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1.
Artículo en Inglés | MEDLINE | ID: mdl-38877157

RESUMEN

We examined whether quarantined individuals complied with rules to prevent transmission at home and whether the government provided appropriate support to individuals in quarantine. Between November 2020 and August 2021, we surveyed 198 individuals who had been or were quarantined at home without infection. The online survey results show that respondents experienced difficulties living in close quarters with their cohabitants and had low compliance with in-house hygiene rules. The government needed to provide adequate employment protection, living expense, or care support. Such failures of the system were mainly due to a lack of legal grounds for the government to operate. To improve compliance, the government can amend laws to permit active communication of public health messages with those quarantined at home and provide the necessary support.

2.
Adv Healthc Mater ; : e2400622, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-38820600

RESUMEN

Virion-mediated outbreaks are imminent and despite rapid responses, continue to cause adverse symptoms and death. Therefore, tunable, sensitive, high-throughput assays are needed to help diagnose future virion-mediated outbreaks. Herein, it is developed a tunable in situ assay to selectively enrich virions and extracellular vesicles (EVs) and simultaneously detect antigens and nucleic acids at a single-particle resolution. The Biochip Antigen and RNA Assay (BARA) enhanced sensitivities compared to quantitative reverse-transcription polymerase chain reaction (qRT-PCR), enabling the detection of virions in asymptomatic patients, genetic mutations in single virions, and enabling the continued long-term expression of viral RNA in the EV-enriched subpopulation in the plasma of patients with post-acute sequelae of the coronavirus disease of 2019 (COVID-19). BARA revealed highly accurate diagnoses of COVID-19 by simultaneously detecting the spike glycoprotein and nucleocapsid-encoding RNA in saliva and nasopharyngeal swab samples. Altogether, the single-particle detection of antigens and viral RNA provides a tunable framework for the diagnosis, monitoring, and mutation screening of current and future outbreaks.

3.
J Dent Educ ; 2024 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-38795325

RESUMEN

OBJECTIVES: Interpretation of dental radiographs is a difficult process, particularly for inexperienced students. This study introduced concept mapping for dental students to help in the radiographic interpretation of common jaw lesions. We aimed to analyze the efficacy of the concept map (CM) in radiographic interpretation, with a discussion of the diagnostic reasoning dilemma. METHODS: This study included 39 dental students. After a 1-h class for CM guidance and based on three group discussions and one-on-one feedback, the students completed and submitted CMs for three jaw diseases (ameloblastoma, odontogenic keratocyst, and simple bone cyst). All participants underwent a pretest and posttest of knowledge and diagnosis; all students but one completed an open-ended questionnaire regarding the use of CMs. RESULTS: Concept mapping effectively improved diagnostic accuracy. The participants' posttest scores were better than their pretest scores in both knowledge and diagnostic tests. Most of the students attempted radiographic interpretation through analytic reasoning. The time required for the students to draw a CM varied from student to student from 3-5 h to 1-3 days. CONCLUSION: This study shows that CMs can improve the radiographic diagnostic ability of dental students by providing a framework for analytic reasoning. Continuous research is warranted to improve the effectiveness of CM in oral radiographic interpretation in the dental student's class.

4.
J Neurol ; 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38811396

RESUMEN

INTRODUCTION: The value of a sural nerve biopsy for the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is controversial. Evidence-based recommendations for its implementation are lacking. We investigated factors leading to biopsy and analyzed biopsy outcomes and consequences, assessed the predictability of biopsy outcomes through clinical parameters to avoid unnecessary biopsies, and compared results with electrophysiological and clinical severity to determine their prognostic value. METHODS: 190 sural nerve biopsies were analyzed in two cohorts. One consisted of 163 biopsies and the second of 72 biopsies from the prospective Immune-mediated Neuropathies Biomaterial and Data registry (INHIBIT). Both have an intersection of 45 patients. 75 data sets from patients without biopsy were used. Analysis of nerve conduction studies, treatment, overall disability sum score (ODSS), biopsy outcomes, and diagnosis was performed. RESULTS: 51% of biopsied patients received the diagnosis CIDP (77% fulfilled EFNS/PNS criteria), 21% were not CIDP typical, and 27% were unspecific. Biopsied patients responded less frequently to immunotherapies at time of biopsy than non-biopsied patients (p = 0.003). Immunotherapy was initiated more frequently after biopsy (p < 0.001) and more often with intravenous immunoglobulins (p < 0.0001). 76% of all biopsied patients met the electrophysiological criteria for CIDP. Sensory nerve action potential amplitudes of 0 µV still provide 73% of histological diagnostic value. Histologic signs of degeneration predicted ODSS worsening after 1 year (p = 0.028) but disease severity did not correlate with histological damage severity. DISCUSSION: The main indication for nerve biopsy was the treatment of refractory cases of autoimmune neuropathies with the therapeutic consequence of treatment initiation or escalation. Sural biopsy also provided prognostic information. Even with extinguished sural SNAP, the biopsy can still have diagnostic value.

5.
BMJ Paediatr Open ; 8(1)2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38508660

RESUMEN

BACKGROUND: Despite the rising trend of tracheostomies in children, there is a lack of comprehensive resources for families to navigate the challenges of living with a tracheostomy, emphasising the need for evidence-based support in understanding postoperative care and long-term adjustments. This study aimed to examine the pattern of using healthcare services and nationwide medical outcomes in children who underwent a tracheotomy before the age of 2 years. METHODS: This retrospective study used the National Health Insurance System database from 2008 to 2016 and included all children codified with tracheotomy procedure codes before their second birthday. Healthcare utilisation, such as medical costs, number of hospital visits, home healthcare nursing and medical diagnoses on readmission, in the first 2 years after tracheotomy was evaluated. Multivariable logistic regression analysis was used to determine the factors affecting mortality. RESULTS: In total, 813 patients were included in this study. Their use of healthcare services and the accompanying expenses were higher than the national medians for similar age groups; however, both metrics decreased in the second year. The major causes of admission within 2 years of surgery were respiratory and neurological diseases. The mortality rate within 2 years was 37.8%. Higher risks of mortality were associated with having two or more complex chronic conditions. Use of home healthcare nursing services was associated with a lower mortality risk. CONCLUSION: Paediatric patients with more complex chronic conditions tended to have higher mortality rates within 2 years after surgery. However, receiving home healthcare nursing was significantly associated with a reduced risk of death. Many causes of hospitalisation may be preventable with education and supportive care. Therefore, further research for establishing an integrated care system for these patients and their caregivers is required.


Asunto(s)
Servicios de Salud , Traqueostomía , Humanos , Niño , Preescolar , Estudios Retrospectivos , Atención a la Salud , Enfermedad Crónica
6.
PLoS One ; 19(2): e0299120, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38394080

RESUMEN

This study proposes a control chart that monitors conditionally heteroscedastic time series by integrating the Huber support vector regression (HSVR) and the one-class classification (OCC) method. For this task, we consider the model that incorporates nonlinearity to the generalized autoregressive conditionally heteroscedastic (GARCH) time series, named HSVR-GARCH, to robustly estimate the conditional volatility when the structure of time series is not specified with parameters. Using the squared residuals, we construct the OCC-based control chart that does not require any posterior modifications of residuals unlike previous studies. Monte Carlo simulations reveal that deploying squared residuals from the HSVR-GARCH model to control charts can be immensely beneficial when the underlying model becomes more complicated and contaminated with noises. Moreover, a real data analysis with the Nasdaq composite index and Korea Composite Stock Price Index (KOSPI) datasets further disclose the validity of using the bootstrap method in constructing control charts.


Asunto(s)
Factores de Tiempo , Método de Montecarlo
7.
Int Dent J ; 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38350800

RESUMEN

OBJECTIVE: The objective of this study was to explore the process of becoming an independent dentist, extending beyond the entry-level period. MATERIALS AND METHODS: Fifteen general dental practitioners were interviewed. The recorded interviews were transcribed verbatim, and utilizing Colaizzi's descriptive phenomenological method, we sought to exclude subjectivity and derive meanings and themes from participants' experiences concerning the process of becoming independent dentists. RESULTS: The study identified 3 phases in the process of developing as an independent dentist: (1) the foundation phase, involving dental training as a student under faculty supervision; (2) the extension phase, expanding experience as an entry-level dentist; (3) the equilibrium phase, characterized by providing stable dental care based on diverse experience and professionalism. CONCLUSION: Becoming an independent dentist entails more than unsupervised treatment provision; it involves developing the professionalism necessary for delivering quality dental care through deliberate practice and reflection. CLINICAL RELEVANCE: The study outlines the stages of transitioning to an independent dentist, spanning foundational training, entry-level experience, and achieving stable care provision. Emphasizing the importance of professionalism and reflection, it provides a valuable framework for enhancing dental education and on-going professional development, fostering both technical proficiency and a commitment to quality patient care.

8.
J Korean Soc Radiol ; 85(1): 77-94, 2024 Jan.
Artículo en Coreano | MEDLINE | ID: mdl-38362381

RESUMEN

If a solitary spinal lesion is found in an older patient, bone metastasis can be primarily considered as the diagnosis. Bone metastasis can occur anywhere, but it mostly occurs in the vertebral body and may sometimes show typical imaging findings, presenting as a single lesion. Therefore, differentiating it from other lesions that mimic bone metastases can be challenging, potentially leading to delayed diagnosis and initiation of primary cancer treatment. This review provides an overview of imaging findings and clinical guidelines for bone metastases and discusses its differences from other diseases that can occur as solitary spinal lesions in older patients.

9.
Adv Mater ; 36(18): e2311809, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38241612

RESUMEN

Mesoporous metal oxides exhibit excellent physicochemical properties and are widely used in various fields, including energy storage/conversion, catalysis, and sensors. Although several soft-template approaches are reported, high-temperature calcination for both metal oxide formation and template removal is necessary, which limits direct synthesis on a plastic substrate for flexible devices. Here, a universal synthetic approach that combines thermal activation and oxygen plasma to synthesize diverse mesoporous metal oxides (V2O5, V6O13, TiO2, Nb2O5, WO3, and MoO3) at low temperatures (150-200 °C), which can be applicable to a flexible polymeric substrate is introduced. As a demonstration, a flexible micro-supercapacitor is fabricated by directly synthesizing mesoporous V2O5 on an indium-tin oxide-coated colorless polyimide film. The energy storage performance is well maintained under severe bending conditions.

10.
Korean J Radiol ; 25(1): 62-73, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38184770

RESUMEN

OBJECTIVE: This study aimed to determine the prevalence of vertebral venous congestion (VVC) in patients with chemoport insertion, evaluate the imaging characteristics of nodular VVC, and identify the factors associated with VVC. MATERIALS AND METHODS: This retrospective single-center study was based on follow-up contrast-enhanced chest computed tomography (CT) of 1412 adult patients who underwent chemoport insertion between January 2016 and December 2016. The prevalence of venous stenosis, reflux, and VVC were evaluated. The imaging features of nodular VVC, including specific locations within the vertebral body, were analyzed. To identify the factors associated with VVC, patients with VVC were compared with a subset of patients without VVC who had been followed up for > 3 years without developing VVC after chemoport insertion. Toward this, a multivariable logistic regression analysis was performed. RESULTS: After excluding 333 patients, 1079 were analyzed (mean age ± standard deviation, 62.3 ± 11.6 years; 540 females). The prevalence of VVC was 5.8% (63/1079), with all patients (63/63) demonstrating vertebral venous reflux and 67% (42/63) with innominate vein stenosis. The median interval between chemoport insertion and VVC was 515 days (interquartile range, 204-881 days). The prevalence of nodular VVC was 1.5% (16/1079), with a mean size of 5.9 ± 3.1 mm and attenuation of 784 ± 162 HU. Nodular VVC tended to be located subcortically. Forty-four patients with VVC underwent CT examinations with contrast injections in both arms; the VVC disappeared in 70% (31/44) when the contrast was injected in the arm contralateral to the chemoport site. Bevacizumab use was independently associated with VVC (odds ratio, 3.45; P < 0.001). CONCLUSION: The prevalence of VVC and nodular VVC was low in patients who underwent chemoport insertion. Nodular VVC was always accompanied by vertebral venous reflux and tended to be located subcortically. To avoid VVC, contrast injection in the arm contralateral to the chemoport site is preferred.


Asunto(s)
Hiperemia , Adulto , Femenino , Humanos , Constricción Patológica , Estudios Retrospectivos , Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos X
11.
Cancer Imaging ; 24(1): 12, 2024 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-38243293

RESUMEN

BACKGROUND: Limited data exist on the optimal postoperative surveillance protocol for high-grade soft tissue sarcoma, particularly regarding the optimal imaging modality and imaging interval for detecting local recurrence. This study aimed to assess the benefit of short-term postoperative ultrasonography (USG) for detecting local recurrence in patients with high-grade soft tissue sarcoma. METHODS: Patients with newly diagnosed high-grade soft tissue sarcoma who underwent surgical resection between January 2010 and June 2020 were included. Short-term USG was added to the follow-up protocol as a surveillance tool alongside routine magnetic resonance imaging (MRI). The primary outcome was the additional detection rate of short-term USG compared with routine MRI surveillance for early local recurrence detection. Subgroup analysis was performed to evaluate factors influencing USG detection rate. The additional detection rate of short-term USG for detection of metastatic lymph nodes was also evaluated. The secondary outcome was the false referral rate of short-term USG. RESULTS: In total, 198 patients (mean age ± standard deviation: 52.1 ± 15.8 years; 94 women) were included. Local recurrence occurred in 20 patients (10.1%; 20/198). Short-term USG detected local recurrence in advance of routine MRI visits in 7 out of 198 patients, resulting in an additional detection rate of 3.5% (95% CI: 1.7-7.1%). Subgroup analysis showed no significant difference in the short-term USG detection rate based on initial tumor characteristics, and receipt of radiotherapy or chemotherapy. Short-term USG additionally detected five of seven patients with metastatic lymph nodes [2.5% (95% CI, 1.1-5.8%, 5/198)]. The false referral rate of short-term USG was 3.5% (95% CI: 1.7-7.1%; 7/198). CONCLUSIONS: Short-term USG as part of postoperative surveillance for high-grade soft tissue sarcoma can enhance early detection of local tumor recurrence and metastatic lymphadenopathy. Early detection of local tumor recurrence could lead to a prompt surgical resection and aid in local disease control.


Asunto(s)
Sarcoma , Neoplasias de los Tejidos Blandos , Humanos , Femenino , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/patología , Imagen por Resonancia Magnética/métodos , Sarcoma/diagnóstico por imagen , Sarcoma/cirugía , Ultrasonografía , Neoplasias de los Tejidos Blandos/patología , Estudios Retrospectivos
12.
J Magn Reson Imaging ; 2023 Dec 29.
Artículo en Inglés | MEDLINE | ID: mdl-38156716

RESUMEN

With a substantial growth in the use of musculoskeletal MRI, there has been a growing need to improve MRI workflow, and faster imaging has been suggested as one of the solutions for a more efficient examination process. Consequently, there have been considerable advances in accelerated MRI scanning methods. This article aims to review the basic principles and applications of accelerated musculoskeletal MRI techniques including widely used conventional acceleration methods, more advanced deep learning-based techniques, and new approaches to reduce scan time. Specifically, conventional accelerated MRI techniques, including parallel imaging, compressed sensing, and simultaneous multislice imaging, and deep learning-based accelerated MRI techniques, including undersampled MR image reconstruction, super-resolution imaging, artifact correction, and generation of unacquired contrast images, are discussed. Finally, new approaches to reduce scan time, including synthetic MRI, novel sequences, and new coil setups and designs, are also reviewed. We believe that a deep understanding of these fast MRI techniques and proper use of combined acceleration methods will synergistically improve scan time and MRI workflow in daily practice. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.

13.
J Extracell Vesicles ; 12(11): e12369, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37908159

RESUMEN

The molecular heterogeneity of extracellular vesicles (EVs) and the co-isolation of physically similar particles, such as lipoproteins (LPs), confounds and limits the sensitivity of EV bulk biomarker characterization. Herein, we present a single-EV and particle (siEVP) protein and RNA assay (siEVP PRA) to simultaneously detect mRNAs, miRNAs, and proteins in subpopulations of EVs and LPs. The siEVP PRA immobilizes and sorts particles via positive immunoselection onto micropatterns and focuses biomolecular signals in situ. By detecting EVPs at a single-particle resolution, the siEVP PRA outperformed the sensitivities of bulk-analysis benchmark assays for RNA and protein. To assess the specificity of RNA detection in complex biofluids, EVs from various glioma cell lines were processed with small RNA sequencing, whereby two mRNAs and two miRNAs associated with glioblastoma multiforme (GBM) were chosen for cross-validation. Despite the presence of single-EV-LP co-isolates in serum, the siEVP PRA detected GBM-associated vesicular RNA profiles in GBM patient siEVPs. The siEVP PRA effectively examines intravesicular, intervesicular, and interparticle heterogeneity with diagnostic promise.


Asunto(s)
Vesículas Extracelulares , Glioblastoma , MicroARNs , Humanos , Vesículas Extracelulares/genética , Vesículas Extracelulares/metabolismo , Lipopolisacáridos , MicroARNs/genética , MicroARNs/metabolismo , ARN Mensajero , Lipoproteínas , Glioblastoma/diagnóstico , Glioblastoma/genética
14.
ACS Omega ; 8(36): 32450-32457, 2023 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-37720774

RESUMEN

In the current and next-generation Si-based semiconductor manufacturing processes, amorphous carbon layer (ACL) hard masks are garnering considerable attention for high-aspect-ratio (HAR) etching due to their outstanding physical properties. However, a current limitation is the lack of research on the etching characteristics of ACL hard masks under plasma etching conditions. Given the significant impact of hard mask etching on device quality and performance, a deeper understanding of the etching characteristics of ACL is necessary. This study aims to investigate the role of oxygen in the etching characteristics of an ACL hard mask in a complex gas mixture plasma etching process. Our results show that a small change of oxygen concentration (3.5-6.5%) can significantly alter the etch rate and profile of the ACL hard mask. Through our comprehensive plasma diagnostics and wafer-processing results, we have also proven a detailed mechanism for the role of the oxygen gas. This research provides a solution for achieving an outstanding etch profile in ACL hard masks with sub-micron scale and emphasizes the importance of controlling the oxygen concentration to optimize the plasma conditions for the desired etching characteristics.

15.
Br J Radiol ; 96(1152): 20230410, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37750840

RESUMEN

OBJECTIVES: To evaluate diagnostic utility of additional DCE-MRI for detecting residual soft tissue sarcomas (STS) after unplanned excision (UPE). METHODS: We retrospectively evaluated 32 patients with UPE of STS, followed by conventional MRI with DCE-MRI and wide excision (WE), between November 2019 and January 2022. Residual tumors on conventional MRI were categorized into three groups: Lesion-type-0, no abnormal enhancement, Lesion-type-1, an indeterminate lesion, and Lesion-type-2, a definite enhancing nodule. On DCE-MRI, ROIs were manually placed on enhancing areas of suspected residual tumor. The mean and 95th percentile values of AUC of time-intensity curve were calculated at 60, 90, and 120 s of Enhancement-cycle-1 and -2. Optimal DCE parameters were identified by ROC analysis. Diagnostic performance of conventional MRI and DCE-MRI was compared using McNemar's test. RESULTS: On WE, residual tumor was present in 23 (71.9%) of 32 patients. On MRI, Lesion-type-1 was found in 16/32 (50%) patients and Lesion-type-2 in 16/32 (50%). The optimal DCE parameter was the 95th percentile value of AUC at 120s of Enhancement-cycle-2. The sensitivity, specificity, and AUC were as follows: 65.2% (95% CI, 45.8-85.7%), 88.9% (CI, 68.4-100%), and 0.77 (CI, 0.62-0.92) for conventional MRI, and 100%, 55.6% (CI, 23.1-88.0%), and 0.78 (CI, 0.61-0.95) for combined conventional and DCE-MRI. CONCLUSIONS: Additional DCE-MRI aided in detecting residual STS after UPE, particularly in cases without definite soft tissue nodular enhancement. ADVANCES IN KNOWLEDGE: Close follow up may be suggested for patients showing abnormality in DCE-MRI, with more suspicion of residual tumor.


Asunto(s)
Sarcoma , Neoplasias de los Tejidos Blandos , Humanos , Estudios Retrospectivos , Estudios de Seguimiento , Neoplasia Residual/diagnóstico por imagen , Medios de Contraste , Imagen por Resonancia Magnética , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias de los Tejidos Blandos/patología , Sarcoma/diagnóstico por imagen , Sarcoma/cirugía , Sarcoma/patología
16.
Nano Converg ; 10(1): 34, 2023 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-37470924

RESUMEN

The study of strong coupling between light and matter has gained significant attention in recent years due to its potential applications in diverse fields, including artificial light harvesting, ultraefficient polariton lasing, and quantum information processing. Plasmonic cavities are a compelling alternative of conventional photonic resonators, enabling ultracompact polaritonic systems to operate at room temperature. This review focuses on colloidal metal nanoparticles, highlighting their advantages as plasmonic cavities in terms of their facile synthesis, tunable plasmonic properties, and easy integration with excitonic materials. We explore recent examples of strong coupling in single nanoparticles, dimers, nanoparticle-on-a-mirror configurations, and other types of nanoparticle-based resonators. These systems are coupled with an array of excitonic materials, including atomic emitters, semiconductor quantum dots, two-dimensional materials, and perovskites. In the concluding section, we offer perspectives on the future of strong coupling research in nanoparticle systems, emphasizing the challenges and potentials that lie ahead. By offering a thorough understanding of the current state of research in this field, we aim to inspire further investigations and advances in the study of strongly coupled nanoparticle systems, ultimately unlocking new avenues in nanophotonic applications.

17.
BMC Med Educ ; 23(1): 508, 2023 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-37461010

RESUMEN

BACKGROUND: Students' perception of their educational environment and satisfaction with their major can reveal the extent of their readiness to practice their profession after graduation. This study aimed to evaluate dental students' perception of their educational environment and satisfaction with their major in dentistry, as well as the relationship between these two factors. METHODS: An online survey was conducted in 2022 among first- to fourth-year students across 11 dental schools in Korea. The Dundee Ready Education Environment Measure (DREEM) and Academic Major Satisfaction Scale (AMSS) were used to measure the students' perception of the educational environment and satisfaction with their major in dentistry, respectively. RESULTS: A total of 539 students participated in the survey (response rate = 18.1%). The overall mean scores of the DREEM and AMSS were 125.03 (maximum score 200) and 22.01 (maximum score 30), respectively. Fourth-year students had the lowest scores in the overall DREEM, DREEM subscales (excluding students' perceptions of atmosphere), and AMSS. The overall DREEM scores and all DREEM subscales showed statistically significant positive and moderate correlations with AMSS (p < 0.001). CONCLUSION: Using the DREEM, we identified areas that need improvement and the academic year (fourth year) that require proactive support. Considering the positive correlation between all DREEM subscales and the AMSS, measures to comprehensively improve the educational environment are needed to improve dental students' satisfaction with their major.


Asunto(s)
Estudiantes de Odontología , Estudiantes de Medicina , Humanos , Estudios Transversales , Encuestas y Cuestionarios , Percepción , Satisfacción Personal , Odontología
18.
BMC Pediatr ; 23(1): 252, 2023 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-37210512

RESUMEN

BACKGROUND: Trisomy 18 syndrome (T18) is the second most common autosomal trisomy and has a high risk of fetal loss and stillbirth. Aggressive surgical treatments for the respiratory, cardiac, or digestive systems of patients with T18 were previously futile, while the results of recent studies are controversial. Over the past decade, there have been approximately 300,000 to 400,000 births annually in the Republic of Korea; however, there have been no nationwide studies on T18. This nationwide retrospective cohort study aimed to determine the prevalence of T18 in Korea and its prognosis according to the presence of congenital heart disease and relevant interventions. METHODS: This study utilized NHIS-registered data between 2008 and 2017. A child was defined as having T18 if the ICD-10 revision code Q91.0-3 was reported. Subgroup analysis was performed for children with congenital heart diseases, and survival rates were compared based on the history of cardiac surgical or catheter interventions. The primary outcomes in this study were the survival rate during the first hospitalization period and the 1-year survival rate. RESULTS: Of the children born between 2008 and 2017, 193 were diagnosed with T18. Of these, 86 died, with a median survival of 127 days. The 1-year survival rate for children with T18 was 63.2%. The survival rate in the first admission of children with T18 who did and did not have congenital heart disease was 58.3% and 94.1%, respectively. Children with heart disease who underwent surgical or catheter intervention had a longer survival time than those who did not. CONCLUSIONS: We suggest these data could be used in ante- and postnatal counseling. Ethical concerns about the prolonged survival of children with T18 remain; however, the potential benefits of interventions for congenital heart disease in this population need further study.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Cardiopatías Congénitas , Humanos , Niño , Síndrome de la Trisomía 18/complicaciones , Estudios Retrospectivos , Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/epidemiología , Trisomía
19.
PLoS One ; 18(5): e0285489, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37216382

RESUMEN

OBJECTIVE: Conventional computer-aided diagnosis using convolutional neural networks (CNN) has limitations in detecting sensitive changes and determining accurate decision boundaries in spectral and structural diseases such as scoliosis. We devised a new method to detect and diagnose adolescent idiopathic scoliosis in chest X-rays (CXRs) employing the latent space's discriminative ability in the generative adversarial network (GAN) and a simple multi-layer perceptron (MLP) to screen adolescent idiopathic scoliosis CXRs. MATERIALS AND METHODS: Our model was trained and validated in a two-step manner. First, we trained a GAN using CXRs with various scoliosis severities and utilized the trained network as a feature extractor using the GAN inversion method. Second, we classified each vector from the latent space using a simple MLP. RESULTS: The 2-layer MLP exhibited the best classification in the ablation study. With this model, the area under the receiver operating characteristic (AUROC) curves were 0.850 in the internal and 0.847 in the external datasets. Furthermore, when the sensitivity was fixed at 0.9, the model's specificity was 0.697 in the internal and 0.646 in the external datasets. CONCLUSION: We developed a classifier for Adolescent idiopathic scoliosis (AIS) through generative representation learning. Our model shows good AUROC under screening chest radiographs in both the internal and external datasets. Our model has learned the spectral severity of AIS, enabling it to generate normal images even when trained solely on scoliosis radiographs.


Asunto(s)
Cifosis , Escoliosis , Humanos , Adolescente , Escoliosis/diagnóstico por imagen , Radiografía , Redes Neurales de la Computación , Diagnóstico por Computador/métodos
20.
Eur Radiol ; 33(9): 6351-6358, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37014404

RESUMEN

OBJECTIVES: To evaluate whether DTI parameters of the ulnar nerve at the elbow are associated with clinical outcomes in patients receiving cubital tunnel decompression (CTD) surgery for ulnar neuropathy. METHODS: This retrospective study included 21 patients with cubital tunnel syndrome who received CTD surgery between January 2019 and November 2020. All patients underwent pre-operative elbow MRI, including DTI. Region-of-interest analysis was performed on the ulnar nerve at three levels around the elbow: above (level 1), cubital tunnel (level 2), and below (level 3). Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated on three sections at each level. Clinical data on symptom improvement in respect to pain and tingling sensation after CTD were recorded. Logistic regression analysis was used to compare DTI parameters of the nerve at three levels and the entire nerve course between patients with and without symptom improvement after CTD. RESULTS: After CTD, 16 patients showed improvement in symptoms, but five did not. ROC analysis of DTI parameters showed that AUCs of FA, AD, and MD were higher at level 1 than at levels 2 and 3, with FA showing the highest AUC (level 1: FA, 0.7104 [95% CI, 0.5206-0.9002] vs AD, 0.6521 [95% CI, 0.4900-0.8142] vs MD, 0.6153 [95% CI, 0.4187-0.8119]). CONCLUSION: In patients who underwent CTD surgery for ulnar neuropathy at the elbow, the DTI parameters of FA, AD, and MD above the cubital tunnel level were associated with clinical outcomes, with FA showing the strongest associations. KEY POINTS: • After CTD surgery for ulnar neuropathy at the elbow, persistent symptoms may be observed, depending on symptom severity. • DTI parameters of the ulnar nerve at the elbow showed differences in their capacity for discriminating between patients with and without symptom improvement following CTD surgery, with this capacity depending on the nerve level at the elbow. • FA, AD, and MD measured above the cubital tunnel on pre-operative DTI may be associated with surgical outcomes, with FA showing the strongest association (AUC at level 1, 0.7104 [95% CI, 0.5206-0.9002]).


Asunto(s)
Codo , Neuropatías Cubitales , Humanos , Codo/diagnóstico por imagen , Codo/cirugía , Estudios Retrospectivos , Nervio Cubital/diagnóstico por imagen , Nervio Cubital/cirugía , Descompresión Quirúrgica/métodos
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