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1.
Nat Commun ; 15(1): 3356, 2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38637502

RESUMEN

To realize economically feasible electrochemical CO2 conversion, achieving a high partial current density for value-added products is particularly vital. However, acceleration of the hydrogen evolution reaction due to cathode flooding in a high-current-density region makes this challenging. Herein, we find that partially ligand-derived Ag nanoparticles (Ag-NPs) could prevent electrolyte flooding while maintaining catalytic activity for CO2 electroreduction. This results in a high Faradaic efficiency for CO (>90%) and high partial current density (298.39 mA cm‒2), even under harsh stability test conditions (3.4 V). The suppressed splitting/detachment of Ag particles, due to the lipid ligand, enhance the uniform hydrophobicity retention of the Ag-NP electrode at high cathodic overpotentials and prevent flooding and current fluctuations. The mass transfer of gaseous CO2 is maintained in the catalytic region of several hundred nanometers, with the smooth formation of a triple phase boundary, which facilitate the occurrence of CO2RR instead of HER. We analyze catalyst degradation and cathode flooding during CO2 electrolysis through identical-location transmission electron microscopy and operando synchrotron-based X-ray computed tomography. This study develops an efficient strategy for designing active and durable electrocatalysts for CO2 electrolysis.

2.
J Clin Med ; 13(7)2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38610765

RESUMEN

Background: The vestibular phenotypes of patients with genetic hearing loss are poorly understood. Methods: we performed genetic testing including exome sequencing and vestibular function tests to investigate vestibular phenotypes and functions in patients with genetic hearing loss. Results: Among 627 patients, 143 (22.8%) had vestibular symptoms. Genetic variations were confirmed in 45 (31.5%) of the 143 patients. Nineteen deafness genes were linked with vestibular symptoms; the most frequent genes in autosomal dominant and recessive individuals were COCH and SLC26A4, respectively. Vestibular symptoms were mostly of the vertigo type, recurrent, and persisted for hours in the genetically confirmed and unconfirmed groups. Decreased vestibular function in the caloric test, video head impulse test, cervical vestibular-evoked myogenic potential, and ocular vestibular-evoked myogenic potential was observed in 42.0%, 16.3%, 57.8%, and 85.0% of the patients, respectively. The caloric test revealed a significantly higher incidence of abnormal results in autosomal recessive individuals than in autosomal dominant individuals (p = 0.011). The genes, including SLC26A4, COCH, KCNQ4, MYH9, NLRP3, EYA4, MYO7A, MYO15A, and MYH9, were heterogeneously associated with abnormalities in the vestibular function test. Conclusions: In conclusion, diverse vestibular symptoms are commonly concomitant with genetic hearing loss and are easily overlooked.

3.
Sensors (Basel) ; 24(7)2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38610298

RESUMEN

Radial pulse diagnosis is the most common method to examine the human health state in Traditional East Asian Medicine (TEAM). A cold stress-related suboptimal health state (subhealth) is often undetectable during routine medical examinations, however, it can be detected through the palpation of specific pulse waves, particularly a 'tight pulse', in TEAM. Therefore, this study examined a correlation between 'tight pulse' and vascular changes in the radial artery (RA) induced by a cold pressor trial (CPT). Twenty healthy subjects underwent sequentially control trial and CPT with room-temperature and ice-cold water, respectively, on the right forearm. The radial pulse and vascular changes were then examined on the left arm. The radial pulse scores for frequencies of 'tight pulse' with strong arterial tension increased after the CPT compared with the control trial. The pulse scores were reversely correlated with the RA thickness and volumes in ultrasonography, but not with changes in the systolic/diastolic blood pressure. The RA thickness-based vascular surface and three-dimensional images visualized a 'tight pulse' showing the vasoconstriction and bumpy-/rope-shaped vascular changes in the radial pulse diagnostic region after the CPT. These findings provide valuable insights into the potential integration of clinical radial pulse diagnosis with ultrasonography for cold-related subhealth.


Asunto(s)
Arteria Radial , Diagnóstico Tradicional por el Pulso , Humanos , Respuesta al Choque por Frío , Frecuencia Cardíaca , Frío
4.
Pediatr Cardiol ; 2024 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-38438790

RESUMEN

Ventricular septal defect (VSD) is a common congenital heart disease. However, consensus on the utility of echocardiography in predicting spontaneous closure (SC) of VSD remains lacking. This study aimed to identify and validate significant predictors of SC through a predictive scoring system. This retrospective study included medical records of 712 echocardiography instances performed on 304 patients diagnosed with VSD from 2016 to 2020 in their first year of life. A novel scoring system for predicting the SC of VSD was developed and validated using another dataset from different hospitals. Of the 304 patients, 215 (70.7%) had perimembranous (PM) VSDs and 89 had muscular (29.3%) VSDs. The median follow-up periods were 36.2 (interquartile range [IQR], 13-59) months and 13.7 9 (IQR, 5-37.4) days for PM and muscular VSDs, respectively. The overall SC rate during follow-up was 29.3%. Pulmonary hypertension (HTN), concomitant left ventricle (LV)-right atrium (RA) shunt, VSD size to aortic valve (AV) annulus size ratio, and left ventricular end-diastolic dimension (LVEDD) z-score were significant risk factors affecting SC of VSD. The "P-VSD" score, a new scoring system, demonstrated an area under the curve for predictability of 0.769. Pulmonary HTN, concomitant LV-RA shunt, LVEDD z-score, and VSD size-to-AV annulus size ratio at diagnosis were significantly associated with non-SC VSD after infancy. The P-VSD score can predict the SC of VSD in clinical settings and simplify the identification and appropriate management of high-risk patients.

5.
World J Urol ; 42(1): 119, 2024 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-38446234

RESUMEN

BACKGROUND: The management of patients with ureteral calculi in the emergency department (ED) remains challenging due to high revisit rates. PURPOSE: To identify predictors of revisits among patients with ureteral calculi in the ED. DESIGN, SETTING, AND PARTICIPANTS: Data from patients who presented at a tertiary academic hospital in Seoul, Republic of Korea, between February 2018 and December 2019, were analyzed retrospectively. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Variables, including the respiratory rate (RR), estimated glomerular filtration rate (eGFR), duration of pain, number of analgesic doses, location of ureteral calculi, and ED length of stay (LOS) were examined using logistic regression. We also examined some additional variables included in the STONE and CHOKAI scoring systems to examine their association with revisit. RESULTS: Significant predictors of revisits included the number of analgesic doses and the location of ureteral calculi. Patients who required multiple analgesic doses or those with proximal or mid-ureteral calculi were more likely to revisit the ED. Although the STONE and CHOKAI scores could predict uncomplicated ureteral calculi, we found that the CHOKAI score is a valuable tool for predicting the likelihood of patient revisits (p = 0.021). CONCLUSIONS: Effective pain management and consideration of calculi location are important for predicting patient revisits. More research is required to validate findings, develop precise predictive models, and empower tailored care for high-risk patients. In patients with ureteral calculi in the ED, the number of analgesics given and stone location predict return visits. Proximal ureteral calculi on CT may require early urologic intervention to prevent pain-related revisits.


Asunto(s)
Cálculos Ureterales , Humanos , Cálculos Ureterales/complicaciones , Cálculos Ureterales/terapia , Manejo del Dolor , Readmisión del Paciente , Estudios Retrospectivos , Dolor , Analgésicos
6.
Catheter Cardiovasc Interv ; 103(4): 587-596, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38341624

RESUMEN

BACKGROUND: Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to various native main pulmonary artery (PA) anatomies. METHODS: A multicenter retrospective study included 182 patients with moderate to severe pulmonary regurgitation in the native RVOT who underwent PPVI with Pulsta valves® between February 2016 and August 2023 at five Korean and Taiwanese tertiary referral centers. RESULTS: Pulsta valve implantation was successful in 179 out of 182 patients (98.4%) with an average age of 26.7 ± 11.0 years. The median follow-up duration was 29 months. Baseline assessments revealed enlarged right ventricle (RV) volume (mean indexed RV end-diastolic volume: 163.1 (interquartile range, IQR: 152.0-180.3 mL/m²), which significantly decreased to 123.6(IQR: 106.6-137.5 mL/m2  after 1 year. The main PA types were classified as pyramidal (3.8%), straight (38.5%), reverse pyramidal (13.2%), convex (26.4%), and concave (18.1%) shapes. Pulsta valve placement was adapted, with distal main PA for pyramidal shapes and proximal or mid-PA for reverse pyramidal shapes. Two patients experienced Pulsta valve embolization to RV, requiring surgical removal, and one patient encountered valve migration to the distal main PA, necessitating surgical fixation. CONCLUSIONS: Customized valve insertion sites are pivotal in self-expandable PPVI considering diverse native RVOT shape. The rather soft and compact structure of the Pulsta valve has characteristics to are adaptable to diverse native RVOT geometries.


Asunto(s)
Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Pulmonar , Válvula Pulmonar , Humanos , Adolescente , Adulto Joven , Adulto , Válvula Pulmonar/diagnóstico por imagen , Válvula Pulmonar/cirugía , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Ventrículos Cardíacos , Estudios Retrospectivos , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Resultado del Tratamiento , Insuficiencia de la Válvula Pulmonar/diagnóstico por imagen , Insuficiencia de la Válvula Pulmonar/etiología , Insuficiencia de la Válvula Pulmonar/cirugía , Cateterismo Cardíaco
7.
ACS Appl Mater Interfaces ; 16(6): 7593-7603, 2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38315799

RESUMEN

Materials with van der Waals (vdW) unit structures rely on weak interunit vdW forces, facilitating physical separation and advancing nanomaterial research with remarkable electrical properties. Recently, there has been growing interest in one-dimensional (1D) vdW materials, celebrated for their advantageous properties, characterized by reduced dimensionality and the absence of dangling bonds. In this context, we synthesize Ta2Pt3S8, a 1D vdW material, and assess its suitability for field-effect transistor (FET) applications. Spectroscopic analysis and electrical characterization confirmed that the band gap and work function of Ta2Pt3S8 are 1.18 and 4.77 eV, respectively. Leveraging various electrode materials, we fabricated n-type FETs based on Ta2Pt3S8 and identified Cr as the optimal electrode, exhibiting a high mobility of 57 cm2 V-1 s-1. In addition, we analyzed the electron transport mechanism in n-type FETs by investigating Schottky barrier height, Schottky barrier tunneling width, and contact resistance. Furthermore, we successfully fabricated p-type operating Ta2Pt3S8 FETs using a molybdenum trioxide (MoO3) layer as a high work function contact electrode. Finally, we achieved Ta2Pt3S8 nanowire rectifying diodes by creating a p-n junction with asymmetric contact electrodes of Cr and MoO3, demonstrating an ideality factor of 1.06. These findings highlight the electronic properties of Ta2Pt3S8, positioning it as a promising 1D vdW material for future nanoelectronics and functional vdW-based device applications.

8.
Otolaryngol Head Neck Surg ; 170(2): 490-504, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37811702

RESUMEN

OBJECTIVE: To investigate the safety and efficacy of a novel active transcutaneous bone conduction implant (BCI) device for patients with single-sided deafness (SSD). STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral hospitals. METHODS: This prospective multicenter study was conducted at 15 institutions nationwide. Thirty adult (aged ≥19 years) SSD patients were recruited. They underwent implantation of an active transcutaneous BCI device (Bonebridge BCI602). Objective outcomes included aided pure-tone thresholds, aided speech discrimination scores (SDSs), and the Hearing in Noise Test (HINT) and sound localization test results. The Bern Benefit in Single-Sided Deafness (BBSS) questionnaire, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and the Tinnitus Handicap Inventory (THI) were used to measure subjective benefits. RESULTS: The mean aided pure-tone threshold was 34.2 (11.3), mean (SD), dB HL at 500 to 4000 Hz. The mean total BBSS score was 27.5 (13.8). All APHAB questionnaire domain scores showed significant improvements: ease of communication, 33.6 (23.2) versus 22.6 (21.3), P = .025; reverberation, 44.8 (16.6) versus 32.8 (15.9), P = .002; background noise, 55.5 (23.6) versus 35.2 (18.1), P < .001; and aversiveness, 36.7 (22.8) versus 25.8 (21.4), P = .028. Moreover, the THI scores were significantly reduced [47.4 (30.1) versus 31.1 (27.0), P = .003]. Congenital SSD was a significant factor of subjective benefit (-11.643; 95% confidence interval: -21.946 to -1.340). CONCLUSION: The BCI602 active transcutaneous BCI device can provide functional hearing gain without any adverse effects and is a feasible option for acquired SSD patients with long-term deafness.


Asunto(s)
Sordera , Audífonos , Percepción del Habla , Acúfeno , Adulto , Humanos , Estudios Prospectivos , Conducción Ósea , Audición , Sordera/cirugía , Resultado del Tratamiento
9.
Front Microbiol ; 14: 1273725, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38075926

RESUMEN

Certain Bacillus thuringiensis (Bt) strains such as Bt subsp. kurstaki and Bt subsp. aizawai have been widely used for pest management in agricultural practices. However, each strain only shows high specificity for pest control against a narrow range of lepidopteran species, and numerous lepidopteran pests have developed resistance to commercialized Bt strains. Therefore, there is a need for the development of novel Bt bioinsecticides which allow for potent and broad-spectrum insecticidal activity against lepidopteran species, including Spodoptera spp. (Noctuidae) and Plutella xylostealla (Plutellidae). In order to develop a novel bioinsecticide using Bt subsp. kurstaki IMBL-B9 (Btk IMBL-B9) that exhibits excellent insecticidal activity against three different lepidopteran species, we have developed a viable microencapsulation-based spray drying Btk IMBL-B9 formulation. The spore-crystal complex of Btk IMBL-B9 was microencapsulated using coating materials such as gum arabic, maltodextrin, and corn starch via spray drying. The encapsulated formulation of Btk IMBL-B9 presented an increased survival rate and storage stability at 54 ± 2°C for up to 6 weeks. The formulation showed similar insecticidal activity as the commercial bioinsecticide XenTari® against P. xylostella. Under controlled greenhouse conditions, the Btk IMBL-B9 formulation was more effective against Lepidoptera spp. S. frugiperda and P. xylostella, than XenTari®. These results suggest that the microencapsulation-based spray drying formulation of Btk IMBL-B9 can be used effectively for the control of a wide range of moths.

10.
J Korean Med Sci ; 38(48): e355, 2023 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-38084023

RESUMEN

BACKGROUND: Mutations in mitochondrial DNA (mtDNA) are associated with several genetic disorders, including sensorineural hearing loss. However, the prevalence of mtDNA mutations in a large cohort of Korean patients with hearing loss has not yet been investigated. Thus, this study aimed to investigate the frequency of mtDNA mutations in a cohort of with pre- or post-lingual hearing loss of varying severity. METHODS: A total of 711 Korean families involving 1,099 individuals were evaluated. Six mitochondrial variants associated with deafness (MTRNR1 m.1555A>G, MTTL1 m.3243A>G, MTCO1 m.7444G>A and m.7445A>G, and MTTS1 m.7471dupC and m.7511T>C) were screened using restriction fragment length polymorphism. The prevalence of the six variants was also analyzed in a large control dataset using whole-genome sequencing data from 4,534 Korean individuals with unknown hearing phenotype. RESULTS: Overall, 12 of the 711 (1.7%) patients with hearing loss had mtDNA variants, with 10 patients from independent families positive for the MTRNR1 m.1555A>G mutation and 2 patients positive for the MTCO1 m.7444G>A mutation. The clinical characteristics of patients with the mtDNA variants were characterized by post-lingual progressive hearing loss due to the m.1555A>G variant (9 of 472; 1.9%). In addition, 18/4,534 (0.4%) of the Korean population have mitochondrial variants associated with hearing loss, predominantly the m.1555A>G variant. CONCLUSION: A significant proportion of Korean patients with hearing loss is affected by the mtDNA variants, with the m.1555A>G variant being the most prevalent. These results clarify the genetic basis of hearing loss in the Korean population and emphasize the need for genetic testing for mtDNA variants.


Asunto(s)
Pérdida Auditiva Sensorineural , Pérdida Auditiva , Humanos , Prevalencia , Pérdida Auditiva Sensorineural/epidemiología , Pérdida Auditiva Sensorineural/genética , Mutación , ADN Mitocondrial/genética , República de Corea/epidemiología
11.
Small ; : e2308936, 2023 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-38054614

RESUMEN

Pulmonary arterial hypertension (PAH) is a severe medical condition characterized by elevated blood pressure in the pulmonary arteries. Nitric oxide (NO) is a gaseous signaling molecule with potent vasodilator effects; however, inhaled NO is limited in clinical practice because of the need for tracheal intubation and the toxicity of high NO concentrations. In this study, inhalable NO-releasing microspheres (NO inhalers) are fabricated to deliver nanomolar NO through a nebulizer. Two NO inhalers with distinct porous structures are prepared depending on the molecular weights of NO donors. It is confirmed that pore formation can be controlled by regulating the migration of water molecules from the external aqueous phase to the internal aqueous phase. Notably, open porous NO inhalers (OPNIs) can deliver NO deep into the lungs through a nebulizer. Furthermore, OPNIs exhibit vasodilatory and anti-inflammatory effects via sustained NO release. In conclusion, the findings suggest that OPNIs with highly porous structures have the potential to serve as tools for PAH treatment.

12.
bioRxiv ; 2023 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-38106000

RESUMEN

Telomeres are nucleoprotein complexes with a crucial role of protecting chromosome ends. It consists of simple repeat sequences and dedicated telomere-binding proteins. Because of its vital functions, components of the telomere, for example its sequence, should be under strong evolutionary constraint. But across all plants, telomere sequences display a range of variation and the evolutionary mechanism driving this diversification is largely unknown. Here, we discovered in Monkeyflower (Mimulus) the telomere sequence is even variable between species. We investigated the basis of Mimulus telomere sequence evolution by studying the long noncoding telomerase RNA (TR), which is a core component of the telomere maintenance complex and determines the telomere sequence. We conducted total RNA-based de novo transcriptomics from 16 Mimulus species and analyzed reference genomes from 6 species, and discovered Mimulus species have evolved at least three different telomere sequences: (AAACCCT)n, (AAACCCG)n, and (AAACCG)n. Unexpectedly, we discovered several species with TR duplications and the paralogs had functional consequences that could influence telomere evolution. For instance, M. lewisii had two sequence-divergent TR paralogs and synthesized a telomere with sequence heterogeneity, consisting of AAACCG and AAACCCG repeats. Evolutionary analysis of the M. lewisii TR paralogs indicated it had arisen from a transposition-mediate duplication process. Further analysis of the TR from multiple Mimulus species showed the gene had frequently transposed and inserted into new chromosomal positions during Mimulus evolution. From our results, we propose the TR transposition, duplication, and divergence model to explain the evolutionary sequence turnovers in Mimulus and potentially all plant telomeres.

13.
Biosensors (Basel) ; 13(11)2023 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-37998137

RESUMEN

Surface-enhanced Raman spectroscopy (SERS) is an effective technique for biosensing, enabling label-free detection of biomolecules with enhanced sensitivity. There is a tremendous probability of signal failure in Raman frequencies because of the scattering of the Raman radiation in liquids, effective SERS improvement is required to reduce this issue when considering liquid specimens. We examined a liquid bacterial sample, investigating the electrostatic interactions of the bacterial samples with gold nanorods (AuNRs) and graphene. We established a voltage-gated 3D graphene functionalized with an AuNR-based device on the silicon substrate for SERS measurements when the applied voltage ranges from 0 to 3 V. Moreover, AuNRs density-susceptible bacterial sample analysis with varied concentrations of bacterial samples has also been described. Using bacterial SERS analysis, the bacterial components amide II (1555-1565 cm-1) and amide III (1250-1350 cm-1) have been discovered for both bacteria, Gram-positive, Listeria monocytogenes and Gram-negative, Salmonella typhi. Our fabricated device affords an interesting label-free, rapid, and reproducible bacterial sample analysis based on the density of the AuNRs when functionalizing flake-like 3D graphene, which can help facilitate label-free bacteria sensing platforms.


Asunto(s)
Grafito , Nanopartículas del Metal , Nanotubos , Grafito/química , Oro/química , Nanotubos/química , Espectrometría Raman/métodos , Bacterias , Amidas , Nanopartículas del Metal/química
14.
Healthc Inform Res ; 29(4): 323-333, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37964454

RESUMEN

OBJECTIVES: Systematic evaluations of the benefits of health information technology (HIT) play an essential role in enhancing healthcare quality by improving outcomes. However, there is limited empirical evidence regarding the benefits of IT adoption in healthcare settings. This study aimed to review the benefits of artificial intelligence (AI), the internet of things (IoT), and personal health records (PHR), based on scientific evidence. METHODS: The literature published in peer-reviewed journals between 2016 and 2022 was searched for systematic reviews and meta-analysis studies using the PubMed, Cochrane, and Embase databases. Manual searches were also performed using the reference lists of systematic reviews and eligible studies from major health informatics journals. The benefits of each HIT were assessed from multiple perspectives across four outcome domains. RESULTS: Twenty-four systematic review or meta-analysis studies on AI, IoT, and PHR were identified. The benefits of each HIT were assessed and summarized from a multifaceted perspective, focusing on four outcome domains: clinical, psycho-behavioral, managerial, and socioeconomic. The benefits varied depending on the nature of each type of HIT and the diseases to which they were applied. CONCLUSIONS: Overall, our review indicates that AI and PHR can positively impact clinical outcomes, while IoT holds potential for improving managerial efficiency. Despite ongoing research into the benefits of health IT in line with advances in healthcare, the existing evidence is limited in both volume and scope. The findings of our study can help identify areas for further investigation.

15.
ACS Appl Mater Interfaces ; 15(48): 55745-55752, 2023 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-38011599

RESUMEN

In this study, the one-dimensional (1D) material V2Se9 was successfully synthesized using a colloidal method with VO(acac)2 and Se powder as precursors in a 1-octadecene solvent. The obtained colloidally synthesized V2Se9 (C-V2Se9) has an ultrathin nanobelt shape and a 4.5 times higher surface area compared with the bulk V2Se9, which is synthesized in a solid-state reaction as previously reported. In addition, all surfaces of C-V2Se9 are exposed to Se atoms, which is advantageous for storing Li through the conversion reaction into the Li2Se phase. Herein, the electrochemical performance of the C-V2Se9 anode material is evaluated; thus, the novelty of C-V2Se9 as a Se-rich 1D anode material is verified. The C-V2Se9 electrode exhibits a reversible capacity of 893.21 mA h g-1 and a Coulombic efficiency of 97.82% at the 100th cycle and excellent structural stability. Compared with the bulk V2Se9 electrode, the outstanding electrochemical performance of C-V2Se9 is attributed to its ultrathin nanobelt shape, high surface area, shorter Li diffusion length, and more electrochemically active sites. This work indicates the great potential of the Se-rich 1D material, C-V2Se9, as a post-transition metal dichalcogenide material for high-performance LIBs.

17.
Sci Rep ; 13(1): 17716, 2023 10 18.
Artículo en Inglés | MEDLINE | ID: mdl-37853041

RESUMEN

Suggested several decades ago, the nine-step test is an intuitive test of Eustachian tube function. However, studies employing the nine-step test to assess the results of Eustachian tube balloon dilation (EBD) are limited. We aimed to objectively evaluate the efficacy of EBD in opening failure patients with decreased maximal peak pressure difference (MPD) using the nine-step test. Patients who had MPD values ≤ 13 daPa in the nine-step test were enrolled. The patients were categorized into two groups according to treatment decisions after discussion with a clinician: an EBD group (N = 26) and a medication group (N = 30). One month after treatment, the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ7) and the nine-step test were administered to all participants and subgroups of symptomatic participants (ETDQ7 > 15). MPD improved (increased) in both the EBD group and the medication group. ETDQ7 values improved (decreased) in the EBD group, but not in the medication group. In subgroup analysis, MPD and ETDQ7 values improved only in the symptomatic EBD group. According to the nine-step test, EBD can normalize 53.8% of decreased MPD. Posttreatment MPD and ETDQ7 scores were significantly better in the EBD group than in the medication group. However, EBD in patients with abnormal nine-step test results seemed less efficacious when the treatment results of the medication group were considered.


Asunto(s)
Enfermedades del Oído , Trompa Auditiva , Humanos , Dilatación/métodos , Prueba de Esfuerzo , Resultado del Tratamiento , Endoscopía , Enfermedades del Oído/diagnóstico , Enfermedades del Oído/terapia
18.
Sci Rep ; 13(1): 16204, 2023 09 27.
Artículo en Inglés | MEDLINE | ID: mdl-37758800

RESUMEN

Artificial intelligence (AI) using deep learning approaches the capabilities of human experts in medical image diagnosis. However, due to liability issues in medical decisions, AI is often relegated to an assistant role. Based on this responsibility constraint, the effective use of AI to assist human intelligence in real-world clinics remains a challenge. Given the significant inter-individual variations in clinical decisions among physicians based on their expertise, AI needs to adapt to individual experts, complementing weaknesses and enhancing strengths. For this adaptation, AI should not only acquire domain knowledge but also understand the specific human experts it assists. This study introduces a meta-model for human-machine cooperation that first evaluates each expert's class-specific diagnostic tendencies using conditional probability, based on which the meta-model adjusts the AI's predictions. This meta-model was applied to ear disease diagnosis using otoendoscopy, highlighting improved performance when incorporating individual diagnostic characteristics, even with limited evaluation data. The highest accuracy was achieved by combining each expert's conditional probabilities with machine classification probability, using optimal weights specific to each individual's overall classification accuracy. This tailored model aims to mitigate potential misjudgments due to psychological effects caused by machine suggestions and to capitalize on the unique expertise of individual clinicians.


Asunto(s)
Inteligencia Artificial , Médicos , Humanos , Inteligencia , Conocimiento , Probabilidad
19.
Cells ; 12(18)2023 Sep 21.
Artículo en Inglés | MEDLINE | ID: mdl-37759551

RESUMEN

Genetic hearing loss is the most common hereditary sensorial disorder. Though more than 120 genes associated with deafness have been identified, unveiled causative genes and variants of diverse types of hearing loss remain. Herein, we identified a novel nonsense homozygous variant in CEP250 (c.3511C>T; p.Gln1171Ter) among the family members with progressive moderate sensorineural hearing loss in nonsyndromic autosomal recessive type but without retinal degeneration. CEP250 encodes C-Nap1 protein belonging to the CEP protein family, comprising 30 proteins that play roles in centrosome aggregation and cell cycle progression. The nonsense variant in CEP250 led to the early truncating protein of C-Nap1, which hindered centrosome localization; heterologous expression of CEP250 (c.3511C>T) in NIH3T3 cells within cilia expression condition revealed that the truncating C-Nap1 (p.Gln1171Ter) was not localized at the centrosome but was dispersed in the cytosol. In the murine adult cochlea, Cep250 was expressed in the inner and outer hair cells. Knockout mice of Cep250 showed significant hair cell degeneration and progressive hearing loss in auditory brainstem response. In conclusion, a nonsense variant in CEP250 results in a deficit of centrosome localization and hair cell degeneration in the cochlea, which is associated with the progression of hearing loss in humans and mice.

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