Depth-Camera Based Energy Expenditure Estimation System for Physical Activity Using Posture Classification Algorithm.

Insufficient physical activity is common in modern society. By estimating the energy expenditure (EE) of different physical activities, people can develop suitable exercise plans to improve their lifestyle quality. However, several limitations still exist in the related works. Therefore, the aim of this study is to propose an accurate EE estimation model based on depth camera data with physical activity classification to solve the limitations in the previous research. To decide the best location and amount of cameras of the EE estimation, three depth cameras were set at three locations, namely the side, rear side, and rear views, to obtain the kinematic data and EE estimation. Support vector machine was used for physical activity classification. Three EE estimation models, namely linear regression, multilayer perceptron (MLP), and convolutional neural network (CNN) models, were compared and determined the model with optimal performance in different experimental settings. The results have shown that if only one depth camera is available, optimal EE estimation can be obtained using the side view and MLP model. The mean absolute error (MAE), mean square error (MSE), and root MSE (RMSE) of the classification results under the aforementioned settings were 0.55, 0.66, and 0.81, respectively. If higher accuracy is required, two depth cameras can be set at the side and rear views, the CNN model can be used for light-to-moderate activities, and the MLP model can be used for vigorous activities. The RMSEs for estimating the EEs of standing, walking, and running were 0.19, 0.57, and 0.96, respectively. By applying the different models on different amounts of cameras, the optimal performance can be obtained, and this is also the first study to discuss the issue.

Procrastination predicts online self-regulated learning and online learning ineffectiveness during the coronavirus lockdown.

During the lockdown due to SARS-CoV-2 (coronavirus lockdown), there has been a tremendous increase in the number of students taking online courses. Few studies, however, have examined the individual dispositions that influence self-regulated online learning during the coronavirus lockdown. To address this gap, the present study explored the ineffectiveness of online learning and examined how it can be predicted by self-regulated online learning and participants' procrastination disposition. Data of 433 participants were collected and subjected to confirmatory factor analysis with structural equation modeling. The results indicated that procrastination is negatively related to 6 sub-constructs of self-regulated online learning: task strategy, mood adjustment, self-evaluation, environmental structure, time management, and help-seeking. These sub-constructs were negatively related to the learners' perceived ineffectiveness of online learning. However, the relationship between perceived learning ineffectiveness and environmental structure or help-seeking was weaker than that with task strategy or mood adjustment, indicating that the latter two subtypes of self-regulated online learning should be considered before students engage in online learning.

ClearCell® FX, a label-free microfluidics technology for enrichment of viable circulating tumor cells.

Circulating tumor cells (CTCs) dissociate from primary tumor into the bloodstream, and carry with them cancer's fingerprints as well as the potential to turn aggressive and metastasize. In order to understand CTCs and develop clinical utility, different methods of enrichment and isolation of CTCs can be used. Here, we report the use of a label-free platform, ClearCell® FX which isolates CTCs by their mechanical features and its advantages. The technology utilizes Dean Flow Fractionation (DFF) principle in a spiral microfluidics system to separate the larger CTCs from smaller blood cells. The gentle and fast workflow allows for a range of downstream assays to be performed on the intact CTCs, particularly studies that examine an epithelial cell adhesion molecular (EpCAM)-independent population. Viable, intact cells are also retrievable for development of culture or in vivo models. © 2018 International Society for Advancement of Cytometry.

Modeling the economic burden of postpartum hemorrhage due to substandard uterotonics in Ghana.

Uterotonics are essential in preventing postpartum hemorrhage (PPH), the leading direct cause of maternal death worldwide. However, uterotonics are often substandard in low- and middle-income countries, contributing to poor maternal health outcomes. This study examines the health and economic impact of substandard uterotonics in Ghana. A decision-tree model was built to simulate vaginal and cesarean section births across health facilities, uterotonic quality and utilization, PPH risk and diagnosis, and resulting health and economic outcomes. We utilized delivery data from Ghana's maternal health survey, risks of health outcomes from a Cochrane review, and E-MOTIVE trial data for health outcomes related to oxytocin quality. We compared scenarios with and without substandard uterotonics, as well as scenarios altering uterotonic use and care-seeking behaviors. We found that substandard uterotonic use contributes to $18.8 million in economic burden annually, including $6.3 million and $4.8 million in out-of-pocket expenditures in public and private sectors, respectively. Annually, the National Health Insurance Scheme bears $1.6 million in costs due to substandard uterotonic use. Substandard uterotonics contribute to $6 million in long-term productivity losses from maternal mortality annually. Improving the quality of uterotonics could reduce 20,000 (11%) PPH cases, 5,000 (11%) severe PPH cases, and 100 (11%) deaths due to PPH annually in Ghana. Ensuring the quality of uterotonics would result in millions of dollars in cost savings and improve maternal health outcomes for the government and families in Ghana. Cost savings from improving uterotonic quality would provide financial protection and help Ghana advance toward Universal Health Coverage.

Investigation on the Photodegradation Stability of Acrylic Acid-Grafted Poly(butylene carbonate-co-terephthalate)/Organically Modified Layered Zinc Phenylphosphonate Composites.

The application efficiency of biodegradable polymers used in a natural environment requires improved resistance to ultraviolet (UV) photodegradation. In this report, 1,6-hexanediamine modified layered zinc phenylphosphonate (m-PPZn), utilized as a UV protection additive for acrylic acid-grafted poly(butylene carbonate-co-terephthalate) (g-PBCT), was successfully fabricated and compared to the solution mixing process. Experimental data of both wide-angle X-ray diffraction and transmission electron microscopy reveal that the g-PBCT polymer matrix was intercalated into the interlayer spacing of m-PPZn, which was approximately delaminated in the composite materials. The evolution of photodegradation behavior for g-PBCT/m-PPZn composites was identified using Fourier transform infrared spectroscopy and gel permeation chromatography after being artificially irradiated by a light source. The change of carboxyl group produced via photodegradation was used to show the enhanced UV protection ability of m-PPZn in the composite materials. All results indicate that the carbonyl index of the g-PBCT/m-PPZn composite materials after photodegradation for 4 weeks was extensively lower than that of the pure g-PBCT polymer matrix. These findings were also supported by the decrease in the molecular weight of g-PBCT after photodegradation for 4 weeks, from 20.76% to 8.21%, with the loading of 5 wt% m-PPZn content. Both observations were probably owing to the better UV reflection ability of m-PPZn. This investigation shows, through typical methodology, a significant advantage of fabricating the photodegradation stabilizer to enhance the UV photodegradation behavior of the biodegradable polymer using an m-PPZn compared to other UV stabilizer particles or additives.

Assessing Study Skill Needs for Information Technology and Computer Science Students in Technical and Vocational Universities.

Not a great deal is known about what study skills are essential for success in the science, technology, engineering, and mathematics' disciplines, particularly in information technology (IT) and computer science (CS) programs in the technical and vocational education (TVE) in Taiwanese higher education. Since TVE accounts for more than half of the post-secondary enrolments in the country, and with the increasing demand for IT and CS talents, we studied perceptions of the importance and competency of such skills to identify the students' needs and demographic factors influencing them. A survey was administered to 1398 students in IT and CS programs in Taiwanese TVE universities. General skills were seen as the most important one among the study skills examined, and students felt competent using them. The needs to manage time, perform quantitative/mathematical tasks, and delegate were identified and these needs were affected by institutional quality, gender, and academic achievement. The results might be useful for further investigation in this area and guiding future plan to improve student performance in TVE.

How to increase and maintain high immunization coverage: Vaccination Demand Resilience (VDR) framework.

BACKGROUND: Resilience in vaccination demand is ever more critical as the COVID-19 pandemic has increased our understanding of the importance of vaccines on health and well-being. Yet timid demand for COVID-19 vaccines where available and reduced uptake of routine immunizations globally further raise the urgent need to build vaccination resilience. We demonstrate the complexity of vaccination demand and resilience in a framework where relevant dimensions are intertwined, fluid, and contextual. METHODS: We developed the Vaccination Demand Resilience (VDR) framework based on a literature review on vaccination demand and expert consultation. The matrix framework builds on three main axes: 1) vaccination attitudes and beliefs; 2) vaccination seeking behavior; and 3) vaccination status. The matrix generated eight quadrants, which can help explain people's levels of vaccination demand and resilience. We selected four scenarios as examples to demonstrate different interventions that could move people across quadrants and build vaccination resilience. RESULTS: Incongruence between individuals' attitudes and beliefs, vaccination behavior, and vaccination status can arise. For example, an individual can be vaccinated due to mandates but reject vaccination benefits and otherwise avoid seeking vaccination. Such incongruence could be altered by interventions to build resilience in vaccination demand. These interventions include information, education and communication to change individuals' vaccination attitudes and beliefs, incentive programs and reminder-recalls to facilitate vaccination seeking, or by strengthening healthcare provider communications to reduce missed opportunities. CONCLUSIONS: Vaccination decision-making is complex. Individuals can be vaccinated without necessarily accepting the benefits of vaccination or seeking vaccination, threatening resilience in vaccination demand. The VDR framework can provide a useful lens for program managers and policy makers considering interventions and policies to improve vaccination resilience. This would help build and sustain confidence and demand for vaccinations, and help to continue to prevent disease, disability, and death from vaccine-preventable diseases.

Knowledge Sharing Types as Predictors of Job Performance Mediated by Problem-Solving Self-Efficacy in the Information System Integration Service Industry.

Knowledge sharing is an essential approach to creative problem solving in technology firms, but few studies have considered the information system integration service industry. To address this gap, drawing on the micro-ecology theory, we developed a research model to explore the mediating role of four types of knowledge sharing (i.e., automatic response, rational reflection, ridiculed reflection, and stolen reflection) in the relationship between problem solving self-efficacy (PSSE) and IT workers' job performance. Data were collected from 307 System Integration IT workers by using the snowball sampling method via a Google questionnaire. Structural equation modeling was used to test the hypotheses of the relationships between the variables. The results showed that PSSE can positively predict four knowledge sharing types; except for stolen reflection, the others can positively predict job performance. The implication of this study is that automatic response systems and rational reflection systems in knowledge sharing can enhance job performance, supported by PSSE. It is hoped that managers can generate System Integration workers' rational reflection to effectively evoke knowledge sharing.

Characterizing Medicine Quality by Active Pharmaceutical Ingredient Levels: A Systematic Review and Meta-Analysis across Low- and Middle-Income Countries.

Substandard and falsified medicines are often reported jointly, making it difficult to recognize variations in medicine quality. This study characterized medicine quality based on active pharmaceutical ingredient (API) amounts reported among substandard and falsified essential medicines in low- and middle-income countries (LMICs). A systematic review and meta-analysis was conducted using PubMed, supplemented by results from a previous systematic review, and the Medicine Quality Scientific Literature Surveyor. Study quality was assessed using the Medicine Quality Assessment Reporting Guidelines (MEDQUARG). Random-effects models were used to estimate the prevalence of medicines with < 50% API. Among 95,520 medicine samples from 130 studies, 12.4% (95% confidence interval [CI]: 10.2-14.6%) of essential medicines tested in LMICs were considered substandard or falsified, having failed at least one type of quality analysis. We identified 99 studies that reported API content, where 1.8% (95% CI: 0.8-2.8%) of samples reported containing < 50% of stated API. Among all failed samples (N = 9,724), 25.9% (95% CI: 19.3-32.6%) reported having < 80% API. Nearly one in seven (13.8%, 95% CI: 9.0-18.6%) failed samples were likely to be falsified based on reported API amounts of < 50%, whereas the remaining six of seven samples were likely to be substandard. Furthermore, 12.5% (95% CI: 7.7-17.3%) of failed samples reported finding 0% API. Many studies did not present a breakdown of actual API amount of each tested sample. We offer suggested improved guidelines for reporting poor-quality medicines. Consistent data on substandard and falsified medicines and medicine-specific tailored interventions are needed to ensure medicine quality throughout the supply chain.

Stimuli-responsive hydrogel microcapsules for the amplified detection of microRNAs.

A method for the synthesis of DNA-based acrylamide hydrogel microcapsules loaded with quantum dots as a readout signal is introduced. The shell of DNA-acrylamide hydrogel microcapsules is encoded with microRNA-responsive functionalities, being capable of the detection of cancer-associated microRNA. The microRNA-141 (miR-141), a potential biomarker in prostate cancer, was employed as a model target in the microcapsular biosensor. The sensing principle of the microcapsular biosensor is based on the competitive sequence displacement of target miR-141 with the bridging DNA in the microcapsule's shell, leading to the unlocking of DNA-acrylamide hydrogel microcapsules and the release of the readout signal provided by fluorescent quantum dots. The readout signal is intensified as the concentration of miR-141 increases. While miR-141 was directly measured by DNA-acrylamide hydrogel microcapsules, the linear range for the detection of miR-141 is 2.5 to 50 µM and the limit of detection is 1.69 µM. To improve the sensitivity of the microcapsular biosensor for clinical needs, the isothermal strand displacement polymerization/nicking amplification machinery (SDP/NA) process was coupled to the DNA-acrylamide hydrogel microcapsule sensor for the microRNA detection. The linear range for the detection of miR-141 is improved to the range of 102 to 105 pM and the limit of detection is 44.9 pM. Compared to direct microcapsular biosensing, the detection limit for miR-141 by microcapsules coupled with strand-displacement amplification is enhanced by four orders of magnitude.

MiDSystem: A comprehensive online system for de novo assembly and analysis of microbial genomes.

The substantial reduction in experimental cost of next-generation sequencing techniques makes it feasible to assemble a bacterial genome of unknown species de novo and acquire substantial genetic information from environmental samples. Many bioinformatics tools and algorithms have also been developed for prokaryotes, but complex parameter settings and command line-based user interfaces cause a significant entry barrier for novices. Efficient construction of pipelines that integrate all the available genomic data poses a major challenge to the understanding of unknown pathogens. MiDSystem is a comprehensive online system for analyzing genomic data from microbiomes. With a user-friendly interface, MiDSystem supports both de novo assembly and metagenomic analysis pipelines. It is designed to automatically analyze whole genome shotgun sequencing data of bacteria submitted by users. Multiple analytical steps can be performed directly on the system, and the results generated from the embedded tools are visualized in an online summary report to make it more interpretable. Constructing a genome de novo has gradually become the foundation of bacterial studies. Taking both single species and metagenomic samples into consideration, MiDSystem can greatly reduce the time and effort for analysis of bacterial genomic data. Use of MiDSystem will enable more focus to be placed on understanding the etiology of bacterial infections and microorganism ecologies.

Proposal and validation of a new grading system for pterygium (SLIT2).

BACKGROUND/AIMS: To propose and validate a new pterygium grading system based on slit-lamp evaluation. METHODS: This prospective cross-sectional study included 217 patients with pterygium. All patients underwent slit-lamp examination, and slit-lamp photographs were independently graded by two graders twice. A total of eight parameters were evaluated and all parameters were assigned with a score of 1-4 (normal-severe). Intra-rater and inter-rater reliability as determined by weighted Cohen's kappa analysis. RESULTS: A total of 868 independent assessment, based on 217 slit-lamp images, were performed by two graders. For conjunctival assessment, the intra-rater reliability was excellent for body thickness (κ=0.81-0.89) and size at limbus (κ=0.87-0.92), substantial-to-excellent for body vascularity (κ=0.72-0.86), and moderate-to-excellent for body length (κ=0.57-0.81), whereas the inter-rater reliability was excellent for size at limbus (κ=0.86), substantial for body thickness (κ=0.72-0.73) and body vascularity (κ=0.66-0.75), and moderate for body length (κ=0.54-0.57). For corneal assessment, the intra-rater reliability was excellent for all four parameters (κ=0.84-0.90) whereas the inter-rater reliability was excellent for head length (κ=0.86-0.87), substantial-to-excellent for head vascularity (κ=0.78-0.82), substantial for Stocker's line (κ=0.79-0.80) and head thickness (κ=0.67-0.69). The grading system was named SLIT2, which included S tocker's line, S ize at limbus, L ength of head/body, I njection/vascularity of body/head, and T hickness of body/head. CONCLUSION: The proposed SLIT2 grading system, consisting of eight components, may serve as a reliable tool to standardise the reporting of pterygium severity and disease recurrence for clinical and research applications.

RNASeqR: An R Package for Automated Two-Group RNA-Seq Analysis Workflow.

RNA-Seq analysis has revolutionized researchers' understanding of the transcriptome in biological research. Assessing the differences in transcriptomic profiles between tissue samples or patient groups enables researchers to explore the underlying biological impact of transcription. RNA-Seq analysis requires multiple processing steps and huge computational capabilities. There are many well-developed R packages for individual steps; however, there are few R/Bioconductor packages that integrate existing software tools into a comprehensive RNA-Seq analysis and provide fundamental end-to-end results in pure R environment so that researchers can quickly and easily get fundamental information in big sequencing data. To address this need, we have developed the open source R/Bioconductor package, RNASeqR. It allows users to run an automated RNA-Seq analysis with only six steps, producing essential tabular and graphical results for further biological interpretation. The features of RNASeqR include: six-step analysis, comprehensive visualization, background execution version, and the integration of both R and command-line software. RNASeqR provides fast, light-weight, and easy-to-run RNA-Seq analysis pipeline in pure R environment. It allows users to efficiently utilize popular software tools, including both R/Bioconductor and command-line tools, without predefining the resources or environments. RNASeqR is freely available for Linux and macOS operating systems from Bioconductor (https://bioconductor.org/packages/release/bioc/html/RNASeqR.html).

A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media.

Whether the dimension of the osseous external auditory canal (OEAC) is related to chronic otitis media (COM) remains an important but unresolved issue. In the literature, routine canaloplasty has been suggested to help elucidate this problem. In this study, we intended to investigate the relationship between the diameter or shape of OEAC and COM. We retrospectively reviewed the high-resolution computed tomography (HRCT) images of the temporal bones of 62 patients with unilateral COM who underwent tympanoplasty from January 1, 2011, to December 31, 2013. For comparison, the HRCT images of another 62 patients with normal ears were collected to be the control group. The shape of OEAC was categorized into 5 groups according to Mahboubi's classification, and the dimension of each patient's OEAC was measured at 2 defined sections (annular section and isthmus/midcanal section). The most prevalent shape of OEAC for the lesion sides of the ears was cylindrical, followed by conical, and hourglass in both the COM and the control groups. As to the dimension of OEAC, there were no significant differences between lesion ears and normal ears among patients in the COM group as well as between lesion ears in the COM group and normal ears in the control group. We concluded that the bony dimension of the external ear canal was not related to COM. This suggested that chronic inflammation or infection of middle ear may not cause bony thickening of OEAC, despite the kind of OEAC shape involved.

Intact protein core structure is essential for protein-binding, mononuclear cell proliferating, and neutrophil phagocytosis-enhancing activities of normal human urinary Tamm-Horsfall glycoprotein.

Tamm-Horsfall glycoprotein (THP) is synthesized in the particular sites of renal tubules acting as a defense molecule in the urinary system. In the present study, we found that THP contained high amount of Siaalpha(2,3)Gal/GalNAc, moderate amount of beta(1,4)GlcNAc oligomers and GlcNAc/branched mannose, and low amount of mannose residues, but no Siaalpha(2,6)Gal/GalNAc, in the side-chains of the molecule. THP exhibited high binding affinity with human TNF-alpha, IgG, C1q and BSA, moderate binding affinity with IL-8, and low binding affinity with IL-6 and IFN-gamma. For exploring the role of carbohydrate side-chains and protein core in the protein-binding and cell-stimulating activities, THP was enzyme-digested with carbohydrate-specific [neuraminidase (Nase), beta-galactosidase (Gase)], protein-specific [V8 protease (V8), proteinase K (PaseK)] and glycoconjugate-specific [carboxypeptidase Y (Case), O-sialoglycoprotein endopeptidase (Oase)] degrading enzymes. We found that THP digested with V8, Oase, and PaseK, significantly reduced its protein-binding, mononuclear cell proliferating, and neutrophil phagocytosis-enhancing activities. These results suggest that the intact protein core structure, but not carbohydrate side-chains, is essential for pleotropic functions of THP molecule.

CellExpress: a comprehensive microarray-based cancer cell line and clinical sample gene expression analysis online system.

Database URL: http://cellexpress.cgm.ntu.edu.tw/.

Whole-genome de novo sequencing reveals unique genes that contributed to the adaptive evolution of the Mikado pheasant.

Background: The Mikado pheasant (Syrmaticus mikado) is a nearly endangered species indigenous to high-altitude regions of Taiwan. This pheasant provides an opportunity to investigate evolutionary processes following geographic isolation. Currently, the genetic background and adaptive evolution of the Mikado pheasant remain unclear. Results: We present the draft genome of the Mikado pheasant, which consists of 1.04 Gb of DNA and 15,972 annotated protein-coding genes. The Mikado pheasant displays expansion and positive selection of genes related to features that contribute to its adaptive evolution, such as energy metabolism, oxygen transport, hemoglobin binding, radiation response, immune response, and DNA repair. To investigate the molecular evolution of the major histocompatibility complex (MHC) across several avian species, 39 putative genes spanning 227 kb on a contiguous region were annotated and manually curated. The MHC loci of the pheasant revealed a high level of synteny, several rapidly evolving genes, and inverse regions compared to the same loci in the chicken. The complete mitochondrial genome was also sequenced, assembled, and compared against four long-tailed pheasants. The results from molecular clock analysis suggest that ancestors of the Mikado pheasant migrated from the north to Taiwan about 3.47 million years ago. Conclusions: This study provides a valuable genomic resource for the Mikado pheasant, insights into its adaptation to high altitude, and the evolutionary history of the genus Syrmaticus, which could potentially be useful for future studies that investigate molecular evolution, genomics, ecology, and immunogenetics.

Novel quinolone chalcones targeting colchicine-binding pocket kill multidrug-resistant cancer cells by inhibiting tubulin activity and MRP1 function.

Agents targeting colchicine-binding pocket usually show a minimal drug-resistance issue, albeit often associated with high toxicity. Chalcone-based compounds, which may bind to colchicine-binding site, are found in many edible fruits, suggesting that they can be effective drugs with less toxicity. Therefore, we synthesized and examined 24 quinolone chalcone compounds, from which we identified ((E)-3-(3-(2-Methoxyphenyl)-3-oxoprop-1-enyl) quinolin-2(1H)-one) (CTR-17) and ((E)-6-Methoxy-3-(3-(2-methoxyphenyl)-3-oxoprop-1-enyl) quinolin-2(1H)-one) (CTR-20) as promising leads. In particular, CTR-20 was effective against 65 different cancer cell lines originated from 12 different tissues, largely in a cancer cell-specific manner. We found that both CTR-17 and CTR-20 reversibly bind to the colchicine-binding pocket on ß-tubulin. Interestingly however, both the CTRs were highly effective against multidrug-resistant cancer cells while colchicine, paclitaxel and vinblastine were not. Our study with CTR-20 showed that it overcomes multidrug-resistance through its ability to impede MRP1 function while maintaining strong inhibition against microtubule activity. Data from mice engrafted with the MDA-MB-231 triple-negative breast cancer cells showed that both CTR-17 and CTR-20 possess strong anticancer activity, alone or in combination with paclitaxel, without causing any notable side effects. Together, our data demonstrates that both the CTRs can be effective and safe drugs against many different cancers, especially against multidrug-resistant tumors.

A preliminary study for the assessment of PD-L1 and PD-L2 on circulating tumor cells by microfluidic-based chipcytometry.

AIM: Expression of PD-L1 in the tumor is associated with more favorable responses to anti-PD-1 therapy in multiple cancers. However, obtaining tumor biopsies for PD-L1 interrogation is an invasive procedure and challenging to assess repeatedly as the disease progresses. MATERIALS & METHODS: Here we assess an alternative, minimally invasive approach to analyze blood samples for circulating tumor cells (CTCs) that have broken away from the tumor and entered the periphery. Our approach uses sized-based microfluidic CTC enrichment and subsequent characterization with microfluidic-based cytometry (chipcytometry). CONCLUSION: We demonstrate tumor-cell detection and characterization for PD-L1, and other markers, in both spiked and patient samples. This preliminary communication is the first report using chipcytometry for the characterization of CTCs.

Cervical vestibular-evoked myogenic potential in vestibular schwannoma after gamma-knife surgery.

OBJECTIVE: Gamma-knife radiosurgery (GKS) for vestibular schwannomas (VSs) has become popular during the last two decades, and a promising tumor control rate has been reported. Therefore, the evaluation and preservation of auditory-vestibular nerve function after GKS have become more and more important in these patients with long-term survival. We have traditionally used pure-tone audiometry (PTA) for evaluation of auditory nerve function, and the caloric test for superior vestibular nerve function. Vestibular-evoked myogenic potential (VEMP) has recently emerged from various neurophysiological examinations for assessment of the integrity of the inferior vestibular nerve function. This novel tool has been established to represent a sacculo-collic reflex. By using these three tools, the auditory-vestibular nerve function of VS patients can be evaluated and monitored before and after GKS. METHODS: Fourteen patients with unilateral VS that underwent GKS were prospectively recruited. All of them received a battery of auditory-vestibular function tests including PTA, caloric, and cVEMP tests before and after GKS at each time point (1, 6, and 12 months). Our data also included the tumor volumes and their relationship with the PTA, caloric, and cVEMP test results. RESULTS: The PTA, caloric, and cVEMP tests showed abnormal results before GKS in 85.7%, 78.6% and 78.6% of our VS patients, respectively. The PTA, caloric, and cVEMP results did not show strong correlations between each other. However, there was a tendency that when the tumor grew larger, the auditory-vestibular function deficits became more severe. The PTA and cVEMP test results remained stable during the 1-year follow-up after GKS. However, the caloric test showed transient deterioration at the 6th month follow-up, which then recovered by the 1-year follow-up. CONCLUSION: The combination of these three tests can help us diagnose VS and assess the change in auditory-vestibular nerve function during the post-GKS follow-up period. The results of these three tests were independent for smaller tumors, but all tests may show abnormal findings with larger tumors. Although the study is still ongoing, the preliminary data showed that GKS treatment would not affect the auditory-vestibular nerve function within a 1-year follow-up period.