Association between Apolipoprotein E Polymorphism and Clinical Outcome after Ischemic Stroke, Intracerebral Hemorrhage, and Subarachnoid Hemorrhage.

BACKGROUNDS: Previous studies reported inconsistent results regarding associations between apolipoprotein E (APOE) polymorphism and clinical outcomes after ischemic stroke (IS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). Thus, the study was designed to make a systematic review and meta-analysis regarding the association between APOE polymorphism and clinical outcome after IS, ICH, and SAH. METHODS: To identify studies eligible for this meta-analysis, we searched for articles published before August 2021 in the databases (PubMed, Web of Science, and Google Scholar). We used STATA 12.0 software to compute hazard ratios (HRs) and their 95% confidence intervals (CIs) regarding APOE polymorphism and clinical outcome after IS, ICH, and SAH. RESULTS: Meta-analysis showed no significant association between APOE polymorphism and functional outcome after IS with fixed effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.00; 95% CI: 0.83-1.21, I2 = 29.4%, p = 0.183; ε2 carrier vs. non-ε2 carrier: HR, 0.92; 95% CI: 0.72-1.16, I2 = 15.6%, p = 0.307). Meta-analysis showed that ICH patients carrying ε4 allele have increased risk of poor outcome in Caucasian population with fixed effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.75; 95% CI: 1.19-2.57, I2 = 0.0%, p = 0.543). Meta-analysis showed no significant association between APOE polymorphism and functional outcomes after SAH with random effects models (ε4 carrier vs. non-ε4 carrier: HR, 1.51; 95% CI: 0.80-2.84, I2 = 57.1%, p = 0.022). CONCLUSIONS: In conclusion, the present study demonstrated APOE ε4 carriers show worse functional outcomes after ICH, but not after IS or SAH. More large-scale studies were critical to explore the association between APOE polymorphism and clinical outcome after IS, ICH, and SAH.

Inner ear function in patients with obstructive sleep apnea.

OBJECTIVE: Because of their high metabolic activity and low-resting oxygen tension, the organs of the inner ear are vulnerable to hypoxia, a condition that occurs repetitively in obstructive sleep apnea-hypopnea syndrome (OSAHS). The present study aimed to investigate the inner ear function of patients with OSAHS. METHODS: A total of 58 patients with OSAHS (116 ears) and 20 adults without OSAHS were enrolled in the present study. The clinical features, such as air-conduction thresholds, auditory brainstem response (ABR, 11 times/s and 51 times/s stimulation rates), and distorted products otoacoustic emission (DPOAE), were evaluated and compared between these two groups. RESULTS: Air-conduction thresholds at 4 kHz and 8 kHz were higher in patients with OSAHS compared with controls (P < 0.001). At the rate of 11 times per second, biauricular wave I latencies and wave V latencies in the OSAHS group were longer than those in the control group (1.51 ± 0.13 vs. 1.33 ± 0.07 ms, P < 0.001; 5.65 ± 0.23 vs. 5.53 ± 0.23 ms, P = 0.0016). At the rate of 51 times per second, biauricular wave I latencies and wave V latencies in the OSAHS group were longer than those in the control group (1.64 ± 0.12 vs. 1.44 ± 0.06 ms, P = 0.0001; 5.92 ± 0.26 vs. 5.80 ± 0.18 ms, P = 0.0077). However, there was no significant difference in the wave I and wave V interval between these two groups (P = 0.10). DPOAE amplitude was significantly reduced in OSAHS patients, although no hearing loss was observed. CONCLUSION: High-frequency hearing loss was detected in adults with severe OSAHS, and wave I latencies and wave V latencies of ABR were prolonged.

Automatic Recognition of Auditory Brainstem Response Waveforms Using a Deep Learning-Based Framework.

OBJECTIVE: Recognition of auditory brainstem response (ABR) waveforms may be challenging, particularly for older individuals or those with hearing loss. This study aimed to investigate deep learning frameworks to improve the automatic recognition of ABR waveforms in participants with varying ages and hearing levels. STUDY DESIGN: The research used a descriptive study design to collect and analyze pure tone audiometry and ABR data from 100 participants. SETTING: The research was conducted at a tertiary academic medical center, specifically at the Clinical Audiology Center of Tsinghua Chang Gung Hospital (Beijing, China). METHODS: Data from 100 participants were collected and categorized into four groups based on age and hearing level. Features from both time-domain and frequency-domain ABR signals were extracted and combined with demographic factors, such as age, sex, pure-tone thresholds, stimulus intensity, and original signal sequences to generate feature vectors. An enhanced Wide&Deep model was utilized, incorporating the Light-multi-layer perceptron (MLP) model to train the recognition of ABR waveforms. The recognition accuracy (ACC) of each model was calculated for the overall data set and each group. RESULTS: The ACC rates of the Light-MLP model were 97.8%, 97.2%, 93.8%, and 92.0% for Groups 1 to 4, respectively, with a weighted average ACC rate of 95.4%. For the Wide&Deep model, the ACC rates were 93.4%, 90.8%, 92.0%, and 88.3% for Groups 1 to 4, respectively, with a weighted average ACC rate of 91.0%. CONCLUSION: Both the Light-MLP model and the Wide&Deep model demonstrated excellent ACC in automatic recognition of ABR waveforms across participants with diverse ages and hearing levels. While the Wide&Deep model's performance was slightly poorer than that of the Light-MLP model, particularly due to the limited sample size, it is anticipated that with an expanded data set, the performance of Wide&Deep model may be further improved.

Efficient CRISPR/Cas9-mediated ebony gene editing in the greater wax moth Galleria mellonella.

The greater wax moth, Galleria mellonella (Lepidoptera, Pyralidae), is a major bee pest that inflicts considerable harm on beehives, leading to economic losses. It also serves as a valuable resource insect and a model organism. The clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system plays a crucial role in improving economic insect breeding and developing efficient agricultural pest management systems in Lepidoptera. However, the CRISPR/Cas9 protocols have not been developed for G. mellonella. Here, the Gmebony knockout (KO) strain was established using the CRISPR/Cas9 genome editing system. We obtained Gmebony KO strain in the G4 generation, which took approximately 10 months. When compared with wild-type, the head, notum, and the terminal abdominal surface of 1st to 4th instar larvae in the KO strain changed from yellow to brown, and these regions of the KO strain gradually transformed into a black color from the 5th instar larvae, and the body color of the adult moth in the KO strain changed to black. The developmental period of the early larval and the following larval instars extended. The embryonic hatchability of the Gmebony KO strain was significantly decreased. The pupal body weight of the Gmebony KO strain was not affected. The feasibility of the CRISPR/Cas9 methodology was validated by single-target editing of Gmebony. Our findings provide the first evidence that the ebony gene can serve as a pigmentation reference gene for genetic modifications of G. mellonella. Meanwhile, it can be utilized in the development of genome editing control strategies and for gene function analyses in G. mellonella.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment.

Background: Sudden sensorineural hearing loss (SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy (IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy (SST). Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors. Methods: Totally, 74 patients who were aged 22-81 years with SSNHL were enrolled and allocated to either the control group (n = 25) or the treatment group (n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2-6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST. Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies (250-8000 Hz) compared with the control group (P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment (P = 0.002), whereas age, duration of SST, and time of IST were not (P > 0.05). Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.

Analysis of cognitive function and its related factors after treatment in Meniere's disease.

A growing body of research recently suggested the association between vestibular dysfunction and cognitive impairment. Meniere's disease (MD), a common clinical vestibular disorder, is usually accompanied by hearing loss and emotional stress, both of which may mediate the relationship between vestibule dysfunction and cognition. It is currently unknown whether the cognitive decline in MD patients could improve through treatment and how it relates to multiple clinical characteristics, particularly the severity of vertigo. Therefore, in the present study, the MD patients were followed up for 3, 6, and 12 months after treatment, and the cognitive functions, vertigo symptoms, and related physical, functional, and emotional effects of the patients were assessed using the Montreal Cognitive Assessment (MoCA) and Dizziness Handicap Inventory (DHI), aiming to explore the change in cognition before and after therapy and the correlation with various clinical features. It was found that cognitive decline in MD patients compared to healthy controls before therapy. Importantly, this cognitive impairment could improve after effective therapy, which was related to the severity of vertigo, especially in functional and physical impacts. Our results support the view that vestibular dysfunction is a potentially modifiable risk factor for cognitive decline.

Plasma Oscillatory Pressure Sintering of Mo-9Si-8B Alloy with ZrB2 Addition.

Oscillatory pressure sintering is a novel crystal refinement technology. The doping of different concentrations of ZrB2 under oscillatory sintering technology (9 Hz) is discussed here, focusing on its macroscopic mechanics and oxidation resistance. In particular, doping 2.5 wt% ZrB2 can effectively increase the hardness of the alloy, slightly increase the fracture toughness of the alloy and have an outstanding effect on the oxidation resistance of the alloy at 1300 °C, achieving the effect of reducing mass loss by 80.3%.

Clinical case control study analysis of vestibular function in patients with obstructive sleep apnea-hypopnea syndrome.

BACKGROUND: To investigate the effects of hypoxia degree and sleep duration on vestibular function in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients. We made further study of the low oxygen levels of OSAHS and hypoxic duration on the impact of vestibular function, and further studied the OSAHS the longest apnea time and Vestibular Evoked Myogenic Potential (VEMP) abnormal rate and the relationship between the vestibular function of canal paralysis (CP). METHODS: A total of 87 OSAHS patients and 47 healthy individuals were enrolled in this study. There was no difference in gender, age and body mass index (BMI) values in matched experimental groups. Other diseases of other systems were excluded. All the participants completed sleepiness questionnaires (i.e., the Epworth sleepiness scale and the STOP-BANG questionnaire) and the Dizziness Handicap Inventory (DHI). Additionally, a caloric test, positional test, electrocochleogram, and VEMP test were administered to evaluate the vestibular function of all the participants. A polysomnography (PSG) was also performed. RESULTS: The current investigation generated the following three major findings: (I) there was a significant correlation between body mass index and canal paresis [CP; P=0.014, odds ratio (OR) =1.791, 95% confidence interval (CI): 1.125-2.851] and a significant positive correlation between the DHI score and VEMP results (P=0.0061, OR =3.667, 95% CI: 1.449-9.276); (II) the CP abnormality rate of the OSAHS group was significantly higher than that of the control group (P<0.05); (III) there was a significant correlation between the longest apnea duration and the DHI score (r=-0.191, P<0.05). CONCLUSIONS: The abnormality rate of the vestibular function of OSAHS patients is higher than that of healthy people. OSAHS intermittent hypoxia can affect vestibular function in the inner ear, and the longer the duration of prolonged hypoxia, the more serious the vestibular function damage.

Study on the Pre-Oxidation and Resulting Oxidation Mechanism and Kinetics of Mo-9Si-8B Alloy.

Molybdenum silicon boron alloy is regarded as the next generation of superalloy that is expected to replace nickel-based superalloys. However, the high-temperature oxidation resistance of Mo-Si-B alloy has always been an issue worth studying. In this study, Mo-9Si-8B alloy was prepared via a plasma oscillatory pressure sintering process and pre-oxidized at 1300 °C while maintaining a certain balance of mechanical and oxidation properties. The influence of the oxide protective layer on its performance at high temperature of 1150 °C was explored, the micro-mechanism of its performance and its failure mode of the hinge-locking mechanism was illustrated, and finally, its oxidation kinetics was inferred. In conclusion, pre-oxidized Mo-9Si-8B (at.%) alloy did play a role in delaying the oxidation process during the initial period of cyclic oxidation. However, with the increase of cyclic oxidation time, the improvement of high-temperature oxidation resistance was limited.

Heat Transfer, Molten Pool Flow Micro-Simulation, and Experimental Research on Molybdenum Alloys Fabricated via Selective Laser Melting.

Molybdenum-based alloys fabricated via selective laser melting are considered to represent the next generation of high-temperature structural materials, but the additive manufacturing technology aiming at refractory alloys has not been explored extensively. Multi-field coupling simulation can be used as a practical tool to simulate a single track of molybdenum alloy printed via selective laser melting, observe the topography of the molten pool over time, and determine the effect of Marangoni flow on defect suppression. In this study, the tmelt, tvapor, and the competition mechanism of spreading/solidification time were considered, the dominant spreading time was calculated, and a reasonable process parameter window for fabricating molybdenum alloy was obtained. It was found that keeping the energy density in the range of 3.1 × 1011 J/m3-4.0 × 1011 J/m3 could better maintain appropriate melt channel depth and width and was beneficial to the droplet spreading behavior. This range was deemed suitable for printing molybdenum alloy.

[The association between genetic polymorphisms of DNA repair genes XPD, XPC and susceptibility to laryngeal carcinoma].

OBJECTIVE: To analyze the association between genetic polymorphisms of DNA repair genes of XPD (751 Lys/Gln), XPC (PAT)and susceptibility to laryngeal carcinoma. To explore the effect between DNA repair genes of XPD (751 Lys/Gln), XPC (PAT) and carcinogenesis of LSCC(laryngeal squamous cell carcinoma). METHOD: A case-control study was conducted involving 233 LSCC patients and 102 healthy controls to investigate the association between polymorphisms of XPD(751 Lys/Gln), XPC (PAT) and LSCC. All blood samples of the Han people from the Guang Dong Zone was analysze with methods of PCR, PCR-RFLP, ASA and the technique of checking DNA sequencing with sequenator. We explored the association between polymorphisms and the clinical pathologic characteristic of LSCC. The data was compute with SPSS13.0. Odds Ratios (ORs) with 95% CI for relevancy intensity were calculated using binary logistic regression analysis. REULT: There is no difference of the frequency of XPC-PAT and XPD (751 Lys/Gln) genotype between in LSCC and in healthy contradistinguish (P > 0.05). CONCLUSION: There may be no association between the susceptibility to laryngeal carcinoma and the genotype of XPC-PAT and XPD (751 Lys/Gln).

[Surgical treatment of nasosinus tumor involving base of the anterior cranial fossa].

OBJECTIVE: To explore the operative approach for nasosinus tumors involving the base of the anterior cranial fossa. METHOD: Seven cases with defects, diameter less than 2 cm, on the skull base without damage of the duramater were not repaired. Other 7 cases with defects, diameter more than 2.5 cm, on both the skull base and duramater were covered with frontalis muscle flap or temporalis fascia flap. RESULT: Following up 1-8 year. 6 of the 11 malignant tumors survived after 3 years and 2 cases did after 4 years; 3 cases of benignant tumors are still alive, neither meningoephalocele nor cerebrospinal fluid fistula and extracranial or intracranial infection occurred. CONCLUSION: This operative mode is closer to the tumor and easy to repair duramater and stop bleeding, and has fine exposure of every nasal sinus, minimal retraction of the frontal lobe. If diameter of defect is more than 2 cm on the skull base, the reconstruction is necessary.