Purpose
The objective of this retrospective study was to assess safety and comparative clinical effectiveness of laparoscopic inguinal hernia repair (LIHR) and robot-assisted inguinal hernia repair ...(RIHR) from multi-institutional experience in Taiwan.
Methods
Medical records from a total of eight hospitals were retrospectively collected and analyzed. Patients primarily diagnosed of inguinal hernia, recurrent inguinal hernia or incarceration groin hernia patients who either underwent laparoscopic or robot-assisted inguinal hernia repair between January 2018 and December 2022 were included in the study. Baseline characteristics, intra-operative and post-operative results were analyzed. To compare two cohorts, overlap weighting was employed to balance the significant inter-group differences. We also conducted subgroup analyses by state of a hernia (primary or recurrent/incarceration) and laterality (unilateral or bilateral) that indicated complexity of surgery.
Results
A total of 1,080 patients who underwent minimally invasive inguinal hernia repair from 8 hospitals across Taiwan were collected. Following the application of inclusion criteria, there were 279 patients received RIHR and 763 patients received LIHR. In the baseline analysis, RIHR was more often performed in recurrent/incarceration (RIHR 18.6% vs LIHR 10.3%,
p
= 0.001) and bilateral cases (RIHR 81.4 vs LIHR 58.3,
p
< 0.001). Suturing was dominant mesh fixation method in RIHR (RIHR 81% vs LIHR 35.8%,
p
< 0.001). More overweight patients were treated with RIHR (RIHR 58.8% vs LIHR 48.9%,
p
= 0.006). After overlap weighting, there were no significant difference in intraoperative and post-operative complications between RIHR and LIHR. Reoperation and prescription rates of pain medication (opioid) were significantly lower in RIHR than LIHR in overall group comparison (reoperation: RIHR 0% vs. LIHR 2.9%,
p
= 0.016) (Opioid prescription: RIHR 3.34 mg vs LIHR 10.82 mg,
p
= 0.001) while operation time was significantly longer in RIHR (OR time: RIHR 155.27 min vs LIHR 95.30 min, p < 0.001).
Conclusions
This real-world experience suggested that RIHR is a safe, and feasible option with comparable intra-operative and post-operative outcomes to LHIR. In our study, RIHR showed technical advantages in more complicated hernia cases with yielding to lower reoperation rates, and less opioid use.
We have fabricated surface-enhanced Raman scattering (SERS) substrates based on arrays of silver nanoparticles grown on porous anodic alumina templates. Using this nanotechnology platform, label-free ...and high-speed detection of bacteria are achieved. SERS spectra of various bacteria including Staphylococcus Aureus (Gram-positive bacterium), Klebsiella Pneumoniae (Gram-negative bacterium), and Mycobacterium Smegmatis (Mycobacterium) were recorded. The highly reproducible SERS-based technological platform is capable of differentiating different kinds of bacteria by PCA, LDA, clustering analysis, and SVM methods, which provides promising opportunity for biosensing of clinical microbes.
Size distributions of expiratory droplets expelled during coughing and speaking and the velocities of the expiration air jets of healthy volunteers were measured. Droplet size was measured using the ...interferometric Mie imaging (IMI) technique while the particle image velocimetry (PIV) technique was used for measuring air velocity. These techniques allowed measurements in close proximity to the mouth and avoided air sampling losses. The average expiration air velocity was 11.7
m/s for coughing and 3.9
m/s for speaking. Under the experimental setting, evaporation and condensation effects had negligible impact on the measured droplet size. The geometric mean diameter of droplets from coughing was 13.5
μm and it was 16.0
μm for speaking (counting 1–100). The estimated total number of droplets expelled ranged from 947 to 2085 per cough and 112–6720 for speaking. The estimated droplet concentrations for coughing ranged from 2.4 to 5.2
cm
−3 per cough and 0.004–0.223
cm
−3 for speaking.
An essential starting point when investigating the potential role of human expired aerosols in the transmission of disease is to gain a comprehensive knowledge of the expired aerosol generation ...process, including the aerosol size distribution, the various droplet production mechanisms involved and the corresponding sites of production within the respiratory tract. In order to approach this level of understanding we have integrated the results of two different investigative techniques spanning 3 decades of particle size from 700
nm to 1
mm, presenting a single composite size distribution, and identifying the most prominent modes in that distribution. We link these modes to specific sites of origin and mechanisms of production. The data for this were obtained using the Aerodynamic Particle Sizer (APS) covering the range 0.7≤
d≤20
μm and Droplet Deposition Analysis (DDA) covering the range
d≥20
μm.
In the case of speech three distinct droplet size distribution modes were identified with count median diameters at 1.6, 2.5 and 145
μm. In the case of voluntary coughing the modes were located at 1.6, 1.7 and 123
μm. The modes are associated with three distinct processes: one occurring deep in the lower respiratory tract, another in the region of the larynx and a third in the upper respiratory tract including the oral cavity. The first of these, the Bronchiolar Fluid Film Burst (BFFB or B) mode contains droplets produced during normal breathing. The second, the Laryngeal (L) mode is most active during voicing and coughing. The third, the Oral (O) cavity mode is active during speech and coughing. The number of droplets and the volume of aerosol material associated with each mode of aerosol production during speech and coughing is presented. The size distribution is modeled as a tri-modal lognormal distribution dubbed the Bronchiolar/Laryngeal/Oral (B.L.O.) tri-modal model.
► We investigate the role of human expired aerosols in disease transmission. ► Three droplet size distribution modes were identified during speech and coughing. ► We present the number of droplets and volume of aerosol material for each mode. ► Results provide insight into expired aerosol generation process.
A new expiratory droplet investigation system (EDIS) was used to conduct the most comprehensive program of study to date, of the dilution corrected droplet size distributions produced during ...different respiratory activities.
Distinct physiological processes were responsible for specific size distribution modes. The majority of particles for all activities were produced in one or more modes, with diameters below 0.8
μm at average concentrations up to 0.75
cm
−3. These particles occurred at varying concentrations, during all respiratory activities, including normal breathing. A second mode at 1.8
μm was produced during all activities, but at lower concentrations of up to 0.14
cm
−3.
Speech produced additional particles in modes near 3.5 and 5
μm. These two modes became most pronounced during sustained vocalization, producing average concentrations of 0.04 and 0.16
cm
−3, respectively, suggesting that the aerosolization of secretions lubricating the vocal chords is a major source of droplets in terms of number.
For the entire size range examined of 0.3–20
μm, average particle number concentrations produced during exhalation ranged from 0.1
cm
−3 for breathing to 1.1
cm
−3 for sustained vocalization.
Non-equilibrium droplet evaporation was not detectable for particles between 0.5 and 20
μm, implying that evaporation to the equilibrium droplet size occurred within 0.8
s.
HOLISMOKES Cañameras, R.; Schuldt, S.; Shu, Y. ...
Astronomy and astrophysics (Berlin),
09/2021, Letnik:
653
Journal Article
Recenzirano
Odprti dostop
We have carried out a systematic search for galaxy-scale strong lenses in multiband imaging from the Hyper Suprime-Cam (HSC) survey. Our automated pipeline, based on realistic strong-lens ...simulations, deep neural network classification, and visual inspection, is aimed at efficiently selecting systems with wide image separations (Einstein radii
θ
E
∼ 1.0–3.0″), intermediate redshift lenses (
z
∼ 0.4–0.7), and bright arcs for galaxy evolution and cosmology. We classified
gri
images of all 62.5 million galaxies in HSC Wide with
i
-band Kron radius ≥0.8″ to avoid strict preselections and to prepare for the upcoming era of deep, wide-scale imaging surveys with Euclid and Rubin Observatory. We obtained 206 newly-discovered candidates classified as definite or probable lenses with either spatially-resolved multiple images or extended, distorted arcs. In addition, we found 88 high-quality candidates that were assigned lower confidence in previous HSC searches, and we recovered 173 known systems in the literature. These results demonstrate that, aided by limited human input, deep learning pipelines with false positive rates as low as ≃0.01% can be very powerful tools for identifying the rare strong lenses from large catalogs, and can also largely extend the samples found by traditional algorithms. We provide a ranked list of candidates for future spectroscopic confirmation.
We report on the development of a high‐resolution and highly efficient beamline for soft X‐ray resonant inelastic X‐ray scattering (RIXS) located at the Taiwan Photon Source. This beamline adopts an ...optical design that uses an active grating monochromator (AGM) and an active grating spectrometer (AGS) to implement the energy compensation principle of grating dispersion. Active gratings are utilized to diminish defocus, coma and higher‐order aberrations, as well as to decrease the slope errors caused by thermal deformation and optical polishing. The AGS is mounted on a rotatable granite platform to enable momentum‐resolved RIXS measurements with scattering angles over a wide range. Several high‐precision instruments developed in‐house for this beamline are described briefly. The best energy resolution obtained from this AGM–AGS beamline was 12.4 meV at 530 eV, achieving a resolving power of 4.2 × 104, while the bandwidth of the incident soft X‐rays was kept at 0.5 eV. To demonstrate the scientific impact of high‐resolution RIXS, we present an example of momentum‐resolved RIXS measurements on a high‐temperature superconducting cuprate, i.e. La2–xSrxCuO4. The measurements reveal the A1g buckling phonons in superconducting cuprates, opening a new opportunity to investigate the coupling between these phonons and charge‐density waves.
The development of a high‐resolution and highly efficient beamline for soft X‐ray resonant inelastic X‐ray scattering (RIXS) located at the Taiwan Photon Source is reported.
This study aimed to investigate the effects of eight metals on the anaerobic digestion of the organic fraction of municipal solid waste (OFMSW) in bioreactors. Anaerobic bioreactors containing 200 mL ...MSW mixed completely with 200 mL sludge seeding. Ca and K (0, 1000, 2000 and 6000 mg L−1) and Cr, Ni, Zn, Co, Mo and W (0, 5, 50 and 100 mg L−1) of various dose were added to anaerobic bioreactors to examine their anaerobic digestion performance. Results showed that except K and Zn, Ca (~728 to ~1461 mg L−1), Cr (~0.0022 to ~0.0212 mg L−1), Ni (~0.801 to ~5.362 mg L−1), Co (~0.148 to ~0.580 mg L−1), Mo (~0.044 to ~52.94 mg L−1) and W (~0.658 to ~40.39 mg L−1) had the potential to enhance the biogas production. On the other hand, except Mo and W, inhibitory concentrations IC50 of Ca, K, Cr, Ni, Zn and Co were found to be ~3252, ~2097, ~0.124, ~7.239, ~0.482, ~8.625 mg L−1, respectively. Eight spiked metals showed that they were adsorbed by MSW to a different extent resulting in different liquid metals levels and potential stimulation and inhibition on MSW anaerobic digestion. These results were discussed and compared to results from literature.
COSMOGRAIL Bonvin, V.; Chan, J. H. H.; Millon, M. ...
Astronomy and astrophysics (Berlin),
09/2018, Letnik:
616
Journal Article
Recenzirano
Odprti dostop
We present time-delay estimates for the quadruply imaged quasar PG 1115+080. Our results are based on almost daily observations for seven months at the ESO MPIA 2.2 m telescope at La Silla ...Observatory, reaching a signal-to-noise ratio of about 1000 per quasar image. In addition, we re-analyze existing light curves from the literature that we complete with an additional three seasons of monitoring with the
Mercator
telescope at La Palma Observatory. When exploring the possible source of bias we considered the so-called microlensing time delay, a potential source of systematic error so far never directly accounted for in previous time-delay publications. In 15 yr of data on PG 1115+080, we find no strong evidence of microlensing time delay. Therefore not accounting for this effect, our time-delay estimates on the individual data sets are in good agreement with each other and with the literature. Combining the data sets, we obtain the most precise time-delay estimates to date on PG 1115+080, with Δ
t
(
AB
) = 8.3
+1.5
−1.6
days (18.7% precision), Δ
t
(
AC
) = 9.9
+1.1
−1.1
days (11.1%) and Δ
t
(
BC
) = 18.8
+1.6
−1.6
days (8.5%). Turning these time delays into cosmological constraints is done in a companion paper that makes use of ground-based Adaptive Optics (AO) with the Keck telescope.
Aliment Pharmacol Ther 2011; 34: 994–1004
Summary
Background The diagnosis of gastro‐oesophageal reflux disease (GERD) is based on reflux symptoms. Although metabolic syndrome has been linked to ...erosive oesophagitis (EO), the impact of insulin resistance, the core of the metabolic syndrome, on reflux symptoms remains to be elucidated.
Aim To assess the effects of insulin resistance on GERD, including both endoscopic findings and symptoms.
Methods A total of 743 sonographic noncirrhotic adult subjects, who underwent an upper gastrointestinal endoscopic examination, completed a gastro‐oesophageal reflux questionnaire and had available fasting insulin data were included. Endoscopic findings were classified according to the Los Angeles classification. Homeostatic model assessment‐insulin resistance (HOMA‐IR) index was used to evaluate the status of insulin resistance. Univariate and multivariate approaches were used to evaluate the associations between insulin resistance and GERD.
Results Older age, male gender, smoking and alcohol consumption increased the prevalence of EO, but not GERD symptoms. A large waist circumference, high fasting blood glucose levels and high number of metabolic syndrome components were associated with increased prevalence of both EO and GERD symptoms, while high blood pressure was associated with increased prevalence of EO only. Moreover, higher scores in the gastro‐oesophageal reflux questionnaire were associated with higher HOMA‐IR index, and higher HOMA‐IR index was associated with increased prevalence of EO (adjusted odds ratio 1.14, 95% CI 1.03–1.26, P = 0.012).
Conclusions Our findings demonstrate clear associations between insulin resistance, metabolic syndrome and GERD. Whether reducing insulin resistance may improve GERD symptoms or EO deserves prospective study.
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