Search Results (12)

Background/Objectives: Extrahepatic recurrence (EHR) is a significant negative prognostic factor in hepatocellular carcinoma (HCC). Although EHR is commonly observed in high-risk patients following HCC hepatectomy, its occurrence without concurrent intrahepatic HCC remains poorly understood. Therefore, this study aims to examine the clinical characteristics and risk factors associated with EHR in patients without intrahepatic HCC at diagnosis. Methods: This study included 1066 treatment-naïve patients who underwent curative hepatectomy for HCC at four tertiary academic centers between January 2004 and December 2019. After excluding those with intrahepatic recurrence (IHR), concurrent EHR, or incomplete clinical records, 569 patients were included in the final analysis. Risk factors for EHR were assessed using multivariate Cox regression over a median follow-up period of 3.91 years. Results: Among the cohort, 38 patients developed EHR post-surgery without residual intrahepatic HCC, with a median follow-up of 1.04 years. These patients experienced earlier initial HCC recurrence than those without EHR (1.73 vs. 4.43 years). Multivariate analysis revealed significant associations between EHR and microvascular invasion (hazard ratio [HR]: 2.418, p = 0.020), tumor necrosis (HR: 2.592, p = 0.009), and initial tumor staging beyond the Milan criteria (HR: 3.008, p = 0.001). Moreover, Cox regression analysis revealed that EHR strongly correlated with decreased post-hepatectomy survival (HR: 14.044, p < 0.001). Cumulative EHR and survival rates were closely linked to the number of risk factors present. Conclusions: EHR without detectable IHR is significant and warrants close monitoring in high-risk patients. Full article

Regular inspections and hull cleanings are essential to prevent bio-fouling on ships. However, traditional cleaning methods such as brush cleaning and high-pressure water-jet cleaning at docks are ineffective in cleaning niche areas like bow thrusters and sea chests. Consequently, cleaning robots based on brushes and water jets have been developed to effectively remove bio-fouling. However, there are concerns that brushes may damage hull coatings, allowing bio-fouling to penetrate the damaged areas. In this study, removal experiments were conducted to identify the most dominant factor in fouling removal using water jet-based cleaning, in preparation for the development of non-contact cavitation high-pressure water jet-cleaning robots. The Taguchi method was used to identify influential factors and generate experimental conditions, and equipment systems for the removal experiments were established. Image analysis was performed to assess the bio-fouling occurrences on each specimen before and after cleaning, and numerical simulations of the nozzle were conducted to estimate stagnation pressure and wall shear stress to confirm the effect on micro-fouling removal. The results indicated that pump pressure is the most influential factor in removing large bio-fouling organisms grown in marine environments and on ship surfaces. Full article

Fouling organisms reduce a ship’s fuel efficiency and disturb the ecosystem. Therefore, the International Maritime Organization (IMO) and many nations have enacted laws that mandate periodic hull cleaning for removing fouling organisms. However, cleaning niche areas of the ship hull is extremely difficult. Due to their complex shape, applying antifouling paint and cleaning with hull cleaning robots is difficult, but about 80% of fouling organisms are concentrated in the niche areas. To resolve this issue, this research proposes the use of an autonomous cleaning robot with a hydraulic polyarticular robot arm to clean niche areas of the ship hull. This robot can approach niche areas of the ship hull with complex shapes using its polyarticular arm. It was designed to be able to scan the cleaning area, establish a cleaning plan, and clean accordingly. This robot autonomously cleaned a propeller blade, which is a typical niche area of the ship hull, to verify the applicability of this system. The experiment results show that approximately 80% of the biofouling was removed from the hull crevices and 81% of the cleaned biofouling was recovered. Full article

This study aimed to prove that deep learning can be effectively used for identifying various equine facial expressions as welfare indicators. In this study, a total of 749 horses (healthy: 586 and experiencing pain: 163) were investigated. Moreover, a model for recognizing facial expressions based on images and their classification into four categories, i.e., resting horses (RH), horses with pain (HP), horses immediately after exercise (HE), and horseshoeing horses (HH), was developed. The normalization of equine facial posture revealed that the profile (99.45%) had higher accuracy than the front (97.59%). The eyes–nose–ears detection model achieved an accuracy of 98.75% in training, 81.44% in validation, and 88.1% in testing, with an average accuracy of 89.43%. Overall, the average classification accuracy was high; however, the accuracy of pain classification was low. These results imply that various facial expressions in addition to pain may exist in horses depending on the situation, degree of pain, and type of pain experienced by horses. Furthermore, automatic pain and stress recognition would greatly enhance the identification of pain and other emotional states, thereby improving the quality of equine welfare. Full article

Although fish oil (FO) and lipid mediators (LM) derived from polyunsaturated fatty acids can prevent obesity, their combined effects and cellular metabolism remain unclear. Therefore, this study aimed to examine the potential protective and metabolic effects of FO in combination with LM (a mixture of 17S-monohydroxy docosahexaenoic acid, resolvin D5, and protectin DX [3:47:50], derived from docosahexaenoic acid (DHA)) on palmitic acid (PA)-induced HepG2 cells and high-fat- diet (HFD)-induced C57BL/6J mice after 9-week treatment. Lipid metabolism disorders and inflammation induced by HFD and PA were substantially reduced after FO and LM treatment. Further, FO and LM treatments reduced lipid accumulation by increasing fatty acid oxidation via peroxisome proliferator-activated receptor α and carnitine-palmitoyl transferase 1 as well as by decreasing fatty acid synthesis via sterol regulatory element-binding protein-1c and fatty acid synthase. Finally, FO and LM treatment reduced inflammation by blocking the NF-κB signaling pathway. Importantly, the combination of FO and LM exhibited more robust efficacy against nonalcoholic fatty liver disease, suggesting that FO supplemented with LM is a beneficial dietary strategy for treating this disease. Full article

This study aimed to determine the impact of modifications in emergency department (ED) practices caused by the coronavirus disease 2019 (COVID-19) pandemic on the clinical outcomes and management of patients with septic shock. We performed a retrospective study. Patients with septic shock who presented to the ED between 1 January 2018 and 19 January 2020 were allocated to the pre-COVID-19 group, whereas those who presented between 20 January 2020 and 31 December 2020 were assigned to the post-COVID-19 group. We used propensity score matching to compare the sepsis-related interventions and clinical outcomes. The primary outcome measure was in-hospital mortality. Of the 3697 patients included, 2254 were classified as pre-COVID-19 and 1143 as post-COVID-19. A total of 1140 propensity score-matched pairings were created. Overall, the in-hospital mortality rate was 25.5%, with no statistical difference between the pre- and post-COVID-19 groups (p = 0.92). In a matched cohort, the post-COVID-19 group had delayed lactate measurement, blood culture test, and infection source control (all p < 0.05). There was no significant difference in time to antibiotics (p = 0.19) or vasopressor administration (p = 0.09) between the groups. Although sepsis-related interventions were delayed during the COVID-19 pandemic, there was no significant difference in the in-hospital mortality between the pre- and post-COVID-19 groups. Full article

In this study, the performance evaluation of a semi-type floating offshore wind turbine system according to the direction of the incoming waves is investigated. The target model in this this study is a DTU 10 MW reference wind turbine and a LIFES50+ OO-Star Wind Floater Semi 10 MW, which is the semisubmersible platform. Numerical simulation is performed using FAST developed by National Renewable Energy Laboratory (NREL), which is an aero-hydro-servo-elastic fully coupled simulation tool. The analysis condition used in this study is the misalignment condition, which is the wind direction fixed at 0 degree and the wave direction changed at 15 degrees intervals. In this study, two main contents could be confirmed. First, it is confirmed that sway, roll, and yaw motions occur even though the direction of the incoming waves is 0 degree. The cause of the platform’s motion such as sway, roll and yaw is the turbulent wind and gyroscope phenomenon. In addition, the optimal value for the nacelle–yaw angle that maximizes the rotor power and minimizes the tower load is confirmed by solving the multiobjective optimization problem. These results show the conclusion that setting the initial nacelle–yaw angle can reduce the tower load and get a higher generator power. Second, it is confirmed that the platform’s motion and loads may be underestimated depending on the interval angle of incidence of the wind and waves. In particular, through the load diagram results, it is confirmed that most of the results are asymmetric, and the blade and tower loads are especially spiky. Through these results, the importance of examining the interval angle of incidence of the wind and waves is confirmed. Unlike previous studies, this will be a more considerable issue as turbines become larger and platforms become more complex. Full article

Background: The platelet-to-white blood cell ratio (PWR) is a hematologic marker of the systemic inflammatory response. Recently, the PWR was revealed to have a role as an independent prognostic factor for mortality in patients with hepatitis B virus (HBV)-related acute-on-chronic failure (ACLF) and HBV-related liver cirrhosis (LC) with acute decompensation (AD). However, the prognostic role of the PWR still needs to be investigated in LC patients with AD. In this study, we analyzed whether the PWR could stratify the risk of adverse outcomes (death or liver transplantation (LT)) in these patients. Methods: A prospective cohort of 1670 patients with AD of liver cirrhosis ((age: 55.2 ± 7.8, male = 1226 (73.4%)) was enrolled and evaluated for 28-day and overall adverse outcomes. Results: During a median follow-up of 8.0 months (range, 1.9–15.5 months), 424 (25.4%) patients had adverse outcomes (death = 377, LT = 47). The most common etiology of LC was alcohol use (69.7%). The adverse outcome rate was higher for patients with a PWR ≤ 12.1 than for those with a PWR > 12.1. A lower PWR level was a prognostic factor for 28-day adverse outcomes (PWR: hazard ratio 1.707, p = 0.034) when adjusted for the etiology of cirrhosis, infection, ACLF, and the MELD score. In the subgroup analysis, the PWR level stratified the risk of 28-day adverse outcomes regardless of the presence of ACLF or the main form of AD but not for those with bacterial infection. Conclusions: A lower PWR level was associated with 28-day adverse outcomes, indicating that the PWR level can be a useful and simple tool for stratifying the risk of 28-day adverse outcomes in LC patients with AD. Full article

The voltage and current ripples in the three-level bi-directional converter (TLBC) can be reduced by an interleaving technique that controls a phase difference between the modules of power converter. On the other hand, the inductor current ripple in TLBC is increased due to the circulating current between the modules. In this paper, the effects of two interleaving methods on a two-phase TLBC, Z-type and N-type, are investigated and compared. In particular, capacitor current ripple, and voltage ripple are compared by two interleaving methods verified through Powersim (PSIM) simulation. Full article

This study aimed to validate eye temperature (ET) assessed using infrared thermography (IRT) as an indicator of welfare in horses. Moreover, this study aimed to determine the most accurate position for ET measured using IRT and to validate this approach as a gold-standard measurement method. As the quantitative data obtained by IRT have strongly influenced the ET results depending on the specific location of the measurement area, an accurate definition of the regions of interest (ROI) was established. A total of 176 horses (Thoroughbred, Warmblood, and Halla horses) were used at the racing course of the Korea Racing Authority and public horse-riding clubs in South Korea. The present study also compared temperatures among three ROIs of the eye—lacrimal sac, medial canthus, and lateral canthus—at rest. Correlations between ET, rectal temperature (RT), heart rate (HR), and respiratory rate (RR) were assessed. There were no significant correlations between HR, RR or RT; however, among the three ROIs, the temperature of the medial canthus was positively correlated with RT (p < 0.05). Furthermore, the size of ROI was negatively correlated with accuracy of temperature measurement. These results indicate that the most suitable area for ET measurement using IRT in horses is the medial canthus, and it is recommended to use the average temperature of the smallest ROIs (2 × 2 pixels) for temperature analysis. Therefore, this study offers a validated protocol in which ET measured using IRT in the horses is useful as an indicator of welfare. Full article

Recently, logistics platforms that facilitate interaction and the exchange and transaction of information have quickly emerged in the Korean domestic market. In order to further advance the development of logistics platforms into green logistics platforms in which participation in the early stages is not active, appropriate checks and balances are needed so that service providers, users, and platform operators can grow together in green logistics platforms. The purpose of this study is to empirically verify the factors affecting participants’ intentions to use green logistics platforms. Out of the 230 questionnaires distributed from 25 June to 11 July 2019, 14 were excluded from analyses due to unsatisfactory responses, while 216 responses were used for statistical processing. The structural equation model (SEM) was used to test hypotheses in this research. The results showed that the network effect and security factors influenced perceived usefulness, and trust did not affect perceived usefulness. Perceived usefulness also significantly influenced the intention to use green logistics platforms. The results of this study present strategies and directions for the future development of green logistics platforms. Full article

Minor glomerular abnormalities (MGAs) are unclassified glomerular lesions indicated by the presence of minor structural abnormalities that are insufficient for a specific pathological diagnosis. The long-term clinical outcomes and pathogenesis have not been examined. We hypothesized that MGAs would be associated with the deterioration of long-term kidney function and increased urinary mitochondrial DNA (mtDNA) copy numbers. We retrospectively enrolled patients with MGAs, age-/sex-/estimated glomerular filtration rate (eGFR)-matched patients with immunoglobulin A nephropathy (IgAN), and similarly matched healthy controls (MHCs; n = 49 each). We analyzed the time × group interaction effects of the eGFR and compared mean annual eGFR decline rates between the groups. We prospectively enrolled patients with MGAs, age- and sex-matched patients with IgAN, and MHCs (n = 15 each) and compared their urinary mtDNA copy numbers. Compared to the MHC group, the MGA and IgAN groups displayed differences in the time × group effects of eGFR, higher mean annual rates of eGFR decline, and higher urinary mtDNA copy numbers; however, these groups did not significantly differ from each other. The results indicate that MGAs are associated with deteriorating long-term kidney function, and mitochondrial injury, despite few additional pathological changes. We suggest that clinicians conduct close long-term follow-up of patients with MGAs. Full article