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Background: Voice disorders in occupations connected with excessive voice use can be attributed to the inappropriate use of voice and poor vocal hygiene. Therefore, it is essential for persons in such occupations to be aware of vocal abuse, vocal hygiene, practices and their influence on maintaining healthy voice. Objectives: To assess knowledge, attitude and practice on vocal abuse and vocal hygiene among diverse occupational voice users in Jodhpur. Methodology: A cross-sectional study was conducted in Jodhpur district, Rajasthan. Data was collected from 424 participants (106 Doctors, 106 Teachers, 106 Advocates, 106 Vendors) from May 2023 to July 2023 by administrating a pretested semi structured questionnaire. Microsoft Excel and IBM SPSS (V. 23) statistical software were used for descriptive and inferential statistical analysis. Results: Majority (92%) of the participants felt that their quality of voice was good. About 55% participants were not aware about the term vocal abuse (Doctors 17.9%, Teachers 39.6%, Advocates 79.2%, Vendors 44.3%). Around 56% participants (Doctors 63.3%, Teachers 66.0%, Advocates 32.1%, Vendors 61%) had negative attitude towards vocal hygiene practices. About 47% of the participants preferred home remedies and 44.3% (Doctors 72.6%, Teachers 48.1%, Advocates 41.5%, Vendors 15.1%) preferred to consult ENT specialist for their voice related problem. Perception of vocal abuse on vocal health and hygiene practices was found to statistically significant (p = 0.001) among the different category of occupations. Conclusion: In this perception-based, cross-sectional study it was found that majority of the participants were neither aware about term vocal abuse nor followed vocal hygiene practices. In view of the above findings it is strongly recommended that excessive voice users should be made aware of vocal hygiene practices & repeated reinforcement of the same is required to prevent voice related problem.
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Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19, this study was designed to assess the QOL in patients with and its predictability for survival in CAM victims. This long term prospective observational study of 290 patients with CAM was conducted over 2 years using a standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]), Karnofsky performance scale (KPS), palliative performance scale (PPS) and patient rated improvement (PRI) ranging from 0 to 9. Cut-off values of ≤ median score was considered to indicate poor QOL or poor improvement. The overall 2 year survival rate was 78.27% with mean survival time of 763.2 ± 1.2 days (Mean ± S.E) (95% CI: 760.76-765.6). The disease specific mortality was 22.1%. The overall mean QOL was 53.5(10.2) with 51% of population exhibiting poor QOL. Spearman rho correlation showed strong positive correlation between the three QOL scales and PRI (ρ-0.72, p < 0.001). On Cox regression analysis the stage, all four domains of WHO BREF, KPS, and PPS were independent predictors of long term survival in CAM patients. Approximately half of the patients with CAM had poor QOL and poor improvement. All 4 domains of WHO BREF score can be used as a predictor of long term survival in CAM patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.
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BACKGROUND AND AIM: Coronavirus disease 2019 (COVID-19) led to a major global health crisis, leading to a worldwide pandemic. Several therapeutic interventions have been tried with varied results. The purpose of this academic work was to assess the efficacy of immunoglobulin M (IgM)-enriched Ig in the management of patients with severe COVID-19 pneumonia. MATERIALS AND METHODS: In this retrospective cohort study, severe COVID-19 pneumonia patients who received IgM-enriched immunoglobulin, in addition to standard-of-care treatment, were retrospectively enrolled. Levels of inflammatory biomarkers, oxygenation status, and organ dysfunction were evaluated, and differences were noted after giving IgM-supplemented IgM. RESULTS: Data from 32 consecutive severe COVID-19 patients admitted to medical intensive care units (ICUs) were analyzed. After giving IgM-enriched Ig, there was an improvement in oxygenation indices as shown by saturation of oxygen/fraction of inspired oxygen (SpO2/FiO2) on days 3 and 7, but it was not statistically significant. Oxygen support could be de-escalated in 13 (40.6%) patients on day 3 and in 8 (25%) patients on day 7, after giving IgM-enriched Ig. After giving IgM-enriched Ig, there was a reduction in the levels of all the studied inflammatory markers [interleukin-6 (IL-6), D-dimer, and ferritin) on days 3 and 7, but it was statistically significant only for IL-6. The overall ICU mortality was 53.1%. CONCLUSION: Outcomes of patients with severe COVID-19 requiring ICU care remain dismal. IgM-enriched Ig may be helpful in improving oxygenation and combating cytokine storm in these patients. However, in the present study, the improvement in oxygenation indices (SpO2/FiO2) and reduction in inflammatory markers like D-dimer and ferritin were not statistically significant. Hence, larger randomized controlled trials are required to get more definitive evidence to support this therapy and show significant clinical and mortality benefits.
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COVID-19 , Inmunoglobulina M , Humanos , COVID-19/terapia , COVID-19/inmunología , Estudios Retrospectivos , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Femenino , Resultado del Tratamiento , Adulto , Anciano , SARS-CoV-2 , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Unidades de Cuidados Intensivos , Ferritinas/sangre , Interleucina-6/sangreRESUMEN
Objective: To perform a retrospective, multicenter, external validation of the Cleveland Clinic malignancy probability prediction model for incidental pulmonary nodules. Patients and Methods: From July 1, 2022, to May 31, 2023, we identified 296 patients who underwent tissue acquisition at Mayo Clinic (MC) (n=198) and Loyola University Medical Center (n=98) with histopathology indicating malignant (n=195) or benign (n=101). Data was collected at initial radiographic identification (point 1) and at the time of intervention (point 2). Point 3 represented the most recent data. The areas under the receiver operating characteristics were calculated for each model per time point. Calibration was evaluated by comparing the predicted and observed rates of malignancy. Results: The areas under the receiver operating characteristics at time points 1, 2, and 3 for the MC model were 0.67 (95% CI, 0.61-0.74), 0.67 (95% CI, 0.58-0.77), and 0.70 (95% CI, 0.63-0.76), respectively. The Cleveland Clinic model (CCM) was 0.68 (95% CI, 0.61-0.74), 0.75 (95% CI, 0.65-0.84), and 0.72 (95% CI, 0.66-0.78), respectively. The mean ± SD estimated probability for malignant pulmonary nodules (PNs) at time points 1, 2, and 3 for the CCM was 64.2±25.9, 65.8±24.0, and 64.7±24.4, which resembled the overall proportion of malignant PNs (66%). The mean estimated probability of malignancy for the MC model at each time point was 38.3±27.4, 36.2±24.4, and 42.1±27.3, substantially lower than the observed proportion of malignancies. Conclusion: The CCM found discrimination similar to its internal validation and good calibration. The CCM can be used to augment clinical and shared decision-making when evaluating high-risk PNs.
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BACKGROUND: Invasive fungal sinusitis, particularly mucormycosis, presents a significant clinical challenge, especially in pediatric populations. This retrospective epidemiologic study aimed to investigate the clinical characteristics, risk factors and outcomes associated with this rare but severe condition, with a focus on orbital morbidity. METHODS: Clinical data of 12 pediatric patients diagnosed with invasive fungal sinusitis between 2021 and 2023 were retrospectively analyzed. Diagnosis involved microbiological and histopathologic examinations, alongside radiologic imaging. Treatment comprised surgical intervention and antifungal therapy, with a detailed evaluation of orbital involvement. Statistical analysis included descriptive statistics and logistic regression. RESULTS: Predominantly affecting males, the median age of the patients was 8 years. Common symptoms included orbital swelling and impaired vision. Imaging revealed characteristic features of invasive fungal sinusitis, including fat stranding and bone erosions. Orbital involvement was extensive, with poor visual outcomes observed in several cases. Surgical debridement and antifungal therapy, including transcutaneous retrobulbar Amphotericin B, were administered. Risk factors associated with poor orbital outcomes included duration of diabetes and glycated hemoglobin levels. Mortality rate stood at 22.2%. CONCLUSIONS: Early diagnosis, aggressive surgical intervention and combined antifungal therapy are essential for improving outcomes. Timely intervention showed stabilization of the orbital disease and better outcomes in pediatric patients. Further research with larger sample sizes is warranted to better understand and address this serious condition.
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Algoritmos , Antifúngicos , Sinusitis , Humanos , Masculino , Niño , Femenino , Estudios Retrospectivos , Sinusitis/microbiología , Sinusitis/epidemiología , Sinusitis/cirugía , Sinusitis/tratamiento farmacológico , Antifúngicos/uso terapéutico , Preescolar , Factores de Riesgo , Adolescente , Infecciones Fúngicas Invasoras/tratamiento farmacológico , Infecciones Fúngicas Invasoras/epidemiología , Infecciones Fúngicas Invasoras/mortalidad , Infecciones Fúngicas Invasoras/microbiología , Infecciones Fúngicas Invasoras/diagnóstico , Desbridamiento , Resultado del Tratamiento , Mucormicosis/epidemiología , Mucormicosis/tratamiento farmacológico , Mucormicosis/mortalidad , Mucormicosis/diagnóstico , Enfermedades Orbitales/microbiología , Enfermedades Orbitales/epidemiología , Enfermedades Orbitales/terapia , LactanteRESUMEN
OBJECTIVE: This study aims to discern the disparities in the electrode-to-modiolus distance (EMD) between cochleostomy and round window approaches when performed sequentially in the same temporal bone. Additionally, the study seeks to identify the cochlear metrics that contribute to these differences. METHODOLOGY: A cross-sectional study was conducted, involving the sequential insertion of a 12-electrode array through both round window and cochleostomy approaches in cadaveric temporal bones. Postimplantation high-resolution CT scans were employed to calculate various parameters. RESULTS: A total of 12 temporal bones were included in the imaging analysis, revealing a mean cochlear duct length of 32.892 mm. The EMD demonstrated a gradual increase from electrode 1 (C1) in the apex (1.9 ± 0.07 mm; n = 24) to electrode 12 (C12) in the basal turn (4.6 ± 0.24 mm; n = 12; p < 0.01). Significantly higher EMD values were observed in the cochleostomy group. Correlation analysis indicated a strong positive correlation between EMD and cochlear perimeter (CP) (rs = 0.64; n = 12; p = 0.03) and a strong negative correlation with the depth of insertion (DOI) in both the middle and basal turns (rs = - 0.78; n = 20; p < 0.01). Additionally, EMD showed a strong negative correlation with the DOI-CP ratio (rs = -0.81; n = 12; p < 0.01). CONCLUSION: The cochleostomy group exhibited a significantly higher EMD compared with the round window group. The strong negative correlation between EMD and DOI-CP ratio suggests that in larger cochleae with shallower insertions, EMD is greater than in smaller cochleae with deeper insertions. LEVEL OF EVIDENCE: N/A Laryngoscope, 2024.
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Artemisinin and its derivatives have been commonly used to treat malaria. However, the emergence of resistance against artemisinin derivatives has posed a critical challenge in malaria management. In the present study, we have proposed a combinatorial approach, utilizing pH-responsive acetal-dextran nanoparticles (Ac-Dex NPs) as carriers for the delivery of withaferin-A (WS-3) and artesunate (Art) to improve treatment efficacy of malaria. The optimized WS-3 and Art Ac-Dex NPs demonstrated enhanced pH-responsive release profiles under parasitophorous mimetic conditions (pH 5.5). Computational molecular modeling reveals that Ac-Dex's polymeric backbone strongly interacts with merozoite surface protein-1 (MSP-1), preventing erythrocyte invasion. In-vitro antimalarial activity of drug-loaded Ac-Dex NPs reveals a 1-1.5-fold reduction in IC50 values compared to pure drug against the 3D7 strain of Plasmodium falciparum. Treatment with WS-3 Ac-Dex NPs (100 mg/kg) and Art Ac-Dex NPs (30 mg/kg) to Plasmodium berghei-infected mice resulted in 78.11 % and 100 % inhibition of parasitemia. Notably, the combination therapy comprised of Art and WS-3 Ac-Dex NPs achieved complete inhibition of parasitemia even at a half dose of Art, indicating the synergistic potential of the combinations. However, further investigations are necessary to confirm the safety and effectiveness of WS-3 and Art Ac-Dex NPs for their successful clinical implications.
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Antimaláricos , Artesunato , Dextranos , Malaria , Nanopartículas , Witanólidos , Artesunato/química , Artesunato/farmacología , Artesunato/uso terapéutico , Nanopartículas/química , Animales , Antimaláricos/química , Antimaláricos/farmacología , Antimaláricos/uso terapéutico , Concentración de Iones de Hidrógeno , Ratones , Dextranos/química , Malaria/tratamiento farmacológico , Witanólidos/química , Witanólidos/farmacología , Portadores de Fármacos/química , Plasmodium berghei/efectos de los fármacos , Plasmodium falciparum/efectos de los fármacos , Artemisininas/farmacología , Artemisininas/química , Liberación de Fármacos , Polímeros/químicaAsunto(s)
Estenosis de la Válvula Aórtica , Válvula Aórtica , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Estenosis de la Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Estenosis de la Válvula Aórtica/fisiopatología , Válvula Aórtica/cirugía , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/fisiopatología , Resultado del Tratamiento , Prótesis Valvulares Cardíacas , Factores de RiesgoRESUMEN
This study presents a novel method leveraging surface wave-assisted photonic spin Hall effect (PSHE) to construct physical unclonable functions (PUFs). PUFs exploit inherent physical variations to generate unique Challenge-Response pairs, which are critical for hardware security and arise from manufacturing discrepancies, device characteristics, or timing deviations. We explore PSHE generation-based PUF design, expanding existing design possibilities. With recent applications in precise sensing and computing, PSHE offers promising performance metrics for our proposed PUFs, including an inter-Hamming distance of 47.50% , an average proportion of unique responses of 62.5% , and a Pearson correlation coefficient of - 0.198. The PUF token demonstrates robustness to simulated noise. Additionally, we evaluate security using a machine learning-based attack model, employing a multi-layer perceptron (MLP) regression model with a randomized search method. The average accuracy of successful attack prediction is 9.70% for the selected dataset. Our novel PUF token exhibits high non-linearity due to the PSHE effect, resilience to MLP-based attacks, and sensitivity to process variation.
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This article investigates the performance of a contact-mode Triboelectric Nanogenerator (TENG) utilizing polydimethylsiloxane (PDMS) with nano gratings as a dielectric in a metal-dielectric configuration. The evaluation encompasses the impact of gratings, tapping frequency, various load conditions, and contact area on the TENG performance. The fabrication involves spin-coating PDMS onto a master mold to create the device. Experimental measurements reveal a significant enhancement of 97% in open-circuit voltage by introducing gratings on PDMS. Furthermore, as the tapping frequency increases from 1 Hz to 3 Hz, there is a corresponding rise of 108% in output voltage. The influence of load resistance on TENG output performance demonstrates its ability to drive different loads efficiently. Moreover, enlarging the contact area of the device substantially increases the open-circuit voltage. A device with a 400 mm2 contact area can generate a voltage of 80 V at a low frequency of 3 Hz, indicating the importance of considering device size and contact area for specific applications. A practical circuit integrating a TENG with a full-wave bridge rectifier demonstrates energy harvesting capabilities by successfully illuminating a light-emitting diode (LED) and charging various capacitors. The fabricated devices exhibit better performance along with a cost-effective and easy fabrication process.
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Recent advances in semiconductor based electronic devices can be attributed to the technological demands of ever increasing, application specific markets. These rapidly evolving markets for devices such as displays, wireless communication, photovoltaics, medical devices, etc. are demanding electronic devices that are increasingly thinner, smaller, lighter and flexible. High-quality, III-V epitaxial thin-films deposited on single-crystal substrates have yielded extremely high-performance, but are extremely expensive and rigid. Here we demonstrate heteroepitaxial deposition of GaAs thin-films on large-grained, single-crystal-like, biaxially-aligned, flexible, metallic substrates. We use molecular beam epitaxy (MBE) for the controlled growth of high quality GaAs layers on lattice matched Ge capped, flexible metal substrates. The structural, optical, interfacial and electrical characteristics and properties of the heteroepitaxial GaAs layers are analyzed and discussed. The results show that heteroepitaxial GaAs layers with good crystalline and optoelectronic properties can be realized for flexible, III-V based semiconductor devices. III-V materials integrated on large-grained, single-crystal-like, flexible, metallic substrates offer a potential route towards fabrication of large-area, high-performance electronic devices.
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BACKGROUND: Evaluation of axillary lymph nodes status in cN0 axilla is performed by sentinel lymph node biopsy (SLNB) utilizing a combination of radioactive isotope and blue dye or alternative to isotope like Indocyanine green (ICG). Both are very resource-intensive; which has prompted development of low-cost technique of Fluorescein Sodium (FS)-guided SLNB. This systematic review and meta-analysis evaluate the diagnostic performance of FS-guided SLNB in early breast cancer. OBJECTIVES: The objective was to evaluate the diagnostic performance of FS for sentinel lymph node biopsy. METHODS: Eligibility criteria: Studies where SLNB was performed using FS. INFORMATION SOURCES: PubMed, EMBASE, Cochrane library and online clinical trial registers. Risk of bias: Articles were assessed for risk of bias using the QUADAS-2 tool. SYNTHESIS OF RESULTS: The main summary measures were pooled Sentinel Lymph Node Identification Rate (SLN-IR) and pooled False Negative Rate (FNR) using random-effects model. RESULTS: A total of 45 articles were retrieved by the initial systematic search. 7 out of the 45 studies comprising a total of 332 patients were included in the meta-analysis. The pooled SLN-IR was 93.2% (95% confidence interval [CI], 0.87-0.97; 87% to 97%). Five validation studies were included for pooling the false negative rate and included a total of 211 patients. The pooled FNR was 5.6% (95% confidence interval [CI], 2.9-9.07). CONCLUSION: Fluorescein-guided SLNB is a viable option for detection of lymph node metastases in clinically node negative patients with early breast cancer. It achieves a high pooled Sentinel Lymph Node Identification Rate (SLN-IR) of 93% with a false negative rate of 5.6% for the detection of axillary lymph node metastasis.
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Neoplasias de la Mama , Fluoresceína , Metástasis Linfática , Biopsia del Ganglio Linfático Centinela , Humanos , Biopsia del Ganglio Linfático Centinela/métodos , Neoplasias de la Mama/patología , Neoplasias de la Mama/diagnóstico , Femenino , Metástasis Linfática/diagnóstico , Metástasis Linfática/patología , Ganglio Linfático Centinela/patología , Axila , Biopsia Guiada por Imagen/métodosRESUMEN
In this manuscript, what we believe to be a novel hyperbolic-graded topological nano-photonic resonator structure is proposed to excite robust topological edge states. The graded refractive index is realized by considering a porous silicon material having a deliberately modulated local refractive index. The introduction of grading effectively modifies its dispersion characteristics leading to distinctive topological properties. This results in excitation of a topologically protected edge state (TES) having significantly higher interface electric field intensity at an operational wavelength of 1521â nm. Additionally, the impact of interface layer thicknesses on the excitation of these TES is thoroughly investigated. Finally, the structure's capability to be used as a refractive index sensor is also demonstrated. The analytical results demonstrate an average sensitivity of 852.14â nm/RIU, coupled with a quality factor of 4019.23 and a figure of merit (FOM) of 1277.13 RIU-1. With its remarkable performance metrics, the proposed device holds significant promise for accurately detecting and sensing biochemical samples with very high efficiency.
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BACKGROUND: Pain is a significant global public health concern, particularly among individuals aged 45 and above. Its impact on the overall lifestyle of the individuals varies depending on the affected anatomical parts. Despite its widespread impact, there is limited awareness of the attributes of pain, making effective pain management challenging, particularly in India. This study aims to estimate the prevalence and variation in pain in different anatomical sites among middle-aged and older adults in India. METHODS: A cross-sectional design was employed, utilising data from the first wave of the Longitudinal Aging Study in India (LASI), 2017-2018. The age-sex adjusted prevalence of pain by anatomical sites (the back, joints, and ankles) was estimated using a multivariate logistic regression model. RESULTS: 47% of individuals aged 45 years and above reported joint pain, 31% reported back pain and 20% suffered from ankle or foot pain. The prevalence of pain at all the anatomical sites increased with age and was reported higher among females. Relative to respondents aged 45-59 years, those aged 75 years and older exhibited a 41% higher likelihood of experiencing back pain (AOR: 1.41, 95% CI: 1.19-1.67), a 67% higher likelihood of joint pain (AOR: 1.67, 95% CI: 1.49-1.89), and a 32% higher likelihood of ankle/foot pain (AOR: 1.32, 95% CI: 1.16-1.50). In comparison to males, females had a 56% higher likelihood of encountering back pain (AOR: 1.56, 95% CI: 1.40-1.74), a 38% higher likelihood of joint pain (AOR: 1.38, 95% CI: 1.27-1.50), and a 35% higher likelihood of ankle/foot pain (AOR: 1.35, 95% CI: 1.17-1.57). We also found significant regional variations in pain prevalence, with higher rates in the mountainous regions of India. CONCLUSION: This research highlights the high burden of pain in major anatomical sites among middle-aged and older adults in India and emphasises the need for increased awareness and effective pain management strategies.
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Artralgia , Dolor de Espalda , Masculino , Femenino , Humanos , Persona de Mediana Edad , Anciano , Prevalencia , Estudios Transversales , Artralgia/diagnóstico , Artralgia/epidemiología , Factores Socioeconómicos , India/epidemiologíaRESUMEN
Objective: To review new drugs and devices relevant to otolaryngology approved by the Food and Drug Administration (FDA) in 2022. Data Sources: Publicly available FDA data on drugs and devices approved in 2022. Review Methods: A preliminary screen was conducted to identify drugs and devices relevant to otolaryngology. A secondary screen by members of the American Academy of Otolaryngology-Head and Neck Surgery's (AAO-HNS) Medical Devices and Drugs Committee differentiated between minor updates and new approvals. The final list of drugs and devices was sent to members of each subspecialty for review and analysis. Conclusion: A total of 1251 devices and 37 drugs were identified on preliminary screening. Of these, 329 devices and 5 drugs were sent to subspecialists for further review, from which 37 devices and 2 novel drugs were selected for further analysis. The newly approved devices spanned all subspecialties within otolaryngology. Many of the newly approved devices aimed to enhance patient experience, including over-the-counter hearing aids, sleep monitoring devices, and refined CPAP devices. Other advances aimed to improve surgical access, convenience, or comfort in the operating room and clinic. Implications for Practice: Many new devices and drugs are approved each year to improve patient care and care delivery. By staying up to date with these advances, otolaryngologists can leverage new innovations to improve the safety and quality of care. Given the recent approval of these devices, further studies are needed to assess long-term impact within the field of otolaryngology.
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INTRODUCTION: Round window approach and cochleostomy approach can have different depth of electrode insertion during cochlear implantation which itself can alter the audiological outcomes in cochlear implant. OBJECTIVE: The current study was conducted to determine the difference in the depth of electrode insertion via cochleostomy and round widow approach when done serially in same temporal bone. METHODOLOGY: This is a cross-sectional study conducted in the Department of Otorhinolaryngology in conjunction with Department of Anatomy and Department of Diagnostic and Interventional Radiology over a period of 1 year. 12-electrode array insertion was performed via either approach (cochleostomy or round window) in the cadaveric temporal bone. HRCT temporal bone scan of the implanted temporal bone was done and depth of insertion and various cochlear parameters were calculated. RESULT: A total of 12 temporal bones were included for imaging analysis. The mean cochlear duct length was 32.892 mm; the alpha and beta angles were 58.175° and 8.350°, respectively. The mean angular depth of electrode insertion via round window was found to be 325.2° (SD = 150.5842) and via cochleostomy 327.350 (SD = 112.79) degree and the mean linear depth of electrode insertion via round window was found to be 18.80 (SD = 4.4962) mm via cochleostomy 19.650 (SD = 3.8087) mm, which was calculated using OTOPLAN 1.5.0 software. There was a statically significant difference in linear depth of insertion between round window and cochleostomy. Although the angular depth of insertion was higher in CS group, there was no statistically significant difference with round window type of insertion. CONCLUSION: The depth of electrode insertion is one of the parameters that influences the hearing outcome. Linear depth of electrode insertion was found to be more in case of cochleostomy compared to round window approach (p = 0.075) and difference in case of angular depth of electrode insertion existed but not significant (p = 0.529).
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Cadáver , Cóclea , Implantación Coclear , Implantes Cocleares , Ventana Redonda , Hueso Temporal , Humanos , Ventana Redonda/cirugía , Implantación Coclear/métodos , Hueso Temporal/cirugía , Hueso Temporal/diagnóstico por imagen , Estudios Transversales , Cóclea/cirugía , Cóclea/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Electrodos ImplantadosRESUMEN
This work presents a dielectric material-based optical Tamm state (OTS) excitation technique with modified dispersion characteristics for photonic spin hall effect (PSHE) enhancement. The dispersion analysis of the structure is carried out to validate OTS's localization and corresponding PSHE generation for a given polarization at 632.8 nm incident wavelength. The exceptional points are optimized by considering thickness-dependent angular dispersion analysis. PSHE-based transverse displacement (PSHE-TD) is dependent on the defect layer thickness. The optimized structure provides 10.73 [Formula: see text] (or 6.78 [Formula: see text]m) PSHE-TD at an incidence angle of 41.86[Formula: see text]. The PSHE-TD of the optimized structure is sufficiently high due to the much narrower resonance than the plasmonic-based structures. Further, the structure's potential to function as a PSHE-TD-based optical sensor is assessed. The optimized structure shows an analytical average sensitivity of about 43,789 [Formula: see text]m/RIU showing its capability to detect the analytes with refractive index variations in the [Formula: see text] range. The structure demonstrates a three-time sensitivity improvement compared to similar resonance designs. Considering only dielectric materials in the proposed structure and considerably enhanced PSHE-TD, the development of highly efficient PSHE-TD-assisted commercial structures is anticipated.
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This study aimed to investigate the risk factors associated with intracranial involvement in COVID-19-associated mucormycosis (CAM) and to develop a nomogram model for predicting the risk of intracranial involvement, with a specific focus on perineural spread. An ambispective analysis was conducted on 275 CAM patients who received comprehensive treatment. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors, and a nomogram was created based on the results of the multivariable analysis. The performance of the nomogram was evaluated using a receiver operating characteristic (ROC) curve, and the discriminatory capacity was assessed using the area under the curve (AUC). The model's calibration was assessed through a calibration curve and the Hosmer Lemeshow test. In the results, the multivariable logistic regression analysis revealed that age (OR: 1.23, 95% CI 1.06-3.79), HbA1c (OR: 7.168, 95% CI 1.724-25.788), perineural spread (OR: 6.3, 95% CI 1.281-19.874), and the disease stage were independent risk factors for intracranial involvement in CAM. The developed nomogram demonstrated good discriminative capacity with an AUC of 0.821 (95% CI 0.713-0.909) as indicated by the ROC curve. The calibration curve showed that the nomogram was well-calibrated, and the Hosmer Lemeshow test yielded a P-value of 0.992, indicating a good fit for the model. In conclusion, this study found that CAM particularly exhibits perineural spread, which is a predictive factor for intracranial involvement. A nomogram model incorporating age, HbA1c, disease stage, and perineural spread was successfully developed for predicting intracranial involvement in CAM patients in both in-patient and out-patient settings.
Discovery of perineural spread in COVID-19-associated mucormycosis reveals a new predictive model for intracranial complications which is crucial for early intervention.
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COVID-19 , Mucormicosis , Humanos , Mucormicosis/epidemiología , Mucormicosis/veterinaria , Hemoglobina Glucada , COVID-19/veterinaria , Curva ROC , Factores de Riesgo , Estudios RetrospectivosRESUMEN
The continuous emergence of resistance against most frontline antimalarial drugs has led to countless deaths in malaria-endemic countries, counting 619,000 deaths in 2021, with mutation in drug targets being the sole cause. As mutation is correlated frequently with fitness cost, the likelihood of mutation emergence in multiple targets at a time is extremely low. Hence, multitargeting compounds may seem promising to address drug resistance issues with additional benefits like increased efficacy, improved safety profile, and the requirement of fewer pills compared to traditional single and combinational drugs. In this study, we attempted to use the High Throughput Virtual Screening approach to predict multitarget inhibitors against six chemically validated Plasmodium falciparum (Pf) kinases (PfPKG, PfMAP2, PfCDPK4, PfTMK, PfPK5, PfPI4K), resulting in 21 multitargeting hits. The molecular dynamic simulation of the top six complexes (Myricetin-MAP2, Quercetin-CDPK4, Myricetin-TMK, Quercetin-PKG, Salidroside-PK5, and Salidroside-PI4K) showed stable interactions. Moreover, hierarchical clustering reveals the structural divergence of the compounds from the existing antimalarials, indicating less chance of cross-resistance. Additionally, the top three hits were validated through parasite growth inhibition assays, with quercetin and myricetin exhibiting an IC50 value of 1.84 and 3.93 µM, respectively.
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Ameloblastoma is the most common aggressive benign odontogenic tumour of the jaws. Ameloblastoma is a benign epithelial odontogenic tumour that typically arises in the mandible or maxilla. A clinical, radiographic and histopathological report is presented of a case of giant acanthomatous ameloblastoma in the left hemi mandible of a 46-year-old healthy lady. The histopathological examination of the removed specimen revealed the histopathological pattern of an acanthomatous ameloblastoma. The radiographic appearance of the lesion showed the presence of multilocular radiolucencies, which were crossing the midline, which is rarely found in ameloblastoma. Due to its rarity and lack of data, we take this opportunity to present a case of advanced acanthomatous ameloblastoma and its surgical challenges.