Assessment of the total organic carbon employing the different nature-inspired approaches in the Nakdong River, South Korea.

Total organic carbon (TOC) has vital significance for measuring water quality in river streamflow. The detection of TOC can be considered as an important evaluation because of issues on human health and environmental indicators. This research utilized the novel hybrid models to improve the predictive accuracy of TOC at Andong and Changnyeong stations in the Nakdong River, South Korea. A data pre-processing approach (i.e., complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN)) and evolutionary optimization algorithm (i.e., crow search algorithm (CSA)) were implemented for enhancing the accuracy and robustness of standalone models (i.e., multivariate adaptive regression spline (MARS) and M5Tree). Various water quality indicators (i.e., TOC, potential of Hydrogen (pH), electrical conductivity (EC), dissolved oxygen (DO), water temperature (WT), chemical oxygen demand (COD), and suspended solids (SS)) were utilized for developing the standalone and hybrid models based on three input combinations (i.e., categories 1~3). The developed models were evaluated utilizing the correlation coefficient (CC), root-mean-square error (RMSE), and Nash-Sutcliffe efficiency (NSE). The CEEMDAN-MARS-CSA based on category 2 (C-M-CSA2) model (CC = 0.762, RMSE = 0.570 mg/L, and NSE = 0.520) was the most accurate for predicting TOC at Andong station, whereas the CEEMDAN-MARS-CSA based on category 3 (C-M-CSA3) model (CC = 0.900, RMSE = 0.675 mg/L, and NSE = 0.680) was the best at Changnyeong station.

Long-term risk of congestive heart failure in younger breast cancer survivors: A nationwide study by the SMARTSHIP group.

BACKGROUND: There is a controversy about late-onset congestive heart failure (CHF) among breast cancer survivors. This study investigated the incidence rate and risk factors of late-onset CHF more than 2 years after the breast cancer diagnosis. METHODS: A nationwide, retrospective study was conducted with the National Health Information Database. With 1:3 age- and sex-matched noncancer controls, Cox proportional hazard regression models were used to analyze the incidence and risk factors of late CHF. The cumulative incidence rate of late CHF was evaluated with a Kaplan-Meier analysis and a log-rank test. RESULTS: A total of 91,227 cases (286,480 person-years) and 273,681 controls (884,349 person-years) were evaluated between January 2007 and December 2013. The risks of late CHF were higher in cases than controls (hazard ratio [HR], 1.396; 95% confidence interval [CI], 1.268-1.538). Younger survivors (age ≤ 50 years) showed a higher risk of late CHF than their younger counterparts (HR, 2.903; 95% CI, 2.425-3.474). Although older age was a risk factor for late CHF, older survivors (age ≥ 66 years) showed no difference in the risk of late CHF in comparison with their counterparts (HR, 0.906; 95% CI, 0.757-1.084). Anthracyclines and taxanes were risk factors for late CHF, although trastuzumab, radiation, and endocrine therapy were not. CONCLUSIONS: Young breast cancer survivors have a greater risk of late CHF than the young population without cancer. More attention should be paid to young breast cancer survivors who receive taxane- or anthracycline-based regimens over the long term.

Unexpected double-primary aortoenteric fistula resulting in massive bleeding after induction of anesthesia.

We report a case of a patient with a double-primary aortoenteric fistula with an abdominal aortic aneurysm. A 75-year-old man was taken to the operating room for the repair of an abdominal aortic aneurysm and a suspected aortoenteric fistula between the aorta and sigmoid colon. Sudden onset of massive bleeding through the nasogastric tube occurred after the induction of anesthesia. Surgical exploration confirmed an unexpected aortoduodenal fistula. Primary aortoenteric fistula is extremely rare and difficult to diagnose, and may cause fatal bleeding. The possibility of the presence of aortoenteric fistula, including multiple types, should be considered in the anesthetic management of abdominal aortic aneurysm.

Drought index prediction using advanced fuzzy logic model: Regional case study over Kumaon in India.

A new version of the fuzzy logic model, called the co-active neuro fuzzy inference system (CANFIS), is introduced for predicting standardized precipitation index (SPI). Multiple scales of drought information at six meteorological stations located in Uttarakhand State, India, are used. Different lead times of SPI were computed for prediction, including 1, 3, 6, 9, 12, and 24 months, with inputs abstracted by autocorrelation function (ACF) and partial-ACF (PACF) analysis at 5% significance level. The proposed CANFIS model was validated against two models: classical artificial intelligence model (e.g., multilayer perceptron neural network (MLPNN)) and regression model (e.g., multiple linear regression (MLR)). Several performance evaluation metrices (root mean square error, Nash-Sutcliffe efficiency, coefficient of correlation, and Willmott index), and graphical visualizations (scatter plot and Taylor diagram) were computed for the evaluation of model performance. Results indicated that the CANFIS model predicted the SPI better than the other models and prediction results were different for different meteorological stations. The proposed model can build a reliable expert intelligent system for predicting meteorological drought at multi-time scales and decision making for remedial schemes to cope with meteorological drought at the study stations and can help to maintain sustainable water resources management.

Advanced machine learning model for better prediction accuracy of soil temperature at different depths.

Soil temperature has a vital importance in biological, physical and chemical processes of terrestrial ecosystem and its modeling at different depths is very important for land-atmosphere interactions. The study compares four machine learning techniques, extreme learning machine (ELM), artificial neural networks (ANN), classification and regression trees (CART) and group method of data handling (GMDH) in estimating monthly soil temperatures at four different depths. Various combinations of climatic variables are utilized as input to the developed models. The models' outcomes are also compared with multi-linear regression based on Nash-Sutcliffe efficiency, root mean square error, and coefficient of determination statistics. ELM is found to be generally performs better than the other four alternatives in estimating soil temperatures. A decrease in performance of the models is observed by an increase in soil depth. It is found that soil temperatures at three depths (5, 10 and 50 cm) could be mapped utilizing only air temperature data as input while solar radiation and wind speed information are also required for estimating soil temperature at the depth of 100 cm.

Multimodality images of myofibroblastoma in the male breast: A case report and a review of the literature.

We report a case of a 58-year-old male diagnosed with myofibroblastoma using mammography, ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI), as well as present a review of the literature. The pathological diagnosis was myofibroblastoma with spindle cell neoplasm with immunoreactivity. Myofibroblastoma is a rare benign disease and there is a lack of reports of multimodality imaging of this disease. We review the imaging features of this rare disease across multiple imaging modalities with pathological correlation, and provide current treatment recommendations as well.

Development of second primary cancer in Korean breast cancer survivors.

PURPOSE: Breast cancer survivors have slightly increased the risk of second primary cancers. Breast, colon, uterine, and ovarian cancers are common secondary cancers in breast cancer survivors. In this study, we assessed the development of second primary cancers of breast cancer survivors in Korea. METHODS: Medical records of patients with breast cancer in 3 tertiary medical institutions were reviewed retrospectively. We evaluated secondary malignancy diagnosed at least 2 months after the breast cancer diagnosis. Based on the International Classification of Disease-9 codes of malignancies, secondary primary breast cancer records were evaluated with person-year adjustment. The standardized incidence ratio (SIR) was assessed using national cancer incidence. RESULTS: A total of 3,444 treatment records were included from 3 medical centers. The cumulative incidence of overall second primary cancers was 2.8% (n = 93). The SIR was significantly higher in all sites (1.56; 95% confidence interval [CI], 1.26-1.91), endometrial cancer (5.65; 95% CI, 2.06-12.31), biliary tract cancer (3.96; 95% CI, 1.19-8.60), and thyroid cancer (2.29; 95% CI, 1.67-3.08). CONCLUSION: The incidence of cancer was higher in breast cancer survivors compared to general population. Surveillance of secondary cancer in this group should be recommended individually considering the benefit related to the prognosis of primary breast cancer.

Endobronchial hemorrhage after intubation with double-lumen endotracheal tube in a patient with idiopathic thrombocytopenic purpura for minimally invasive cardiac surgery: a case report.

Minimally invasive cardiac surgery (MICS) requires lung isolation. Lung isolation is usually achieved with double-lumen endotracheal tube (DLT). Patients with idiopathic thrombocytopenic purpura (ITP) have an increased risk of bleeding events. We suspected endobronchial hemorrhage after exchange of DLT during induction of anesthesia for replacement of mitral valve in a 62-year-old man with a known ITP. The MICS was stopped and bronchial artery embolization was performed in the angiographic room. In the present case, in order to reduce the risk of bronchial arterial injury in ITP patient we intubated with single lumen endotracheal tube. Lung isolation led to achievement of intermittent total lung deflation. Based on the results, we recommend a high-dose intravenous immunoglobulin therapy and platelet transfusion prior to cardiac surgery in patients with ITP to increase platelet count. Moreover, it is proposed that in order to clear the vision during the operation, ventilation can be held or made intermittent both prior to cardiopulmonary bypass or at its conclusion to permit exposure.

Correlation between Liver Metastases and the Level of PRL-3 mRNA Expression in Patients with Primary Colorectal Cancer.

PURPOSE: Phosphatase of regenerating liver-3 (PRL-3) has been associated with metastasis promotion. However, clinical applications of this association have not yet been clearly demonstrated. In this study, we evaluated the relation of PRL-3 mRNA level in primary colorectal cancer to the corresponding stage and to other clinicopathologic factors. METHODS: Two hundred forty-five patients with histologically-proven colorectal cancer underwent surgery between January 2004 and December 2006. RNA was extracted and cDNA was prepared by using reverse transcription. Quantification of PRL-3 was done using a real-time polymerase chain reaction. RESULTS: Eighty-six cases with well-preserved specimens were enrolled: 53 males and 33 females. The mean age was 63.4 years. According to tumour node metastasis (TNM) stage of the American Joint Committee on Cancer (AJCC), stage I was 11 cases, stage II was 38 cases, stage III was 23 cases, and stage IV was 14 cases. Among stage IV cases, one case was combined with liver and lung metastases, and one case was combined with liver metastases and peritoneal dissemination. The remaining stage IV patients were combined with only liver metastases. There was a significant correlation in PRL-3 mRNA expression between primary colorectal cancer and corresponding tumor stage. PRL-3 mRNA expression was increased in the liver metastases cases. Lymphatic and vascular invasion were significantly related with PRL-3 mRNA levels. CONCLUSION: Advanced stage prediction may be obtained by measuring the level of PRL-3 mRNA expression in primary colorectal cancer. Especially, the risk of liver metastases may be predicted by measuring the level of PRL-3 mRNA expression in primary colorectal cancer. Further study is required to confirm these preliminary results.