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Neuromorphic computing, a promising solution to the von Neumann bottleneck, is paving the way for the development of next-generation computing and sensing systems. Axon-multisynapse systems enable the execution of sophisticated tasks, making them not only desirable but essential for future applications in this field. Anisotropic materials, which have different properties in different directions, are being used to create artificial synapses that can mimic the functions of biological axon-multisynapse systems. However, the restricted variety and unadjustable conductive ratio limit their applications. Here, it is shown that anisotropic artificial synapses can be achieved on isotropic materials with externally localized doping via electron beam irradiation (EBI) and purposefully induced trap sites. By employing the synapses along different directions, artificial neural networks (ANNs) are constructed to accomplish variable neuromorphic tasks with optimized performance. The localized doping method expands the axon-multisynapse device family, illustrating that this approach has tremendous potentials in next-generation computing and sensing systems.
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Background: Working memory (WM) involves temporarily storing and manipulating information. Research on the impact of aging on WM has shown inconsistent results regarding the decline in visual and verbal WM, with a lack of studies on tactile WM. This study aimed to assess the effects of aging on WM across verbal, visuospatial, and tactile modalities using span tasks of forward (storage) and backward (manipulation) stages. Methods: A total of 130 participants, divided into four age groups of 20-29, 60-69, 70-79, and 80-89, completed the Digit, Visuospatial, and Tactual Spans. Performance was analyzed using a 3 (Task) × 4 (Group) × 2 (Stage) mixed design repeated measures ANOVA. Results: The analysis revealed significant main effects for modality (p < 0.001, ηp2 = 0.15), age (p < 0.001, ηp2 = 0.48), and stage (p < 0.001, ηp2 = 0.30). Digit Span outperformed the other modalities, while Tactual Span showed the worst performance. Additionally, task performance declined with age, and the forward stage was superior to the backward stage. Interaction effects indicated that Digit Span was less affected by aging compared to the Visuospatial and Tactual Spans (p = 0.004, ηp2 = 0.07). Post hoc analyses further revealed that the Digit Span consistently outperformed the other modalities in both stages, with more pronounced differences observed in the forward stage. Conclusions: Verbal WM is more resilient to aging compared to the other modalities while tactile WM declines with age in a manner similar to verbal and visuospatial WM, suggesting a modality-specific impact of aging on WM.
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In adult mammals, limb regeneration is limited by the absence of blastemal cells (BCs) and the lack of the regenerative signaling cascade. The utilization of transgenic cells circumvents the limitations associated with the absence of BCs. In a previous investigation, we successfully regenerated mouse phalanx amputations using blastema-like cells (BlCs) generated from bone marrow-derived mesenchymal stem cells (mBMSCs) overexpressing Msx1 and Msx2 genes. Recently, extracellular vesicles (EVs) have emerged as potent biological tools, offering a promising alternative to manipulated cells for clinical applications. This research focuses on utilizing BlCs-derived extracellular vesicles (BlCs-EVs) for regenerating mouse digit tips. The BlCs were cultured and expanded, and then EVs were isolated via ultracentrifugation. The size, morphology, and CD81 marker expression of the EVs were confirmed through Dynamic Light Scattering (DLS), Scanning Electron Microscope (SEM), and Western Blot (WB) analyses. Additionally, WB analysis demonstrated the presence of MSX1, MSX2, FGF8, and BMP4 proteins. The uptake of EVs by mBMSCs was shown through immunostaining. Effects on cell proliferation, migration, and osteogenic activity post-treatment with BlCs-EVs were assessed through MTT assay, scratch assay, and Real-time PCR. The regenerative potential of BlCs-EVs was evaluated in a mouse digit tip amputation model using histological assessments. Results indicated that BlCs-EVs enhanced several abilities of mBMSCs, such as migration, proliferation, and osteogenesis in vitro. Notably, BlCs-EVs significantly improved digit tip regeneration in mice, promoting the formation of new bone and nails, which was absent in control groups. In summary, BlCs-EVs are promising tools for digit tip regeneration, avoiding the ethical concerns associated with using genetically modified cells.
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Vesículas Extracelulares , Factor de Transcripción MSX1 , Células Madre Mesenquimatosas , Regeneración , Animales , Células Madre Mesenquimatosas/metabolismo , Células Madre Mesenquimatosas/citología , Vesículas Extracelulares/metabolismo , Vesículas Extracelulares/trasplante , Ratones , Factor de Transcripción MSX1/metabolismo , Factor de Transcripción MSX1/genética , Proliferación Celular , Osteogénesis , Proteínas de Homeodominio/genética , Proteínas de Homeodominio/metabolismo , Modelos Animales de Enfermedad , Movimiento Celular , Factor 8 de Crecimiento de Fibroblastos/metabolismo , Factor 8 de Crecimiento de Fibroblastos/genéticaRESUMEN
OBJECTIVE: This study evaluates the feasibility of reducing in-person appointments by utilizing Remote Check (RC) in pediatric cochlear implant (CI) recipients and investigates the most suitable age range for implementing RC. METHODS: Fifty-eight pediatric CI recipients, aged 1-17 years, were evaluated using a web-based RC application by audiologists. Most (84.5 %) used verbal communication. Inclusion criteria required stable map status, caregiver tech proficiency, and a compatible phone. RESULTS: Remote assessments were beneficial, with 89.7 % of participants successfully completing RC. Aided threshold tests (ATT) were completed in 73.2 % of participants, while speech-in-noise tests (Digit Triplet Test, DTT) were completed in 47.3 %. Children as young as 4 successfully completed ATT, while a minimum age of 7 was required for DTT. A significant relationship between age and test success was demonstrated. Verbally communicative children had higher completion success rates. Parental education was significantly correlated with DTT success, with higher success rates in children whose parents had undergraduate degrees. With RC use, 69 % of children did not need clinic visits, emphasizing the need for personalized and remote support for optimal cochlear implant performance. In-person appointments were primarily required due to concerns about the duration of device usage. CONCLUSION: The study confirms the effectiveness and feasibility of using RC in pediatric CI users, even as young as one year old with stable aided hearing. The findings advocate for the integration of RC into routine follow-up protocols, offering a more accessible option for enhanced patient care.
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Digital ischemia with gangrene is a rare manifestation of chronic myeloid leukemia (CML). We report a rare CML case with severe thrombocytosis presenting clinically as digital ischemia and gangrene, the sole primary symptom. A 40-year-old patient presented with pain and discoloration of the tips of the ring and little fingers of the right hand for 20 days, which later progressed to dry gangrene with a line of demarcation and pre-gangrenous changes in the index and middle fingers. He was a chronic smoker and alcoholic with no other comorbidities. On investigation, he was found to have abnormal leukocytosis (153,000/mm3) and moderate thrombocytosis (969,000/mm3) with anemia. In view of abnormal leukocytosis, he was investigated for leukemia. He was found to be positive for BCR-ABL by reverse transcription polymerase chain reaction (RT-PCR), thus confirming the diagnosis of CML. He received imatinib 400â mg/day and subsequently experienced resolution of symptoms and complete hematological response by the 12th week of therapy.
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The ability to maintain and manipulate sequential information in working memory, referred to as sequential working memory, plays a vital role in our daily life. While research has shown that methamphetamine abuse affects the neural substrates and the overall functioning of working memory, its specific impact on sequential working memory remains unclear. In this study, we asked 62 abstinent methamphetamine-dependent participants and 59 control participants to complete a digit ordering task in which they saw four digits one-by-one over time and subsequently rearranged them in ascending order. The four digits were presented either randomly in the experimental condition or in ascending order in the control condition. Results show that methamphetamine-dependent participants performed worse than the controls in the experimental condition in which sequential working memory was needed to complete the task, but not in the control condition in which only short-term memory was needed. This finding demonstrates that methamphetamine abuse impairs sequential working memory.
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BACKGROUND: Traumatic digit amputation is a common injury with life-altering consequences for thousands of patients each year. In this study, we aim to update and expand the reported outcomes of return-to-work (RTW) and functional recovery in patients treated with digit replant after traumatic amputation. METHODS: A PRISMA-guided systematic review was performed to identify all published articles related to digit replantation following amputation. We queried the following 4 databases: Scopus, Embase, Web of Science, and PubMed-MEDLINE. A total of 31 studies were included in the analysis of return-to-work data. RESULTS: Of the 31 included studies, 26 studies reported that 1976 digits were successfully replanted, while 27 studies reported that 300 replants failed (86.8% success rate). Among 1087 patients in these studies, 82.9% who underwent replantation returned to work. The mean RTW time in 16 studies was 4.7 months (weighted average). Return-to-work time ranged from 0 to 26 months in 12 studies. Of 352 patients who returned to work in 17 studies, 90.9% resumed their previous occupation, while 29 (8.2%) changed occupations. The RTW for finger-only replantations was significantly lower compared to thumb-only, distal digit-only, and any digit replantations (66.0% vs 82.8%; 66.0% vs 87.6%; 66.0% vs 82.9%). CONCLUSION: Despite a declining prevalence of digit replantation surgery in recent years, this study illustrates that replantation provides beneficial outcomes for patients with a high return-to-work rate.
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OBJECTIVES: The digit ratio (2D:4D) is a possible marker of prenatal hormone exposure. The purpose of this study was to explore the relationships between digit ratio (2D:4D) and anthropometric indexes in Chinese children and adolescents. METHODS: This study is a cross-sectional study. A school-based survey among 685 children and adolescents aged 8-15 years were conducted by stratified cluster sampling. The length of index finger (2D) and ring finger (4D) of the left hand, height, sitting height (ST), weight, chest circumference (CC), waist circumference (WC), hip circumference (HC), and abdominal skinfold thickness (AST) were measured. Pearson correlation and multivariate linear regression were used to analyze associations between 2D:4D and above indexes. RESULTS: In girls, 2D:4D was positively related to WC, AST, waist-to-height (WHtR), waist-to-hip ratio (WHR) after adjusting for ages (p < 0.05). The WC, AST, WHtR, and WHR among girls with 2D:4D ≥ 1 were significantly higher than those among girls with 2D:4D < 1, respectively (p < 0.05). However, there was no correlations between digit ratio (2D:4D) and above anthropometric indexes in boys (p > 0.05). CONCLUSIONS: The 2D:4D was related to anthropometric indexes in girls, which suggests that the maternal prenatal hormone exposure might be related to the anthropometric indexes of their female offspring.
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Verification of the effectiveness of motor imagery (MI) has mainly focused on the method of implementing MI, and few studies have assessed individual factors. This study examined the individual differences in MI effects from the viewpoint of the multiple components of working memory. Forty-six healthy subjects (mean age 20.8 years) performed the Stroop Test (central executive within working memory) and reverse chanting (phonological loop within working memory). Then, F-waves were measured at rest for 30 s, the Purdue Pegboard was performed with the non-dominant hand to evaluate finger dexterity (Peg score) before MI, F-waves were measured during 30 s of kinesthetic MI, and the Peg score was evaluated after MI. For statistical analysis, the amplitude F/M ratio and Peg score were used as dependent variables, and the subjects were divided into Good and Poor groups according to cognitive function. The results showed an interaction for the amplitude F/M ratio and Peg score when grouped by reverse inverse chanting. In the subsequent simple main effect analysis, the Peg score was significantly improved after MI in both groups. The amplitude F/M ratio was significantly increased during MI compared to the resting state only in the Poor phonological loop group. Conversely, there was no interaction when the groups were divided by Stroop interference. No relationship was found between individual differences in central executive and changes in hand finger dexterity and spinal motor nerve excitability induced by MI. However, there may be a relationship between individual differences in phonological loops and changes in MI-induced finger dexterity and spinal motor nerve excitability.
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OBJECTIVES: Second to fourth digit ratio is widely known indicator of prenatal sex hormones proportion. Higher prenatal androgenization results in longer fourth finger and lower 2D:4D index. The aim of this study was to determine whether the 2D:4D digit ratio is associated with DNA methylation (DNAm) age dependently on sex. MATERIAL AND METHODS: The study included 182 adults (106 females and 76 males) with a mean age of 51.5 ± 13 years. The investigation consisted of three main parts: a survey, anthropometric dimensions measurements (fingers length) and methylome analysis using collected blood samples. Genome-wide methylation was analyzed using EPIC microarray technology. Epigenetic age and epigenetic age acceleration were calculated using several widely applied algorithms. RESULTS: Males with the female left hand pattern had more accelerated epigenetic age than those with the male pattern as calculated with PhenoAge and DNAmTL clocks. CONCLUSIONS: Finger female pattern 2D:4D above or equal to 1 in males is associated with epigenetic age acceleration, indicating that prenatal exposure to estrogens in males may be related to aging process in the later ontogenesis.
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Digital mucous cysts are benign synovial fluid collections that typically involve the lateral or dorsal surfaces of the distal interphalangeal joints (DIPJs) or beneath the proximal nail fold. They are typically found in the setting of arthritic degeneration of the underlying joint and occur most frequently between the fifth and seventh decades. 1 Many treatment options for digital mucous cysts have been described, ranging from conservative/minimally invasive to complete surgical excision, with no consensus on best technique. Here, a surgical approach is presented which allows access to address the cyst pedicle as well as any underlying osteophyte while preserving the overlying skin with good outcomes even with compromised or involved dermis and epidermis. This is a reproducible, readily adaptable technique. The surgical technique is presented and reviewed in detail.
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Exponential expressions represent series that grow at a fast pace such as carbon pollution and the spread of disease. Despite their importance, people tend to struggle with these expressions. In two experiments, participants chose the larger of two exponential expressions as quickly and accurately as possible. We manipulated the distance between the base/power components and their compatibility. In base-power compatible pairs, both the base and power of one expression were larger than the other (e.g., 23 vs. 34), while in base-power incompatible pairs, the base of one expression was larger than the base in the other expression but the relation between the power components of the two expressions was reversed (e.g., 32 vs. 24). Moreover, while in the first experiment the larger power always led to the larger result, in the second experiment we introduced base-result congruent pairs as well. Namely, the larger base led to the larger result. Our results showed a base-power compatibility effect, which was also larger for larger power distances (Experiments 1-2). Furthermore, participants processed the base-result congruent pairs faster and more accurately than the power-result congruent pairs (Experiment 2). These findings suggest that while both the base and power components are processed when comparing exponential expressions, the base is more salient. This exemplifies an incorrect processing of the syntax of exponential expressions, where the power typically has a larger mathematical contribution to the result of the expression.
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INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common syndrome often observed during adolescence, characterized by ovulatory dysfunction and hyperandrogenism. It is determined that, when female fetuses are exposed to high levels of androgens, it increases their likelihood of developing PCOS in later ages. The 2D:4D digit ratio, which measures the length of the index finger compared to the ring finger, is a precise anatomical indicator of the degree of prenatal androgen exposure. Higher digit ratios in individuals have been associated with outcomes typically attributed to females. In the adolescent age group, the relationship between PCOS and androgen exposure during the antenatal period is not clear. AIM: The study was aimed to evaluate digit ratios in adolescents with PCOS. METHODS: The study included 38 adolescent girls with PCOS, and 40 healthy adolescent girls were selected as the control group. The digit ratio (2D:4D) was evaluated by digital calipers, and the digit ratios of the patient and control groups were compared. RESULTS: The mean age in the PCOS group was 15.99±1.18 years, while the control group had a mean age of 16.02±1.06 years. The right-hand 2D:4D digit ratio was significantly lower in the PCOS group (0.93±0.02) compared to the control group (1.00±0.01, p<0.001). Similarly, the left-hand 2D:4D digit ratio was also lower in the PCOS group (0.98±0.03) compared to the control group (1.00±0.01, p<0.001). There was a moderate negative correlation between the left-hand 2D:4D ratio and the modified Ferriman-Gallwey score (mFGS) (r=0.53, p=0.01). Nevertheless, there was not a significant association found between the 2D:4D ratio of the right hand and mFGS. CONCLUSION: This study demonstrates that PCOS patients have significantly lower both-hand 2D:4D ratios than healthy controls, suggesting prenatal androgen exposure. Recognizing anatomic markers in adolescence may predict the development of PCOS. The findings align with previous research linking low digit ratios to androgen exposure and various reproductive outcomes.
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BACKGROUND: Multimodal analgesia is crucial for effective postoperative pain management in minor hand surgeries, enhancing patient satisfaction. The use of local wound infiltration with Ketorolac as an adjuvant pain management strategy is proposed for open trigger finger release surgery. This study aims to compare pain scores and functional outcomes between local wound infiltration with Ketorolac and oral non-steroidal anti-inflammatory drugs. METHODS: This study is a double-blind, parallel design, randomized controlled trials. Sixty-nine patients underwent trigger finger surgery between December 2021 and October 2022 were randomized into one of three groups: oral Ibuprofen alone group, local Ketorolac alone group and local Ketorolac with oral Ibuprofen group. The assessment included postoperative numeric rating scale (NRS) pain score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, grip strength, mobility of proximal interphalangeal (PIP) joint. and complications. RESULTS: NRS pain scores during movement of the operated fingers were significantly lower at 6 h in local Ketorolac alone group and local Ketorolac with oral Ibuprofen group compared to oral Ibuprofen alone group. However, there were no significant differences between the groups in postoperative DASH scores, grip strength, mobility of PIP joints, and complications. CONCLUSIONS: Local infiltration of Ketorolac as an adjunct in postoperative pain management has been shown to provide superior analgesia during finger movement within the initial 6 h following trigger finger surgery, in comparison to oral NSAIDs. CLINICAL TRIAL REGISTRATION: Thaiclinicaltrials.org identifier: TCTR20210825002. Registered 25/08/2021. https://www.thaiclinicaltrials.org/show/TCTR20210825002.
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Antiinflamatorios no Esteroideos , Ibuprofeno , Ketorolaco , Dimensión del Dolor , Dolor Postoperatorio , Trastorno del Dedo en Gatillo , Humanos , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/etiología , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/prevención & control , Trastorno del Dedo en Gatillo/cirugía , Trastorno del Dedo en Gatillo/tratamiento farmacológico , Ketorolaco/administración & dosificación , Ketorolaco/uso terapéutico , Femenino , Masculino , Método Doble Ciego , Persona de Mediana Edad , Antiinflamatorios no Esteroideos/administración & dosificación , Antiinflamatorios no Esteroideos/uso terapéutico , Ibuprofeno/administración & dosificación , Ibuprofeno/uso terapéutico , Anciano , Resultado del Tratamiento , Adulto , Administración Oral , Manejo del Dolor/métodos , Fuerza de la ManoRESUMEN
INTRODUCTION: "Pelvic rib", "pelvic digit (finger)", or "eleventh digit (finger)" is a rare congenital anomaly, in which a finger-like bony structure is present in the soft tissue in the pelvic or abdomen (less common) area. CASE PRESENTATION: This case report presents a symptomatic "pelvic digit" discovered in a patient referred to the radiology department after prolonged unilateral hip pain, especially during long walks. To our knowledge, this is the first case report of unilateral pelvic digit occurrence in our region. It is an extremely rare condition that is often discovered incidentally due to the lack of clinical symptoms. CONCLUSION: To the best of the authors' knowledge, this is the tenth reported case of symptomatic pelvic digit in the literature and four of them have required surgical intervention.
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Hallazgos Incidentales , Humanos , Bulgaria , Radiografía/métodos , Masculino , Femenino , Pelvis/diagnóstico por imagen , Adulto , Huesos Pélvicos/diagnóstico por imagenRESUMEN
BACKGROUND: Hispanics/Latinos are the largest racial/ethnic group among underrepresented populations in the U.S. and multiple sociodemographic, cultural, and linguistic factors have been found to impact their performances on cognitive testing. Despite this, few normative data are available for the heterogeneous Spanish-speaking population in the U.S. OBJECTIVE: To generate normative data on the Trail-Making Test (TMT), Bells Test, Symbol-Digit Modalities Test (SDMT), and the Brief Test of Attention (BTA) for Spanish speakers residing in the U.S. METHODS: The sample included 245 Spanish-speaking individuals aged 18- 80 from eight states across the U.S. (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered attention and processing speed measures as part of a comprehensive neuropsychological battery. We used a Bayesian regression approach to estimate normative data, including covariates found to be important for predicting performances on measures of attention and processing speed. RESULTS: Sociodemographic factors including education, time in the U.S., acculturation, age, and/or sex had differential effects on the TMT-A, TMT-B, SDMT, and the BTA whereas the Bells Test was not influenced by any of these sociodemographic factors. CONCLUSION: Our findings indicate that while sex, age, and educational attainment are important factors to consider, language and acculturation can also influence attention and processing speed performances among Spanish speakers in the U.S.
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Atención , Hispánicos o Latinos , Pruebas Neuropsicológicas , Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Adolescente , Adulto Joven , Anciano , Estados Unidos , Atención/fisiología , Pruebas Neuropsicológicas/estadística & datos numéricos , Pruebas Neuropsicológicas/normas , Anciano de 80 o más Años , Valores de Referencia , Lenguaje , Velocidad de ProcesamientoRESUMEN
OBJECTIVES: The relationship between sleep and memory has been well documented. However, it remains unclear whether a mind-body exercise, that is, Tai Chi exercise, can improve memory performance in older adults by improving their subjective and objective sleep. METHODS: A randomized controlled trial was conducted with participants (M = 67.36, 56-79 years) randomly assigned to Tai Chi and control groups. The primary outcomes were sleep, both subjectively reported and objectively assessed by actigraphy, and memory performance, as well as the mediating role of sleep in memory improvement with Tai Chi practice. RESULTS: Tai Chi exercise led to improvements in subjective sleep, as indicated by Insomnia Severity Index (ISI) (pâ <â .001, Cohen's dâ =â 0.62) and daytime dysfunction of the Pittsburgh sleep quality index (PSQI) (pâ =â .02, Cohen's dâ =â 0.80), and in actigraphy-assessed sleep onset latency (pâ <â .01, Cohen's dâ =â 0.61), as well as improved memory performance on digit span forward (pâ <â .001, Cohen's dâ =â 1.20) and visual spatial memory tasks (pâ <â .01, Cohen's dâ =â 0.83) compared to the control group. Importantly, Tai Chi practice improved digit span forward memory performance through parallel mediation of both subjective sleep (i.e., daytime dysfunction of the PSQI) and objective sleep (i.e., sleep onset latency; bâ =â 0.29, pâ <â .01). DISCUSSION: Our findings uncovered the potential benefits of Tai Chi exercise in relation to both subjective and objective sleep in older adults, in turn, how sleep changes played a role in the link between Tai Chi exercise and memory changes in older adults.
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Actigrafía , Vida Independiente , Taichi Chuan , Humanos , Taichi Chuan/métodos , Anciano , Masculino , Femenino , Persona de Mediana Edad , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Calidad del Sueño , Sueño/fisiología , Memoria/fisiologíaRESUMEN
This article presents a concise proof of the famous Benford's law when the distribution has a Riemann integrable probability density function and provides a criterion to judge whether a distribution obeys the law. The proof is intuitive and elegant, accessible to anyone with basic knowledge of calculus, revealing that the law originates from the basic property of human number system. The criterion can bring great convenience to the field of fraud detection.
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BACKGROUND: The digit in the noise test is a simple hearing screening tool that can identify hearing loss at the early stage. This screening tool takes less time than traditional pure-tone audiometry. There is a scarcity of hearing health professionals with few resources for carrying out hearing screening on a large scale in India. Hence, a hearing screening tool for the Hindi-speaking population is needed. AIM AND OBJECTIVE: The study aimed to develop and validate the Digit in Noise test in Hindi (DIN-H). METHODS: A native Hindi female speaker recorded single digits from 1 to 9 made into triplet combinations, which were binaurally presented to 20 normal hearing subjects having hearing thresholds less than 25 dBHL from 250 to 8000 Hz in the presence of broadband speech-shaped noise. The digit triplets were homogenized using speech intelligibility function for similar difficulty levels across stimuli. The homogenized stimuli were evaluated by obtaining the Speech Recognition Threshold (SRT) of 20 normal hearing subjects. RESULTS: The Mean SRT was - 10.4 and - 11.3 dB before and after homogenization. A strong positive correlation existed between test and retest SRTs (0.78). Mean SRT and slope obtained before and after optimization were comparable to other languages like Korean and English. This test can act as a reliable screening tool for assessing individuals. The test was administered to 106 normal hearing participants. The 95th percentile of the SRT value obtained was - 5.6 dB, which was kept as a cut-off score for the screening test. CONCLUSION: DIN-H can be used as a screening tool for assessing the integrity of the auditory system on a large scale in less time for the Hindi-speaking population.
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OBJECTIVE: To develop a methodologically uniform digits-in-noise (DIN) test in 17 different languages. DESIGN: The DIN test was developed for Android devices as an extension to the open-access Hearing Test™ app, available on the Google Play store. It utilised professionally recorded female speech, speech-shaped noise, a digit scoring method and a variable step size. The test was adaptively optimised and evaluated as the results of tests taken online by users of the app became available. STUDY SAMPLE: Optimisation using 35,534 ears, evaluation using 6012 ears. RESULTS: Optimisation improved the slopes of the psychometric functions for all languages by an average of 6.8%/dB. Evaluation included calculation of normative speech reception thresholds (SRTs) and estimation of test-retest standard deviations. Normative values for SRTs ranged from -14.2 dB SNR (95% CI -14.3 to -14.0) for Chinese to -11.2 dB SNR (95% CI -11.3 to -11.1) for Japanese, with reliability estimates ranging from 0.48 dB (95% CI 0.36-0.64) for Portuguese to 0.91 dB (95% CI 0.73-1.21) for Romanian. CONCLUSIONS: The optimisation of each language version was confirmed by the improvement in the slopes of the psychometric functions. The normative values obtained from the test evaluation were in agreement with literature data. TRIAL REGISTRATION: Science Support Centre of Wroclaw Medical University BW-59/2020.