2.45 GHz Active Isolator based on asymmetric coupler

An active isolator achieving both high isolation and low insertion loss at 2.45 GHz is proposed. The isolator is based on an asymmetric coupler and is designed to leverage the gain and reverse isolation of an amplifier and coupling coefficients between the input and output of the coupler. The insertion loss and isolation of the isolator are enhanced by using the coefficients, and the power level with optimal isolation can be determined for a target specification. The asymmetric coupler increases the power handling capability of the proposed isolator that has a low coupling coefficient and achieves highly efficient isolation with a high coupling coefficient. Electromagnetic-circuit co-simulation results show that the proposed isolator with operation stability has ≥40 dB isolation and <1 dB insertion loss for input power between 0−8 dBm

Emergency endoscopic variceal ligation in cirrhotic patients with blood clots in the stomach but no active bleeding or stigmata increases the risk of rebleeding

Background/Aims This study aimed to evaluate the efficacy and safety of emergency variceal ligation for the prevention of rebleeding in cirrhotic patients who are found on initial endoscopy to have blood clots in the stomach but no actively bleeding esophageal and gastric varices or stigmata. Methods This study included 28 cirrhotic patients who underwent emergency prophylactic EVL and 41 who underwent an elective intervention between January 2009 and June 2014. Clinical outcomes were analyzed, including the rebleeding, 6-week mortality, and rebleeding-free survival rates. Results The rebleeding rate was higher in the emergency than in the elective group (28.6% vs. 7.3%, P=0.041). Multivariate analysis showed that emergency prophylactic EVL (odds ratio [OR] = 7.4, 95% confidence interval [CI]=1.634.8, P=0.012) and Child-Pugh score C (OR=10.6, 95% CI=1.4-80.8, P=0.022) were associated with rebleeding. In the emergency group, the gastric varices were associated with rebleeding (OR=12.0, 95% CI=1.7-83.5, P=0.012). Conclusions Emergency EVL may be associated with variceal rebleeding when blood clots are present in the stomach without active esophageal and gastric variceal bleeding or stigmata. Elective intervention should be considered as a safer strategy for preventing variceal rebleeding in this situation

Bone marrow metastasis presenting as bicytopenia originating from hepatocellular carcinoma

The bone is a common site for metastasis in hepatocellular carcinoma (HCC). However, bone marrow metastasis from HCC is rarely reported, and its frequency is unclear. Here we report a rare case of bone marrow metastasis that presented as bicytopenia originating from HCC without bone metastasis. A 58-year-old man was admitted for investigation of a liver mass with extensive lymph node enlargement that was detected when examining his general weakness and weight loss. Laboratory findings revealed anemia, thrombocytopenia, mild elevated liver enzymes, normal prothrombin time percentage and high levels of tumor markers (α-fetoprotein and des-γ-carboxyprothrombin). Abdominal computed tomography showed multiple enhanced masses in the liver and multiple enlarged lymph nodes in the abdomen. A bone marrow biopsy revealed only a few normal hematopoietic cells and abundant tumor cells. Despite its rarity, bone marrow metastasis should always be suspected in HCC patients even if accompanied by cirrhosis

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

Environmental Pyrethroid Exposure and Cognitive Dysfunction in U.S. Older Adults: The NHANES 2001–2002

Pyrethroid compounds are widely used in household insecticides and agricultural pesticides. Recent studies, however, report that pyrethroid exposures affect neurobehavioral function in animals and may be associated with adverse neurocognitive development in children. This study aimed to examine the association between pyrethroid exposure and cognitive dysfunction in older adults using a well-defined general population. We analyzed data from 336 individuals, aged 60–84 years, who participated in the National Health and Nutrition Examination Survey 2001–2002. We used urinary 3-phenoxybenzoic acid (3-PBA) concentration as a biomarker of pyrethroid exposures and assessed cognitive function with the digit–symbol coding test. The geometric means (±geometric standard errors) of creatinine-uncorrected and corrected urinary 3-PBA were 0.30 (±0.87) μg/L and 0.36 (±0.89) μg/g. After adjusting for sociodemographic factors, higher 3-PBA concentrations (&gt; vs. ≤0.30 μg/g creatinine (median)) were associated with lower scores of cognitive function (−3.83 95% confidence interval: −7.11, −0.54). Significance was persistent after additionally adjusting for physical activity and smoking pack-year (−3.76 95% CI: −7.16, −0.36) and further adjusting for BMI and presence of hypertension and diabetes (−3.82 95% CI: −6.92, −0.71). Our findings suggest that pyrethroid exposure is associated with cognitive dysfunction in older adults

Genetical identification and morphological description of the larvae and juveniles of Porocottus leptosomus (Pisces: Cottidae) from Korea

Abstract The larvae and juveniles of Porocottus leptosomus belonging to the family Cottidae were collected (n = 95, 3.9–16.5 mm in body length, BL) from Busan, Korea, in March 2015. The larvae and juvenile were identified using DNA barcoding as P. leptosomus, and their morphological description was presented in detail. The yolk-sac larvae (3.9–5.6 mm BL) body was slightly compressed, the head was large, the eye was round and large, and the anus was before the middle of the body. The preflexion larvae (5.2–10.0 mm BL) body length drastically increased; caudal fin rays began to occur. The flexion larvae (9.4–11.8 mm BL) notochord flexion started; dorsal, pectoral, and anal fin rays began to occur; pelvic fin buds are seen; they possessed a pair of parietal spine; and a pair of supraocular cirri was first to develop. At 12 mm BL, the notochord was completely flexed. The larva stage (3.9–12.6 mm SL) had the stellate melanophores in the head, isthmus, gut, and tail (along to the ventral midline). During the juvenile stage (11.4–16.5 mm BL), melanophores covered the head and began to form five black bands on the side of the body. The larvae of P. leptosomus spent pelagic life, but moved to the bottom during the juvenile stage. The larvae and juveniles of P. leptosomus differ from other cottid larval fishes by body shape, melanophore head pattern, and spine development. P. leptosomus can be distinguished from Porocottus allisi by morphological development and the occurrence of larval fish: preopercular spine development, melanophore pattern, and caudal fin development

The antipyretic efficacy and safety of propacetamol compared with dexibuprofen in febrile children: a multicenter, randomized, double-blind, comparative, phase 3 clinical trial

Abstract Background We aimed to compare the antipyretic efficacy, safety, and tolerability between oral dexibuprofen and intravenous propacetamol in children with upper respiratory tract infection (URTI) presenting with fever. Methods Patients aging from 6 months to 14 years admitted for URTI with axillary body temperature ≥ 38.0 °C were enrolled and randomized into the study or control group. Patients in the study group were intravenously infused with propacetamol and subsequently oral placebo medication was administered. Patients in the control group were intravenously infused with 100 mL of 0.9% sodium chloride solution without propacetamol and then oral dexibuprofen was administered. We checked the body temperature of all patients at 0.5 h (hr), 1 h, 1.5 h, 2 h, 3 h, 4 h, and 6 h after oral placebo or dexibuprofen had been applied. Results A total of 263 patients (125 in the study group) were finally enrolled. The body temperatures of patients in the study group were significantly lower until 2 h after administration (37.73 ± 0.58 vs 38.36 ± 0.69 °C (p < 0.001), 37.37 ± 0.53 vs 37.88 ± 0.69 °C (p < 0.001), 37.27 ± 0.60 vs 37.62 ± 0.66 °C (p < 0.001), 37.25 ± 0.62 vs 37.40 ± 0.60 °C (p = 0.0452), at 0.5 h, 1 h, 1.5 h, and 2 h, respectively). The two groups showed no significant differences in terms of the range of body temperature decrease, the Area Under the Curve of body temperature change for antipyretic administration-and-time relationship, the maximum value of body temperature decrease during the 6 h test period, the number of patients whose body temperature normalized (< 37.0 °C), the mean time when first normalization of body temperature, and the development of adverse events including gastrointestinal problem, elevated liver enzyme, and thrombocytopenia. Conclusions Intravenous propacetamol may be a safe and effective choice for pediatric URTI patients presenting with fever who are not able to take oral medications or need faster fever control. Trial registration CRIS KCT0002888. Date of registration: July 31st, 2013

Risk factors of emergency reoperations

Background Emergency reoperation is considered to be a quality indicator in surgery. We analyzed the risk factors for emergency reoperations. Methods Patients who underwent emergency operations from January 1, 2017, to December 31, 2017, at our hospital were reviewed in this retrospective study. Multivariate logistic regression was performed for the perioperative risk factors for emergency reoperation. Results A total of 1,481 patients underwent emergency operations during the study period. Among them, 79 patients received emergency reoperations. The variables related to emergency reoperation included surgeries involving intracranial and intraoral lesions, highest mean arterial pressure ≥ 110 mmHg, highest heart rate ≥ 100 beats/min, anemia, duration of operation >120 min, and arrival from the intensive care unit (ICU). Conclusions The type of surgery, hemodynamics, hemoglobin values, the duration of surgery, and arrival from ICU were associated with emergency reoperations

Cohort Profile: The Korean Vietnam War Veterans&rsquo; Health Study Cohort (KOVECO)

During the Vietnam War, many troops and citizen were exposed to large amounts of Agent Orange (AO), and the hazardous effects of AO are continuously being researched and reported. The Korean Vietnam War Veterans&rsquo; Health Study Cohort (KOVECO) is a retrospective cohort to demonstrate the health status of the Korean Vietnam War veterans and their second-generation offsprings. The KOVECO is a collaboration of data from the Ministry of Patriots and Veterans Affairs and the National Health Insurance Sharing Service from 2002 to 2018. The study participants were all Korean Vietnam War veterans and their second-generation offsprings, and the references were the general population in which gender and region were matched with the participants. As of 2002, 191,272 Vietnam War veterans (1,000,320 comparisons) and 1,963,402 s-generations (1,173,061 references) were included in the cohort. The KOVECO consists of personal information, medical facility visit information, and general health examination information. The KOVECO could act as a health surveillance system, which would be able to detect long-term health effects caused by exposure to AO and provide a direction for policy making through academic research