Data Interworking Model and Analysis for Harmonization of Smart Metering Protocols in IoT-Based AMI System.

In the energy sector, since the adoption of remote device management for massive advanced metering infrastructure (AMI) devices and Internet of Things (IoT) technology using a representational state transfer (RESTful) architecture, a blurred boundary has been developed between traditional AMI and IoT. With respect to smart meters, the standard-based smart metering protocol, called the device language message specification (DLMS) protocol, still has a predominant role in the AMI industry. Thus, we aim to propose a novel data interworking model in this article that embraces the DLMS protocol in AMI using the most promising IoT protocol, the so-called lightweight machine-to-machine (LwM2M) protocol. We provide a 1:1 conversion model using the correlation of the two protocols with an analysis of the object modeling and resource management methods of both the LwM2M and DLMS protocols. The proposed model utilizes a complete RESTful architecture, which is the most beneficial in the LwM2M protocol. It improves the average packet transmission efficiency and packet delay on the plaintext and encrypted text (session establishment and authenticated encryption) by 52.9%p and 9.9%p, respectively, and by 11.86 ms for both cases, compared to the encapsulation method of the LwM2M protocol, KEPCO's current approach. This work provides the key idea to unify the protocol for the remote metering and device management of field devices into the LwM2M protocol, and it is expected that this work will improve the efficiency in the operation and management of KEPCO's AMI system.

Clinical characteristics of small bowel tumors diagnosed by double-balloon endoscopy: KASID multi-center study.

BACKGROUND: Small bowel tumors are relatively rare, and their confirmative diagnosis before surgery is not easy. AIMS: This study was performed to investigate the clinical characteristics of patients with small bowel tumors who received double-balloon enteroscopy (DBE). Secondary end points were to evaluate the usefulness and safety of DBE for the diagnosis of patients with suspected SB tumors derived from other previous procedures. METHODS: We retrospectively analyzed consecutive DBE examinations to explore the small intestine in eight university hospitals over a 5-year period. RESULTS: A total of 877 DBE examinations (per oral 487, per anal 390) were performed in 645 patients (405 males, mean age 48.2 years). Small bowel tumors were diagnosed in 112 patients (17.4%), of which 38 patients had benign polyps, 29 had gastrointestinal stromal tumors/leiomyomata, 18 had lymphomas, 14 had adenocarcinomas, five had metastatic or invasive cancers, five had lipomas, and three patients had cystic tumors. The main reasons for DBE among patients with small bowel tumors were obscure gastrointestinal bleeding (OGIB, 40.2%) followed by abnormal imaging study (25.2%). The concordance rate of diagnoses based on DBE with diagnoses based on small bowel follow-through, CT, and capsule endoscopy among patients with small bowel tumors was 68.9% (42/61), 75.3% (70/93), and 78.3% (18/23), respectively. Therapeutic plans were changed due to the DBE results in 64.2% of patients with small bowel tumors. CONCLUSIONS: Approximately one-sixth of patients who received DBE had small bowel tumors, and the most common reason for DBE among patients with small bowel tumors was OGIB. DBE is a useful method for the confirmative diagnosis of small bowel tumors and has a good clinical impact on therapeutic plans and short-term clinical results.

Gastric Cancer and the Daily Intake of the Major Dish Groups Contributing to Sodium Intake: A Case-Control Study in Korea.

Studies on the association between gastric cancer (GC) and the intake of soup-based dish groups (noodles and dumplings, soups, and stews), which are sodium-contributing foods, in Korea are insufficient, and the results of studies on the intake of pickled vegetables such as kimchi are inconsistent. This study aimed to determine the association between the incidence of GC and the daily intake of high-sodium dish groups (noodles and dumplings, soups, stews, and pickled vegetables) and whether these associations differ depending on behavioral risk factors for GC. In this case-control study, subjects aged 20-79 years were recruited from two hospitals between December 2002 and September 2006. A total of 440 cases and 485 controls were recruited, of which 307 pairs were matched and included for the analysis. In our results, a higher intake of noodles and dumplings was associated with a significantly increased incidence of GC. In the participants who consumed past or current alcohol, a higher intake of noodles and dumplings was associated with a significantly increased incidence of GC. Our results suggest that efforts to reduce the daily sodium intake from noodles and dumplings are needed to prevent and reduce the incidence of GC.

An adequate level of training for technical competence in screening and diagnostic colonoscopy: a prospective multicenter evaluation of the learning curve.

BACKGROUND: Various training programs in colonoscopy recommend that trainees should perform at least 100 to 200 procedures to be considered technically competent at diagnostic colonoscopy. OBJECTIVE: Our purpose was to determine the adequate level of training for technical competence in screening and diagnostic colonoscopy. DESIGN: A prospective multicenter trial. SETTING: Fifteen tertiary care academic medical centers. PATIENTS: Over 8 months we prospectively evaluated the procedures of 24 first-year GI fellows in 15 tertiary care academic medical centers. A total of 4351 colonoscopies were assessed prospectively with variable clinical factors. INTERVENTION: Cecal intubation was documented by photographing the identified cecal landmarks, including the appendiceal orifice and the ileocecal valve. MAIN OUTCOME MEASUREMENTS: Acquisition of competence (success rate) was evaluated for colonoscopic training on the basis of 2 objective criteria: (1) adjusted completion rate (>90%) and (2) cecal intubation time (<20 minutes). RESULTS: The overall success rate was 83.5% (3635/4351). The mean cecal intubation time was 9.23 +/- 4.63 minutes. The success rate significantly improved and reached the requisite standard of competence after 150 procedures (71.5%, 82.6%, 91.3%, 94.4%, 98.4%, and 98.7%, respectively, for every 50 consecutive blocks). The polyp detection rate did not improve significantly during the 8 months and was not correlated with the learning curve. In addition, mean time to cecal intubation decreased significantly, from 11.16 to 8.39 minutes, after 150 procedures. Logistic regression analysis found that prolonged cecal intubation was caused by the following factors: elderly patients, female sex, low body mass index, poor bowel preparation, poor American Society of Anesthesiologists status, abdominal pain as an indication, instructor's supervision, and low case volume. LIMITATIONS: We did not record final pathologic reports of detected polyps and withdrawal time. CONCLUSIONS: Competence in technically efficient screening and diagnostic colonoscopy generally requires experience with more than 150 cases. Also, factors associated with prolonged cecal intubation for typical trainees did not differ from those for experienced colonoscopists.

Korean experience with double balloon endoscopy: Korean Association for the Study of Intestinal Diseases multi-center study.

BACKGROUND: Double balloon endoscopy (DBE) is a new diagnostic and therapeutic tool for the management of patients with small-bowel disease. OBJECTIVE: To evaluate the feasibility, clinical usefulness, and safety of DBE in Korean patients with suspected or known small-bowel disease. DESIGN: Retrospective, multicenter study from April 2004 to March 2006. SETTING: University hospitals. PATIENTS: Two hundred twenty-five consecutive patients. INTERVENTIONS: Subjects underwent 311 procedures with DBE via the oral and/or anal routes. MAIN OUTCOME MEASUREMENTS: The indications, diagnostic yield, therapeutic use, and complications. RESULTS: Overall diagnostic yield was 75% (169/225). Diagnostic yields for obscure GI bleeding (OGIB) (n = 137), chronic abdominal pain (n = 32), radiologic/capule endoscopic abnormality (n = 25), polyposis (n = 9), and chronic diarrhea (n = 9) were 73.7% (101/137), 75.0% (24/32), 64% (16/25), 100% (9/9), and 0% (0/9), respectively. In patients with OGIB, ulcerating lesions (n = 54) were more common than vascular lesions (n = 20) or tumors (n = 27). Some lesions detected in DBE were treated effectively with electrocoagulation or argon plasma coagulation, polypectomy, and dilation. Entrapped capsules were removed easily with polypectomy snare in 3 patients with small-bowel stricture. Some patients with strictures had transient abdominal discomfort during and/or after the procedure. With the exception of 1 mucosal tear, there were no technical problems or serious complications. LIMITATIONS: Descriptive, retrospective study. CONCLUSIONS: DBE is safe and useful for diagnosis and treatment of a variety of small-bowel diseases. The most common indication of DBE was OGIB. Ulcerating small-bowel lesions are more common than vascular lesions in Korea.