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A vision-based gait analysis method using monocular videos was proposed to estimate temporo-spatial gait parameters by leveraging deep learning algorithms. This study aimed to validate vision-based gait analysis using GAITRite as the reference system and analyze relationships between Frontal Assessment Battery (FAB) scores and gait variability measured by vision-based gait analysis in idiopathic normal pressure hydrocephalus (INPH) patients. Gait data from 46 patients were simultaneously collected from the vision-based system utilizing deep learning algorithms and the GAITRite system. There was a strong correlation in 11 gait parameters between our vision-based gait analysis method and the GAITRite gait analysis system. Our results also demonstrated excellent agreement between the two measurement systems for all parameters except stride time variability after the cerebrospinal fluid tap test. Our data showed that stride time and stride length variability measured by the vision-based gait analysis system were correlated with FAB scores. Vision-based gait analysis utilizing deep learning algorithms can provide comparable data to GAITRite when assessing gait dysfunction in INPH. Frontal lobe functions may be associated with gait variability measurements using vision-based gait analysis for INPH patients.

To investigate incidence and distribution of major adverse reproductive health problems related to various kinds of industries in Korea and to compare risks for major reproductive outcomes to assess maternal health in working and non-working women. We requested claim data from the Korean National Health Insurance. We defined reference groups as (1) non-working women and (2) workers in the education field. Women working in each industry were compared with reference groups regarding rates of miscarriage, threatened abortion, preterm labor, and intrauterine growth restriction. Logistic regression was used for multivariate analysis, and age and income adjustment was performed. The percentages of all adverse obstetric outcomes were higher in working women than in non-working women. Working women had higher and statistically significant adjusted odds ratios (ORs) for miscarriage in 18 of the 21 industries. The age and income-adjusted OR for miscarriage for all working women was 1.26 (95% confidence interval, 1.23-1.28). Business facilities management and business support services, manufacturing, human health and social work activities, wholesale and retail trade, and professional, scientific, and technical activities were major industries with higher adjusted ORs for adverse obstetric outcomes. We confirmed that compared to non-working women, working women have a higher risk for adverse pregnancy outcomes. Thus, adverse pregnancy outcomes such as threatened abortion, preterm labor, and intrauterine growth restriction may be associated with working status. This exploratory study identified several industries where in-depth studies are required in future to improve occupational safety in women of reproductive age.

There has been no feasible approach for predicting weight loss after bariatric surgery. This study develops wide and deep learning (WAD), a predictive and explainable artificial intelligence for weight loss after sleeve gastrectomy with medical image and non-image data, such as electronic medical records (EMRs). Prospective data came from 42 patients with sleeve gastrectomy at a university hospital. They were followed for one year after surgery. The dependent variable consisted of three categories: minimal, moderate, and significant change groups, classified based on postoperative percentage total weight loss (%TWL) in body mass index. A pair of 100 images and their non-image data came from each patient, with 4200 pairs from 42 patients in total. A WAD model was trained and tested with 3200 and 1000 pairs, respectively. Here, the WAD model combined a convolutional neural network (CNN) for image data and a linear layer for non-image data (EMR). The study population included 42 patients, with a mean age of 36.6 years (standard deviation SD 11.0) and a female proportion of 58% (26/45). On average, %TWL was 19.1 (SD 2.8), 27.3 (SD 2.2), and 35.1 (SD 4.7) for the minimal, moderate, and significant change groups, respectively. The corresponding accuracy outcomes were 61%, 100%, and 75% for the minimal, moderate, and significant change groups (average 71%). When the minimal and moderate change groups were combined, the accuracy was 100% for the combined group and 75% for the significant change group, with an overall average accuracy of 88%. Baseline HOMA2-B, insulin, and vitamin B12 were major predictors of %TWL. The optimal region of interest for predicting %TWL was found to be the entire cross-section above the diaphragm. In conclusion, WAD is an effective predictive and explainable artificial intelligence for weight loss following sleeve gastrectomy with image and non-image data. The most important predictors of postoperative weight loss were identified as baseline HOMA2-B, insulin, and vitamin B12 levels, while the key region of interest (ROI) in abdominal CT imaging was the entire cross-section located above the diaphragm.

Background Therapeutic hypothermia is one of the neuroprotective strategies that improve neurological outcomes after brain damage in ischemic stroke and traumatic brain injury. Microglial cells become activated following brain injury and play an important role in neuroinflammation and subsequent brain damage. The aim of this study was to determine the time-dependent effects of hypothermia on microglial cell activation and migration, which are accompanied by neuroinflammation. Methods Microglial cells in culture were subjected to mild (33 °C) or moderate (29 °C) hypothermic conditions before, during, or after lipopolysaccharide (LPS) or hypoxic stimulation, and the production of nitric oxide (NO), proinflammatory cytokines, reactive oxygen species, and neurotoxicity was evaluated. Effects of hypothermia on microglial migration were also determined in in vitro as well as in vivo settings. Results Early-, co-, and delayed-hypothermic treatments inhibited microglial production of inflammatory mediators to varying degrees: early treatment was the most efficient, and delayed treatment showed time-dependent effects. Delayed hypothermia also suppressed the mRNA levels of proinflammatory cytokines and iNOS, and attenuated microglial neurotoxicity in microglia-neuron co-cultures. Furthermore, delayed hypothermia reduced microglial migration in the Boyden chamber assay and wound healing assay. In a stab injury model, delayed local hypothermia reduced migration of microglia toward the injury site in the rat brain. Conclusion Taken together, our results indicate that delayed hypothermia is sufficient to attenuate microglial activation and migration, and provide the basis of determining the optimal time window for therapeutic hypothermia. Delayed hypothermia may be neuroprotective by inhibiting microglia-mediated neuroinflammation, indicating the therapeutic potential of post-injury hypothermia for patients with brain damages exhibiting some of the inflammatory components.

Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. Citation: Park C, Kang M-Y, Kim D, Park J, Eom H, Kim E-A (2017) Correction: Prevalence of abortion and adverse pregnancy outcomes among working women in Korea: A cross-sectional study.

Purpose To assess female healthcare workers’ pregnancy complications and outcomes including abortion, fetal screening abnormalities, intrauterine growth retardation (IUGR), and preterm labor using nationwide population data and compare these results with those of the general population in Korea. Methods Korean National Health Insurance (NHI) claim data was used. We choose 3 different reference groups for comparison: (1) dependents of employees insured by NHI, i.e. non-working women, (2) all insured employees, i.e. all working women, and (3) workers in the education division. To compare the groups, logistic regression was used for multivariate analysis after adjusting for age and income level. Results Overall, healthcare workers showed a higher adjusted OR (odds ratio) in almost all obstetrical consequences. Miscarriage, threatened abortion, preterm labor, fetal screening abnormalities, and IUGR showed a higher adjusted OR in the working group than in the non-working group. We also observed similar results in a comparison of both the working groups. Regarding workers in the education division, ORs for obstetrical outcomes were also high, except for preterm labor. Conclusions Health care workers have a higher risk of adverse pregnancy outcomes such as miscarriage, IUGR, and fetal screening abnormalities.

Purpose Occupational risks for reproductive disorders among hairdressers and cosmetologists have been examined in numerous epidemiological studies, although the results of those studies have been inconsistent. Therefore, we conducted a meta-analysis of published studies to evaluate the risks of reproductive disorders among cosmetologists and hairdressers. Methods We searched the MEDLINE, EMBASE, and Cochrane Library databases, as well as the reference lists of relevant publications, to identify studies for our analysis. After careful consideration, 19 eligible studies were included in the meta-analysis. We also performed systematic evaluations of publication bias, heterogeneity, and publication quality. Results Study-specific odds ratios (ORs) were weighted using the inverse of their variance to calculate fixed- and random-effect pooled estimates. The meta-analysis revealed a significantly increased risk of infertility (OR 1.15, 95 % CI 1.03–1.28), fetal death (OR 1.14, 95 % CI 1.04–1.24), and preterm delivery (OR 1.04, 95 % CI 1.00–1.07) among hairdressers and cosmetologists. Conclusion These findings indicate that hairdressers and cosmetologists have a higher risk of reproductive disorders, compared to the general population.

Background An intra-arterial (IA) mechanical thrombectomy has increased the recanalization rates for acute occlusion of proximal intracranial arteries. However, the current failure rate of endovascular recanalization remains at approximately 10 %, resulting in the need for surgical rescue treatment. The authors applied a minimally invasive and rapid surgical embolectomy (MIRSE) as a final rescue treatment after the failure of endovascular recanalization, and investigated the incidence, technical feasibility, and treatment results. Methods For two years, from 2012 to 2013, a total of 131 patients with acute occlusion of proximal intracranial arteries underwent an IA mechanical thrombectomy using a Penumbra System and a Solitaire stent, yet ten (7.6 %) patients still experienced final recanalization failure. Four (40 %) of these ten patients subsequently underwent a MIRSE consisting of a superciliary keyhole approach, arteriotomy to remove the embolus, and arteriotomy repair techniques using aneurysm clips as the final repair material, or a temporary compartmentalizing clip. Results Four patients aged 39 to 78 years with an embolic occlusion in the middle cerebral artery (n = 1) and internal carotid artery (n = 3) were treated using a MIRSE. Complete recanalization was achieved in all four patients, and the time from skin incision to reperfusion was 40–50 minutes. The modified Rankin Scale (mRS) scores at 3 months after surgery were 1 (n = 2), 2 (n = 1), and 3 (n = 1), respectively. Conclusions A MIRSE can be an effective rescue treatment after the failure of endovascular recanalization therapies for acute occlusion of proximal intracranial arteries if the patient is within the therapeutic time window.

Background One of the most difficult procedures through a deep and narrow surgical corridor is tying a knot following microsuturing, even though microvascular suturing is a fundamental technique for neurovascular surgeons. Methods A novel technique replacing the conventional knot-tying method was devised. The proposed clip-knotting technique uses an aneurysm clip to hold both remaining ends of a thread that is sutured in a running manner. Conclusions The proposed clip-knotting technique can facilitate the microsuturing procedure for intracranial arterial repair in a deep and narrow operative field.

Background Interest in radiation-related health problems has been growing with the increase in the number of workers in radiation-related jobs. Although an occupational level of radiation exposure would not likely cause azoospermia, several studies have reported the relation between radiation exposure and azoospermia after accidental or therapeutic radiation exposure. We describe a case of azoospermia in a non-destructive testing (NDT) worker exposed to radiation and discuss the problems of the related monitoring system. Case presentation A 39-year-old man who was childless after 8 years of marriage was diagnosed with azoospermia through medical evaluations, including testicular biopsy. He did not have any abnormal findings on biochemical evaluations, other risk factors, or evidence of congenital azoospermia. He had been working in an NDT facility from 2005 to 2013, attaching and arranging gamma-ray films on the structures and inner spaces of ships. The patient’s thermoluminescent dosimeter (TLD) badge recorded an exposure level of 0.01781 Gy for 80 months, whereas results of his florescence in situ hybridization (FISH) translocation assay showed an exposure level of up to 1.926 Gy of cumulative radiation, which was sufficient to cause azoospermia. Thus, we concluded that his azoospermia was caused by occupational radiation exposure. Conclusion The difference between the exposure dose records measured through TLD badge and the actual exposure dose implies that the monitor used by the NDT worker did not work properly, and such a difference could threaten the health and safety of workers. Thus, to protect the safety and health of NDT workers, education of workers and strengthening of law enforcement are required to ensure that regulations are strictly followed, and if necessary, random sampling of NDT workers using a cytogenetic dosimeter, such as FISH, should be considered.