Isolated Subtalar Repositional Arthrodesis Compared With Triple Arthrodesis for the Treatment of Progressive Collapsing Foot Deformity.

The optimal extent of arthrodesis for severe and rigid progressive collapsing foot deformity is controversial. Traditionally, triple arthrodesis has been recommended; however, good results have been reported using subtalar arthrodesis only. We compared the results of triple arthrodesis and isolated subtalar repositional arthrodesis. A total of 22 symptomatic feet were evaluated retrospectively. Isolated subtalar repositional arthrodesis was performed in 13 cases (the subtalar group) and double or triple arthrodesis in 9 cases (the triple group). Various radiographic variables for assessing flatfoot and osteoarthritic changes in ankle and tarsal joints were measured and compared between the 2 groups at 3 time points: preoperatively, 3 months postoperatively, and 4 y postoperatively. Additionally, we analyzed various factors that affect postoperative valgus talar tilt in the ankle joint, which has been associated with poor prognosis. There were no differences in preoperative demographic data and the severity of the disease between the 2 groups; both groups showed improvement in radiographic parameters postoperatively compared with preoperative results. With the numbers available, no significant differences could be detected in postoperative radiographic measurements between the 2 groups. Of all the variables analyzed, postoperative hindfoot alignment angle was associated with postoperative talar tilt development. Additionally, postoperative talar tilt was observed more in triple group than in subtalar group. In conclusion, isolated subtalar repositional arthrodesis is an effective procedure to correct advanced progressive collapsing foot deformity. In addition, Chorpart joint arthrodesis with improper position can cause valgus talar tilt in the ankle joint.

Study on the Global Sustainability of the Korean Construction Industry Based on the GRI Standards.

This study began with the increasing importance of ESG through sustainable management evaluation across all industries, predicting market demand through the ESG management paradigm and financial environment changes in the global industry, and establishing international strategies for the construction industry. Compared to other industries, the construction industry is in the early stages of ESG formation, and it is unclear how to expand its base by establishing evaluation system standards such as innovation of individual services, interaction of social capital, and definition of stakeholders. Currently, some large construction companies in the construction industry are publishing sustainability management reports at the group level, but given the recently strengthened global sustainability of ESG by GRI Standards, efficient analysis of global construction markets and strategic orders are needed. Therefore, this study focuses on assessing the sustainability strategies and directions of the construction industry from an ESG perspective. To this end, sustainability issues and insights, as well as global issues in Korea and the worldwide construction sector, were analyzed. The analysis showed that global construction companies were highly interested in business management approaches, such as safety and health, as critical issues regarding the construction industry's sustainability strategy. In contrast, South Korean construction companies prioritize business values such as value creation, fair trade, and win-win. Both global and South Korean construction companies have been working on greenhouse gas reduction and energy sustainability. Regarding other issues, cultivating construction specialists, enhancing the job training system, and limiting serious accidents and safety mishaps were all significant from a social standpoint among South Korean construction companies. Conversely, global construction companies appeared to focus on issues related to ethical and environmental management from an organizational standpoint.

Hyperspectral reflectance imaging for nondestructive evaluation of root rot in Korean ginseng (Panax ginseng Meyer).

Root rot of Panax ginseng caused by Cylindrocarpon destructans, a soil-borne fungus is typically diagnosed by frequently checking the ginseng plants or by evaluating soil pathogens in a farm, which is a time- and cost-intensive process. Because this disease causes huge economic losses to ginseng farmers, it is important to develop reliable and non-destructive techniques for early disease detection. In this study, we developed a non-destructive method for the early detection of root rot. For this, we used crop phenotyping and analyzed biochemical information collected using the HSI technique. Soil infected with root rot was divided into sterilized and infected groups and seeded with 1-year-old ginseng plants. HSI data were collected four times during weeks 7-10 after sowing. The spectral data were analyzed and the main wavelengths were extracted using partial least squares discriminant analysis. The average model accuracy was 84% in the visible/near-infrared region (29 main wavelengths) and 95% in the short-wave infrared (19 main wavelengths). These results indicated that root rot caused a decrease in nutrient absorption, leading to a decline in photosynthetic activity and the levels of carotenoids, starch, and sucrose. Wavelengths related to phenolic compounds can also be utilized for the early prediction of root rot. The technique presented in this study can be used for the early and timely detection of root rot in ginseng in a non-destructive manner.

Evaluating the Impact on Clinical Task Efficiency of a Natural Language Processing Algorithm for Searching Medical Documents: Prospective Crossover Study.

BACKGROUND: Information retrieval (IR) from the free text within electronic health records (EHRs) is time consuming and complex. We hypothesize that natural language processing (NLP)-enhanced search functionality for EHRs can make clinical workflows more efficient and reduce cognitive load for clinicians. OBJECTIVE: This study aimed to evaluate the efficacy of 3 levels of search functionality (no search, string search, and NLP-enhanced search) in supporting IR for clinical users from the free text of EHR documents in a simulated clinical environment. METHODS: A clinical environment was simulated by uploading 3 sets of patient notes into an EHR research software application and presenting these alongside 3 corresponding IR tasks. Tasks contained a mixture of multiple-choice and free-text questions. A prospective crossover study design was used, for which 3 groups of evaluators were recruited, which comprised doctors (n=19) and medical students (n=16). Evaluators performed the 3 tasks using each of the search functionalities in an order in accordance with their randomly assigned group. The speed and accuracy of task completion were measured and analyzed, and user perceptions of NLP-enhanced search were reviewed in a feedback survey. RESULTS: NLP-enhanced search facilitated more accurate task completion than both string search (5.14%; P=.02) and no search (5.13%; P=.08). NLP-enhanced search and string search facilitated similar task speeds, both showing an increase in speed compared to the no search function, by 11.5% (P=.008) and 16.0% (P=.007) respectively. Overall, 93% of evaluators agreed that NLP-enhanced search would make clinical workflows more efficient than string search, with qualitative feedback reporting that NLP-enhanced search reduced cognitive load. CONCLUSIONS: To the best of our knowledge, this study is the largest evaluation to date of different search functionalities for supporting target clinical users in realistic clinical workflows, with a 3-way prospective crossover study design. NLP-enhanced search improved both accuracy and speed of clinical EHR IR tasks compared to browsing clinical notes without search. NLP-enhanced search improved accuracy and reduced the number of searches required for clinical EHR IR tasks compared to direct search term matching.

Subacute Oral Toxicity Evaluation of Expanded-Polystyrene-Fed Tenebrio molitor Larvae (Yellow Mealworm) Powder in Sprague-Dawley Rats.

Tenebrio molitor larvae, as known as edible insects, has advantages of being rich in protein, and has been recognized as a suitable alternate protein source for broiler and pig feed. Moreover, given their ability to biodegrade polystyrene, a major pollutant, Tenebrio molitor larvae has been proposed as an innovative solution to environmental problems. In the present study, we investigated the toxicity of Tenebrio molitor larvae powder (TMlp) ingested with expanded-polystyrene (W/ eps) through in vitro and in vivo experiments. The objective of this study was to determine whether TMlp W/ eps can be applied as livestock alternative protein source. For in vitro experiments, cytotoxicity test was performed to investigate the effects of TMlp-extract on the viability of estrogen-dependent MCF-7 cells. The possibility of estrogen response was investigated in two groups: Expanded-polystyrene-fed (W/ eps) TMlp group and without expanded-polystyrene-fed (W/o eps) TMlp group. For in vivo experiments, The male Sprague-Dawley rats were divided based on the dosage of TMlp administered and oral administration was performed to every day for 5 weeks. A toxicological assessments were performed, which included clinical signs, food consumption, body and organ weights, hematology, serum chemistry, and hematoxylin and eosin staining of liver and kidney. There were no specific adverse effect of TMlp W/ eps-related findings under the experimental conditions of this study, but further studies on both sexes and animal species differences should be investigated. In conclusion, TMlp W/ eps was considered non-toxic and observed to be applicable as an alternative protein source for livestock feed.

Retrospective study of the absorbable braided polydioxanone threads' usefulness in the aged lower eyelids' rejuvenation.

BACKGROUND: Tear trough deformity, hyperpigmentation, and skin laxity of the lower eyelid make individuals appear fatigued and elderly. Many patients prefer less invasive, cosmetic correction of the aged lower eyelid. Polydioxanone (PDO)-barbed threads introduced braided fine threads design, which works as a template for attraction of the regenerative factors and for cells' migration and proliferation. The purpose of this study was to estimate the outcomes of simultaneous additional application of braided type PDO threads (N-scaffold) for aged lower eyelids' rejuvenation in patients, who underwent the midface PDO thread lifting. MATERIALS AND METHODS: A total of 30 patients with mildly loose skin in the facial area, who underwent the thread lifting using PDO threads, were included in this study. Patients were divided into two groups, 15 patients per group. The first group underwent the midface thread lifting using PDO threads ("non-SCA" group). The second group underwent midface thread lifting in combination with braided PDO threads for tear trough deformity improvement ("N-scaffold" group). The results were evaluated subjectively, based on the patients' satisfaction rates, and objectively, by evaluating photographs. RESULTS: According to Barton's grading system, 7 months after the treatment, there was a statistically significant difference between the two groups: 1.733 ± 0.74 in the non-SCA group and 0.733 ± 0.83 in the N-scaffold group (p < 0.05). Based on patients' self-assessment, there was a significant difference at 7 months after the treatment: 2.86 ± 0.84 in "non-SCA" group and 3.76 ± 0.90 in "N-scaffold" group, p < 0.05. Complications such as persistent swelling, hematoma, skin irregularity, and infection were not observed during follow-up assessments. CONCLUSION: The application of braided type PDO threads (N-scaffold) as part of the midface thread lifting, for aged lower eyelids rejuvenation appears to be effective and safe within a period. This study suggests that PDO threads insertion may be a useful, additional, and non-invasive tool for the aged lower eyelids rejuvenation.

Efficacy and safety of a novel combined 1060-nm and 635-nm laser device for non-invasive reduction of abdominal and submental fat.

The aim of this study was to evaluate the safety and efficacy of combined 1060-nm diode laser and 635-nm low-level laser therapy (LLLT) device for non-invasive reduction of the abdominal and submental fat. Forty-two healthy subjects received single laser treatment on both the abdomen and submental area. Ultrasound images measuring the thickness of abdominal and submental fat were taken at baseline, follow-up at 4, 8, and 12 weeks after treatment. Waist circumference and body weight were also measured at all visits. Adverse events were recorded at all visits. Subjects completed a satisfaction questionnaire at the end of the trial. Twelve weeks after a single treatment with the investigational device, ultrasound images showed statistically significant (P < 0.0001) reductions in abdominal and submental fat by 18.62 and 26.4%, respectively. In addition, significant (P < 0.0001) reduction in waist circumference was observed. Ninety-six percent of subjects rated that they were satisfied. Noted side effects were transient mild to moderate tenderness which subsided within 1 to 3 weeks. No serious treatment-related adverse events were reported. The dual wavelength device combining 1060-nm diode laser with 635-nm LLLT was safe and effective for non-invasive reduction of both abdominal and submental fat.

High-Throughput Phenotyping Approach for the Evaluation of Heat Stress in Korean Ginseng (Panax ginseng Meyer) Using a Hyperspectral Reflectance Image.

Panax ginseng has been used as a traditional medicine to strengthen human health for centuries. Over the last decade, significant agronomical progress has been made in the development of elite ginseng cultivars, increasing their production and quality. However, as one of the significant environmental factors, heat stress remains a challenge and poses a significant threat to ginseng plants' growth and sustainable production. This study was conducted to investigate the phenotype of ginseng leaves under heat stress using hyperspectral imaging (HSI). A visible/near-infrared (Vis/NIR) and short-wave infrared (SWIR) HSI system were used to acquire hyperspectral images for normal and heat stress-exposed plants, showing their susceptibility (Chunpoong) and resistibility (Sunmyoung and Sunil). The acquired hyperspectral images were analyzed using the partial least squares-discriminant analysis (PLS-DA) technique, combining the variable importance in projection and successive projection algorithm methods. The correlation of each group was verified using linear discriminant analysis. The developed models showed 12 bands over 79.2% accuracy in Vis/NIR and 18 bands with over 98.9% accuracy at SWIR in validation data. The constructed beta-coefficient allowed the observation of the key wavebands and peaks linked to the chlorophyll, nitrogen, fatty acid, sugar and protein content regions, which differentiated normal and stressed plants. This result shows that the HSI with the PLS-DA technique significantly differentiated between the heat-stressed susceptibility and resistibility of ginseng plants with high accuracy.

First-phase ejection fraction by cardiovascular magnetic resonance predicts outcomes in aortic stenosis.

BACKGROUND: First-phase ejection fraction (EF1; the ejection fraction measured during active systole up to the time of maximal aortic flow) measured by transthoracic echocardiography (TTE) is a powerful predictor of outcomes in patients with aortic stenosis. We aimed to assess whether cardiovascular magnetic resonance (CMR) might provide more precise measurements of EF1 than TTE and to examine the correlation of CMR EF1 with measures of fibrosis. METHODS: In 141 patients with at least mild aortic stenosis, we measured CMR EF1 from a short-axis 3D stack and compared its variability with TTE EF1, and its associations with myocardial fibrosis and clinical outcome (aortic valve replacement (AVR) or death). RESULTS: Intra- and inter-observer variation of CMR EF1 (standard deviations of differences within and between observers of 2.3% and 2.5% units respectively) was approximately 50% that of TTE EF1. CMR EF1 was strongly predictive of AVR or death. On multivariable Cox proportional hazards analysis, the hazard ratio for CMR EF1 was 0.93 (95% confidence interval 0.89-0.97, p = 0.001) per % change in EF1 and, apart from aortic valve gradient, CMR EF1 was the only imaging or biochemical measure independently predictive of outcome. Indexed extracellular volume was associated with AVR or death, but not after adjusting for EF1. CONCLUSIONS: EF1 is a simple robust marker of early left ventricular impairment that can be precisely measured by CMR and predicts outcome in aortic stenosis. Its measurement by CMR is more reproducible than that by TTE and may facilitate left ventricular structure-function analysis.

The Application of Ball Shaped Diced Conchal Cartilage Wrapped With Dermofat in Tip Plasty.

BACKGROUND: Based on previous reports, in comparison with Caucasian, nose anatomy has features that have to be considered by surgeons during the tip augmentation in Asian patients. Weak alar cartilages, thick soft-tissue envelope, and bifid-like tip in most cases. This case report demonstrates our experience of using ball-shaped diced conchal cartilage during the tip plasty in Asian patients. CASE REPORT: Twenty-seven-year-old female patient underwent tip plasty augmentation with ball shaped diced cartilage wrapped with dermofat. There were no complications in postoperative period. DISCUSSION: Based on the Asian nasal anatomy features, surgeons commonly use septal extension graft in tip projection and derotation. However, it is still challenging to perform it in patients with septal cartilage insufficiency. In this case report, the authors introduce the alternative surgical option for nasal tip augmentation. The ball shaped cartilage autologous implant can be successfully used in tip plasty.

Combined press cog type and cog PDO threads in comparison with the cog PDO threads in facial rejuvenation.

BACKGROUND: Thread lifting is one of the most common minimally invasive options in facial rejuvenation procedures. The application of polydioxanone (PDO) showed good results and fewer complications. PDO threads effectively strengthen the contour of the face, reduce roundness, and lift sagging skin due to collagen-stimulating properties. OBJECTIVE: The purpose of this study was an evaluation of the efficacy of the PDO threads: the combination of the cog type and press cog type threads (Ncog and Nfix) and cog type thread (Ncog) alone. And this study was conducted to define complications related to thread inserting during the follow-up period. MATERIALS AND METHODS: Thirty patients who underwent PDO thread treatment for facial rejuvenation and tightening sagging skin tissues were evaluated. The follow-up period was seven months. Photographic objective and subjective evaluations were performed during this period. RESULTS: Thirty patients were included in this study. The mean age of participants was 51.8 years (range 65 to 34). There was a statistically significant difference between pre and 1-month post-operative results in both groups with a mean score of 1.94 ± 0.43 (p < 0.05). Furthermore, the combination of Ncog and N fix showed slightly better results than Ncog alone. According to patient satisfaction, all patients were satisfied with the clinical outcomes. CONCLUSIONS: Our results revealed PDO threads are effective in aged skin rejuvenation, soft tissue retraction, and support, showing fewer complications. In addition, it could be assumed that treatment with thicker thread could be a more efficacious procedure. However, this statement requires further researches.

Formation of Li2CO3 Nanostructures for Lithium-Ion Battery Anode Application by Nanotransfer Printing.

Various high-performance anode and cathode materials, such as lithium carbonate, lithium titanate, cobalt oxides, silicon, graphite, germanium, and tin, have been widely investigated in an effort to enhance the energy density storage properties of lithium-ion batteries (LIBs). However, the structural manipulation of anode materials to improve the battery performance remains a challenging issue. In LIBs, optimization of the anode material is a key technology affecting not only the power density but also the lifetime of the device. Here, we introduce a novel method by which to obtain nanostructures for LIB anode application on various surfaces via nanotransfer printing (nTP) process. We used a spark plasma sintering (SPS) process to fabricate a sputter target made of Li2CO3, which is used as an anode material for LIBs. Using the nTP process, various Li2CO3 nanoscale patterns, such as line, wave, and dot patterns on a SiO2/Si substrate, were successfully obtained. Furthermore, we show highly ordered Li2CO3 nanostructures on a variety of substrates, such as Al, Al2O3, flexible PET, and 2-Hydroxylethyl Methacrylate (HEMA) contact lens substrates. It is expected that the approach demonstrated here can provide new pathway to generate many other designable structures of various LIB anode materials.

Determinants and prognostic value of echocardiographic first-phase ejection fraction in aortic stenosis.

OBJECTIVE: First-phase ejection fraction (EF1) is a novel measure of early left ventricular systolic dysfunction. We investigated determinants of EF1 and its prognostic value in aortic stenosis. METHODS: EF1 was measured retrospectively in participants of an echocardiography/cardiovascular magnetic resonance cohort study which recruited patients with aortic stenosis (peak aortic velocity of ≥2 m/s) between 2012 and 2014. Linear regression models were constructed to examine variables associated with EF1. Cox proportional hazards were used to determine the prognostic power of EF1 for aortic valve replacement (AVR, performed as part of clinical care in accordance with international guidelines) or death. RESULTS: Total follow-up of the 149 participants (69.8% male, 70 (65-76) years, mean gradient 33 (21-42) mm Hg) was 238 029 person-days. Sixty-seven participants (45%) had a low baseline EF1 (<25%) despite normal ejection fraction (67% (62%-71%)). Patients with low EF1 had more severe aortic stenosis (mean gradient 39 (34-45) mm Hg vs 24 (16-35) mm Hg, p<0.001) and more myocardial fibrosis (indexed extracellular volume (iECV) (24.2 (19.6-28.7) mL/m2 vs 20.6 (16.8-24.3) mL/m2, p=0.002; late gadolinium enhancement (LGE) prevalence 52% vs 20%, p<0.001). Zva, iECV and infarct LGE were independent predictors of EF1. EF1 improved post-AVR (n=57 with post-AVR EF1 available, baseline 16 (12-24) vs follow-up 27% (22%-31%); p<0.001). Low baseline EF1 was an independent predictor of AVR/death (HR 5.6, 95% CI 3.4 to 9.4), driven by AVR. CONCLUSION: EF1 quantifies early, potentially reversible systolic dysfunction in aortic stenosis, is associated with global afterload and myocardial fibrosis, and is an independent predictor of AVR.

fPADnet: Small and Efficient Convolutional Neural Network for Presentation Attack Detection.

The rapid growth of fingerprint authentication-based applications makes presentation attack detection, which is the detection of fake fingerprints, become a crucial problem. There have been numerous attempts to deal with this problem; however, the existing algorithms have a significant trade-off between accuracy and computational complexity. This paper proposes a presentation attack detection method using Convolutional Neural Networks (CNN), named fPADnet (fingerprint Presentation Attack Detection network), which consists of Fire and Gram-K modules. Fire modules of fPADnet are designed following the structure of the SqueezeNet Fire module. Gram-K modules, which are derived from the Gram matrix, are used to extract texture information since texture can provide useful features in distinguishing between real and fake fingerprints. Combining Fire and Gram-K modules results in a compact and efficient network for fake fingerprint detection. Experimental results on three public databases, including LivDet 2011, 2013 and 2015, show that fPADnet can achieve an average detection error rate of 2.61%, which is comparable to the state-of-the-art accuracy, while the network size and processing time are significantly reduced.

Raman Hyperspectral Imaging for Detection of Watermelon Seeds Infected with Acidovorax citrulli.

The bacterial infection of seeds is one of the most important quality factors affecting yield. Conventional detection methods for bacteria-infected seeds, such as biological, serological, and molecular tests, are not feasible since they require expensive equipment, and furthermore, the testing processes are also time-consuming. In this study, we use the Raman hyperspectral imaging technique to distinguish bacteria-infected seeds from healthy seeds as a rapid, accurate, and non-destructive detection tool. We utilize Raman hyperspectral imaging data in the spectral range of 400-1800 cm-1 to determine the optimal band-ratio for the discrimination of watermelon seeds infected by the bacteria Acidovorax citrulli using ANOVA. Two bands at 1076.8 cm-1 and 437 cm-1 are selected as the optimal Raman peaks for the detection of bacteria-infected seeds. The results demonstrate that the Raman hyperspectral imaging technique has a good potential for the detection of bacteria-infected watermelon seeds and that it could form a suitable alternative to conventional methods.

Patient-Specific Augmentation Rhinoplasty Using a Three-Dimensional Simulation Program and Three-Dimensional Printing.

Background: The convergence of three-dimensional (3D) simulation, tissue engineering, and 3D printing technology is creating a paradigm shift in plastic surgery. In augmentation rhinoplasty, determining the ideal material and design method has been a critical issue for many years. Thus, these technologies are expected to make important contributions to augmentation rhinoplasty. Objectives: We sought to validate the feasibility of the 3D carving simulation and patient-specific implant fabrication system (3D carving system) in a clinical trial using reproducibility tests. Methods: Patient-specific implants were designed using a program developed in-house with preoperative computed tomography (CT). Negative molds of the implant were fabricated by a 3D printer and silicone was injected into these molds. Ten actual silicone implants were fabricated and compared with virtually designed implants. Seven patients underwent surgery and postoperative CT to confirm implant positioning. Results: Virtually designed implants were produced into actual implants within 0.07 mm with a 0.17% ± 0.11% difference. The percentage within the gap was the highest at the cephalic end of the implant and reduced from the cephalic to caudal end (most cephalic point: 100%; rightmost and leftmost point of the implant at the caudal end of the nasal bone: 57.1% and 71.4%, respectively; rightmost and leftmost point at the supratip break: 28.6% and 28.6%, respectively; and most caudal point: 0%). Conclusions: The 3D carving system can facilitate rhinoplasty by enabling the more intuitive, rapid, and accurate fabrication of implants irrespective of surgeon experience level. Level of Evidence: 4.

The Efficacy and Safety of HA IDF Plus (with Lidocaine) Versus HA IDF (Without Lidocaine) in Nasolabial Folds Injection: A Randomized, Multicenter, Double-Blind, Split-Face Study.

BACKGROUND: Injection-related pain of dermal fillers is a consistent and bothersome problem for patients undergoing soft tissue augmentation. Reducing the pain could improve overall patient satisfaction. OBJECTIVE: The purpose of this study was to compare the pain relief, efficacy, and safety of HA IDF plus containing lidocaine with HA IDF without lidocaine during correction of nasolabial folds (NLFs). METHODS: Sixty-two subjects were enrolled in a randomized, multicenter, double-blind, split-face study of HA IDF plus and HA IDF for NLF correction. For split-face study, HA IDF plus was injected to one side of NLF, and HA IDF was injected to the other side. The first evaluation variable was the injection site pain measured using a 100-mm visual analogue scale (VAS). The second evaluation variables included the global aesthetic improvement scale, wrinkle severity rating scale, and adverse events. RESULTS: Immediately after injection, 91.94% of subjects experienced at least 10 mm decrease in VAS scores at the side injected with HA IDF plus compared with HA IDF, and the rate of subjects is statistically significant. The two fillers were not significantly different in safety profile or wrinkle correction during the follow-up visit. CONCLUSIONS: HA IDF plus significantly reduced the injection-related pain during NLFs correction compared with HA IDF without altering clinical outcomes or safety. Both HA IDF plus and HA IDF were considerably tolerated and most adverse reactions were mild and transient. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Visual Analysis for Detection and Quantification of Pseudomonas cichorii Disease Severity in Tomato Plants.

Pathogen infection in plants induces complex responses ranging from gene expression to metabolic processes in infected plants. In spite of many studies on biotic stress-related changes in host plants, little is known about the metabolic and phenotypic responses of the host plants to Pseudomonas cichorii infection based on image-based analysis. To investigate alterations in tomato plants according to disease severity, we inoculated plants with different cell densities of P. cichorii using dipping and syringe infiltration methods. High-dose inocula (≥ 10(6) cfu/ml) induced evident necrotic lesions within one day that corresponded to bacterial growth in the infected tissues. Among the chlorophyll fluorescence parameters analyzed, changes in quantum yield of PSII (ΦPSII) and non-photochemical quenching (NPQ) preceded the appearance of visible symptoms, but maximum quantum efficiency of PSII (Fv/Fm) was altered well after symptom development. Visible/near infrared and chlorophyll fluorescence hyperspectral images detected changes before symptom appearance at low-density inoculation. The results of this study indicate that the P. cichorii infection severity can be detected by chlorophyll fluorescence assay and hyperspectral images prior to the onset of visible symptoms, indicating the feasibility of early detection of diseases. However, to detect disease development by hyperspectral imaging, more detailed protocols and analyses are necessary. Taken together, change in chlorophyll fluorescence is a good parameter for early detection of P. cichorii infection in tomato plants. In addition, image-based visualization of infection severity before visual damage appearance will contribute to effective management of plant diseases.

Abducens nerve palsy as a postoperative complication of minimally invasive thoracic spine surgery: a case report.

BACKGROUND: Thoracic disc surgeries make up only a small number of all spine surgeries performed, but they can have a considerable number of postoperative complications. Numerous approaches have been developed and studied in an attempt to reduce the morbidity associated with the procedure; however, we still encounter cases that develop serious and unexpected outcomes. CASE PRESENTATION: This case report presents a patient with abducens nerve palsy after minimally invasive surgery for thoracic disc herniation with an intraoperative spinal fluid fistula. A literature review of all cases related to this complication after spine surgery is included. Despite the uncommon nature of this type of complication, understanding the procedure itself, the principle occurrences and outcomes following the procedure, the physiopathogical features of abducens nerve palsy, and the possible adverse effects of spinal surgery, including minimally invasive procedures, can enable an early diagnosis of complications and facilitate the procedure. CONCLUSIONS: In spite of being very rare and multifactorial, uni- or bilateral abducens nerve paralysis carries significant morbidity and can occur as a postoperative complication after conventional or minimally invasive spine surgery. This condition requires an accurate diagnosis and adequate multidisciplinary follow up.