Validation of the predictive model for operative intervention after blunt abdominal trauma in children with equivocal computed tomography findings: a multi-institutional study.

BACKGROUND: We recently developed a preliminary predictive model identifying clinical and radiologic factors associated with the need for surgery following blunt abdominal trauma (BAT) in children. Our aim in this study was to further validate the factors in this predictive model in a multi-institutional study. METHODS: A retrospective chart review of pediatric patients from five pediatric trauma centers who experienced BAT between 2011 and 2020 was performed. Patients under 18 years of age who had BAT and computed tomography (CT) abdomen imaging were included. Children with evidence of pneumoperitoneum, and hemodynamic instability were excluded. Fisher's exact test was used for statistical analysis of the association between the following risk factors and need for laparotomy: abdominal wall bruising (AWB), abdominal pain/tenderness (APT), thoracolumbar fracture (TLF), presence of free fluid (FF), presence of solid organ injury (SOI). A predictive logistic regression model was then estimated employing these factors. FINDINGS: Seven hundred thirty-four patients were identified in this multi-institutional dataset with BAT and abdominal CT imaging, and 726 were included. Of those, 59 underwent surgical intervention (8.8%). Univariate analysis of association between the studied factors and need for surgical management showed that the presence of TLF (p < 0.01), APT (p < 0.01), FF (p < 0.01), and SOI (p < 0.01) were significantly associated. A predictive model was created using the 5 factors resulting in an area under the curve (AUC) of 0.80. For the motor vehicle collisions (MVC) group, only FF, SOI, and TLF are significantly associated with the need for surgical intervention. The AUC for the MVC group was 0.87. CONCLUSIONS: A clinical and radiologic prediction rule was validated using a large multi-institutional dataset of pediatric BAT patients, demonstrating a high degree of accuracy in identifying children who underwent surgery. FF, SOI, and TLF are the most important factors associated with the need for surgical intervention. LEVEL OF EVIDENCE: Level III.

A novel network architecture combining central-peripheral deviation with image-based convolutional neural networks for diffusion tensor imaging studies.

Brain imaging research is a very challenging topic due to complex structure and lack of explicitly identifiable features in the image. With the advancement of magnetic resonance imaging (MRI) technologies, such as diffusion tensor imaging (DTI), developing classification methods to improve clinical diagnosis is crucial. This paper proposes a classification method for DTI data based on a novel neural network strategy that combines a convolutional neural network (CNN) with a multilayer neural network using central-peripheral deviation (CPD), which reflects diffusion dynamics in the white matter by spatially evaluating the deviation of diffusion coefficients between the inner and outer parts of the brain. In our method, a multilayer perceptron (MLP) using CPD is combined with the final layers for classification after reducing the dimensions of images in the convolutional layers of the neural network architecture. In terms of training loss and the classification error, the proposed classification method improves the existing image classification with CNN. For real data analysis, we demonstrate how to process raw DTI image data sets obtained from a traumatic brain injury study (MagNeTS) and a brain atlas construction study (ICBM), and apply the proposed approach to the data, successfully improving classification performance with two age groups.

A novel variant of THRß and its 4-year clinical course in a Korean boy with resistance to thyroid hormone.

Thyroid hormone resistance (RTH) is characterized by a decreased sensitivity of target tissues to thyroid hormones due to a defect in the THRα- and THRß-encoded thyroid hormone receptors (THRs). The clinical manifestations range from no symptoms to simple goiter and hypo- or hyperthyroidism, depending on the receptor subtype distribution in the tissues. Here, we report the case of a thyroid hormone-resistant 12-month-old boy carrying a novel THRß variant who was initially diagnosed with congenital hypothyroidism. An extensive evaluation revealed increased free T4 level and inappropriately increased thyroid-stimulating hormone (TSH) level; a normal lipid profile, sex hormone-binding globulin, and free alpha subunit of TSH; exaggerated TSH response to THR; and no radiological evidence of pituitary adenoma. A targeted next-generation sequencing panel identified a heterozygote c.993T>G (p.Asn331Lys) mutation in the THRß gene. During the first year of life, a higher dose of levothyroxine was administered to the patient due to uncompensated RTH. Levothyroxine treatment was continued after 3 years to maintain TSH level <5 mIU/mL, but the observed weight gain was poor, height increase was insufficient, and bone development was delayed. However, neither hyperactivity nor developmental delay was observed. Patients with RTH exhibit various clinical features. Due to its heterogeneous nature, genetic test for accurate diagnosis is important to provide proper management.

Physician satisfaction with telemedicine and in-person visits in otolaryngology.

OBJECTIVES: To investigate the differential factors associated with physician satisfaction between telemedicine and in-person visits in otolaryngology. METHODS: Study data included 646 telemedicine and 365 in-person encounters delivered from May-June 2020 at a tertiary center outpatient setting. Encounter-specific physician satisfaction was rated by 15 otolaryngologists using Provider Satisfaction Questionnaire (range 0-100) consisted of 5 items (patient needs addressed, patient involvement, adequacy of information given, quality of emotion support provided, and general interaction satisfaction). A multivariable linear mixed-effects model was used to explore patient demographic and clinical factors associated with physician satisfaction. RESULTS: Physician satisfaction scores for telemedicine and in-person visits were 83.0 [95 % CI: 77.0-88.9] and 88.1 [95 % CI: 82.5-93.6], respectively. Among telemedicine visits, physician satisfaction scores were significantly higher for follow-up (vs. new), videoconference (vs. telephone) encounters, and English-speaking patients in a multivariable model. New encounters had significantly lower satisfaction subdomain scores for adequacy of information given to the patient (ß = -4.7 [95 % CI: -7.3 to -2.0], p = 0.001) and addressing the needs of the patient among telemedicine visits (ß = -4.1, [95 % CI: -7.1 to -1.1], p = 0.007) while there were no differences in satisfaction scores between new vs follow-up visits among in-person visits. For non-English speaking patients, the physician satisfaction scores were significantly lower for subdomain scores assessing active patient participation (ß = -13.1, [95 % CI: -13.1 to -17.4], p < 0.001) and emotional support given to the patient (ß = -7.8, [95 % CI: -11.0 to -4.5], p < 0.001) for telemedicine visits. CONCLUSIONS: Telemedicine has been broadly adopted as an alternative option to deliver care in otolaryngology since COVID-19 pandemic. Appropriate triaging based on patient and encounter characteristics may enhance physician satisfaction and overall experiences with telemedicine. Further efforts are needed to provide adequate interpretation and videoconference services during telemedicine visits.

Malignancy Rates by Bethesda Subcategory in the Pediatric Population.

INTRODUCTION: While the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the most widely used method for categorizing thyroid nodules, its applicability to children is often debated. We describe our institution's experience utilizing the TBSRTC and examine the rates of malignancy in our population. METHODS: We conducted a retrospective chart review of eligible patients undergoing primary thyroidectomy at a high-volume tertiary care pediatric hospital. All patients had pre-operative fine needle aspiration. RESULTS: Of the 112 patients in our cohort, 85 (76%) were female. The median age was 15.1 years. The patients were divided into groups based on the Bethesda categorization of the fine needle aspirations of their nodules. The percentages of patients whose resection specimens showed evidence of malignancy on the surgical pathology reports were recorded as follows: category I (n = 5): 20%, category II (n = 11): 0%, category III (n = 30): 17%, category IV (n = 13): 31%, category V (n = 17): 94% and category VI (n = 36): 100%. CONCLUSION: Our findings indicate that the malignancy rates at our institution are comparable to those reported by other high-volume studies. When compared with the 2017 TBSRTC data, we found that our results were similar in many categories, with the exception of categories I and V.

Incidence of thymic tissue in pediatric thyroidectomy.

OBJECTIVES: The nuances in the technical approach to pediatric thyroidectomy have been sparsely reported in the literature. No previous studies have reported on the rates of unintentional thymic tissue excision during pediatric thyroidectomy. In this study, we sought to describe the rates of thymic tissue excision noted on surgical specimens from pediatric thyroidectomies and investigate any correlations with preoperative factors and long-term outcomes. METHODS: A retrospective chart review was conducted of patients who underwent thyroidectomy at a tertiary care children's hospital between January 2010 and October 2020. Presence of thymic tissue (PTT) was defined as any pathologist-documented evidence of thymic tissue in the surgical specimen. Patient characteristics, operative details, and disease related datapoints were investigated for any correlation with PTT. RESULTS: Of the 209 patients who underwent thyroidectomy in the study period, 53 (25%) had PTT. After conducting a stepwise multivariate analysis, those with a concomitant central neck dissection had 3.3 times the odds of having PTT as compared to those with no neck dissection (p = 0.013, 95%CI: 1.3, 8.3). Additionally, patients with evidence of incidental parathyroidectomy had 8.99 times the odds of also having PTT as compared to those without IPE (p < 0.001, 95%CI: 4.0, 20.1). CONCLUSION: This is the first report analyzing the rate of thymic tissue excision during pediatric thyroidectomy. Thyroid surgeons should be prepared to encounter thymic tissue during pediatric cases and be aware of its associated risk of incidental parathyroid gland excision and dissection of tissue beyond intended surgical limits.

Thyroid tumor ratio: Improving the assessment of the impact of size in pediatric thyroid cancer.

BACKGROUND: The impact of thyroid nodule size is less useful in children who have smaller thyroid volumes than in adults. We investigate using a novel thyroid tumor ratio measurement in children with thyroid cancer. METHODS: Patient and pathologic characteristics were investigated via Student's t-test in a univariate analysis for any correlation with the log-transformed tumor ratio, followed by a multivariate linear regression. RESULTS: Of 75 patients with malignancy and tumor ratio information, mean ratio decreased with increasing age (p = 0.04). Out of several clinical factors, patients with lymph node metastases and those treated with postoperative radioactive iodine had significantly higher mean tumor ratios on multivariate analysis (p = 0.04 for both factors). CONCLUSIONS: Our study is the first to describe thyroid tumor volume in pediatric thyroid cancer and shows that increased tumor ratio was associated with indicators of more advanced disease such as lymph node metastases and use of radioactive iodine.

Practical and robust test for comparing binomial proportions in the randomized phase II setting.

The one-arm, non-randomized, one/two-stage phase II designs have been a mainstay in oncology trials for evaluating response rates or similar variants (i.e., tests about single proportions). With the goal of screening new therapies that have the potential to move into a randomized phase III trial or a subsequent randomized phase II trial, all while maintaining a logistically feasible sample size. However, since the implementation of the Food and Drug Administration's Fast Track Designation, there has been a trend toward randomized phase II clinical trials as a source of stronger evidence for those seeking fast-track approvals. While there are many single- and multi-stage randomized designs for evaluating proportions in this phase II setting, there still exist limitations in terms of sample size (which directly impacts cost and study duration) or operating characteristics (ex. maintained type I error). In this article, we propose a new test for comparing two binomial proportions, which is a modification across existing methods (the standard z-test and Jung's test). This approach is contrasted with existing methods via numeric evaluation and further contrasted using a real-world oncology trial. The proposed method demonstrates improvements in efficiency and robustness against deviations from design assumptions. When applied to the existing trial, significant savings with respect to cost and time are illustrated. Our proposed test for comparing binomial proportions provides an efficient and robust alternative in the randomized phase II oncology setting, especially when the control arm has a high rate.

Telemedicine in Otolaryngology During COVID-19: Patient and Physician Satisfaction.

OBJECTIVE: To examine patient and physician satisfaction with telemedicine in otolaryngology during COVID-19 and identify associated factors. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary care center. METHODS: Patient satisfaction was rated by patients (age ≥18 years) who had encounters from May to July 2020 (n = 407). Physician satisfaction was rated by 15 otolaryngologists for specific encounters delivered from May to June 2020 (n = 1011). Patient satisfaction was measured with a Press Ganey questionnaire and a Telemedicine Satisfaction Questionnaire. Mean Press Ganey satisfaction scores of telemedicine encounters during COVID-19 were compared with the pre-COVID-19 Press Ganey scores from in-person encounters (n = 3059) to test a noninferiority hypothesis. Physician satisfaction was measured with a Provider Satisfaction Questionnaire. RESULTS: The mean Press Ganey patient satisfaction score for telemedicine encounters was 94.5 (SD, 8.8), no worse than that for in-person encounters prior to COVID-19 at 93.7 (SD, 15.5; Δ = 0.8 [95% CI, -0.5 to 2.1, excluding the noninferiority margin of -1]). Encounters with videoconference (vs telephone) and patients reporting higher income were associated with higher Telemedicine Satisfaction Questionnaire scores. Physician satisfaction scores during COVID-19 with telemedicine encounters were overall high at 83.3 (95% CI, 77.5-89.1), slightly lower when compared with the scores with in-person encounters at 88.4 (95% CI, 82.5-94.3; Δ = -5.2 [95% CI, -6.6 to -3.8]). Encounters with videoconference (vs telephone) and patients with English as a preferred language and follow-up visits were associated with higher Provider Satisfaction Questionnaire scores. CONCLUSIONS: Telemedicine is a feasible alternative format in otolaryngology during COVID-19 with overall high patient and physician satisfaction. Patient satisfaction with telemedicine encounters during COVID-19 was no worse than in-person encounters prior to the pandemic. Physician satisfaction with telemedicine was relatively lower in comparison with in-person encounters.

Rate of Incidental Parathyroidectomy in a Pediatric Population.

OBJECTIVE: Incidental parathyroidectomy is a relatively common occurrence in thyroid surgery, which may lead to hypoparathyroidism and postoperative hypocalcemia, but it is not well studied in children. The objectives of this study were to determine the rate of incidental parathyroidectomy, identify potential risk factors, and investigate postoperative complications in children undergoing thyroidectomy. STUDY DESIGN: Retrospective cohort study. SETTING: Patients who underwent thyroidectomy over a 10-year period at a tertiary children's hospital. METHODS: Pathology reports were reviewed to determine incidental parathyroid gland tissue. Additional data collected included patient demographics, type of procedure, underlying thyroid pathology, as well as immediate and long-term postoperative clinical outcomes. RESULTS: Of 209 patients, 65 (31%) had incidental parathyroidectomy. Several variables were associated with incidental parathyroidectomy on univariable analysis. However, in the final multivariable model, only thyroidectomy with lymph node dissection was associated with increased odds of having incidental parathyroidectomy (odds ratio, 3.3; P = .04; 95% CI, 1.1-9.8). After a median follow up of 1 year, a significantly higher percentage of patients with incidental parathyroidectomy had evidence of long-term hypoparathyroidism (9/62 [15%] vs 3/144 [2%], P = .001). CONCLUSION: Incidental parathyroidectomy was relatively common in our pediatric thyroidectomy population, which may be a result of several anatomic, clinical, and surgeon-related factors. Close attention to parathyroid preservation with meticulous surgical technique is the most practical method of preventing long-term hypoparathyroidism and hypocalcemia.

Factors Associated With Unilateral Hearing Loss and Impact on Communication in US Adults.

OBJECTIVE: To investigate the factors associated with unilateral hearing loss (UHL) and its impact on communication in US adults. STUDY DESIGN: Cross-sectional study. SETTING: Nationally representative sample of US adults. METHODS: We analyzed data from the 2011-2012 and 2015-2016 National Health and Nutritional Examination Survey, in which participants aged 20 to 69 years completed an audiometric evaluation (n = 8138). UHL was defined as a speech frequency pure-tone average ≥25 dB in the worse hearing ear and <25 dB in the better hearing ear. Logistic regression was used to examine the association between UHL and relevant factors. RESULTS: The prevalence of UHL was 8.1% (95% CI, 7.3%-9.0%) in US adults. Factors associated with UHL included older age, male sex, white race, lower level of education, diabetes, cardiovascular disease, and off-work noise exposure. Among adults with UHL, 40% (95% CI, 32%-48%) reported subjective trouble with hearing, a rate higher than the 12% (95% CI, 11%-14%) among normal-hearing adults. After adjusting for relevant factors, adults with UHL were more likely to report difficulties with following conversations with noise (odds ratio [OR], 1.7; 95% CI, 1.2-2.5) and frustration when talking to family and friends (OR, 3.0; 95% CI, 1.9-4.6). Higher levels of communication difficulties were observed with worsening level of UHL. CONCLUSIONS: Adults with UHL report significant communication difficulties in comparison to normal-hearing adults. Further research is needed to understand the psychosocial impact of UHL on adults and ways to improve communication support for adults with UHL.

Fatal Events Associated with Adverse Drug Reactions in the Korean National Pharmacovigilance Database.

Adverse drug reactions (ADRs) pose a global public health threat, substantially contributing to death. Due to the relative paucity of clinical evidence regarding fatal ADRs, this study was performed to characterize the epidemiology of fatal ADRs in Korea. This was a retrospective, cross-sectional analysis of ADR cases reported to the Korea Adverse Event Reporting System from 2010 to 2019. All ADRs were coded using the World Health Organization-Adverse Reaction Terminology system and classified as either fatal or non-fatal events. Logistic regression was performed to identify factors associated with fatal events. Among 289,756 ADR records, 629 fatal events (0.2%) occurred. The most common causative agent of fatal ADRs was antibacterials (20.3%), followed by antimycobacterials (5.4%), analgesics (4.0%), and contrast media (1.9%). Among antimicrobials, vancomycin was most frequently implicated without significantly increasing the risk of fatal events. The risk for fatal ADRs was significantly increased with male sex; advanced age; polypharmacy; piperacillin/ß-lactamase inhibitor; cefotetan; ceftriaxone; combination antimycobacterial therapy consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol; morphine; and iopromide (reporting odds ratio > 1, p < 0.05 for all). Although fatal ADRs are uncommon (<1%) in Korea, they are primarily caused by commonly used medications including antibiotics, analgesics, and contrast media.

Hemoperitoneum: a complication of loop electrosurgical excision procedure.

Loop electrosurgical excision procedure (LEEP) is commonly performed for the management of cervical intraepithelial neoplasia. Although LEEP is considered to be a relatively simple procedure, several unexpected complications have been reported in the literature. Herein, we report a case of hemoperitoneum caused by uterine perforation following LEEP. Blood collection in pelvic cavity and two small defects of the uterus were confirmed by diagnostic laparoscopy. The defects were sutured and the patient recovered well after the operation.

Sonographic evaluation of bladder wall thickness in women with lower urinary tract dysfunction.

OBJECTIVE: To investigate the correlation between bladder wall thickness (BWT) measured by ultrasonography and lower urinary tract dysfunction (LUTD) in patients with lower urinary tract symptoms (LUTS). METHODS: Forty-eight women with LUTS who underwent urodynamic study and BWT by ultrasonography as outpatients were studied. We assessed LUTS during a medical examination by interview. The thinnest part of the bladder wall was measured by a transabdominal ultrasonography. We excluded patients who had visited another hospital previously because we did not know what treatment they had received, including medications, behavioral therapy, or other treatments. We constructed receiver operating characteristic (ROC) curves for diagnosis of LUTD and also determined reliable BWT criteria by calculating the area under the curve. Statistical analyses were performed using the Kolmogorov-Smirnov method and Student's t-test. RESULTS: The mean age, body mass index, and duration of symptoms were 59.9±9.7 years, 26.06±3.4 kg/m2, and 53.4±38.2 months, respectively. Urodynamic study parameters (Valsalva leak point pressure, maximal urethral closure pressure, functional length, and postvoid residual volume) were lower in patients with BWT <3 mm; however, these differences were not significant. Patients with BWT ≥3 mm developed a hypoactive bladder (P=0.009) and intrinsic sphincter deficiency (ISD) (P=0.001) at a significantly higher rate. According to the ROC analysis, the best BWT cut-off value was 3 mm for overactive bladder diagnosis. CONCLUSIONS: Women with LUTD showed higher BWT values (≥3 mm), especially patients with hypoactive bladder and ISD. Sonographic evaluation of BWT is an easy, fast, and noninvasive method for possible diagnostic tool for LUTD.

Covalent organic nanosheets for effective charge transport layers in planar-type perovskite solar cells.

Herein, solvent-treated bandgap-tunable covalent organic nanosheets (CONs) were prepared via the Stille cross-coupling reaction. These materials are considered useful as interlayers in photovoltaic devices upon the alignment of energy levels between other components. Among various types of solar cells, according to the organic-interlayer study, inverted planar perovskite solar cells (PSCs) are mostly demanded to effectively transport and collect charge carriers due to their high performance. At first, the C-V analysis proved the energy levels of the frontier orbitals for CON-10 and CON-16 nanosheets; this verified the suitability of these nanosheets as hole transport layers (HTLs) with the PEDOT:PSS upon casting both films from DMSO. It became evident, however, that the hole transport property of the PEDOT:PSS on the CON-16 layer was unfavorable with the increasing UPS-proven hole injection barrier. In addition, both CONs induced a rough surface morphology; however, CON-10 showed a relatively smooth surface as compared to CON-16 based on the Scanning electron microscopy (SEM) and Atomic force microscopy (AFM) profiles; furthermore, their surface properties influenced both the PEDOT:PSS layers and the perovskite layers. Especially, the XRD profiles presented an enhanced crystallinity of the perovskite layers with CON-10. All these aspects indicate that CON-10 is a more effective HTL material, and several versions of perovskite solar cells (PSCs) have been fabricated with/without CON-10 and CON-16 together with the PEDOT:PSS to determine the more-HTL-suitable CON. As a result, the power conversion efficiencies (PCEs) of the optimized devices with CON-10 exhibited a value of 10.2%, which represented a 1% increase over those of the reference devices without the CONs and was 4% higher than that of the CON-16 devices. Moreover, the devices with CON-10 were further optimized with TiOx using Al electrodes, leading to a PCE increase of these devices that became slightly higher than the PCEs of the device with CON-10 and without TiOx. This tendency was supported by photoluminescence (PL) spectroscopy, photocurrent density (Jph), and space-charge-limited current (SCLC) mobility results.

Gastric type mucinous endocervical adenocarcinoma of the uterine cervix: very rare and interesting case.

Gastric type mucinous endocervical adenocarcinomas of the uterine cervix (GAC) are a newly classified mucinous subtype with morphologically in 2014, WHO. They have a much more aggressiveness and show unusual metastatic patterns compared to usual type endocervical adenocarcinoma. They tend to present at higher stage and even in stage I, they have worse survival. Therefore, differential diagnosis of GAC from the usual type of endocervical adenocarcinoma is very important because they are related to a significant risk of recurrence and decreased 5-year disease-specific survival. Besides, GACs are mostly not associated with human papillomavirus (HPV) infection and p16 immunohistochemistry is also typically negative in GAC that is HPV-unassociated tumor. We report a very rare and interesting case of stage IB1 GAC with negative HPV DNA and p16.

Dry-Stamping-Transferred PC71BM Charge Transport Layer via an Interface-Controlled Polyurethane Acrylate Mold Film for Efficient Planar-Type Perovskite Solar Cells.

The study of interlayers is important to enhance the performance of inverted perovskite solar cells (PSCs) because interlayers in PSCs align energy levels and improve charge transport. However, previous research into applying interlayers for PSCs has focused only on wet-coated methods, such as spin coating, to form the interlayer. Here, we fabricated planar-type PSCs deposited with a 6,6-phenyl-C71 butyric acid methyl ester (PC71BM) layer onto a CH3NH3PbI3 (MAPbI3) layer by stamping transfer through a relatively dry process condition. We demonstrated the effects of a stamping-transferred PC71BM layer using polyurethane acrylate (PUA), the surface energy of which was modified by 2-hydroxyethyl methacrylate (HEMA) to increase the transfer reproducibility. In PSCs with a stamping-transferred PC71BM layer, we observed an enhanced JSC and a comparable power conversion efficiency (PCE), which were caused by an enhanced coverage of the electron transport layer onto the MAPbI3 layer with preserved crystallinity, which occurs owing to improved electron mobility and exciton dissociation. The optimized device PCE through the dry-transferred PC71BM exhibited a JSC, fill factor, and PCE of 21.65 mA/cm2, 76.0%, and 15.46%, respectively. Moreover, morphological analysis and electrical measurements confirmed the improved durability of dry-stamping-transferred PSCs.

Analysis of the influential factors of maximal-effort expiratory capacity of elderly women.

[Purpose] The purpose of this study was to find the influential factors of maximal-effort expiratory capacity of elderly women. [Subjects and Methods] The subjects of this study were 83 healthy elderly women. The study's methods and purpose were explained and these women agreed to participate. The maximal-effort expiratory capacity was measured using spirometry (Pony FX, COSMED Inc., Italy). We measured forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity, maximal expiratory flow 75%, maximal expiratory flow 50%, and maximal expiratory flow 25%. [Results] Regarding forced vital capacity and forced expiratory volume in 1 second, it was found that height and age were influential factors. Regarding forced expiratory volume in 1 second/forced vital capacity %, maximal expiratory flow 75%, maximal expiratory flow 50%, and maximal expiratory flow 25%, it was found that only age was an influential factor. [Conclusion] This study demonstrated that the most influential factors of maximal-effort expiratory capacity of elderly women were age, and the second influential factor was height. We noticed that weight was the least influential factor among them.

Counterbalancing of morphology and conductivity of poly(3,4-ethylenedioxythiophene) polystyrene sulfonate based flexible devices.

The importance of conductive polymer electrodes with a balance between the morphology and electrical conductivity for flexible organic photovoltaic properties has been demonstrated. Highly transparent PEDOT:PSS anodes with controlled conductivity and surface properties were realized by insertion of dimethyl sulfoxide (DMSO) and a fluorosurfactant (Zonyl) as efficient additives and used for flexible organic photovoltaic cells (OPVs) which are based on a bulk-heterojunction of polythieno[3,4-b]-thiophene-co-benzodithiophene (PTB7):[6,6]phenyl-C71-butyric acid methyl ester (PC71BM). We investigated the correlation between the electrical properties of PEDOT:PSS electrodes and their influences on the surface morphology of the active materials (PTB7:PC71BM). When the device was prepared from the PEDOT:PSS layer functioning as an anode of OPV through an optimized ratio of 5 vol% of DMSO and 0.1 wt% of fluorosurfactant, the devices exhibited improved fill factor (FF) due to the enhanced coverage of PEDOT:PSS films. These results correlate with reduced photoluminescence and increased charge extraction as seen through Raman spectroscopy and electrical analysis, respectively. The conductive polymer electrode with the balance between the morphology and electrical conductivity can be a useful replacement for brittle electrodes such as those made of indium tin oxide (ITO) as they are more resistant to cracking and bending conditions, which will contribute to the long-term operation of flexible devices.

Comparison of ultrasound-guided endometrial polypectomy carried out on the oocyte retrieval day and the first day of ovarian stimulation in IVF-ICSI cycles.

In this retrospective cohort study, the effect of endometrial polypectomy carried out on the day of oocyte retrieval and on the first day of ovarian stimulation in patients with a large (≥10 mm) endometrial polyp undergoing IVF and intractyoplasmic sperm injection (ICSI) was investigated and compared. A total of 74 eligible IVF-ICSI cycles in 74 women who underwent endometrial polypectomy on either the day of oocyte pick-up (late polypectomy group, 39 cycles) or the first day of ovarian stimulation (early polypectomy group, 35 cycles) between January 2007 and July 2012 were included in this study. Patient characteristics between early and late polypectomy groups were similar. Total dose and days of recombinant human FSH administered, numbers of retrieved oocytes, mature oocytes, fertilized oocytes, grade 1 or 2 embryos and embryos transferred between the two groups were also similar, as was clinical pregnancy rate per cycle, embryo implantation rate and spontaneous abortion rate between the two groups. Therefore, endometrial polypectomy on the day of oocyte retrieval could be a more patient-friendly option for patients with a large endometrial polyp undergoing IVF-ICSI.