A 48 WL stacked 256-Gb V-NAND flash memory with a 3 b MLC technology is presented. Several vertical scale-down effects such as deteriorated WL loading and variations are discussed. To enhance ...performance, reverse read scheme and variable-pulse scheme are presented to cope with nonuniform WL characteristics. For improved performance, dual state machine architecture is proposed to achieve optimal timing for BL and WL, respectively. Also, to maintain robust IO driver strength against PVT variations, an embedded ZQ calibration technique with temperature compensation is introduced. The chip, fabricated in a third generation of V-NAND technology, achieved a density of 2.6 Gb/mm 2 with 53.2 MB/s of program throughput.
Background For prevention of ventilator-associated pneumonia (VAP), a bundle approach was applied to patients receiving mechanical ventilation in intensive care units. The incidence of VAP and the ...preventive efficacy of the VAP bundle were investigated. Methods A quasi-experimental study was conducted in adult intensive care units of 6 university hospitals with similar VAP rates. We implemented the VAP bundle between March 2011 and June 2011, then compared the rate of VAP after implementation of the VAP bundle with the rate in the previous 8 months. Our ventilator bundle included head of bed elevation, peptic ulcer disease prophylaxis, deep venous thrombosis prophylaxis, and oral decontamination with chlorhexidine 0.12%. Continuous aspiration of subglottic secretions was an option. Results Implementation of the VAP bundle reduced the VAP rate from a mean of 4.08 cases per 1,000 ventilator-days to 1.16 cases per 1,000 ventilator-days. The incidence density ratio (rate) was 0.28 (95% confidence interval, 0.275-0.292). Conclusions Implementing the appropriate VAP bundle significantly decreased the incidence of VAP in patients with mechanical ventilation.
Particulate matter (PM) is suspended dust that has a diameter of <10 μm and can be inhaled by humans and deposited in the lungs, particularly the alveoli. Recent studies have shown that PM has an ...adverse effect on respiratory diseases. The aim of this article is to review respiratory diseases associated with PM. According to existing studies, PM is associated with chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases and increases the mortality rates of these diseases. Moreover, increased exposure in the high concentration of atmospheric PM is associated with the development of lung cancer. The most simple and common way to protect an individual from airborne PM is to wear a face mask that filters out PM. In areas of high concentration PM, it is recommended to wear a face mask to minimize the exposure to PM. However, the use of N95 or KF94 masks can interfere with respiration in patients with chronic respiratory diseases who exhibit low pulmonary function, leading to an increased risk of respiratory failure. Conclusionally, reduction of the total amount of PM is considered to be important factor and strengthening the national warning notification system to vulnerable patients and proper early management of exacerbated patients will be needed in the future.
Abstract Introduction This study aimed to evaluate the efficacy of epigallocatechin gallate (EGCG), an antibacterial cross-linking agent, on the proliferation and differentiation of human dental pulp ...cells (hDPCs) cultured in hydrogel collagen scaffolds. Methods The odontogenic differentiation induced by EGCG was evaluated by alkaline phosphatase (ALP) activity and odontogenic-related gene expression using real-time polymerase chain reaction. The antibacterial effect of EGCG was investigated by a disc diffusion assay in comparison with glutaraldehyde. Proliferation was analyzed by cell number counting under both optical and confocal laser scanning microscopes. To assess the mechanical properties of collagen treated with EGCG, the setting time, surface roughness, and compressive strength were measured. Results EGCG itself did not up-regulate the odontogenic-related markers ( P > .05) although ALP activity was slightly increased. The proliferation and differentiation of hDPCs cultured in collagen increased significantly in the presence of EGCG ( P < .05). The antibacterial activity of EGCG was similar to that of glutaraldehyde. The setting time of collagen was significantly shortened when it was treated with EGCG ( P < .05). The surface roughness and compressive strength of the cross-linked collagen were higher than those of collagen without EGCG ( P < .05). Conclusions Our results showed that EGCG, the antibacterial cross-linking agent, promoted the proliferation and differentiation of hDPCs cultured in collagen scaffolds. Furthermore, the enhanced mechanical properties of collagen scaffolds induced by EGCG may play important roles in cell behavior. Consequently, the application of EGCG to collagen scaffolds might be beneficial for regenerative endodontic therapy.
Purpose
Genexol-PM is a Cremorphor EL (CrEL)-free polymeric micelle formulation of paclitaxel that allows higher-dose administration with less hypersensitivity. This study was designed to evaluate ...the efficacy and safety of Genexol-PM and gemcitabine combination in advanced non-small cell lung cancer patients as a first-line treatment.
Patients and methods
This is a prospective, single-arm, single-center phase II study. Patients with advanced NSCLC received Genexol-PM at 230 mg/m
2
on day 1 and gemcitabine 1,000 mg/m
2
on day 1 and day 8 of a 3-week cycle. Six cycles of chemotherapy were planned unless there was disease progression. The primary endpoint was overall response rate.
Results
Forty-three patients received the study drugs with a median of 4 cycles per patient (range 1–6). The overall response rate was 46.5 %. The median progression-free survival was 4.0 months (95 % CI 2.0–6.0 months), and median overall survival was 14.8 months (95 % CI 9.1–20.5 months). The most common toxicities were anemia (
n
= 29, 67 %), asthenia (
n
= 17, 40 %), myalgia (
n
= 16, 37 %), peripheral neuropathy (
n
= 15, 35 %), and diarrhea (
n
= 12, 30 %). The most common grade 3/4 adverse events were neutropenia (
n
= 7, 16 %) and pneumonia (
n
= 5, 12 %). Two patients died of pneumonia and dyspnea.
Conclusions
CrEL-free paclitaxel in combination with gemcitabine demonstrated favorable antitumor activity with little emetogenicities in non-small cell lung cancer patients. However, frequent grade 3/4 toxicities were observed, and safety should be evaluated thoroughly in future studies.
In 21 consecutive patients with confirmed Covid-19, the median times from symptom onset to negative viral culture and negative real-time RT-PCR were 7 days and 34 days, respectively. The longest ...interval from symptom onset and from resolution of fever to positive culture was 12 days and 3 days, respectively.
Osteoporosis has increased and developed into a serious public health concern worldwide. Despite the high prevalence, osteoporosis is silent before major fragility fracture and the osteoporosis ...screening rate is low. Abdomen-pelvic CT (APCT) is one of the most widely conducted medical tests. Artificial intelligence and radiomics analysis have recently been spotlighted. This is the first study to evaluate the prediction performance of femoral osteoporosis using machine-learning analysis with radiomics features and APCT.
500 patients (M: F = 70:430; mean age, 66.5 ± 11.8yrs; range, 50-96 years) underwent both dual-energy X-ray absorptiometry and APCT within 1 month. The volume of interest of the left proximal femur was extracted and 41 radiomics features were calculated using 3D volume of interest analysis. Top 10 importance radiomic features were selected by the intraclass correlation coefficient and random forest feature selection. Study cohort was randomly divided into 70% of the samples as the training cohort and the remaining 30% of the sample as the validation cohort. Prediction performance of machine-learning analysis was calculated using diagnostic test and comparison of area under the curve (AUC) of receiver operating characteristic curve analysis was performed between training and validation cohorts.
The osteoporosis prevalence of this study cohort was 20.8%. The prediction performance of the machine-learning analysis to diagnose osteoporosis in the training and validation cohorts were as follows; accuracy, 92.9% vs. 92.7%; sensitivity, 86.6% vs. 80.0%; specificity, 94.5% vs. 95.8%; positive predictive value, 78.4% vs. 82.8%; and negative predictive value, 96.7% vs. 95.0%. The AUC to predict osteoporosis in the training and validation cohorts were 95.9% 95% confidence interval (CI), 93.7%-98.1% and 96.0% 95% CI, 93.2%-98.8%, respectively, without significant differences (P = 0.962).
Prediction performance of femoral osteoporosis using machine-learning analysis with radiomics features and APCT showed high validity with more than 93% accuracy, specificity, and negative predictive value.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background/Aims
In areas with >15% clarithromycin resistance, bismuth‐based quadruple therapy is recommended for first‐line Helicobacter pylori eradication. This study aimed to determine the efficacy ...of the twice‐daily intake of bismuth‐based quadruple therapy among 10‐day, 14‐day, and half‐dose antibiotic regimens.
Methods
From May 2021 to March 2023, H. pylori‐infected Korean adults were administered tetracycline (1 g), metronidazole (750 mg), bismuth potassium citrate (300 mg), and lansoprazole (30 mg) twice daily, after breakfast and dinner, for 10 days. The regimen was administered for 14 days if the body weight was ≥70 kg or if the patient had reinfection. Half doses of antibiotics were administered for 14 days if there was a risk of drug interactions or if the patient was aged ≥75 years. The 13C‐urea breath test was performed after 6 weeks.
Results
Among the 1258 infected Koreans, 85.1% (412/484) in the 10‐day, 84.3% (498/591) in the 14‐day, and 86.3% (158/183) in the half‐dose antibiotic groups followed the instructions. In the per‐protocol (PP) analysis, eradication rates were higher in the 10‐day (90.5%, p = 0.019) and 14‐day (90.2%, p = 0.023) groups than in the half‐dose group (83.5%). In the intention‐to‐treat (ITT) analysis, eradication rates were higher in the 10‐day group (80.6%) than in the half‐dose group (73.2%, p = 0.039). In the half‐dose group, the eradication rate was lower in patients aged ≥75 years (PP: 74.6%, ITT: 66.2%) than in those with a risk of drug interactions (PP: 89.7% p = 0.017, ITT: 82.4% p = 0.019).
Conclusions
Twice‐daily intake of bismuth‐based quadruple therapy for 10–14 days showed an eradication rate of >90% in the PP analysis. A 10‐day regimen could be administered to eradication‐naive patients with a body weight below 70 kg. A half‐dose antibiotic regimen might be recommended to patients with a risk of drug interactions but not to those aged ≥75 years simply due to old age.
Abstract
Background
There have been many prediction studies for imported infectious diseases, employing air-travel volume or the importation risk (IR) index, which is the product of travel-volume and ...disease burden in the source countries, as major predictors. However, there is a lack of studies validating the predictability of the variables especially for infectious diseases that have rarely been reported. In this study, we analyzed the prediction performance of the IR index and air-travel volume to predict disease importation.
Methods
Rabies and African trypanosomiasis were used as target diseases. The list of rabies and African trypanosomiasis importation events, annual air-travel volume between two specific countries, and incidence of rabies and African trypanosomiasis in the source countries were obtained from various databases.
Results
Logistic regression analysis showed that IR index was significantly associated with rabies importation risk (p value < 0.001), but the association with African trypanosomiasis was not significant (p value = 0.923). The univariable logistic regression models showed reasonable prediction performance for rabies (area under curve for Receiver operating characteristic AUC = 0.734) but poor performance for African trypanosomiasis (AUC = 0.641).
Conclusions
Our study found that the IR index cannot be generally applicable for predicting rare importation events. However, it showed the potential utility of the IR index by suggesting acceptable performance in rabies models. Further studies are recommended to explore the generalizability of the IR index’s applicability and to propose disease-specific prediction models.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this study, we performed a comprehensive analysis of BRCA1/2 variants and associated cancer risk in Korean patients considering two aspects: variants of uncertain significance (VUS) and pathogenic ...or likely pathogenic variants (PLPVs) in BRCA1 and BRCA2. This study included 5433 Korean participants who were tested for BRCA1/2 genes. The BRCA1/2 variants were classified following the standards/guidelines for interpretation of genetic variants and using a multifactorial probability-based approach. In Korea, 15.8% of participants had BRCA1 or BRCA2 PLPVs. To estimate the additional sample numbers needed to resolve unclassified status, we applied a simulation analysis. The simulation study for VUS showed that the smaller the number of samples, the more the posterior probability was affected by the prior probability; in addition, more samples for BRCA2 VUS than those of BRCA1 VUS were required to resolve the unclassified status, and the presence of clinical information associated with their VUS was an important factor. The cumulative lifetime breast cancer risk was 59.1% (95% CI: 44.1–73.6%) for BRCA1 and 58.3% (95% CI: 43.2–73.0%) for BRCA2 carriers. The cumulative lifetime ovarian cancer risk was estimated to be 36.9% (95% CI: 23.4–53.9%) for BRCA1 and 14.9% (95% CI: 7.4–28.5%) for BRCA2 carriers.
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