Objective: : Patients with traumatic brain injury (TBI) commonly exhibit a poor mental health status and can easily develop aspiration pneumonia. Thus, early proper nutrition through oral or tube feeding is difficult to achieve, leading to malnutrition. However, evidence regarding early nutritional support in the intensive care unit (ICU) is lacking. We aimed to assess the effect of early nutrition in patients with TBI admitted to the ICU. Methods: : Data of adult patients with TBI admitted to the trauma ICU of a regional trauma center in Korea between 2022 and 2023 were retrospectively analyzed. Those with ICU stay <7 days, younger than 18 years, and with underlying diseases that could alter baseline metabolism, were excluded. Nutritional support on day 4 of ICU admission was measured. The patients were classified into mortality and survival groups, and risk factors for mortality were evaluated. Subgroup analyses were performed based on TBI severity. Results: : Overall, 864 patients were diagnosed with acute TBI, of whom 227 were included in this study. The mortality rate in the study population was 15% (n=34). Those in the survival group were younger, had longer hospital stays, had a higher initial Glasglow coma scale (GCS) score, and had a higher intake of calorie supplements than those in the mortality group. In a subgroup analysis of patients with non-severe TBI (GCS >8), total calorie intake (751.4 vs. 434.2 kcal, p=0.029), total protein intake (37.5 vs. 22.1 g, p=0.045), and ratio of supplied to target calories (0.49 vs. 0.30, p=0.047) were higher in the survival group than in the mortality group. Logistic regression analysis revealed that calorie intake (B=-0.002, p=0.040) and initial hemoglobin level (B=-0.394, p=0.005) were risk factors for mortality in patients with non-severe TBI. Conclusion : More calories were supplied to the survival group than the mortality group among patients with TBI. Additionally, logistic regression analysis showed that increased calorie supply was associated with reduced mortality in patients with non-severe TBI. The mortality group had low protein intake; however, this did not emerge as a risk factor for mortality. Early sufficient nutritional support improves the prognosis of patients with TBI.

Objective: : Patients with traumatic brain injury (TBI) commonly exhibit a poor mental health status and can easily develop aspiration pneumonia. Thus, early proper nutrition through oral or tube feeding is difficult to achieve, leading to malnutrition. However, evidence regarding early nutritional support in the intensive care unit (ICU) is lacking. We aimed to assess the effect of early nutrition in patients with TBI admitted to the ICU. Methods: : Data of adult patients with TBI admitted to the trauma ICU of a regional trauma center in Korea between 2022 and 2023 were retrospectively analyzed. Those with ICU stay <7 days, younger than 18 years, and with underlying diseases that could alter baseline metabolism, were excluded. Nutritional support on day 4 of ICU admission was measured. The patients were classified into mortality and survival groups, and risk factors for mortality were evaluated. Subgroup analyses were performed based on TBI severity. Results: : Overall, 864 patients were diagnosed with acute TBI, of whom 227 were included in this study. The mortality rate in the study population was 15% (n=34). Those in the survival group were younger, had longer hospital stays, had a higher initial Glasglow coma scale (GCS) score, and had a higher intake of calorie supplements than those in the mortality group. In a subgroup analysis of patients with non-severe TBI (GCS >8), total calorie intake (751.4 vs. 434.2 kcal, p=0.029), total protein intake (37.5 vs. 22.1 g, p=0.045), and ratio of supplied to target calories (0.49 vs. 0.30, p=0.047) were higher in the survival group than in the mortality group. Logistic regression analysis revealed that calorie intake (B=-0.002, p=0.040) and initial hemoglobin level (B=-0.394, p=0.005) were risk factors for mortality in patients with non-severe TBI. Conclusion : More calories were supplied to the survival group than the mortality group among patients with TBI. Additionally, logistic regression analysis showed that increased calorie supply was associated with reduced mortality in patients with non-severe TBI. The mortality group had low protein intake; however, this did not emerge as a risk factor for mortality. Early sufficient nutritional support improves the prognosis of patients with TBI.

Objective: Patients with severe symptomatic aortic stenosis are assessed for coronary artery disease (CAD) prior to transcatheter aortic valve implantation (TAVI) with treatment implications. Invasive coronary angiography (ICA) is the recommended modality but is associated with peri-procedural complications. Integrating machine learning (ML)-based computed tomography-derived fractional flow reserve (CT-FFR) into existing TAVI-planning CT protocol may aid exclusion of significant CAD and thus avoiding ICA in selected patients. Materials and Methods: A single-center, retrospective study was conducted, 41 TAVI candidates with both TAVI-planning CT and ICA performed were analyzed. CT datasets were evaluated by a ML-based CT-FFR software. Beta-blocker and nitroglycerin were not administered in these patients. The primary outcome was to identify significant CAD. The diagnostic performance of CT-FFR was compared against ICA. Results: On per-patient level, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 89%, 94%, 80%, 97% and 93%, respectively. On per-vessel level, the sensitivity, specificity, PPV, NPV and diagnostic accuracy were 75%, 94%, 67%, 96% and 92%, respectively. The area under the receiver operative characteristics curve per individual coronary vessels yielded overall 0.90 (95% confidence interval 85%–95%). ICA may be avoided in up to 80% of patients if CT-FFR results were negative. Conclusion ML-based CT-FFR can provide accurate screening capabilities for significant CAD thus avoiding ICA. Its integration to existing TAVI-planning CT is feasible with the potential of improving the safety and efficiency of pre-TAVI CAD assessment.

Objective: : Patients with traumatic brain injury (TBI) commonly exhibit a poor mental health status and can easily develop aspiration pneumonia. Thus, early proper nutrition through oral or tube feeding is difficult to achieve, leading to malnutrition. However, evidence regarding early nutritional support in the intensive care unit (ICU) is lacking. We aimed to assess the effect of early nutrition in patients with TBI admitted to the ICU. Methods: : Data of adult patients with TBI admitted to the trauma ICU of a regional trauma center in Korea between 2022 and 2023 were retrospectively analyzed. Those with ICU stay <7 days, younger than 18 years, and with underlying diseases that could alter baseline metabolism, were excluded. Nutritional support on day 4 of ICU admission was measured. The patients were classified into mortality and survival groups, and risk factors for mortality were evaluated. Subgroup analyses were performed based on TBI severity. Results: : Overall, 864 patients were diagnosed with acute TBI, of whom 227 were included in this study. The mortality rate in the study population was 15% (n=34). Those in the survival group were younger, had longer hospital stays, had a higher initial Glasglow coma scale (GCS) score, and had a higher intake of calorie supplements than those in the mortality group. In a subgroup analysis of patients with non-severe TBI (GCS >8), total calorie intake (751.4 vs. 434.2 kcal, p=0.029), total protein intake (37.5 vs. 22.1 g, p=0.045), and ratio of supplied to target calories (0.49 vs. 0.30, p=0.047) were higher in the survival group than in the mortality group. Logistic regression analysis revealed that calorie intake (B=-0.002, p=0.040) and initial hemoglobin level (B=-0.394, p=0.005) were risk factors for mortality in patients with non-severe TBI. Conclusion : More calories were supplied to the survival group than the mortality group among patients with TBI. Additionally, logistic regression analysis showed that increased calorie supply was associated with reduced mortality in patients with non-severe TBI. The mortality group had low protein intake; however, this did not emerge as a risk factor for mortality. Early sufficient nutritional support improves the prognosis of patients with TBI.

Objective: : Patients with traumatic brain injury (TBI) commonly exhibit a poor mental health status and can easily develop aspiration pneumonia. Thus, early proper nutrition through oral or tube feeding is difficult to achieve, leading to malnutrition. However, evidence regarding early nutritional support in the intensive care unit (ICU) is lacking. We aimed to assess the effect of early nutrition in patients with TBI admitted to the ICU. Methods: : Data of adult patients with TBI admitted to the trauma ICU of a regional trauma center in Korea between 2022 and 2023 were retrospectively analyzed. Those with ICU stay <7 days, younger than 18 years, and with underlying diseases that could alter baseline metabolism, were excluded. Nutritional support on day 4 of ICU admission was measured. The patients were classified into mortality and survival groups, and risk factors for mortality were evaluated. Subgroup analyses were performed based on TBI severity. Results: : Overall, 864 patients were diagnosed with acute TBI, of whom 227 were included in this study. The mortality rate in the study population was 15% (n=34). Those in the survival group were younger, had longer hospital stays, had a higher initial Glasglow coma scale (GCS) score, and had a higher intake of calorie supplements than those in the mortality group. In a subgroup analysis of patients with non-severe TBI (GCS >8), total calorie intake (751.4 vs. 434.2 kcal, p=0.029), total protein intake (37.5 vs. 22.1 g, p=0.045), and ratio of supplied to target calories (0.49 vs. 0.30, p=0.047) were higher in the survival group than in the mortality group. Logistic regression analysis revealed that calorie intake (B=-0.002, p=0.040) and initial hemoglobin level (B=-0.394, p=0.005) were risk factors for mortality in patients with non-severe TBI. Conclusion : More calories were supplied to the survival group than the mortality group among patients with TBI. Additionally, logistic regression analysis showed that increased calorie supply was associated with reduced mortality in patients with non-severe TBI. The mortality group had low protein intake; however, this did not emerge as a risk factor for mortality. Early sufficient nutritional support improves the prognosis of patients with TBI.

Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.

Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.

Medication-related osteonecrosis of the jaw (MRONJ) is a refractory disease that can lead to severe destruction of the jaw. As there is no standard protocol for treating MRONJ, various treatments have been studied. Teriparatide has been used as an adjunct therapy for MRONJ. However, its effectiveness has not been sufficiently demonstrated for use as a standard treatment for MRONJ. This study aimed to demonstrate the efficacy of teriparatide in treating MRONJ by presenting two successfully treated cases. Each patient received teriparatide therapy with surgical intervention. The appropriateness of teriparatide use was evaluated based on the patient’s systemic condition, and the administration of teriparatide was supervised by a physician.Complete resolution of the lesion was observed clinically and radiographically in both patients. The first patient underwent implant placement at the lesion site. Due to its anabolic properties and ability to stimulate bone remodeling, teriparatide is an effective adjunctive pharmacological treatment for bone healing before and after surgery with associated beneficial effects on bone and mucosal healing.

Medication-related osteonecrosis of the jaw (MRONJ) is a refractory disease that can lead to severe destruction of the jaw. As there is no standard protocol for treating MRONJ, various treatments have been studied. Teriparatide has been used as an adjunct therapy for MRONJ. However, its effectiveness has not been sufficiently demonstrated for use as a standard treatment for MRONJ. This study aimed to demonstrate the efficacy of teriparatide in treating MRONJ by presenting two successfully treated cases. Each patient received teriparatide therapy with surgical intervention. The appropriateness of teriparatide use was evaluated based on the patient’s systemic condition, and the administration of teriparatide was supervised by a physician.Complete resolution of the lesion was observed clinically and radiographically in both patients. The first patient underwent implant placement at the lesion site. Due to its anabolic properties and ability to stimulate bone remodeling, teriparatide is an effective adjunctive pharmacological treatment for bone healing before and after surgery with associated beneficial effects on bone and mucosal healing.

Objective: This study aims to develop a practical procedure to assess retired Thoroughbreds for their suitability for equestrian sports or leisure purposes and to assess if horses identified as having reactive temperaments in response to a standardized startle test, will have improved test results following a period of transition training. Methods: Behavioral reactivity data and cardiac autonomic responses to a startle test (comprising of a plastic bag applied to the neck area) were collected from twelve retired Thoroughbred racehorses (6 males and 6 females; average age: 4.33 ± 0.89 years old; average body weight 465.17 ± 25.33 kg), before and after the three-month transition training for equestrian sports. A priori power calculation indicated a requirement of 12 individuals for a power of 80%. Results: Following the training, there was a significant reduction in the behavioral score (BS), peak heart rate (HR), and response duration (RD) of all horses compared to their pre-training scores. However, 25% of horses (3/12) retained a BS of 2 or above post-training, exhibiting significantly higher peak HR and longer RD compared to those with a BS below 2.Post-training, the females demonstrated a significant increase in the root mean square of the successive differences between normal heartbeats compared to their pre-training levels. Conclusions and Relevance: Transition training of retired Thoroughbreds can assist in improving horses' suitability for equestrian sports, based on their successive responses to a novel startle test.