Selective Enhancement of Viewing Angle Characteristics and Light Extraction Efficiency of Blue Thermally Activated Delayed Fluorescence Organic Light-Emitting Diodes through an Easily Tailorable Si3N4 Nanofiber Structure.

We selectively improved the viewing angle characteristics and light extraction efficiency of blue thermally activated delayed fluorescence (TADF) organic light-emitting diodes (OLEDs) by tailoring a nanofiber-shaped Si3N4 layer, which was used as an internal scattering layer. The diameter of the polymer nanofibers changed according to the mass ratio of polyacrylonitrile (PAN) and poly(methyl methacrylate) (PMMA) in the polymer solution for electrospinning. The Si3N4 nanofiber (SNF) structure was fabricated by etching an Si3N4 film using the PAN/PMMA nanofiber as a mask, making it easier to adjust parameters, such as the diameter, open ratio, and height, even though the SNF structure was randomly shaped. The SNF structures exhibited lower transmittance and higher haze with increasing diameter, showing little correlation with their height. However, all the structures demonstrated a total transmittance of over 80%. Finally, by applying the SNF structures to the blue TADF OLEDs, the external quantum efficiency was increased by 15.6%. In addition, the current and power efficiencies were enhanced by 23.0% and 25.6%, respectively. The internal light-extracting SNF structure also exhibited a synergistic effect with the external light-extracting structure. Furthermore, when the viewing angle changed from 0° to 60°, the peak wavelength and CIE coordinate shift decreased from 20 to 6 nm and from 0.0561 to 0.0243, respectively. These trends were explained by the application of Snell's law to the light path and were ultimately validated through finite-difference time-domain simulations.

The association of withholding or continuing angiotensin-converting enzyme inhibitors or angiotensin 2 receptor blockers on acute kidney injury after non-cardiac surgery.

BACKGROUND: Withholding or continuing angiotensin-converting enzyme inhibitors or angiotensin 2 receptor blockers peri-operatively in non-cardiac surgery remains controversial as they may result in intra-operative hypotension and postoperative organ damage. METHODS: We included patients prescribed angiotensin-converting enzyme inhibitors or angiotensin 2 receptor blockers who underwent surgical procedures > 1 h duration under general or spinal anaesthesia from January 2012 to June 2022 in a single centre. We categorised patients by whether these drugs were withheld for 24 h before surgery. We evaluated the association of withholding these drugs before non-cardiac surgery with creatinine concentrations that increased ≥ 26.4 µmol.l-1 in the first 48 postoperative hours (acute kidney injury). We also analysed changes in creatinine concentrations and estimated glomerular filtration rates. RESULTS: Angiotensin-converting enzyme inhibitors or angiotensin 2 receptor blockers were withheld in 24,285 of 32,933 (74%) patients and continued in 8648 (26%) patients. We used propensity scores for drug discontinuation to match 8631 patient pairs who did or did not continue these drugs: acute kidney injury was recorded for 1791 (21%) patients who continued these drugs vs. 1587 (18%) who did not (OR (95%CI) 1.16 (1.08-1.25), p < 0.001). Intra-operative hypotension was recorded for 3892 (45%) patients who continued drugs vs. 3373 (39%) patients who did not (OR (95%CI) 1.28 (1.21-1.36), p < 0.001). Continuing drugs was independently associated with a mean increase in creatinine of 2.2 µmol.l-1 (p < 0.001) and a mean decrease in estimated glomerular filtration rate of 1.4 ml.min.1.73 m-2 (p < 0.001). CONCLUSIONS: Continuing angiotensin-converting enzyme inhibitors or angiotensin 2 receptor blockers 24 h before non-cardiac surgery was associated with intra-operative hypotension and postoperative acute kidney injury.

Multiple-Junction-Based Traffic-Aware Routing Protocol Using ACO Algorithm in Urban Vehicular Networks.

The burgeoning interest in intelligent transportation systems (ITS) and the widespread adoption of in-vehicle amenities like infotainment have spurred a heightened fascination with vehicular ad-hoc networks (VANETs). Multi-hop routing protocols are pivotal in actualizing these in-vehicle services, such as infotainment, wirelessly. This study presents a novel protocol called multiple junction-based traffic-aware routing (MJTAR) for VANET vehicles operating in urban environments. MJTAR represents an advancement over the improved greedy traffic-aware routing (GyTAR) protocol. MJTAR introduces a distributed mechanism capable of recognizing vehicle traffic and computing curve metric distances based on two-hop junctions. Additionally, it employs a technique to dynamically select the most optimal multiple junctions between source and destination using the ant colony optimization (ACO) algorithm. We implemented the proposed protocol using the network simulator 3 (NS-3) and simulation of urban mobility (SUMO) simulators and conducted performance evaluations by comparing it with GSR and GyTAR. Our evaluation demonstrates that the proposed protocol surpasses GSR and GyTAR by over 20% in terms of packet delivery ratio, with the end-to-end delay reduced to less than 1.3 s on average.

Efficacy of Botulinum Toxin Injection for Airway Management in Patients with Transient Bilateral Vocal Fold Paresis Following Thyroidectomy: A Prospective Study.

OBJECTIVES: This prospective study evaluated the effectiveness and safety of botulinum toxin injection for airway management in patients with transient bilateral vocal fold paresis (BVFP) after thyroidectomy. STUDY DESIGN: Prospective clinical study. METHODS: A prospective study was conducted at Soonchunhyang University, Bucheon, Korea, between March 2005 and February 2023. This study enrolled 12 patients with BVFP after thyroidectomy who received botulinum toxin injections into the thyroarytenoid muscles. Vocal fold mobility and airway distress were assessed using a flexible laryngoscope before and after injection. RESULTS: Of the 3018 thyroidectomy patients, 12 (0.39%) developed transient BVFP after surgery. Under the guidance of laryngeal electromyography, 3.6 ± 0.6 IU botulinum toxin was administered into the bilateral thyroarytenoid muscles. Notably, nine patients (75%) received a single injection, whereas three (25%) received an additional injection after 7days. The mean time for vocal fold movement recovery was 33.2 ± 17.2days after injection; conventional destructive procedures for BVFP were avoided in 10 of the 12 patients (83.3%). CONCLUSIONS: Botulinum toxin injection offers a novel approach to airway management in patients with transient BVFP after thyroidectomy. LEVEL OF EVIDENCE: Level 4.

Does Radial Extracorporeal Shockwave Therapy Applied to the Achilles Tendon Influence Ankle Functionality?

This study aimed to determine the effectiveness of radial extracorporeal shockwave therapy (rESWT) in enhancing ankle function in patients with Achilles tendon injuries. The choice of rESWT was based on previous success in the treatment of musculoskeletal conditions. The study involved an intervention group that received rESWT, and a control group that received sham therapy. The results revealed that rESWT led to significant improvements in single-leg vertical jump (d = 0.55, p < 0.05), indicating enhanced power generation and ankle functionality that were not observed in the control group. Additionally, the therapy resulted in increased ankle mobility, as observed by improvements in plantar flexion and heel-rise tests. Interestingly, these functional gains were not accompanied by changes in the Achilles tendon stiffness, suggesting that the benefits of rESWT may be more functional than structural. This study highlights rESWT as a promising tool for rehabilitation, particularly following Achilles tendon injuries. The study concluded that, although rESWT appears to improve certain aspects of ankle function, further studies with a larger and more diverse population over a longer period are necessary to confirm these findings and establish comprehensive treatment protocols.

Hollow Microcavity Electrode for Enhancing Light Extraction.

Luminous efficiency is a pivotal factor for assessing the performance of optoelectronic devices, wherein light loss caused by diverse factors is harvested and converted into the radiative mode. In this study, we demonstrate a nanoscale vacuum photonic crystal layer (nVPCL) for light extraction enhancement. A corrugated semi-transparent electrode incorporating a periodic hollow-structure array was designed through a simulation that utilizes finite-difference time-domain computational analysis. The corrugated profile, stemming from the periodic hollow structure, was fabricated using laser interference lithography, which allows the precise engineering of various geometrical parameters by controlling the process conditions. The semi-transparent electrode consisted of a 15 nm thick Ag film, which acted as the exit mirror and induced microcavity resonance. When applied to a conventional green organic light-emitting diode (OLED) structure, the optimized nVPCL-integrated device demonstrated a 21.5% enhancement in external quantum efficiency compared to the reference device. Further, the full width at half maximum exhibited a 27.5% reduction compared to that of the reference device, demonstrating improved color purity. This study presents a novel approach by applying a hybrid thin film electrode design to optoelectronic devices to enhance optical efficiency and color purity.

Ten-year outcomes of recurrent laryngeal nerve reinnervation for thyroidectomy-related unilateral vocal fold paralysis: A single-surgeon, prospective study.

OBJECTIVES: This study evaluated the long-term outcomes of intraoperative recurrent laryngeal nerve (RLN) reinnervation for managing thyroidectomy-related unilateral vocal fold paralysis (UVFP) over a period of 10 years and assessed the long-term efficacy of this technique. METHODS: This study was conducted between March 2006 and July 2022 at Soonchunhyang University Bucheon Hospital. We enrolled 25 patients who underwent RLN reinnervation via direct neurorrhaphy or ansa cervicalis-to-RLN anastomosis and completed subjective and objective voice measurements over 5 years period. Among these, 10 patients completed voice measurements over 10 years period. RESULTS: Six months post-RLN reinnervation, most subjective voice parameters and some of objective voice parameters showed significant improvement (p < 0.05). Twelve months after the procedure, most parameters demonstrated significant voice improvements. These improvements remained stable in follow-up examinations 10 years post-RLN reinnervation (p < 0.05). CONCLUSIONS: With stable voice outcomes over a decade, primary intraoperative RLN reinnervation provides satisfactory voice outcomes for 10 years postoperatively. Concerning the long-term survival of thyroid cancer patients, primary intraoperative RLN reinnervation is the first recommended voice rehabilitation technique for thyroidectomy related permanent UVFP.

Evaluating the coding accuracy of type 2 diabetes mellitus among patients with non-alcoholic fatty liver disease.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) describes a spectrum of chronic fattening of liver that can lead to fibrosis and cirrhosis. Diabetes has been identified as a major comorbidity that contributes to NAFLD progression. Health systems around the world make use of administrative data to conduct population-based prevalence studies. To that end, we sought to assess the accuracy of diabetes International Classification of Diseases (ICD) coding in administrative databases among a cohort of confirmed NAFLD patients in Calgary, Alberta, Canada. METHODS: The Calgary NAFLD Pathway Database was linked to the following databases: Physician Claims, Discharge Abstract Database, National Ambulatory Care Reporting System, Pharmaceutical Information Network database, Laboratory, and Electronic Medical Records. Hemoglobin A1c and diabetes medication details were used to classify diabetes groups into absent, prediabetes, meeting glycemic targets, and not meeting glycemic targets. The performance of ICD codes among these groups was compared to this standard. Within each group, the total numbers of true positives, false positives, false negatives, and true negatives were calculated. Descriptive statistics and bivariate analysis were conducted on identified covariates, including demographics and types of interacted physicians. RESULTS: A total of 12,012 NAFLD patients were registered through the Calgary NAFLD Pathway Database and 100% were successfully linked to the administrative databases. Overall, diabetes coding showed a sensitivity of 0.81 and a positive predictive value of 0.87. False negative rates in the absent and not meeting glycemic control groups were 4.5% and 6.4%, respectively, whereas the meeting glycemic control group had a 42.2% coding error. Visits to primary and outpatient services were associated with most encounters. CONCLUSION: Diabetes ICD coding in administrative databases can accurately detect true diabetic cases. However, patients with diabetes who meets glycemic control targets are less likely to be coded in administrative databases. A detailed understanding of the clinical context will require additional data linkage from primary care settings.

Epigenome editing in cancer: Advances and challenges for potential therapeutic options.

Cancers are diseases caused by genetic and non-genetic environmental factors. Epigenetic alterations, some attributed to non-genetic factors, can lead to cancer development. Epigenetic changes can occur in tumor suppressors or oncogenes, or they may contribute to global cell state changes, making cells abnormal. Recent advances in gene editing technology show potential for cancer treatment. Herein, we will discuss our current knowledge of epigenetic alterations occurring in cancer and epigenetic editing technologies that can be applied to developing therapeutic options.

Complexation-driven assembly of imine-linked helical receptors showing adaptive folding and temperature-dependent guest selection.

The development of synthetic receptors capable of selectively binding guests with diverse structures and multiple functional groups poses a significant challenge. Here, we present the efficient assembly of foldamer-based receptors for monosaccharides, utilising the principles of complexation-induced equilibrium shifting and adaptive folding. Diimine 4 can be quantitatively assembled from smaller components when D-galactose is added as a guest among monosaccharides we examined. During this assembly, dual complexation-induced equilibrium shifts toward both the formation of diimine 4 and the conversion of D-galactose into α-D-galactofuranose are observed. Diimine 6 is quantitatively assembled in the presence of two different guests, methyl ß-D-glucopyranoside and methyl ß-D-galactopyranoside, resulting in the formation of two dimeric complexes: (6-MP)2⊃(methyl ß-D-glucopyranoside)2 and (6-MM)2⊃(methyl ß-D-galactopyranoside∙2H2O)2, respectively. These two complexes exhibit distinct folding structures with domain-swapping cavities depending on the bound guest and temperature. Interestingly, (6-MM)2⊃(methyl ß-D-galactopyranoside∙2H2O)2 is exclusively formed at lower temperatures, while (6-MP)2⊃(methyl ß-D-glucopyranoside)2 is only formed at higher temperatures.

Effect of continuing angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers on the day of surgery on myocardial injury after non-cardiac surgery: A retrospective cohort study.

STUDY OBJECTIVE: To evaluate the effect of continuing of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) prescriptions 24 h before surgery on postoperative myocardial injury and blood pressure in patients undergoing non-cardiac surgery. DESIGN: A single-center, retrospective study. SETTING: Operating room and perioperative care area. PATIENTS: 42,432 patients who had been taking chronic ACEI/ARB underwent non-cardiac surgery from January 2012 to June 2022. INTERVENTIONS: Patients who discontinued ACEI/ARB 24 h before surgery (withheld group, n=31,055) and those who continued ACEI/ARB 24 h before surgery (continued group, n=11,377). MEASUREMENTS: Primary outcome was myocardial injury after non-cardiac surgery (MINS) within 7 days postoperatively. MINS was defined as an elevated postoperative cardiac troponin measurement above the 99th percentile of the upper reference limit with a rise/fall pattern. Perioperative blood pressure and clinical outcomes were secondary outcomes. MAIN RESULTS: Among 42,432 patients, MINS occurred in 2848 patients (6.7%) and was the all-cause of death within 30 days in 122 patients (0.3%). Incidence of MINS was significantly higher in the continued group than the withheld group (847/11,377 [7.4%] vs. 2001/31,055 [6.4%]; OR [95% CI] 1.17 [1.07-1.27]; P<0.001). After 1:1 propensity score matching, 11,373 patients were included in each group. There was still a significant difference for the occurrence of MINS between two groups in matched cohort (7.4% vs. 6.6%, OR [95% CI] 1.14 [1.03-1.26]; P=0.015). Time-average weight of mean arterial pressure <65 mmHg during surgery was significantly higher in the continued group (mean 0.11 vs. 0.09 [95% CI of mean difference] [0.01-0.03]; P<0.001). However, there was no significant difference in other clinical outcomes and mortality. CONCLUSIONS: Withholding ACEI/ARB before surgery was associated with a reduced risk of intraoperative hypotension and postoperative myocardial injury, but it did not affect overall clinical outcomes in patients undergoing non-cardiac surgery.

Comparison of the Influence of Dual-Task Activities on Prefrontal Activation and Gait Variables in Older Adults with Mild Cognitive Impairment during Straight and Curved Walking.

Background and Objectives: Mild cognitive impairment (MCI) is an early stage of dementia in which everyday tasks can be maintained; however, notable challenges may occur in memory, focus, and problem-solving skills. Therefore, motor-cognitive dual-task training is warranted to prevent cognitive decline and improve cognition in aging populations. This study aimed to determine the influence of such dual-task activities during straight and curved walking on the activities of the prefrontal cortex and associated gait variables in older adults with MCI. Materials and Methods: Twenty-seven older adults aged ≥65 years and identified as having MCI based on their scores (18-23) on the Korean Mini-Mental State Examination were enrolled. The participants performed four task scenarios in random order: walking straight, walking straight with a cognitive task, walking curved, and walking curved with a cognitive task. The activation of the prefrontal cortex, which is manifested by a change in the level of oxyhemoglobin, was measured using functional near-infrared spectroscopy. The gait speed and step count were recorded during the task performance. Results: Significant differences were observed in prefrontal cortex activation and gait variables (p < 0.05). Specifically, a substantial increase was observed in prefrontal cortex activation during a dual task compared with that during a resting-state (p < 0.013). Additionally, significant variations were noted in the gait speed and step count (p < 0.05). Conclusions: This study directly demonstrates the impact of motor-cognitive dual-task training on prefrontal cortex activation in older adults with MCI, suggesting the importance of including such interventions in enhancing cognitive function.

BERT-Based Neural Network for Inpatient Fall Detection From Electronic Medical Records: Retrospective Cohort Study.

BACKGROUND: Inpatient falls are a substantial concern for health care providers and are associated with negative outcomes for patients. Automated detection of falls using machine learning (ML) algorithms may aid in improving patient safety and reducing the occurrence of falls. OBJECTIVE: This study aims to develop and evaluate an ML algorithm for inpatient fall detection using multidisciplinary progress record notes and a pretrained Bidirectional Encoder Representation from Transformers (BERT) language model. METHODS: A cohort of 4323 adult patients admitted to 3 acute care hospitals in Calgary, Alberta, Canada from 2016 to 2021 were randomly sampled. Trained reviewers determined falls from patient charts, which were linked to electronic medical records and administrative data. The BERT-based language model was pretrained on clinical notes, and a fall detection algorithm was developed based on a neural network binary classification architecture. RESULTS: To address various use scenarios, we developed 3 different Alberta hospital notes-specific BERT models: a high sensitivity model (sensitivity 97.7, IQR 87.7-99.9), a high positive predictive value model (positive predictive value 85.7, IQR 57.2-98.2), and the high F1-score model (F1=64.4). Our proposed method outperformed 3 classical ML algorithms and an International Classification of Diseases code-based algorithm for fall detection, showing its potential for improved performance in diverse clinical settings. CONCLUSIONS: The developed algorithm provides an automated and accurate method for inpatient fall detection using multidisciplinary progress record notes and a pretrained BERT language model. This method could be implemented in clinical practice to improve patient safety and reduce the occurrence of falls in hospitals.

Unified Interpretations of Two Kinds of Needle-Shaped Precipitates Using Transmission Electron Microscopy and Small-Angle Neutron Scattering in Aged Al-Mg2Si(-Cu) Alloys.

This study investigates the nanostructural properties of pseudo-binary Al-1.0Mg2Si (mass%) alloys with and without 0.5Cu using transmission electron microscopy (TEM) and small-angle neutron scattering (SANS). The TEM results show that both alloys exhibit extra electron diffraction spots related to MgSiMg second clusters at peak-aged conditions. High-resolution TEM images have revealed that the second cluster exists as a needle-shaped precipitate that is shorter and thicker than the ß″ phase. We found that the second cluster, which we referred to as the R phase in this paper, is more likely to form partially along the longitudinal axis of a random-type precipitate. Thus, the atomic arrangement in the random-type precipitate is not completely random. SANS is used to quantify the size and volume fraction of the observed needle-shaped precipitates since the R phase is difficult to observe with TEM. The R phase forms even in the Cu-free alloy, but the volume fraction is low, and the growth and formation are retarded near the peak-aged conditions. Undoubtedly, the Cu addition has the effect of stabilizing the growth of the R phase and also promoting its formation. Therefore, the R phase also contributes to the increase in hardness at both under- and peak-aged conditions in the Cu-containing alloy in addition to the strengthening ß″ phases.

Characteristics of particulate matter from asphalt pavement and tire of a moving bus through driving tests in city road and proving ground.

Non-exhaust PM emissions from vehicles in real road have been conducted, but heavy vehicles have rarely been tested. In this study, PM2.5 and PM10 samples were directly collected from a tire of a moving bus and the composition was analyzed to investigate the sources of PM emissions. Driving tests were conducted at a proving ground (PG) and a city road (CR). PM2.5 emissions considerably increased when the lateral force of the tire increased and the vehicle accelerated. The PM emission rate was higher in the PG test than in the CR test because of the harsher driving conditions at PG. The emission rates of PM10 in the PG and CR tests were higher than those of PM2.5 by approximately 6 and 11 times, respectively. In the PG and CR tests, the proportions of tire wear particles (TWPs) were 4.9% and 2.1% in the PM2.5 samples, and 6.8% and 8.2% in the PM10 samples, respectively. Furthermore, TWPs with PM (TWPPM) were generated by other sources: secondary production of TWPPM by fragmentation of TWPs and resuspension of TWPPM on the road. The contributions of other sources to TWP2.5 generation were at least 6% and 57% in the PG and CR tests, respectively, whereas that to TWP10 generation was at least 3.5% in the CR test. Iron derived from brake abrasion and mineral particles was observed in the PM samples, and the Fe concentrations were higher in the PM10 samples than in the PM2.5 samples by over 9 and 18 times for the PG and CR tests, respectively. Sulfur sources, such as TWPs, exhaust gas, and bitumen, were observed in the PM samples. Based on our findings, we recommend that road wear particles should be removed from roads to reduce PM emissions upon driving.

An adaptive ensemble deep learning framework for reliable detection of pandemic patients.

Nurses, often considered the backbone of global health services, are disproportionately vulnerable to COVID-19 due to their front-line roles. They conduct essential patient tests, including blood pressure, temperature, and complete blood counts. The pandemic-induced loss of nursing staff has resulted in critical shortages. To address this, robotic solutions offer promising avenues. To solve this problem, we developed an ensemble deep learning (DL) model that uses seven different models to detect patients. Detected images are then used as input for the soft robot, which performs basic assessment tests. In this study, we introduce a deep learning-based approach for nursing soft robots, and propose a novel deep learning model named Deep Ensemble of Adaptive Architectures. Our method is twofold: firstly, an ensemble deep learning technique detects COVID-19 patients; secondly, a soft robot performs basic assessment tests on the identified patients. We evaluate the performance of various deep learning-based object detectors for patient detection, examining implementations of You Only Look Once (YOLO), Single Shot MultiBox Detector (SSD), Region-Based Convolutional Neural Network (RCNN), and Region-Based Fully Convolutional Network (R-FCN) on a proprietary dataset comprising 32,668 hospital surveillance images. Our results indicate that while YOLO and VGG facilitate rapid detection, Faster-RCNN (Inception ResNet-v2) and our proposed Ensemble-DL achieve the highest accuracy. Ensemble-DL offers accurate results in a reasonable timeframe, making it apt for patient detection on embedded platforms. Through real-world experiments, our method outperforms baseline approaches (including Faster-RCNN, R-FCN variants, CNN+LSTM, etc.) in terms of both precision and recall. Achieving an impressive accuracy of 98.32%, our deep learning-based model for nursing soft robots presents a significant advancement in the identification and assessment of COVID-19 patients, ultimately enhancing healthcare efficiency and patient care.

A randomized controlled trial of propofol-remifentanil total intravenous anesthesia and sevoflurane-fentanyl anesthesia on early postoperative fatigue in patients undergoing laparoscopic colorectal surgery.

PURPOSE: Even after uncomplicated surgery, postoperative fatigue prevalence has been reported to be 30-80% for various surgeries. We evaluated postoperative fatigue according to anesthetic technique in patients who underwent colorectal surgery. METHODS: One hundred thirty patients who underwent colorectal surgery were randomly assigned to either propofol-remifentanil total intravenous anesthesia (propofol-remifentanil group, n = 65) or sevoflurane-fentanyl anesthesia (sevoflurane-fentanyl group, n = 65). The primary outcome was the prevalence of postoperative fatigue, as defined by the Chalder Fatigue Questionnaire (total score ≥ 16), at 24 h postoperatively. Secondary outcomes were early postoperative complications during hospitalization and laboratory examination. RESULTS: The final analyses included 127 patients. The prevalence of postoperative fatigue on the 1st postoperative day was lower in the propofol-remifentanil group than the sevoflurane-fentanyl group: 56.3% (36/64) in the propofol-remifentanil group and 73.0% (46/63) in the sevoflurane-fentanyl group (relative risk [RR] = 0.77, 95% confidence interval [CI] 0.59-1.00; P = 0.048). However, there was no difference between the two groups in postoperative fatigue at postoperative day 3. Other postoperative outcomes including the severity of pain and the incidence of nausea/vomiting were not different between the two groups, but postoperative atelectasis on chest X-ray was higher in the sevoflurane-fentanyl group (2/64 [3.1%] vs. 9/63 [14.3%], P = 0.025). C-reactive protein change from preoperative to postoperative day 1 and 5 was significantly lower in the propofol-remifentanil group (P = 0.044). CONCLUSION: Propofol-remifentanil total intravenous anesthesia was associated with reduced postoperative fatigue at the 1st postoperative day compared with sevoflurane-fentanyl anesthesia. Clinical trial The Korean Clinical Research Registry (study identifier: KCT0006917, principal investigator's name: MiHye Park, date of registration: January 12, 2022).

Exploring the reliability of inpatient EMR algorithms for diabetes identification.

INTRODUCTION: Accurate identification of medical conditions within a real-time inpatient setting is crucial for health systems. Current inpatient comorbidity algorithms rely on integrating various sources of administrative data, but at times, there is a considerable lag in obtaining and linking these data. Our study objective was to develop electronic medical records (EMR) data-based inpatient diabetes phenotyping algorithms. MATERIALS AND METHODS: A chart review on 3040 individuals was completed, and 583 had diabetes. We linked EMR data on these individuals to the International Classification of Disease (ICD) administrative databases. The following EMR-data-based diabetes algorithms were developed: (1) laboratory data, (2) medication data, (3) laboratory and medications data, (4) diabetes concept keywords and (5) diabetes free-text algorithm. Combined algorithms used or statements between the above algorithms. Algorithm performances were measured using chart review as a gold standard. We determined the best-performing algorithm as the one that showed the high performance of sensitivity (SN), and positive predictive value (PPV). RESULTS: The algorithms tested generally performed well: ICD-coded data, SN 0.84, specificity (SP) 0.98, PPV 0.93 and negative predictive value (NPV) 0.96; medication and laboratory algorithm, SN 0.90, SP 0.95, PPV 0.80 and NPV 0.97; all document types algorithm, SN 0.95, SP 0.98, PPV 0.94 and NPV 0.99. DISCUSSION: Free-text data-based diabetes algorithm can yield comparable or superior performance to a commonly used ICD-coded algorithm and could supplement existing methods. These types of inpatient EMR-based algorithms for case identification may become a key method for timely resource planning and care delivery.

Immediate Effects of Sprinter-Pattern Exercise on the Lordotic Curve and Abdominal Muscle Activity in Individuals with Hyperlordosis.

Background and Objectives: Abdominal muscle exercises with limb movements are more effective for trunk stabilization than traditional exercises involving trunk flexion alone. This study examined the effects of abdominal exercises incorporating sprinter pattern and crunch exercises on changes in the lordotic curve and abdominal muscle activation in individuals with low back pain caused by hyperlordosis resulting from weak abdominal muscles. Materials and Methods: In this single-blind, randomized controlled trial, a total of 40 participants with hyperlordosis were recruited and randomly assigned to perform either sprinter-pattern abdominal exercises or crunch exercises. The participants assigned to each group performed three sets of ten abdominal exercises. The lumbar lordotic angle (LLA) and sacrohorizontal angle (SHA) were assessed prior to and following the intervention, whereas abdominal muscle activity was gauged throughout the intervention period. Changes in the LLA and SHA were measured by radiography. Abdominal muscle activity was measured using electromyography. Results: The LLA and SHA decreased significantly in both groups (p < 0.001), while the sprinter-pattern exercise group showed a statistically significant decrease compared to the crunch exercise group (p < 0.001). In the activity of the abdominal muscles, there was no significant difference in the rectus abdominis muscle between the two groups (p > 0.005). However, a significant difference between the external and internal oblique muscles was observed, and the activities of both muscles were significantly higher in the sprinter-pattern exercise group than in the crunch exercise group (p < 0.005). Conclusions: Abdominal exercise using a sprinter pattern may be effective in reducing lumbar lordosis by strengthening the abdominal muscles in patients with hyperlordosis.

Single-cell transcriptome sequencing of plant leaf expressing anti-HER2 VHH-FcK cancer therapeutic protein.

The transgenic plant is a promising strategy for the production of highly valuable biotherapeutic proteins such as recombinant vaccines and antibodies. To achieve an efficient level of protein production, codon sequences and expression cassette elements need to be optimized. However, the systematical expression of recombinant proteins in plant biomass can generally be controlled for the production of therapeutic proteins after the generation of transgenic plants. Without understanding the transgene expression patterns in plant tissue, it is difficult to enhance further production levels. In this study, single-cell RNA-sequencing (scRNA-seq) analysis of transgenic tobacco (Nicotiana tabacum) leaf, expressing an immunotherapeutic llama antibody against breast cancer, anti-HER2 VHH-Fc, was conducted to obtain data on the expression pattern of tissue-specific cells. These high-quality scRNA-seq data enabled the identification of gene expression patterns by cell types, which can be applied to select the best cell types or tissues for the high production of these recombinant antibodies. These data provide a foundation to elucidate the mechanisms that regulate the biosynthesis of recombinant proteins in N. tabacum.