Detection of tropical overshooting cloud tops using himawari-8 imagery

Overshooting convective cloud Top (OT)-accompanied clouds can cause severe weather conditions, such as lightning, strong winds, and heavy rainfall. The distribution and behavior of OTs can affect regional and global climate systems. In this paper, we propose a new approach for OT detection by using machine learning methods with multiple infrared images and their derived features. Himawari-8 satellite images were used as the main input data, and binary detection (OT or nonOT) with class probability was the output of the machine learning models. Three machine learning techniques-random forest (RF), extremely randomized trees (ERT), and logistic regression (LR)-were used to develop OT classification models to distinguish OT from non-OT. The hindcast validation over the Southeast Asia andWest Pacific regions showed that RF performed best, resulting in a mean probabilities of detection (POD) of 77.06% and a mean false alarm ratio (FAR) of 36.13%. Brightness temperature at 11.2 ??m (Tb11) and its standard deviation (STD) in a 3 ?? 3 window size were identified as the most contributing variables for discriminating OT and nonOT classes. The proposed machine learning-based OT detection algorithms produced promising results comparable to or even better than the existing approaches, which are the infrared window (IRW)-texture and water vapor (WV) minus IRW brightness temperature difference (BTD) methods

Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis

Background/Aims:Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. Methods:Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). Results:The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both p<0.001), and did not differ significantly between the latter two groups (p=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). Conclusions:Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC

Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial

Abstract Background General anesthesia is often necessary for dental treatment of outpatients with mental disabilities. Rapid recovery and effective management of postoperative nausea and vomiting (PONV) are critical for outpatients. This study aimed to investigate the effect of transitioning from propofol to remimazolam with flumazenil reversal administered toward the end of surgery during propofol-based total intravenous anesthesia (TIVA) on recovery. Methods Adults with mental disabilities scheduled to undergo dental treatment were randomly assigned to receive either propofol-based TIVA (Group P) or propofol-remimazolam-based TIVA with flumazenil reversal (Group PR). Propofol was replaced with remimazolam 1 h before the end of surgery in Group PR; moreover, 0.5 mg of flumazenil was administered after the neuromuscular blockade reversal agent. The primary outcome was the duration of stay in the post-anesthesia care unit (PACU). The secondary outcomes included time to eye-opening, time to extubation, occurrence of PONV, and quality of recovery. Results Fifty-four patients were included in this study. The duration of stay in the PACU in Group PR was significantly shorter than that in Group P (mean difference, 8.7 min; confidence interval [95% CI], 3.3–14.2; P = 0.002). Group PR exhibited a shorter time to eye opening (mean difference, 5.4 min; 95% CI, 3.3–8.1; P < 0.001) and time to extubation (mean difference, 5.5 min; 95% CI, 3.6–7.9; P < 0.001) than Group P. Neither group required the administration of rescue analgesics, and the incidence of PONV was not reported. Conclusions Transitioning from propofol to remimazolam 1 h before the end of surgery followed by flumazenil reversal reduced the duration of stay in the PACU and the time to eye opening and extubation without affecting the incidence of PONV and quality of recovery. Trial registration number Clinical Research Information Service (KCT0007794), Clinical trial first registration date: 12/10/2022

Thermodynamic Modeling and Performance Analysis of a Combined Power Generation System Based on HT-PEMFC and ORC

Recently, the need for energy-saving and eco-friendly energy systems is increasing as problems such as rapid climate change and air pollution are getting more serious. While research on a power generation system using hydrogen energy-based fuel cells, which rarely generates harmful substances unlike fossil fuels, is being done, a power generation system that combines fuel cells and Organic Rankine Cycle (ORC) is being recognized. In the case of High Temperature Proton Exchange Membrane Fuel Cell (HT-PEMFC) with an operating temperature of approximately 150 to 200 &deg;C, the importance of a thermal management system increases. It also produces the waste heat energy at a relatively high temperature, so it can be used as a heat source for ORC system. In order to achieve this outcome, waste heat must be used on a limited scale within a certain range of the temperature of the stack coolant. Therefore, it is necessary to utilize the waste heat of ORC system reflecting the stack thermal management and to establish and predict an appropriate operating range. By constructing an analytical model of a combined power generation system of HT-PEMFC and ORC systems, this study compares the stack load and power generation performance and efficiency of the system by operating temperature. In the integrated lumped thermal capacity model, the effects of stack operating temperature and current density, which are important factors affecting the performance change of HT-PEMFC and ORC combined cycle power generation, were compared according to operating conditions. In the comparison of the change in power and waste heat generation of the HT-PEMFC stack, it was shown that the rate of change in power and waste heat generation by the stack operating temperature was clearly changed according to the current density. In the case of the ORC system, changes in the thermal efficiency of the ORC system according to the operating temperature of the stack and the environmental temperature (cooling temperature) of the object to which this system is applied were characteristic. This study is expected to contribute to the establishment of an optimal operation strategy and efficient system configuration according to the subjects of the HT-PEMFC and ORC combined power generation system in the future

Changes of knowledge and practical skills before and after retraining for basic life support: Focused on students of Dental School

Background: Considering the increasing possibility of emergency situations in dental clinics over time, we conducted this study to evaluate the changes in the knowledge and practical skills of students of dental school before and after retraining for 2 years after the initial education on basic life support (BLS) of the American Heart Association (AHA). Methods: All third-year students of dental school who had received the same education on BLS provider training of the AHA 2 years earlier were included in this study. Among them, 98 students were asked to answer a questionnaire about BLS knowledge and conduct a practical skills assessment of high-quality cardiopulmonary resuscitation using Little Anne QCPR before and after retraining. Results: After retraining, the level of BLS knowledge increased in all 7 categories, and BLS performance increased in all 19 subcategories. Comparison of the QCPR numerical data items before and after retraining showed that all items after retraining met the criteria recommended by the AHA. Conclusion: Students of dental school had low levels of knowledge and practical skills of BLS before retraining after 2 years from the initial education and had high levels after retraining. Therefore, BLS training must be updated periodically, and more effective education methods are required to maintain BLS knowledge and practical skills.Y

Cooled radiofrequency ablation of genicular nerves for knee osteoarthritis

Knee osteoarthritis (OA) is a prevalent and debilitating musculoskeletal condition that significantly affects the quality of life of millions of individuals worldwide. In recent years, cooled radiofrequency ablation (CRFA) has become a viable treatment option for knee OA. This review thoroughly evaluated the existing literature on CRFA therapy for knee OA. It delved into the mechanisms behind CRFA, evaluated its clinical efficacy, and investigated potential avenues for future research and application. The insights gained from this review are crucial for healthcare professionals, researchers, and policymakers, offering an updated perspective on CRFA&apos;s role as a viable therapeutic option for knee OA.Y