Background: Brainwave entrainment using binaural beats has shown potential in treating tinnitus, but most studies have focused on one-month treatment durations. Objective: This study aimed to evaluate the time-bound e...Background: Brainwave entrainment using binaural beats has shown potential in treating tinnitus, but most studies have focused on one-month treatment durations. Objective: This study aimed to evaluate the time-bound efficacy of brainwave entrainment using binaural beats, comparing it to a standard tinnitus masker over a three-month duration. Method: Sixty-three individuals having tinnitus with normal hearing sensitivity were enrolled in the study. The participants were categorized into groups Ⅰ, Ⅱ, and Ⅲ. They were provided with delta(4 Hz) and alpha(10 Hz) frequency binaural beats and standard tinnitus masker, respectively, for a duration of three months. The tinnitus handicap inventory(THI) scores, Visual analogue scale(VAS) rating for tinnitus distress, and quality of life parameters were measured. The reductions obtained for each measure during the end of the first, second and third month were measured and compared across the groups. Results: All three groups showed considerable reductions in THI and VAS scores and improvements in the quality of life domains, focusing on physical and psychological health. However, groups Ⅰ and Ⅱ, who received binaural beats stimuli, showed higher benefits than those who received standard tinnitus masker. Conclusion: The results of the current study indicated that binaural beats can be an effective treatment technique for individuals with tinnitus having normal hearing sensitivity. Clinicians and otology/audiology practitioners shall adopt this innovative treatment after further validating these findings.展开更多
Clinical inertia(CI)is common in clinical practice.Sexual health issues are common in society,and CI is ubiquitous in sexual medicine practice.CI influences all aspects of healthcare,including prevention,diagnosis,and...Clinical inertia(CI)is common in clinical practice.Sexual health issues are common in society,and CI is ubiquitous in sexual medicine practice.CI influences all aspects of healthcare,including prevention,diagnosis,and treatment.In this short review,we briefly describe the various aspects of CI in sexual medicine practice and ways to tackle them.展开更多
Chronic suppurative otitis media(CSOM)is a prevalent condition in otolaryngology with significant medical and social implications,including hearing loss and severe intracranial complications.This article discusses the...Chronic suppurative otitis media(CSOM)is a prevalent condition in otolaryngology with significant medical and social implications,including hearing loss and severe intracranial complications.This article discusses the challenges in diagnosing cholesteatoma,a common complication of CSOM,particularly when using computed tomography(CT)and magnetic resonance imaging(MRI).We present three clinical cases where MRI,particularly in the non-EPI diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)modes,effectively identified the presence and extent of cholesteatoma that CT could not reliably distinguish due to overlapping features with other soft tissue formations.The high sensitivity of MRI,highlight its value in both primary diagnosis and assessment of recurrence.Our findings advocate for the incorporation of MRI into the diagnostic protocols for CSOM in the Republic of Kazakhstan,emphasizing the need for reliable epidemiological data to inform future research and prevent potential intracranial complications.展开更多
BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing li...BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.展开更多
The integration of academic research methodologies into design thinking processes presents a transformative approach to addressing complex challenges in group housing,fostering inclusive,sustainable,and user-centered ...The integration of academic research methodologies into design thinking processes presents a transformative approach to addressing complex challenges in group housing,fostering inclusive,sustainable,and user-centered solutions.This research explores how methodologies such as Participatory Action Research,post-occupancy evaluations,and Research through Design can be systematically embedded within design thinking to bridge the gap between academic rigor and empathy-driven,iterative design practices.By synthesizing these paradigms,the study proposes a framework for group housing design that prioritizes co-design processes,empathy-based data collection,and participatory evaluation,while emphasizing adaptability through sociocultural insights and user feedback.Case studies analysis demonstrate the effectiveness of flexible,community-driven design,while emerging technologies like IoT-enabled cohousing signal new opportunities for innovation.Challenges,including scalability,long-term validation,and reconciling user autonomy with professional expertise,are critically analyzed.Ultimately,this research advances a hybrid methodology to redefine the conceptualization,implementation,and assessment of group housing,offering actionable pathways to achieve affordable,inclusive,and context-sensitive housing solutions.展开更多
Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of t...Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.展开更多
Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with id...Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with idiopathic oligoasthenozoospermia were examined.The first group(n=125)received 100 mg/day of CoQ10 and the second group(n=125)received 200 mg/day of CoQ10 orally for 6 months.Semen parameters,DNA fragmentation index(DFI)and the partner pregnancy rate were analyzed at baseline and after 6 months of treatment.Results:Comparing with baseline data,treatment with CoQ10(100 mg/day or 200 mg/day)resulted in a significant increase in sperm concentration(both P<0.001),a significant improvement in progressive motility and total motile sperm count(P=0.05,P=0.001,respectively).The mean DFI was significantly improved after treatment with CoQ10 at 100 mg/day and at 200 mg/day,after 6 months of treatment(P<0.01).Moreover,CoQ10 significantly improved the partner pregnancy rate.A strongest correlation was found between seminal fluid parameters and DFI(P<0.001).Conclusions:CoQ10 is effective in improving semen parameters,DFI and on the partner pregnancy rate after 6 months with CoQ10 at two doses,with a greater improvement shown in men who took 200 mg/day than in those who took 100 mg/day.展开更多
The integration of artificial intelligence(AI)and multiomics has transformed clinical and life sciences,enabling precision medicine and redefining disease understanding.Scientific publications grew significantly from ...The integration of artificial intelligence(AI)and multiomics has transformed clinical and life sciences,enabling precision medicine and redefining disease understanding.Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022,with AI research tripling during this period.Multiomics fields,including genomics and proteomics,also advanced,exemplified by the Human Proteome Project achieving a 90%complete blueprint by 2021.This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting.A review of studies and case reports was conducted to evaluate AI and multiomics integration.Key areas analyzed included diagnostic accuracy,predictive modeling,and personalized treatment approaches driven by AI tools.Case examples were studied to assess impacts on clinical decision-making.AI and multiomics enhanced data integration,predictive insights,and treatment personalization.Fields like radiomics,genomics,and proteomics improved diagnostics and guided therapy.For instance,the“AI radiomics,geno-mics,oncopathomics,and surgomics project”combined radiomics and genomics for surgical decision-making,enabling preoperative,intraoperative,and post-operative interventions.AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data.AI and multiomics enable standardized data analysis,dynamic updates,and predictive modeling in case reports.Traditional reports often lack objectivity,but AI enhances reproducibility and decision-making by processing large datasets.Challenges include data standardization,biases,and ethical concerns.Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine.AI and multiomics integration is revolutionizing clinical research and practice.Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential.Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.展开更多
BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in iden...BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.展开更多
Hepatic arterial infusion(HAI)chemotherapy,first introduced in the 1980s,has gained recognition as an effective locoregional treatment for colorectal liver metastasis(CRLM).Initially used for unresectable liver metast...Hepatic arterial infusion(HAI)chemotherapy,first introduced in the 1980s,has gained recognition as an effective locoregional treatment for colorectal liver metastasis(CRLM).Initially used for unresectable liver metastases,HAI’s app-lication has expanded to the adjuvant setting following hepatic resection,with early studies indicating improved hepatic disease-free survival.Recent research demonstrates that combining HAI with modern systemic therapies enhances conversion to resectability and prolongs both recurrence-free and overall survival,even in heavily pretreated patients with diverse RAS mutational statuses.Person-alization through approaches like microsatellite instability status and dose mo-difications further optimize outcomes.However,the complexity of HAI requires expertise across multidisciplinary teams,limiting its widespread adoption to specialized centers.Ongoing clinical trials continue to investigate HAI’s role in CRLM management,highlighting its potential to become a cornerstone of liver-directed therapy.We explore how HAI chemotherapy,in combination with personalized medicine,can advance treatment strategies for metastatic colorectal cancer.展开更多
Anastomotic leakage(AL)is a significant complication following rectal cancer surgery,adversely affecting both quality of life and oncological outcomes.Recent advancements in artificial intelligence(AI),particularly ma...Anastomotic leakage(AL)is a significant complication following rectal cancer surgery,adversely affecting both quality of life and oncological outcomes.Recent advancements in artificial intelligence(AI),particularly machine learning and deep learning,offer promising avenues for predicting and preventing AL.These technologies can analyze extensive clinical datasets to identify preoperative and perioperative risk factors such as malnutrition,body composition,and radiological features.AI-based models have demonstrated superior predictive power compared to traditional statistical methods,potentially guiding clinical decisionmaking and improving patient outcomes.Additionally,AI can provide surgeons with intraoperative feedback on blood supply and anatomical dissection planes,minimizing the risk of intraoperative complications and reducing the likelihood of AL development.展开更多
Despite advances in surgery,chemotherapy,and radiotherapy,the treatment of colorectal cancer(CRC)requires more personalized approaches based on tumor biology and molecular profiling.While some relevant mutations have ...Despite advances in surgery,chemotherapy,and radiotherapy,the treatment of colorectal cancer(CRC)requires more personalized approaches based on tumor biology and molecular profiling.While some relevant mutations have been associated with differential response to immunotherapy,such as RAS and BRAF mutations limiting response to anti-epithelial growth factor receptor drugs or microsatellite instability predisposing susceptibility to immune checkpoint inhibitors,the role of inflammation in dictating tumor progression and treatment response is still under investigation.Several inflammatory biomarkers have been identified to guide patient prognosis.These include the neutrophil-lymphocyte ratio,Glasgow prognostic score(GPS)and its modified version,lymphocyte-Creactive protein ratio,and platelet-lymphocyte ratio.However,these markers are not yet included in the standard clinical management of patients with CRC,and further research is needed to evaluate their efficacy in different patient populations.A recent study by Wang et al,published in the World Journal of Gastroenterology,sheds light on the prognostic significance of pan-immune-inflammation value(PIV)in CRC,particularly concerning primary tumor location.Specifically,the authors found that a high PIV was strongly correlated with worse disease-free survival in patients with left-sided colon cancer,whereas no such association was observed in patients with right-sided colon cancer.Integrating tumor location into the prognostic assessment of CRC may improve our ability to more accurately identify high-risk patients and develop personalized treatment plans that are more likely to improve patient outcomes.展开更多
Objective Size distribution is an important biophysical property of extracellular vesicles(EVs).EVs include small EVs(s-EVs)and large EVs(l-EVs)by size.Differential ultracentrifugation(dUC)is widely used to separate E...Objective Size distribution is an important biophysical property of extracellular vesicles(EVs).EVs include small EVs(s-EVs)and large EVs(l-EVs)by size.Differential ultracentrifugation(dUC)is widely used to separate EVs from biofluids,but it can precipitate large impurity particles.Dynamic light scattering(DLS)is a simple and fast method for analyzing the size distribution of EVs.However,this approach is nonideal for heterogeneous and polydisperse samples since a small quantity of large impurity particles can markedly disturb the DLS results.Here,we developed a simple method to improve the reliability of DLS measurements.Methods Plasma was obtained from 13 volunteers.The plasma was first processed by dUC to obtain crude l-EVs.The crude l-EVs were filtered with syringe filters(pore size of 1μm and membrane material of hydrophilic polyvinylidene fluoride(PVDF))to remove large impurity particles from l-EVs.The size distributions of the crude l-EVs and filtered l-EVs were measured via DLS.Results After the samples were filtered,the coefficients of variation of the hydrodynamic radius and Peak 1 intensity of the filtered l-EVs decreased from 20.39%(12.76–28.96%)and 20.44%(14.58–28.32%)to 3.05%(1.79–4.72%)and 3.43%(1.76–5.88%),respectively,compared with those of the crude l-EVs.Conclusion These findings suggest that filtration can effectively separate circulating l-EVs in plasma to remove large impurity particles and make samples suitable for characterization by DLS.Our findings provide a simple method to improve precision via DLS to measure the size distribution of EVs.展开更多
In early 2019, Mozambique was struck by two cyclones, Cyclone Idai in Sofala Province and Cyclone Kenneth in Cabo Delgado Province. Outbreaks of cholera were declared soon after both cyclones in Beira and Pemba cities...In early 2019, Mozambique was struck by two cyclones, Cyclone Idai in Sofala Province and Cyclone Kenneth in Cabo Delgado Province. Outbreaks of cholera were declared soon after both cyclones in Beira and Pemba cities. In response to the emergencies and outbreaks, government and humanitarian partners collaborated to create a mobile phone based water quality monitoring program to monitor daily free residual chlorine (FRC) levels in the piped network in both locations and at accommodation centers created for internally displaced persons in Beira. Overall, 87% of the 1080 samples from the piped network in Beira had detectable FRC and at accommodation centers, 73% of the 179 samples collected had detectable FRC. In Pemba, 64% of the 114 total samples collected had detectable FRC. Data from the water quality monitoring programs allowed for the identification of trends that helped increase the effectiveness of the response, including identifying areas where chlorination could be strengthened with the installation of booster chlorinators, issues with the consistency of daily chlorine treatment, and sites where water availability was limited. The water quality monitoring activities were a result of productive collaboration and could be replicated after similar emergencies in cholera endemic areas to prevent and control outbreaks.展开更多
BACKGROUND Although inflammatory diseases commonly affect the pleura and pleural space,their mechanisms of action remain unclear.The presence of several mediators emphasizes the concept of pleural inflammation.Adenosi...BACKGROUND Although inflammatory diseases commonly affect the pleura and pleural space,their mechanisms of action remain unclear.The presence of several mediators emphasizes the concept of pleural inflammation.Adenosine deaminase(ADA)is an inflammatory mediator detected at increased levels in the pleural fluid.AIM To determine the role of total pleural ADA(P-ADA)levels in the diagnosis of pleural inflammatory diseases.METHODS 157 patients with inflammatory pleural effusion(exudates,n=124,79%)and noninflammatory pleural effusion(transudates,n=33,21%)were included in this observational retrospective cohort study.The P-ADA assay was tested using a kinetic technique.The performance of the model was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC).The ideal cutoff value for P-ADA in pleural inflammation was determined using the Youden index in the ROC curve.RESULTS The transudates included congestive heart failure(n=26),cirrhosis of the liver with ascites(n=3),chronic renal failure(n=3),and low total protein levels(n=1).The exudate cases included tuberculosis(n=44),adenocarcinoma(n=37),simple parapneumonic effusions(n=15),complicated parapneumonic effusions/empyema(n=8),lymphoma(n=7),and other diseases(n=13).The optimal cutoff value of P-ADA was≥9.00 U/L.The diagnostic parameters as sensitivity,specificity,positive and negative predictive values,positive and negative likelihood values,odds ratio,and accuracy were 77.69(95%CI:69.22-84.75);68.75(95%CI:49.99-83.88);90.38 and 44.90(95%CI:83.03-95.29;30.67-59.77);2.48 and 0.32(95%CI:2.21-11.2;0.27-0.51);7.65(95%CI:0.78-18.34),and 75.82(95%CI:68.24-82.37),respectively(χ^(2)=29.51,P=0.00001).An AUC value of 0.8107(95%CI:0.7174-0.8754;P=0.0000)was clinically useful.The Hosmer-Lemeshow test showed excellent discrimination.CONCLUSION P-ADA biomarker has high diagnostic performance for pleural inflammatory exudates.展开更多
BACKGROUND Early identification of bowel resection risks is crucial for patients with incarcerated inguinal hernia(IIH).However,the prompt detection of these risks remains a significant challenge.Advancements in radio...BACKGROUND Early identification of bowel resection risks is crucial for patients with incarcerated inguinal hernia(IIH).However,the prompt detection of these risks remains a significant challenge.Advancements in radiomic feature extraction and machine learning algorithms have paved the way for innovative diagnostic approaches to assess IIH more effectively.AIM To devise a sophisticated radiomic-clinical model to evaluate bowel resection risks in IIH patients,thereby enhancing clinical decision-making processes.METHODS This single-center retrospective study analyzed 214 IIH patients randomized into training(n=161)and test(n=53)sets(3:1).Radiologists segmented hernia sac-trapped bowel volumes of interest(VOIs)on computed tomography images.Radiomic features extracted from VOIs generated Rad-scores,which were combined with clinical data to construct a nomogram.The nomogram’s performance was evaluated against standalone clinical and radiomic models in both cohorts.RESULTS A total of 1561 radiomic features were extracted from the VOIs.After dimensionality reduction,13 radiomic features were used with eight machine learning algorithms to develop the radiomic model.The logistic regression algorithm was ultimately selected for its effectiveness,showing an area under the curve(AUC)of 0.828[95%confidence interval(CI):0.753-0.902]in the training set and 0.791(95%CI:0.668-0.915)in the test set.The comprehensive nomogram,incorporating clinical indicators showcased strong predictive capabilities for assessing bowel resection risks in IIH patients,with AUCs of 0.864(95%CI:0.800-0.929)and 0.800(95%CI:0.669-0.931)for the training and test sets,respectively.Decision curve analysis revealed the integrated model’s superior performance over standalone clinical and radiomic approaches.CONCLUSION This innovative radiomic-clinical nomogram has proven to be effective in predicting bowel resection risks in IIH patients and has substantially aided clinical decision-making.展开更多
Background:Exercise induces molecular changes that involve multiple organs and tissues.Moreover,these changes are modulated by various exercise parameters—such as intensity,frequency,mode,and duration—as well as by ...Background:Exercise induces molecular changes that involve multiple organs and tissues.Moreover,these changes are modulated by various exercise parameters—such as intensity,frequency,mode,and duration—as well as by clinical features like gender,age,and body mass index(BMI),each eliciting distinct biological effects.To assist exercise researchers in understanding these changes from a comprehensive perspective that includes multiple organs,diverse exercise regimens,and a range of clinical features,we developed Exercise Regulated Genes Database(ExerGeneDB),a database of exercise-regulated differential genes.Methods:ExerGeneDB aggregated publicly available exercise-related sequencing datasets and subjected them to uniform quality control and preprocessing.The data,encompassing a variety of types,were organized into a specialized database of exercise-regulated genes.Notably,Exer-GeneDB conducted differential analyses on this collected data,leveraging curated clinical information and accounting for important factors such as gender,age,and BMI.Results:ExerGeneDB has assembled 1692 samples from rats and mice as well as 4492 human samples.It contains data from various tissues and organs,such as skeletal muscle,blood,adipose tissue,intestine,heart,liver,spleen,lungs,kidneys,brain,spinal cord,bone marrow,and bones.ExerGeneDB features bulk ribonucleic acid sequencing(RNA-seq)(including non-coding RNA(ncRNA)and protein-coding RNA),microarray(including ncRNA and protein-coding RNA),and single cell RNA-seq data.Conclusion:ExerGeneDB compiles and re-analyzes exercise-related data with a focus on clinical information.This has culminated in the crea-tion of an interactive database for exercise regulation genes.The website for ExerGeneDB can be found at:https://exergenedb.com.展开更多
文摘Background: Brainwave entrainment using binaural beats has shown potential in treating tinnitus, but most studies have focused on one-month treatment durations. Objective: This study aimed to evaluate the time-bound efficacy of brainwave entrainment using binaural beats, comparing it to a standard tinnitus masker over a three-month duration. Method: Sixty-three individuals having tinnitus with normal hearing sensitivity were enrolled in the study. The participants were categorized into groups Ⅰ, Ⅱ, and Ⅲ. They were provided with delta(4 Hz) and alpha(10 Hz) frequency binaural beats and standard tinnitus masker, respectively, for a duration of three months. The tinnitus handicap inventory(THI) scores, Visual analogue scale(VAS) rating for tinnitus distress, and quality of life parameters were measured. The reductions obtained for each measure during the end of the first, second and third month were measured and compared across the groups. Results: All three groups showed considerable reductions in THI and VAS scores and improvements in the quality of life domains, focusing on physical and psychological health. However, groups Ⅰ and Ⅱ, who received binaural beats stimuli, showed higher benefits than those who received standard tinnitus masker. Conclusion: The results of the current study indicated that binaural beats can be an effective treatment technique for individuals with tinnitus having normal hearing sensitivity. Clinicians and otology/audiology practitioners shall adopt this innovative treatment after further validating these findings.
文摘Clinical inertia(CI)is common in clinical practice.Sexual health issues are common in society,and CI is ubiquitous in sexual medicine practice.CI influences all aspects of healthcare,including prevention,diagnosis,and treatment.In this short review,we briefly describe the various aspects of CI in sexual medicine practice and ways to tackle them.
文摘Chronic suppurative otitis media(CSOM)is a prevalent condition in otolaryngology with significant medical and social implications,including hearing loss and severe intracranial complications.This article discusses the challenges in diagnosing cholesteatoma,a common complication of CSOM,particularly when using computed tomography(CT)and magnetic resonance imaging(MRI).We present three clinical cases where MRI,particularly in the non-EPI diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)modes,effectively identified the presence and extent of cholesteatoma that CT could not reliably distinguish due to overlapping features with other soft tissue formations.The high sensitivity of MRI,highlight its value in both primary diagnosis and assessment of recurrence.Our findings advocate for the incorporation of MRI into the diagnostic protocols for CSOM in the Republic of Kazakhstan,emphasizing the need for reliable epidemiological data to inform future research and prevent potential intracranial complications.
文摘BACKGROUND Gastric adenoma is widely acknowledged as a premalignant lesion that can progress to gastric adenocarcinoma.The distinctions among subtypes of gastric adenomas have been infrequently explored in existing literature.AIM To assess the subtype-specific risk factors and outcomes of endoscopic resection(ER)for gastric adenomas.METHODS This is a retrospective cohort study.Among 162 patients who underwent ER for gastric lesions larger than 10 mm between 2017 and 2022,79 patients with gastric adenomas were included.Hyperplastic polyps(n=37)and subepithelial lesions(n=46)were excluded.Logistic regression and survival analyses were conducted.RESULTS The 79 patients(mean age 68.1 years;65%male)had adenoma subtypes:62%intestinal,29%foveolar,8%pyloric,and 1%oxyntic.The mean follow-up was 26 months.Intestinal adenoma was strongly linked to a family history of gastric adenocarcinoma and atrophic gastritis(P<0.001);foveolar adenoma was significantly associated with intestinal metaplasia(P<0.001).Pyloric adenomas had the largest polyp size(P<0.001).Recurrence rates were 8%,17%,and 17%for the respective subtypes(P=0.07),with no significant difference in the meantime to recurrence(P=0.8).Independent predictors of recurrence after ER included a family history of gastric adenocarcinoma,active Helicobacter pylori infection,polyp size≥30 mm,presence of>3 polyps and Paris 0-IIc morphology(P<0.001).CONCLUSION This study identifies distinct risk factor profiles for different subtypes of gastric adenomas and independent recurrence predictors post-ER,underscoring the importance of subtype-specific tailored risk assessment and surveillance strategies.
文摘The integration of academic research methodologies into design thinking processes presents a transformative approach to addressing complex challenges in group housing,fostering inclusive,sustainable,and user-centered solutions.This research explores how methodologies such as Participatory Action Research,post-occupancy evaluations,and Research through Design can be systematically embedded within design thinking to bridge the gap between academic rigor and empathy-driven,iterative design practices.By synthesizing these paradigms,the study proposes a framework for group housing design that prioritizes co-design processes,empathy-based data collection,and participatory evaluation,while emphasizing adaptability through sociocultural insights and user feedback.Case studies analysis demonstrate the effectiveness of flexible,community-driven design,while emerging technologies like IoT-enabled cohousing signal new opportunities for innovation.Challenges,including scalability,long-term validation,and reconciling user autonomy with professional expertise,are critically analyzed.Ultimately,this research advances a hybrid methodology to redefine the conceptualization,implementation,and assessment of group housing,offering actionable pathways to achieve affordable,inclusive,and context-sensitive housing solutions.
文摘Since the early days of assisted reproductive technology(ART),the importance of sperm processing,employed to separate the motile,morphologically normal sperm from the semen,has been shown to be beneficial.The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation.Additionally,the presence of leukocytes,bacteria,and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development.Hence,removal of leukocytes,bacteria,and dead spermatozoa is an important step of sperm processing for assisted reproduction.Currently,several sperm processing techniques have been evolved and optimized in the field of assisted reproduction.The requirements for in vitro fertilization(IVF),intracytoplasmic sperm injection(ICSI),and testicular sperm extraction(TESE)are different than those of intrauterine insemination(IUI).The yield of as many motile,morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure.In ICSI,where injection of a single spermatozoon into the oocyte is performed by the embryologist,sperm selection techniques play a crucial role in the ICSI procedure.Finally,sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing.Additionally,sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.
文摘Objective:To evaluate the effectiveness of two doses of coenzyme Q10(CoQ10)on semen parameters,sperm DNA damage,and the partner pregnancy rate in men with idiopathic oligoasthenozoospermia.Methods:250 patients with idiopathic oligoasthenozoospermia were examined.The first group(n=125)received 100 mg/day of CoQ10 and the second group(n=125)received 200 mg/day of CoQ10 orally for 6 months.Semen parameters,DNA fragmentation index(DFI)and the partner pregnancy rate were analyzed at baseline and after 6 months of treatment.Results:Comparing with baseline data,treatment with CoQ10(100 mg/day or 200 mg/day)resulted in a significant increase in sperm concentration(both P<0.001),a significant improvement in progressive motility and total motile sperm count(P=0.05,P=0.001,respectively).The mean DFI was significantly improved after treatment with CoQ10 at 100 mg/day and at 200 mg/day,after 6 months of treatment(P<0.01).Moreover,CoQ10 significantly improved the partner pregnancy rate.A strongest correlation was found between seminal fluid parameters and DFI(P<0.001).Conclusions:CoQ10 is effective in improving semen parameters,DFI and on the partner pregnancy rate after 6 months with CoQ10 at two doses,with a greater improvement shown in men who took 200 mg/day than in those who took 100 mg/day.
文摘The integration of artificial intelligence(AI)and multiomics has transformed clinical and life sciences,enabling precision medicine and redefining disease understanding.Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022,with AI research tripling during this period.Multiomics fields,including genomics and proteomics,also advanced,exemplified by the Human Proteome Project achieving a 90%complete blueprint by 2021.This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting.A review of studies and case reports was conducted to evaluate AI and multiomics integration.Key areas analyzed included diagnostic accuracy,predictive modeling,and personalized treatment approaches driven by AI tools.Case examples were studied to assess impacts on clinical decision-making.AI and multiomics enhanced data integration,predictive insights,and treatment personalization.Fields like radiomics,genomics,and proteomics improved diagnostics and guided therapy.For instance,the“AI radiomics,geno-mics,oncopathomics,and surgomics project”combined radiomics and genomics for surgical decision-making,enabling preoperative,intraoperative,and post-operative interventions.AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data.AI and multiomics enable standardized data analysis,dynamic updates,and predictive modeling in case reports.Traditional reports often lack objectivity,but AI enhances reproducibility and decision-making by processing large datasets.Challenges include data standardization,biases,and ethical concerns.Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine.AI and multiomics integration is revolutionizing clinical research and practice.Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential.Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.
基金Supported by National Natural Science Foundation of China,No.82271546 and No.82301744The Shanxi Province Science and Technology Innovation Think Tank Construction Research Project,No.KXKT202317+1 种基金Fundamental Research Program of Shanxi Province,No.202303021222346 and No.202103021223224The Research Foundation of The First Hospital of Shanxi Medical University,No.YQ2208.
文摘BACKGROUND The coronavirus disease 2019 pandemic has had an ongoing impact on the public’s mental health that requires long-term attention.Exploring the relationship between mental health indicators would aid in identifying solutions to improve public mental health.AIM To investigate the prevalence of anxiety,depression,and insomnia and explore the relationship among neuroticism,cognitive failures,and mental health.METHODS A cross-sectional survey was conducted in December 2023 using an online platform to recruit adult participants.The neuroticism,subjective cognitive function,and mental health of the participants were assessed using the neuroticism subscale of the Chinese Big Five Personality Inventory Brief Version,cognitive failures questionnaire,generalized anxiety disorder-7,patient health questionnaire-9,and insomnia severity index.Pearson's correlation analysis,independent samples t-tests,one-way analysis of variance,and structural equation model were used to examine the relationship between mental health indicators.RESULTS A total of 1011 valid questionnaires were collected,of which 343 were completed by male(33.93%)respondents and 668 were completed by female(66.07%)respondents.The rates of anxiety,depression,and insomnia were 41.3%,44.6%,and 36.3%,respectively,most cases of which were mild.Among the mental health indicators,there were significant differences by age and between those with siblings and those who were only children.Neuroticism and cognitive failures were significantly positively correlated with mental health indicators.Further moderated mediation analysis showed that cognitive failures mediated the relationship between insomnia and anxiety and between insomnia and depression,with neuroticism moderating the first half of this pathway and the effect being greater in the low-neuroticism group.CONCLUSION Cognitive failures and neuroticism play important roles in mental health.Therefore,enhancing subjective cognitive function and regulating emotional stability may contribute to the improvement of mental health.
文摘Hepatic arterial infusion(HAI)chemotherapy,first introduced in the 1980s,has gained recognition as an effective locoregional treatment for colorectal liver metastasis(CRLM).Initially used for unresectable liver metastases,HAI’s app-lication has expanded to the adjuvant setting following hepatic resection,with early studies indicating improved hepatic disease-free survival.Recent research demonstrates that combining HAI with modern systemic therapies enhances conversion to resectability and prolongs both recurrence-free and overall survival,even in heavily pretreated patients with diverse RAS mutational statuses.Person-alization through approaches like microsatellite instability status and dose mo-difications further optimize outcomes.However,the complexity of HAI requires expertise across multidisciplinary teams,limiting its widespread adoption to specialized centers.Ongoing clinical trials continue to investigate HAI’s role in CRLM management,highlighting its potential to become a cornerstone of liver-directed therapy.We explore how HAI chemotherapy,in combination with personalized medicine,can advance treatment strategies for metastatic colorectal cancer.
文摘Anastomotic leakage(AL)is a significant complication following rectal cancer surgery,adversely affecting both quality of life and oncological outcomes.Recent advancements in artificial intelligence(AI),particularly machine learning and deep learning,offer promising avenues for predicting and preventing AL.These technologies can analyze extensive clinical datasets to identify preoperative and perioperative risk factors such as malnutrition,body composition,and radiological features.AI-based models have demonstrated superior predictive power compared to traditional statistical methods,potentially guiding clinical decisionmaking and improving patient outcomes.Additionally,AI can provide surgeons with intraoperative feedback on blood supply and anatomical dissection planes,minimizing the risk of intraoperative complications and reducing the likelihood of AL development.
文摘Despite advances in surgery,chemotherapy,and radiotherapy,the treatment of colorectal cancer(CRC)requires more personalized approaches based on tumor biology and molecular profiling.While some relevant mutations have been associated with differential response to immunotherapy,such as RAS and BRAF mutations limiting response to anti-epithelial growth factor receptor drugs or microsatellite instability predisposing susceptibility to immune checkpoint inhibitors,the role of inflammation in dictating tumor progression and treatment response is still under investigation.Several inflammatory biomarkers have been identified to guide patient prognosis.These include the neutrophil-lymphocyte ratio,Glasgow prognostic score(GPS)and its modified version,lymphocyte-Creactive protein ratio,and platelet-lymphocyte ratio.However,these markers are not yet included in the standard clinical management of patients with CRC,and further research is needed to evaluate their efficacy in different patient populations.A recent study by Wang et al,published in the World Journal of Gastroenterology,sheds light on the prognostic significance of pan-immune-inflammation value(PIV)in CRC,particularly concerning primary tumor location.Specifically,the authors found that a high PIV was strongly correlated with worse disease-free survival in patients with left-sided colon cancer,whereas no such association was observed in patients with right-sided colon cancer.Integrating tumor location into the prognostic assessment of CRC may improve our ability to more accurately identify high-risk patients and develop personalized treatment plans that are more likely to improve patient outcomes.
基金National Natural Science Foundation of China(No.82495171,92268202,82270485)National Key R&D Program of China(No.2021YFA0805100)+5 种基金Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2023-PT320-03)Guangdong Basic and Applied Basic Research Foundation,China(No.2024A1515030041)The Science and Technology Planning Project of Guangdong Province,(No.2023B1212060018)Sun Yat-sen University Basic Research Funds(No.24qnpy354)Clinical Research 5010 Program(No.2014002)Program of National Key Clinical Specialties.
文摘Objective Size distribution is an important biophysical property of extracellular vesicles(EVs).EVs include small EVs(s-EVs)and large EVs(l-EVs)by size.Differential ultracentrifugation(dUC)is widely used to separate EVs from biofluids,but it can precipitate large impurity particles.Dynamic light scattering(DLS)is a simple and fast method for analyzing the size distribution of EVs.However,this approach is nonideal for heterogeneous and polydisperse samples since a small quantity of large impurity particles can markedly disturb the DLS results.Here,we developed a simple method to improve the reliability of DLS measurements.Methods Plasma was obtained from 13 volunteers.The plasma was first processed by dUC to obtain crude l-EVs.The crude l-EVs were filtered with syringe filters(pore size of 1μm and membrane material of hydrophilic polyvinylidene fluoride(PVDF))to remove large impurity particles from l-EVs.The size distributions of the crude l-EVs and filtered l-EVs were measured via DLS.Results After the samples were filtered,the coefficients of variation of the hydrodynamic radius and Peak 1 intensity of the filtered l-EVs decreased from 20.39%(12.76–28.96%)and 20.44%(14.58–28.32%)to 3.05%(1.79–4.72%)and 3.43%(1.76–5.88%),respectively,compared with those of the crude l-EVs.Conclusion These findings suggest that filtration can effectively separate circulating l-EVs in plasma to remove large impurity particles and make samples suitable for characterization by DLS.Our findings provide a simple method to improve precision via DLS to measure the size distribution of EVs.
文摘In early 2019, Mozambique was struck by two cyclones, Cyclone Idai in Sofala Province and Cyclone Kenneth in Cabo Delgado Province. Outbreaks of cholera were declared soon after both cyclones in Beira and Pemba cities. In response to the emergencies and outbreaks, government and humanitarian partners collaborated to create a mobile phone based water quality monitoring program to monitor daily free residual chlorine (FRC) levels in the piped network in both locations and at accommodation centers created for internally displaced persons in Beira. Overall, 87% of the 1080 samples from the piped network in Beira had detectable FRC and at accommodation centers, 73% of the 179 samples collected had detectable FRC. In Pemba, 64% of the 114 total samples collected had detectable FRC. Data from the water quality monitoring programs allowed for the identification of trends that helped increase the effectiveness of the response, including identifying areas where chlorination could be strengthened with the installation of booster chlorinators, issues with the consistency of daily chlorine treatment, and sites where water availability was limited. The water quality monitoring activities were a result of productive collaboration and could be replicated after similar emergencies in cholera endemic areas to prevent and control outbreaks.
文摘BACKGROUND Although inflammatory diseases commonly affect the pleura and pleural space,their mechanisms of action remain unclear.The presence of several mediators emphasizes the concept of pleural inflammation.Adenosine deaminase(ADA)is an inflammatory mediator detected at increased levels in the pleural fluid.AIM To determine the role of total pleural ADA(P-ADA)levels in the diagnosis of pleural inflammatory diseases.METHODS 157 patients with inflammatory pleural effusion(exudates,n=124,79%)and noninflammatory pleural effusion(transudates,n=33,21%)were included in this observational retrospective cohort study.The P-ADA assay was tested using a kinetic technique.The performance of the model was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC).The ideal cutoff value for P-ADA in pleural inflammation was determined using the Youden index in the ROC curve.RESULTS The transudates included congestive heart failure(n=26),cirrhosis of the liver with ascites(n=3),chronic renal failure(n=3),and low total protein levels(n=1).The exudate cases included tuberculosis(n=44),adenocarcinoma(n=37),simple parapneumonic effusions(n=15),complicated parapneumonic effusions/empyema(n=8),lymphoma(n=7),and other diseases(n=13).The optimal cutoff value of P-ADA was≥9.00 U/L.The diagnostic parameters as sensitivity,specificity,positive and negative predictive values,positive and negative likelihood values,odds ratio,and accuracy were 77.69(95%CI:69.22-84.75);68.75(95%CI:49.99-83.88);90.38 and 44.90(95%CI:83.03-95.29;30.67-59.77);2.48 and 0.32(95%CI:2.21-11.2;0.27-0.51);7.65(95%CI:0.78-18.34),and 75.82(95%CI:68.24-82.37),respectively(χ^(2)=29.51,P=0.00001).An AUC value of 0.8107(95%CI:0.7174-0.8754;P=0.0000)was clinically useful.The Hosmer-Lemeshow test showed excellent discrimination.CONCLUSION P-ADA biomarker has high diagnostic performance for pleural inflammatory exudates.
基金Supported by the National Natural Science Foundation of China,No.82000482China Postdoctoral Science Foundation funded,No.2023M741858China Crohn’s and Colitis Foundation,No.CCCF-QF-2023C18-3.
文摘BACKGROUND Early identification of bowel resection risks is crucial for patients with incarcerated inguinal hernia(IIH).However,the prompt detection of these risks remains a significant challenge.Advancements in radiomic feature extraction and machine learning algorithms have paved the way for innovative diagnostic approaches to assess IIH more effectively.AIM To devise a sophisticated radiomic-clinical model to evaluate bowel resection risks in IIH patients,thereby enhancing clinical decision-making processes.METHODS This single-center retrospective study analyzed 214 IIH patients randomized into training(n=161)and test(n=53)sets(3:1).Radiologists segmented hernia sac-trapped bowel volumes of interest(VOIs)on computed tomography images.Radiomic features extracted from VOIs generated Rad-scores,which were combined with clinical data to construct a nomogram.The nomogram’s performance was evaluated against standalone clinical and radiomic models in both cohorts.RESULTS A total of 1561 radiomic features were extracted from the VOIs.After dimensionality reduction,13 radiomic features were used with eight machine learning algorithms to develop the radiomic model.The logistic regression algorithm was ultimately selected for its effectiveness,showing an area under the curve(AUC)of 0.828[95%confidence interval(CI):0.753-0.902]in the training set and 0.791(95%CI:0.668-0.915)in the test set.The comprehensive nomogram,incorporating clinical indicators showcased strong predictive capabilities for assessing bowel resection risks in IIH patients,with AUCs of 0.864(95%CI:0.800-0.929)and 0.800(95%CI:0.669-0.931)for the training and test sets,respectively.Decision curve analysis revealed the integrated model’s superior performance over standalone clinical and radiomic approaches.CONCLUSION This innovative radiomic-clinical nomogram has proven to be effective in predicting bowel resection risks in IIH patients and has substantially aided clinical decision-making.
基金supported by grants from the National Natural Science Foundation of China(82225005, 82020108002 to JX,82200321 to QZ)Science and Technology Commission of ShanghaiMunicipality(23410750100,20DZ2255400,, 21XD1421300 to JX)+1 种基金the“Dawn”Program of Shanghai Educa-tion Commission(19SG34 to JX)Shanghai Sailing Program(21YF1413200 to QZ).
文摘Background:Exercise induces molecular changes that involve multiple organs and tissues.Moreover,these changes are modulated by various exercise parameters—such as intensity,frequency,mode,and duration—as well as by clinical features like gender,age,and body mass index(BMI),each eliciting distinct biological effects.To assist exercise researchers in understanding these changes from a comprehensive perspective that includes multiple organs,diverse exercise regimens,and a range of clinical features,we developed Exercise Regulated Genes Database(ExerGeneDB),a database of exercise-regulated differential genes.Methods:ExerGeneDB aggregated publicly available exercise-related sequencing datasets and subjected them to uniform quality control and preprocessing.The data,encompassing a variety of types,were organized into a specialized database of exercise-regulated genes.Notably,Exer-GeneDB conducted differential analyses on this collected data,leveraging curated clinical information and accounting for important factors such as gender,age,and BMI.Results:ExerGeneDB has assembled 1692 samples from rats and mice as well as 4492 human samples.It contains data from various tissues and organs,such as skeletal muscle,blood,adipose tissue,intestine,heart,liver,spleen,lungs,kidneys,brain,spinal cord,bone marrow,and bones.ExerGeneDB features bulk ribonucleic acid sequencing(RNA-seq)(including non-coding RNA(ncRNA)and protein-coding RNA),microarray(including ncRNA and protein-coding RNA),and single cell RNA-seq data.Conclusion:ExerGeneDB compiles and re-analyzes exercise-related data with a focus on clinical information.This has culminated in the crea-tion of an interactive database for exercise regulation genes.The website for ExerGeneDB can be found at:https://exergenedb.com.
