Effect of Pregnancy on Postoperative Nausea and Vomiting in Female Patients Who Underwent Nondelivery Surgery: Multicenter Retrospective Cohort Study.

Pregnant women usually have several risk factors of postoperative nausea and vomiting (PONV) and physiologic changes that make them susceptible to PONV development. We investigated the risk of PONV and postoperative vomiting (PV) in pregnant women in nondelivery surgery compared to nonpregnant women. This study included female adult patients who underwent nondelivery surgery at five hospitals between January 2011 and March 2021. To identify the association between pregnancy and PONV, logistic regression was used to calculate the odds ratio and 95% confidence intervals (CIs), adjusting for covariates. A total of 60,656 (nonpregnant women = 57,363 and pregnant women = 3293) complete patient outcomes and perioperative data were eligible for analysis. Although there was no significant association between pregnancy and PONV, the risk of PV in the pregnant women was 3.9-fold higher (95% confidence interval (95% CI), 3.06-4.97) than in the nonpregnant women. In addition, increased pregnancy duration increased the risk of PV (odds ratio (95% CI), 1.05 (1.01-1.09)) and preoperative nausea, and vomiting increased the risk of PONV (odds ratio (95% CI), 2.68 (1.30-5.54)) and PV (odds ratio (95% CI), 4.52 (2.36-8.69)). Pregnancy increased the risk of PV in female patients who underwent nondelivery surgery, and pregnancy duration and preoperative nausea and vomiting also were associated with PONV or PV.

Comparison of the C-MAC D-blade video laryngoscope and the McCoy laryngoscope for double-lumen endotracheal tube intubation: A prospective randomized controlled study.

BACKGROUND: Inserting a double-lumen endotracheal tube (DLT) poses more challenge than inserting a single-lumen tube. The C-MAC D-blade videolaryngoscope is a useful alternative to the direct laryngoscope. However, no study has compared its performance with that of the McCoy laryngoscope, which has a hyperangulated blade tip similar to that of the C-MAC D-blade. We aimed to compare the performance of the C-MAC D-blade videolaryngoscope with that of the McCoy laryngoscope in DLT intubation. METHODS: In this prospective randomized controlled study, 90 patients requiring DLT intubation were randomly allocated to either the C-MAC D-blade videolaryngoscope group (group C, n = 47) or McCoy laryngoscope group (group M, n = 43). During intubation, the percentage of glottic opening, modified Cormack-Lehane grade, time taken for intubation, malposition of the bronchial lumen, and hemodynamic parameters were recorded. After intubation, we assessed the intubation difficulty scale score and, a postoperative sore throat in the recovery room. RESULTS: The time taken for intubation was 35.85 ±â€…10.77 seconds and 33.18 ±â€…11.97 seconds in groups C and M, respectively (P = .269). The modified Cormack-Lehane grade was significantly lower in group C than in group M (P = .000). Percentage of glottic opening was significantly higher in group C (79.36 ±â€…13.42%) than in group M (53.49 ±â€…29.83%) (P = .000). The intubation difficulty scale score was significantly lower in group C than in group M (P = .030). There were no significant differences between the 2 groups in terms of malposition status, hemodynamic parameters, or visual analog scale score for a postoperative sore throat. CONCLUSION: Although the time taken for intubation was comparable between the 2 intubation devices, the C-MAC D-blade videolaryngoscope facilitated glottis visualization and reduced the intubation difficulty scale better than the McCoy laryngoscope in patients undergoing DLT intubation.

Divergent substrate specificities and regioselectivities of three lipase isoforms from Cordyceps militaris: Combinatorial advantages for entomopathogenicity and prospects as biocatalysts.

Cordyceps militaris, an entomopathogenic Cordyceps mushroom, is a crucial ethnopharmacological agricultural product with applications in traditional oriental remedies in East Asia. Since lipases are reported to serve as key enzymatic equipment for entomopathogenic fungi during the host infection, the presence of various lipases with different biochemical features in C. militaris was elucidated. Three lipases from C. militaris (CML) of 60-70 kDa were isolated according to protein hydrophobicity; isoform relationships were identified by peptide mapping using liquid chromatography-electrospray ionization-tandem mass spectrometry. The CML isoforms exhibited distinct substrate specificities, which were related to the hydrophobicity of each isoform. Furthermore, the integral stereoselectivity of each lipase towards trioleoylglycerol diverged into two classes (sn-1,3 and sn-2 regioselectivity) that are rare in canonical fungal lipases. Overall, our results demonstrate that C. militaris secretes lipase isoforms with cocktail-like enzyme functions that may contribute to the entomopathogenic life cycle of C. militaris. Each CML isoform has distinct advantages for biocatalyst applications in the food and oleochemical industries.

Modulation of osteogenic differentiation by Escherichia coli-derived recombinant bone morphogenetic protein-2.

Recombinant human bone morphogenetic protein-2 (rhBMP-2), a key regulator of osteogenesis, induces the differentiation of mesenchymal cells into cartilage or bone tissues. Early orthopedic and dental studies often used mammalian cell-derived rhBMP-2, especially Chinese hamster ovary (CHO) cells. However, CHO cell-derived rhBMP-2 (C-rhBMP-2) presents disadvantages such as high cost and low production yield. To overcome these problems, Escherichia coli-derived BMP-2 (E-rhBMP-2) was developed; however, the E-rhBMP-2-induced signaling pathways and gene expression profiles during osteogenesis remain unclear. Here, we investigated the E-rhBMP-2-induced osteogenic differentiation pattern in C2C12 cells and elucidated the difference in biological characteristics between E-rhBMP-2 and C-rhBMP-2 via surface plasmon resonance, western blotting, qRT-PCR, RNA-seq, and alkaline phosphatase assays. The binding affinities of E-rhBMP-2 and C-rhBMP-2 towards BMP receptors were similar, both being confirmed at the nanomolecular level. However, the phosphorylation of Smad1/5/9 at 3 h after treatment with E-rhBMP-2 was significantly lower than that on treatment with C-rhBMP-2. The expression profiles of osteogenic marker genes were similar in both the E-rhBMP-2 and C-rhBMP-2 groups, but the gene expression level in the E-rhBMP-2 group was lower than that in the C-rhBMP-2 group at each time point. Taken together, our results suggest that the osteogenic signaling pathways induced by E-rhBMP-2 and C-rhBMP-2 both follow the general Smad-signaling pathway, but the difference in intracellular phosphorylation intensity results in distinguishable transcription profiles on osteogenic marker genes and biological activities of each rhBMP-2. These findings provide an extensive understanding of the biological properties of E-rhBMP-2 and the signaling pathways during osteogenic differentiation.

Predicting preventive travel behaviors under the COVID-19 pandemic through an integration of Health Belief Model and Value-Belief-Norm.

This study developed a conceptual framework for a preventive travel decision-making process amidst the COVID-19 pandemic, combining the Health Belief Model (HBM) and Value-Belief-Norm (VBN). Analyzing 409 responses collected from an online survey, this study verified the integrated model as a salient theory addressing the importance of social components and health belief factors in affecting behavior. The model revealed that altruistic value influences the HBM variables, whereas personal norms mediate preventive behaviors and beliefs in both VBN and HBM. These findings offer new theoretical insights into decision-making process and provide practitioners with effective crisis management strategies concerning pro-social and health beliefs.

Association between Dietary Protein Intake, Regular Exercise, and Low Back Pain among Middle-Aged and Older Korean Adults without Osteoarthritis of the Lumbar Spine.

This study aimed to evaluate the effect of dietary protein intake and regular exercise on low back pain (LBP) using data from the Korea National Health and Nutrition Examination Survey. A total of 2367 middle-aged and older adults (≥50 years) who underwent dual-energy X-ray absorptiometry and plain radiography of the lumbar spine were included. LBP was defined using a questionnaire to determine the presence of LBP lasting more than 30 days in the preceding three months. Twenty-four-hour dietary recall data were used to estimate protein intake, and regular exercise was assessed using the International Physical Activity Questionnaire. Multivariable logistic regression analysis revealed that men who did not perform regular exercise had a high probability of LBP (odds ratio [OR] 2.34; 95% confidence interval [CI] 1.24−4.44). Low protein intake (<0.8 g/kg/day) was associated with high odds for LBP in women (OR 1.83; 95% CI 1.12−2.99). Low protein intake and lack of regular exercise were also associated with a higher probability of LBP in women (OR 2.91; 95% CI 1.48−5.72). We recommend that women over 50 years of age consume the recommended daily amount of protein to prevent LBP and engage in regular exercise.

Potential ecotoxicological effects of elevated bicarbonate ion concentrations on marine organisms.

Recently, a novel method for carbon capture and storage has been proposed, which converts gaseous CO2 into aqueous bicarbonate ions (HCO3-), allowing it to be deposited into the ocean. This alkalinization method could be used to dispose large amounts of CO2 without acidifying seawater pH, but there is no information on the potential adverse effects of consequently elevated HCO3- concentrations on marine organisms. In this study, we evaluated the ecotoxicological effects of elevated concentrations of dissolved inorganic carbon (DIC) (max 193 mM) on 10 marine organisms. We found species-specific ecotoxicological effects of elevated DIC on marine organisms, with EC50-DIC (causing 50% inhibition) of 11-85 mM. The tentative criteria for protecting 80% of individuals of marine organisms are suggested to be pH 7.8 and 11 mM DIC, based on acidification data previously documented and alkalinization data newly obtained from this study. Overall, the results of this study are useful for providing baseline information on ecotoxicological effects of elevated DIC on marine organisms. More complementary studies are needed on the alkalinization method to determine DIC effects on seawater chemistry and marine organisms.

Exploring for the optimal structural design for the 3D-printing technology for cranial reconstruction: a biomechanical and histological study comparison of solid vs. porous structure.

PURPOSE: Cranioplasty for recovering skull defects carries the risk for a number of complications. Various materials are used, including autologous bone graft, metallic materials, and non-metallic materials, each of which has advantages and disadvantages. If the use of autologous bone is not feasible, those artificial materials also have constraints in the case of complex anatomy and/or irregular defects. MATERIAL AND METHODS: This study used metal 3D-printing technology to overcome these existing drawbacks and analyze the clinical and mechanical performance requirements. To find an optimal structure that satisfied the structural and mechanical stability requirements, we evaluated biomechanical stability using finite element analysis (FEA) and mechanical testing. To ensure clinical applicability, the model was subjected to histological evaluation. Each specimen was implanted in the femur of a rabbit and was evaluated using histological measurements and push-out test. RESULTS AND CONCLUSION: We believe that our data will provide the basis for future applications of a variety of unit structures and further clinical trials and research, as well as the direction for the study of other patient-specific implants.

Prediction Forecast for Culex tritaeniorhynchus Populations in Korea.

OBJECTIVES: Japanese encephalitis is considered as a secondary legal infectious disease in Korea and is transmitted by mosquitoes in the summer season. The purpose of this study was to predict the ratio of Culex tritaeniorhynchus to all the species of mosquitoes present in the study regions. METHODS: From 1999 to 2012, black light traps were installed in 10 regions in Korea (Busan, Gyeonggi, Gangwon, Chungbuk, Chungnam, Jeonbuk, Jeonnam, Gyeongbuk, Gyeongnam, and Jeju) to capture mosquitoes for identification and classification under a dissecting microscope. The number of mosquitoes captured/week was used to calculate its daily occurrence (mosquitoes/trap/night). To predict the characteristics of the mosquito population, an autoregressive model of order p (AR(p)) was used to execute the out-of-sample prediction and the in-sample estimation after presumption. RESULTS: Compared with the out-of-sample method, the sample-weighted regression method's case was relatively superior for prediction, and this method predicted a decrease in the frequency of Cx. tritaeniorhynchus for 2013. However, the actual frequency of this species showed an increase in frequency. By contrast, the frequency rate of all the mosquitoes including Cx. tritaeniorhynchus gradually decreased. CONCLUSION: The number of patients with Japanese encephalitis has been strongly associated with the occurrence and density of vector mosquitoes, and the importance of this infectious disease has been highlighted since 2010. The 2013 prediction indicated an increase after an initial decrease, although the ratio of the two mosquito species decreased. The increase in vector density may be due to changes in temperature and the environment. Thus, continuous prevalence prediction is warranted.

Isolation and characterization of fenobucarb-degrading bacteria from rice paddy soils.

Forty-five fenobucarb-degrading bacteria were isolated from rice paddy soils, and their genetic and phenotypic characteristics were investigated. The isolates were able to utilize fenobucarb as a sole source of carbon and energy. Analysis of the 16S rRNA gene sequence indicated that all the isolates were related to members of the genera Sphingobium and Novosphingobium. Among 45 isolates, 21 different chromosomal DNA fingerprinting patterns were obtained. All these strains exhibited similar growth and degradation patterns on fenobucarb. 2-sec-butylphenol was identified as an intermediate during fenobucarb degradation by HPLC analysis. All of the isolates were able to degrade another carbamate insecticide, carbaryl, and 2-sec-butylphenol, but not other fenobucarb related compounds such as aldicarb and fenoxycarb. Representative strains of the different repetitive extragenic palindromic sequence PCR fingerprint types had one to six plasmids. The plasmid-cured strains lost their degradation abilities, suggesting that fenobucarb degradative genes were on their plasmid DNAs in these strains. When analyzed with PCR amplification using the primers targeting for the previously reported carbamate hydrolase genes, most of the isolates did not exhibit any positive signals for different genes involved in carbamate degradation such as mcd, cahA and cehA genes. This is the first report that microorganisms involved in the degradation of fenobucarb have been isolated and the intermediate of fenobucarb biodegradation was identified.

Integration of IEEE 1451 and HL7 exchanging information for patients' sensor data.

HL7 (Health Level 7) is a standard developed for exchanging incompatible healthcare information generated from programs or devices among heterogenous medical information systems. At present, HL7 is growing as a global standard. However, the HL7 standard does not support effective methods for treating data from various medical sensors, especially from mobile sensors. As ubiquitous systems are growing, HL7 must communicate with various medical transducers. In the area of sensor fields, IEEE 1451 is a group of standards for controlling transducers and for communicating data from/to various transducers. In this paper, we present the possibility of interoperability between the two standards, i.e., HL7 and IEEE 1451. After we present a method to integrate them and show the preliminary results of this approach.

Ubiquitous-severance hospital project: implementation and results.

OBJECTIVES: The purpose of this study was to review an implementation of u-Severance information system with focus on electronic hospital records (EHR) and to suggest future improvements. METHODS: Clinical Data Repository (CDR) of u-Severance involved implementing electronic medical records (EMR) as the basis of EHR and the management of individual health records. EHR were implemented with service enhancements extending to the clinical decision support system (CDSS) and expanding the knowledge base for research with a repository for clinical data and medical care information. RESULTS: The EMR system of Yonsei University Health Systems (YUHS) consists of HP integrity superdome servers using MS SQL as a database management system and MS Windows as its operating system. CONCLUSIONS: YUHS is a high-performing medical institution with regards to efficient management and customer satisfaction; however, after 5 years of implementation of u-Severance system, several limitations with regards to expandability and security have been identified.

Closed-form algorithms for phase retrieval with an additive point signal.

The phase retrieval problem is a problem of a reconstruction of a signal from the magnitude of its Fourier transform. In this paper, we consider the problem of reconstructing an unknown one-dimensional signal from the magnitude of its Fourier transform and the magnitude of the Fourier transform of another signal that is made by the addition of a point signal at the center of the original signal. After we show that there are exactly two solution signals that satisfy the given condition, we develop a closed-form algorithm that may reconstruct the two solution signals.

20-Year-Follow up of Treatment Using Spine Osteotomy and Halo-pelvic Traction for Tuberculous Kyphosis - A Case Report -.

A 23-year-old male whose medical history included tuberculous spondylitis presented with a kyphotic deformity and incomplete paraplegia of twenty days duration. Preoperative radiographs demonstrated a T12-L4 kyphotic Cobb's angle of 100 degrees with a complete block showing on the lumbar myelogram at L4-5. The patient underwent anterior osteotomy and release. After the operation, a halo-pelvic apparatus was fit onto the patient, and distraction was begun. After distraction for 2 months, posterior osteotomy and release was performed for final correction, and distraction was maintained for another three weeks. Finally, the kyphotic deformity was corrected to a Cobb's angle of 62 degrees from T12 to L4. Supplementary anterior fusion was done, and the apparatus was removed after consolidation of the fusion mass.Even twenty years after correction of a tuberculous kyphosis, he had no neurological deterioration, and could work as a farmer using agricultural machines. Correction angle and sagittal balance were well maintained.

The application of a digital solution for completing EMR consent.

There are several crucial obstacles to change such as user resistance and the time it takes to type data. So there is a significant need for an easy and user-friendly migration tool toward EMR. The purpose of this study was to develop a digital pen solution to support electronic medical recording. A digital pen is not only good for saving images quickly but also useful in digitalizing text by applying a text recognition engine. Therefore, we expect the digital pen solution to be the most helpful and easiest migration tool in the successful adaptation of EMR.

Using neural network to recognize human emotions from heart rate variability and skin resistance.

The purpose of this paper is to estimate emotions using Neural network and the changes in activities of autonomic nervous system(ANS). Since ANS cannot be controlled artificially, we presumed that the changes in emotions would be reflected to the changes in ANS. In order to observe those changes, we provided the subjects with some video clips which can induce a variety of emotions and measured the changes in ANS, especially in Heart Rate Variability(HRV) and in Galvanic Skin Response(GSR). With those analyzed results from the experiments, we established an algorithm based on Neural network, finally we could reach the estimating rate of 80.2%

Genetic analysis of phosphomannomutase/phosphoglucomutase from Vibrio furnissii and characterization of its role in virulence.

The pmm gene from Vibrio furnissii, which encodes phosphomannomutase (PMM), was cloned and sequenced. The open reading frame consisted of 1,434 bp, encoding a polypeptide of 477 amino acids with a molecular mass of 53,325 Da. The predicted amino acid sequence of V. furnissii PMM showed high similarity with PMMs from other enteric bacteria, such as V. cholerae, Salmonella sp. and Escherichia coli. The PMM protein was overexpressed in E. coli as a His(6)-tagged recombinant protein. The estimated apparent K(m )and k(cat) values of the purified recombinant protein for mannose 1-phosphate were about 60 microM and 800 min(-1), respectively. To investigate the biochemical functions and the role of pmm in the virulence of V. furnissii, a pmm knock-out mutant was constructed by homologous recombination mutation. Under the various physical conditions, cell numbers of the wild-type and the mutant did not differ. Oral introduction of bacterial suspensions to a mouse model showed that the pmm-deficient mutant decreased in viability at the intestine. Microscopy of the isolated intestines from mice revealed significant damage after 3 days in intestinal mucosa infected with the wild-type as compared with the mutant. The pmm-deficient mutant caused a reduction of virulence in mice and the loss of O-antigen polysaccharide, and showed low resistance relative to the wild-type when incubated with normal human serum.

Feasibility of ultrasound examination in posterior ligament complex injury of thoracolumbar spine fracture.

STUDY DESIGN: A prospective study of 12 patients with thoracolumbar spinal fractures was conducted. OBJECTIVE: To assess the feasibility of ultrasound examination for posterior ligament complex injury in thoracolumbar spinal fractures. SUMMARY OF BACKGROUND DATA: In posterior ligament complex injury of thoracolumbar spine fracture, the reliability of magnetic resonance imaging (MRI) for diagnosis has been reported. Nevertheless the usefulness of ultrasound for diagnosis has not been studied, whereas diagnostic ultrasound has been applied in the musculoskeletal system. METHODS: Two healthy volunteers without a history of spinal trauma were recruited for pilot examination of the ultrasound procedure to access normal findings of the posterior ligament complex. This study investigated 12 thoracolumbar spine fractures. Four were flexion distraction injury; six were stable or unstable burst fractures; and two were simple compression fractures. Osteoporotic spine fractures were excluded from this study. Ultrasound was performed over the injured area by an experienced musculoskeletal radiologist in addition to radiography and MRI. Five patients underwent operative procedures to stabilize the fractured spine. Imaging data and operative findings were correlated with ultrasound examination. RESULTS: In the patients who did not undergo surgery, agreement in diagnosis between MRI and ultrasound was moderate (5 of 7). Difficulty evaluating ligament status was encountered when the region of interest was the lower thoracic level (T10, T11, T12) because of long overlapping spinous processes. In the patients who underwent surgery, correlation between MRI, ultrasound, and operative findings was excellent, especially in diagnosing the status of the supraspinous and interspinous ligaments. Nevertheless, it is impossible to visualize deep-seated structures (i.e., ligamentum flavum, deep muscles of the spine, and facet joint) with ultrasound. CONCLUSIONS: This study demonstrated the excellent diagnostic ability of ultrasound to detect the status of the supraspinous and interspinous ligaments, especially in patients who undergo surgery. Although ultrasound examination appears to be less sensitive than MRI in predicting ligament status, the cost effectiveness of ultrasound and its use as an alternative to MRI in special situations (i.e., patients with pacemaker, ferromagnetic implant, or severe claustrophobia) should be emphasized. More clinical data concerning the sensitivity, specificity, and accuracy of ultrasound examination should be addressed in future studies.