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A detailed analysis of high-resolution (3.5 kHz) chirp seismic profiles acquired in the Gunsan Basin of the central Yellow Sea revealed that hydrocarbon gases are actively seeping via the formation of many plumes. The uppermost sedimentary layer was acoustically confirmed to be fully or partially charged with gases. Somewhat favored by the low-tide period, episodic gas seepage is mainly associated with the underlying fault systems of Cretaceous-Cenozoic sedimentary strata in the southwestern part of the basin. Catastrophic gas expulsion seems to have formed a crater at the sidewall of a sedimentary ridge and two diapirs. Here, methane is poorly concentrated but rich in the heavy carbon isotope (δ13C, −52.6‰ to −44.7‰ The Vienna Peedee Belemnite [VPDB]), indicating that methane formed mainly through biodegradation of heavy oils at depth remains in the shallow sediments following its expulsion. Episodic rapid upward advection of porewater is also manifest by unmixed heavy methane trapped in the upper part of the primary biogenic methane (δ13C, about −90‰ VPDB)-filled sediment core. These findings imply that the Gunsan Basin fulfills the requirements for possible generation and preservation of oil and gas, like the petroliferous basins of eastern China and the Yellow Sea.

BackgroundRecent advancements in artificial intelligence, such as GPT-3.5 Turbo (OpenAI) and GPT-4, have demonstrated significant potential by achieving good scores on text-only United States Medical Licensing Examination (USMLE) exams and effectively answering questions from physicians. However, the ability of these models to interpret medical images remains underexplored. ObjectiveThis study aimed to comprehensively evaluate the performance, interpretability, and limitations of GPT-3.5 Turbo, GPT-4, and its successor, GPT-4 Vision (GPT-4V), specifically focusing on GPT-4V’s newly introduced image-understanding feature. By assessing the models on medical licensing examination questions that require image interpretation, we sought to highlight the strengths and weaknesses of GPT-4V in handling complex multimodal clinical information, thereby exposing hidden flaws and providing insights into its readiness for integration into clinical settings. MethodsThis cross-sectional study tested GPT-4V, GPT-4, and ChatGPT-3.5 Turbo on a total of 227 multiple-choice questions with images from USMLE Step 1 (n=19), Step 2 clinical knowledge (n=14), Step 3 (n=18), the Diagnostic Radiology Qualifying Core Exam (DRQCE) (n=26), and AMBOSS question banks (n=150). AMBOSS provided expert-written hints and question difficulty levels. GPT-4V’s accuracy was compared with 2 state-of-the-art large language models, GPT-3.5 Turbo and GPT-4. The quality of the explanations was evaluated by choosing human preference between an explanation by GPT-4V (without hint), an explanation by an expert, or a tie, using 3 qualitative metrics: comprehensive explanation, question information, and image interpretation. To better understand GPT-4V’s explanation ability, we modified a patient case report to resemble a typical “curbside consultation” between physicians. ResultsFor questions with images, GPT-4V achieved an accuracy of 84.2%, 85.7%, 88.9%, and 73.1% in Step 1, Step 2 clinical knowledge, Step 3 of USMLE, and DRQCE, respectively. It outperformed GPT-3.5 Turbo (42.1%, 50%, 50%, 19.2%) and GPT-4 (63.2%, 64.3%, 66.7%, 26.9%). When GPT-4V answered correctly, its explanations were nearly as good as those provided by domain experts from AMBOSS. However, incorrect answers often had poor explanation quality: 18.2% (10/55) contained inaccurate text, 45.5% (25/55) had inference errors, and 76.3% (42/55) demonstrated image misunderstandings. With human expert assistance, GPT-4V reduced errors by an average of 40% (22/55). GPT-4V accuracy improved with hints, maintaining stable performance across difficulty levels, while medical student performance declined as difficulty increased. In a simulated curbside consultation scenario, GPT-4V required multiple specific prompts to interpret complex case data accurately. ConclusionsGPT-4V achieved high accuracy on multiple-choice questions with images, highlighting its potential in medical assessments. However, significant shortcomings were observed in the quality of explanations when questions were answered incorrectly, particularly in the interpretation of images, which could not be efficiently resolved through expert interaction. These findings reveal hidden flaws in the image interpretation capabilities of GPT-4V, underscoring the need for more comprehensive evaluations beyond multiple-choice questions before integrating GPT-4V into clinical settings.

The cultivation of abalone, a species with high economic value, faces significant challenges due to its slow growth rate and sensitivity to environmental conditions, resulting in prolonged cultivation periods and increased mortality risks. To address these challenges, we propose a novel probabilistic machine learning approach based on a Bayesian framework to predict abalone growth by modeling key environmental factors, including water temperature, pH, salinity, nutrient supply, and dissolved oxygen levels. The proposed method employs a weighted Bayesian kernel machine regression model, integrating Gaussian processes with a spike-and-slab prior to identify influential variables. This approach accommodates heteroscedasticity, capturing varying levels of variance across observations, and models complex, non-linear relationships between environmental factors and abalone growth. Our analysis reveals that time, dissolved oxygen, salinity, and nutrient supply are the most critical factors influencing growth, while water temperature and pH play relatively minor roles under controlled indoor farming conditions. Interaction analysis highlights the non-linear dependencies among factors, such as the combined effects of salinity and nutrient supply. The proposed model not only improves prediction accuracy compared to baseline methods, but also provides actionable insights into the environmental dynamics that optimize abalone growth. These findings underscore the potential of advanced machine learning techniques in enhancing aquaculture practices and offer a robust framework for managing complex, multi-variable systems in sustainable farming.

The application of machine learning (ML) and remote sensing (RS) in soil and water conservation has become a powerful tool. As analytical tools continue to advance, the variety of ML algorithms and RS sources has expanded, providing opportunities for more sophisticated analyses. At the same time, researchers are required to select appropriate technologies based on the research objectives, topic, and scope of the study area. In this paper, we present a comprehensive review of the application of ML algorithms and RS that has been implemented to advance research in soil and water conservation. The key contribution of this review paper is that it provides an overview of current research areas within soil and water conservation and their effectiveness in improving prediction accuracy and resource management in categorized subfields, including soil properties, hydrology and water resources, and wildfire management. We also highlight challenges and future directions based on limitations of ML and RS applications in soil and water conservation. This review aims to serve as a reference for researchers and decision-makers by offering insights into the effectiveness of ML and RS applications in the fields of soil and water conservation.

Abstract The Pacific abalone (Haliotis discus hannai) is the most economically valuable shellfish species in Northeast Asia, accounting for most of the shellfish production in South Korea. Despite the continuous improvement in the productivity of domestic abalone aquaculture, rapid seawater temperature changes caused by global warming have led to mass mortality in coastal abalone farms. Therefore, research on environmental stressors is urgently needed to prevent abalone production losses. This study analyzed the expression of heat shock protein (HSP) genes in foot muscles of H. discus hannai and metabolic parameters including glucose, lysozyme, catalase, D‐lactate, and trehalose levels in the hemolymph under acute high temperature, low temperature, low salinity, and air exposure. Quantitative reverse‐transcription polymerase chain reaction analysis showed that HSP20 expression was downregulated in all experimental groups, whereas HSP70 expression increased immediately in all experimental groups except for the low‐temperature stress group. Hemolymph analysis showed that glucose and lysozyme levels increased significantly immediately after treatment in all groups, and decreased during the recovery period. Together, the results indicate that low water temperature stress had the smallest effect on abalone among the treatments. We conclude that the other treatments acted as stressors of abalone and that HSP genes, glucose, and lysozyme can be used as stress indicators in H. discus hannai.

Abstract Near-perfect light absorbers (NPLAs), with absorbance, $${{{{{{{\mathcal{A}}}}}}}}$$ A , of at least 99%, have a wide range of applications ranging from energy and sensing devices to stealth technologies and secure communications. Previous work on NPLAs has mainly relied upon plasmonic structures or patterned metasurfaces, which require complex nanolithography, limiting their practical applications, particularly for large-area platforms. Here, we use the exceptional band nesting effect in TMDs, combined with a Salisbury screen geometry, to demonstrate NPLAs using only two or three uniform atomic layers of transition metal dichalcogenides (TMDs). The key innovation in our design, verified using theoretical calculations, is to stack monolayer TMDs in such a way as to minimize their interlayer coupling, thus preserving their strong band nesting properties. We experimentally demonstrate two feasible routes to controlling the interlayer coupling: twisted TMD bi-layers and TMD/buffer layer/TMD tri-layer heterostructures. Using these approaches, we demonstrate room-temperature values of $${{{{{{{\mathcal{A}}}}}}}}$$ A =95% at λ=2.8 eV with theoretically predicted values as high as 99%. Moreover, the chemical variety of TMDs allows us to design NPLAs covering the entire visible range, paving the way for efficient atomically-thin optoelectronics.

Recently, there has been increasing awareness about greenhouse gases, resulting in considerable efforts to increase the fuel efficiency of ships and reduce the amount of gases they emit. Thus, pre-swirl ducts (PSDs) have been widely adopted in ships due to their high fuel efficiency. However, attaching PSDs induces a change in the fatigue characteristics of ship structures, as evidenced by the reported crack in the rudder of a ship with an attached PSD. Nevertheless, the arrangement of a ship’s rudder, which is a crucial factor in a rudder’s fatigue characteristics, continues to rely on the empirical rule without any consideration of fatigue characteristics. This study investigated a propeller–rudder interaction distance ensuring fatigue stability with the PSD attachment and developed a procedure for designing it considering fatigue characteristics. In the developed procedure, the fatigue characteristics of rudders due to the propeller wake were obtained through frequency domain finite element method (FEM) analysis utilizing computational fluid dynamics (CFD) analysis results of a rudder’s surface pressure fluctuations. In addition, the potential for fatigue failures in ship rudders was evaluated by employing damage factors. A comparative analysis of rudder fatigue characteristics considering the presence of PSDs revealed that attaching them increased the stresses in the rudder. Furthermore, the analysis results demonstrated that PSD attachment can result in the fatigue failure of rudders. Finally, the propeller–rudder interaction distance of ships with an attached PSD was newly proposed using the developed procedure. The proposed propeller–rudder interaction distance is expected to enable the design of appropriate rudder arrangements for ships with attached PSDs while ensuring fatigue stability.

The popliteal artery damage is present to range from 1.6% to 64% of patients with knee dislocation, and it is crucial to evaluate vascular damage even if there are no prominent ischemic changes in the distal area. The injury of the popliteal artery by high-energy forces around the knee caused by a fall or traffic accident is a potentially limb-threatening complication in traumatic knee dislocation. The popliteal artery injury by blunt trauma has a high risk of limb amputation because the initial symptoms can show normal vascular circulation without urgent ischemia or obvious vascular injury signs. Since the collateral branches can delay the symptoms of decisive ischemia or pulseless extremity, the vascular damage is a major cause of limb amputation. In the present study, we describe a rare case of delayed diagnosis of popliteal artery injury after traumatic knee dislocation, requiring urgent limb revascularization surgery. After revascularization of the occluded popliteal artery, graft interposition was performed, and successful restoration was confirmed. This case illustrates that, even if ankle-brachial index >0.9 or equal pedal pulse to the uninjured extremity, serial vascular evaluation is required if there are soft signs such as diminished pulses, neurologic signs, or high-energy damage such as multiple ligament ruptures since delayed diagnosis of artery injury can be the major cause of limb amputation. The clinicians need to regard high-energy trauma such as multiple ligament rupture around the knee as a hard sign, and immediate computed tomography angiography can be helpful for accurate diagnosis and treatment.

Background: The number of patients with incidentally identified pulmonary nodules is increasing. This study attempted to confirm the usefulness and safety of video-assisted thoracic surgery (VATS) core needle biopsy of pulmonary nodules. Methods: Data from 18 patients diagnosed with pulmonary nodules who underwent VATS core need biopsy were retrospectively reviewed. Results: Of the 18 patients, 15 had malignancies (primary lung cancer, n=14; metastatic lung cancer, n=1), and 3 had benign nodules. Mortality and pleural metastasis did not occur during the follow-up period. Conclusion: In patients with solitary pulmonary nodules that require tissue confirmation, computed tomography-guided percutaneous cutting needle biopsy or diagnostic pulmonary resection sometimes may not be feasible choices due to the location of the solitary pulmonary nodule or the patient’s impaired pulmonary function, VATS core needle biopsy may be performed in these patients as an alternative method.

Summary: Metasurface-based color splitters are emerging as next-generation optical components for image sensors, replacing classical color filters and microlens arrays. In this work, we report how the design parameters such as the device dimensions and refractive indices of the dielectrics affect the optical efficiency of the color splitters. Also, we report how the design grid resolution parameters affect the optical efficiency and discover that the fabrication of a color splitter is possible even in legacy fabrication facilities with low structure resolutions.

Background: Carotid endarterectomy (CEA) is used to treat carotid stenosis, which is associated with cerebral infarction and may result in neurologic deficits such as stroke, transient ischemic attack (TIA), and local nerve injury. To decrease surgery-related complications and improve patient satisfaction with esthetic outcomes, efforts have been made to minimize incision size instead of using a standard longitudinal incision. Methods: We performed a retrospective analysis of 151 cases of CEA, of which 110 used conventional incisions and 41 used high mini-skin incisions (HMIs), from March 2015 to December 2021 at a single institution. Short-term (30-day) postoperative results were evaluated for rates of mortality, stroke, TIA, and cranial/cervical nerve injuries. Risk factors for nerve injury were also assessed. Results: The HMI group showed significantly (p

Black ice is a thin coating of ice on the road surface, which strongly reduces friction at the tire-road surface, resulting in dangerous driving when it happens. An appropriate diagnostic of black ice could prevent traffic accidents as well as provide timely notice to drivers. Therefore, this study aims at developing a black ice prediction model to diagnose the probability of black ice formation. Several combinations that can form road ice have been considered, including freezing rain, hoar frost, freezing of wet roads. In addition, black ice risky index (BRI) has been computed to reflect the probability of black ice formation. To acquire a fast prediction and high accuracy, the existing Geographical Information System (GIS) database and meteorological data have been utilized. GIS database includes road geometry and location of automatic weather stations, while the meteoritical data consists of air temperature, wind speed, humidity, cloud cover. The model has been developed based on the Python programming language. A 5-km road condition was observed from 1 December to 31 December 2021 to determine the model accuracy. Based on the results from the prediction model, black ice formation has been verified when the BRI is higher than 0.8. The model may be useful to develop black ice diagnostic program.

Background Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. Methods We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. Results Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. Conclusion Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.

Abstract Biomedical databases grow by more than a thousand new publications every day. The large volume of biomedical literature that is being published at an unprecedented rate hinders the discovery of relevant knowledge from keywords of interest to gather new insights and form hypotheses. A text-mining tool, PubTator, helps to automatically annotate bioentities, such as species, chemicals, genes, and diseases, from PubMed abstracts and full-text articles. However, the manual re-organization and analysis of bioentities is a non-trivial and highly time-consuming task. ChexMix was designed to extract the unique identifiers of bioentities from query results. Herein, ChexMix was used to construct a taxonomic tree with allied species among Korean native plants and to extract the medical subject headings unique identifier of the bioentities, which co-occurred with the keywords in the same literature. ChexMix discovered the allied species related to a keyword of interest and experimentally proved its usefulness for multi-species analysis.

Abstract Background The axial headless compression screw (AHCS) technique is a widely used method for distal interphalangeal joint (DIPJ) and thumb IPJ arthrodesis. However, it might not be suitable for cases over 10° flexion of fusion angle and extremely small-sized phalanx. Here, the authors describe the nonaxial multiple small screws (NMSS) technique, compare the mechanical strength of the NMSS technique with the AHCS technique, and suggest clinical outcomes of the NMSS technique. Methods DIPJ and thumb IPJ arthrodesis models were simulated in the 4th generation composite bone hand. Fixation with three 1.5 mm cortical screws (NMSS) or one HCS (AHCS) was performed in each pair of the phalanx. The bending stiffness and load to failure were tested in 10 pairs of each specimen, and the torsional stiffness and torque to failure were tested in seven pairs of each specimen. Moreover, 15 consecutive clinical DIPJ and thumb IPJ arthrodesis cases were reviewed retrospectively. Results The NMSS specimens showed significantly higher bending load to failure, torsional stiffness, and torque to failure than the AHCS specimens. All 15 arthrodesis cases were united without severe complications. The mean fusion angle was 16.3° for the nine cases of the flexed target position. Conclusions The NMSS technique showed biomechanical stability comparable to that of the AHCS technique in DIPJ and thumb IPJ arthrodesis. Thus, the NMSS technique could be used as a feasible option in DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required.

Abstract Background Mini-screws are widely used as temporary anchorages in orthodontic treatment, but have the disadvantage of showing a high failure rate of about 10%. Therefore, orthodontic mini-screws should have high biocompatibility and retention. Previous studies have demonstrated that the retention of mini-screws can be improved by imparting bioactivity to the surface. The method for imparting bioactivity proposed in this paper is to sequentially perform anodization, periodic pre-calcification, and heat treatments with a Ti–6Al–4V ELI alloy mini-screw. Materials and methods A TiO2 nanotube-structured layer was formed on the surface of the Ti–6Al–4V ELI alloy mini-screw through anodization in which a voltage of 20 V was applied to a glycerol solution containing 20 wt% H2O and 1.4 wt% NH4F for 60 min. Fine granular calcium phosphate precipitates of HA and octacalcium phosphate were generated as clusters on the surface through the cyclic pre-calcification and heat treatments. The cyclic pre-calcification treatment is a process of immersion in a 0.05 M NaH2PO4 solution and a saturated Ca(OH)2 solution at 90 °C for 1 min each. Results It was confirmed that the densely structured protrusions were precipitated, and Ca and P concentrations, which bind and concentrate endogenous bone morphogenetic proteins, increased on the surface after simulated body fluid (SBF) immersion test. In addition, the removal torque of the mini-screw fixed into rabbit tibias for 4 weeks was measured to be 8.70 ± 2.60 N cm. Conclusions A noteworthy point in this paper is that the Ca and P concentrations, which provide a scaffold suitable for endogenous bone formation, further increased over time after SBF immersion of the APH group specimens. The other point is that our mini-screws have a significantly higher removal torque compared to untreated mini-screws. These results represent that the mini-screw proposed in this paper can be used as a mini-screw for orthodontics.

Though active metasurfaces have been attractive for applications requiring control of optical wavefronts, realizing metasurfaces with full phase control remains a challenge. Here, the authors report a metasurface design strategy for enhanced dynamic phase modulation and tunability.

Herein, a multimodal tactile sensing module that can improve the dexterous manipulation capabilities of robots with parallel grippers is reported. The tactile sensor consists of a 4 × 4 matrix 3‐axis force sensor array (with spacings of 2 mm) and a single‐temperature sensor. The tactile sensor uses inorganic silicon and gold as materials for the detection of strain and temperature and a polymer‐based elastomer to encapsulate the sensing layer. The sensing module is equipped with a readout circuitry for signal processing. Within the measurable force range (≈1.5 N) of the sensor cell, a prototype module exhibits a repeatability error within 2%, a hysteresis error within 3%, and a resolution as small as 10 mN. Furthermore, each sensor cell independently measures 3‐axis forces with a cross‐talk error of approximately 3%. The temperature sensor exhibits linear output properties in the approximate range of 5–75 °C. Experiments are performed by mounting the module on a parallel gripper to grasp a paper cup and a reflex hammer toy. According to the experimental results, the sensor can accurately detect the state of contact with an object by analyzing three tactile modalities (i.e., 3‐axis force distribution, vibration, and temperature).

Light-burned MgO cement has a lower calcination temperature than ordinary Portland cement. It has been widely studied as a measure to reduce carbon dioxide because of its property of absorbing carbon dioxide during curing. This study investigated the effects of calcination temperature on the physical properties of light hydrated magnesium carbonate and calcined MgO hydrated in moisture and CO2 at 25 °C and 60 °C. The crystal size of light-burned MgO increased with increasing calcination temperature, and carbonates were formed through carbonation curing. Further, nesquehonite and hydromagnesite were formed in the 25CC and 60CC specimens, respectively, and the carbonate formation reduced with increasing crystal size. The highest compressive strength of 3.5 MPa was obtained for the 25CC specimen in which nesquehonite was formed; however, hydromagnesite exhibited better CO2 sequestration capacity.

The stomach temporarily stores food and secretes gastric juices to break down and digest food. The normal process is the movement of food digested from the stomach to the duodenum, with the pylorus as a passageway. This paper reports the case of a patient with an ectopic gastric pylorus who presented with gastrointestinal bleeding. A 62-year-old man complained of melena with mild dizziness and nausea. An endoscopic examination revealed a gastric ulcer, approximately 1 cm in diameter, and exposed blood vessels on the posterior wall of the upper body. No normal pyloric structure was observed in the distal antrum, and an opening leading to the duodenum was noted in the posterior wall of the upper body adjacent to the ulcer. This case presents a congenital pyloric ectopic opening in the upper body of the stomach, not in the distal antrum, suggesting a rare gastric morphological variation.

Abstract Background Coronavirus disease 2019 (COVID-19) has become a global pandemic, with healthcare workers at a high risk of exposure. During this pandemic, endoscopists must wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission; however, few studies have reported the impact of face shields on the quality of gastrointestinal (GI) endoscopy. We aimed to determine whether the use of PPE, including face shields, affected the quality of GI endoscopy during the COVID-19 pandemic. Methods The medical records of patients who had undergone screening or surveillance colonoscopy and gastric endoscopic submucosal dissection (ESD) at Dong-A University Hospital between June 2020 and March 2021 were retrospectively reviewed. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists also wore face shields. We compared GI endoscopy quality indicators between the first five months (no face shields) and the second five months (with face shields). In the non-face shield and face shield groups, we calculated the overall adenoma detection rates (ADRs), polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), complete resection rate (CRR), number of polyps and/or adenomas per colonoscopy, and gastric ESD procedure time. Results In total, 1359 study patients had undergone screening or surveillance colonoscopy (face shield group, n = 679; non-face shield group, n = 680). No statistically significant between-group differences were observed (PDR, 49.04 vs. 52.50%, p = 0.202; ADR, 38.59 vs. 38.97%, p = 0.884; SSPDR, 1.91 vs. 1.32%, p = 0.388; ANDR, 3.98 vs. 3.97%, p = 0.991, respectively). No difference was found in colonoscopy quality indicators between patients examined by experienced and trainee endoscopists with and without face shields. Of 144 study patients who had undergone gastric ESD for gastric neoplasms, there were 72 patients in each group. No statistically significant differences were found in the CRR (94.44 vs 93.05%, p = 1.000) and procedure times (19.22 ± 9.33 vs. 19.03 ± 11.49, p = 0.911). Conclusions Wearing face shields during the COVID-19 pandemic did not affect the quality indicators for GI endoscopy.

BackgroundThe purpose of this study was to examine the relationship between the lobar emphysema ratio (LER) and tumor recurrence and survival in patients with stage I non-small cell lung cancer (NSCLC).MethodsWe enrolled 258 patients with surgically proven stage I NSCLC. These patients underwent noncontrast chest CT, and pulmonary lobe segmentation and lobar emphysema quantification were performed using commercially available software. We assessed the LER in the lobe with lung cancer. We divided the patients into two groups according to the LER, and the cut-off value was 1. Furthermore, we analyzed the disease-free survival of high LER and other clinical factors after surgical resection.ResultsThe 258 patients were divided into two groups: low LER (n = 195) and high LER (n = 63). The right upper lobe was the most frequent location in lung cancer and the most severe location in emphysema. In the Kaplan‒Meier curve, high LER showed a significantly lower disease-free survival (8.21 ± 0.27 years vs 6.53 ± 0.60 years, p = 0.005) and overall survival (9.56 ± 0.15 years vs. 8.51 ± 0.49 years, p = 0.011) than low LER. Stage Ib (2.812 [1.661-4.762], pConclusionA LER of more than 1% in the lobe with lung cancer is a poor predictor for cancer recurrence and overall survival in patients with stage I NSCLC.

Innominate artery aneurysms are challenging for surgeons to treat because of the requirement for brain protection during surgery. In innominate artery aneurysms, the endovascular approach does not require cardiopulmonary bypass, but patients who can be treated using this approach are limited in number, and the long-term results of endovascular treatment are unclear. Here, we report our experience of successfully treating a patient with an innominate artery aneurysm using near-infrared spectroscopy without cardiopulmonary bypass support or hypothermic circulatory arrest.

Background/Aims A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model. Methods In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed. Results The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group. Conclusions The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.

Background: Based on the controversy over whether the extensor tendon is the only lesion of lateral epicondylitis of the elbow and numerous reports of concomitant lateral collateral ligament involvement, potential damage to the lateral collateral ligament complex should be considered for the treatment. Methods: About 25 elbows in 23 patients (débridement group) and 22 elbows in 20 patients (reconstruction group) who were diagnosed with lateral epicondylitis and had an average of 22 months of symptoms revealing anatomical lesion on MRI were included. The capitellum-sublime tubercle-radial head (CSR) angle was measured on both sides preoperatively, and the visual analog scale (VAS) and Mayo elbow performance score (MEPS) were measured over 12 months, postoperatively. Results: The initial preoperative mean VAS was statistically significant with 4.6 in the débridement group and 6.5 in the reconstruction group (P

Subwavelength dielectric resonators have been demonstrated to provide an authentic platform to excite high-Q resonances in flat optics. Here, we present a strategy to modulate the high-Q resonances electrically using graphene. In the proposed strategy, the high-Q resonance is invoked through the use of a lateral guided-mode resonance that is spectrally aligned with a vertical thin film interference, while graphene is employed to engineer the overall absorption rate. This configuration allows for near unity modulations in both the transmission and the reflection simultaneously. Theoretical analysis shows that the excitation of the high-Q guided-mode resonance is dictated by the electrically tunable interband absorption in graphene while the radiative coupling channel remains intact. In particular, it is shown that the electrical modulation of the high-Q guided-mode resonance facilitates remarkably efficient light modulation without being limited by the graphene quality.

The H contents and H embrittlement (HE) of Zn- and ZnNi-electrodeposited SCM435 bolts were quantitatively evaluated before and after baking. The Zn-coated bolt possessed higher H contents than the ZnNi-coated bolt in as-electrodeposited and baked states. H atoms were strongly trapped inside the coating layers. The Zn-coated bolt underwent flaking of coating layer during baking at temperatures above 200 °C due to H effusion through the brittle δ phase. The Zn-coated bolt exhibited no HE regardless of baking despite of its high H content due to no permeation of H into the steel substrate during electrodeposition and tensile deformation.

Since the first reported case of coronavirus disease 2019 (COVID-19) in December 2019, the numbers of confirmed cases and deaths have continued to increase exponentially despite multi-factorial efforts. Although various attempts have been made to improve the level of evidence for extracorporeal membrane oxygenation (ECMO) treatment over the past 10 years, most experts still hesitate to take an active position on whether to apply ECMO in COVID-19 patients. Several ECMO management guidelines have been published recently, but they reflect some important differences from the Korean medical system and aspects of real-world medical practice in Korea. We aimed to find evidence on the efficacy of ECMO for COVID-19 patients by reviewing the published literature and to propose expert recommendations by analyzing the Korean COVID-19 ECMO registry data.

Acoustic graphene plasmons are superior to the graphene surface plasmons in field confinement and normalized propagation length, thus promising for applications. Here, the authors report near-field imaging of acoustic plasmons in high-quality CVD graphene, measure the AGP dispersion and propagation loss, and investigate their behavior in a periodic structure.

Abstract Background Septic arthritis of digits needs urgent treatment. When treatments delayed or insufficient, patients may be referred to the upper-level hospital due to uncontrolled infection. We reviewed the treatment history of referred patients and compared the microorganisms and the clinical course of both primary and referred patients as relevant studies are rare. Methods In this retrospective review of consecutive case series, 45 patients (primary, n = 11; referred, n = 34) were treated with multiple irrigation and debridement. Cefazolin was used as empiric antibiotics, then changed according to microbiologic study. Previously used antibiotics, treatment delay, surgical history of the referred patients were reviewed. Identified microorganisms, required surgical intervention, hospital stay, radiologic outcome, functional outcomes were compared between both groups. Results In the referred patients, methicillin-resistant Staphylococcus aureus (MRSA) was commonly found and cefazolin was susceptible in only 15% of the cases. Longer hospital stay, prolonged antibiotic therapy, more surgical intervention including flap surgery was required to treat the referred patients. Postoperative pain was not severe in daily activities, but the final range of motion was significantly less in the referred patients compared to the primary patients. Conclusions This study suggests that in the treatment of uncontrolled septic arthritis of the digits, antibiotic agents covering MRSA may shorten the duration of antibiotic therapy in areas of high MRSA incidence. Besides, more number of I & D including flap surgery may be required for the referred patients compared with the primary patients. These findings can help the surgeon in setting up a treatment plan or in counseling of referred patients with uncontrolled septic arthritis of the digits.

As regulations concerning ship vibration and noise are becoming stricter, considerable attention is being drawn to prediction technologies for ship vibration and noise. In particular, the resonance and lock-in phenomena caused by vortex-induced vibration (VIV) have become considerably important with increases in the speed and the size of ships and ocean structures, which are known to cause structural problems. This study extends the fluid-structure interaction (FSI) analysis method to predict resonances and lock-in phenomena of high modes and VIV of ship rudders. Numerical stability is secured in underwater conditions by implementing added mass, added damping, and added stiffness by applying the potential theory to structural analysis. An expanded governing equation is developed by implementing displacements and twist angles of high modes. The lock-in velocity range and resonant frequencies of ship rudders obtained using the developed FSI method agree well with the experimental results and the analytic solution. A comparison with local vibration guidelines published by Lloyd’s Register shows that predictions of resonances and lock-in phenomena of high modes are necessary in the shipbuilding industry due to the possible risks like fatigue failure.

Cases of undifferentiated pleomorphic sarcoma of the thoracic aorta are rare, and usually present with embolic events, renovascular hypertension, or back pain. Mural-based undifferentiated pleomorphic sarcomas that present as ruptured saccular aneurysms are extremely rare and are difficult to differentiate from mycotic aneurysms or penetrating atherosclerotic ulcers. Herein, we report a case of histopathologically proven undifferentiated pleomorphic sarcoma arising from the wall of the descending thoracic aorta that manifested as a mass after thoracic endovascular aortic repair for the treatment of a ruptured saccular aneurysm. We present findings obtained by CT and PET to provide helpful information for the accurate diagnosis and appropriate treatment of future cases.

An endoscopic mucosal resection (EMR) is used widely as an alternative treatment to a surgical resection for early gastric neoplastic lesions. Among the unusual complications of gastric EMR, perforation is usually manifested as a pneumoperitoneum. This paper reports a patient with a left-side pneumothorax without pneumoperitoneum as a complication of gastric EMR. The patient developed a left side pneumothorax after gastric EMR in the gastric fundus and recovered without further complications after conservative treatment, including endoscopic clipping.

In the oxidative dehydrogenation (ODH) process that converts ethylbenzene to styrene, vanadium-based catalysts, especially V2O5, are used in a CO2 atmosphere to enhance process efficiency. Here we demonstrate that the activation energy of V2O5 can be manipulated by exposure to high pressure CO2, using V2O5 nanowires (VON). The oxidation of V4+ to V5+ was observed by X-ray photoelectron spectroscopy. The ratio of V4+/V5+ which the typical comparable feature decreased 73.42%. We also found an increase in the interlayer distance in VON from 9.95 Å to 10.10 Å using X-ray diffraction patterns. We observed changes in the peaks of the stretching mode of bridging triply coordinated oxygen (V3O), and the bending vibration of the bridging VOV, using Raman spectroscopy. We confirmed this propensity by measuring the CO2 pressure-dependent conductance of VON, up to 45 bar. 92.52% of decrease in the maximum conductance compared with that of the pristine VON was observed. The results of this study suggest that ODH process performance can be improved using the VON catalyst in a high pressure CO2 atmosphere.