Preoperative C-reactive protein/albumin ratio and mortality of off-pump coronary artery bypass graft.

Background: We sought to investigate the prognostic value of preoperative C-reactive protein (CRP)-to-albumin ratio (CAR) for the prediction of mortality in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Methods: From January 2010 to August 2016, adult patients undergoing OPCAB were analyzed retrospectively. In a total of 2,082 patients, preoperative inflammatory markers including CAR, CRP, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were recorded. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold and compare the predictive values of the markers. The patients were divided into two groups according to the cut-off value of CAR, and then the outcomes were compared. The primary end point was 1-year mortality. Results: During the 1-year follow-up period, 25 patients (1.2%) died after OPCAB. The area under the curve of CAR for 1-year mortality was 0.767, which was significantly higher than other inflammatory markers. According to the calculated cut-off value of 1.326, the patients were divided into two groups: 1,580 (75.9%) patients were placed in the low CAR group vs. 502 (24.1%) patients in the high CAR group. After adjustment with inverse probability weighting, high CAR was significantly associated with increased risk of 1-year mortality after OPCAB (Hazard ratio, 5.01; 95% Confidence interval, 2.01-12.50; p < 0.001). Conclusions: In this study, we demonstrated that preoperative CAR was associated with 1-year mortality following OPCAB. Compared to previous inflammatory markers, CAR may offer superior predictive power for mortality in patients undergoing OPCAB. For validation of our findings, further prospective studies are needed.

Liquid Crystals for Advanced Smart Devices with Microwave and Millimeter-Wave Applications: Recent Progress for Next-Generation Communications.

Liquid crystals (LCs) technology have a well-established history of applications in visible light, particularly in the display industry. However, with the rapid growth in communication technology, LCs have become a topic of current interest for high-frequency microwave (MW) and millimeter-wave (mmWave) applications due to promising characteristics such as tunability, continuous tuning, low losses, and price compatibility. To improve the performance of future communication technology using LCs, it is not sufficient only with the perspective of radio-frequency (RF) technology. Therefore, it is imperative to understand not only the novel structural designs and optimization of MW engineering but also the perspective of materials engineering when implementing advanced RF devices with maximum performance for next-generation satellite and terrestrial communication. Herein, based on advanced nematic LCs, polymer-modified LCs, dual-frequency LCs, and photo-reactive LCs, this article summarizes and examines the modulation principles and key research directions for the design strategies of LCs for advanced smart RF devices with improved driving performance and novel functionality. Furthermore, the challenges in development of state-of-the-art smart RF devices that use LCs are discussed.

Days alive and out of hospital at 30 days and outcomes of off-pump coronary artery bypass grafting.

Days alive and out of hospital (DAOH) is a simple estimator based on the number of days not in hospital within a defined period. In cases of mortality within the period, DAOH is regarded as zero. It has not been validated solely in off-pump coronary artery bypass grafting (OPCAB). This study aimed to demonstrate a correlation between DAOH and outcome of OPCAB. We identified 2211 OPCAB performed from January 2010 to August 2016. We calculated DAOH at 30 and 60 days. We generated a receiver-operating curve and compared outcomes. The median duration of hospital stay after OPCAB was 6 days. The median DAOH values at 30 and 60 days were 24 and 54 days. The estimated thresholds for 3-year mortality for DAOH at 30 and 60 days were 20 and 50 days. Three-year mortality was higher for short DAOH (1.2% vs. 5.7% and 1.1% vs. 5.6% DAOH at 30 and 60 days). After adjustment, the short DAOH 30 group showed significantly higher mortality during 3-year follow-up (hazard ratio 3.07; 95% confidence interval 1.45-6.52; p = 0.004). DAOH at 30 days after OPCAB showed a correlation with 3-year outcomes. DAOH 30 might be a reliable long-term outcome measure that can be obtained within 30 days after surgery.

A simulation of diffractive liquid crystal smart window for privacy application.

Using a single substrate, we demonstrate a simple two-dimensional (2-D) phase grating cell with an octothorp electrode. Owing to the large spatial phase difference in any direction, the proposed grating cell has a high haze value in the opaque state (76.7%); Moreover, it has the advantages of a one-dimensional (1-D) phase grating cell, such as high fabricability, fast response time, and low operating voltage. Furthermore, the proposed grating cell has a faster response time than the 2-D grating cell (comparable to a 1-D grating cell). All the electro-optic parameters have been calculated using a commercial modeling tool. Consequently, we expect our proposed grating cell to find applications in virtual reality (VR)/augmented reality (AR) systems or window displays with fast response times.

Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting.

Increased vasoactive-inotropic score (VIS) is a reliable predictor of mortality and morbidity after cardiac surgery. Here, we retrospectively evaluated the association between VIS and adverse outcomes in adult patients after off-pump coronary artery bypass grafting (OPCAB). We included 2149 patients who underwent OPCAB. The maximal VIS was calculated for the initial 48 postoperative hours using standard formulae. The primary outcome was 1-year death. The composite adverse outcome was death, resuscitation or mechanical support, myocardial infarction, revascularization, new-onset atrial fibrillation, infection requiring antibacterial therapy, acute kidney injury, and stroke. Path-analysis was conducted using lactate and prognostic nutritional index (PNI). VIS was associated with 1-year death (odds ratio [OR] 1.07 [1.04-1.10], p < 0.001) and 1-year composite outcome (OR 1.02 [1.0-1.03], p = 0.008). In path-analysis, high VIS showed a direct effect on the increased risk of 1-year death and composite outcome. In the pathway using lactate as a mediating variable, VIS showed an indirect effect on the composite outcome but no significant effect on death. Low PNI directly affected the increased risk of 1-year death and composite outcome, and had an indirect effect on both outcomes, even when VIS was used as a mediating variable. In patients undergoing OPCAB, high VIS independently predicted morbidity and 1-year death. Patients with increased lactate levels following high VIS had an increased risk of postoperative complications, although not necessarily resulting in death. However, patients with poor preoperative nutritional status had an increased risk of unfavourable outcomes, including death, implying the importance of preoperative nutritional support.

The Effect of Korean Native Chicken Breed Information on Consumer Sensory Evaluation and Purchase Behavior.

This study examined how chicken breed affects consumer behavior. The breeds evaluated were a Korean native chicken (KNC) and a commercial broiler (CB). Consumer behavior was measured by evaluating sensory attributes (taste, odor, and texture) and purchase behaviors [satisfaction, purchase intention, and willingness to pay (WTP)]. The sensory evaluation was conducted using healthy Korean consumers (n=100). The chicken was cooked in baeksuk (Korean traditional chicken soup), which is a seasonal summer health food in Korea. The participants evaluated sensory attributes and purchase behaviors between blinded samples of baeksuk (CB) and unblinded samples of baeksuk (KNC). The sensory evaluation involved chicken breasts and legs. The participants considered KNC as having a more umami taste, a chewier and juicer texture, and a less metallic odor than CB. Moreover, when participants were given KNC breed information, they expressed higher satisfaction, purchase intention, and WTP. The results of this study contribute to consumer behavior literature by revealing the effects of breed information on consumer sensory perceptions and purchase behaviors. Furthermore, the findings provide evidence that branding KNC is one way to increase its demand and low market share while contributing to sustainable consumption.

Replacement of calcified ascending aorta in patients undergoing aortic valve replacement.

BACKGROUND: Aortic stenosis (AS) with an extensively calcified ascending aorta is a growing indication for transcatheter aortic valve implantation (TAVI) because aortic manipulation during surgical aortic valve replacement (AVR) is unsafe in these patients. The aim of this study was to evaluate the outcomes of AVR plus ascending aorta replacement (AAR) in patients with severe AS and a heavily calcified ascending aorta. METHODS: From 2004 to 2014, a total of 32 patients with severe AS and extensive aortic calcification underwent concomitant first-time AVR and AAR (AVR + AAR). The mean patient age was 74±7 (range, 59-87) years, and 7 (22%) patients were octogenarians. The mean logistic EuroSCORE was 21.4%±19.0% (range, 3.3-68.2%). Arterial cannulae were placed at the ascending aorta (n=26, 81%), aortic arch (n=5, 16%), or axillary artery (n=1, 3%). The aorta was not clamped, and circulatory arrest was used in all patients. One-to-many (1:n) propensity score matching between the study population (AVR + AAR, n=29) and control group (isolated AVR for severe AS, n=433) was performed. RESULTS: There was no early mortality in the study population. Postoperative neurologic complications included a minor stroke, which resolved without sequelae at discharge, and a transient ischemic attack. The 5-year survival rate was 83%±9%. In the propensity score-matched comparison, 5-year survival was not significantly different between groups; 81%±10% in the AVR + AAR group vs. 87%±2% in the isolated AVR group (P=0.950). CONCLUSIONS: Surgical AVR with AAR in AS patients with calcified ascending aortas led to acceptable early and late outcomes. Although the applications for TAVI are growing, a surgical approach may be an alternative option for relatively younger patients with severely calcified aorta.

The effect of human blood on the setting and surface micro-hardness of calcium silicate cements.

OBJECTIVES: The purpose of the present study was to evaluate the effects of human blood on the setting and microhardness of calcium silicate cements. MATERIALS AND METHODS: Three types of silicate-based cements were used: ProRoot MTA (PMTA), OrthoMTA (OMTA), and RetroMTA (RMTA). Mixed cement was placed into polyethylene molds with lengths of 2 and 4 mm. After storage for 4 days under three different storage conditions, i.e., saline, saline after 5 min of human blood, and human blood, the polyethylene molds were removed. With the specimens set, the surface microhardness was measured using a Vickers microhardness tester, crystalline structure was analyzed with X-ray diffraction (XRD), and the surface characteristics were examined with scanning electron microscopy (SEM). RESULTS: All specimens of 4 mm in length were set with all materials, and the blood groups exhibited lower microhardnesses than did the saline groups (p < 0.05). Among the 2-mm specimens that were stored in blood, the numbers of specimens that set were significantly different across the materials (p < 0.001). Regarding the microhardnesses of the RMTA and OMTA groups, there were no significant differences between storage conditions. For the PMTA group, only one specimen that was set in the blood group exhibited reduced microhardness. XRD showed changes of crystalline structure in the PMTA and OMTA blood group, whereas RMTA did not. SEM analysis revealed more rounded and homogeneous structures and demonstrated a clear lack of acicular or needle-like crystals in the PMTA and OMTA blood groups, while RMTA did not reveal substantial differences between the saline- and blood-stored groups. CONCLUSION: Blood contamination detrimentally affected the surface microhardnesses of all materials; furthermore, among the 2-mm specimens, blood contamination interfered with normal setting. Therefore, RMTA might be a more suitable choice when blood contamination is unavoidable due to limited depth. Clinical relevance RetroMTA might be a more suitable choice in situations in which blood contamination is unavoidable.

Tooth discoloration after the use of new pozzolan cement (Endocem) and mineral trioxide aggregate and the effects of internal bleaching.

INTRODUCTION: The aim of this study was to evaluate tooth discoloration after the use of mineral trioxide aggregate (MTA) and to examine the effect of internal bleaching on discoloration associated with MTA. METHODS: Thirty-two teeth were endodontically treated. Three-millimeter plugs of MTA, ProRoot, Angelus, or Endocem were placed on the access cavities of 24 teeth. Eight teeth served as the control group. After 24 hours, the access cavities were restored, and the tooth color was recorded at baseline and at 1, 2, 4, 8, and 12 weeks. After 12 weeks, the MTA materials were removed under a microscope, and an internal bleaching treatment was performed. After removal of the MTA materials and after a 1-week bleaching treatment, the color changes were measured, and the MTA-dentin interfaces were observed under a microscope. RESULTS: The ProRoot and Angelus groups displayed increasing discoloration during a period of 12 weeks. The discoloration associated with ProRoot and Angelus was observed at the MTA-dentin interface and on the interior surface of the dentin. However, the Endocem groups demonstrated no significant discoloration (P < .05). No marginal discoloration was observed around the material in the Endocem group. Removal of the discolored MTA was effective for resolving the discoloration in all of the experimental groups (P < .05). However, a subsequent internal bleaching treatment was not significantly effective compared with the removal of MTA. CONCLUSIONS: ProRoot and Angelus caused tooth discoloration. However, Endocem did not affect the contacting dentin surface. Removing the discolored MTA materials contributed more to resolving the tooth discoloration than post-treatment internal bleaching.

First case of Bartonella quintana endocarditis in Korea.

Since microbial gene sequencing was utilized for etiologic diagnosis of culture-negative endocarditis, cases of Bartonella endocarditis have been reported in various countries. Herein we report the first case of Bartonella quintana endocarditis, which was confirmed for the first time in Korea by 16S rRNA gene sequencing from the excised valve. A 75-yr-old woman was hospitalized due to dyspnea. Echocardiography demonstrated large oscillating vegetation at the aortic valve. Blood culture was negative. She underwent valve replacement and sequencing of the 16S rRNA gene from excised valve identified Bartonella quintana. She was successfully treated with combined use of ceftriaxone and gentamicin.

Increasing the flexoelastic ratio of liquid crystals using highly fluorinated ester-linked bimesogens.

We present experimental results on the bulk flexoelectric coefficients e and effective elastic coefficients K of non-symmetric bimesogenic liquid crystals when the number of terminal and lateral fluoro substituents is increased. These coefficients are of importance because the flexoelastic ratio e/K governs the magnitude of flexoelectro-optic switching in chiral nematic liquid crystals. The study is carried out for two different types of linkage in the flexible spacer chain that connects the separate mesogenic units: these are either an ether or an ester unit. It is found that increasing the number of fluorine atoms on the mesogenic units typically leads to a small increase in e and a decrease in K, resulting in an enhancement of e/K. The most dramatic increase in e/K, however, is observed when the linking group is changed from ether to ester units, which can largely be attributed to an increase in e. Increasing the number of fluorine atoms does, however, increase the viscoelastic ratio and therefore leads to a concomitant increase in the response time. This is observed for both types of linkage, although the ester-linked compounds exhibit smaller viscoelastic ratios compared with their ether-linked counterparts. Highly fluorinated ester-linked compounds are also found to exhibit lower transition temperatures and dielectric anisotropies. As a result, these compounds are promising materials for use in electro-optic devices.

A hybrid operation in a patient with complex right subclavian artery aneurysm.

We report a hybrid surgery including endovascular aneurysm repair and debranching procedures to treat a patient with a complex right subclavian artery aneurysm. The patient was a 70-year-old woman who presented with dry cough and hoarseness. The aneurysm was characterized by the absence of a proximal neck, and involvement of the origin of the right vertebral artery. She underwent carotid-vertebral artery bypass, stent graft from the innomiate artery to the common carotid artery and carotid-axillary artery bypass. Great saphenous vein was used for the carotid-vertebral artery bypass and 7 mm reinforced polytetrafluoroethylene graft was used for the carotid-axillary artery bypass. The postoperative course was uneventful.