Design guidelines for movement-assistive clothing based on a comprehensive understanding of older adults' needs and preferences.

This study aimed to explore the needs and wants of older adults in the context of movement-assistive clothing (MSC), with a focus on muscle strength and posture correction. A survey was conducted to understand the needs and wants of older adults, considering aspects of functions and designs, and to evaluate the comfort, safety, ease of use, usefulness, and intention of users to purchase and use products. A total of 408 individuals aged > 65 years participated in the study. The data were analyzed using descriptive analyses, such as mean, standard deviation, percentages, Cronbach's alpha, chi-square test, independent t-test, analysis of variance, and regression using IBM SPSS 27.0. Exploratory Factor Analysis was also conducted to test the hypotheses. Open-ended questions were extracted using major themes after color-coding. Based on the results, design recommendations were derived, including the development of pants and innerwear with casual, minimalist styles, featuring achromatic colors, and utilizing stretchy, breathable fabrics. Comfort, safety, ease of use, and usefulness emerged as critical factors influencing the purchase and use of MSC by older adults. This study aimed to establish design guidelines by understanding the needs and wants of older adults and considering the aspects of movement-assistive clothing to relieve musculoskeletal issues. Accordingly, these findings are expected to aid in the creation of wearable suits using flexible fabric artificial muscles for active musculoskeletal correction in older adults.

Development and feasibility of new cardiac measurement method using vertebral heart area ratio in dogs.

The vertebral heart scale (VHS) is the most common method used for the objective evaluation of heart size, however, VHS cannot evaluate the entire heart area. This retrospective study aimed to evaluate the development and feasibility of vertebral heart area ratio (VHAR=heart area/the fourth thoracic vertebra [T4] body area) as a new cardiac measurement method. A total of 125 dogs considered without clinical heart abnormalities in the pre-anesthetic examination, measurements of the VHS and VHAR using thoracic radiography were compared with computed tomography measurements of the vertebral cardiac volume ratio (VCVR=cardiac volume/T4 body volume) and investigate whether the VHAR values differed between observers. The mean cardiac and T4 body volumes were 116.99 ± 108.07 cm3 and 0.92 ± 0.91 cm3, respectively. The mean values of observers 1 and 2 were 9.9 ± 0.7 v (VHS), 42.64 ± 27.94 cm2 (heart area), and 1.37 ± 0.96 cm2 (T4 body area). Intraclass coefficients were the highest for the heart area, followed by the T4 body area and VHS. The VHAR showed a moderate correlation with VHS in observers 1 (r=0.671) and 2 (r=0.633). The VCVR showed a more positive correlation with VHAR (r=0.573) than with VHS (r=0.426). These results indicated that VHAR could be used as a complement to VHS for heart size measurement, and the high degree of observer agreement for the measurements indicated the measurement reproducibility of VHAR.

Credit Card Fraud Detection: An Improved Strategy for High Recall Using KNN, LDA, and Linear Regression.

Efficiently and accurately identifying fraudulent credit card transactions has emerged as a significant global concern along with the growth of electronic commerce and the proliferation of Internet of Things (IoT) devices. In this regard, this paper proposes an improved algorithm for highly sensitive credit card fraud detection. Our approach leverages three machine learning models: K-nearest neighbor, linear discriminant analysis, and linear regression. Subsequently, we apply additional conditional statements, such as "IF" and "THEN", and operators, such as ">" and "<", to the results. The features extracted using this proposed strategy achieved a recall of 1.0000, 0.9701, 1.0000, and 0.9362 across the four tested fraud datasets. Consequently, this methodology outperforms other approaches employing single machine learning models in terms of recall.

Shoulder magnetic resonance arthrography in dogs: Comparison of craniolateral and caudolateral approach for ultrasound-guided contrast injection.

Shoulder joint disease is a common cause of forelimb lameness in dogs. To diagnose this condition, shoulder magnetic resonance arthrography (MRA) is performed, which involves the injection of contrast agents into the shoulder joint space under ultrasound (US)-guidance. The objective of this study was to compare the craniolateral and caudolateral approaches for shoulder MRA using US-guided injection techniques, and investigate their clinical feasibility in dogs. Forty shoulder joints from 10 adult beagles were studied in two repetitions. The craniolateral (n = 20) and caudolateral (n = 20) injection techniques were applied randomly under US-guidance. The shoulder MRA was conducted immediately after the contrast agents was injected. The procedure time (scan and injection time), number of attempts, joint distension and degree of extraarticular extravasation were recorded and compared between the two groups. The results showed that the caudolateral approach had significantly more contrast agents extravasation compared to the craniolateral approach (p < 0.05). However, there were no significant differences between the two groups in terms of procedure time (scan time p = 0.80, injection time p = 0.74), number of attempts (p = 0.70) and joint distension (p = 0.23). The craniolateral approach of US-guided contrast injection techniques for shoulder MRA minimizes damage to the juxta-articular structures and reduces extraarticular extravasation, resulting in good-quality images. This study demonstrates the feasibility and advantages of the craniolateral approach under US-guidance for shoulder MRA in dogs.

Tumor-infiltrating lymphocyte therapy: Clinical aspects and future developments in this breakthrough cancer treatment.

Tumor-infiltrating lymphocyte (TIL) therapy is a promising approach for treating refractory or advanced solid cancers by using autologous TILs harvested from cancer tissues. Despite the heterogeneity of cancer, TIL therapy can potentially produce a positive therapeutic response, including complete remission. After decades of research on lymphocyte functions, culture/expansion methods, therapeutic protocols, and multiple clinical trials, TIL therapy has finally reached a stage where it can be formally approved for clinical use. TIL therapy is expected to hold a unique position among anti-cancer therapeutic options as a standard intervention. To successfully introduce TIL therapy into clinical settings, there is a need to expand therapeutic indications and set up the best protocols for cancer tissue sampling and manufacturing, and related clinical trials. Moreover, studies on next-generation TIL therapy have already begun, and post-approval real-world data will promote and support further research.

Respiratory phase can affect pulmonary vein-to-pulmonary artery ratio measured with CT.

OBJECTIVE: To evaluate pulmonary vein (PV)-to-pulmonary artery (PA) ratios obtained in healthy dogs by means of various CT protocols, accounting for the effects of the respiratory phase and contrast agent used. ANIMALS: 10 healthy Beagles. PROCEDURES: Before and after contrast medium (600 mg iodine/kg) was injected IV, thoracic CT was performed with a positive-pressure breath-hold (inspiratory phase) and at the end of expiration (expiratory phase). After CT scanning, echocardiography was performed, and an optimized right parasternal long-axis view was obtained for measurement of PV and PA diameters. The PV and PA diameters were measured subsequently for each CT protocol. RESULTS: Mean ± SD PV:PA values obtained from pre- and postcontrast inspiratory CT were 1.058 ± 0.072 and 1.020 ± 0.053, respectively, which were comparable to the echocardiographic value (P > .05). Mean PV:PA values obtained with pre- and postcontrast expiratory CT were 1.259 ± 0.094 and 1.239 ± 0.066, respectively, which were significantly (P = .005) greater than inspiratory CT measurements. There was a significant (r > 0.5, P < .05) linear relationship between PV:PA values obtained with pre- and postcontrast inspiratory CT and echocardiography. CLINICAL RELEVANCE: PV:PA could be measured with thoracic CT in a manner similar to that for echocardiography. However, PV:PA values measured with expiratory CT were different from previously reported values. Therefore, the respiratory phase should be considered when evaluating pulmonary vascular size through CT, and measurements with the inspiratory CT protocol would be more accurate.

Analgesic effects of erector spinae plane block can differ according to needle size: A case report.

RATIONALE: Unlike brachial plexus block, erector spinae plane block (ESPB) does not target specific nerves, so the analgesic effect may differ depending on the extent of diffusion of local anesthetic. Therefore, needle size, which can affect the diffusion of local anesthetic, may be an important factor in the analgesic effect. PATIENT CONCERNS: Four patients with end-stage renal disease on hemodialysis received vascular surgery due to arteriovenous fistula occlusion. Vascular bypass surgery was performed on the axillary vein. DIAGNOSES: Four patients with end-stage renal disease on hemodialysis were diagnosed with arteriovenous fistula occlusion. One in 4 patients was diagnosed with diaphragm paralysis after ESPB, and the other 3 did not develop diaphragm paralysis. INTERVENTIONS: ESPB was conducted by ultrasound using a 25- or 22-gauge needle at the C7 level. The extent of nerve blockade was determined based on cold sensation, and diaphragm excursion and thickness were measured via ultrasound. OUTCOMES: The analgesic effect was excellent in 2 patients treated using a 22-gauge needle, but was poor in 2 other patients treated with a 25-gauge needle. LESSONS: ESPB at the C7 level can cause diaphragm paralysis, and needle size may affect the extent of diffusion of local anesthetic.

Detection of anatomical variation during left internal jugular vein cannulation under ultrasound: A case report.

RATIONALE: The left internal jugular vein has a higher possibility of anatomical variation than the right side. Therefore, the complication risk during cannulation is expected to be higher. PATIENT CONCERNS: A 74-year-old woman was scheduled for elective surgery for left upper lobe wedge resection. We observed an anatomical abnormality at the location of the common carotid artery (CCA) and left internal jugular vein (IJV). DIAGNOSIS: During the ultrasound, the left IJV was detected at the medial side of the CCA, and this anatomical variation was confirmed by color Doppler ultrasonography. Enhanced chest computed tomography showed that the left CCA ran across the left IJV from medial to lateral at the level of the clavicle. INTERVENTION: A triple-lumen central venous catheter was inserted at the right IJV to avoid complications caused by the anatomical variation. OUTCOMES: There were no intraoperative or postoperative complications. LESSONS: Anesthesiologists should consider anatomical variation during central venous cannulation, especially with the left IJV approach. Because of anatomical variation, ultrasound-guided intervention is highly recommended to prevent procedure-related complications.

Quality of postoperative recovery after upper-arm vascular surgery for hemodialysis in patients with end-stage renal disease: A prospective comparison of cervical epidural anesthesia vs general anesthesia.

Cervical epidural anesthesia (CEA) is generally not used during upper-arm vascular surgery for hemodialysis in end-stage renal disease (ESRD) patients, despite its advantages. The Quality of Recovery-40 questionnaire (QOR-40) has been validated as a tool for assessing the degree of recovery after surgery. We hypothesized that CEA could provide a better outcome on the QOR-40 than general anesthesia after upper-arm vascular surgery for hemodialysis in ESRD patients.We divided anesthetic methods into general anesthesia and CEA. The QOR-40 was administered to 70 patients on the night before surgery and at 24 hours after surgery. Additional data, including consumption of opioid analgesics, occurrence of postoperative nausea and vomiting, and scores on a numeric rating scale (NRS) were collected.The total QOR-40 scores of the two groups differed significantly (P = .024) on postoperative day 1. Opioid consumption (P = .005) and occurrence of postoperative nausea (P = .019) in the post-anesthesia care unit (PACU) were significantly lower in the CEA group, whose NRS scores were significantly lower in the PACU (P < .001) and at postoperative day 1 (P = .016).Assessment of postoperative quality of recovery after upper-arm vascular surgery in ESRD patients showed that the CEA group had significantly better total QOR-40 and NRS scores. CEA could be used as an alternative anesthetic technique for upper-arm vascular surgery for hemodialysis in ESRD patients to improve the quality of recovery.

A comparison of oxycodone and fentanyl in intravenous patient-controlled analgesia after laparoscopic hysterectomy.

BACKGROUND: We planned to compare the effect of intravenous oxycodone and fentanyl on post-operative pain after laparoscopic hysterectomy. METHODS: We examined 60 patients were randomized to postoperative pain treatment with either oxycodone (n = 30, Group O) or fentanyl (n = 30, Group F). The patients received 10 mg oxycodone/100 µg fentanyl with ketorolac 30 mg before the end of anesthesia and then continued with patient-controlled analgesia for 48 h postoperatively. RESULTS: The accumulated oxycodone consumption was less than fentanyl during 8, 24 and 48 h postoperatively. Numeric rating score of Group O showed significantly lower than that of Group F during 30 min, 2, 4, 8 and 24 h postoperatively. The incidences of adverse reactions were similar in the two groups, though the incidence of nausea was higher in the Group O during the 24 and 48 h postoperative period. CONCLUSIONS: Oxycodone IV-PCA was more advantageous than fentanyl IV-PCA for laparoscopic hysterectomy in view of accumulated oxycodone consumption, pain control and cost beneficial effect. However, patient satisfaction was not good in the group O compared to group F.

Comparison of 2 cuff inflation methods of laryngeal mask airway Classic for safe use without cuff manometer in adults.

PURPOSE: This single-center, prospective, randomized, double-blind, 2-arm, parallel group comparison trial was performed to establish whether the adult-sized laryngeal mask airway (LMA) Classic (The Laryngeal Mask Company Ltd, Henley-on-Thames, UK) could be used safely without any consideration of cuff hyperinflation when a cuff of the LMA Classic was inflated using half the maximum inflation volume or the resting volume before insertion of device. BASIC PROCEDURES: Eighty patients aged 20 to 70 years scheduled for general anesthesia using the LMA Classic were included. Before insertion, the cuff was partially filled with half the maximum inflation volume in the half volume group or the resting volume created by opening the pilot balloon valve to equalize with atmospheric pressure in the resting volume group. Several parameters regarding insertion, intracuff pressure, airway leak pressure, and leakage volume/fraction were collected after LMA insertion. MAJOR FINDINGS: The LMA Classic with a partially inflated cuff was successfully inserted in all enrolled patients. Both groups had the same success rate of 95% at the first insertion attempt. The half volume group had a lower mean intracuff pressure compared with the resting volume group (54.5 ± 16.1 cm H2O vs 61.8 ± 16.1 cm H2O; P = .047). There was no difference in airway leak pressure or leakage volume/fraction between the 2 groups under mechanical ventilation. CONCLUSIONS: The partially inflated cuff method using half the maximum recommended inflation volume or the resting volume is feasible with the adult-sized LMA Classic, resulting in a high success rate of insertion and adequate range of intracuff pressures.

Study for the discrepancy of arterial blood pressure in accordance with method, age, body part of measurement during general anesthesia using sevoflurane.

BACKGROUND: Many pieces of previous research on measuring blood pressure (BP) using different methods focused on the disparity in the results. However, none of them dealt with the disparity caused by the difference in age and inhalation anesthetics. We attempted to find the variance in accordance with age, body part, and measuring methods (invasive vs noninvasive) and also studied how sevoflurane influences BP as the operation progresses. METHODS: In sixty patients, we measured the arterial BP in the upper and lower limbs by noninvasive methods before inducing anesthesia. After induction, we used sevoflurane to maintain anesthesia, and injected catheters into the radial artery and dorsalis pedis artery to measure arterial pressure at every ten minute by both invasive and noninvasive methods. RESULTS: The patients who were 40 or older showed significantly higher values in the systolic BP than the patients younger than 40. The values of systolic and diastolic BP measured by a noninvasive oscillometric method were meaningfully higher than those measured by an invasive method. As the operations progressed, the lower limbs showed higher systolic pressure than the upper limbs regardless of measuring methods, whereas the opposite is true for diastolic pressure. CONCLUSIONS: The values in the arterial BP were measured high by noninvasive method. Systolic BP were estimated significantly high in the older patients and in the lower leg. Due to the effect of sevoflurane, the diastolic BP in the lower limbs becomes lower than that of upper limbs regardless of measuring methods, as the operation progresses.

Escherichia coli with autodisplayed Z-domain of protein A for signal amplification of SPR biosensor.

Generally, an immunoaffinity SPR biosensor detects a target analyte in a sample through highly selective adsorption by using the antigen-antibody interaction. For improving the sensitivity, various kinds of particles have been added to the already bound analytes on the SPR biosensor (sandwich assay). In this work, signal amplification was demonstrated by the expression of the IgG-binding Z-domain of protein A on the outer membrane of Escherichia coli via "Autodisplay". The amount of Z-domain of protein A expressed on the outer membrane was calculated to be 280,000 molecules per cell. In addition, the IgG-binding ability of the expressed protein was characterized using FACS analysis. The signal amplification of the SPR biosensor was performed in the sandwich assay format using a model of horseradish peroxidase (HRP); the limit of detection was determined to be significantly improved from 1 microg/ml to 1 ng/ml. Finally, myoglobin analysis was demonstrated for the medical diagnosis of cardiac diseases. The detection limit was estimated to be improved from 10 ng/ml to <1 ng/ml. These results show that Z-domain-displaying E. coli can be successfully used for the signal amplification of immunoaffinity biosensors, thereby improving the sensitivity and the limit of detection.