Assessing the suitability of artificial intelligence-based chatbots as counseling agents for brain tumor patients: A comprehensive survey analysis.

The internet, particularly social media, has become a popular resource for learning about health and investigating one's own health conditions. The development of AI chatbots has been fueled by the increasing availability of digital health data and advances in natural language processing techniques. While these chatbots are more accessible than before, they sometimes fail to provide accurate information. We used representative chatbots currently available (ChatGPT-3.5, Bing Chat, and Google Bard) to answer questions commonly asked by brain tumor patients. The simulated situations with questions were made and selected by the brain tumor committee. These questions are commonly asked by brain tumor patients. The goal of the study was introduced to each chatbot, the situation was explained, and questions were asked. All responses were collected without modification. The answers were shown to the committee members, and they were asked to judge the responses while blinded to the type of chatbot. There was no significant difference in accuracy and communication ability among the three groups (p=0.253, 0.090, respectively). For empathy, Bing Chat and Google Bard were superior to ChatGPT (p=0.004, 0.002, respectively). The purpose of this study was not to assess or verify the relative superiority of each chatbot. Instead, the aim was to identify the shortcomings and changes needed if AI chatbots are to be used for patient medical purposes. AI-based chatbots are a convenient way for patients and the general public to access medical information. Under such circumstances, medical professionals must ensure that the information provided to chatbot users is accurate and safe.

Medical Ethics and Artificial Intelligence in Neurosurgery-How Should We Prepare?

BACKGROUND: The development of artificial intelligence (AI) raises ethical concerns about its side effects on the attitudes and behaviors of clinicians and medical practitioners. The authors aim to understand the medical ethics of AI-based chatbots and to suggest coping strategies for an emerging landscape of increased access and potential ambiguity using AI. METHODS: This study examines the medical ethics of AI-based chatbots (Chat generative pretrained transformer [GPT], Bing Chat, and Google's Bard) using multiple-choice questions. ChatGPT and Bard correctly answered all questions (5/5), while Bing Chat correctly answered only 3 of 5 questions. ChatGPT explained answers simply. Bing Chat explained answers with references, and Bard provided additional explanations with details. RESULTS: AI has the potential to revolutionize medical fields by improving diagnosis accuracy, surgical planning, and treatment outcomes. By analyzing large amounts of data, AI can identify patterns and make predictions, aiding neurosurgeons in making informed decisions for increased patient wellbeing. As AI usage increases, the number of cases involving AI-entrusted judgments will rise, leading to the gradual emergence of ethical issues across interdisciplinary fields. The medical field will be no exception. CONCLUSIONS: This study suggests the need for safety measures to regulate medical ethics in the context of advancing AI. A system should be developed to verify and predict pertinent issues.

Predicting the wicking rate of nitrocellulose membranes from recipe data: a case study using ANN at a membrane manufacturing in South Korea.

Lateral flow assays have been widely used for detecting coronavirus disease 2019 (COVID-19). A lateral flow assay consists of a Nitrocellulose (NC) membrane, which must have a specific lateral flow rate for the proteins to react. The wicking rate is conventionally used as a method to assess the lateral flow in membranes. We used multiple regression and artificial neural networks (ANN) to predict the wicking rate of NC membranes based on membrane recipe data. The developed ANN predicted the wicking rate with a mean square error of 0.059, whereas the multiple regression had a square error of 0.503. This research also highlighted the significant impact of the water content on the wicking rate through images obtained from scanning electron microscopy. The findings of this research can cut down the research and development costs of novel NC membranes with a specific wicking rate significantly, as the algorithm can predict the wicking rate based on the membrane recipe.

Endoscopic endonasal pituitary sacrifice for select tumors with retrochiasmatic and/or retrosellar extension: surgical anatomy, operative technique, and case series.

OBJECTIVE: Tumors located in the retrochiasmatic region with extension to the third ventricle might be difficult to access when the pituitary-chiasmatic corridor is narrow. Similarly, tumor extension into the interpeduncular and retrosellar space poses a major surgical challenge. Pituitary transposition techniques have been developed to gain additional access. However, when preoperative pituitary function is already impaired or the risk of postoperative panhypopituitarism (PH) is considered to be particularly high, removal of the pituitary gland (PG) might be the preferred option to increase the working corridor. The aim of this study was to describe the relevant surgical anatomy, operative steps, and clinical experience with the endoscopic endonasal pituitary sacrifice (EEPS) and transsellar approach. METHODS: This study comprised anatomical dissections to highlight the relevant surgical steps and a retrospective case series reporting clinical characteristics, indications, and outcomes of patients who underwent EEPS. The surgical technique is as follows: both lateral opticocarotid recesses are exposed laterally, the limbus sphenoidale superiorly, and the sellar floor inferiorly. After opening the dura, the PG is detached circumferentially and mobilized off the medial walls of the cavernous sinuses. The descending branches of the superior hypophyseal artery are coagulated, and the stalk is transected. After removal of the PG, drilling of the dorsum sellae and bilateral posterior clinoidectomies are performed to gain access to the hypothalamic region, interpeduncular, and prepontine cisterns. RESULTS: From 2018 to 2023, 11 patients underwent EEPS. The cohort comprised mostly tuberoinfundibular craniopharyngiomas (n = 8, 73%). Seven (64%) patients had partial or complete anterior PG dysfunction preoperatively, while 4 (36%) had preoperative diabetes insipidus. Because of the specific tumor configuration, the chance of preserving endocrine function was estimated to be very low in patients with intact function. The main reasons for pituitary sacrifice were impaired visibility and surgical accessibility to the retrochiasmatic and retrosellar spaces. Gross-total tumor resection was achieved in 10 (91%) patients and near-total resection in 1 (9%) patient. Two (18%) patients experienced a postoperative CSF leak, requiring surgical revision. CONCLUSIONS: When preoperative pituitary function is already impaired or the risk for postoperative PH is considered particularly high, the EEPS and transsellar approach appears to be a feasible surgical option to improve visibility and accessibility to the retrochiasmatic hypothalamic and retrosellar spaces, thus increasing tumor resectability.

The Use of Histoacryl Injections to Treat Subgaleal Cerebrospinal Fluid Collection After Cranioplasty.

BACKGROUND AND OBJECTIVES: Cranioplasty is an important and basic operation in the neurosurgical field. An emergency craniectomy is performed to control malignant cerebral edema. If the patient survives, cranioplasty is performed to restore the skull defect; however, subgaleal cerebrospinal fluid collection (SCSFC) may occur. The authors aimed to identify risk factors for postoperative SCSFC and effective solutions with the subgaleal Histoacryl injection. METHODS: From January 2020 to December 2022, 154 craniectomies were performed at our hospital to relieve significant cerebral edema after traumatic brain injury; of these, 67 patients survived and underwent cranioplasty. Ten cases of postcranioplasty SCSFC were identified, among which 6 received subgaleal Histoacryl injection. RESULTS: Among the 10 SCSFC cases, 3 resolved with compression after cerebrospinal fluid aspiration, and 1 resolved after revision surgery and dural closure. Histoacryl injection was attempted for the other 6 patients. A single injection was sufficient for SCSFC resolution in 3 patients. One patient required 2 injections, and another required 3 injections. The remaining patient underwent epiduroperitoneal shunt surgery because of SCSFC persistence after 3 Histoacryl injections. Five of 6 patients (83.3%) showed an improvement of more than 80% after Histoacryl injection. CONCLUSION: Subgaleal Histoacryl injection is not considered a fundamental treatment for postoperative SCSFC but can be a successful alternative treatment.

Percutaneous coronary intervention versus medical therapy in stable angina: a matched cohort study.

OBJECTIVE: It is uncertain whether percutaneous coronary intervention (PCI) in addition to optimal medical therapy (OMT) can reduce adverse clinical events in the long term as compared with OMT alone in patients with pure stable angina. METHODS: We enrolled patients from 2006 to 2010 using the Korean national insurance data. 58 742 patients with pure stable angina with no history of myocardial infarction (MI) nor PCI were candidate, and finally, 5673 patients in the PCI plus OMT group and 5673 in the OMT alone group were selected with 1:1 propensity matching. They were followed up for 9.3 years. RESULTS: Primary endpoint, a composite of MI, stroke and cardiac death rate was significantly higher in the PCI group than in the OMT group, 13.5/1000 vs 11.5/1000 person-year with HR of 1.18 (95% CI 1.06 to 1.32, p=0.003). Individual event rate of MI and cardiac death rate was higher in the PCI group than in the OMT group at 9.3 years, 2.9 vs 2.1 (HR 1.38, 95% CI 1.09 to 1.7, p=0.009) and 4.8 vs 3.4/1000 person-year (HR 1.40, 95% CI 1.16 to 1.69, p=0.001), respectively. Revascularisation and total death occurred more in the PCI group as compared with the OMT group, 30.3 vs 8.2 (HR 3.64, 95% CI 3.27 to 4.05, p<0.001) and 13.5 vs 10.6/1000 person-year (HR 1.23, 95% CI 1.12 to 1.40, p<0.001), respectively. In subgroup analysis, the same trend of more event in the PCI group was detected. CONCLUSIONS: PCI plus OMT was associated with higher rate of primary endpoint of MI, stroke, cardiac death as compared with OMT alone in patients with pure stable angina at 9.3-year follow-up in large population.

Construction of a High-Performance Composite Solid Electrolyte Through In-Situ Polymerization within a Self-Supported Porous Garnet Framework.

Composite solid electrolytes (CSEs) have emerged as promising candidates for safe and high-energy-density solid-state lithium metal batteries (SSLMBs). However, concurrently achieving exceptional ionic conductivity and interface compatibility between the electrolyte and electrode presents a significant challenge in the development of high-performance CSEs for SSLMBs. To overcome these challenges, we present a method involving the in-situ polymerization of a monomer within a self-supported porous Li6.4La3Zr1.4Ta0.6O12 (LLZT) to produce the CSE. The synergy of the continuous conductive LLZT network, well-organized polymer, and their interface can enhance the ionic conductivity of the CSE at room temperature. Furthermore, the in-situ polymerization process can also construct the integration and compatibility of the solid electrolyte-solid electrode interface. The synthesized CSE exhibited a high ionic conductivity of 1.117 mS cm-1, a significant lithium transference number of 0.627, and exhibited electrochemical stability up to 5.06 V vs. Li/Li+ at 30 °C. Moreover, the Li|CSE|LiNi0.8Co0.1Mn0.1O2 cell delivered a discharge capacity of 105.1 mAh g-1 after 400 cycles at 0.5 C and 30 °C, corresponding to a capacity retention of 61%. This methodology could be extended to a variety of ceramic, polymer electrolytes, or battery systems, thereby offering a viable strategy to improve the electrochemical properties of CSEs for high-energy-density SSLMBs.

A comparative study of ammonia solubility in imidazolium-based ionic liquids with different structural compositions.

Four imidazolium-based ionic liquids (ILs) with two cations 1-pentyl-3-butylimidazolium [PBIM]+ and 1-benzyl-3-butylimidazolium tetrafluoroborate [BzBIM]+, and two anions tetrafluoroborate (BF4-) and trifluoromethanesulfonate (OTf-) were synthesized for NH3 solubility enhancement. The structural, thermal, and electrochemical stabilities, ionic conductivity, and viscosity of the four ILs, namely, [PBIM]BF4, [BzBIM]BF4, [PBIM]OTf, and [BzBIM]OTf, were investigated. Due to the intermolecular interaction of the benzyl group attached to the imidazolium ring, [BzBIM]+-based ILs exhibited higher thermal stability but lower ionic conductivity compared to [PBIM]+-based ILs. Further, the NH3 solubility in all ILs was measured using a custom-made setup at temperatures ranging from 293.15 to 323.15 K and pressures ranging from 1 to 5 bar. The effects of the cation and anion structures of ILs, as well as pressure and temperature, on the NH3 solubility in the ILs were also investigated. [PBIM]BF4 showed the best solubility because of its high free volume and low viscosity. Density functional calculations validated the superior NH3 solubility in [PBIM]BF4, attributable to the minimal reorganization of the [cation]anion complex geometry during the solvation process, yielding a low solvation free energy. The findings of this study suggest that ILs exhibit a high NH3 solubility capacity and cation and anion structures considerably affect the NH3 solubility in ILs.

Guided bone regeneration of calcium phosphate-coated and strontium ranelate-doped titanium mesh in a rat calvarial defect model.

PURPOSE: When applied alone, titanium (Ti) mesh may not effectively block the penetration of soft tissues, resulting in insufficient new bone formation. This study aimed to confer bioactivity and improve bone regeneration by doping calcium phosphate (CaP) precipitation and strontium (Sr) ranelate onto a TiO2 nanotube (TNT) layer on the surface of a Ti mesh. METHODS: The TNT layer was obtained by anodizing on the Ti mesh, and CaP was formed by cyclic pre-calcification. The final specimens were produced by doping with Sr ranelate. The surface properties of the modified Ti mesh were investigated using high-resolution field emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, and X-ray diffraction. To evaluate the effects of surface treatment on cell viability, osteoblasts were cultured for 1-3 days, and their absorbance was subsequently measured. In an in vivo experiment, critical-size defects were created in rat calvaria (Ф=8 mm). After 5 weeks, the rats were sacrificed (n=4 per group) and bone blocks were taken for micro-computed tomography and histological analysis. RESULTS: After immersing the Sr ranelate-doped Ti mesh in simulated body fluid, the protrusions observed in the initial stage of hydroxyapatite were precipitated as a dense structure. On day 3 of osteoblast culture, cell viability was significantly higher on the pre-calcified Sr ranelate-doped Ti mesh surface than on the untreated Ti mesh surface (P<0.05). In the in vivo experiment, a bony bridge formed between the surrounding basal bone and the new bone under the Sr ranelate-doped Ti mesh implanted in a rat calvarial defect, closing the defect. New bone mineral density (0.91±0.003 g/mm3) and bone volume (29.35±2.082 mm3) significantly increased compared to the other groups (P<0.05). CONCLUSIONS: Cyclic pre-calcification of a Ti mesh with a uniform TNT layer increased bioactivity, and subsequent doping with Sr ranelate effectively improved bone regeneration in bone defects.

Ratiometric electrochemical detection of kojic acid based on glassy carbon modified MXene nanocomposite.

The significance of developing a selective and sensitive sensor for quality control purposes is underscored by the prevalent use of kojic acid (KA) in cosmetics, pharmaceuticals, and food items. KA's utility stems from its ability to inhibit tyrosinase activity. However, the instability of KA and its potential adverse effects have created a pressing need for accurate and sensitive sensors capable of analyzing real samples. This research introduces an electrochemical ratiometric sensor designed to accurately detect KA in actual cosmetic and food samples. The ratiometric sensor offers distinct advantages such as enhanced selectivity, reproducibility, and sensitivity. It achieves this by leveraging the ratio between two output signals, thereby producing reliable and undistorted results. The sensor is constructed by modifying a Glassy Carbon Electrode (GCE) with a nanocomposite consisting of Ti3C2 MXene, Prussian blue, and gold nanoparticles. The incorporation of MXene and gold nanoparticles heightens sensitivity and reduces impedance. Meanwhile, the Prussian blue signal diminishes proportionally with increasing KA concentration, forming the basis for the ratiometric sensing mechanism. The outcomes of the study reveal a broad linear range (1-600 µM), a low detection limit (1 µM), and strong selectivity for KA. These findings suggest the sensor's potential efficacy in quality control across cosmetics, pharmaceuticals, and food products.

Phenylalkyl Glycosides from the Flowers of Brugmansia arborea L. and Their Radical Scavenging Effect and Protective Effect on Pancreatic Islets Damaged by Alloxan in Zebrafish (Danio rerio) Larvae.

The study aimed to investigate the antioxidant and antidiabetic activity of Brugmansia arborea L. flower extracts, solvent fractions, and isolated compounds. B. arborea L flowers were extracted with aqueous methanol, and concentrated extract was successively partitioned into EtOAc, n-BuOH, and H2O fractions. Repeated silica gel and octadecyl silica gel column chromatographies for EtOAc and n-BuOH fractions led to the isolation of a new phenylalkyl glycoside (6), along with five known ones. Several spectroscopic data led to the structure determination of one new phenylalky glycoside as brugmansioside C (named) (6) and five known ones as benzyl-O-ß-D-glucopyranoside (1), benzyl-O-ß-D-glucosyl-(1→6)-ß-D-glucopyranoside (2), 2-phenylethyl-O-ß-D-glucopyranoside (3), 2-phenylethyl-O-ß-D-glucosyl-(1→6)-ß-D-glucopyranoside (4), and 3-phenylpropyl-O-ß-D-glucopyranoside (5). The five known ones (1-5) were isolated from B. arborea flowers for the first time in this study. The extract, solvent fractions, and all isolated compounds showed radical scavenging activities using ABTS radical, and EtOAc fraction showed the highest scavenging capacity, whereas compounds 2, 4, and 6 did not display the capacity to use the DPPH radical. The extract, solvent fractions, and all isolated compounds showed a protective effect on pancreatic islets damaged by alloxan treatment in zebrafish larvae. The pancreatic islet size treated with EtOAc, n-BuOH fractions, and all compounds significantly increased by 64.0%, 69.4%, 82.0%, 89.8%, 80.0%, 97.8%, 103.1%, and 99.6%, respectively, compared to the alloxan-induced group. These results indicate that B. arborea flowers and their isolated compounds are useful as potential antioxidant and antidiabetic agents.

Potential impact of high-density lipoprotein cholesterol in the postoperative outcomes of chronic subdural hematoma patients: multi-institutional study in Korea.

BACKGROUND: Chronic subdural hematoma (CSDH) is a common clinical situation in neurosurgical practice, but the optimal treatment option is controversial. This study aimed to evaluate the effect of cholesterol-lowering medications on and how they affected the prognoses of CSDH patients. METHODS: In this multi-institutional observational study performed in Korea, data from recently treated CSDH patients were gathered from 5 hospitals. A total of 462 patients were collected from March 2010 to June 2021. Patient clinical characteristics, history of underlying diseases and their treatments, radiologic features, and surgical outcomes were analyzed. RESULTS: Seventy-five patients experienced recurrences, and 62 had reoperations after the initial burr hole surgery. Among these, 15 patients with recurrences and 12 with reoperations were taking cholesterol-lowering medications. However, the use of medications did not significantly affect recurrence or reoperation rates (P = 0.350, P = 0.336, respectively). When analyzed by type of medication, no clinically relevant differences in total cholesterol (TC), triglyceride (TG), or low-density lipoprotein cholesterol (LDL-C) levels were identified. The combination of a statin drug and ezetimibe significantly elevated high-density lipoprotein cholesterol (HDL-C) levels (P = 0.004). TC, LDL-C, and TG levels did not significantly affect patient prognoses. However, HDL-C levels and recurrence (odds ratio (OR) = 0.96; 95% confidence interval (CI): 0.94-0.99; p = 0.010) were negatively correlated. An HDL-C level of 42.50 mg/dL was identified as the threshold for recurrence and reoperation. CONCLUSIONS: In this study, using cholesterol-lowering medications did not significantly impact the prognosis of patients who underwent surgical management for a chronic subdural hematoma. However, the findings showed that the higher the HDL-C level, the lower the probability of recurrence and reoperation.

Penetrating Orbitocranial Injuries in the Republic of Korea.

Objective: Penetrating brain injury occurs when an object enters the skull and pierces the brain. These injuries can damage small or large parts of the brain, are life-threatening, and require emergency care. This study is a summary of penetrating head injuries at our hospital and an analysis of their treatments and prognoses. Methods: Patients with penetrating brain involving the orbit and/or cranial region were recruited among patients with trauma who visited our regional trauma center between 2019 and 2022. Results: Eight patients with penetrating brain injuries were enrolled. One patient was female; the median age was 53 years (range, 24-72 years). Five patients with Glasgow Coma Scale (GCS) scores of 14 or 15 showed no major vessel injury or midline intracranial involvement on imaging and were discharged safely. The other three patients with suspected major vessel injuries and midline involvement did not survive. Conclusion: The greatest influences on patient prognosis were the area of damage and level of consciousness, along with the GCS score at the time of the visit. The probability of survival is extremely low if the midline structure is damaged.

Development of Gelatin Methacryloyl/Sodium Alginate Interpenetrating Polymer Network Hydrogels for Bone Regeneration by Activating the Wnt/ß-Catenin Signaling Pathway via Lithium Release.

Hydrogels have gained significant attention as biomaterials due to their remarkable properties resembling those of the extracellular matrix (ECM). In the present investigation, we successfully synthesized interpenetrating polymer network (IPN) hydrogels using gelatin methacryloyl (GelMA) and sodium alginate (SA), incorporating various concentrations of lithium chloride (LiCl; 0, 5, and 10 mM), aiming to develop a hydrogel scaffold for bone regeneration. Notably, the compressive modulus of the IPN hydrogels remained largely unaffected upon the inclusion of LiCl. However, the hydrogel with the high concentration of LiCl exhibited reduced fragmentation after compression testing. Intriguingly, we observed a significant improvement in cellular biocompatibility, primarily attributed to activation of the Wnt/ß-catenin signaling pathway induced by LiCl. Subsequently, we evaluated the efficacy of the newly developed IPN-Li hydrogels in a rat cranial defect model and found that they substantially enhanced bone regeneration. Nevertheless, it is important to note that the introduction of high concentrations of LiCl did not significantly promote osteogenesis. This outcome can be attributed to the excessive release of Li+ ions into the extracellular matrix, hindering the desired effect. Overall, the IPN-Li hydrogel developed in this study holds great promise as a biodegradable material for bone regeneration applications.

Protamine dose to neutralize heparin at the completion of cardiopulmonary bypass can be reduced significantly without affecting post-operative bleeding.

BACKGROUND: Systemic anticoagulation with heparin during cardiopulmonary bypass (CPB) should be neutralized by protamine administration to restore normal hemostasis. Our previous study showed the protamine-to-heparin ratio (P-to-H) of 1:1 (1 mg protamine:100 IU circulating heparin; 1.0 Ratio) is likely an overestimation. Thus, we reduced the P-to-H in the HMS Plus Hemostasis Management System to 0.9:1 (0.9 Ratio) for 5 months and then to 0.8:1 (0.8 Ratio). We monitored post-operative (post-op) bleeding in the setting of reduced protamine dose (PD). METHODS: We performed a retrospective study of 632 patients (209 for the 1.0 Ratio, 211 for 0.9 Ratio, 212 for 0.8 Ratio group) who underwent cardiac surgery to measure the reduction of PD and how it affects 24-hour (24 h) post-op chest tube output. We also analyzed the entire data set to explore whether further reduction of P-to-H is warranted. RESULTS: While there was no difference in the indexed heparin dose among the three groups, we achieved a significant reduction in the indexed actual protamine dose (APDi) by 24% (0.9 Ratio) and 31% (0.8 Ratio) reductions compared to the 1.0 Ratio group. On average, APDi was 88 ± 22, 67 ± 18, and 61 ± 15 mg/m2 in the 1.0, 0.9, and 0.8 Ratio groups, respectively. We found no significant difference in 24 h post-op bleeding among the three groups. CONCLUSION: 1.0 Ratio at the completion of CPB is likely an excessive administration of protamine. With the stepwise reduction of PD, we observed no increase in post-op bleeding, which may indicate that no meaningful increase in heparin rebound occurred. In addition, further analysis of the entire data set demonstrates that a 0.75 Ratio is likely sufficient to neutralize the heparin completely.

The Direction of Neurosurgery to Overcome the Living with COVID-19 Era : The Possibility of Telemedicine in Neurosurgery.

OBJECTIVE: Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. METHODS: The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. RESULTS: During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. CONCLUSION: In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

Electrochemical sensors for cortisol detection: Principles, designs, fabrication, and characterisation.

Psychological stress is a major factor contributing to health discrepancies among individuals. Sustained exposure to stress triggers signalling pathways in the brain, which leading to the release of stress hormones in the body. Cortisol, a steroid hormone, is a significant biomarker for stress management due to its responsibility in the body's reply to stress. The release of cortisol in bloodstream prepares the body for a "fight or flight" response by increasing heart rate, blood pressure, metabolism, and suppressing the immune system. Detecting cortisol in biological samples is crucial for understanding its role in stress and personalized healthcare. Traditional techniques for cortisol detection have limitations, prompting researchers to explore alternative strategies. Electrochemical sensing has emerged as a reliable method for point-of-care (POC) cortisol detection. This review focuses on the progress made in electrochemical sensors for cortisol detection, covering their design, principle, and electroanalytical methodologies. The analytical performance of these sensors is also analysed and summarized. Despite significant advancements, the development of electrochemical cortisol sensors faces challenges such as biofouling, sample preparation, sensitivity, flexibility, stability, and recognition layer performance. Therefore, the need to develop more sensitive electrodes and materials is emphasized. Finally, we discussed the potential strategies for electrode design and provides examples of sensing approaches. Moreover, the encounters of translating research into real world applications are addressed.

Unlocking the Potential of Colloidal Quantum Dot/Organic Hybrid Solar Cells: Band Tunable Interfacial Layer Approach.

Hybrid colloidal quantum dot (CQD)/organic architectures are promising candidates for emerging optoelectronic devices having high performance and inexpensive fabrication. For unlocking the potential of CQD/organic hybrid devices, enhancing charge extraction properties at electron transport layer (ETL)/CQD interfaces is crucial. Hence, we carefully adjust the interface properties between the ETL and CQD layer by incorporating an interfacial layer for the ETL (EIL) using several types of cinnamic acid ligands. The EIL having a cascading band offset (ΔEC) between the ETL and CQD layer suppresses the potential barrier and the local charge accumulation at ETL/CQD interfaces, thereby reducing the bimolecular recombination. An optimal EIL effectively expands the depletion region that facilitates charge extraction between the ETL and CQD layer while preventing the formation of shallow traps. Representative devices with an EIL exhibit a maximum power conversion efficiency of 14.01% and retain over 80% of initial performances after 300 h under continuous maximum power point operation.

Balancing Bleeding Risk and Thromboembolic Complications in Elderly Chronic Subdural Hematoma Patients Undergoing Burr Hole Trephination : A Multicenter Retrospective Cohort Study and Literature Review.

OBJECTIVE: Chronic subdural hematoma (CSDH) patients using antithrombotic agents (AT) at high risk for cardiovascular disease are increasing. The authors aimed to analyze the factors influencing outcome by targeting patients using AT and to establish a desirable treatment strategy. METHODS: A retrospective analysis was performed on data from 462 patients who underwent burr hole trephination (BHT) surgery for CSDH at five hospitals from March 2010 to June 2021. Outcomes included incidence of postoperative acute bleeding, recurrence rate, and morbidity or mortality rate. Patients were divided into the following four groups based on their history of AT use : no AT. Only antiplatelet agents (AP), only anticoagulants (AC), both of AP and AC. In addition, a concurrent literature review was conducted alongside our cohort study. RESULTS: Of 462 patients, 119 (119/462, 25.76%) were using AT. AP prescription did not significantly delay surgery (p=0.318), but AC prescription led to a significant increase in the time interval from admission to operation (p=0.048). After BHT, AP or AC intake significantly increased the period required for an in-dwelling drain (p=0.026 and p=0.037). The use of AC was significantly related to acute bleeding (p=0.044), while the use of AP was not (p=0.808). Use of AP or AC had no significant effect on CSDH recurrence (p=0.517 and p=1.000) or reoperation (p=0.924 and p=1.000). Morbidity was not statistically correlated with use of either AP or AC (p=0.795 and p=0.557, respectively), and there was no significant correlation with mortality for use of these medications (p=0.470 and p=1.000). CONCLUSION: Elderly CSDH patients may benefit from maintenance of AT therapy during BHT due to reduced thromboembolic risk. However, the use of AC necessitates individualized due to potential postoperative bleeding. Careful post-operative monitoring could mitigate prognosis and recurrence impacts.