Surgical techniques for early-stage thymoma: Video-assisted thoracoscopic thymectomy versus transsternal thymectomy

ObjectiveThe present study compared the outcomes between patients who had undergone video-assisted thoracoscopic surgery (VATS) thymectomy and transsternal (TS) thymectomy for Masaoka stage I and II thymoma.MethodsThe outcomes of 262 patients without myasthenia gravis who had undergone surgery for Masaoka stage I and II thymoma from January 2008 to December 2012 at our center were retrospectively evaluated. The study included 125 patients who had undergone unilateral VATS thymectomy (VATS group) and 137 patients who had undergone TS thymectomy (TS group).ResultsThe VATS group had a shorter operative time than the TS group (170 vs 210 minutes, P < .001). The VATS group also had a smaller intraoperative blood loss (200 vs 450 mL, P < .001), smaller pleural drainage volume in the first 24 hours postoperatively (300 vs 500 mL, P < .0010), shorter postoperative pleural drainage duration (3 vs 5 days, P < .001), and shorter postoperative hospital stay (8 vs 10 days, P < .001). Four patients in the VATS group underwent conversion to open surgery because of injury to the innominate vein. The postoperative complication rate was similar between the 2 groups. One patient in the VATS group developed pleural recurrence, and one in the TS group developed local recurrence.ConclusionsUnilateral VATS thymectomy for Masaoka stage I and II thymoma is technically feasible and safe and is less invasive than TS thymectomy, with a shorter duration of surgery, less intraoperative blood loss, less postoperative pleural drainage, shorter postoperative pleural drainage duration, and shorter postoperative hospital stay. We have concluded that it is preferable to perform VATS thymectomy, although perhaps under certain circumstances sternotomy might be preferred. The oncologic outcomes were comparable between the 2 procedures. Additional follow-up is required to evaluate the long-term outcomes

Effect of sarcopenia on survival of patients with cirrhosis: A meta-analysis

The association between sarcopenia and prognosis in patients with cirrhosis remains to be determined. In this study, we aimed to quantify the association between sarcopenia and the risk of mortality in patients with cirrhosis, by sex, underlying liver disease etiology, and severity of hepatic dysfunction.PubMed, Web of Science, EMBASE, and major scientific conference sessions were searched without language restriction through 13 January 2021 with additional manual search of bibliographies of relevant articles. Cohort studies of ?100 patients with cirrhosis and ?12 months of follow-up that evaluated the association between sarcopenia, muscle mass and the risk of mortality were included.22 studies with 6965 patients with cirrhosis were included. The pooled prevalence of sarcopenia in patients with cirrhosis was 37.5% overall (95% CI 32.4%-42.8%), higher in male patients, patients with alcohol associated liver disease (ALD), patients with CTP grade C, and when sarcopenia was defined in patients by lumbar 3- skeletal muscle index (L3-SMI). Sarcopenia was associated with the increased risk of mortality in patients with cirrhosis (adjusted-hazard ratio [aHR] 2.30, 95% CI 2.01-2.63), with similar findings in sensitivity analysis of cirrhosis patients without HCC (aHR 2.35, 95% CI 1.95-2.83) and in subgroup analysis by sex, liver disease etiology, and severity of hepatic dysfunction. The association between quantitative muscle mass index and mortality further supports the poor prognosis for patients with sarcopenia (aHR 0.95, 95% CI 0.93-0.98). There was no significant heterogeneity in all analyses.Sarcopenia was highly and independently associated with higher risk of mortality in patients with cirrhosis.The prevalence of sarcopenia and its association with death in patients with cirrhosis remain unclear. This meta-analysis indicated that sarcopenia affected about one-third of patients with cirrhosis and up to 50% in patients with ALD or Child's class C cirrhosis. Sarcopenia was independently associated with about 2-fold higher risk of mortality in patients with cirrhosis. The mortality rate increased with greater severity or longer period of having sarcopenia. Increasing awareness about the importance of sarcopenia in patients with cirrhosis among stakeholders must be prioritized

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Facial Gestures for Infotainment Systems

The long term purpose of this project is to reduce the attention demand of drivers whenusing infotainment systems in a car setting. With the development of the car industry,a contradiction between safety issue and entertainment demands in cars has arisen.Speech-recognition-based controls meet their bottleneck in the presence of backgroundaudio (such as engine noise, other passengers speech and/or the infotainment systemitself). We propose a new method to control the infotainment system using computervision technology in this thesis. This project uses algorithms of object detection, opticalflow(estimated motion) and feature analysis to build a communication channel betweenhuman and machine. By tracking the driver’s head and measuring the optical flow overthe lip region, the driver’s mouth feature can be indicated. Performance concerning theefficiency and accuracy of the system is analyzed. The contribution of this thesis is toprovide a method using facial gestures to communicate with the system, and we focuson the movement of lips especially. This method offers a possibility to create a new modeof interaction between human and machine

Study of the Interaction of Dissolved Organic Carbon, Available Nutrients, and Clay Content Driving Soil Carbon Storage in the Rice Rotation Cropping System in Northern Thailand

The appropriate management of crop residues in a rice rotation cropping system (RRCS) can promote carbon storage and contribute to soil health. The objective of this study was to determine and analyze the amount of organic carbon in the soil, the amount of labile carbon in a dissolved state in the soil, and the physicochemical properties of the soil and their relationship with soil organic carbon dynamics under the RRCS in northern Thailand. The RRCS can be divided into the following four categories by pattern: (1) Rice_F (rice (Oryza sativa) followed by a fallow period); (2) Rice_S (rice followed by shallots (Allium cepa L.); (3) Rice_Mixed crop (rice followed by tobacco (Nicotiana tabacum), vegetables, or maize (Zea mays)); and (4) Rice_P (rice followed by potatoes (Solanum tuberosum)). These patterns can be classified according to the dissolved organic carbon (DOC), the availability of nutrients from fertilization, and clay contents. In our study, the Rice-F and Rice-S patterns led to higher soil organic carbon (SOC) and dissolved organic carbon (DOC) in the soil, but when the Rice-P pattern was followed, the soil had a lower clay content, lower available phosphorus (Avail P), the lowest DOC, and high contents of calcium (Ca2+) and magnesium (Mg2+). This study also revealed that on the basis of relationships, clay content, Avail P, and DOC were the most important factors for the formation of SOC, while Ca2+ and Mg2+ were the subordinate factors for the decreased formation of SOC and carbon storage when the RRCS was followed. In addition, low SOC/clay when the Rice-P pattern was followed could reflect carbon saturation, while the percentages of DOC/SOC could indicate the decomposition and formation of SOC

Effects of Shoulder Taping on Discomfort and Electromyographic Responses of the Neck While Texting on a Touchscreen Smartphone

Background: Prolonged neck flexion during smartphone use is known as a factor of neck pain and alteration of neck muscle activity. Studies on the effects of shoulder taping on neck discomfort and neck muscle responses while texting on a smartphone are still lacking. The aim of this study was to examine the effects of shoulder taping on neck discomfort using a numerical rating scale, and neck muscle activity and fatigue using a surface electromyography during a texting task on a touchscreen smartphone. Methods: Twenty-five healthy adolescents used the dominant hand to perform a 30-minute texting task using a touchscreen smartphone at two separate times under one of the following two conditions: taping across the upper trapezius muscle and no taping. Neck discomfort, normalized root mean square, and normalized median frequency slopes for upper trapezius, cervical erector spinae, and sternocleidomastoid muscles were recorded. Results: The results revealed that shoulder taping provided significantly lower neck discomfort than no taping (p < 0.001). However, shoulder taping did not significantly alter normalized root mean square and normalized median frequency slope values of all muscles when compared with no taping controls. Conclusion: Shoulder taping reduces neck discomfort but does not affect neck muscle activity and fatigue while texting on a touchscreen smartphone. Keywords: Muscle activity, Muscle fatigue, Neck discomfort, Shoulder taping, Smartphon