in patients who received a radiation therapy dose of ≥5400 cGy/30 fractions (group A) with those who received a radiation therapy dose of <5400 cGy/30 fractions (group B). The incidence and hazard ratios were quantified using Cox proportional hazards models. Results: A total of 19,964 patients were identified in group A and group B. Among them, 965 and 863 cases of CAS and 435 and 359 cases of RIBN were identified in group A and group B, respectively. There was no statistically significant association between the two groups for CAS risk, whereas there was a statistically significant association between the two groups for RIBN risk. The most common primary site of head and neck cancers was the nasopharynx (1144 of 19,964, 5.73%). Conclusions: Our study suggests that RT may increase the risk of carotid stenosis and brain necrosis in patients with NPC. To ensure patient safety during treatment, the optimal balance between tumor control and toxicity prevention in individual patients through minimization of the radiation dose to all relevant OARs must be properly understood. [ABSTRACT FROM AUTHOR]

VO2 thin films are fabricated by the reactive high power impulse magnetron sputtering technique. Their thermochromic properties are found to be greatly affected by the addition of nitrogen during the deposition process. These include an effect of localized surface plasmon resonance due to isolated island structures. Furthermore, low transition temperatures below 45 °C are observed due to oxygen-deficient conditions. Also, the transition temperature decreases with an increase in the thickness of the TiO2 buffer layer. The reduction in transition temperature could be as low as 39 °C with a solar modulating ability of 4% at a thicker buffer of 300 nm under a high gas ratio of 21.7% for nitrogen. The crystalline phase is identified by x-ray diffraction, showing that the intensity of monoclinic crystallites at a diffraction angle of 2θ = 27.8° for (011) phase decreases with an increase in the amount of nitrogen, whereas a relaxing shift is detected near the diffraction angle of 2θ = 37.0° for ( 2 ¯ 11) phase. Similar behavior is seen in the peak shift of the (004) phase for TiO2. The d-spacing of the crystallization phase with island structure is identified by high-resolution transmission electron microscopy. The evolution of stress release, which is strongly dependent on surface morphology, is consistent with x-ray pole figure representation. The visible transmittance and solar modulation ability as functions of the amount of nitrogen and the buffer thickness of TiO2 are discussed. [ABSTRACT FROM AUTHOR]