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To identify the differences between COVID-19-associated and non-COVID-19-associated olfactory dysfunction (OD), we analyzed demographic and clinical characteristics based on the causative virus (COVID versus non-COVID groups) in patients with post-infectious olfactory dysfunction (PIOD) who underwent the olfactory questionnaire and olfactory function test. Out of 169 patients with PIOD, 99 were diagnosed with COVID-19 (COVID group), while 70 were not (non-COVID group). The COVID group was younger and had a higher percentage of male patients as well as patients with parosmia than the non-COVID group. In the initial olfactory function tests, the TDI, discrimination and identification scores were significantly higher in the COVID group than in the non-COVID group. TDI scores were significantly increased in patients with PIOD after treatment, regardless of the group. The threshold score was significantly increased by 1.38 in the COVID group while the identification score was significantly increased by 2.67 in the non-COVID group. Patients with COVID-19-associated OD were younger in age, tended to be male, had a higher incidence of parosmia, and had better initial olfactory function test results compared to those with non-COVID-19-associated OD. Following treatment, odor detection threshold improved in the COVID group, whereas odor identification improved in the non-COVID group.
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COVID-19 , Trastornos del Olfato , SARS-CoV-2 , Humanos , COVID-19/complicaciones , Masculino , Persona de Mediana Edad , Trastornos del Olfato/etiología , Trastornos del Olfato/virología , Femenino , Anciano , Adulto , SARS-CoV-2/aislamiento & purificación , Olfato/fisiología , Encuestas y CuestionariosRESUMEN
This study aimed to investigate the impact of different types of nasal inflammation on the regulation of entry-associated genes of respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV), human coronavirus 229E (HCoV-229E), and influenza virus, in the nasal epithelium. Subjects were classified into three groups: control, eosinophilic chronic rhinosinusitis (ECRS), and noneosinophilic CRS (NECRS) groups. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), alanyl aminopeptidase (ANPEP), dipeptidyl peptidase 4 (DPP4), and beta-galactoside alpha-2,6-sialyltransferase 1 (ST6GAL1), and beta-galactoside alpha-2,3-sialyltransferase 4 (ST3GAL4) were selected as key entry-associated genes for SARS-CoV-2, HCoV-229E, MERS-CoV, and influenza, respectively, and were evaluated. Brushing samples obtained from each group and human nasal epithelial cells cultured using an air-liquid interface system were treated for 7 days with typical inflammatory cytokines and analyzed using real-time polymerase chain reaction. Western blot analysis and confocal microscopy were performed. The entry-associated genes showed distinct regulation patterns in response to each interleukin-4 (IL-4), interleukin-13 (IL-13), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). Specifically, ACE2 significantly decreased in type 2 cytokines (IL-4 and IL-13), while TMPRSS2 significantly decreased in type 1 cytokines (TNF-α and IFN-γ). ANPEP significantly decreased in both types of cytokines. Remarkably, DPP4 significantly increased in type 2 cytokines and decreased in type 1 cytokines. Moreover, ST6GAL1 and ST3GAL4 significantly increased in type 2 cytokines and decreased in type 1 cytokines, particularly IFN-γ. These findings were supported by western blot analysis and confocal imaging results, especially for ACE2 and DPP4. The findings regarding differential regulation suggest that patients with ECRS, primarily mediated by type 2 inflammation, may have lower susceptibility to SARS-CoV-2 and HCoV-229E infections but higher susceptibility to MERS-CoV and influenza infections.
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Citocinas , Mucosa Nasal , Internalización del Virus , Humanos , Citocinas/genética , Citocinas/metabolismo , Mucosa Nasal/virología , Adulto , Masculino , Femenino , Persona de Mediana Edad , Enzima Convertidora de Angiotensina 2/genética , Enzima Convertidora de Angiotensina 2/metabolismo , Sinusitis/virología , Sinusitis/genética , Sinusitis/inmunología , SARS-CoV-2/inmunología , Rinitis/virología , Rinitis/genética , Rinitis/inmunología , Regulación de la Expresión Génica , Serina Endopeptidasas/genética , Serina Endopeptidasas/metabolismo , COVID-19/inmunología , COVID-19/virología , Coronavirus Humano 229E/genética , Dipeptidil Peptidasa 4/genética , Dipeptidil Peptidasa 4/metabolismo , Coronavirus del Síndrome Respiratorio de Oriente Medio/genética , Coronavirus del Síndrome Respiratorio de Oriente Medio/inmunologíaRESUMEN
The optically tuneable nature of hybrid organic/inorganic heterostructures tailored by interfacing photochromic molecules with 2D semiconductors (2DSs) can be exploited to endow multi-responsiveness to the exceptional physical properties of 2DSs. In this study, a spiropyran-molybdenum disulfide (MoS2) light-switchable bi-functional field-effect transistor is realized. The spiropyran-merocyanine reversible photo-isomerization has been employed to remotely control both the electron transport and wettability of the hybrid structure. This manipulation is instrumental for tuning the sensitivity in humidity sensing. The hybrid organic/inorganic heterostructure is subjected to humidity testing, demonstrating its ability to accurately monitor relative humidity (RH) across a range of 10%-75%. The electrical output shows good sensitivity of 1.0% · (%) RH-1. The light-controlled modulation of the sensitivity in chemical sensors can significantly improve their selectivity, versatility, and overall performance in chemical sensing.
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Conventional anticancer therapies, including surgical resection, radiation, and chemotherapy, are the primary modalities for treating various forms of cancer. However, these treatments often bring significant side effects and risk of recurrence, underscoring the need for more targeted and less invasive therapeutic options. To address this challenge, we developed an adhesive nanoparticle (NP)-based effective anticancer photothermal therapy (PTT) system using bioengineered mussel adhesion protein (MAP). The unique underwater tissue adhesive properties of MAP NPs enabled targeted delivery and prolonged retention at the tumor site, thereby improving therapeutic efficacy. Our innovative indocyanine green (ICG)-loaded MAP NPs (MAP@ICG NPs) demonstrated strong photothermal capability and stability, and potent anticancer activity in vitro. In vivo intratumor injection of the MAP@ICG NPs showed remarkable anticancer PTT effects, effectively reducing tumor growth with minimal damage to surrounding tissues. The development and utilization of this adhesive proteinic NP-based PTT system represent a significant advancement in cancer therapy, offering a promising alternative that combines the precision of NP delivery with effective therapeutic efficacy.
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Verde de Indocianina , Nanopartículas , Terapia Fototérmica , Verde de Indocianina/química , Verde de Indocianina/administración & dosificación , Animales , Nanopartículas/química , Ratones , Humanos , Terapia Fototérmica/métodos , Proteínas/química , Proteínas/administración & dosificación , Línea Celular Tumoral , Neoplasias/terapia , Neoplasias/tratamiento farmacológico , Neoplasias/patología , Femenino , Ratones Endogámicos BALB C , Ratones Desnudos , Antineoplásicos/farmacología , Antineoplásicos/química , Antineoplásicos/administración & dosificaciónRESUMEN
Virus-specific nasal resident T cells are important for protection against subsequent infection with a similar virus. Here we examine the phenotypes and functions of SARS-CoV-2-specific T cells in the nasal mucosa of vaccinated individuals with breakthrough infection (BTI) or without infection. Nasal tissues are obtained from participants during sinus surgery. Analysis of activation-induced markers implicates that a considerable proportion of spike (S)-reactive nasal CD8+ T cells express CD103, a tissue-resident marker. MHC-I multimer staining is performed to analyze the ex vivo phenotype and function of SARS-CoV-2 S-specific CD8+ T cells. We detect multimer+CD8+ T cells with tissue-resident phenotypes in nasal tissue samples from vaccinees without infection as well as vaccinees with BTI. Multimer+CD8+ T cells remain present in nasal tissues over one year after the last exposure to S antigen, although the frequency decreases. Upon direct ex vivo stimulation with epitope peptides, nasal multimer+CD8+ T cells-particularly the CD49a+ subset-exhibit immediate effector functions, including IFN-γ production. CITE-seq analysis of S-reactive AIM+CD8+ T cells confirms the enhanced effector function of the CD49a+ subset. These findings indicate that among individuals previously exposed to S antigen by vaccination or BTI, S-specific nasal-resident CD49a+CD8+ memory T cells can rapidly respond to SARS-CoV-2 during infection or reinfection.
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Linfocitos T CD8-positivos , COVID-19 , Interferón gamma , Células T de Memoria , Mucosa Nasal , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , Humanos , Glicoproteína de la Espiga del Coronavirus/inmunología , Linfocitos T CD8-positivos/inmunología , Interferón gamma/inmunología , Interferón gamma/metabolismo , SARS-CoV-2/inmunología , Mucosa Nasal/inmunología , Mucosa Nasal/virología , COVID-19/inmunología , COVID-19/virología , Células T de Memoria/inmunología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Integrina alfa1/inmunología , Integrina alfa1/metabolismo , Vacunas contra la COVID-19/inmunología , Antígenos CD/metabolismo , Antígenos CD/inmunología , Memoria Inmunológica/inmunología , Cadenas alfa de IntegrinasRESUMEN
OBJECTIVE: To assess the surgical outcomes and identify predictors of surgical success in patients with positional and non-positional obstructive sleep apnea following multilevel airway surgery. STUDY DESIGN: Retrospective cohort study. SETTING: Singe-tertiary medical center. METHODS: This study included 158 patients with obstructive sleep apnea who underwent multilevel airway surgery. Patients were divided into 2 groups according to position dependency: "positional patients" group (n = 100), and "nonpositional patients" group (n = 58). The characteristics and surgical outcomes of the 2 groups were compared. RESULTS: The nonpositional group included younger and more obese patients in comparison to the positional group. Moreover, the nonpositional group had more severe disease than the positional group. Both groups showed overall improvement after surgery, and the surgical success rate did not differ significantly between the 2 groups (nonpositional, 41.4% vs positional, 48.0%; P = .424). Notably, 69.0% of patients belonging to the non-positional group converted to positional group postoperatively. Logistic regression analysis revealed that larger tonsil size, female sex, and higher mean O2 saturation were associated with higher success rate in the positional group, whereas larger tonsil size was associated with surgical success in the nonpositional group. CONCLUSION: Both nonpositional and positional groups showed improvements following multilevel airway surgery, and surgery induced a transition from nonpositional to positional group. Given that the factors related to surgical success differed between the two groups, surgeons should consider position dependency and these distinct factors during decision-making.
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Apnea Obstructiva del Sueño , Humanos , Apnea Obstructiva del Sueño/cirugía , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Resultado del Tratamiento , AdultoRESUMEN
Molybdenum ditelluride (MoTe2) nanosheets have displayed intriguing physicochemical properties and opto-electric characteristics as a result of their tunable and small band gap (Eg â¼ 1 eV), facilitating concurrent electron and hole transport. Despite the numerous efforts devoted to the development of p-type MoTe2 field-effect transistors (FETs), the presence of tellurium (Te) point vacancies has caused serious reliability issues. Here, we overcome this major limitation by treating the MoTe2 surface with thiolated molecules to heal Te vacancies. Comprehensive materials and electrical characterizations provided unambiguous evidence for the efficient chemisorption of butanethiol. Our thiol-treated MoTe2 FET exhibited a 10-fold increase in hole current and a positive threshold voltage shift of 25 V, indicative of efficient hole carrier doping. We demonstrated that our powerful molecular engineering strategy can be extended to the controlled formation of van der Waals heterostructures by developing an n-SnS2/thiol-MoTe2 junction FET (thiol-JFET). Notably, the thiol-JFET exhibited a significant negative photoresponse with a responsivity of 50 A W-1 and a fast response time of 80 ms based on band-to-band tunneling. More interestingly, the thiol-JFET displayed a gate tunable trimodal photodetection comprising two photoactive modes (positive and negative photoresponse) and one photoinactive mode. These findings underscore the potential of molecular engineering approaches in enhancing the performance and functionality of MoTe2-based nanodevices as key components in advanced 2D-based optoelectronics.
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A gate stack that facilitates a high-quality interface and tight electrostatic control is crucial for realizing high-performance and low-power field-effect transistors (FETs). However, when constructing conventional metal-oxide-semiconductor structures with two-dimensional (2D) transition metal dichalcogenide channels, achieving these requirements becomes challenging due to inherent difficulties in obtaining high-quality gate dielectrics through native oxidation or film deposition. Here, a gate-dielectric-less device architecture of van der Waals Schottky gated metal-semiconductor FETs (vdW-SG MESFETs) using a molybdenum disulfide (MoS2) channel and surface-oxidized metal gates such as nickel and copper is reported. Benefiting from the strong SG coupling, these MESFETs operate at remarkably low gate voltages, <0.5 V. Notably, they also exhibit Boltzmann-limited switching behavior featured by a subthreshold swing of ≈60 mV dec-1 and negligible hysteresis. These ideal FET characteristics are attributed to the formation of a Fermi-level (EF) pinning-free gate stack at the Schottky-Mott limit. Furthermore, authors experimentally and theoretically confirm that EF depinning can be achieved by suppressing both metal-induced and disorder-induced gap states at the interface between the monolithic-oxide-gapped metal gate and the MoS2 channel. This work paves a new route for designing high-performance and energy-efficient 2D electronics.
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Antígenos CD , Cadenas alfa de Integrinas , Células T de Memoria , Pólipos Nasales , Rinitis , Sinusitis , Humanos , Sinusitis/inmunología , Pólipos Nasales/inmunología , Rinitis/inmunología , Rinitis/diagnóstico , Enfermedad Crónica , Antígenos CD/metabolismo , Cadenas alfa de Integrinas/metabolismo , Células T de Memoria/inmunología , Células T de Memoria/metabolismo , Células Th17/inmunología , Células Th17/metabolismo , Células TH1/inmunología , Memoria Inmunológica , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/metabolismo , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/metabolismo , Masculino , RinosinusitisRESUMEN
Periprosthetic infection is a devastating postimplantation complication in which a biofilm layer harboring invasive microorganisms forms around orthopedic implants, leading to severe implant failure and patient morbidity. Despite the development of several infection-triggered antibiotic release approaches, most current antibacterial coatings are susceptible to undesired antibiotic leakage or mechanical disintegration during prosthesis installation. Herein, we propose a self-controllable proteinic antibacterial coating capable of both long-lasting adherence onto titanium implant substrates over the implant fixation period and instantaneous bacterial eradication. Importantly, the pH-dependent reversible metal coordination of mussel adhesive protein (MAP) enabled bacterial concentration-dependent antibiotic delivery in response to infection-induced acidification. In addition, the MAP coating exhibited superior self-healable adhesive properties and scratch resistance, which enabled to avert issues associated with mechanical damages, including peeling and cracking, often occurring in conventional implant coating systems. The gentamicin-loaded MAP coating exhibited complete inhibition of bacterial growth in vivo against Staphylococcus aureus penetrations during implantation surgery (immediate infection) and even 4 weeks after implantation (delayed infection). Thus, our antibiotic-loaded MAP hydrogel coating can open new avenues for self-defensive antibiotic prophylaxis to achieve instant and sustainable bacteriocidal activity in orthopedic prostheses. © 2017 Elsevier Inc. All rights reserved.
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Antibacterianos , Prótesis e Implantes , Humanos , Antibacterianos/farmacología , Antibacterianos/química , Metales , Titanio/química , Bacterias , Materiales Biocompatibles Revestidos/farmacología , Materiales Biocompatibles Revestidos/químicaRESUMEN
Eosinophilic otitis media (EOM) is a rare middle ear disease with unfavorable outcomes. Under the current diagnostic criteria of EOM, it is challenging to suspect EOM before tympanostomy. Therefore, this study attempted to use blood eosinophil levels for the differential diagnosis of EOM from other conditions. Three disease groups with features of recurrent otorrhea were categorized, which included the following: EOM (n = 9), granulomatosis with polyangiitis (GPA, n = 12), and primary ciliary dyskinesia (PCD, n = 6). Clinical and radiological characteristics were analyzed in the three groups. Patients who underwent ventilation tube insertion due to serous otitis media were enrolled as the control group (n = 225) to evaluate the diagnostic validity of blood eosinophilia. The EOM group showed a significantly higher blood eosinophil concentration (p < 0.001) and blood eosinophil count (p < 0.001) compared to the GPA and PCD groups. The estimated sensitivity and specificity for diagnosing EOM from OME patients who underwent ventilation tube insertion were 100% and 95.6%, respectively. In addition, EOM tended to have protympanic space soft tissue density and a relatively clear retrotympanic space in temporal bone computerized tomography. Blood eosinophil evaluation is a significant clinical indicator of EOM. Furthermore, the assessment of exclusive protympanic soft tissue density can provide an additional diagnostic clue.
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Extensive study on 2D van der Waals (vdW) heterojunctions has primarily focused on PN diodes for fast-switching photodetection, while achieving the same from 2D channel phototransistors is rare despite their other advantages. Here, a high-speed phototransistor featuring a type III junction between p-MoTe2 channel and n-SnS2 top layer is designed. The photodetecting device operates with a basis of negative photoresponse (NPR), which originates from the recombination of photoexcited electrons in n-SnS2 and accumulated holes in the p-MoTe2 channel. For the NPR to occur, high-energy photons capable of exciting SnS2 (band gap ≈2.2 eV) are found to be effective because lower-energy photons simply penetrate the SnS2 top layer only to excite MoTe2 , leading to normal positive photoresponse (PPR) which is known to be slow due to the photogating effects. The NPR transistor showcases 0.5 ms fast photoresponses and a high responsivity over 5000 A W-1 . More essentially, such carrier recombination mechanism is clarified with three experimental evidences. The phototransistor is finally modified with Au contact on n-SnS2 , to be a more practical device displaying voltage output. Three different photo-logic states under blue, near infrared (NIR), and blue-NIR mixed photons are demonstrated using the voltage signals.
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Recent advances in two-dimensional semiconductors, particularly molybdenum disulfide (MoS2), have enabled the fabrication of flexible electronic devices with outstanding mechanical flexibility. Previous approaches typically involved the synthesis of MoS2 on a rigid substrate at a high temperature followed by the transfer to a flexible substrate onto which the device is fabricated. A recurring drawback with this methodology is the fact that flexible substrates have a lower melting temperature than the MoS2 growth process, and that the transfer process degrades the electronic properties of MoS2. Here we report a strategy for directly synthesizing high-quality and high-crystallinity MoS2 monolayers on polymers and ultrathin glass substrates (thickness ~30 µm) at ~150 °C using metal-organic chemical vapour deposition. By avoiding the transfer process, the MoS2 quality is preserved. On flexible field-effect transistors, we achieve a mobility of 9.1 cm2 V-1 s-1 and a positive threshold voltage of +5 V, which is essential for reducing device power consumption. Moreover, under bending conditions, our logic circuits exhibit stable operation while phototransistors can detect light over a wide range of wavelengths from 405 nm to 904 nm.
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Interpreting the relationship between different taste function tests of different stimuli, such as chemical and electrical stimulation, is still poorly understood. This study aims to analyze visually as well as quantitatively how to interpret the relationship of results between taste function tests using different stimuli. Patients who underwent the whole mouth test and Electrogustometry (EGM) at a tertiary medical center between August 2018 and December 2018 were reviewed retrospectively with electronic medical records. Of the 110 patients, a total of 86 adults who self-reported that their taste function was normal through a questionnaire were enrolled. EGM measured the thresholds of the chorda tympani (CT) and glossopharyngeal nerve (GL) area of the tongue. The whole mouth test measured detection and recognition thresholds for sweet, salty, bitter, sour, and umami taste. Statistical analyses of Pearson's, Spearman's rank and polyserial correlation and multidimensional scaling (MDS) was performed. The EGM threshold for the average value of both CT regions and the recognition threshold of the whole mouth test were significantly correlated in sweet, salty, bitter, and sour taste (r = 0.244-0.398, P < 0.05), and the detection threshold was correlated only significant in sweet (r = 0.360, P = 0.007). In the MDS analysis results, the three-dimensional (D) solution was chosen over the 2-D solution because of the lower stress. Detection-, recognition threshold of whole mouth test and EGM thresholds of CT and GL area, those were standardized by Z-score, formed well-distinguished sections in the MDS analyses. The EGM threshold of the CT area was closer to the detection and recognition thresholds than the EGM threshold of the GL area. In general, the EGM threshold was closer to the recognition threshold than the detection threshold for each taste. Overall, visualization of the relationship of whole mouth test and EGM by MDS was in good agreement with quantitative analysis. EGM and whole mouth test seem to reflect different aspects of taste. However, when interpreting the EGM results, the EGM threshold of the CT area will show more similarity to the recognition threshold than the detection threshold for the whole mouth test.
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Análisis de Escalamiento Multidimensional , Umbral Gustativo , Adulto , Humanos , Umbral Gustativo/fisiología , Estudios Retrospectivos , Boca/fisiología , Gusto/fisiología , DisgeusiaRESUMEN
Two-dimensional (2D)-layered material tantalum disulfide (2H-TaS2) is known to be a van der Waals conductor at room temperature. Here, 2D-layered TaS2 has been partially oxidized by utraviolet-ozone (UV-O3) annealing to form a 12-nm-thin TaOX on conducting TaS2, so that the TaOX/2H-TaS2 structure might be self-assembled. Utilizing the TaOX/2H-TaS2 structure as a platform, each device of a ß-Ga2O3 channel MOSFET and a TaOX memristor has been successfully fabricated. An insulator structure of Pt/TaOX/2H-TaS2 shows good a dielectric constant (k â¼ 21) and strength (â¼3 MV/cm) of achieved TaOX, which is enough to support a ß-Ga2O3 transistor channel. Based on the quality of TaOX and low trap density of the TaOX/ß-Ga2O3 interface, which is achieved via another UV-O3 annealing, excellent device properties such as little hysteresis (<â¼0.04 V), band-like transport, and a steep subthreshold swing of â¼85 mV/dec are achieved. With a Cu electrode on top of the TaOX/2H-TaS2 structure, the TaOX acts as a memristor operating around â¼2 V for nonvolatile bipolar and unipolar mode memories. The functionalities of the TaOX/2H-TaS2 platform become more distinguished finally when the Cu/TaOX/2H-TaS2 memristor and ß-Ga2O3 MOSFET are integrated to form a resistive memory switching circuit. The circuit nicely demonstrates the multilevel memory functions.
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OBJECTIVES: This study is aimed to investigate the differences in the clinical features and surgical outcomes between hypopnea- and apnea-predominant obstructive sleep apnea (OSA). DESIGN: Cohort study. SETTING: Single tertiary care centre. PARTICIPANTS: This study included 190 patients with OSA who underwent multilevel upper airway surgery between September 2012 and September 2021. The patients were divided into two groups according to the proportion of each respiratory event: hypopnea-predominant (n = 102) and apnea-predominant (n = 88). MAIN OUTCOME MEASURES: The primary outcome measure was the percentage improvement in the apnea-hypopnea index (AHI) from baseline AHI after surgery. RESULTS: The apnea-predominant group included more male patients and had higher AHI, respiratory disturbance index (RDI) and oxygen desaturation index (ODI) than the hypopnea-predominant group. Both groups showed significant improvements in AHI, apnea index, RDI, supine AHI, REM AHI, non-REM AHI, ODI, lowest O2 saturation and Epworth Sleepiness Scale scores following the surgery. Notably, hypopnea index increased after surgery in the apnea-predominant OSA group. Although the improvement in the absolute value of AHI by surgery was significantly greater in the apnea-predominant group than in the hypopnea-predominant group, the two groups showed no significant difference in the percentage improvement in AHI from baseline AHI. CONCLUSION: Patients with apnea-predominant OSA had more severe disease than those with hypopnea-predominant OSA; however, surgical outcomes, as evaluated by percentage AHI improvement, were comparable between the two groups. In addition, multilevel upper airway surgery may induce the transition from apnea to hypopnea in patients with apnea-predominant OSA.
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Apnea Obstructiva del Sueño , Humanos , Masculino , Estudios de Cohortes , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/diagnóstico , Resultado del TratamientoRESUMEN
OBJECTIVE: This study was aimed to investigate clinical implications of mixed apnea (MA) in patients with obstructive sleep apnea (OSA), particularly whether surgical outcomes differ between OSA patients with and without MA events. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary medical center. METHODS: Eighty-eight patients with OSA who underwent multilevel upper airway surgery were included. Patients were divided into 2 groups according to the presence of MA events: "pure group" (n = 30) and "mixed group" (n = 58). The clinical characteristics and surgical outcomes were compared between the 2 groups. RESULTS: The mixed group included more males (P = .020) and hypertensive patients (P = .009) and had a higher apnea-hypopnea index (AHI; P < .001) than the pure group. The surgical success rate was lower in the mixed group (29.3%) than in the pure group (73.3%; P < .001). Furthermore, the postoperative improvements in total AHI (P < .001), supine AHI (P < .001), and oxygen desaturation index (P = .006) were lower in the mixed group than in the pure group. Logistic regression analysis confirmed that the presence of MA (P = .002) was an independent predictor of poor surgical outcomes in patients with OSA. CONCLUSION: OSA patients with MA showed different clinical features and poor surgical outcomes compared to those without MA. These results imply that OSA with MA components may have a distinct pathophysiology, and the presence of MA should be considered in the surgical treatment of OSA.
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Apnea Obstructiva del Sueño , Masculino , Humanos , Estudios Retrospectivos , Polisomnografía , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/cirugía , Oxígeno , Resultado del TratamientoRESUMEN
Two-dimensional (2D) devices and their van der Waals (vdW) heterostructures attract considerable attention owing to their potential for next-generation logic and memory applications. In addition, 2D devices are projected to have high integration capabilities, while maintaining nanoscale thickness. However, the fabrication of 2D devices and their circuits is challenging because of the high precision required to etch and pattern ultrathin 2D materials for integration. Here, the fabrication of a graphene via contact architecture to electrically connect graphene electrodes (or leads) embedded in vdW heterostructures is demonstrated. Graphene via contacts comprising of edge and fluorinated graphene (FG) electrodes are fabricated by successive fluorination and plasma etching processes. A one-step fabrication process that utilizes the graphene contacts is developed for a vertically integrated complementary inverter based on n- and p-type 2D field-effect transistors (FETs). This study provides a promising method to fabricate vertically integrated 2D devices, which are essential in 2D material-based devices and circuits.
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The desire to enhance the efficiency of organic light-emitting devices (OLEDs) has driven to the investigation of advanced materials with fascinating properties. In this work, the efficiency of top-emission OLEDs (TEOLEDs) is enhanced by introducing ampicillin microstructures (Amp-MSs) with dual phases (α-/ß-phase) that induce photoluminescence (PL) and electroluminescence (EL). Moreover, Amp-MSs can adjust the charge balance by Fermi level (EF ) alignment, thereby decreasing the leakage current. The decrease in the wave-guided modes can enhance the light outcoupling through optical scattering. The resulting TEOLED demonstrates a record-high external quantum efficiency (EQE) (maximum: 68.7% and average: 63.4% at spectroradiometer; maximum: 44.8% and average: 42.6% at integrating sphere) with a wider color gamut (118%) owing to the redshift of the spectrum by J-aggregation. Deconvolution of the EL intensities is performed to clarify the contribution of Amp-MSs to the device EQE enhancement (optical scattering by Amp-MSs: 17.0%, PL by radiative energy transfer: 9.1%, and EL by J-aggregated excitons: 4.6%). The proposed TEOLED outperforms the existing frameworks in terms of device efficiency.
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Objective: The aim of this systematic review and meta-analysis was to investigate the association between obstructive sleep apnea (OSA) and erythrocytosis. Methods: The PubMed, Web of Science, and Cochrane Library databases were searched for articles examining hematocrit values in patients with OSA and control individuals published till September 1, 2021. The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated, and subgroup analyses were performed. Results: Eleven eligible studies with a total of 4608 patients with OSA were included in this meta-analysis. Pooled outcomes revealed that hematocrit values were significantly higher in patients with OSA than in controls (SMD, 0.19; 95% CI, 0.08-0.29; p < .01). When studies were stratified by disease severity, the significant differences in hematocrit values between patients and controls were only observed in the severe OSA group (SMD, 0.34; 95% CI, 0.08-0.59; p < .01), but not in the mild and moderate OSA groups. In subgroup analyses according to sex and publication year, significant differences in hematocrit values between patients and controls remained stable in studies with only female patients (SMD, 0.25; 95% CI, 0.12-0.38; p < .01) and in studies published after 2012 (SMD, 0.17; 95% CI, 0.06-0.28, p < .01). Conclusion: Our meta-analysis revealed that the hematocrit value was significantly increased in patients with OSA, particularly in severe patients, compared with that in controls. However, the elevation was modest, and the hematocrit value is expected to be within the normal range in patients with OSA. These data suggest that OSA leads to slight increases in hematocrit but does not cause clinically significant erythrocytosis.