Treatment of malignant airway obstruction with Y-shape sigma stent loaded with I125 seeds installed via rigid bronchoscopy.

PURPOSE: To summarize and analyze the safety and efficacy of a Y-shape Sigma stent loaded with I125 in patients with inoperable malignant main airway obstruction. METHODS: This study was approved by the Institutional Ethics Committee, and a written informed consent was obtained from each participant. A Y-shape Sigma stent loaded with I125 was placed under vision from rigid bronchoscopy. The primary endpoint was alleviation of symptoms and improvement of Karnofsky Performance Status (KPS) score, and the secondary endpoint was complications and technical success. RESULTS: From November 2018 through June 2023, total 33 patients with malignant airway obstruction were palliatively treated by installing Y-shape Sigma stents loaded with I125. The airway lumen was immediately restored and the average airway opening significantly increased to 70 ± 9.4% after the procedure from baseline 30.2 ± 10.5% (p < 0.05). Average KPS score was improved from baseline 30.0 ± 10.0 to 70.0 ± 10.0 (p < 0.05) as well as PaO2 from baseline 50.1 ± 15.4 mmHg to 89.3 ± 8.6 mmHg (p < 0.05). The technical success rate of placing the stent in this study was 73%, and adverse events or complications including bleeding, I125 loss, and airway infection occurred during or after the procedure. CONCLUSION: Placement of Y-shape Sigma stents under vision from rigid bronchoscopy in the patients with malignant airway obstruction is feasible and it immediately alleviates dyspnea and significantly improves quality of life.

Gd-modified Mn-Co oxides derived from layered double hydroxides for improved catalytic activity and H2O/SO2 tolerance in NH3-SCR of NOx reaction.

Metal oxides derived from layered double hydroxides (LDHs) are expected to obtain low-temperature denitrification (de-NOx) catalysts with high catalytic activity and H2O/SO2 tolerance in the selective catalytic reduction (SCR) of NOx with NH3. In current work, we successfully prepared Gd-modified Mn-Co metal oxides derived from Gd-modified Mn-Co LDHs. The resultant Gd-modified Mn-Co metal oxides exhibit excellent catalytic activity and high H2O/SO2 tolerance in the NH3-SCR de-NOx reaction. The reasons for the enhancement can be ascribed to the unique surface physicochemical properties inherited from LDHs and the modification of Gd, which increase the specific surface area, improve the relative content of Mn4+ and Co3+ on the surface, enhance the number of acidic sites, strengthen the reducibility of catalyst, resulting in the enhanced catalytic activity and H2O/SO2 tolerance. Additionally, it is demonstrated that the NH3-SCR de-NOx reaction occurred on the surface of Gd-modified Mn-Co oxides followed both Eley-Rideal (E-R) and Langmuir-Hinshelwood (L-H) mechanisms. This study provides us with a design approach to promote catalytic activity and H2O/SO2 tolerance through morphology control and rare earth modification.

Metabolic Syndrome-Related Knowledge, Attitudes, and Behavior among Indigenous Communities in Taiwan: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome is characterized by cardiovascular and chronic disease risk factors that cause health problems. Inequalities in medical resources and information present a challenge in this context. Indigenous communities may be unaware of their risk for metabolic syndrome. AIMS: This study explored factors associated with metabolic syndrome-related knowledge, attitudes, and behaviors among Taiwanese indigenous communities. METHODS: For this descriptive cross-sectional survey, we collected anthropometric data and used a self-administered questionnaire between 1 July 2016, to 31 July 2017, from a convenience sample of an indigenous tribe in eastern Taiwan. The response rate was 92%. RESULTS: The prevalence of metabolic syndrome was as high as 71%, and the average correct knowledge rate was 39.1%. The participants' self-management attitudes were mainly negative, and the self-management behaviors were low in this population. Stepwise regression analysis showed that knowledge, attitude, age, perception of physical condition, and body mass index, which accounted for 65% of the total variance, were the most predictive variables for self-management behaviors. CONCLUSIONS: This is the first study to report the relationship between metabolic syndrome knowledge, attitudes, and behaviors in an indigenous population. There is an urgent need to develop safety-based MetS health education programs that can provide access to the right information and enhance self-management approaches to lessen the growing burden of MetS in indigenous communities.

Would It Be Better if Instructors Technically Adjust Their Image or Voice in Online Courses? Impact of the Way of Instructor Presence on Online Learning.

This study investigated the effects of the changes in the image and voice of instructors in online video courses on online learner's learning achievement, social presence, learning satisfaction, and academic emotion. Two simultaneous online experiments were conducted with 122 college students in the image experiment, where the course videos varied in terms of the instructor's image (original image, face-beautified image, virtual image, and no image), and 93 college students in the voice experiment, where the course videos varied in terms of the instructor's voice (original voice, mutated voice, computer-synthesized voice). The results showed that learners viewing videos without instructor images had better learning achievements and less academic boredom relative to those who viewed videos with instructor images. However, the real instructor images were able to promote learners' learning satisfaction of instructor-student interaction more than no image and virtual image and promote satisfaction of instructor teaching more than virtual image. Meanwhile, learners' evaluation of the real instructor images was better than that of the virtual instructor image, and their evaluation of the face-beautified instructor image was better than the original image. Moreover, learners evaluated real instructor voices better than the computer-synthesized voice. In addition, the linear regression analysis revealed that the evaluations of both instructor's image and voice had a positive relationship with learners' social presence, learning satisfaction, and enjoyment, whereas they had a negative relationship with learner's boredom. And the evaluation of the instructor's image positively predicted student's transfer learning achievement. Thus, we suggested that the way of instructor presence should be well-designed and integrated with the course's instructional design and image and voice processing technology can be applied to assist online video course development.

Genetic mutations in non-syndromic deafness patients in Hainan Province have a different mutational spectrum compared to patients from Mainland China.

OBJECTIVES: To provide appropriate genetic testing and counseling for non-syndromic hearing impairment patients in Hainan Province, an island in the South China Sea. METHODS: 299 unrelated students with non-syndromic hearing loss who attended a special education school in Hainan Province were enrolled in this study. Three prominent deafness-related genes (GJB2, SLC26A4, and mtDNA 12S rRNA) were analyzed using Sanger sequencing. RESULTS: GJB2 mutations were detected in 32.78% (98/299) of the entire cohort; however, only 5.69% (17/299) had two confirmed pathogenic mutations. The most common mutation observed in this population was c.109G > A in the GJB2 gene, with an allelic frequency of 15.05% (90/598), which is significantly higher than that reported in previous cohorts. A total of 16 patients had two confirmed pathogenic SLC26A4 gene mutations, and 16 patients had one. The IVS7-2A > G mutation was the most commonly observed, with an allelic frequency of 3.51% (21/598). Three patients had a m.1555A > G mutation in the mtDNA 12S rRNA gene. CONCLUSIONS: These results reveal that genetic etiology occurred in 11.71% (35/299) of patients, suggesting that Hainan province have a different mutational spectrum compare to Mainland China in non-syndromic deafness patients, which provide useful information to genetic counseling in Hainan province.

Preliminary application of intra-operative hearing monitoring by tone pip ABR via loudspeakers.

CONCLUSION: This method might be an effective intra-operative way to access hearing threshold under general anesthesia in the operating room. OBJECTIVE: To develop an intra-operative hearing monitoring method for surgeons to access hearing threshold under general anesthesia in the operating room. METHOD: System establishment and calibration was done firstly. Normal hearing (NH) and conductive hearing loss (CHL) participants were recruited. This study applied pure tone audiometry (PTA) to all subjects and tone pip ABR (tp-ABR) via loudspeakers in sound booth and operating room for NH and CHL subjects, respectively. For NH subjects, Bland Altman was conducted to compare 1k Hz PTA and tp-ABR threshold. For CHL participants, Paired t-test, Satterth waite t'-test, and linear correlation analysis were used to compare the two methods. p < .05 was considered statistically different. RESULTS: (1) Bland Altman showed all plots were inside the 95% confidence interval, indicating that there was no difference between the two methods for NH subjects. (2) The two methods had a high correlation (Pearson's coefficient =0.872 > 0.6, p < .05) in assessing hearing threshold in the operating room. (3) Satterth waite t'-test showed the ossicular chain malfunction enlarged the deviation of threshold by the two methods (.01 < p < .025).

Intra-operative hearing monitoring methods in middle ear surgeries.

Hearing loss is a condition affecting millions of people worldwide. Conductive hearing loss (CHL) is mainly caused by middle ear diseases. The low frequency area is the pivotal part of speech frequencies and most frequently impaired in patients with CHL. Among various treatments of CHL, middle ear surgery is efficient to improve hearing. However, variable success rates and possible needs for prolonged revision surgery still frustrate both surgeons and patients. Nowadays, increasing numbers of researchers explore various methods to monitor the efficacy of ossicular reconstruction intraoperatively, including electrocochleography (ECochG), auditory brainstem response (ABR), auditory steady state response (ASSR), distortion product otoacoustic emissions (DPOAE), subjective whisper test, and optical coherence tomography (OCT). Here, we illustrate several methods used clinically by reviewing the literature.

A novel mutation in POU3F4 in a Chinese family with X-linked non-syndromic hearing loss.

OBJECTIVE: Based on the clinical manifestations of a hearing loss patient, the POU3F4 gene was tested for diagnosis of etiology. METHODS: A comprehensive physical examination was performed on the proband to exclude abnormalities of other organs, and detailed audiological testing and temporal bone CT scan were also performed. Genomic DNA was extracted using the proband's peripheral blood leukocytes. Polymerase chain reactions (PCR) were performed in the coding sequence of the POU3F4 gene. Direct DNA sequencing was subsequently applied to screen the entire coding region of the POU3F4 gene. RESULTS: The proband had severe sensorineural hearing loss. Temporal CT showed bilateral cochlear incomplete partition, vestibule dysplasia, internal auditory canal fundus expansion, and cochlear interlink with the internal auditory canal fundus. A novel mutation (c.530C > A (p.S177X)) in the POU3F4 gene was found in this patient, creating an new stop codon and was predicted to result in a truncated protein lacking normal POU3F4 transcription factor function. CONCLUSION: Through analysis of the POU3F4 gene and clinical manifestations in the patient, we conclude that a novel mutation may have resulted in a premature stop codon, contributing to the mutation of POU3F4 gene.