Safety and efficacy of low-power pure-cut hot snare polypectomy for small nonpedunculated colorectal polyps compared with conventional resection methods: A propensity score matching analysis.

Objectives: Cold snare polypectomy (CSP) is widely performed for small colorectal polyps. However, small colorectal polyps sometimes include high-grade adenomas or carcinomas that require endoscopic resection with electrocautery. This study aimed to evaluate the efficacy and safety of a novel resection technique, hot snare polypectomy with low-power pure-cut current (LPPC-HSP) for small colorectal polyps, compared with CSP and conventional endoscopic mucosal resection (EMR). Methods: Records of patients who underwent CSP, EMR, or LPPC-HSP for nonpedunculated colorectal polyps less than 10 mm between April 2021 and March 2022 were retrospectively evaluated. We analyzed and compared the treatment outcomes of CSP and EMR with those of LPPC-HSP using propensity score matching. Results: After propensity score matching of 396 pairs, an analysis of CSP and LPPC-HSP indicated that LPPC-HSP had a significantly higher R0 resection rate (84% vs. 68%; p < 0.01). Delayed bleeding was observed in only two cases treated with CSP before matching. Perforation was not observed with either treatment. After propensity score matching of 176 pairs, an analysis of EMR and LPPC-HSP indicated that their en bloc and R0 resection rates were not significantly different (99.4% vs. 100%, p = 1.00; 79% vs. 81%, p = 0.79). Delayed bleeding and perforation were not observed with either treatment. Conclusions: The safety of LPPC-HSP was comparable to that of CSP. The treatment outcomes of LPPC-HSP were comparable to those of conventional EMR for small polyps. These results suggest that this technique is a safe and effective treatment for nonpedunculated polyps less than 10 mm.

Towards Self-regeneration: Exploring the Limits of Protein Synthesis in the Protein Synthesis Using Recombinant Elements (PURE) Cell-free Transcription-Translation System.

Self-regeneration is a key function of living systems that needs to be recapitulated in vitro to create a living synthetic cell. A major limiting factor for protein self-regeneration in the PURE cell-free transcription-translation system is its high protein concentration, which far exceeds the system's protein synthesis rate. Here, we were able to drastically reduce the nonribosomal PURE protein concentration up to 97.3% while increasing protein synthesis efficiency. Although crowding agents were not effective in the original PURE formulation, we found that in highly dilute PURE formulations, addition of 6% dextran considerably increased protein synthesis rate and total protein yield. These new PURE formulations will be useful for many cell-free synthetic biology applications, and we estimate that PURE can now support the complete self-regeneration of all 36 nonribosomal proteins, which is a critical step toward the development of a universal biochemical constructor and living synthetic cell.

Machine Learning-Aided Analysis of the Rolling and Recrystallization Textures of Pure Iron with Different Cold Reduction Ratios and Cold-Rolling Directions.

We performed a machine learning-aided analysis of the rolling and recrystallization textures in pure iron with different cold reduction ratios and cold-rolling directions. Five types of specimens with different cold reduction ratios and cold-rolling directions were prepared. The effect of two-way cold-rolling on the rolling texture was small at cold reduction ratios different from 60%. The cold reduction ratio in each stage hardly affected the texture evolution during cold-rolling and subsequent short-term annealing. In the case of long-term annealing, although abnormal grain growth occurred, the crystal orientation of the grains varied. Moreover, the direction of cold-rolling in each stage also hardly affected the texture evolution during cold-rolling and subsequent short-term annealing. During long-term annealing, sheets with the same cold-rolling direction in the as-received state and in the first stage showed the texture evolution of conventional one-way cold-rolled pure iron. Additionally, we conducted a machine learning-aided analysis of rolling and recrystallization textures. Using cold-rolling and annealing conditions as the input data and the degree of Goss orientation development as the output data, we constructed high-accuracy regression models using artificial neural networks and XGBoost. We also revealed that the annealing temperature is the dominant factor in the nucleation of Goss grains.

Evaluation of the auditory brainstem response test in patients with type 2 diabetes mellitus.

Background: Hearing loss is an unknown complication of diabetes mellitus (DM). The aim of this study was to evaluate hearing function using auditory brainstem response (ABR) in diabetic patients. Methods: The present case-control study was performed on thirty diabetic patients as a case group and thirty healthy individuals as a control group. Baseline demographic information, HbA1c level, and duration of diabetes were obtained from all diabetic patients. In all subjects, the ABR and pure-tone audiometry (PTA) tests were performed and the results were analyzed using the t-test and logistic regression. Results: The absolute latency of I was significantly lower in diabetes patients. The absolute latency of III and the interpeak latencies (IPL) I-III were significantly higher in diabetic patients. No significant relationship was noticed in the absolute latency of V and the IPL I-V among diabetic patients in the right and left ears (P>0.05). Conclusion: The results of this study suggested that diabetes may cause central auditory dysfunction manifested on the absolute latency of III, the IPL I-III and III-V.

Effect of combining batroxobin with acupuncture treatment on hearing recovery in patients with sudden sensorineural hearing loss.

BACKGROUND: The effect of batroxobin on hearing recovery in patients with Sudden Sensorineural Hearing Loss (SSNHL) is still controversial, and acupuncture shows auxiliary benefits for SSNHL. OBJECTIVES: To investigate the effectiveness of combining acupuncture with batroxobin therapy for patients with SSNHL. MATERIAL AND METHODS: One hundred and fifty-six patients with SSNHL were retrospectively enrolled in this study, and categorized into the control group (only batroxobin treatment) and observation group (batroxobin and acupuncture treatment). Pure Tone Audiograms (PTA) threshold and clinical outcomes of hearing recovery were compared. Logistic regression analysis was used to evaluate the association between hearing recovery and potential risk factors. RESULTS: Compared to the control group, the observation group had a higher overall effective rate (p = 0.006) and improvement in PTA threshold (p = 0.007). Among SSNHL patients with high-frequency and flat-type hearing loss, observation group demonstrated superior hearing recovery post-treatment compared to the control group (p < 0.05). Additionally, hearing recovery in patient with SSNHL were associated with SSNHL types, disease duration, neutrophil count and acupuncture (p < 0.05). CONCLUSIONS AND SIGNIFICANCE: Combining batroxobin and acupuncture treatments enhences the improvement of hearing recovery in SSNHL patients compared to only batroxobin treatments, especially high-frequency and flat-type hearing loss.

The differences between pure and mixed invasive micropapillary breast cancer: the epithelial-mesenchymal transition molecules and prognosis.

PURPOSE: Invasive micropapillary carcinoma (IMPC) of the breast is known for its high metastatic potential, but the definition of pure and mixed IMPC remains unclear. This retrospective cohort study aims to investigate the prognostic significance of the micropapillary component ratio and the expression of critical molecules of epithelial-mesenchymal transition (EMT), including E-cadherin (E-cad), N-cadherin (N-cad), CD44s, and ß-catenin (ß-cat), in distinguishing between pure and mixed IMPCs. METHODS: We analyzed 100 cases of locally advanced IMPC between 2000 and 2018 and excluded patients who received neoadjuvant chemotherapy. Pure IMPC was defined as having a micropapillary component of over 90%. A comprehensive recording of prognostic parameters was conducted. The IMPC areas were analyzed using the immunohistochemical (IHC) staining method on the microarray set for pure and mixed IMPC patients. Pearson's chi-square, Fisher's exact tests, Kaplan-Meier analysis, and Cox proportional hazards analysis were employed. RESULTS: The comparative survival analysis of the entire group, based on overall survival (OS) and disease-free survival (DFS), revealed no significant difference between the pure and mixed groups (P = 0.480, HR = 1.474 [0.502-4.325] and P = 0.390, HR = 1.587 [0.550-4.640], respectively). However, in the pure IMPC group, certain factors were found to be associated with a higher risk of short survival. These factors included skin involvement (P = 0.050), pT3&4 category (P = 0.006), a ratio of intraductal component (> 5%) (P = 0.032), and high-level expression of N-cad (P = 0.020). Notably, none of the risk factors identified for short OS in pure IMPC cases were observed as significant risks in mixed cases and vice versa. Furthermore, N-cad was identified as a poor prognostic marker for OS in pure IMPCs (P = 0.002). CONCLUSION: The selection of a 90% ratio for classifying pure IMPCs revealed significant differences in certain molecular and prognostic parameters between pure and mixed groups. Notably, the involvement of N-cadherin in the epithelial-mesenchymal transition (EMT) process provided crucial insights for predicting OS and DFS while also distinguishing between the two groups. These findings strongly support the notion that the pure IMPC subgroup represents a distinct entity characterized by unique molecular characteristics and behavioral patterns.

Prevalence and Severity of Sensorineural Hearing Loss in Diabetic and Hypertensive Patients: A Comparative Cross-Sectional Study.

Background The ability to perceive sound is crucial for effective communication and environmental awareness. This study aimed to assess sensorineural hearing loss (SNHL) in patients with both diabetes mellitus (DM) and hypertension (HTN). Materials and methods A total of 120 participants of both genders were divided into three groups: Group I consisted of diabetic patients (n=40, 22 males and 18 females), Group II included hypertensive individuals (n=40, 16 males and 24 females), and Group III served as controls (n=40, 15 males and 25 females). General ear examinations, including otoscopy, were conducted. Hearing function and the degree, pattern, and configuration of hearing loss were assessed using general ear examinations and pure tone audiometry. Results Normal hearing was observed in 25% of Group I, 26% of Group II, and 85% of Group III. Mild hearing loss was evident in 75% of Group I, 50% of Group II, and 15% of Group III, while moderate hearing loss was observed in 24% of Group II. These differences were statistically significant (P < 0.05). Conclusion Diabetic and hypertensive individuals demonstrated a higher hearing loss prevalence than healthy controls.

Pure Red Cell Aplasia secondary to Erythropoietin Therapy.

We report a case series of two chronic kidney disease patients (CKD) who developed erythropoietin-induced pure red cell aplasia following a change in erythropoietin preparation. Both patients responded well to immunosuppressive treatments, but unfortunately developed severe infections as a result of being immunosuppressed.

An unusual case of pure erythroid leukemia with normal karyotype and NPM1 mutation.

Pure erythroid leukemia (PEL) is an extremely rare subtype of acute myeloid leukemia (AML). Although not specific, PEL is almost uniformly associated with complex karyotype and TP53 mutations. Given the rarity of the disease, our understanding of its cytogenetic and molecular features deems incomplete. We aim to complement existing literature by presenting an unusual case of PEL. The case is comprehensively worked up with multiple modalities. We present for the first time a case of PEL with unusual cytogenetic and molecular features: normal karyotype with absence of TP53 mutations and presence of NPM1 and NRAS mutations. This is a valuable addition to literature, expanding our understanding of molecular and cytogenetic spectra of PEL.

Prediction of the Benign or Malignant Nature of Pulmonary Pure Ground-Glass Nodules Based on Radiomics Analysis of High-Resolution Computed Tomography Images.

To evaluate the efficacy of radiomics features extracted from preoperative high-resolution computed tomography (HRCT) scans in distinguishing benign and malignant pulmonary pure ground-glass nodules (pGGNs), a retrospective study of 395 patients from 2016 to 2020 was conducted. All nodules were randomly divided into the training and validation sets in the ratio of 7:3. Radiomics features were extracted using MaZda software (version 4.6), and the least absolute shrinkage and selection operator (LASSO) was employed for feature selection. Significant differences were observed in the training set between benign and malignant pGGNs in sex, mean CT value, margin, pleural retraction, tumor-lung interface, and internal vascular change, and then the mean CT value and the morphological features model were constructed. Fourteen radiomics features were selected by LASSO for the radiomics model. The combined model was developed by integrating all selected radiographic and radiomics features using logistic regression. The AUCs in the training set were 0.606 for the mean CT value, 0.718 for morphological features, 0.756 for radiomics features, and 0.808 for the combined model. In the validation set, AUCs were 0.601, 0.692, 0.696, and 0.738, respectively. The decision curves showed that the combined model demonstrated the highest net benefit.

Controlling the Phase Distribution of Single Bromide Quasi-2-Dimensional Perovskite Crystals via Solvent Engineering for Pure-Blue Light-Emitting Diodes.

To achieve pure-blue emission (460-470 nm), we manipulate the crystallization process of the quasi-2D perovskite, (PBA)2Csn-1PbnBr3n+1, prepared by a solution process. The strategy involves controlling the distribution of "n" phases with different bandgaps, solely utilizing changes in the precursor's supersaturation to ensure that the desired emission aligns with the smallest bandgap. Adjustments in photoluminescence (PL) wavelength are made by changing the solute concentration and solvent polarity, as these factors heavily influence the diffusion of cations, a crucial determinant for the value of "n". Subsequently, we enhance the PL quantum yield from 31 to 51% at 461 nm using trioctylphosphine oxide (TOPO) as an additive of antisolvent, which passivates halide vacancy and promotes orderly crystal growth, leading to faster carrier transfer between phases. With these strategies, we successfully demonstrate pure-blue LEDs with a turn-on voltage of 3.3 V and an external quantum efficiency of 5.5% at an emission peak of 470 nm with a full-width at half-maximum of 31 nm.

Effect of Reinforcement Bar on Trueness of Printed Titanium Kennedy I Removable Partial Denture Frameworks by Selective Laser Melting.

OBJECTIVE: The addition of reinforcement bars is a commonly used method to improve the fabrication trueness of selective laser melting removable partial denture alloy frameworks. However, the effects of different reinforcement bar designs on the trueness of the entire framework remain unclear. This study investigated the trueness of removable partial denture frameworks of pure titanium fabricated by selective laser melting under different reinforcement bar settings. METHOD: A virtual framework was designed based on the Kennedy Class I partially edentulous model using computer-aided design software. Frameworks with different reinforcement bar settings (Ti-A without reinforcement bar, Ti-B with a single horizontal bar joining the lingual bar, Ti-C with two more bars at the anterior region, Ti-D with another horizontal bar at the anterior region, and Ti-E with one more bar at the posterior region, n = 5) were printed using pure titanium powder using a direct metal laser melting machine. The fabricated frameworks were scanned, and their fabrication trueness was compared with the designed virtual framework using one-way ANOVA. RESULTS: The overall mean discrepancies for Ti-A, Ti-B, Ti-C, Ti-D, and Ti-E were 0.111, 0.047, 0.073, 0.068, and 0.047 mm, respectively. For the group of Ti-A set with no reinforcement bars, larger discrepancies were observed compared with the other four groups (P < .05). Groups Ti-B and Ti-E showed better trueness of the RPI clasps, rests, and distal ends (P < .05). CONCLUSIONS: Adding reinforcement bars improved the printing trueness of the pure titanium frameworks, and different settings resulted in various degrees of improvement. Setting a single reinforcement bar to join the lingual bar or an additional reinforcement bar at the distal end significantly enhanced the printing trueness of the RPI clasps, rests, and distal ends.

Association of oxidative balance score with hearing loss and tinnitus: NHANES 1999-2018.

Background: Oxidative stress is associated with the occurrence of hearing loss and tinnitus. The oxidative balance score (OBS), a composite indicator evaluating the balance between antioxidant and pro-oxidative components across various dietary and lifestyle factors, indicates the overall oxidative balance status. However, the association of OBS with hearing loss and tinnitus has not been reported previously. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were analyzed. Weighted multivariable logistic regression, weighted multivariable linear regression, and restricted cubic spline curve (RCS) regression were employed to explore the relationship between OBS and hearing loss at speech, low, and high frequencies, along with tinnitus. Subgroup analysis and sensitivity analysis were used to ascertain the consistency across subgroups and stability of the results. Results: We included 13,715 and 21,644 individuals to investigate the association between OBS and hearing loss, as well as between OBS and tinnitus, respectively. The second, third, and fourth quartiles of OBS were significantly associated with a lower risk of hearing loss at speech, low, and high frequencies, as well as tinnitus, compared to the lowest quartile. The RCS regression analysis indicated a negative linear association of OBS with hearing loss and tinnitus. Most associations were maintained in subgroup analysis and sensitivity analysis. Additionally, the dietary and lifestyle OBS independently contribute to the protection against hearing loss and tinnitus. Conclusion: OBS is negatively correlated with the risk of hearing loss and tinnitus. The findings suggest that combined antioxidant diet and lifestyle hold promise as potential strategies for reducing the prevalence of hearing loss and tinnitus.

Cultivation of novel Atribacterota from oil well provides new insight into their diversity, ecology, and evolution in anoxic, carbon-rich environments.

BACKGROUND: The Atribacterota are widely distributed in the subsurface biosphere. Recently, the first Atribacterota isolate was described and the number of Atribacterota genome sequences retrieved from environmental samples has increased significantly; however, their diversity, physiology, ecology, and evolution remain poorly understood. RESULTS: We report the isolation of the second member of Atribacterota, Thermatribacter velox gen. nov., sp. nov., within a new family Thermatribacteraceae fam. nov., and the short-term laboratory cultivation of a member of the JS1 lineage, Phoenicimicrobium oleiphilum HX-OS.bin.34TS, both from a terrestrial oil reservoir. Physiological and metatranscriptomics analyses showed that Thermatribacter velox B11T and Phoenicimicrobium oleiphilum HX-OS.bin.34TS ferment sugars and n-alkanes, respectively, producing H2, CO2, and acetate as common products. Comparative genomics showed that all members of the Atribacterota lack a complete Wood-Ljungdahl Pathway (WLP), but that the Reductive Glycine Pathway (RGP) is widespread, indicating that the RGP, rather than WLP, is a central hub in Atribacterota metabolism. Ancestral character state reconstructions and phylogenetic analyses showed that key genes encoding the RGP (fdhA, fhs, folD, glyA, gcvT, gcvPAB, pdhD) and other central functions were gained independently in the two classes, Atribacteria (OP9) and Phoenicimicrobiia (JS1), after which they were inherited vertically; these genes included fumarate-adding enzymes (faeA; Phoenicimicrobiia only), the CODH/ACS complex (acsABCDE), and diverse hydrogenases (NiFe group 3b, 4b and FeFe group A3, C). Finally, we present genome-resolved community metabolic models showing the central roles of Atribacteria (OP9) and Phoenicimicrobiia (JS1) in acetate- and hydrocarbon-rich environments. CONCLUSION: Our findings expand the knowledge of the diversity, physiology, ecology, and evolution of the phylum Atribacterota. This study is a starting point for promoting more incisive studies of their syntrophic biology and may guide the rational design of strategies to cultivate them in the laboratory. Video Abstract.

Performance of Purpose-Built vs Off-Label Transcatheter Devices for Aortic Regurgitation: The PURPOSE Study.

BACKGROUND: Severe pure aortic regurgitation (AR) carries a high mortality and morbidity risk, and it is often undertreated because of the inherent surgical risk. Transcatheter heart valves (THVs) have been used off-label in this setting with overall suboptimal results. The dedicated "purpose-built" Jena Valve Trilogy (JVT, JenaValve Technology) showed an encouraging performance, although it has never been compared to other THVs. OBJECTIVES: The aim of our study was to assess the performance of the latest iteration of THVs used off-label in comparison to the purpose-built JVT in inoperable patients with severe AR. METHODS: We performed a multicenter, retrospective registry with 18 participating centers worldwide collecting data on inoperable patients with severe AR of the native valve. A bicuspid aortic valve was the main exclusion criterion. The primary endpoints were technical and device success, 1-year all-cause mortality, and the composite of 1-year mortality and the heart failure rehospitalization rate. RESULTS: Overall, 256 patients were enrolled. THVs used off-label were used in 168 cases (66%), whereas JVT was used in 88 (34%). JVT had higher technical (81% vs 98%; P < 0.001) and device success rates (73% vs 95%; P < 0.001), primarily driven by significantly lower incidences of THV embolization (15% vs 1.1%; P < 0.001), the need for a second valve (11% vs 1.1%; P = 0.004), and moderate residual AR (10% vs 1.1%; P = 0.007). The permanent pacemaker implantation rate was comparable and elevated for both groups (22% vs 24%; P = 0.70). Finally, no significant difference was observed at the 1-year follow-up in terms of mortality (HR: 0.99; P = 0.980) and the composite endpoint (HR: 1.5; P = 0.355). CONCLUSIONS: The JVT platform has a better acute performance than other THVs when used off-label for inoperable patients with severe AR. A longer follow-up is conceivably needed to detect a possible impact on prognosis.

The Value of Radiomics Features Based on HRCT in Predicting whether the Lung Sub-Centimeter Pure Ground Glass Nodule is Benign or Malignant.

OBJECTIVE: In this study, a radiomics model was created based on High-Resolution Computed Tomography (HRCT) images to noninvasively predict whether the sub-centimeter pure Ground Glass Nodule (pGGN) is benign or malignant. METHODS: A total of 235 patients (251 sub-centimeter pGGNs) who underwent preoperative HRCT scans and had postoperative pathology results were retrospectively evaluated. The nodules were randomized in a 7:3 ratio to the training (n=175) and the validation cohort (n=76). The volume of interest was delineated in the thin-slice lung window, from which 1316 radiomics features were extracted. The Least Absolute Shrinkage and Selection Operator (LASSO) was used to select the radiomics features. Univariate and multivariable logistic regression were used to evaluate the independent risk variables. The performance was assessed by obtaining Receiver Operating Characteristic (ROC) curves for the clinical, radiomics, and combined models, and then the Decision Curve Analysis (DCA) assessed the clinical applicability of each model. RESULTS: Sex, volume, shape, and intensity mean were chosen by univariate analysis to establish the clinical model. Two radiomics features were retained by LASSO regression to build the radiomics model. In the training cohort, the Area Under the Curve (AUC) of the radiomics (AUC=0.844) and combined model (AUC=0.871) was higher than the clinical model (AUC=0.773). In evaluating whether or not the sub-centimeter pGGN is benign, the DCA demonstrated that the radiomics and combined model had a greater overall net benefit than the clinical model. CONCLUSION: The radiomics model may be useful in predicting the benign and malignant sub-centimeter pGGN before surgery.

Exploring 1,3-Dioxolane Extraction of Poly(3-hydroxybutyrate) and Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) from Methylocystis hirsuta and Mixed Methanotrophic Strain: Effect of Biomass-to-Solvent Ratio and Extraction Time.

The increasing need for biodegradable polymers demands efficient and environmentally friendly extraction methods. In this study, a simple and sustainable method for extracting polyhydroxybutyrate (PHB) and poly(3-hydroxybutyrate-co-3-hydroxyvalerate (PHB-co-HV) from Methylocystis hirsuta and a mixed methanotrophic consortium with different biopolymer contents was presented. The extraction of biopolymers with 1,3-dioxolane was initially investigated by varying the biomass-to-solvent ratio (i.e., 1:2 w v-1, 1:4 w v-1, 1:6 w v-1, 1:8 w v-1 and 1:10 w v-1) and extraction time (6, 8 and 10 h) at the boiling point of the solvent and atmospheric pressure. Based on the results of the preliminary tests, and only for the most efficient biomass-to-solvent ratio, the extraction kinetics were also studied over a time interval ranging from 30 min to 6 h. For Methylocystis hirsuta, the investigation of the extraction time showed that the maximum extraction was reached after 30 min, with recovery yields of 87% and 75% and purities of 98.7% and 94% for PHB and PHB-co-HV, respectively. Similarly, the extraction of PHB and PHB-co-HV from a mixed methanotrophic strain yielded 88% w w-1 and 70% w w-1 recovery, respectively, with 98% w w-1 purity, at a biomass-to-solvent ratio of 6 in 30 min.

Rational Design of Color-Pure Blue Organic Emitters by Poly-Heteroaromatic Omni-Delocalization.

Current research on organic light emitters which utilize multiple resonance-induced thermally activated delayed fluorescence (MR-TADF) materials is gaining significant interest because of the materials' ability to efficiently generate color-pure blue emission. However, the underlying reasons for high color purity remain unclear. It is shown here that these emitters share a common electronic basis, which is deduced from resonance structure considerations following Clar's rule, and which is termed as "poly-heteroaromatic omni-delocalization" (PHOD). The simple and clear design rules derived from the PHOD concept allow extending the known chemical space by new structural motifs. Based on PHOD, a set of novel high-efficiency color-pure emitters with brilliant deep-blue hue is specifically designed.

Accuracy and Consistency of Confidence Limits for Monosyllable Identification Scores Derived Using Simulation, the Harrell-Davis Estimator, and Nonlinear Quantile Regression.

BACKGROUND: Audiological diagnosis and rehabilitation often involve the assessment of whether the maximum speech identification score (PBmax) is poorer than expected from the pure-tone average (PTA) threshold. This requires the estimation of the lower boundary of the PBmax values expected for a given PTA (one-tailed 95% confidence limit, CL). This study compares the accuracy and consistency of three methods for estimating the 95% CL. METHOD: The 95% CL values were estimated using a simulation method, the Harrell-Davis (HD) estimator, and non-linear quantile regression (nQR); the latter two are both distribution-free methods. The first two methods require the formation of sub-groups with different PTAs. Accuracy and consistency in the estimation of the 95% CL were assessed by applying each method to many random samples of 50% of the available data and using the fitted parameters to predict the data for the remaining 50%. STUDY SAMPLE: A total of 642 participants aged 17 to 84 years with sensorineural hearing loss were recruited from audiology clinics. Pure-tone audiograms were obtained and PBmax scores were measured using monosyllables at 40 dB above the speech recognition threshold or at the most comfortable level. RESULTS: For the simulation method, 6.7 to 8.2% of the PBmax values fell below the 95% CL for both ears, exceeding the target value of 5%. For the HD and nQR methods, the PBmax values fell below the estimated 95% CL for approximately 5% of the ears, indicating good accuracy. Consistency, estimated from the standard deviation of the deviations from the target value of 5%, was similar for all the methods. CONCLUSIONS: The nQR method is recommended because it has good accuracy and consistency, and it does not require the formation of arbitrary PTA sub-groups.

Clinical characteristics and analysis of vestibular-evoked myogenic potentials in patients with sudden sensorineural hearing loss in different ages.

BACKGROUND: Numerous studies have found that patients experiencing sudden sensorineural hearing loss (SSHL), with or without accompanying vertigo, often show impaired vestibular function. However, there is a dearth of studies analyzing vestibular-evoked myogenic potentials (VEMPs) in SSHL patients across various age groups. AIM: To investigate vestibular condition in SSHL patients across various age demographics. METHODS: Clinical data of 84 SSHL patients were investigated retrospectively. Audiometry, cervical vestibular evoked myogenic potentials (c-VEMPs), and ocular vestibular evoked myogenic potentials (o-VEMPs) were conducted on these patients. Parameters assessed included the latencies of P1 and N1 waves, as well as the amplitudes of P1-N1 waves. Moreover, the study evaluated the influence of factors such as sex, affected side, configuration of hearing loss, and presence of accompanying vertigo. RESULTS: Among the 84 SSHL patients, no significant differences were observed among the three groups in terms of gender, affected side, and the presence or absence of vertigo. Group II (aged 41-60 years) had the highest number of SSHL cases. The rates of absent o-VEMPs in the affected ears were 20.83%, 31.58%, and 22.72% for the three age groups, respectively, with no statistically significant difference among them. The rates of absent c-VEMPs in the affected ears were 8.3%, 34.21%, and 18.18% for the three age groups, respectively, with significant differences. In the unaffected ears, there were differences observed in the extraction rates of o-VEMPs in the unaffected ears among the age groups. In the three age groups, no significant differences were noted in the three age groups in the latencies of P1 and N1 waves or in the amplitude of N1-P1 waves for c-VEMPs and o-VEMPs, either on the affected side or on the unaffected side, across the three age groups. CONCLUSION: The extraction rate of VEMPs is more valuable than parameters. Regardless of the presence of vertigo, vestibular organs are involved in SSHL. Notably, SSHL patients aged 41-60 appear more susceptible to damage to the inferior vestibular nerve and saccule.