Predictive Capabilities of Human Leukocyte Antigen-G and Galectin-13 Levels in the Amniotic Fluid and Maternal Blood for the Pregnancy Outcome.

Background and Objectives: Increasing evidence points to the significant role of the angiogenic factor levels in screening for pregnancy outcome. To examine the potential relationship between concentrations of placental protein 13 (PP13) and soluble human leukocyte antigen-G (sHLA-G) in maternal serum and amniotic fluid at 16-23 weeks of gestation and the sonographic features of pregnancy as well as pregnancy outcome. Materials and Methods: PP13 and sHLA-G in serum and amniotic fluid, fetal biometrical data, and placental volume and perfusion indices were determined in 71 euploid, singleton pregnancies. Results: The serum sHLA-G level exhibits a negative correlation with the serum PP13 level (r = -0.186, p < 0.001) and a positive correlation with the sHLA-G level in amniotic fluid (r = 0.662, p < 0.001). A significant correlation was found between serum sHLA-G level and placental volume (r = 0.142, p < 0.05) and between amniotic sHLA-G level and placental perfusion (r = -0.450, p < 0.001). A low amniotic PP13 level significantly predicted the birth weight (r = -0.102, p < 0.05), the duration of pregnancy (r = -0.155, p < 0.05), and the fetal abdominal circumference (r = -0.098, p < 0.05). Conclusions: PP13 assayed in amniotic fluid might be a potential marker of fetal growth, and sHLA-G can be an adjunct modality reflecting placental sonographic parameters.

The prognostic role of ultrasound and magnetic resonance imaging in obstructive sleep apnoea based on lateral oropharyngeal wall obstruction.

PURPOSE: This study examined the prognostic value of the lateral pharyngeal wall (LPW)-based obstruction and obstructive sleep apnoea (OSA) prediction using ultrasound (US) and MRI (magnetic resonance imaging). METHODS: One hundred patients with and without OSA were enrolled, according to overnight polysomnography. The LPW thickness (LPWT) was measured using a Philips Ingenia 1.5 T MRI device, and US measurements were carried out at rest and during Müller's manoeuvre (MM) with a Samsung RS85 device. The obstruction was localised under drug-induced sleep endoscopy. RESULTS: Significantly greater LPWT using MRI was observed in the OSA group compared to the control group, while US results showed a significant difference only in the case of LPWT during MM on the left side. Obese patients presented significantly higher LPWT values. A significant correlation between BMI and LPWT was observed. Men presented significantly higher LPWT MRI values and left-sided LPWT using US compared to women. LPWT and AHI parameters were significantly correlated. The severity of LPW obstruction correlated with LPWT, while the LPW collapse significantly correlated with AHI. The severity of LPW collapse differed depending on the AHI values. Using US LPWT values and anthropometric parameters, a 93% effectiveness in OSA prognostication and 89% in LPWT-based obstruction were detected. MRI detected OSA in 90% and LPW-based obstruction in 84%. US successfully detected LPW-based collapse severity in 67%. CONCLUSION: US LPWT measurements were helpful in detecting OSA and LPWT-based obstruction. These examinations may be useful for surgical planning.

Long-term follow-up of patients with vestibular neuritis by caloric testing and directional preponderance calculation.

OBJECTIVES: This study focuses on the diagnostic precision of caloric testing in detecting vestibular neuritis (VN). MATERIALS AND METHODS: In this study, 99 patients (36 men, 63 women, mean age: 44.63 years [Formula: see text] 12.08 SD) with superior VN were involved, and 157 participants with a normal functioning vestibular system were also investigated. All patients underwent a complete neurotological examination, including the caloric test with electronystagmography registration. The canal paresis (CP) and directional preponderance (DP) values were analysed. RESULTS: A VN on the right side was diagnosed in 31.3% and on the left side in 68.7%. When the CP parameters between the control and VN patients were contrasted, a statistically significant difference was observed (p < 0.00001*, Mann-Whitney U test), indicating higher values in the latter group. The prediction of VN based on the CP value was successful in 71%, and statistical analysis indicated a significant result [p < 0.0001*; OR: 5.730 (95% CI 3.301-9.948)]. The DP values were also significantly higher in the VN group (p < 0.00001*). The prediction of VN according to the DP value was successful in 69.8%. A significant result was also observed in this case [p < 0.001*; OR: 4.162 (95% CI 2.653-8.017)]. When both CP and DP were considered, a predictive value of 84.8% with a significant outcome [p < 0.0001*; OR: 82.7 (95% CI 28.4-241.03)] was detected. CONCLUSIONS: Including the CP and DP parameters of the caloric test, VN could be detected in around 85%. Therefore, the caloric helps diagnose the disorder, but both parameters must be considered.

Analysis of possible risk factors for the severity of paediatric obstructive sleep apnoea syndrome.

PURPOSE: This study aimed to determine the effect of body mass index (BMI) percentile, asthma, sex, and age on the paediatric obstructive sleep apnoea (OSA) severity. Furthermore, to determine the possible predictive role of the BMI percentile and age in severe OSA. METHODS: This retrospective study included 921 children aged 2-18 years diagnosed with OSA by polysomnography. Analysis of Covariance (ANCOVA), Spearman's correlation, Receiver Operating Characteristics (ROC) analyses were performed and area under the curve (AUC) was determined. RESULTS: We observed a significant association between a higher BMI percentile and the severity of OSA (p < 0.001, ρ = 0.15). The correlation also was significant under (p = 0.007, ρ = 0.11) and over 7 (p = 0.0002, ρ = 0.23) years of age. There was no association between the severity of OSA and the presence of asthma (p = 0.9) or sex (p = 0.891), respectively. Age was significantly related to OSA severity (p = 0.01, ρ = 0.08). Although both the BMI percentile (0.59 AUC [0.54-0.65]) and age (0.58 AUC [0.52-0.63]) predicted severe OSA, according to the sensitivity and specificity values of the ROC curve, the association presents a slight clinical relevance. CONCLUSIONS: OSA severity is determined by the BMI percentile and age in children; however, these factors are unsuitable for predicting severe OSA in clinical practice. Based on our results, obesity is also a significant risk factor for OSA in younger children. Our study highlights that older, overweight, and obese children have a higher risk for severe OSA.

Comparison between caloric and video-head impulse tests in Ménière's disease and vestibular neuritis.

OBJECTIVE: To compare the diagnostic accuracies of air caloric testing with electronystagmography and the vHIT (video-head impulse test). DESIGN: Prospective, controlled study. STUDY SAMPLE: MD (Ménière's disease), 26; vestibular neuritis, 27; control, 56. RESULTS: In MD, CP (canal paresis) was pathological in 88.5%, the GA (gain asymmetry) on vHIT was pathological in 65.3%, and the gain was abnormal in only one patient. The GA and CP, were significantly higher in the MD group than in the control group, indicating hypofunction of the horizontal canals in MD, whereas a hyperfunction may also occur. No correlation was observed between the results of the two tests for evaluating MD, suggesting that pathological outcomes of one test do not guarantee abnormalities on the other test. For vestibular neuritis, significantly higher CP (96.3%), GA (81.5%), and gain (51.9%) values were detected. A correlation was identified between the two tests for vestibular neuritis, indicating a similar diagnostic efficiency. The higher percentage of pathological GA versus pathological gain values indicates that the asymmetry may be more informative. CONCLUSIONS: The vHIT showed a higher specificity, whereas the caloric test a higher sensitivity. No correlation between the two methods was observed; therefore, the tests appear to provide complementary information.

Radiation Source Localization Using a Model-Based Approach.

The procedure is practically an optimization method, during which it is assumed that the gamma dose values detected at different points above the area come from the background radiation and from a single source found in the area. Accordingly, the procedure searches within the area for a geographical coordinate for which the distance law for the spatial propagation of radiation will be true. In order to validate the procedure, we performed measurements in a test area in such a way that all parameters of the source, including its location, were well defined. However, these data were not taken into account during the processing, i.e., the search procedure did not have these data. We can estimate the radiation position without a positional parameter. The exact coordinate and the intensity of the radiating sample were only used when checking the results. We have also applied the method to the raw data of our experiments carried out in the past if we used one source for them. The results confirmed our assumptions. The method is suitable for determining the starting parameters of more complex processes that can even detect multiple sources, but assuming one source, it has proven to be a reliable analytical method on its own.

Examination of the diaphragm in obstructive sleep apnea using ultrasound imaging.

PURPOSE: The aim of this study was to analyze the effect of obstructive sleep apnea (OSA) on the ultrasound (US) features of the diaphragm and to determine if diaphragmatic US may be a useful screening tool for patients with possible OSA. METHODS: Patients complaining of snoring were prospectively enrolled for overnight polygraphy using the ApneaLink Air device. Thickness and motion of the diaphragm during tidal and deep inspiration were measured. Logistic regression was used to assess parameters of the diaphragm associated with OSA. RESULTS: Of 100 patients, 64 were defined as having OSA. Thicknesses of the left and right hemidiaphragms were significantly different between OSA and control groups. Using a combination of diaphragmatic dimensions, diaphragm dilation, age, sex, and BMI, we developed an algorithm that predicted the presence of OSA with 91% sensitivity and 81% specificity. CONCLUSION: A combination of anthropometric measurements, demographic factors, and US imaging may be useful for screening patients for possible OSA. These findings need to be confirmed in larger sample sizes in different clinical settings.

Depression scores and quality of life of vertiginous patients, suffering from different vestibular disorders.

PURPOSE: To contrast the quality of life (QoL) impairment and depression scores of patients suffering from different vestibular disorders. METHODS: 301 patients were examined due to vertiginous complaints at the Neurotology Centre of the Department of Otolaryngology and Head and Neck Surgery of Semmelweis University. These patients completed the Hungarian version of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory, and the Symptom Checklist-90-Revised questionnaires. RESULTS: According to neurotological examination, the distribution of the different diagnoses was as follows: Menière's disease (n = 101), central vestibular disorders (n = 67), BPPV (n = 47), vestibular neuritis (n = 39), other unilateral peripheral vestibulopathy (n = 18), PPPD (Persistent Postural-Perceptual Dizziness) (n = 16), vestibular migraine (n = 8), and vestibular Schwannoma (n = 5). The results of the DHI questionnaire have indicated worsened QoL in 86.4%, out of which 33.6% was defined as severe. The Beck scale has shown depressive symptoms in 42.3% of the cases, with severe symptoms in 6.3%. Significantly higher total DHI and Beck scale results were observed in patients with central vestibular disorders, vestibular migraine, PPPD and peripheral vestibulopathy, contrasted to the results of the other four diagnosis groups. The onset of the symptoms did not significantly affect the severity of QoL worsening and depression symptoms. CONCLUSION: In this study, the QoL of vertiginous patients was worse in general, with the occurrence of depression symptoms. A difference was observed in the case of the values of patients with different vestibular disorders, indicating the importance of different factors, e.g., central vestibular compensation, behavioural strategies and psychological factors.

Gamma Radiation Dose Measurement Using an Energy-Selective Method with the Help of a Drone.

Several dose distribution maps were obtained using a gamma radiation detector mounted to a drone. Based on the results and experience of the experiments, the shortcomings of the system and the possibilities for further development were identified. The primary goal of the development was to create a more compact, easy-to-carry, and easy-to-install system with increased sensitivity, which was achieved by several different methods and their combinations. During the discrete measurement procedure, the aim was to decrease the detection threshold, +0.005 to +0.007 µS/h measured above the background radiation. The increase in sensitivity was based on the characteristic energy spectrum of radiative materials. We took advantage of the fact that the radiating samples do not evenly increase the amount of gamma radiation over the entire energy spectrum. During the processing of the measurement data, we performed a comparison with the background radiation in the vicinity of the energy peaks characteristic of the sample and its decay products. This provides a better signal-to-noise ratio, thus enabling a more sensitive detection procedure. An important feature of our method is that in the traditional intensity curve displayed as a function of flight time only noise is visible, therefore one cannot directly conclude the presence of the sample. However, our method is clearly able to identify the location of the searched source at a height of 8 m with a continuous flight speed of 2 m/s using a 500 µS/h activity sample (as measured at a distance of 0.1 m from the sample). The increase in sensitivity allows either a higher scanning height (approximately +1 to 2 m) or, in the case of the same aircraft at the same altitude, a larger area from one take-off. Of course, the scan height or scan speed can increase significantly if the activity of the source being sought is high. In our experiments, we used a natural uranium mineral (Autunite) with activity far below that of artificially produced isotopes. In the series of our experiments, we also covered the detection of several sources, which modeled the possibility of mapping scattered active sources. The main advantages of the system developed and presented by us over the survey procedures used in practice is that a large area can be mobilized easily, without the risk of a human operator in the field, and the survey of a large area can be carried out at a low cost. The purpose of the system is to detect the presence of the source and to localize it to such an extent that the localization can then be easily refined by manual or other ground procedures. As we do not aim for positioning accuracy by centimeter, standard GPS localization is sufficient for the measurements. During the measurements, the geographical coordinates are interpreted in the GWS'84 system. The coordinates of the latitude and longitude circles are also shown in this system in the figures presented.

Drone-Based Gamma Radiation Dose Distribution Survey with a Discrete Measurement Point Procedure.

A dose distribution map can be created using geographic information system (GIS) methods from sensor data that do not provide image information in a classical way. The results of discrete radiation measurements can be properly represented in a uniform raster above the surface. If the radiation measured at each site does not show a jump-like change, a dose distribution map can be prepared by interpolating the measured values. The coordinates of the measuring points can be used to calibrate the map. The calibrated and georeferenced map is suitable for locating hidden or lost radiation sources or for mapping active debris scattered during a possible reactor accident. The advantage of the developed method is the measurement can be performed with a small multicopter, cost-effectively, even without human intervention. The flight time of small multicopters is very limited, so it is especially important to increase the efficiency of the measurement. During the experiments, a practical comparison of several methods was made with regard to the measurement procedure. Similarly, based on the measurement experience, the detector system was further developed and tested in three main steps. A system was developed with a detector system with a total weight of 500 g, including a battery capable of operating the detector for at least 120 min. The device is capable of detecting an average of 30 events/min at of 0.01 µSv/h background radiation. Experiments have shown that the system is able to significantly detect a source with an activity of 300 µSv/h by scanning above 10 m ground level.

Intratympanic gentamycine for Ménière's disease: is there a selective vestibulotoxic effect?

PURPOSE: The aim of our study is to investigate the effectiveness and safety of the treatment, based on vertigo diaries and pure tone audiograms. METHODS: The complete medical documentation of 105 definite patients suffering from Ménière's disease was analyzed. In the studied group, nine patients were treated with intratympanic gentamycine. Long-term follow-up of the patients was carried out, using vertigo diaries, medical letters, anamnestic data, and pure tone audiograms. Audiometric results and vertigo complaints before and after treatment were contrasted using IBM SPSS V24 software. RESULTS: Based on our analysis, vertigo attacks appeared significantly less often after gentamycine treatment [p < 0.001; Odds ratio 0.003 (95% CI 0.001-0.012)], which confirms the efficacy of the therapy. Pure tone stages before and after the application of gentamycine were contrasted using the Mann-Whitney U test. When comparing the audiometric results of long-term follow-ups by using the logistic regression, a statistically significant difference was observed between the treated and not treated groups [p = 0.001; Odds ratio 0.141 (95% CI 0.064-0.313)], and based on the survivorship curve hearing impairment was more common in the not treated group which also supports our results. Based on the non-parametric test, there was no significant difference (p = 0.84) between the pure-tone stages of the control group and of those treated with gentamycine. CONCLUSION: Our results indicate that intratympanic gentamycine is effective in controlling vertigo attacks, and there is no higher risk for hearing loss than in case of spontaneous progression of the disorder.

Accurate Non-Disturbance Population Survey Method of Nesting Colonies in the Reedbed with Georeferenced Aerial Imagery.

High altitude aerial surveys have the potential to improve disturbance-free data collection in wildlife research, but previously, bird species were not recognizable in high-altitude orthophotos. This method of aerial surveying is effective and can be repeated frequently due to its low cost; it also has the additional advantage of being able to monitor the status of protected areas. In the case of waterbirds, due to the low vegetation coverage, aerial remote sensing is an exceptionally effective technique for surveying populations and detecting nests. Aerial surveys made at low altitudes can cause serious stress for birds. The method we developed and employed is unlikely to be detected by either ground-based or nesting birds but is far more reliable compared to the low-resolution imaging methods and to the evaluation of non-georeferenced photo series. The modern sensors and photogrammetric procedures enable the use of the present method worldwide; furthermore, the large-scale ortho image-derived information has become obtainable more frequently. Direct georeferencing makes the field geodetic survey unnecessary. Orthophotos with a 0.7 cm spatial resolution allow us to reliably identify even the individuals of smaller species, and by the use of oblique images, they can be tracked from two or four different directions.

[What happens to vertiginous population after emission from the Emergency Department?] / Mi történik a szédülô beteggel a sürgôsségi osztály elhagyása után?

Background - Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose - The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods - 879 patients were examined at the Semmel-weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results - Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion - The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion - Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.

Matrix Product States: Entanglement, Symmetries, and State Transformations.

We analyze entanglement in the family of translationally invariant matrix product states (MPS). We give a criterion to determine when two states can be transformed into each other by local operations with a nonvanishing probability, a central question in entanglement theory. This induces a classification within this family of states, which we explicitly carry out for the simplest, nontrivial MPS. We also characterize all symmetries of translationally invariant MPS, both global and local (inhomogeneous). We illustrate our results with examples of states that are relevant in different physical contexts.

[Vaginal birth after cesarean section in light of international opinions]. / Császármetszést követo hüvelyi szülések vezetése a nemzetközi vélemények tükrében.

INTRODUCTION: The tendency of increasing cesarean section rate has drawn worldwide attention. The vaginal birth after cesarean section is a useful method to decrease cesarean section rate at defined cases. AIM: Retrospective overview of factors resulting successful vaginal birth, labor/induction's condition, criterias, short and long term benefits and consequences. METHOD: Overview recommendations of international guidelines and publications' results concerned vaginal birth after cesarean section in "PubMed", "MEDLINE", "Cochrane" databases from 1996 to 2016. RESULTS: Reviewing results of recommendations and publications we can declare that statements are inconsistent, however the option of vaginal birth after cesarean section is appropriate for decrease complications and trend of increasing cesarean section rate. CONCLUSIONS: It would be important in our country to define a uniform recommendation regarding vaginal birth after cesarean section, with supporting evidence in obstetrical and gynecological practice. Orv Hetil. 2017; 158(30): 1168-1174.

[Examination of placental three-dimensional power Doppler indices and perinatal outcome in pregnancies complicated by intrauterine growth restriction]. / A háromdimenziós power Doppler-indexek és a perinatalis kimenetel vizsgálata méhen belüli növekedési restrikcióval szövodött terhességekben.

INTRODUCTION: Development of intrauterine growth restriction (IUGR) can be traced back to maternal or fetal factors, but in many cases we find placental factors (reduced placental circulation) in the background. AIM: Our aim was to examine whether the reduced placental bloodperfusion and vascularity show any correlation with cesarean section frequency and the clinical outcome in IUGR pregnancies. The aim of the present study was also to use a properly calibrated and reproducible method for evaluating placental blood flow, that can later be incorporated into the routine examination. METHOD: 254 women were recruited in our prospective case-control study. The 3 dimensional power Doppler (3DPD) ultrasound indices; vascularisation index (VI), flow index (FI) and vascularization flow index (VFI) were measured on each participant. RESULTS: Median VI was 3.7% (interquartile range [IQR] 3.2%-4.2%) in the IUGR group and 10.1% (IQR 8.6%-10.9%) in the control group (p = 0.001). Median FI value was 40.0 (IQR 39.7-42.5) in the IUGR group and 45.1 (IQR 44.1-53.1) in the control group (p = 0.012). Median VFI was 2.2 (IQR 2.1-2.4) in the IUGR group and 4.8 (IQR 4.4-5.3) in the control. CONCLUSIONS: The 3DPD indices may be useful for examining changes in circulation in IUGR pregnancies to characterize the underlying pathology. Orv Hetil. 2017; 158(26): 1008-1013.

Rapid Adiabatic Preparation of Injective Projected Entangled Pair States and Gibbs States.

We propose a quantum algorithm for many-body state preparation. It is especially suited for injective projected entangled pair states and thermal states of local commuting Hamiltonians on a lattice. We show that for a uniform gap and sufficiently smooth paths, an adiabatic runtime and circuit depth of O(polylogN) can be achieved for O(N) spins. This is an almost exponential improvement over previous bounds. The total number of elementary gates scales as O(NpolylogN). This is also faster than the best known upper bound of O(N^{2}) on the mixing times of Monte Carlo Markov chain algorithms for sampling classical systems in thermal equilibrium.

Influencing Factors of Survival in Hypopharyngeal Squamous Cell Cancer.

Objectives: This study examined the effects of various factors on survival in hypopharyngeal cancer, involving a total of 100 patients. Methods: Comorbidities, treatment modalities, survival times, and potential factors affecting survival were retrospectively analysed. The expression of p16 was also examined. A statistical analysis was conducted using IBM SPSS V25 software. Results: The mean overall survival time was determined to be 30.8 months. Smoking was observed in 95%, and regular alcohol consumption was reported in 75% of the cases. The expression of p16 did not significantly affect survival (p = 0.74) or the maximum tumour size (p = 0.21). The Kaplan-Meier method demonstrated significantly longer survival times (p = 0.047 *) in the group that underwent partial pharyngolaryngectomy with or without adjuvant therapy (median: 75.25 months, 95% CI: 31.57-118.93), compared to the other four treatment groups (i.e., total laryngectomy with pharyngectomy with or without adjuvant therapy, chemoradiation, chemotherapy, and radiotherapy). Conclusions: The study found that factors such as sex, comorbidities (e.g., type 2 diabetes and chronic obstructive pulmonary disease), TNM and stage, weight loss, smoking, and alcohol consumption did not have a significant effect on survival. In conclusion, the longest survival was observed after partial pharyngolaryngectomy with or without adjuvant therapy. Risk factors and comorbidities did not show a significant effect on survival. p16 expression was not a factor that affected either survival or tumour size.

Seen and not seen: How people judge ambiguous behavior during the COVID-19 pandemic.

How do we judge others' behavior when they are both seen and not seen-when we observe their behavior but not the underlying traits or history that moderate the perceived riskiness of their behavior? We investigate this question in the context of the COVID-19 pandemic: How people make sense of, and judge, vaccination-contingent behaviors-behaviors, such as going to the gym or a bar, which are considered to be more or less risky and appropriate, depending on the target's vaccination status. While decision theoretic models suggest that these judgments should depend on the probability that the target is vaccinated (e.g., the positivity of judgments should increase linearly with the probability of vaccination), in a large-scale pre-registered experiment (N = 936) we find that both riskiness and appropriateness judgments deviate substantially from such normative benchmarks. Specifically, when participants judge a stranger's behavior, without being asked to think about the stranger's vaccination status, they tend to judge these behaviors similarly positively to behaviors of others who are known to be fully vaccinated. By contrast, when participants are explicitly prompted to think about the vaccination status of others, they do so, leading them to view others more disparagingly, at times even more negatively than what a normative benchmark would imply. More broadly, these results suggest new directions for research on how people respond to risk and ambiguity. We demonstrate that even subtle cues can fundamentally alter what information is "top of mind," that is, what information is included or excluded when making judgments. Supplementary Information: The online version contains supplementary material available at 10.1007/s11166-022-09396-7.