ABSTRACT
Objectives: This study aimed to develop and validate a model to predict the need for intensive care unit (ICU) admission in patients with dental infections using an automated machine learning (ML) program called H2O-AutoML. Materials and Methods: Two models were created using only the information available at the initial examination. Model 1 was parameterized with only clinical symptoms and blood tests, excluding contrast-enhanced multi-detector computed tomography (MDCT) images available at the initial visit, whereas model 2 was created with the addition of the MDCT information to the model 1 parameters. Although model 2 was expected to be superior to model 1, we wanted to independently determine this conclusion. A total of 210 patients who visited the Department of Oral and Maxillofacial Surgery at the Dankook University Dental Hospital from March 2013 to August 2023 was included in this study. The patients' demographic characteristics (sex, age, and place of residence), systemic factors (hypertension, diabetes mellitus [DM], kidney disease, liver disease, heart disease, anticoagulation therapy, and osteoporosis), local factors (smoking status, site of infection, postoperative wound infection, dysphagia, odynophagia, and trismus), and factors known from initial blood tests were obtained from their medical charts and retrospectively reviewed. Results: The generalized linear model algorithm provided the best diagnostic accuracy, with an area under the receiver operating characteristic values of 0.8289 in model 1 and 0.8415 in model 2. In both models, the C-reactive protein level was the most important variable, followed by DM. Conclusion: This study provides unprecedented data on the use of ML for successful prediction of ICU admission based on initial examination results. These findings will considerably contribute to the development of the field of dentistry, especially oral and maxillofacial surgery.
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3D printing has been widely used for on-demand prototyping of complex three-dimensional structures. In biomedical applications, PEDOT:PSS has emerged as a promising material in versatile bioelectronics due to its tissue-like mechanical properties and suitable electrical properties. However, previously developed PEDOT:PSS inks have not been able to fully utilize the advantages of commercial 3D printing due to its long post treatment times, difficulty in high aspect ratio printing, and low conductivity. We propose a one-shot strategy for the fabrication of PEDOT:PSS ink that is able to simultaneously achieve on-demand biocompatibility (no post treatment), structural integrity during 3D printing for tall three-dimensional structures, and high conductivity for rapid-prototyping. By using ionic liquid-facilitated PEDOT:PSS colloidal stacking induced by a centrifugal protocol, a viscoplastic PEDOT:PSS-ionic liquid colloidal (PILC) ink was developed. PILC inks exhibit high-aspect ratio vertical stacking, omnidirectional printability for generating suspended architectures, high conductivity (~286 S/cm), and high-resolution printing (~50 µm). We demonstrate the on-demand and versatile applicability of PILC inks through the fabrication of 3D circuit boards, on-skin physiological signal monitoring e-tattoos, and implantable bioelectronics (opto-electrocorticography recording, low voltage sciatic nerve stimulation and recording from deeper brain layers via 3D vertical spike arrays).
Subject(s)
Biocompatible Materials , Colloids , Electric Conductivity , Ionic Liquids , Polystyrenes , Printing, Three-Dimensional , Ionic Liquids/chemistry , Colloids/chemistry , Biocompatible Materials/chemistry , Animals , Polystyrenes/chemistry , Rats , Ink , Polymers/chemistry , Thiophenes/chemistry , Neurons/physiology , Bridged Bicyclo Compounds, Heterocyclic/chemistryABSTRACT
BACKGROUND: Traditional pharmacological interventions are well tolerated in the management of elevated blood pressure (BP) for individuals with resistant hypertension. Although neuromodulation has been investigated as an alternative solution, its open-loop (OL) modality cannot follow the patient's physiological state. In fact, neuromodulation for controlling highly fluctuating BP necessitates a closed-loop (CL) stimulation modality based on biomarkers to monitor the patient's continuously varying physiological state. OBJECTIVE: By leveraging its intuitive linkage with BP responses in ongoing efforts aimed at developing a CL system to enhance temporal BP reduction effect, this study proposes a CL neuromodulation modality that controls nucleus tractus solitarius (NTS) activity to effectively reduce BP, thus reflecting continuously varying physiological states. METHOD: While performing neurostimulation targeting the NTS in the rat model, the arterial BP response and neural activity of the NTS were simultaneously measured. To evaluate the temporal BP response effect of CL neurostimulation, OL (constant parameter; 20 Hz, 200 µA) and CL (Initial parameter; 11 Hz, 112 µA) stimulation protocols were performed with stimulation 180 s and rest 600 s, respectively, and examined NTS activity and BP response to the protocols. RESULTS: In-vivo experiments for OL versus CL protocol for direct NTS stimulation in rats demonstrated an enhancement in temporal BP reduction via the CL modulation of NTS activity. CONCLUSION: This study proposes a CL stimulation modality that enhances the effectiveness of BP control using a feedback control algorithm based on neural signals, thereby suggesting a new approach to antihypertensive neuromodulation.
Subject(s)
Blood Pressure , Solitary Nucleus , Animals , Rats , Blood Pressure/physiology , Blood Pressure/drug effects , Solitary Nucleus/physiology , Male , Rats, Sprague-Dawley , Brain Stem/physiology , Hypertension/therapy , Hypertension/physiopathology , Electric Stimulation Therapy/methods , Electric Stimulation Therapy/instrumentationABSTRACT
This paper presents a current-mode VCSEL driver (CMVD) implemented using 180 nm CMOS technology for application in short-range LiDAR sensors, in which current-steering logic is suggested to deliver modulation currents from 0.1 to 10 mApp and a bias current of 0.1 mA simultaneously to the VCSEL diode. For the simulations, the VCSEL diode is modeled with a 1.6 V forward-bias voltage and a 50 Ω series resistor. The post-layout simulations of the proposed CMVD clearly demonstrate large output pulses and eye-diagrams. Measurements of the CMVD demonstrate large output pulses, confirming the simulation results. The chip consumes a maximum of 11 mW from a 3.3 V supply, and the core occupies an area of 0.1 mm2.
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Bioengineered hearts, which include single cardiomyocytes, engineered heart tissue, and chamber-like models, generate various biosignals, such as contractility, electrophysiological, and volume-pressure dynamic signals. Monitoring changes in these signals is crucial for understanding the mechanisms of disease progression and developing potential treatments. However, current methodologies face challenges in the continuous monitoring of bioengineered hearts over extended periods and typically require sacrificing the sample post-experiment, thereby limiting in-depth analysis. Thus, a biohybrid system consisting of living and nonliving components was developed. This system primarily features heart tissue alongside nonliving elements designed to support or comprehend its functionality. Biohybrid printing technology has simplified the creation of such systems and facilitated the development of various functional biohybrid systems capable of measuring or even regulating multiple functions, such as pacemakers, which demonstrates its versatility and potential applications. The future of biohybrid printing appears promising, with the ongoing exploration of its capabilities and potential directions for advancement.
Subject(s)
Biosensing Techniques , Myocytes, Cardiac , Printing, Three-Dimensional , Tissue Engineering , Humans , Biosensing Techniques/instrumentation , Biosensing Techniques/methods , Tissue Engineering/methods , Animals , Bioprinting/methods , Heart/physiologyABSTRACT
Left ventricular twist is influenced by the unique oriented structure of myocardial fibers. Replicating this intricate structural-functional relationship in an in vitro heart model remains challenging, mainly due to the difficulties in achieving a complex structure with synchrony between layers. This study introduces a novel approach through the utilization of bioprinting-assisted tissue assembly (BATA)-a synergistic integration of bioprinting and tissue assembly strategies. By flexibly manufacturing tissue modules and assembly platforms, BATA can create structures that traditional methods find difficult to achieve. This approach integrates engineered heart tissue (EHT) modules, each with intrinsic functional and structural characteristics, into a layered, multi-oriented tissue in a controlled manner. EHTs assembled in different orientations exhibit various contractile forces and electrical signal patterns. The BATA is capable of constructing complex myocardial fiber orientations within a chamber-like structure (MoCha). MoCha replicates the native cardiac architecture by exhibiting three layers and three alignment directions, and it reproduces the left ventricular twist by exhibiting synchronized contraction between layers and mimicking the native cardiac architecture. The potential of BATA extends to engineering tissues capable of constructing and functioning as complete organs on a large scale. This advancement holds the promise of realizing future organ-on-demand technology.
Subject(s)
Bioprinting , Heart Ventricles , Tissue Engineering , Tissue Engineering/methods , Bioprinting/methods , Animals , Tissue Scaffolds/chemistry , Myocardium/cytology , Myocardium/metabolism , Humans , Myocytes, Cardiac/cytologyABSTRACT
Biomimetic stress-relaxing hydrogels with reversible crosslinks attract significant attention for stem cell tissue regeneration compared with elastic hydrogels. However, stress-relaxing hyaluronic acid (HA)-based hydrogels fabricated using conventional technologies lack stability, biocompatibility, and mechanical tunability. Here, it is aimed to address these challenges by incorporating calcium or phosphate components into the HA backbone, which allows reversible crosslinking of HA with alginate to form interpenetrating networks, offering stability and mechanical tunability for mimicking cartilage. Diverse stress-relaxing hydrogels (τ1/2; SR50, 60-2000 s) are successfully prepared at ≈3 kPa stiffness with self-healing and shear-thinning abilities, favoring hydrogel injection. In vitro cell experiments with RNA sequencing analysis demonstrate that hydrogels tune chondrogenesis in a biphasic manner (hyaline or calcified) depending on the stress-relaxation properties and phosphate components. In vivo studies confirm the potential for biphasic chondrogenesis. These results indicate that the proposed stress-relaxing HA-based hydrogel with biphasic chondrogenesis (hyaline or calcified) is a promising material for cartilage regeneration.
Subject(s)
Cartilage , Chondrogenesis , Hyaluronic Acid , Hydrogels , Regeneration , Hyaluronic Acid/chemistry , Hyaluronic Acid/pharmacology , Hydrogels/chemistry , Hydrogels/pharmacology , Chondrogenesis/drug effects , Animals , Regeneration/drug effects , Cartilage/drug effects , Cartilage/physiology , Humans , Stress, Mechanical , Tissue Engineering/methods , MiceABSTRACT
BACKGROUND: There are two types of speech processors used in CI devices: behind-the-ear (BTE) and off-the-ear (OTE). OBJECTIVES: This study aimed to investigate the characteristics of patients and revision cases in relation to the type of speech processors. MATERIALS AND METHODS: A retrospective review of 452 ears that underwent CI was performed. RESULTS: Children with severe inner ear anomalies (91.7%) more frequently preferred BTE speech processors than those without severe inner ear anomalies (p = .000). The magnet strength used in OTE speech processor users was significantly higher than in BTE speech processor users (p = .002). In cochlear implantees who underwent surgery before 12 months of age, the magnet strength in the revision group was greater than in the non-revision group (p = .025). CONCLUSIONS AND SIGNIFICANCE: Overall, our findings suggest factors to consider when choosing the type of speech processor and modifying the magnet strength of the implant device. The choice between BTE and OTE speech processors led to different required magnet strengths, contributing to the occurrence of skin flap inflammation.
Subject(s)
Cochlear Implants , Tertiary Care Centers , Humans , Retrospective Studies , Male , Female , Child, Preschool , Child , Infant , Adolescent , Adult , Cochlear Implantation , Young Adult , Middle Aged , ReoperationABSTRACT
OBJECTIVES: The recent expansion of eligibility for cochlear implantation (CI) by the U.S. Food and Drug Administration (FDA) to include infants as young as 9 months has reignited debates concerning the clinically appropriate cut-off age for pediatric CI. Our study compared the early postoperative trajectories of receptive and expressive language development in children who received CI before 9 months of age with those who received it between 9 and 12 months. This study involved a unique pediatric cohort with documented etiology, where the timing of CI was based on objective criteria and efforts were made to minimize the influence of parental socioeconomic status. METHODS: A retrospective review of 98 pediatric implantees recruited at a tertiary referral center was conducted. The timing of CI was based on auditory and language criteria focused on the extent of delay corresponding to the bottom 1st percentile of language development among age-matched controls, with patients categorized into very early (CI at <9 months), early (CI at 9-12 months) and delayed (CI at 12-18 months) CI groups. Postoperative receptive/expressive language development was assessed using the Sequenced Language Scale for Infants receptive and expressive standardized scores and percentiles. RESULTS: Only the very early CI group showed significant improvements in receptive language starting at 3 months post-CI, aligning with normal-hearing peers by 9 months and maintaining this level until age 2 years. During this period (<2 years), all improvements were more pronounced in receptive language than in expressive language. CONCLUSION: CI before 9 months of age significantly improved receptive language development compared to later CI, with improvements sustained at least up to the age of 2. This study supports the consideration of earlier CI, beyond pediatric Food and Drug Administration labeling criteria (>9 months), in children with profound deafness who have a clear deafness etiology and language development delays (<1st percentile).
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Side streams and byproducts of food are established sources of natural ingredients in cosmetics. In the present study, we obtained upcycled low-molecular-weight anionic peptides (LMAPs) using byproducts of the post-yuzu-juicing process by employing an enzyme derived from Bacillus sp. For the first time, we isolated anionic peptides less than 500 Da in molecular weight from Citrus junos TANAKA seeds via hydrolysis using this enzyme. The protective effect of LMAPs against UVR-induced photoaging was evaluated using a reconstructed skin tissue (RST) model and keratinocytes. The LMAPs protected the keratinocytes by scavenging intracellular reactive oxygen species and by reducing the levels of paracrine cytokines (IL-6 and TNF-α) in UVR (UVA 2 J/cm2 and UVB 15 mJ/cm2)-irradiated keratinocytes. Additionally, the increase in melanin synthesis and TRP-2 expression in RST caused by UVR was significantly inhibited by LMAP treatment. This treatment strongly induced the expression of filaggrin and laminin-5 in UVR-irradiated RST. It also increased type I collagen expression in the dermal region and in fibroblasts in vitro. These results suggest that a hydrolytic system using the enzyme derived from Bacillus sp. can be used for the commercial production of LMAPs from food byproducts and that these LMAPs can be effective ingredients for improving photoaging-induced skin diseases.
Subject(s)
Citrus , Skin Aging , Skin Diseases , Skin/metabolism , Cytokines/metabolism , Skin Diseases/metabolism , Ultraviolet Rays/adverse effects , Fibroblasts/metabolismABSTRACT
In implantable bioelectronics, which aim for semipermanent use of devices, biosafe energy sources and packaging materials to protect devices are essential elements. However, research so far has been conducted in a direction where they cannot coexist. Here, the development of capacitance-matched triboelectric implants driven is reported by ultrasound under 500 mW cm-2 safe intensity and realize a battery-free, miniatured, and wireless neurostimulator with full titanium (Ti) packaging. The triboelectric implant with high dielectric composite, which has ultralow output impedance, can efficiently deliver sufficient power to generate the stimulation pulse without an energy-storing battery, despite ultrasound attenuation due to the Ti, and has the highest energy transmission efficiency among those reported so far. In vivo study using a rat model demonstrated that the proposed device system is an effective solution for relieving urinary symptoms. These achievements provide a significant step toward permanently implantable devices for controlling human organs and treating various diseases.
Subject(s)
Electric Power Supplies , Prostheses and Implants , Humans , Rats , Animals , Ultrasonography , Electric CapacitanceABSTRACT
This study addresses the propagation challenges faced by 'Shine Muscat', a newly introduced premium grapevine cultivar in South Korea, where multiple viral infections pose considerable economic loss. The primary objective was to establish a robust in vitro propagation method for producing disease-free grapes and to identify effective plant growth regulators to facilitate large-scale mass cultivation. After experimentation, 2.0 µM 6-benzyladenine (BA) exhibited superior shoot formation in the Murashige and Skoog medium compared with kinetin and thidiazuron. Conversely, α-naphthaleneacetic acid (NAA) hindered shoot growth and induced callus formation, while indole-3-butyric acid (IBA) and indole-3-acetic acid (IAA) demonstrated favorable root formation, with IBA showing better results overall. Furthermore, inter simple sequence repeat analysis confirmed the genetic stability of in vitro-cultivated seedlings using 2.0 µM BA and 1.0 µM IBA, validating the suitability of the developed propagation method for generating disease-free 'Shine Muscat' grapes. These findings offer promising prospects for commercial grape cultivation, ensuring a consistent supply of healthy grapes in the market.
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Red color conversion materials have often been used in conventional white LEDs (light-emitting diodes) to enhance the insufficient deep-red component and thus improve the color-rendering property. Quantum dots (QDs) are one of the candidates for this due to their flexibility in controlling the emission wavelength, which is attributed to the quantum confinement effect. Two types of remote QD components, i.e., QD films and QD caps, were prepared and applied to conventional white LED illumination to improve the color-rendering properties. Thanks to the red component near 630 nm caused by the QD components, the color rendering indices (CRIs) of both Ra and R9 could be increased to over 95. It was found that both the diffusing nature of the reflector and the light recycling process in the vertical cavity between the bottom reflector and the top optical films play important roles in improving the color conversion efficiency of remote QD components. The present study showed that the proper application of remote QDs combined with a suitable optical cavity can control the correlated color temperature of the illumination over a wide range, thus realizing different color appearances of white LED illumination. In addition, a high CRI of over 95 could be achieved due to the sufficient excitation from fewer QDs, due to the strong optical cavity effect.
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Advancing the technologies for cellular reprogramming with high efficiency has significant impact on regenerative therapy, disease modeling, and drug discovery. Biophysical cues can tune the cell fate, yet the precise role of external physical forces during reprogramming remains elusive. Here the authors show that temporal cyclic-stretching of fibroblasts significantly enhances the efficiency of induced pluripotent stem cell (iPSC) production. Generated iPSCs are proven to express pluripotency markers and exhibit in vivo functionality. Bulk RNA-sequencing reveales that cyclic-stretching enhances biological characteristics required for pluripotency acquisition, including increased cell division and mesenchymal-epithelial transition. Of note, cyclic-stretching activates key mechanosensitive molecules (integrins, perinuclear actins, nesprin-2, and YAP), across the cytoskeletal-to-nuclear space. Furthermore, stretch-mediated cytoskeletal-nuclear mechano-coupling leads to altered epigenetic modifications, mainly downregulation in H3K9 methylation, and its global gene occupancy change, as revealed by genome-wide ChIP-sequencing and pharmacological inhibition tests. Single cell RNA-sequencing further identifies subcluster of mechano-responsive iPSCs and key epigenetic modifier in stretched cells. Collectively, cyclic-stretching activates iPSC reprogramming through mechanotransduction process and epigenetic changes accompanied by altered occupancy of mechanosensitive genes. This study highlights the strong link between external physical forces with subsequent mechanotransduction process and the epigenetic changes with expression of related genes in cellular reprogramming, holding substantial implications in the field of cell biology, tissue engineering, and regenerative medicine.
Subject(s)
Induced Pluripotent Stem Cells , Mechanotransduction, Cellular , Cellular Reprogramming/genetics , Induced Pluripotent Stem Cells/metabolism , Epigenesis, Genetic , RNA/metabolismABSTRACT
Spinal cord stimulation (SCS) is an emerging therapeutic option for patients with neuropathic pain due to spinal cord injury (SCI). Numerous studies on pain relief effects with SCS have been conducted and demonstrated promising results while the mechanisms of analgesic effect during SCS remain unclear. However, an experimental system that enables large-scale long-term animal studies is still an unmet need for those mechanistic studies. This study proposed a fully wireless neurostimulation system that can efficiently support a long-term animal study for neuropathic pain relief. The developed system consists of an implantable stimulator, an animal cage with an external charging coil, and a wireless communication interface. The proposed device has the feature of remotely controlling stimulation parameters via radio-frequency (RF) communication and wirelessly charging via magnetic induction in freely moving rats. Users can program stimulation parameters such as pulse width, intensity, and duration through an interface on a computer. The stimulator was packaged with biocompatible epoxy to ensure long-term durability under in vivo conditions. Animal experiments using SCI rats were conducted to demonstrate the functionality of the device, including long-term usability and therapeutic effects. The developed system can be tailored to individual user needs with commercially available components, thus providing a cost-effective solution for large-scale long-term animal studies on neuropathic pain relief.
Subject(s)
Neuralgia , Spinal Cord Injuries , Humans , Animals , Rats , Prostheses and Implants , Communication , Heart Rate , Longitudinal Studies , Neuralgia/therapyABSTRACT
Introduction: Once the underlying pathology has been identified, pulsatile tinnitus (PT) can be treated successfully with surgical or interventional management. However, some patients experience residual or recurrent symptoms following initially successful surgical treatment, and require revision surgery or additional procedures. Here, we report a case series of patients who had undergone revision surgery or interventional treatment, and suggest possible ways of minimizing the need for revision. Methods: Between January 2014 and March 2023, a total of seven subjects underwent revision surgery or interventional treatment for persistent or recurrent PT after initial surgical treatment. Demographic data, reasons for revision, and changes in symptoms before and after revision were analyzed retrospectively. Temporal bone computed tomographic angiography images were reviewed to identify the causes and reasons for revision. Results: Of the seven subjects, six underwent sigmoid sinus (SS) resurfacing/reshaping due to ipsilateral diverticulum (Div) or dehiscence (Deh), and one underwent jugular bulb (JB) resurfacing due to a high-riding JB with bony Deh. Of the five subjects who underwent revision SS surgery due to recurrent SS-Div or SS-Deh, three showed marked resolution of PT, while the other two showed partial improvement of the symptoms. One subject who underwent revision JB resurfacing, and another who underwent additional transarterial embolization for a concurrent ipsilateral dural arteriovenous fistula, reported marked improvement of PT. Discussion: The possibility of recurrence should be taken into account when performing surgical intervention in patients with PT. The likelihood of recurrence can be minimized through a comprehensive evaluation to identify possible multiple etiologies, and through the use of durable materials and appropriate surgical methods.
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BACKGROUND: Pigmented fungiform papillae of the tongue (PFPT) is a rare benign pigmentary disorder of the tongue. In dark-skinned individuals, PFPT appears to be relatively common. However, limited data exist on PFPT in Korean patients. OBJECTIVE: We aimed to investigate the clinical characteristics of PFPT in Korean patients. METHODS: Patients diagnosed with PFPT between 1995 and 2021 at the Pusan National University Hospital were included. Clinical characteristics of PFPT, dermoscopic findings, and comorbidities were reviewed. RESULTS: A total of 19 patients diagnosed with PFPT were enrolled. The male to female ratio was approximately 1:5. The mean age at diagnosis was 41.1 years (range, 8~67 years). According to Holzwanger's classification, Type I was the most common (89.5%). PFPT was commonly concomitant with pigmentary disorders, including mucosal melanotic macules, Laugier-Hunziker syndrome, melasma, and melanonychia (6/19, 31.6%). Preceding oral infection or inflammatory lesions were found in four patients (21.1%), and systemic diseases and infectious diseases existed in two patients (10.5%). Dermoscopic examination was performed in seven patients; pigmented border with dichotomized vessels (rose petal pattern, 71.4%) and diffuse pigmentation (cobblestone pattern, 71.4%) were common findings. CONCLUSION: Our study shows PFPT can coexist with pigmentary disorders. Concomitant pigmentary disorder shows an association with sex hormone or susceptibility to abnormal pigmentation may be a possible cause of PFPT.
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BACKGRUOUND: There was limited evidence to evaluate the association between lifestyle habits and continuous glucose monitoring (CGM) metrics. Thus, we aimed to depict the behavioral and metabolic determinants of CGM metrics in insulin-treated patients with type 2 diabetes mellitus (T2DM). METHODS: This is a prospective observational study. We analyzed data from 122 insulin-treated patients with T2DM. Participants wore Dexcom G6 and Fitbit, and diet information was identified for 10 days. Multivariate-adjusted logistic regression analysis was performed for the simultaneous achievement of CGM-based targets, defined by the percentage of time in terms of hyper, hypoglycemia and glycemic variability (GV). Intake of macronutrients and fiber, step counts, sleep, postprandial C-peptide-to-glucose ratio (PCGR), information about glucose lowering medications and metabolic factors were added to the analyses. Additionally, we evaluated the impact of the distribution of energy and macronutrient during a day, and snack consumption on CGM metrics. RESULTS: Logistic regression analysis revealed that female, participants with high PCGR, low glycosylated hemoglobin (HbA1c) and daytime step count had a higher probability of achieving all targets based on CGM (odds ratios [95% confidence intervals] which were 0.24 [0.09 to 0.65], 1.34 [1.03 to 1.25], 0.95 [0.9 to 0.99], and 1.15 [1.03 to 1.29], respectively). And participants who ate snacks showed a shorter period of hyperglycemia and less GV compared to those without. CONCLUSION: We confirmed that residual insulin secretion, daytime step count, HbA1c, and women were the most relevant determinants of adequate glycemic control in insulin-treated patients with T2DM. In addition, individuals with snack consumption were exposed to lower times of hyperglycemia and GV.
Subject(s)
Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Hyperglycemia , Female , Humans , Blood Glucose/metabolism , Blood Glucose Self-Monitoring , Diabetes Mellitus, Type 1/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/chemically induced , Glycated Hemoglobin , Hyperglycemia/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Life StyleABSTRACT
Objectives: This study aimed to develop and validate machine learning (ML) models using H2O-AutoML, an automated ML program, for predicting medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis undergoing tooth extraction or implantation. Patients and. Methods: We conducted a retrospective chart review of 340 patients who visited Dankook University Dental Hospital between January 2019 and June 2022 who met the following inclusion criteria: female, age ≥55 years, osteoporosis treated with antiresorptive therapy, and recent dental extraction or implantation. We considered medication administration and duration, demographics, and systemic factors (age and medical history). Local factors, such as surgical method, number of operated teeth, and operation area, were also included. Six algorithms were used to generate the MRONJ prediction model. Results: Gradient boosting demonstrated the best diagnostic accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.8283. Validation with the test dataset yielded a stable AUC of 0.7526. Variable importance analysis identified duration of medication as the most important variable, followed by age, number of teeth operated, and operation site. Conclusion: ML models can help predict MRONJ occurrence in patients with osteoporosis undergoing tooth extraction or implantation based on questionnaire data acquired at the first visit.
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This paper presents a test methodology to facilitate the measuring processes of LiDAR receiver ICs by avoiding the inherent walk error issue. In a typical LiDAR system, a costly laser diode driver emits narrow light pulses with fast rising edges, and the reflected pulses from targets enter an optical detector followed by an analog front-end (AFE) circuit. Then, the received signals pass through the cascaded amplifiers down to the time-to-digital converter (TDC) that can estimate the detection range. However, this relatively long signal journey leads to the significant decline of rising-edge slopes and the output pulse spreading, thus producing inherent walk errors in LiDAR receiver ICs. Compensation methods requiring complex algorithms and extra chip area have frequently been exploited to lessen the walk errors. In this paper, however, a simpler and lower-cost methodology is proposed to test LiDAR receiver ICs by employing a high-speed buffer and variable delay cells right before the TDC. With these circuits, both START and STOP pulses show very similar pulse shapes, thus effectively avoiding the walk error issue. Additionally, the time interval between two pulses is easily determined by varying the number of the delay cells. Test chips of the proposed receiver IC implemented in a 180-nm CMOS process successfully demonstrate easier and more accurate measurement results.