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1.
Adv Mater ; : e2411015, 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39350462

RESUMEN

The potential of hybrid perovskite/organic solar cells (HSCs) is increasingly recognized owing to their advantageous characteristics, including straightforward fabrication, broad-spectrum photon absorption, and minimal open-circuit voltage (VOC) loss. Nonetheless, a key bottleneck for efficiency improvement is the energy level mismatch at the perovskite/bulk-heterojunction (BHJ) interface, leading to charge accumulation. In this study, it is demonstrated that introducing a uniform sub-nanometer dipole layer formed of B3PyMPM onto the perovskite surface effectively reduces the 0.24 eV energy band offset between the perovskite and the donor of BHJ. This strategic modification suppresses the charge recombination loss, resulting in a noticeable 30 mV increase in the VOC and a balanced carrier transport, accompanied by a 5.0% increase in the fill factor. Consequently, HSCs that achieve power conversion efficiency of 24.0% is developed, a new record for Pb-based HSCs with a remarkable increase in the short-circuit current of 4.9 mA cm-2, attributed to enhanced near-infrared photon harvesting.

3.
PLoS One ; 19(10): e0304710, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39361921

RESUMEN

BACKGROUND: Dyslipidemia is an important risk factor for acute myocardial infarction. However, real-world data on its prevalence and lipid management trends for Korean patients with acute myocardial infarction are limited. This study aimed to determine the 10-year temporal trends in dyslipidemia prevalence and lipid management in this patient population. METHODS AND FINDINGS: The study used a merged database of two nationwide observational cohorts (2011-2020) that included 26,751 participants. The primary endpoints were the achievement rates of the (1) absolute low-density lipoprotein cholesterol (LDL-C) target of <70 mg/dL (<1.8 mmol/L), (2) relative LDL-C target reduction of >50% from the baseline, (3) absolute or relative LDL-C target (American target), and (4) both absolute and relative LDL-C targets (European target). The dyslipidemia prevalence increased from 11.1% to 17.1%, whereas the statin prescription rate increased from 92.9% to 97.0% from 2011 to 2020. The rate of high-intensity statin use increased from 12.80% in 2012 to 69.30% in 2020. The rate of ezetimibe use increased from 4.50% in 2016 to 22.50% in 2020. The high-intensity statin and ezetimibe prescription rates (0.20% to 9.30% from 2016 to 2020) increased gradually. The absolute and relative LDL-C target achievement rates increased from 41.4% and 20.8% in 2012 to 62.5% and 39.5% in 2019, respectively. The American (45.7% in 2012 to 68.6% in 2019) and European (16.5% in 2012 to 33.8% in 2019) target achievement rates also increased. CONCLUSIONS: The adoption of lipid management guidelines in clinical practice has improved. However, continued efforts are needed to reduce the risk of recurrent ischemic events.


Asunto(s)
LDL-Colesterol , Dislipidemias , Infarto del Miocardio , Humanos , República de Corea/epidemiología , Infarto del Miocardio/epidemiología , Infarto del Miocardio/tratamiento farmacológico , Masculino , Femenino , Persona de Mediana Edad , Dislipidemias/tratamiento farmacológico , Dislipidemias/epidemiología , Anciano , LDL-Colesterol/sangre , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Prevalencia , Ezetimiba/uso terapéutico , Factores de Riesgo
4.
Allergy Asthma Immunol Res ; 16(5): 490-504, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39363768

RESUMEN

PURPOSE: Wheezing in early life is most frequently caused by viral lower respiratory tract illnesses, constituting a significant disease burden in children. This study aimed to investigate the association of wheezing in early life with autoimmune diseases throughout childhood. METHODS: A population-matched retrospective cohort study was conducted in Korea between 2002 and 2017. The cohort comprised 34,959 children admitted with viral wheezing before 2 years of age and an equal number of the matched unexposed children born in 2002 and 2003. Exposed infants were defined as those hospitalized for bronchiolitis or bronchial asthma before the age of 2. Unexposed controls were matched by sex and birth year at a 1:1 ratio, using incidence density sampling. A Cox proportional hazard model controlled for multiple risk factors was employed. RESULTS: The median age at hospitalization for wheeze was 9 months (interquartile range, 5-15 months), and 63% of the exposed infants were male. Over the mean 15-year follow-up period, the incidence rate of autoimmune diseases was 74.0 and 62.2 per 10,000 person-years in the exposed and matched unexposed cohorts, respectively. The adjusted hazard ratio for any autoimmune disease in the exposed cohort was 1.15 (95% confidence interval, 1.09-1.23) in comparison with the unexposed cohort. The exposed cohort revealed an augmented risk for specific autoimmune diseases, including juvenile idiopathic arthritis, Kawasaki disease, Henoch-Schönlein purpura, psoriasis, idiopathic thrombocytopenic purpura, and immunoglobulin A nephropathy. Risks were heightened for children with multiple wheezing episodes or a persistent wheezing episode after the age of 2 years. CONCLUSIONS: This research identifies associations between early-life wheeze and the development of autoimmune diseases in childhood. Understanding these relationships can aid in recognizing the underlying pathophysiology of early-life wheeze and childhood autoimmune diseases, contributing to management strategies for these conditions.

5.
Sci Rep ; 14(1): 23289, 2024 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-39375426

RESUMEN

Electrical cardioversion (ECV) a widely utilized intervention for persistent atrial fibrillation (AF) aimed at restoring sinus rhythm. However, ECV can be ineffective, raising questions about subsequent treatment options. This study aimed to compare the outcomes of non-ablation therapy versus ablation therapy following unsuccessful ECV. A total of 125 consecutive patients with persistent AF who underwent unsuccessful ECV between November 2017 and August 2023 was included in this retrospective analysis. Of these, 51.2% received only medical therapy (non-ablation therapy group, n = 64), while 48.8% underwent AF ablation (ablation therapy group, n = 61). Various ablation methods were employed, including catheter and thoracoscopic ablation. Ablation therapy was associated with significantly better AF-free survival compared to non-ablation therapy [hazard ratio (HR), 0.37; 95% confidence interval (CI) 0.22-0.61; p < 0.01]. There was no difference of AF-free survival between catheter ablation and thoracoscopic ablation groups (HR 0.79, 95% CI 0.34-1.83; p = 0.58). AF duration > 5 year (HR 1.51; 95% CI 0.930-2.437; p = 0.10), BMI ≤ 25 kg/m2 (HR 1.61; 95% CI 1.004-2.581; p = 0.05) and diabetes (HR 2.38; 95% CI 0.902-6.266; p = 0.08) were considerable as predictor of AF recurrence. Ablation therapy following unsuccessful ECV was associated with maintaining sinus rhythm, regardless of the specific ablation method utilized.


Asunto(s)
Fibrilación Atrial , Ablación por Catéter , Cardioversión Eléctrica , Humanos , Fibrilación Atrial/terapia , Masculino , Femenino , Cardioversión Eléctrica/métodos , Persona de Mediana Edad , Ablación por Catéter/métodos , Anciano , Estudios Retrospectivos , Resultado del Tratamiento , Recurrencia , Toracoscopía/métodos
6.
Chonnam Med J ; 60(3): 147-154, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39381120

RESUMEN

Prescribing a P2Y12 inhibitor for patients with diabetes mellitus (DM) and acute myocardial infarction (AMI) who have undergone percutaneous coronary intervention (PCI) is challenging because of the risk of bleeding and ischemia. We compared the risk of ischemia and bleeding between clopidogrel and ticagrelor in elderly East Asian patients with diabetes using the Korea Acute Myocardial Infarction Registry (KAMIR)-V data. This study included 838 patients enrolled in the KAMIR-V who were >75 years, had DM, AMI, and had undergone PCI. The patients were divided into two groups based on the treatment drug. After propensity score matching, 466 patients (ticagrelor: clopidogrel= 233:233) were included in the Cox regression analyses to determine the risk of bleeding and ischemia. The baseline characteristics were not different. The type of antiplatelet therapy did not affect the incidence of Bleeding Academic Research Consortium type ≥2 bleeding. There was no significant difference between ticagrelor and clopidogrel treatment outcomes with respect to ischemia risk. This prospective study of a Korean patient cohort (elderly Korean patients with DM) showed no differences in bleeding and ischemia risks based on the use of either ticagrelor or clopidogrel. Large scale randomized controlled trials are warranted to determine the optimal antiplatelet agents for these patients.

7.
Womens Health Nurs ; 30(3): 175-177, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39385543
8.
Parasit Vectors ; 17(1): 417, 2024 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-39369247

RESUMEN

BACKGROUND: The Anopheles Hyrcanus group, which transmits Plasmodium vivax, consists of six confirmed species in South Korea. An epidemiological study revealed differences in the seasonal occurrence patterns of each species. Pyrethroid resistance in An. sinensis dates back to the early 2000s, whereas information on pyrethroid resistance in other species is lacking despite their greater significance in malaria epidemiology. METHODS: Anopheles mosquitoes were collected from two malaria-endemic regions in South Korea for 2 years and their knockdown resistance (kdr) mutations were genotyped. The larval susceptibility to λ-cyhalothrin was compared in six Anopheles species and its seasonal changes in three species were investigated. The full-length sequences of the voltage-sensitive sodium channel (VSSC) were compared across six species to evaluate potential target-site insensitivity. The contribution of the kdr mutation to phenotypic resistance was confirmed by comparing median lethal time (LT50) to λ-cyhalothrin between populations of Anopheles belenrae with distinct genotypes. RESULTS: The composition and seasonal occurrence of rare species (Anopheles kleini, Anopheles lestri, and Anopheles sineroides) varied considerably, whereas An. sinensis occurs continuously throughout the season. A kdr mutation in the form of heterozygous allele was newly identified in An. belenrae, An. lesteri, An. pullus, and An. sineroides. The baseline susceptibility to λ-cyhalothrin was the highest in An. belenrae, followed by An. lesteri, An. sineroides, An. kleini, An. pullus, and An. sinensis, with median lethal concentration (LC50) values ranging from 6.0- to 73.5-fold higher than that of An. belenrae. The susceptibility of An. sinensis and An. pullus varied by season, whereas that of An. belenrae remained stable. The kdr-heterozygous An. belenare population exhibited 5.1 times higher LT50 than that of the susceptible population. Species-specific VSSC sequence differences were observed among the six species. CONCLUSIONS: Our findings suggest that the status and extent of pyrethroid resistance vary among Anopheles Hyrcanus group species. While An. sinensis, the predominant species, developed a considerable level of pyrethroid resistance through kdr mutation, the resistance levels of other species appeared to be less pronounced. Large-scale monitoring is crucial to fully understand species-specific seasonal occurrence and resistance status for effective management strategies, considering the ongoing impact of climate change on their vectorial capacity.


Asunto(s)
Anopheles , Resistencia a los Insecticidas , Insecticidas , Piretrinas , Estaciones del Año , Animales , Anopheles/genética , Anopheles/efectos de los fármacos , Piretrinas/farmacología , Resistencia a los Insecticidas/genética , Insecticidas/farmacología , República de Corea , Mosquitos Vectores/genética , Mosquitos Vectores/efectos de los fármacos , Mutación , Genotipo , Larva/efectos de los fármacos , Larva/genética , Nitrilos/farmacología , Canales de Sodio Activados por Voltaje/genética
9.
Ther Adv Med Oncol ; 16: 17588359241281480, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39371616

RESUMEN

Background: Many patients with lung cancer have underlying chronic lung diseases. We assume that baseline lung functions might also affect the prognosis of non-small cell lung cancer (NSCLC) patients receiving immunotherapy. Objectives: We aimed to assess the impact of pretreatment clinical parameters, including lung function measures such as forced vital capacity (FVC), on the prognosis of patients with NSCLC following immune checkpoint inhibitors (ICIs) therapy. Design: Retrospective multicenter study. Methods: Study subjects were consecutively selected from a multicenter cohort of patients with NSCLC who were undergoing immunotherapy. Patients were selected regardless of their initial cancer stage and prior treatment. The primary outcome was immunotherapy-related overall survival (iOS), defined as the duration from the initiation of immunotherapy to the time patients were censored. Spirometry values were acquired before bronchodilator application and were performed within the year before the first ICI treatment. Results: We selected 289 patients for evaluation. The median iOS was 10.9 months (95% confidence interval (CI), 7.5-14.3). Programmed death-ligand 1 (PD-L1) expression, tested by SP263, was <1% in 20.9%, 1%-49% in 44.3%, and ⩾50% in 32.6% of the patients. ICI was used most often as second-line treatment (70.2%), followed by first line (13.1%), and third line (11.4%). In the Kaplan-Meier analysis, the median iOS of the low FVC group was significantly shorter than that in the preserved FVC group (6.10 (95% CI, 4.45-7.76) months vs 14.40 (95% CI, 10.61-18.34) months, p < 0.001)). A Cox regression analysis for iOS showed that age, poor performance status, PD-L1 expression measured by SP263, stage at diagnosis, and FVC (% predicted) were independent predictive factors. When we replaced FVC (%) in the multivariable analysis with forced expiratory volume in 1 s (%), diffusing lung capacity for carbon monoxide (DLco; %), or DLco (absolute), each of the pulmonary function factors showed a significant association with iOS. Conclusion: Pre-immunotherapy FVC (%) predicted immunotherapy-related outcomes in NSCLC patients, regardless of initial stage at diagnosis and prior treatment modalities.

10.
JACC Asia ; 4(9): 639-656, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39371623

RESUMEN

In recent years, a wealth of clinical data has emerged regarding intravascular imaging involving either intravascular ultrasound or optical coherence tomography. This surge in data has propelled the adoption of intravascular imaging-guided percutaneous coronary intervention (PCI) in daily clinical practice. The findings of current randomized clinical trials regarding imaging guidance have lent strong support to the benefits of intravascular imaging-guided PCI. This holds especially true for the diagnosis and treatment of complex lesions, such as left main disease, diffuse long lesions, chronic total occlusion, severely calcified lesions, bifurcations, and in-stent restenosis, as well as in high-risk patients such as those with acute myocardial infarction or chronic kidney disease. During intravascular imaging-guided PCI, operators attempt to achieve stent optimization for maximized benefits of imaging guidance. This paper provides a comprehensive review on the updated clinical data of intravascular imaging-guided PCI and intravascular ultrasound/optical coherence tomography-derived stent optimization criteria.

11.
Clin Pharmacol Ther ; 2024 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-39377297

RESUMEN

There had been concerns about the acute complications during or shortly after coronavirus disease 2019 (COVID-19) treatment with nirmatrelvir/ritonavir (NMVr) and molnupiravir (MOL). This study aimed to compare the risks of selected acute safety events in patients treated with or without NMVr or MOL using the COVID-19 oral treatment safety assessment data, constructed through the linkage of nationwide databases: National COVID-19 registry, Real-time Prescription Surveillance, and National Health Insurance data. We identified all adults diagnosed with COVID-19 between January and November 2022, and then constructed two cohorts by matching up to four patients without antiviral treatment records to NMVr or MOL users using propensity score matching. Outcomes of interest were incident-selected cardiac (i.e., atrial fibrillation, other arrhythmia, bradycardia), neurological (i.e., seizure, neuropathy, encephalomyelitis), and miscellaneous (i.e., acute pancreatitis, acute liver injury, dysgeusia) events. A total of 739,935 NMVr users were matched with 2,951,690 comparators and 150,431 MOL users with 759,521 comparators. NMVr users were at lower risk for developing selected cardiac events (hazard ratio 0.74 [95% CI 0.65-0.87] for atrial fibrillation, 0.81 [0.65-0.99] for other arrhythmia, and 0.82 [0.70-0.96] for bradycardia) and dysgeusia (0.58 [0.45-0.74]). For MOL users, the risk was lower for atrial fibrillation (0.72 [0.53-0.96]) and dysgeusia (0.34 [0.18-0.65]). Overall, there were no increased risks of acute complications during and shortly after treatment with oral COVID-19 antivirals. Rather, the findings underscore their effectiveness in attenuating the risk of potential acute sequelae of COVID-19.

12.
Emerg Infect Dis ; 30(11)2024 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-39378869

RESUMEN

We conducted a self-controlled case series study to investigate the association between COVID-19 vaccination and facial palsy (FP) in South Korea. We used a large immunization registry linked with the national health information database. We included 44,564,345 patients >18 years of age who received >1 dose of COVID-19 vaccine (BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, or Ad.26.COV2.S) and had an FP diagnosis and corticosteroid prescription within 240 days postvaccination. We compared FP incidence in a risk window (days 1-28) with a control window (the remainder of the 240-day observation period, excluding any risk windows). We found 5,211 patients experienced FP within the risk window and 10,531 experienced FP within the control window. FP risk increased within 28 days postvaccination, primarily after first and second doses and was observed for both mRNA and viral vaccines. Clinicians should carefully assess the FP risk-benefit profile associated with the COVID-19 vaccines and monitor neurologic signs after vaccination.

13.
Nano Lett ; 2024 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-39382529

RESUMEN

The precise characterization and control of single-electron wave functions emitted from a single-electron source are essential for advancing electron quantum optics. Here, we introduce a method for tailoring a single-electron emission distribution using energy filtering, enabling selective control of the distribution under various energy barrier conditions of the filter. The tailored electron is studied by reconstructing its Wigner distribution in the time-energy phase space using the continuous-variable tomography method. Our results reveal that the filtering cuts the portion of the distribution below the energy-barrier height of the filter in the time-energy space. While the filtering is demonstrated in a classical regime of the emitted electrons, we expect that this study significantly contributes to the design and implementation of advanced experiments toward quantum information processing based on single electrons.

14.
J Affect Disord ; 2024 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-39389114

RESUMEN

BACKGROUND: This study investigated the longitudinal associations between serum BDNF (sBDNF) levels measured early after injury and the onset of post-traumatic stress disorder (PTSD) across two years. METHODS: Patients with moderate to severe physical injuries were enrolled from a trauma center. At baseline, sBDNF levels were measured and a comprehensive socio-demographic and clinical data were collected. The range of time from physical injuries to blood collection was 1-28 days, with a median (IQR) of 8.0 (6.0) days. PTSD diagnoses were determined at 3, 6, 12, and 24 months post-injury using the CAPS-5. Linear regression analyses assessed the relationship between sBDNF levels and PTSD diagnoses. RESULTS: Out of 923 patients, 112 (12.1 %) developed PTSD during the study. Prevalence rates were 8.8 % at 3 months, 7.6 % at 6 months, 4.8 % at 12 months, and 3.7 % at 24 months. Significantly, lower sBDNF levels were associated with PTSD at 12 and 24 months, after adjusting for covariates and applying Bonferroni corrections, but not at earlier assessments. LIMITATIONS: Focusing on patients with moderate to severe injuries from a single center may limit the findings' generalizability. CONCLUSION: Early post-injury sBDNF levels are predictive biomarkers for PTSD, especially significant at 12 and 24 months post-injury.

15.
PLoS One ; 19(9): e0309902, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39325726

RESUMEN

BACKGROUND: Pyrazinamide (PZA) usage has been associated with adverse drug reactions, prompting its avoidance in treating elderly tuberculosis (TB) patients. This study aims to examine whether the administration of PZA is associated with poor outcomes during TB treatment among elderly individuals. METHODS: A retrospective analysis was undertaken on data collected from a prospective cohort conducted between July 2019 and June 2023, which involved tuberculosis patients from 18 institutions across the Republic of Korea. The study aimed to assess the impact of PZA on the incidence of serious adverse events (SAEs), medication interruptions, and becoming loss to follow-up (LTFU) during standard short courses of TB treatment in elderly (≥65 years old) patients. RESULTS: PZA was administered to 356 of 390 elderly patients (91.3%), and 98 of the 390 (25.1%) experienced SAEs. Treatment success was significantly lower in patients not treated with PZA compared to those who received PZA (64.7% vs 89.9%, p < 0.001). The incidence of SAEs, medication interruption, or LTFU was higher in patients not given PZA compared those who received PZA (52.9% vs. 27.2%, p = 0.002). A multivariate logistic regression analysis, factoring in covariates such as age, comorbidities, and baseline laboratory data, revealed that PZA was not a risk factor for SAEs, medication interruption, or LTFU in TB treatment (odds ratio [OR] 0.457, 95% confidence interval [CI] 0.201-1.041). CONCLUSION: Treating elderly TB patients with PZA did not increase the incidence of SAEs, medication interruptions, or LTFU during the standard short course of TB treatment. Therefore, considering its potential advantages, incorporating PZA into the treatment regimen for elderly TB patients may be advisable.


Asunto(s)
Antituberculosos , Pirazinamida , Tuberculosis , Humanos , Pirazinamida/efectos adversos , Pirazinamida/uso terapéutico , Pirazinamida/administración & dosificación , Anciano , Masculino , Femenino , Antituberculosos/efectos adversos , Antituberculosos/uso terapéutico , Tuberculosis/tratamiento farmacológico , Estudios Retrospectivos , Anciano de 80 o más Años , República de Corea/epidemiología , Resultado del Tratamiento , Estudios Prospectivos , Incidencia
16.
Front Nutr ; 11: 1370737, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39328464

RESUMEN

Introduction: Weight-loss strategies through meal replacements are effective and sustainable options. However, few studies have assessed their effects on weight loss including body composition through protein-supplemented meal replacements targeting the Asian population, including Koreans. This study aimed to assess the effectiveness and safety of a protein-supplemented very-low-calorie diet (PSVLCD) for weight reduction and changes in body composition in individuals with obesity over a 12-month long-term period. Methods: In total, 106 participants with obesity were randomly assigned to a PSVLCD or control group (food-based calorie-restricted diet). Body weight, waist circumference, body composition, and blood marker levels were measured throughout the study. Statistical analyses were performed to compare outcomes between the groups. Results: Among the 106 participants, 84 completed the 12-month follow-up. Intention-to-treat analysis showed that the mean weight loss from baseline to 12 months was -6.86 kg (8.21% of baseline weight) in the PSVLCD group and - 4.66 kg (5.47% of initial body weight) in the control group; the difference was -2.20 kg with a marginally significant interval (95% confidence interval [CI], -4.90; 0.50). Waist circumference (-8.35 cm vs. -4.85 cm; mean difference, -3.49 cm; 95% CI, -6.48 to -0.50) and visceral fat area (-28.28 cm2 vs. -13.26 cm2; mean difference, -15.03cm2; 95% CI, -29.01 to -1.04) also significantly decreased in the PSVLCD group at 12 months. Discussion: The PSVLCD group demonstrated a substantial initial reduction in waist circumference that was sustained over the study period, alongside a marginally significant decrease in weight. These findings suggest that a protein-supplemented very-low-calorie diet may be an effective strategy for long-term weight management and body composition improvement in individuals with obesity. Clinical trial registration: ClinicalTrials.gov, identififer NCT04597788.

17.
Plast Reconstr Surg ; 2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39331819

RESUMEN

BACKGROUND: Conjoined bilateral deep inferior epigastric perforator (DIEP) flap with intraflap anastomosis is an efficient approach for breast reconstruction, enabling the use of almost the entire abdominal tissue. Variations in bilateral DIEA anatomy may make it challenging to apply this technique consistently. This study aimed to derive optimal strategies for achieving reliable conjoined bilateral DIEP flap with intraflap anastomosis universally. METHODS: For all consecutive patients undergoing conjoined bilateral DIEP flap-based breast reconstruction from 2009 to 2023, preoperative planning and intraoperative execution for the pedicle configurations were reviewed. Their postoperative outcomes were evaluated. RESULTS: In total 201 patients were included, with no cases requiring conversion to extraflap anastomosis. In preoperative planning, candidates for recipient vessels for intraflap anastomosis were typically selected based on DIEA branching patterns, identified through computed tomographic angiography; Type I (single trunk) prioritizing the superior continuation, type II (two main trunks) considering a side branch, and type III (three main trunks) favoring the first bifurcating branch. Comparing candidates from bilateral DIEA, the primary pedicle was determined, providing larger recipient vessels. Most cases followed the planned approach smoothly, however 28 required intraoperative changes, mostly aimed at securing larger recipients by changing the primary pedicle or harvesting more caudally located perforators to obtain larger superior continuations. Four perfusion-related complications developed, which were resolved successfully without flap failure. CONCLUSIONS: Our results suggest an efficient strategy for securing a reliable recipient vessel, tailored to patient anatomy, in conjoined bilateral DIEP flap breast reconstruction with intraflap anastomosis, leading to achieving optimal outcomes.

18.
J Am Heart Assoc ; 13(19): e034154, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39344663

RESUMEN

BACKGROUND: We hypothesized that analysis of serial ECGs could predict new-onset atrial fibrillation (AF) more accurately than analysis of a single ECG by detecting the subtle cardiac remodeling that occurs immediately before AF occurrence. Our aim in this study was to compare the performance of 2 types of machine learning (ML) algorithms. METHODS AND RESULTS: Standard 12-lead ECGs of patients selected by cardiologists between January 2010 and May 2021 were used for ML model development. Two ML models (single ECG and serial ECG) were developed using a light gradient boosting machine-learning algorithm. Model performance was evaluated based on the area under the receiver operating characteristic curve, sensitivity, specificity, accuracy, and F1 score. We trained the ML models on 415 964 ECGs from 176 090 patients. When testing the 2 ML models using external validation data sets, the performance of the serial-ML model was significantly better than that of the single-ML model for predicting new-onset AF (single- versus serial-ML model: sensitivity 0.744 versus 0.810; specificity 0.742 versus 0.822; accuracy 0.743 versus 0.816; F1 score 0.743 versus 0.815; area under the receiver operating characteristic curve 0.812 versus 0.880; P<0.001). The Shapley Additive Explanations analysis ranked P-wave duration and amplitude among the top 10 ECG parameters. CONCLUSIONS: An ML model based on serial ECGs from an individual had greater ability to predict new-onset AF than the ML model based on a single ECG. P-wave morphologies were associated with future AF prediction.


Asunto(s)
Fibrilación Atrial , Remodelación Atrial , Electrocardiografía , Aprendizaje Automático , Valor Predictivo de las Pruebas , Humanos , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Electrocardiografía/métodos , Femenino , Masculino , Anciano , Persona de Mediana Edad , Algoritmos , Estudios Retrospectivos
19.
Int J Oncol ; 65(5)2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39301628

RESUMEN

Following the publication of the above paper, it was drawn to the Editor's attention by concerned readers that ß­actin bands shown in Figs. 1, 2 and 4 were strikingly similar, where the experimental conditions reported in Fig. 4 differed from those in Figs. 1 and 2; moreover, the Slug protein bands featured in Figs. 4a and 5a were remarkably similar in spite of the different experimental conditions that were reported in the respective figure legends, and the shape of the vimentin protein bands in Fig. 5e bore a strong similarity to the Slug protein bands that were featured in Fig. 2c, in spite of the bands being of slightly different sizes and arranged in a different orientation.  Although the possibility of publishing a corrigendum was considered, software analysis of the highlighted bands performed independently by the Editorial Office demonstrated that the bands in question were likely to have been matching bands. Therefore, given the number of potential concerns that were identified with the assembly of various of the figures in this paper, the Editor of International Journal of Oncology has decided not to proceed with a corrigendum, and has determined that the paper should instead be retracted from the Journal on account of an overall lack of confidence in the originally presented data. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a satisfactory reply. The Editor apologizes to the readership for any inconvenience caused. [International Journal of Oncology 46: 1461­1472, 2015; DOI: 10.3892/ijo.2015.2878].

20.
Case Rep Womens Health ; 43: e00650, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39314985

RESUMEN

Lymphangioleiomyomatosis is a rare disease characterized by abnormal smooth muscle cell growth. It primarily occurs in the lungs but can also rarely occur in other organs, in which case it is classified as extrapulmonary lymphangioleiomyomatosis. It often accompanies tuberous sclerosis complex. This report concerns a case of uterine lymphangioleiomyomatosis with spontaneous uterine rupture in a young woman with tuberous sclerosis complex. A 27-year-old nulligravida patient presented to the emergency room with vaginal bleeding. She had a history of clinical diagnosis of tuberous sclerosis complex and pulmonary lymphangioleiomyomatosis. Initially, abdominopelvic computed tomography and magnetic resonance imaging suggested a hemorrhagic necrosis and rupture of degenerated uterine myoma. She underwent emergency exploratory laparotomy. The right side of her normal-sized uterus were ruptured without any specific mass. Active bleeding and hematoma from the ruptured uterus and partially ruptured right ovary were noted. The procedure included total hysterectomy and right salpingo-oophorectomy. Pathological analysis confirmed lymphangioleiomyomatosis in the uterine serosa and myometrium. Lymphangioleiomyomatosis mainly occurs in women of reproductive age and worsens with estrogen. Early diagnosis and careful follow-up are necessary due to the risk of worsening gynecological symptoms or even uterine rupture during pregnancy. This case enhances our understanding of extrapulmonary lymphangioleiomyomatosis and highlights the importance of comprehensive evaluation in complex clinical scenarios.

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