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1.
Sci Rep ; 14(1): 14493, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38914590

RESUMO

In this paper, a compact low-profile dual-band wearable textile antenna is proposed for on-body and off-body communications. The presented antenna works efficiently in the 5G n79 frequency band (4.4 - 5 GHz) and the ISM band (5.725 - 5.875 GHz). The designed antenna has an ultra-wide impedance bandwidth of 2.01 GHz and peak realized gains of 10.5 dBi and 12 dBi at 4.5 GHz and 5.8 GHz, respectively. The antenna has a small footprint (π × 0.3λ02), which is inspired by circular fractal geometry. The performance of the presented wearable antenna is evaluated at various body parts, including the arm, wrist, and chest. The link margin is evaluated in the on-body and off-body communication scenarios, i.e., communication with the implantable antenna and the outside-body antenna, which is 80 dB and 65 dB at 4.5 GHz and 5.8 GHz, respectively. The 1 gm/10 gm specific absorption rate values at 4.5 GHz and 5.8 GHz are 0.12/0.098 and 0.11/0.082, respectively, which are significantly lower than the standard values, making the proposed antenna suitable for modern wearable applications.

2.
J Korean Soc Radiol ; 85(3): 643-648, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38873389

RESUMO

Acinic cell carcinoma is a rare malignant tumor that accounts for 2%-3% of salivary gland tumors. Acinic cell carcinoma arising from the breast is extremely rare, with only approximately 70 cases reported to date. Owing to its rarity, previous studies have primarily focused on pathological findings. Herein, we present the clinical and radiological features of acinic cell carcinoma of the breast in a 33-year-old woman.

3.
Diagnostics (Basel) ; 14(11)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38893660

RESUMO

This study introduces a deep-learning-based automatic sleep scoring system to detect sleep apnea using a single-lead electrocardiography (ECG) signal, focusing on accurately estimating the apnea-hypopnea index (AHI). Unlike other research, this work emphasizes AHI estimation, crucial for the diagnosis and severity evaluation of sleep apnea. The suggested model, trained on 1465 ECG recordings, combines the deep-shallow fusion network for sleep apnea detection network (DSF-SANet) and gated recurrent units (GRUs) to analyze ECG signals at 1-min intervals, capturing sleep-related respiratory disturbances. Achieving a 0.87 correlation coefficient with actual AHI values, an accuracy of 0.82, an F1 score of 0.71, and an area under the receiver operating characteristic curve of 0.88 for per-segment classification, our model was effective in identifying sleep-breathing events and estimating the AHI, offering a promising tool for medical professionals.

4.
Sensors (Basel) ; 24(11)2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38894230

RESUMO

An efficient design method for a compact and ultra-wideband multi-stage Wilkinson power divider in a parallel stripline (PSL) is proposed. To enhance the frequency bandwidth of the proposed power divider while reducing its size, the isolation branch is modified; that is, two capacitors are connected to both sides of a resistor at each isolation branch. For an efficient design process, the PSL power divider is equivalently represented by two microstrip power dividers, and the design equations are derived. Based on the design equations, an in-house algorithm is utilized to optimally determine the design parameters, including the line impedance, resistance, and capacitance of each stage. For example, a three-stage PSL power divider is designed with three λ/4 transmission lines at a base frequency of 5 GHz. To verify the accuracy of the design procedure, 3D EM simulations and measurements are performed, and the results show good agreement. Compared with the conventional three-stage Wilkinson power divider, the proposed PSL power divider achieves a wider frequency bandwidth of 1.16 to 6.51 GHz (139.5%) and a 23% shorter transmission line length of 207°, while exhibiting an insertion loss of 0.7 to 1.4 dB.

5.
J Photochem Photobiol B ; 257: 112949, 2024 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-38865816

RESUMO

Large scale outbreaks of infectious respiratory disease have repeatedly plagued the globe over the last 100 years. The scope and strength of the outbreaks are getting worse as pathogenic RNA viruses are rapidly evolving and highly evasive to vaccines and anti-viral drugs. Germicidal UV-C is considered as a robust agent to disinfect RNA viruses regardless of their evolution. While genomic damage by UV-C has been known to be associated with viral inactivation, the precise relationship between the damage and inactivation remains unsettled as genomic damage has been analyzed in small areas, typically under 0.5 kb. In this study, we assessed genomic damage by the reduced efficiency of reverse transcription of regions of up to 7.2 kb. Our data seem to indicate that genomic damage was directly proportional to the size of the genome, and a single hit of damage was sufficient for inactivation of RNA viruses. The high efficacy of UV-C is already effectively adopted to inactivate airborne RNA viruses.

6.
Anim Cells Syst (Seoul) ; 28(1): 303-314, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38868077

RESUMO

The system forming ovarian follicles is developed to investigate in vitro folliculogenesis in a confined environment to obtain functional oocytes. Several studies have reported the successful generation of fully functional oocytes using mouse-induced pluripotent stem cells (iPSCs) and mouse female germline stem cells (fGSCs) as sources of stem cells for in vitro gametogenesis models. In addition, human oogonia have been generated through heterologous co-culture of differentiated human primordial germ cell-like cells (hPGCLCs) with mouse germline somatic cells, although oocyte formation remains challenging. Thus, studies on in vitro ovarian formation in other species are utilized as an introductory approach for in vitro mammalian gametogenesis by understanding the differences in culture systems between species and underlying mechanisms. In this study, we optimized the method of the entire oogenesis process from rat embryonic gonads. We identified well-maturated MII oocytes from rat gonads using our constructed method. Moreover, we generated the first successful in vitro reconstitution of xenogeneic follicles from mouse primordial germ cells (PGCs) and rat somatic cells. We also established an appropriate culture medium and incubation period for xenogeneic follicles. This method will be helpful in studies of xenogeneic follicular development and oocyte generation.

7.
Thyroid ; 34(6): 723-734, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38874262

RESUMO

Background: Artificial intelligence (AI) is increasingly being applied in pathology and cytology, showing promising results. We collected a large dataset of whole slide images (WSIs) of thyroid fine-needle aspiration cytology (FNA), incorporating z-stacking, from institutions across the nation to develop an AI model. Methods: We conducted a multicenter retrospective diagnostic accuracy study using thyroid FNA dataset from the Open AI Dataset Project that consists of digitalized images samples collected from 3 university hospitals and 215 Korean institutions through extensive quality check during the case selection, scanning, labeling, and reviewing process. Multiple z-layer images were captured using three different scanners and image patches were extracted from WSIs and resized after focus fusion and color normalization. We pretested six AI models, determining Inception ResNet v2 as the best model using a subset of dataset, and subsequently tested the final model with total datasets. Additionally, we compared the performance of AI and cytopathologists using randomly selected 1031 image patches and reevaluated the cytopathologists' performance after reference to AI results. Results: A total of 10,332 image patches from 306 thyroid FNAs, comprising 78 malignant (papillary thyroid carcinoma) and 228 benign from 86 institutions were used for the AI training. Inception ResNet v2 achieved highest accuracy of 99.7%, 97.7%, and 94.9% for training, validation, and test dataset, respectively (sensitivity 99.9%, 99.6%, and 100% and specificity 99.6%, 96.4%, and 90.4% for training, validation, and test dataset, respectively). In the comparison between AI and human, AI model showed higher accuracy and specificity than the average expert cytopathologists beyond the two-standard deviation (accuracy 99.71% [95% confidence interval (CI), 99.38-100.00%] vs. 88.91% [95% CI, 86.99-90.83%], sensitivity 99.81% [95% CI, 99.54-100.00%] vs. 87.26% [95% CI, 85.22-89.30%], and specificity 99.61% [95% CI, 99.23-99.99%] vs. 90.58% [95% CI, 88.80-92.36%]). Moreover, after referring to the AI results, the performance of all the experts (accuracy 96%, 95%, and 96%, respectively) and the diagnostic agreement (from 0.64 to 0.84) increased. Conclusions: These results suggest that the application of AI technology to thyroid FNA cytology may improve the diagnostic accuracy as well as intra- and inter-observer variability among pathologists. Further confirmatory research is needed.


Assuntos
Inteligência Artificial , Neoplasias da Glândula Tireoide , Humanos , Biópsia por Agulha Fina/métodos , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Estudos Retrospectivos , Glândula Tireoide/patologia , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/diagnóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico , Citologia
8.
Acta Otolaryngol ; 144(3): 187-192, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38753949

RESUMO

BACKGROUND: Studies of risk factors for middle ear cholesteatoma surgery using population-based data are lacking. OBJECTIVES: To investigate the risk factors for cholesteatoma surgery in adults based on population data from Korea. MATERIALS AND METHODS: For this retrospective study, we used Korean National Health Insurance Service National Sample Cohort data. Patients who were 20 years or older and underwent mastoidectomy from 2006 through 2015 under the diagnostic codes of cholesteatoma were defined as patients with middle ear cholesteatoma surgery. The control group was comprised of the remaining database sample in 2006. Sociodemographic factors in 2006 and histories of medical diseases, allergic diseases, and chronic sinusitis from 2003 through 2005 were compared between cholesteatoma surgery and control groups. RESULTS: A total of 459 patients underwent cholesteatoma surgery. In multivariate Cox regression analysis, age 40-59 years and residence in metropolitan cities and small- and medium-sized cities and counties were significant risk factors for cholesteatoma surgery whereas allergic rhinitis, asthma, atopic dermatitis, and chronic sinusitis were not significant risk factors for middle ear cholesteatoma surgery. CONCLUSIONS AND SIGNIFICANCE: The present study found no evidence of associations between allergic diseases or chronic sinusitis and cholesteatoma surgery in adults.


Assuntos
Colesteatoma da Orelha Média , Humanos , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Colesteatoma da Orelha Média/cirurgia , Colesteatoma da Orelha Média/epidemiologia , Adulto , Feminino , Masculino , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem , Idoso , Mastoidectomia
9.
Laryngoscope Investig Otolaryngol ; 9(3): e1254, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38736946

RESUMO

Objectives: Comprehensive studies in which the seasonal variation in peripheral vestibular disorders was evaluated using data from an entire population are insufficient. The seasonal variation in peripheral vestibular disorders based on data from the entire Korean population was investigated in the present study. Methods: Retrospective data from the National Health Insurance Service of Korea from 2008 to 2020 was analyzed. Benign paroxysmal positional vertigo (BPPV), vestibular neuritis (VN), and Meniere's disease (MD) were defined based on diagnostic, treatment, or audiovestibular test codes. The seasonal incidence for each peripheral vestibular disorder was calculated among all study subjects. Results: For the entire study cohort, the incidence of BPPV was significantly higher in spring (odds ratio [OR] = 1.031, 95% confidence interval [CI] = 1.026-1.037), autumn (OR = 1.024, 95% CI = 1.019-1.029), and winter (OR = 1.051, 95% CI = 1.046-1.056) than in summer. The incidence of VN was significantly lower in winter (OR = 0.917, 95% CI = 0.907-0.927) than in summer. The incidence of MD was significantly higher in spring (OR = 1.027, 95% CI = 1.015-1.039) and autumn (OR = 1.029, 95% CI = 1.017-1.041) and significantly lower in winter (OR = 0.919, 95% CI = 0.908-0.931) than in summer. Differences were also observed in seasonal variation based on sex and age. Conclusions: Significant seasonal variation occurred in peripheral vestibular disorders including BPPV, VN, and MD based on the entire Korean population data. Furthermore, seasonal variation showed differences based on sex and age. Level of Evidence: 4.

10.
Pain Physician ; 27(4): E419-E429, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38805537

RESUMO

BACKGROUND: The knee joint is one of the most common diseases in elderly individuals. This is a progressive and debilitating condition. The purpose of knee osteoarthritis treatment is to manage pain, increase mobility, and improve the quality of life. OBJECTIVES: This study evaluated the therapeutic effect of radiofrequency thermocoagulation (RFTC) on the genicular nerves in patients with intractable pain due to knee osteoarthritis, as well as its effects on pain severity and magnetic resonance imaging (MRI) findings. STUDY DESIGN: A prospective outcome study. SETTING: The outpatient clinic of a single academic medical center. METHODS: We conducted a prospective study. Fifty consecutive patients with intractable knee pain due to osteoarthritis were enrolled and underwent ultrasound (US)-guided RFTC of the genicular nerves (medial superior genicular nerve, medial inferior genicular nerve, and lateral superior genicular nerve). Pain severity was measured using the Numeric Rating Scale (NRS), and knee osteoarthritis-associated symptoms were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at pretreatment and one, 3, and 6 months after RFTC treatment. We also analyzed the relationship between therapeutic outcomes and pain severity based on pre-treatment and knee MRI findings. RESULTS: No dropouts were observed. The most significant reduction in knee symptoms associated with knee osteoarthritis was observed after one month of treatment; however, at 3 and 6 months, there was a rebound effect, leading to a decrease in therapeutic efficacy. Nonetheless, there was still a noticeable decrease in symptoms due to knee osteoarthritis compared to those prior to RFTC treatment. The effect of RFTC treatment was better when pre-treatment pain was relatively less severe, knee effusion was not severe, there were no meniscal tears in the middle or posterior zones, no bone marrow edema in the middle and posterior zones of the femur and tibia, and no severe cartilage defects in the posterior femur and middle and posterior tibia. LIMITATIONS: We conducted our study without a control or a placebo group. CONCLUSION: RFTC of the genicular nerve is a good therapeutic option for controlling intractable pain following knee osteoarthritis. In addition, we found that a lower level of pain prior to treatment, along with the absence or lesser degree of knee joint effusion, as well as an absence or less severe middle or posterior knee pathologies associated with knee osteoarthritis, can predict a more favorable therapeutic outcome.


Assuntos
Osteoartrite do Joelho , Ablação por Radiofrequência , Humanos , Osteoartrite do Joelho/cirurgia , Osteoartrite do Joelho/complicações , Estudos Prospectivos , Ablação por Radiofrequência/métodos , Idoso , Masculino , Feminino , Pessoa de Meia-Idade , Dor Intratável/terapia , Dor Intratável/etiologia , Dor Intratável/cirurgia , Articulação do Joelho/cirurgia , Articulação do Joelho/inervação , Resultado do Tratamento , Manejo da Dor/métodos , Medição da Dor , Imageamento por Ressonância Magnética
11.
Violence Against Women ; : 10778012241254858, 2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38794891

RESUMO

Using original surveys to investigate how online gender-based harassment marginalizes or empowers female college students, we found increased exposure to misogyny polarizes digital participation. Women aware of gender inequality in Korea encountering online hate speech were more inclined to engage in online movements, unlike women who did not recognize such inequality. This highlights distinct opportunities in relation to digital activism, showing online hate speech can sometimes be a catalyst for online political participation. This study expands current research on digital protest, highlighting the political ramifications of empowering women in the critical context of their unequal democratic rights outside the West.

12.
Sensors (Basel) ; 24(10)2024 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-38794087

RESUMO

A design method for an ultra-wideband coplanar-stripline-based vertical transition that can be used for ultra-high-speed digital interfaces is proposed. A conventional via structure, based on a differential line (DL), inherently possesses performance limitations (<10 GHz) due to difficulties in maintaining constant line impedance and smooth electric field transformation, in addition to the effects of signal skews, FR4 fiber weave, and unbalanced EM interferences. DL-based digital interfaces may not meet the demands of ultra-high-speed digital data transmission required for the upcoming 6G communications. The use of a coplanar stripline (CPS), a type of planar balanced line (BL), for the vertical transition, along with the ultra-wideband DL-to-CPS transition, mostly removes the inherent and unfavorable issues of the DL and enables ultra-high-speed digital data transmission. The design process of the transition is simplified using the analytical design formulas, derived using the conformal mapping method, of the transition. The characteristic line impedances of the transition are calculated and found to be in close agreement with the results obtained from EM simulations. Utilizing these results, the CPS-based vertical transition, maintaining the characteristic line impedance of 100 Ω, is designed and fabricated. The measured results confirm its ultra-wideband characteristics, with a maximum of 1.6 dB insertion loss and more than 10 dB return loss in the frequency range of DC to 30 GHz. Therefore, the proposed CPS-based vertical transition offers a significantly wider frequency bandwidth, i.e., more than three times that of conventional DL-based via structures.

13.
Scand J Gastroenterol ; 59(7): 868-874, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38587111

RESUMO

OBJECTIVES: While endoscopic resection of rectal neuroendocrine tumors (NETs) has significantly increased, long-term data on risk factors for recurrence are still lacking. Our aim is to analyze the long-term outcomes of patients with rectal NETs after endoscopic resection through risk stratification. METHODS: In this multicenter retrospective study, we included patients who underwent endoscopic resection of rectal NETs from 2009 to 2018 and were followed for ≥12 months at five university hospitals. We classified the patients into three risk groups according to the clinicopathological status of the rectal neuroendocrine tumors: low, indeterminate, and high. The high-risk group was defined if the tumors have any of the followings: size ≥ 10 mm, lymphovascular invasion, muscularis propria or deeper invasion, positive resection margins, or mitotic count ≥2/10. RESULTS: A total of 346 patients were included, with 144 (41.6%), 121 (35.0%), and 81 (23.4%) classified into the low-, indeterminate-, and high-risk groups, respectively. Among the high-risk group, seven patients (8.6%) received salvage treatment 28 (27-67) days after the initial endoscopic resection, with no reported extracolonic recurrence. Throughout the follow-up period, 1.1% (4/346) of patients experienced extracolonic recurrences at 56.5 (54-73) months after the initial endoscopic resection. Three of these patients (75%) were in the high-risk group and did not undergo salvage treatment. The risk of extracolonic recurrence was significantly higher in the high-risk group compared to the other groups (p = 0.039). CONCLUSION: Physicians should be concerned about the possibility of metastasis during long-term follow-up of high-risk patients and consider salvage treatment.


Assuntos
Recidiva Local de Neoplasia , Tumores Neuroendócrinos , Neoplasias Retais , Humanos , Estudos Retrospectivos , Neoplasias Retais/cirurgia , Neoplasias Retais/patologia , Masculino , Feminino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/cirurgia , Tumores Neuroendócrinos/patologia , Idoso , Medição de Risco/métodos , Adulto , Fatores de Risco , Resultado do Tratamento , Terapia de Salvação , Ressecção Endoscópica de Mucosa , Margens de Excisão
14.
J Phys Chem A ; 128(18): 3579-3586, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38662918

RESUMO

We report a high-resolution photoelectron imaging study of cryogenically cooled BiB2- and BiB3- clusters. Vibrational features are completely resolved for the ground-state detachment transitions, providing critical information about the structures of the anionic clusters and their corresponding neutrals. The electron affinities of BiB2 and BiB3 are accurately measured to be 2.174(1) and 2.121(1) eV, respectively. The B-B and Bi-B stretching frequencies are measured to be 1262 and 476 cm-1, respectively, in the ground state of BiB2. Three vibrational frequencies are measured for the ground state of BiB3: 1194 cm-1 (B-B stretching), 782 cm-1 (B-B stretching), and 339 cm-1 (Bi-B stretching). Both BiB2- and BiB3- and their neutral ground states are found to have planar C2v structures in which the Bi atom bridges two B atoms. BiB2- is found to have a triplet spin state (3B2), consistent with its complicated photoelectron spectra, whereas BiB3- is a doublet (2B1) and neutral BiB3 is closed shell (1A1). Both BiB2 and BiB3 consist of peripheral localized Bi-B and B-B σ bonds and delocalized π and σ bonds.

15.
J Phys Chem A ; 128(18): 3564-3570, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38676655

RESUMO

Spontaneous symmetry-breaking is common in chemical and physical systems. Here, we show that by adding an electron to the C7v PbB8 cluster, which consists of a planar B8 disk with the Pb atom situated along the C7 axis, the Pb atom spontaneously moves to the off-axis position in the PbB8- anion. Photoelectron spectroscopy of PbB8- reveals a broad ground-state transition and a large energy gap, suggesting a highly stable closed-shell PbB8 borozene complex and a significant geometry change upon electron detachment. Quantum chemistry calculations indicate that the lowest unoccupied molecular orbital of the C7v PbB8 cluster is a degenerate π orbital mainly consisting of the Pb 6px and 6py atomic orbitals. Occupation of one of the 6p orbitals spontaneously break the C7v symmetry in the anion due to the Jahn-Teller effect. The large amplitude of the position change of Pb in PbB8- relative to PbB8 is surprising owing to bonding interactions between the Pb 6p orbital with the π orbital of the B8 borozene.

16.
ACS Appl Mater Interfaces ; 16(17): 22131-22138, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38632927

RESUMO

Due to the increasing complexity in miniaturization of electronic devices, reconfigurable field-effect transistors (RFETs) have emerged as a solution. Although the foundational concepts of RFETs have matured over two decades, ongoing breakthroughs are needed to address challenges such as improving the device performance as well as achieving balanced symmetry between n-type and p-type transport modes with long-term stability. Herein, we present a nonvolatile WSe2-based RFET that utilizes photoassisted interfacial charge trapping at the h-BN and SiO2 interface. Unlike typical RFETs with two gate electrodes, our RFETs achieved polarity control with a single operating gate activated exclusively under white-light exposure. The threshold voltage was tunable, ranging from 27.4 (-31.6 V) to 0.9 (+19.5 V), allowing selective activation of n-type (p-type) operation at VGS = 0 V. Additionally, our WSe2-based RFETs show superior repeatability and long-term stability. Leveraging these advantages, various reconfigurable logic circuits were successfully demonstrated, including complementary inverters and switch circuits as well as pull-up and pull-down circuits, highlighting the potential of WSe2 FETs for future advancements of integrated circuits.

17.
Adv Mater ; : e2314274, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38647521

RESUMO

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.

18.
Brain Behav ; 14(5): e3481, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38680018

RESUMO

BACKGROUND AND PURPOSE: The ANNEXA-4 trial measured hemostatic efficacy of andexanet alfa in patients with major bleeding taking factor Xa inhibitors. A proportion of this was traumatic and nontraumatic intracranial bleeding. Different measurements were applied in the trial including volumetrics to assess for intracranial bleeding depending on the compartment involved. We aimed to determine the most reliable way to measure intracranial hemorrhage (ICrH) volume by comparing individual brain compartment and total ICrH volume. METHODS: Thirty patients were randomly selected from the ANNEXA-4 database to assess measurement of ICrH volume by compartment and in total. Total and compartmental hemorrhage volumes were measured by five readers using Quantomo software. Each reader measured baseline hemorrhage volumes twice separated by 1 week. Twenty-eight different ANNEXA-4 subjects were also randomly selected to assess intra-rater reliability of total ICrH volume measurement change at baseline and 12-h follow up, performed by three readers twice to assess hemostatic efficacy categories used in ANNEXA-4. RESULTS: Compartmental minimal detectable change percentages (MDC%) ranged between 9.72 and 224.13, with the greatest measurement error occurring in patients with a subdural hemorrhage. Total ICrH volume measurements had the lowest MDC%, which ranged between 6.57 and 33.52 depending on the reader. CONCLUSION: Measurement of total ICrH volumes is more accurate than volume by compartment with less measurement error. Determination of hemostatic efficacy was consistent across readers, and within the same reader, as well as when compared to consensus read. Volumetric analysis of intracranial hemostatic efficacy is feasible and reliable when using total ICrH volumes.


Assuntos
Fator Xa , Hemorragias Intracranianas , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Proteínas Recombinantes/administração & dosagem , Inibidores do Fator Xa/administração & dosagem , Inibidores do Fator Xa/uso terapêutico , Idoso , Reprodutibilidade dos Testes , Adulto , Encéfalo/diagnóstico por imagem
20.
Clin Orthop Surg ; 16(2): 326-334, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38562638

RESUMO

Background: The use of electric scooters (e-scooters) continues to increase as a simple, inexpensive means of transport, resulting in a sharp increase in the incidence of scooter-related accidents. No study to date has closely examined the injury extent to the lower leg, joints, and extremities from e-scooter-related accidents. Here, we investigated the epidemiology and injury patterns of such accidents, focusing on injuries to the ankle and foot. Methods: Based on data from a single tertiary hospital's database, the demographics of 563 patients with scooter-associated injuries were analyzed retrospectively. Among the patients, 229 patients who were injured by e-scooter riding were further investigated. Based on the data, the general demographics of whole scooter-associated injuries and the injury characteristics and fracture cases of the lower leg, ankle, and foot were analyzed. Results: During the 4-year study period, the number of patients injured by e-scooters increased every year. Lower extremities were the most common injury site (67.2%) among riders, whereas injuries to the head and neck (64.3%) were more common in riders of non-electric scooters. Among the lower leg, ankle, and foot injuries of riders (52 cases), the ankle joint (53.8%) was the most commonly injured site, followed by the foot (40.4%) and lower leg (21.2%). The fracture group scored significantly higher on the Abbreviated Injury Scale than the non-fracture group (p < 0.001). Among the fracture group (20 cases), ankle fractures (9 cases) were most common, including pronation external rotation type 4 injuries (4 cases) and pilon fractures (2 cases). Five patients (25%) had open fractures, and 12 patients (60%) underwent surgical treatment. Conclusions: The ankle and foot are the most common injury sites in e-scooter-related accidents. Given the high frequency and severity of e-scooter-related ankle and foot injuries, we suggest that more attention be paid to preventing these types of injuries with greater public awareness of the dangers of using e-scooters.


Assuntos
Fraturas do Tornozelo , Traumatismos do Pé , Humanos , Tornozelo , Articulação do Tornozelo , Estudos Retrospectivos , Acidentes de Trânsito , Traumatismos do Pé/epidemiologia , Traumatismos do Pé/etiologia , Acidentes
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