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1.
Acad Radiol ; 2024 Jun 10.
Article in English | MEDLINE | ID: mdl-38862349

ABSTRACT

RATIONALE AND OBJECTIVES: Percutaneous lung tumor ablations are mostly performed in computed tomography (CT) rooms under local anesthesia with conscious sedation. However, maintaining the breath-hold phase during this can be challenging, affecting image quality and increasing complications. With the advent of hybrid operating rooms (HORs), this procedure can be performed with endotracheal tube (ETGA) intubation under general anesthesia with lung separation, ensuring precise imaging in a single-stage setting. Lung separation provides surgical exposure of one lung while ensuring ample gas exchange with the other. This study evaluated tumor ablations performed in an HOR equipped with cone beam CT and laser guidance. MATERIALS AND METHODS: This retrospective study included patients who underwent lung tumor ablation under general anesthesia with an ETGA in an HOR between July 2020 and May 2023. Anesthesia considerations, perioperative management, and postoperative follow-ups were evaluated. RESULTS: 65 patients (78 tumors) underwent ablation using two types of lung ventilation methods including a single-lumen tube with a blocker (SLT/BL) (n = 15) and double-lumen tube (DLT) (n = 50). Most patients experienced desaturation during the apnea phase of dynamic CT and needling. The average SpO2 value was significantly lower in the DLT group than in the SLT/BL group during the procedure (81.1% versus 88.7%, P = 0.033). Five, three, and two patients developed pneumothorax, subcutaneous emphysema, and pleural effusion, respectively. CONCLUSION: Percutaneous ablation under general anesthesia with endotracheal intubation and lung separation performed in HORs was feasible and safe. The setup minimized complication risks and maintained a balance between patient safety and successful procedures.

2.
Updates Surg ; 2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38872023

ABSTRACT

Lung nodule localization using conventional image-guided video-assisted thoracoscopic surgery involves lung puncture, which increases the risk of needle-related complications. We aimed to evaluate the feasibility and safety of a single-stage non-invasive laser-guided stamping localization technique followed by resection under general anesthesia in a hybrid operating room. We retrospectively reviewed consecutive patients who underwent thoracoscopic surgery for small pulmonary nodules using laser-guided dye-stamping localization methods in a hybrid operating room between June 2023 and October 2023. During the study period, 18 patients with 20 lesions underwent single-stage intraoperative image-guided stamping video-assisted thoracoscopic surgery in the hybrid operating room. The median size of the nodules was 7.4 mm (interquartile range [IQR] 5.7-9.8 mm), and median distance from the pleural surface was 9.8 mm (IQR 7.7-14.6 mm). The median localization time was 26 min (IQR 23-34 min), whereas median operation time was 69 min (IQR 62-87 min). The total median operating room time was 146 min (IQR 136-157 min). Twelve patients underwent less than two cone-beam computed tomography scans, while 6 underwent more than two scans. The total median dose area product, including cone-beam computed tomography scans, was 5731.4 uGym2. No localization-related complications were observed, and the postoperative length of stay was 1 day (IQR 1-2 days). The single-stage image-guided pleural stamping technique for localizing small pulmonary nodules in a hybrid operating room is feasible and safe. Future research with larger cohorts is required to further explore the benefits of this workflow.

3.
Cancer Prev Res (Phila) ; 17(5): 193-195, 2024 May 02.
Article in English | MEDLINE | ID: mdl-38693900

ABSTRACT

Improved cancer screening and treatment programs have led to an increased survivorship of patients with cancer, but consequently also to the rise in number of individuals with multiple primary tumors (MPT). Germline testing is the first approach investigating the cause of MPT, as a positive result provides a diagnosis and proper clinical management to the affected individual and their family. Negative or inconclusive genetic results could suggest non-genetic causes, but are negative genetic results truly negative? Herein, we discuss the potential sources of missed genetic causes and highlight the trove of knowledge MPT can provide. See related article by Borja et al., p. 209.


Subject(s)
Genetic Predisposition to Disease , Genetic Testing , Neoplasms, Multiple Primary , Humans , Neoplasms, Multiple Primary/genetics , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/diagnosis , Genetic Testing/methods , Germ-Line Mutation , Early Detection of Cancer/methods , Missed Diagnosis/statistics & numerical data
4.
Article in English | MEDLINE | ID: mdl-38696085

ABSTRACT

PURPOSE: We developed a novel augmented fluoroscopy-guided intrathoracic stamping technique for localizing small pulmonary nodules in the hybrid operating room. We conducted an observational study to investigate the feasibility of this technique and retrospectively compared two augmented fluoroscopy-guided approaches: intrathoracic and transbronchial. METHODS: From August 2020 to March 2023, consecutive patients underwent single-stage augmented fluoroscopy-guided localization under general anaesthesia. This included intrathoracic stamping and bronchoscopic lung marking, followed by thoracoscopic resection in a hybrid operating room. Comparative analyses were performed between the two groups. RESULTS: The data of 50 patients in the intrathoracic stamping and 67 patients in the bronchoscopic lung marking groups were analysed. No significant difference was noted in demographic data between the groups, except a larger lesion depth in the bronchoscopic lung marking group (14.7 ± 11.7 vs 11.0 ± 5.8 mm, p = 0.029). Dye localization was successfully performed in 49 intrathoracic stamping group patients (98.0%) and 67 bronchoscopic lung marking group patients (100%). No major procedure-related complications occurred in either group; however, the time flow (total anaesthesia time/global operating room time) was longer, and the radiation exposure (fluoroscopy duration/total dose area product) was larger in the bronchoscopic lung marking group. CONCLUSIONS: Augmented fluoroscopic stamping localization under intubated general anaesthesia is feasible and safe, providing an alternative with less global operating room time and lower radiation exposure for image-guided thoracoscopic surgery in the hybrid operating room.

5.
Genes Chromosomes Cancer ; 63(2): e23221, 2024 02.
Article in English | MEDLINE | ID: mdl-38682608

ABSTRACT

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is an autosomal dominant cancer predisposition syndrome characterized by cutaneous leiomyomas, uterine leiomyomas, and aggressive renal cancer. Germline variants in the fumarate hydratase (FH) gene predispose to HLRCC. Identifying germline pathogenic FH variants enables lifetime renal cancer screening and genetic testing for family members. In this report, we present a FH missense variant (c.1039T>C (p.S347P)), initially classified as a variant of uncertain significance. Clinical assessment, histopathological findings, molecular genetic studies, and enzymatic activity studies support the re-classification of the FH c.1039T>C variant to "pathogenic" based on ACMG/AMP criteria. Further insights into pathological recognition of FH-deficient renal cancer are discussed and should be recognized. This study has shown how (a) detailed multi-disciplinary analyses of a single variant can reclassify rare missense variants in FH and (b) careful pathological review of renal cancers is obligatory when HLRCC is suspected.


Subject(s)
Fumarate Hydratase , Leiomyomatosis , Mutation, Missense , Neoplastic Syndromes, Hereditary , Skin Neoplasms , Uterine Neoplasms , Humans , Fumarate Hydratase/genetics , Leiomyomatosis/genetics , Leiomyomatosis/pathology , Female , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Uterine Neoplasms/genetics , Uterine Neoplasms/pathology , Neoplastic Syndromes, Hereditary/genetics , Neoplastic Syndromes, Hereditary/pathology , Kidney Neoplasms/genetics , Kidney Neoplasms/pathology , Pedigree , Germ-Line Mutation , Male , Adult , Genetic Predisposition to Disease , Middle Aged
6.
Heliyon ; 10(7): e28569, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38560193

ABSTRACT

The occurrence of wind shear and severe thunderstorms during the final approach phase contributes to nearly half of all aviation accidents. Pilots usually employ the go-around procedure in order to lower the likelihood of an unsafe landing. However, multiple factors influence the go-arounds induced by wind shear. In order to predict the wind shear-induced go-around, this study utilized a cutting-edge AI-based Combined Kernel and Tree Boosting (KTBoost) framework with various data augmentation strategies. First, the KTBoost model was trained, tested, and compared to other Machine Learning models using the data extracted from Hong Kong International Airport (HKIA)-based Pilot Reports for the years 2017-2021. The performance evaluation revealed that the KTBoost model with Synthetic Minority Oversampling Technique - Edited Nearest Neighbor (SMOTE-ENN)- augmented data demonstrated superior performance as measured by the F1-Score (94.37%) and G-Mean (94.87%). Subsequently, the SHapley Additive exPlanations (SHAP) approach was employed to elucidate the interpretation of the KTBoost model using data that had been treated with the SMOTE-ENN technique. According to the findings, flight type, wind shear magnitude, and approach runway contributed the most to the wind shear-induced go-around. Compared to international flights, Hong Kong-based airlines endured the highest number of wind shear-induced go-arounds. Shear due to the tailwind contributed more to the go-around than the headwinds. The runways with the most wind shear-induced Go-arounds were 07C and 07R.

7.
Bioorg Chem ; 146: 107318, 2024 May.
Article in English | MEDLINE | ID: mdl-38579613

ABSTRACT

Twenty-seven rosmarinic acid derivatives were synthesized, among which compound RA-N8 exhibited the most potent antibacterial ability. The minimum inhibition concentration of RA-N8 against both S. aureus (ATCC 29213) and MRSA (ATCC BAA41 and ATCC 43300) was found to be 6 µg/mL, and RA-N8 killed E. coli (ATCC 25922) at 3 µg/mL in the presence of polymyxin B nonapeptide (PMBN) which increased the permeability of E. coli. RA-N8 exhibited a weak hemolytic effect at the minimum inhibitory concentration. SYTOX Green assay, SEM, and LIVE/DEAD fluorescence staining assay proved that the mode of action of RA-N8 is targeting bacterial cell membranes. Furthermore, no resistance in wildtype S. aureus developed after incubation with RA-N8 for 20 passages. Cytotoxicity studies further demonstrated that RA-N8 is non-toxic to the human normal cell line (HFF1). RA-N8 also exerted potent inhibitory ability against biofilm formation of S. aureus and even collapsed the shaped biofilm.


Subject(s)
Anti-Bacterial Agents , Methicillin-Resistant Staphylococcus aureus , Humans , Anti-Bacterial Agents/chemistry , Staphylococcus aureus , Rosmarinic Acid , Escherichia coli , Structure-Activity Relationship , Microbial Sensitivity Tests , Biofilms
8.
ACS Omega ; 9(8): 9161-9169, 2024 Feb 27.
Article in English | MEDLINE | ID: mdl-38434906

ABSTRACT

We successfully developed a fluorescent drug sensor from clinically relevant New Delhi metallo-ß-lactamase-1 (NDM-1). The F70 residue was chosen to be replaced with a cysteine for conjugation with thiol-reactive fluorescein-5-maleimide to form fluorescent F70Cf, where "f" refers to fluorescein-5-maleimide. Our proteolytic studies of unlabeled F70C and labeled F70Cf monitored by electrospray ionization-mass spectrometry (ESI-MS) revealed that fluorescein-5-maleimide was specifically linked to C70 in 1:1 mole ratio (F70C:fluorophore). Our drug sensor (F70Cf) can detect the ß-lactam antibiotics cefotaxime and cephalothin by giving stronger fluorescence in the initial binding phase and then declining fluorescence signals as a result of the hydrolysis of the antibiotics into acid products. F70Cf can also detect non-ß-lactam inhibitors (e.g., l-captopril, d-captopril, dl-thiorphan, and thanatin). In all cases, F70Cf exhibits stronger fluorescence due to inhibitor binding and subsequently sustained fluorescence signals in a later stage. Native ESI-MS results show that F70Cf can bind to all four inhibitors. Moreover, our drug sensor is compatible with a high-throughput microplate reader and has the capability to perform in vitro drug screening.

9.
Digit Health ; 10: 20552076241237678, 2024.
Article in English | MEDLINE | ID: mdl-38449683

ABSTRACT

Background: Taiwan is well-known for its quality healthcare system. The country's medical licensing exams offer a way to evaluate ChatGPT's medical proficiency. Methods: We analyzed exam data from February 2022, July 2022, February 2023, and July 2033. Each exam included four papers with 80 single-choice questions, grouped as descriptive or picture-based. We used ChatGPT-4 for evaluation. Incorrect answers prompted a "chain of thought" approach. Accuracy rates were calculated as percentages. Results: ChatGPT-4's accuracy in medical exams ranged from 63.75% to 93.75% (February 2022-July 2023). The highest accuracy (93.75%) was in February 2022's Medicine Exam (3). Subjects with the highest misanswered rates were ophthalmology (28.95%), breast surgery (27.27%), plastic surgery (26.67%), orthopedics (25.00%), and general surgery (24.59%). While using "chain of thought," the "Accuracy of (CoT) prompting" ranged from 0.00% to 88.89%, and the final overall accuracy rate ranged from 90% to 98%. Conclusion: ChatGPT-4 succeeded in Taiwan's medical licensing exams. With the "chain of thought" prompt, it improved accuracy to over 90%.

10.
Digit Health ; 10: 20552076231224074, 2024.
Article in English | MEDLINE | ID: mdl-38188855

ABSTRACT

Objective: This research explores the performance of ChatGPT, compared to human doctors, in bilingual, Mandarin Chinese and English, medical specialty exam in Nuclear Medicine in Taiwan. Methods: The study employed generative pre-trained transformer (GPT-4) and integrated chain-of-thoughts (COT) method to enhance performance by triggering and explaining the thinking process to answer the question in a coherent and logical manner. Questions from the Taiwanese Nuclear Medicine Specialty Exam served as the basis for testing. The research analyzed the correctness of AI responses in different sections of the exam and explored the influence of question length and language proportion on accuracy. Results: AI, especially ChatGPT with COT, exhibited exceptional capabilities in theoretical knowledge, clinical medicine, and handling integrated questions, often surpassing, or matching human doctor performance. However, AI struggled with questions related to medical regulations. The analysis of question length showed that questions within the 109-163 words range yielded the highest accuracy. Moreover, an increase in the proportion of English words in questions improved both AI and human accuracy. Conclusions: This research highlights the potential and challenges of AI in the medical field. ChatGPT demonstrates significant competence in various aspects of medical knowledge. However, areas like medical regulations require improvement. The study also suggests that AI may help in evaluating exam question difficulty and maintaining fairness in examinations. These findings shed light on AI role in the medical field, with potential applications in healthcare education, exam preparation, and multilingual environments. Ongoing AI advancements are expected to further enhance AI utility in the medical domain.

11.
Sensors (Basel) ; 23(24)2023 Dec 13.
Article in English | MEDLINE | ID: mdl-38139654

ABSTRACT

This paper presents a low-voltage low-power chopper-stabilized differential difference amplifier (DDA) realized using 40 nm CMOS technology. Operating with a supply voltage of 0.5 V, a three-stage DDA has been employed to achieve an open-loop gain of 89 dB, while consuming just 0.74 µW of power. The proposed DDA incorporates feed-forward frequency compensation and a Type II compensator to achieve pole-zero cancellation and damping factor control. The DDA has a unity-gain bandwidth (UGB) of 170 kHz, a phase margin (PM) of 63.98°, and a common-mode rejection ratio (CMRR) of up to 100 dB. This circuit can effectively drive a 50 pF capacitor in parallel with a 300 kΩ resistor. The use of the chopper stabilization technique effectively mitigates the offset and 1/f noise. The chopping frequency of the chopper modulator is 5 kHz. The input noise is 245 nV/sqrt (Hz) at 1 kHz, and the input-referred offset under Monte Carlo cases is only 0.26 mV. Such a low-voltage chopper-stabilized DDA will be very useful for analog signal processing applications. Compared to the reported chopper DDA counterparts, the proposed DDA is regarded as that with one of the lowest supply voltages. The proposed DDA has demonstrated its effectiveness in tradeoff design when dealing with multiple parameters pertaining to power consumption, noise, and bandwidth.

12.
Risk Anal ; 2023 Sep 13.
Article in English | MEDLINE | ID: mdl-37700727

ABSTRACT

The occurrence of severe low-level wind shear (S-LLWS) events in the vicinity of airport runways poses a significant threat to flight safety and exacerbates a burgeoning problem in civil aviation. Identifying the risk factors that contribute to occurrences of S-LLWS can facilitate the improvement of aviation safety. Despite the significant influence of S-LLWS on aviation safety, its occurrence is relatively infrequent in comparison to non-SLLWS incidents. In this study, we develop an S-LLWS risk prediction model through the utilization of ensemble imbalance learning (EIL) strategies, namely, BalanceCascade, EasyEnsemble, and RUSBoost. The data for this study were obtained from PIREPs and LiDAR at Hong Kong International Airport. The analysis revealed that the BalanceCascade strategy outperforms EasyEnsemble and RUSBoost in terms of prediction performance. Afterward, the SHapley Additive exPlanations (SHAP) interpretation tool was used in conjunction with the BalanceCascade model for the risk assessment of various factors. The four most influential risk factors, according to the SHAP interpretation tool, were hourly temperature, runway 25LD, runway 25LA, and RWY (encounter location of LLWS). S-LLWS was likely to happen at Runway 25LD and Runway 25LA in temperatures ranging from low to moderate. Similarly, a high proportion of S-LLWS events occurred near the runway threshold, and a relatively small proportion occurred away from it. The EIL strategies in conjunction with the SHAP interpretation tool may accurately predict the S-LLWS without the need for data augmentation in the data pre-processing phase.

13.
Heliyon ; 9(8): e18641, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37560661

ABSTRACT

Based on the simulation of the fluid-structure interaction response, the cause of an overturning of a gantry crane induced by a downburst in Shenzhen is studied in this paper. According to the results, (1) Vicroy's downburst model could establish the steady-state wind field of the downburst more reasonably when there was only low-level wind speed observation data, and its simulation results were close to the two-dimensional downburst numerical simulation results; (2) Compared with the normal exponential vertical profile of wind speed, the disturbance caused by the front girder of the double-girder gantry crane structure under the downburst wind field was more severe, which increases the probability of the gantry crane overturning. (3) The downwind displacement of the main girder of the gantry crane under the condition of downburst is far greater than that under the normal condition. At the same time, under the condition of downburst, the pressure difference on the surface of the gantry crane was greater, and the distribution of the support reaction force was more uneven, resulting in a stronger overturning tendency of the gantry crane. (4) Under the condition of downburst, the overturning moment and the shearing force borne by the foundation of gantry crane exceeded the critical value to maintain the stability of the gantry crane by the gravity, resulting in the overturning of the gantry crane.

14.
Sci Rep ; 13(1): 10939, 2023 Jul 06.
Article in English | MEDLINE | ID: mdl-37414818

ABSTRACT

Aircraft landings are especially perilous when the wind is gusty near airport runways. For this reason, an aircraft may deviate from its glide slope, miss its approach, or even crash in the worst cases. In the study, we used the state-of-the-art glass-box model, the Explainable Boosting Machine (EBM), to estimate the variation in headwind speed and turbulence intensity along the airport runway glide slope and to interpret the various contributing factors. To begin, the wind field characteristics were examined by developing a scaled-down model of Hong Kong International Airport (HKIA) runway as well as and the surrounding buildings and complex terrain in the TJ-3 atmospheric boundary layer wind tunnel. The placement of probes along the glide slope of the model runway aided in the measurement of wind field characteristics at different locations in the presence and absence of surrounding buildings. Next, the experimental data was used to train the EBM model in conjunction with Bayesian optimization approach. The counterpart black box models (extreme gradient boosting, random forest, extra tree and adaptive boosting) as well as other glass box models (linear regression and decision tree) were compared with the outcomes of the EBM model. Based on the holdout testing data, the EBM model revealed superior performance for both variation in headwind speed and turbulence intensity in terms of mean absolute error, mean squared error, root mean squared error and R-square values. To further evaluate the impact of different factors on the wind field characteristics along the airport runway glide slope, the EBM model allows for a full interpretation of the contribution of individual and pairwise interactions of factors to the prediction results from both a global and a local perspective.


Subject(s)
Aircraft , Airports , Bayes Theorem , Hong Kong
15.
J Alzheimers Dis ; 93(2): 665-682, 2023.
Article in English | MEDLINE | ID: mdl-37092220

ABSTRACT

BACKGROUND: Circulating phospholipid species have been shown to predict Alzheimer's disease (AD) prognosis but the link between phospholipid disturbances and subcortical small vessel cerebrovascular disease (CeVD) common in AD patients is not known. OBJECTIVE: Mass-spectrometry lipidomics was applied to quantify serum diacyl, alkenyl (ether), alkyl, and lyso phospholipid species in individuals with extensive CeVD (n = 29), AD with minimal CeVD (n = 16), and AD with extensive CeVD (n = 14), and compared them to age-matched controls (n = 27). Memory was assessed using the California Verbal Learning Test. 3.0T MRI was used to assess hippocampal volume, atrophy, and white matter hyperintensity (WMH) volumes as manifestations of CeVD. RESULTS: AD was associated with significantly higher concentrations of choline plasmalogen 18:0_18:1 and alkyl-phosphocholine 18:1. CeVD was associated with significantly lower lysophospholipids containing 16:0. Phospholipids containing arachidonic acid (AA) were associated with poorer memory in controls, whereas docosahexaenoic acid (DHA)-containing phospholipids were associated with better memory in individuals with AD+CeVD. In controls, DHA-containing phospholipids were associated with more atrophy, and phospholipids containing linoleic acid and AA were associated with less atrophy. Lysophospholipids containing 16:0, 18:0, and 18:1 were correlated with less atrophy in controls, and of these, alkyl-phosphocholine 18:1 was correlated with smaller WMH volumes. Conversely, 16:0_18:1 choline plasmalogen was correlated with greater WMH volumes in controls. CONCLUSION: This study demonstrates discernable differences in circulating phospholipids in individuals with AD and CeVD, as well as new associations between phospholipid species with memory and brain structure that were specific to contexts of commonly comorbid vascular and neurodegenerative pathologies.


Subject(s)
Alzheimer Disease , Cerebrovascular Disorders , White Matter , Humans , Alzheimer Disease/complications , Lipidomics , Phosphorylcholine , Cerebrovascular Disorders/complications , Magnetic Resonance Imaging , Lysophospholipids , Atrophy/pathology , White Matter/pathology
16.
Diagnostics (Basel) ; 13(4)2023 Feb 12.
Article in English | MEDLINE | ID: mdl-36832173

ABSTRACT

BACKGROUND: When cancer has metastasized to bone, doctors must identify the site of the metastases for treatment. In radiation therapy, damage to healthy areas or missing areas requiring treatment should be avoided. Therefore, it is necessary to locate the precise bone metastasis area. The bone scan is a commonly applied diagnostic tool for this purpose. However, its accuracy is limited by the nonspecific character of radiopharmaceutical accumulation. The study evaluated object detection techniques to improve the efficacy of bone metastases detection on bone scans. METHODS: We retrospectively examined the data of 920 patients, aged 23 to 95 years, who underwent bone scans between May 2009 and December 2019. The bone scan images were examined using an object detection algorithm. RESULTS: After reviewing the image reports written by physicians, nursing staff members annotated the bone metastasis sites as ground truths for training. Each set of bone scans contained anterior and posterior images with resolutions of 1024 × 256 pixels. The optimal dice similarity coefficient (DSC) in our study was 0.6640, which differs by 0.04 relative to the optimal DSC of different physicians (0.7040). CONCLUSIONS: Object detection can help physicians to efficiently notice bone metastases, decrease physician workload, and improve patient care.

18.
Surg Endosc ; 37(2): 1293-1302, 2023 02.
Article in English | MEDLINE | ID: mdl-36192659

ABSTRACT

BACKGROUND: Endoscopic submucosal dissection (ESD) has gained increasing popularity in the management of complicated colorectal polyps. However, clinical outcomes for ESD have remained highly inconsistent worldwide. This study investigated and analysed factors that significantly affect ESD outcomes. METHODS: We conducted a single-centred retrospective study on 220 colorectal polyps removed by ESD from 1st January 2016 to 31st December 2020. Data were collected and retrieved from clinical records. Variables studied included patient demographics, ESD technicalities and polyp characteristics. The primary outcome was completeness of resection based on en bloc and R0 resection rates. The secondary outcomes were recurrence, complications and hospital stay. Further analysis was performed for significant outcome determining factors. RESULTS: The en bloc resection and R0 resection rates were 97.3% and 65% respectively. Intraprocedural and delayed perforation rates were 3.2% and 0.5% respectively. Intraprocedural and delayed bleeding rates were both 1.8%. Post-polypectomy syndrome rate was 2.7%. The median hospital stay was 4 days. Submucosal fibrosis was a significant determining factor for lower en bloc resection (p = 0.004), lower R0 resection (p = 0.002), intraprocedural perforation (p = 0.001), intraprocedural bleeding (p = 0.025) and post-polypectomy syndrome (p = 0.039). Hybrid snaring was associated with lower en bloc resection (p < 0.001), while longer ESD time was associated with lower R0 resection (p = 0.003) and post-polypectomy syndrome (p = 0.025). Other significant factors for post-polypectomy syndrome included young age (p = 0.021) and large polyp size (p = 0.018). Secondary analysis showed that submucosal fibrosis was significantly associated with non-granular lesions (p < 0.001) and prior biopsy (p = 0.003). CONCLUSION: Submucosal fibrosis, hybrid snaring, ESD time, age and polyp size were significant outcome determining factors for ESD. By identifying these factors, strategies may be formulated to improve ESD outcomes.


Subject(s)
Colonic Diseases , Colonic Polyps , Colorectal Neoplasms , Endoscopic Mucosal Resection , Oral Submucous Fibrosis , Humans , Colorectal Neoplasms/surgery , Retrospective Studies , Postoperative Complications , Treatment Outcome
19.
Sensors (Basel) ; 22(23)2022 Dec 03.
Article in English | MEDLINE | ID: mdl-36502168

ABSTRACT

A new precision-aware subthreshold-based MOSFET voltage reference is presented in this paper. The circuit was implemented TSMC-40 nm process technology. It consumed 9.6 µW at the supply voltage of 1.2 V. In this proposed work, by utilizing subthreshold-based MOSFET instead of bipolar junction transistor (BJT), relatively lower power consumption was obtained in the design while offering comparable precision to that offered by its BJT counterpart. Through the proposed second-order compensation, it achieved the temperature coefficient (T.C.) of 3.0 ppm/°C in the TT corner case and a 200-sample Monte-Carlo T.C. of 12.51 ppm/°C from -40 °C to 90 °C. This shows robust temperature insensitivity. The process sensitivity of Vref without and with trimming was 2.85% and 0.75%, respectively. The power supply rejection (PSR) was 71.65 dB at 100 Hz and 52.54 dB at 10 MHz. The Figure-of-Merit (FOM) for the total variation in output voltage was comparable with representative BJT circuits and better than subthreshold-based MOSFET circuits. Due to low T.C., low process sensitivity, and simplicity of the circuit architecture, the proposed work will be useful for sensor circuits with stringent requirements or other analog circuits that require high precision applications.


Subject(s)
Electric Power Supplies , Equipment Design
20.
Article in English | MEDLINE | ID: mdl-36231872

ABSTRACT

Surface sampling is a frequent task in laboratory work and field studies. Simple methods usually have low efficiency in collecting target substances from surfaces. This study developed an advanced tape-stripping approach for efficient sampling on non-absorbent surfaces. A film-forming solution, prepared using polyvinyl alcohol, is applied to the target surface, where it covers and engulfs the surface deposits and then solidifies into an elastic membrane as it is exposed to air. The deposits are collected by stripping off the membrane and re-dissolving it in water. This new approach exhibited an efficiency of 100% in collecting uniform-size microspheres from glass surfaces and extremely high efficiencies (>96.6%) in detecting selected target DNA materials from glass and stainless steel surfaces. In comparison, the common swab-rinse method exhibited an efficiency of 72.6% under similar measuring conditions. The viability of S. aureus during sampling using the new approach decreased as the ethanol concentration in the applied solution increased. Using a solution with a mass ratio of ethanol of 17.6% balanced the effects of multiplication and degradation of the S. aureus on glass surfaces during sampling. Overall, the proposed approach exhibits high efficiency in collecting living and abiotic matter from non-absorbent surfaces, complementing existing sampling methods.


Subject(s)
Stainless Steel , Staphylococcus aureus , Ethanol , Polyvinyl Alcohol , Water
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