A single-center prospective study regarding time to return to activities of daily living after craniotomy for brain tumors.

BACKGROUND: There are few studies on the time to return to activities of daily living (ADL) after craniotomy in patients with brain tumors. This study aimed to investigate the duration before returning to ADLs after craniotomy for brain tumors and present data that can provide information and guidelines on the appropriate time needed. METHODS: Patients (n = 183 of 234) who underwent craniotomy for brain tumors between April 2021 and July 2021 capable of self-care upon discharge were enrolled, and data of 158 were collected. The start time of 85 ADL items was prospectively investigated for 4 months postoperatively, using the self-recording sheet. RESULTS: Over 89% and 87% of the patients performed basic ADL items within a month and instrumental ADL items within 2 months (medians: within 18 days), except for a few. Regarding work, 50% of the patients returned within 4 months. Washing hair with a wound was performed at 18 days of median value, after 4 months of dyeing/perming hair, 6 days of drinking coffee/tea, after 4 months of air travel, and 40 days of complementary and alternative medicine. In patients with infratentorial tumors or surgical problems, return times were much later for various items. CONCLUSIONS: It is possible to provide practical information and guidelines on the duration to return to ADL after craniotomy in brain tumor patients. These study findings also reduce uncertainty about recovery and daily life and help patients return to their daily life at the appropriate time, thereby maintaining function and daily well-being after surgery.

Factors Influencing Patient Satisfaction after Microvascular Decompression for Hemifacial Spasm: A Focus on Residual Spasms.

INTRODUCTION: Patients with hemifacial spasm (HFS) experience improvement in symptoms after microvascular decompression (MVD); however, patient satisfaction is sometimes low. This study aimed to analyze the relationship between residual spasms and patient satisfaction, identify factors affecting satisfaction, and investigate the degree of improvement in spasms which result in patient satisfaction after surgery. METHODS: 297 patients who completed a questionnaire after MVD for HFS between March 2020 and June 2020 were included. Information on surgical outcomes and patient satisfaction was collected using the questionnaire, and their relationships were analyzed. RESULTS: Among the 297 patients, the mean residual spasm percentage and patient satisfaction score were negatively correlated with 14.0% and 8.8 points, respectively. In addition to residual spasms, discomfort caused by persistent spasms, psychological problem-solving, better social life, and interpersonal relationship improvement were associated with satisfaction. There was no significant association between the presence of complications and satisfaction. There was no significant difference in the satisfaction score at up to 30% residual spasm, and the patients with 0-30% residual spasm had a satisfaction score of 7 points or higher. CONCLUSION: Residual spasms and discomfort from residual spasms decreased patient satisfaction after MVD for HFS. It is then necessary to perform accurate surgical resolution to improve surgical outcomes and provide adequate management to reduce postoperative discomfort and anxiety, and ultimately to enhance satisfaction. Residual spasms of up to 30% compared with the preoperative severity can be considered a good outcome when evaluating surgical outcomes.

AoP-LSE: Antioxidant Proteins Classification Using Deep Latent Space Encoding of Sequence Features.

It is of utmost importance to develop a computational method for accurate prediction of antioxidants, as they play a vital role in the prevention of several diseases caused by oxidative stress. In this correspondence, we present an effective computational methodology based on the notion of deep latent space encoding. A deep neural network classifier fused with an auto-encoder learns class labels in a pruned latent space. This strategy has eliminated the need to separately develop classifier and the feature selection model, allowing the standalone model to effectively harness discriminating feature space and perform improved predictions. A thorough analytical study has been presented alongwith the PCA/tSNE visualization and PCA-GCNR scores to show the discriminating power of the proposed method. The proposed method showed a high MCC value of 0.43 and a balanced accuracy of 76.2%, which is superior to the existing models. The model has been evaluated on an independent dataset during which it outperformed the contemporary methods by correctly identifying the novel proteins with an accuracy of 95%.

Association of Thyroid Hypofunction with Clinical Outcomes after Microvascular Decompression for Hemifacial Spasm.

INTRODUCTION: Data regarding the association between thyroid dysfunction and hemifacial spasm (HFS) are limited. We conducted a single-center, retrospective study to investigate the predictive value of thyroid dysfunction in patients with HFS after microvascular decompression (MVD). METHODS: Between July 2004 and January 2015, 156 patients who were tested for thyroid hormones after MVD for HFS were enrolled in the present study. We assessed their detailed history, clinical manifestations, serum thyroid hormone levels, and surgical outcomes. The patients were classified into low and high groups based on thyroid hormone concentrations, and clinical outcomes were evaluated in each group. RESULTS: In a total of 156 patients with a median follow-up period of 40.9 months, the improvement rate was 87.8%. The patients were classified into low (76, 48.7%) or high (80, 51.3%) groups based on serum thyroxine (T4) levels. There was a difference between the 2 groups in terms of postoperative outcomes following MVD (p = 0.020). There were no differences in the outcomes according to serum tri-iodothyronine (T3) levels as well as other factors associated with the outcomes. CONCLUSIONS: We found that decreased serum T4 levels are associated with poor postoperative outcomes among patients with HFS. Further studies are needed to examine the clinical benefit of thyroid hormone replacement therapy for patients with suboptimal T4 concentrations as well as active thyroid hormone screening for patients with HFS.

A Computerized Bioinspired Methodology for Lightweight and Reliable Neural Telemetry.

Personalized health monitoring of neural signals usually results in a very large dataset, the processing and transmission of which require considerable energy, storage, and processing time. We present bioinspired electroceptive compressive sensing (BeCoS) as an approach for minimizing these penalties. It is a lightweight and reliable approach for the compression and transmission of neural signals inspired by active electroceptive sensing used by weakly electric fish. It uses a signature signal and a sensed pseudo-sparse differential signal to transmit and reconstruct the signals remotely. We have used EEG datasets to compare BeCoS with the block sparse Bayesian learning-bound optimization (BSBL-BO) technique-A popular compressive sensing technique used for low-energy wireless telemonitoring of EEG signals. We achieved average coherence, latency, compression ratio, and estimated per-epoch power values that were 35.38%, 62.85%, 53.26%, and 13 mW better than BSBL-BO, respectively, while structural similarity was only 6.295% worse. However, the original and reconstructed signals remain visually similar. BeCoS senses the signals as a derivative of a predefined signature signal resulting in a pseudo-sparse signal that significantly improves the efficiency of the monitoring process. The results show that BeCoS is a promising approach for the health monitoring of neural signals.

Short-term versus long-term outcomes of microvascular decompression for hemifacial spasm.

BACKGROUND: Microvascular decompression (MVD) is a useful treatment for hemifacial spasm (HFS), but the postoperative course is extremely diverse. The purpose of this study was to compare short- and long-term outcomes, find the earliest optimal time for determining the long-term outcomes, and investigate the prognostic factors involved in the outcomes over time. METHODS: From July 2004 to January 2015, 1341 patients who underwent MVD for HFS were enrolled. Information on clinical features, operative findings, and surgical outcomes over time were collected by performing a review of electronic medical records, and their relationships were analyzed. The outcomes of MVD at 1, 3, 6, and 9 months were individually compared against those at > 12 months after surgery. RESULTS: The mean follow-up period after surgery was 44.9 months (median, 36.8 months; range, 12.0-156.6 months). The overall improvement rate for the 1341 patients was 89.0%. Individual postoperative outcomes at 6 and 9 months showed no differences with those at > 12 months after surgery. Furthermore, in the uni- and multi-variable analyses, patients in whom the offending vessels were intraoperatively determined to be veins showed bad outcomes at 6, 9, and > 12 months (p = 0.048, p = 0.004, and p = 0.003, respectively). Patients with intraoperative indentation on the facial nerve showed good outcomes at 6, 9, and > 12 months (p = 0.005, p = 0.039, and p = 0.020, respectively). Patients with delayed facial palsy after surgery showed better outcomes at 6, 9, and > 12 months (p = 0.002, p = 0.003, and p = 0.028, respectively). CONCLUSIONS: Short- and long-term outcomes of MVD in patients with HFS manifested differently, but the outcomes at 6 and 9 months showed similarities with those at > 12 months. In patients in whom the intraoperatively detected offending vessel was not a vein, and in patients with intraoperative indentation on the facial nerve and postoperative delayed facial palsy, good outcomes could be predicted after 6 months of surgery.

Delayed hearing loss after microvascular decompression for hemifacial spasm.

BACKGROUND: This study aimed to analyze cases of delayed hearing loss after microvascular decompression (MVD) for hemifacial spasm and identify the characteristic features of these patients. METHODS: We retrospectively reviewed the medical records of 3462 patients who underwent MVD for hemifacial spasm between January 1998 and August 2017. RESULTS: Among these, there were 5 cases in which hearing was normal immediately postoperatively but delayed hearing loss occurred. None of the 5 patients reported any hearing disturbance immediately after the operation. However, they developed hearing problems suddenly after some time (median, 22 days; range 10-45 days). On examination, sensorineural hearing loss was confirmed. High-dose corticosteroid treatment was prescribed. Preoperative hearing levels were restored after several months (median duration from the time of the operation, 45 days; range 22-118 days). Interestingly, the inter-peak latency of waves I-III in the brainstem auditory evoked potential (BAEP) was prolonged during the surgery, but recovered within a short time. CONCLUSION: Delayed hearing loss may occur after MVD for HFS. Prolongation of the inter-peak latency of waves I-III seems to be associated with the occurrence of delayed hearing loss. It is possible that BAEP changes may predict delayed hearing loss, but confirmatory evidence is not available as yet. Analysis of more cases is necessary to determine the utility of BAEP monitoring to predict delayed hearing loss after MVD and to identify its exact cause.

Design and Performance Evaluation of a Low-Cost Autonomous Sensor Interface for a Smart IoT-Based Irrigation Monitoring and Control System.

Irrigation systems are becoming increasingly important, owing to the increase in human population, global warming, and food demand. This study aims to design a low-cost autonomous sensor interface to automate the monitoring and control of irrigation systems in remote locations, and to optimize water use for irrigation farming. An internet of things-based irrigation monitoring and control system, employing sensors and actuators, is designed to facilitate the autonomous supply of adequate water from a reservoir to domestic crops in a smart irrigation systems. System development lifecycle and waterfall model design methodologies have been employed in the development paradigm. The Proteus 8.5 design suite, Arduino integrated design environment, and embedded C programming language are commonly used to develop and implement a real working prototype. A pumping mechanism has been used to supply the water required by the soil. The prototype provides power supply, sensing, monitoring and control, and internet connectivity capabilities. Experimental and simulation results demonstrate the flexibility and practical applicability of the proposed system, and are of paramount importance, not only to farmers, but also for the expansion of economic activity. Furthermore, this system reduces the high level of supervision required to supply irrigation water, enabling remote monitoring and control.

Randomized controlled trial of piperacillin-tazobactam, cefepime and ertapenem for the treatment of urinary tract infection caused by extended-spectrum beta-lactamase-producing Escherichia coli.

BACKGROUND: Due to limited therapeutic options, the spread of extended-spectrum beta-lactamases (ESBLs) have become a major public health concern. We conducted a prospective, randomized, open-label comparison of the therapeutic efficacy of piperacillin-tazobactam (PTZ), cefepime, and ertapenem in febrile nosocomial urinary tract infection with ESBL-producing Escherichia coli (ESBL-EC). METHODS: This study was conducted at three university hospitals between January 2013 and August 2015. Hospitalized adult patients presenting with fever were screened for healthcare-associated urinary tract infection (HA-UTI). When ESBL-EC was solely detected and susceptible to a randomized antibiotic in vitro, the case was included in the final analysis. Participants were treated for 10-14 days with PTZ, cefepime, or ertapenem. RESULTS: A total of 66 participants were evenly assigned to the PTZ and ertapenem treatment groups. After the recruitment of six participants, assignment to the cefepime treatment group was stopped because of an unexpectedly high treatment failure rate. The baseline characteristics of these participants did not differ from participants in other treatment groups. The clinical and microbiological response to PTZ treatment was estimated to be 94% and was similar to the response to ertapenem treatment. The efficacy of cefepime was 33.3%. In the cefepime group, age, Charlson comorbidity index, genotype, and minimal inhibitory concentration (MIC) did not significantly affect the success of treatment. Similarly, genotype seemed to be irrelevant with respect to clinical outcome in the PTZ group. Expired cases tended to involve septic shock with a high Charlson comorbidity index and high MIC. CONCLUSION: Results from this study suggest that PTZ is effective in the treatment of urinary tract infection caused by ESBL-EC when the in vitro test indicates susceptibility. In addition, cefepime should not be used as an alternative treatment for urinary tract infection caused by ESBL-EC. TRIAL REGISTRATION: The trial was registered with the Clinical Research Information Service of Korea Centers for Disease Control and Prevention. (KCT0001895).

Natural History of Untreated Hemifacial Spasm: A Study of 104 Consecutive Patients over 5 Years.

BACKGROUND: The natural history without treatment of a large series of hemifacial spasm (HFS) patients has not been well-documented. OBJECTIVE: The purpose of this study was to characterize the natural history and clinical outcome in patients with HFS. METHODS: The initial visits of all 2,155 patients and the diagnosis of HFS took place between 2001 and 2010. In 1,775 of the patients, compressing vessels were identified on magnetic resonance imaging. Of these, we excluded 1,469 patients (82.8%) who received microvascular decompression, 101 (5.7%) who continued to visit the clinic for botulinum toxin injections, and 9 (0.5%) who died or suffered from other diseases. Ninety-two (5.2%) of the patients were lost to follow-up; the remaining 104 were followed up for 5-42 years (mean 12 years) after the onset of the symptoms of HFS. RESULTS: The condition was aggravated in 11 (10.6%) of the 104 patients and stationary in 40 (38.5%) for 6-42 years (mean 13 years). Ten (9.6%) improved partially for 7-18 years (mean 11 years). Forty-three (41.3%) were in remission for between 2 months and 23 years (mean 6.4 years) after onset and required no further treatment for 5 months to 13 years (mean 5.7 years). CONCLUSION: This study provides useful information to HFS patients for understanding the disease and determining treatment.

Bioavailability of Silica, Titanium Dioxide, and Zinc Oxide Nanoparticles in Rats.

Inorganic nanoparticles have been widely applied to various industrial fields and biological applications. However, the question as to whether nanoparticles are more efficiently absorbed into the systemic circulation than bulk-sized materials remains to be unclear. In the present study, the physico-chemical and dissolution properties of the most extensively developed inorganic nanoparticles, such as silica (SiO2), titanium dioxide (TiO2), and zinc oxide (ZnO), were analyzed, as compared with bulk-sized particles. Furthermore, the bioavailability of nanoparticles versus their bulk counterparts was evaluated in rats after a single oral administration and intravenous injection, respectively. The results demonstrated that all bulk materials had slightly higher crystallinity than nanoparticles, however, their dissolution properties were not affected by particle size. No significant difference in oral absorption and bioavailability of both SiO2 and TiO2 was found between nano- and bulk-sized materials, while bulk ZnO particles were more bioavailable in the body than ZnO nanoparticles. These finding will provide critical information to apply nanoparticles with high efficiency as well as to predict their toxicity potential.

Inactivation of the virulence factors from 2,3-butanediol-producing Klebsiella pneumoniae.

The microbiological production of 2,3-butanediol (2,3-BDO) has attracted considerable attention as an alternative way to produce high-value chemicals from renewable sources. Among the number of 2,3-BDO-producing microorganisms, Klebsiella pneumoniae has been studied most extensively and is known to produce large quantity of 2,3-BDO from a range of substrates. On the other hand, the pathogenic characteristics of the bacteria have limited its industrial applications. In this study, two major virulence traits, outer core LPS and fimbriae, were removed through homologous recombination from 2,3-BDO-producing K. pneumoniae 2242 to expand its uses to the industrial scale. The K. pneumoniae 2242 ∆wabG mutant strain was found to have an impaired capsule, which significantly reduced its ability to bind to the mucous layer and evade the phagocytic activity of macrophage. The association with the human ileocecal epithelial cell, HCT-8, and the bladder epithelial cell, T-24, was also reduced dramatically in the K. pneumoniae 2242 ∆fimA mutant strain that was devoid of fimbriae. However, the growth rate and production yield for 2,3-BDO were unaffected. The K. pneumoniae strains developed in this study, which are devoid of the major virulence factors, have a high potential for the efficient and sustainable production of 2,3-BDO.

Cerebellar retraction and hearing loss after microvascular decompression for hemifacial spasm.

BACKGROUND: This retrospective study evaluated the length of cerebellar retraction and the changes of intraoperative brainstem auditory evoked potential (BAEP) during microvascular decompression (MVD), and assessed the predictive value of the hearing loss as a prognostic indicator for the treatment outcome of hemifacial spasm (HFS). METHODS: This series included 1,518 consecutive patients affected with HFS who underwent MVD, during which BAEP was monitored. Patients were divided into two groups based on whether hearing loss occurred following decompression or not. Each patient underwent a similar procedure performed by one neurosurgeon. The two patients groups were matched with regard to sex, age, and degree of spasm. RESULTS: Among the 1,518 patients, 106 (6.98 %) displayed functional hearing changes. Hearing loss was permanent in 12 patients (0.79 %). Of the 1,412 patients with stationary hearing compared with preoperative audiometry, 96 patients were selected who were individually matched with respect to sex, age, and degree of spasm. BAEP changed immediately after cerebellar retraction in 7 of 12 hearing-loss patients, suggesting the importance of retraction on hearing outcomes. The distance from the cerebellar surface of the petrous temporal bone to the neurovascular compression point was measured. The median distance of cerebellar retraction in the hearing-loss group was 13.77 mm, which was longer than the median distance in the control group. CONCLUSIONS: Preoperative measurement of the cerebellar retraction distance can be a valuable clue to predict and prevent postoperative hearing loss in MVD for HFS.

An Autonomous Self-Aware and Adaptive Fault Tolerant Routing Technique for Wireless Sensor Networks.

We propose an autonomous self-aware and adaptive fault-tolerant routing technique (ASAART) for wireless sensor networks. We address the limitations of self-healing routing (SHR) and self-selective routing (SSR) techniques for routing sensor data. We also examine the integration of autonomic self-aware and adaptive fault detection and resiliency techniques for route formation and route repair to provide resilience to errors and failures. We achieved this by using a combined continuous and slotted prioritized transmission back-off delay to obtain local and global network state information, as well as multiple random functions for attaining faster routing convergence and reliable route repair despite transient and permanent node failure rates and efficient adaptation to instantaneous network topology changes. The results of simulations based on a comparison of the ASAART with the SHR and SSR protocols for five different simulated scenarios in the presence of transient and permanent node failure rates exhibit a greater resiliency to errors and failure and better routing performance in terms of the number of successfully delivered network packets, end-to-end delay, delivered MAC layer packets, packet error rate, as well as efficient energy conservation in a highly congested, faulty, and scalable sensor network.

Polymer coated CaAl-layered double hydroxide nanomaterials for potential calcium supplement.

We have successfully prepared layered double hydroxide (LDH) nanomaterials containing calcium and aluminum ions in the framework (CaAl-LDH). The surface of CaAl-LDH was coated with enteric polymer, Eudragit®L 100 in order to protect nanomaterials from fast dissolution under gastric condition of pH 1.2. The X-ray diffraction patterns, Fourier transform infrared spectroscopy, scanning electron and transmission electron microscopy revealed that the pristine LDH was well prepared having hydrocalumite structure, and that the polymer effectively coated the surface of LDH without disturbing structure. From thermal analysis, it was determined that only a small amount (less than 1%) of polymer was coated on the LDH surface. Metal dissolution from LDH nanomaterials was significantly reduced upon Eudragit®L 100 coating at pH 1.2, 6.8 and 7.4, which simulates gastric, enteric and plasma conditions, respectively, and the dissolution effect was the most suppressed at pH 1.2. The LDH nanomaterials did not exhibit any significant cytotoxicity up to 1000 µg/mL and intracellular calcium concentration significantly increased in LDH-treated human intestinal cells. Pharmacokinetic study demonstrated absorption efficiency of Eudragit®L 100 coated LDH following oral administration to rats. Moreover, the LDH nanomaterials did not cause acute toxic effect in vivo. All the results suggest the great potential of CaAl-LDH nanomaterials as a calcium supplement.

Compositionally Sequenced Interfacial Layers for High-Energy Li-Metal Batteries.

Electrolyte additives with multiple functions enable the interfacial engineering of Li-metal batteries (LMBs). Owing to their unique reduction behavior, additives exhibit a high potential for electrode surface modification that increases the reversibility of Li-metal anodes by enabling the development of a hierarchical solid electrolyte interphase (SEI). This study confirms that an adequately designed SEI facilitates the homogeneous supply of Li+, nonlocalized Li deposition, and low electrolyte degradation in LMBs while enduring the volume fluctuation of Li-metal anodes on cycling. An in-depth analysis of interfacial engineering mechanisms reveals that multilayered SEI structures comprising mechanically robust LiF-rich species, electron-rich P-O species, and elastic polymeric species enabled the stable charge and discharge of LMBs. The polymeric outer SEI layer in the as-fabricated multilayered SEI could accommodate the volume fluctuation of Li-metal anodes, significantly enhancing the cycling stability Li||LiNi0.8Co0.1Mn0.1O2 full cells with an electrolyte amount of 3.6 g Ah-1 and an areal capacity of 3.2 mAh cm-2. Therefore, this study confirms the ability of interfacial layers formed by electrolyte additives and fluorinated solvents to advance the performance of LMBs and can open new frontiers in the fabrication of high-performance LMBs through electrolyte-formulation engineering.

Correction: Liquid electrolyte chemistries for solid electrolyte interphase construction on silicon and lithium-metal anodes.

[This corrects the article DOI: 10.1039/D3SC03514J.].

Liquid electrolyte chemistries for solid electrolyte interphase construction on silicon and lithium-metal anodes.

Next-generation battery development necessitates the coevolution of liquid electrolyte and electrode chemistries, as their erroneous combinations lead to battery failure. In this regard, priority should be given to the alleviation of the volumetric stress experienced by silicon and lithium-metal anodes during cycling and the mitigation of other problems hindering their commercialization. This review summarizes the advances in sacrificial compound-based volumetric stress-adaptable interfacial engineering, which has primarily driven the development of liquid electrolytes for high-performance lithium batteries. Besides, we discuss how the regulation of lithium-ion solvation structures helps expand the range of electrolyte formulations and thus enhance the quality of solid electrolyte interphases (SEIs), improve lithium-ion desolvation kinetics, and realize longer-lasting SEIs on high-capacity anodes. The presented insights are expected to inspire the design and synthesis of next-generation electrolyte materials and accelerate the development of advanced electrode materials for industrial battery applications.

Identifying the Unmet Medical Needs of HIV-Positive Subjects in Korea: Results of a Nationwide Online Survey.

An online survey was conducted in Korea to identify the unmet medical needs of people living with human immunodeficiency virus (HIV) (PLWH). Participants (n = 105) were mostly male (93.3%), aged >40 years (75.2%), and treated for ≥6 years post-diagnosis (61.9%). Most PLWH (71.4%) were very satisfied/satisfied with their HIV management. Areas of concern were quality of life (QoL) and mental health. Characteristics of a long-term therapeutic agent were 'low risk of resistance', 'high long-term viral suppression efficacy', and 'high degree of safety'. Pre-consultation QoL and mental health screening would be beneficial for the long-term success of HIV management.

Time taken to resume activities of daily living after transsphenoidal surgery for pituitary tumors.

Postoperative management after transsphenoidal surgery (TSS) is important; however, the guidelines for resuming daily activities after TSS are insufficient. This study aimed to examine the time to return to activities of daily living (ADL) after TSS for pituitary tumors. A 4-month prospective data collection was completed for 114 of 117 patients who underwent TSS for pituitary tumors from April to July 2021. The time when the patient returned to ADL after surgery was measured using the self-recording sheet. More than 97% and 92% of the patients returned within 1 month (median: within 7 days) for the elements of basic ADL and within 2 months (median: within 15 days) for the elements of instrumental ADL, excluding a few. Notably, 73.3% of patients returned to work within 4 months. The median time for the activities included 64 days for washing hair head down, 44 days for blowing nose, 59 days for lifting heavy objects, and 102 days for sexual activity. For patients who received extended-TSS or had postoperative problems, the time to return was delayed. Based on these results, it will be possible to provide practical information and guidelines on the time to return to ADL after TSS in pituitary tumor patients.