Long-term prediction of algal chlorophyll based on empirical models and the machine learning approach in relation to trophic variation in Juam Reservoir, Korea.

This study analyzed spatiotemporal variation and long-term trends in water quality indicators and trophic state conditions in an Asian temperate reservoir, Juam Reservoir (JR), and developed models that forecast algal chlorophyll (CHL-a) over a period of 30 years, 1993-2022. The analysis revealed that there were longitudinal gradients in water quality indicators along the reservoir, with notable influences from tributaries and seasonal variations in nutrient regimes and suspended solids. The empirical model showed phosphorus was found to be the key determinant of algal biomass, while suspended solids played a significant role in regulating water transparency. The trophic state indices indicated varying levels of trophic status, ranging from mesotrophic to eutrophic. Eutrophic states were particularly observed in zones after the summer monsoons, indicating a heightened risk of algal blooms, which were more prevalent in flood years. The analysis of trophic state index deviation suggested that phosphorus availability strongly influences the reservoir trophic status, with several episodes of non-algal turbidity at each site during Mon. Increases in non-algal turbidity were more prevalent during the monsoon in flood years. This study also highlighted overall long-term trends in certain water quality parameters, albeit with indications of shifting pollution sources towards non-biodegradable organic matter. According to the machine learning tests, a random forest (RF) model strongly predicted CHL-a (R2 = 0.72, p < 0.01), except for algal biomass peaks (>60 µg/L), compared to all other models. Overall, our research suggests that CHL-a and trophic variation are primarily regulated by the monsoon intensity and predicted well by the machine learning RF model.

Second-Line Bismuth-Containing Quadruple Therapy for Helicobacterpylori Infection: A 12-Year Study of Annual Eradication Rates.

BACKGROUND: Bismuth-containing quadruple therapy (BQT) consisting of a proton-pump inhibitor (PPI), bismuth, metronidazole and tetracycline is recommended as a second-line treatment for Helicobacter pylori (H. pylori) infection when PPI-based standard triple therapy (STT) consisting of a PPI, amoxicillin and clarithromycin is unsuccessful. The purpose of this study was to analyze the long-term results of BQT as a second-line therapy to determine its effectiveness. METHODS: This study included 643 subjects who failed first-line STT and received 7 or 10-14 days of BQT as a second-line therapy. We retrospectively analyzed the annual H. pylori eradication rates, demographic factors and adverse events. RESULTS: The overall eradication rates by intention-to-treat (ITT) and per-protocol (PP) analyses were 80.7% (519/643) and 93.3% (519/556), respectively. By PP analysis, the eradication rates for 2008-2011, 2012-2015, and 2016-2019 were 93.3%, 91.0%, and 96.4%, respectively (p = 0.145). There were no significant differences between the 7-day group and the 10-14-day group in both the ITT (79.7% vs. 86.0%, p = 0.148) and the PP analyses (92.7% vs. 96.6%, p = 0.187). A multivariate analysis showed that current smoking was associated with eradication failure. Eighty-nine subjects (16.0%) suffered adverse events, mainly gastrointestinal symptoms, but only six cases were severe. CONCLUSIONS: BQT as a second-line therapy is an effective treatment for H. pylori. Treatment for 10-14 days showed a higher eradication rate compared with a 7-day regimen, but not significantly.

The Influence of Gastroesophageal Reflux Disease on Daytime Sleepiness and Depressive Symptom in Patients With Obstructive Sleep Apnea.

BACKGROUND/AIMS: As there is insufficient evidence for a relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA), we investigated whether OSA diagnosed by polysomnography (PSG) is related to GERD. METHODS: A total of 402 subjects was evaluated. Overnight PSG was performed and a few questionnaires on GERD, anxiety, depression, and daytime sleepiness were administered. An apnea-hypopnea index < 5 was the classification criterion for subjects without OSA. Subjects with heartburn or acid regurgitation at least once a week were classified as having GERD. RESULTS: Among the 402 subjects, 318 had OSA and 84 did not. The prevalence of GERD was 12.9% among patients with OSA and 10.7% among those without (P = 0.590). The prevalence of GERD did not correlate with OSA severity (P = 0.474). Patients with OSA with GERD had higher Stanford Sleepiness Scale (P = 0.004), Epworth Sleepiness Scale (P = 0.001), and depression (P < 0.001) scores than patients with OSA without GERD. Subjects with nocturnal gastroesophageal reflux symptoms had a higher body mass index, waist-to-height ratio, and waist circumference-to-height index than those without symptoms. Multiple logistic regression showed that higher Epworth Sleepiness Scale and depression scores were independent factors associated with GERD in patients with OSA. CONCLUSIONS: The prevalence of GERD in patients with OSA was 12.9%. The prevalence of GERD did not correlate with OSA severity. Daytime sleepiness and depression seem to be associated with GERD in patients with OSA, while nocturnal reflux symptoms seem to be related to obesity in OSA.

The GlideScope with modified Magill forceps facilitates nasogastric tube insertion in anesthetized patients: A randomized clinical study.

Objective Insertion of a nasogastric tube (NGT) in patients who have been intubated with an endotracheal tube while under general anesthesia can cause difficulties and lead to complications, including hemorrhage. A visualization-aided modality was recently used to facilitate NGT insertion. Some studies have focused on the role of modified Magill forceps, which have angles similar to those of the GlideScope blade (Verathon, Bothell, WA, USA). Methods Seventy patients were divided into a control group (Group C) and an experimental group (GlideScope and modified Magill forceps, Group M). Results The total NGT insertion time was significantly shorter in Group M than C (71.3 ± 22.6 vs. 96.7 ± 57.5 s; mean difference, -25.3 s; 95% confidence interval [CI], 20.8-71.5). There were also significantly fewer mean insertion attempts in Group M than C (1.0 ± 0.0 vs. 2.11 ± 0.93). The success rate for the first attempt in Group C was 37.1%, while that in Group M was 100% (relative risk, 2.7; 95% CI, 1.7-4.1). Conclusion The use of the GlideScope with modified Magill forceps for insertion of an NGT in patients who are already intubated and under general anesthesia will shorten the insertion time and improve the success rate.

Endovascular Treatment of Bilateral Cavernous Sinus Dural Arteriovenous Fistula: Therapeutic Strategy and Follow-Up Outcomes.

Objective: Bilateral cavernous sinus dural arteriovenous fistula (CSdAVF) is very rare, even in Asian countries. The research intended to present clinical and radiologic outcomes of treating such fistulas through endovascular embolization. Materials and Methods: Data was obtained from 220 consecutive patients, with CSdAVF, who were treated from January 2004 to December 2015. Bilateral CSdAVF was identified in 17 patients (7.7%). The clinical and radiologic outcomes of the fistulas were assessed with an emphasis on the technical aspects of treatment. Results: At the time of treatment, 7 and 10 patients presented with bilateral and unilateral symptoms, respectively. In the former cases, 4 patients had progressed from unilateral to bilateral symptoms. Bilateral fistulas were treated with a single-stage transvenous embolization (TVE) in 15 patients, via bilateral inferior petrosal sinuses (IPS) (n = 9) and unilateral IPS (n = 6). In the other 2 patients with one-sided dominance of shunting, only dominant fistula was treated. Two untreated lesions were found on follow-up to have spontaneously resolved after treatment of the dominant contralateral fistula. Of the 34 CSdAVF lesions, complete occlusion was achieved in 32 lesions after TVE. Seven patients (41.2%) developed worsening of cranial nerve palsy after TVE. During the follow-up period, 4 patients obtained complete recovery, whereas the other 3 remained with deficits. Conclusion: With adjustments of endovascular procedures to accommodate distinct anatomical configurations, endovascular treatment for bilateral CSdAVF can achieve excellent angiographic occlusion results. However, aggravation of symptoms after TVE may occur frequently in bilateral CSdAVF. In the patients with one-sided dominance of shunt, treatment of only dominant fistula might be an alternative option.

Enhanced switching behavior of iron oxide nanoparticle-doped liquid-crystal display.

It is well known that doping nanoparticles (NPs) in liquid crystals (LCs) can easily change the physical and electro-optical properties of LC mixture. In this paper, we demonstrate homogeneous, aligned nematic LC (N-LC) system dispersed in iron oxide (Fe2O3) NPs. The prepared Fe2O3 NPs have an average particle size of 50 nm. By changing the doping concentration of Fe2O3 NPs, we observed the characteristics of LC systems. Electrooptical (EO) characteristics included faster rising and falling times (2.14 ms and 10.24 ms, respectively) and lower driving voltage (1.45 V) compared with a pure N-LC cell. We demonstrated these results via the relationship between dielectric con- stant and LC device properties. The results were verified by software simulation based on general physical properties. Moreover, we observed that LC system with Fe2O3 NPs could be accomplished without capacitance hysteresis by capturing charged impurities. Superior performance of LC cell with Fe2O3 NPs indicates that the proposed LC system have strong potential for use in the production of advanced LC displays.

CIS-ZnS quantum dots for self-aligned liquid crystal molecules with superior electro-optic properties.

We demonstrate self-aligned and high-performance liquid crystal (LC) systems doped with 1-dimensional (1D) chain-like clusters of CuInS(2) (CIS)-ZnS core-shell quantum dots (QDs). By changing the cell fabrication method of the LC-QD composites, we can selectively control the orientation of the LC molecules between the homogeneous and homeotropic states without conventional LC alignment layers. The homeotropic alignment of LCs was achieved by random dropcasting and the homogeneous alignment was performed using a capillary injection of LC-QDs due to the random or linear diffusion of QD clusters into ITO defects. The electrically compensated bend (ECB)- and vertically aligned (VA) mode LC displays (LCDs) containing our LC-QD composite both showed superior electro-optic (EO) properties. A 37.1% reduction in the threshold voltage (V(th)) and a 36.6% decrease in the response time were observed for ECB mode LCDs, and a 47.0% reduction in the V(th) and a 38.3% decrease in the response time were observed for VA mode LCDs, meaning that the proposed LC-QD composites have a great potential for the production of advanced flexible LCDs.

Screw loosening and Migration after Dynesys Implantation.

Due to the problems associated with rigid fixation, the concept of dynamic stabilization was introduced. Dynesys is one of the pedicle screw-based dynamic stabilization systems. In spite of the dynamic nature of Dynesys, there are concerns about the rigidity of the Dynesys system. We present a case of vertebral body split fracture after Dynesys implantation in a 74-year-old woman. She had undergone L2-L5 laminectomy and Dynesys implantation for spinal stenosis 15 months ago. She was discharged with improvement in lower back pain and claudication. Follow-up X-ray images were taken at 1, 3 and 6 months and there was no evidence of screw migration. During the follow-up period, she received selective root block due to persistent leg pain. Eight months after the operation, she visited our hospital due to severe lower back pain. Magnetic resonance imaging showed the features of lumbar spondylitis from L2 to L5. Plain X-ray and computed tomography images showed the presence of a superiorly migrated screw at L5. The screws migrated superiorly into the intervertebral disc space creating a bony defect resembling a sagittal migrated fracture. The Dynesys system was removed and lumbar spondylitis was treated with antibiotics. The aim of the present case was to demonstrate the problems caused due to rigidity of the Dynesys system, when postoperative infection occurs after Dynesys implantation.