Corrigendum: The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients

[This corrects the article DOI: 10.3389/fonc.2023.1185389.].

Cross-Modal Sensory Boosting to Improve High-Frequency Hearing Loss: Device Development and Validation

Background

High-frequency hearing loss is one of the most common problems in the aging population and with those who have a history of exposure to loud noises. This type of hearing loss can be frustrating and disabling, making it difficult to understand speech communication and interact effectively with the world.

Objective

This study aimed to examine the impact of spatially unique haptic vibrations representing high-frequency phonemes on the self-perceived ability to understand conversations in everyday situations.

Methods

To address high-frequency hearing loss, a multi-motor wristband was developed that uses machine learning to listen for specific high-frequency phonemes. The wristband vibrates in spatially unique locations to represent which phoneme was present in real time. A total of 16 participants with high-frequency hearing loss were recruited and asked to wear the wristband for 6 weeks. The degree of disability associated with hearing loss was measured weekly using the Abbreviated Profile of Hearing Aid Benefit (APHAB).

Results

By the end of the 6-week study, the average APHAB benefit score across all participants reached 12.39 points, from a baseline of 40.32 to a final score of 27.93 (SD 13.11; N=16; P=.002, 2-tailed dependent t test). Those without hearing aids showed a 10.78-point larger improvement in average APHAB benefit score at 6 weeks than those with hearing aids (t14=2.14; P=.10, 2-tailed independent t test). The average benefit score across all participants for ease of communication was 15.44 (SD 13.88; N=16; P<.001, 2-tailed dependent t test). The average benefit score across all participants for background noise was 10.88 (SD 17.54; N=16; P=.03, 2-tailed dependent t test). The average benefit score across all participants for reverberation was 10.84 (SD 16.95; N=16; P=.02, 2-tailed dependent t test).

Conclusions

These findings show that vibrotactile sensory substitution delivered by a wristband that produces spatially distinguishable vibrations in correspondence with high-frequency phonemes helps individuals with high-frequency hearing loss improve their perceived understanding of verbal communication. Vibrotactile feedback provides benefits whether or not a person wears hearing aids, albeit in slightly different ways. Finally, individuals with the greatest perceived difficulty understanding speech experienced the greatest amount of perceived benefit from vibrotactile feedback.

Evaluation of a Fast Method to Measure High-Frequency Audiometry Based on Bayesian Learning

This study aimed to assess the validity of a high-frequency audiometry tool based on Bayesian learning to provide a reliable, repeatable, automatic, and fast test to clinics. The study involved 85 people (138 ears) who had their high-frequency thresholds measured with three tests: standard audiometry (SA), alternative forced choice (AFC)-based algorithm, and Bayesian active (BA) learning-based algorithm. The results showed median differences within ±5 dB up to 10 kHz when comparing the BA with the other two tests, and median differences within ±10 dB at higher frequencies. The variability increased from lower to higher frequencies. The BA showed lower thresholds compared to the SA at the majority of the frequencies. The results of the different tests were consistent across groups (age, hearing loss, and tinnitus). The data for the BA showed high test-retest reliability (>90%). The time required for the BA was shorter than for the AFC (4 min vs. 13 min). The data suggest that the BA test for high-frequency audiometry could be a good candidate for clinical screening. It would add reliable and significant information without adding too much time to the visit.

Clinical Features of Non-Lateralized Tinnitus

BACKGROUND

We aimed to analyze and confirm the clinical features of patients with non-lateralized tinnitus and to identify clues that can be used in their management.

METHODS

Data from 469 patients who visited a university hospital complaining of tinnitus between March 2020 and December 2021 were reviewed. The patients' medical histories, Tinnitus Handicap Inventory, Beck Depression Inventory, and numerical rating scale scores on tinnitus awareness, annoyance, loudness, and effect on life, audiological profiles, and quantitative electroencephalography findings were documented.

RESULTS

Forty-nine (10.4%) patients had non-lateralized tinnitus. They were older and had a shorter duration of symptoms (13.91 ± 34.16 months) than patients with bilateral tinnitus (duration: 39.15 ± 80.82 months) (P -lt; .05). The accompanying symptoms, Tinnitus Handicap Inventory scores, and numerical rating scale scores were not significantly different between the 2 groups (P -gt; .05). Patients with non-lateralized tinnitus had worse hearing at 12 kHz on the left side than those with unilateral tinnitus. Hearing asymmetry was least common in non-lateralized tinnitus (n=11/49, 10.4%), followed by bilateral tinnitus (n=54/198, 42.2%) and unilateral tinnitus (n=97/222, 47.3%) (P-lt; .001). Regarding quantitative electroencephalography, there were significant differences in the absolute power of the theta, alpha, beta, gamma, and total frequency bands based on tinnitus lateralization (P -lt; .001).

CONCLUSION

Non-lateralized tinnitus can be perceived in elderly patients with symmetric and extended high-frequency hearing loss before habituation is achieved at an early stage of tinnitus. However, there was no difference in the questionnaire scores and accompanying symptoms; therefore, it may not be worth managing non-lateralized tinnitus separately from tinnitus in the ear.

The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients

Background

Despite the increasing use of preoperative ultrasound evaluation for melanoma, there is limited research on the use of this technique for Acral Melanoma (AM).

Methods

This retrospective study analyzed the electronic medical records of patients who underwent preoperative evaluation for cutaneous melanoma maximum thickness using an 18 MHz probe and histopathological examination between December 2017 and March 2021 at the Department of Dermatology in Xiangya Hospital, Central South University.

Results

A total of 105 patients were included in the study. The mean tumor thickness was 3.9 mm (s.d., 2.3), with 63% of the specimens showing ulceration and 44 patients showing lymph node metastasis. The results showed a good correlation between the high-frequency ultrasonography (HFUS) and histopathological thickness measurements, with a Spearman's correlation coefficient of 0.83 [(95% CI 0.73-0.90) (P < 0.001)]. The positive predictive value (PPV) of sonography in identifying tumor thickness was also found to be high.

Conclusion

Our study suggests that high-frequency 18 MHz ultrasonography is an effective tool for the preoperative evaluation of AM thickness. The HFUS measurements correlated well with the histopathological thickness measurements, making it a valuable and reliable method for clinicians to assess the thickness of melanoma lesions preoperatively.

Exploiting Ambipolarity in Graphene Field-Effect Transistors for Novel Designs on High-Frequency Analog Electronics

Exploiting ambipolar electrical conductivity based on graphene field-effect transistors has raised enormous interest for high-frequency (HF) analog electronics. Controlling the device polarity, by biasing the graphene transistor around the vertex of the V-shaped transfer curve, enables to redesign and highly simplify conventional analog circuits, and simultaneously to seek for multifunctionalities, especially in the HF domain. This study presents new insights for the design of different HF applications such as power amplifiers, mixers, frequency multipliers, phase shifters, and modulators that specifically leverage the inherent ambipolarity of graphene-based transistors.

High-frequency rTMS over the left DLPFC improves the response inhibition control of young healthy participants: an ERP combined 1H-MRS study

Introduction

Unlike the effect of repetitive transcranial magnetic stimulation (rTMS) in treating neuropsychiatric diseases, little is known about how personal factors might account for the disparity of results from studies of cognition and rTMS. In this study, we investigated the effects of high-frequency rTMS on response inhibition control and explored the time course changes in cognitive processing and brain metabolic mechanisms after rTMS using event-related potentials (ERPs) and magnetic resonance spectroscopy (¹H-MRS).

Methods

Participants were all right-handed and were naive to rTMS and the Go/NoGo task. Twenty-five healthy young participants underwent one 10 Hz rTMS session per day in which stimulation was applied over the left dorsolateral prefrontal cortex (DLPFC), and a homogeneous participant group of 25 individuals received a sham rTMS treatment for 1  week. A Go/NoGo task was performed, an electroencephalogram (EEG) was recorded, and ¹H-MRS was performed.

Results

The results revealed that there was a strong trend of decreasing commission errors of NoGo stimuli by high frequency rTMS over the left DLPFC, whereas there was no significant difference between before and after rTMS treatment with respect to these parameters in the sham rTMS group. High-frequency rTMS significantly increased the amplitude of NoGo-N2 but not Go-N2, Go-P3, or NoGo-P3. The myo-inositol /creatine complex (MI/Cr) ratio, indexing cerebral metabolism, in the left DLPFC was decreased in the rTMS treated group.

Discussion

This observation supports the view that high-frequency rTMS over the left DLPFC has the strong tendency of reducing commission errors behaviorally, increase the amplitude of NoGo-N2 and improve the response inhibition control of healthy young participants. The results are consistent with the excitatory properties of high frequency rTMS. We suggest that the increase in the NoGo-N2 amplitude may be related to the increased excitability of the DLPFC-anterior cingulate cortex (ACC) neural loop. Metabolic changes in the DLPFC may be a possible mechanism for the improvement of the response inhibition control of rTMS.

High Acoustic Impedance and Attenuation Backing for High-Frequency Focused P(VDF-TrFE)-Based Transducers

Backing materials with tailored acoustic properties are beneficial for miniaturized ultrasonic transducer design. Whereas piezoelectric P(VDF-TrFE) films are common elements in high-frequency (>20 MHz) transducer design, their low coupling coefficient limits their sensitivity. Defining a suitable sensitivity-bandwidth trade-off for miniaturized high-frequency applications requires backings with impedances of >25 MRayl and strongly attenuating to account for miniaturized requirements. The motivation of this work is related to several medical applications such as small animal, skin or eye imaging. Simulations showed that increasing the acoustic impedance of the backing from 4.5 to 25 MRayl increases transducer sensitivity by 5 dB but decreases the bandwidth, which nevertheless remains high enough for the targeted applications. In this paper, porous sintered bronze material with spherically shaped grains, size-adapted for 25-30 MHz frequency, was impregnated with tin or epoxy resin to create multiphasic metallic backings. Microstructural characterizations of these new multiphasic composites showed that impregnation was incomplete and that a third air phase was present. The selected composites, sintered bronze-tin-air and sintered bronze-epoxy-air, at 5-35 MHz characterization, produced attenuation coefficients of 1.2 and >4 dB/mm/MHz and impedances of 32.4 and 26.4 MRayl, respectively. High-impedance composites were adopted as backing (thickness = 2 mm) to fabricate focused single-element P(VDF-TrFE)-based transducers (focal distance = 14 mm). The center frequency was 27 MHz, while the bandwidth at -6 dB was 65% for the sintered-bronze-tin-air-based transducer. We evaluated imaging performance using a pulse-echo system on a tungsten wire (diameter = 25 μm) phantom. Images confirmed the viability of integrating these backings in miniaturized transducers for imaging applications.

Application of Low Temperature Processed 0-3 Composite Piezoelectric Thick Films in Flexible, Non-planar, High Frequency Ultrasonic Devices

Low-temperature, flexible, 0-3 composite piezoelectric materials can decrease the size, cost, and complexity of high-frequency acoustic devices on temperature sensitive substrates such as those in catheter based ultrasonic devices and acoustooptic sensors. In this paper, the application of low-temperature 0-3 connected composite thick films in flexible, non-planar, high frequency ultrasonic devices is reported. A flexible high-frequency ultrasound transducer and an acousto-optic radio-frequency (RF) field sensor are demonstrated utilizing PZT-based composite thick films. Flexible composite films have been fabricated with thicknesses between 20-100μm utilizing screen-printing, stencil-printing, and dip-coating techniques. Composite films' piezoelectric d33 coefficient is measured, with results between 35-43 pC/N. Ultrasonic transducers utilizing these films demonstrate broadband acoustic response. A composite transducer is fabricated on flexible polyimide and wrapped around a 3mm catheter. Pulse-echo experiments demonstrate viability of these films as both as an actuator and a sensor in flexible devices. The composite material is further dip-coated onto an optical fiber Bragg grating to form a flexible acousto-optic RF field sensor. The sensor demonstrates RF field sensing in the 20-130 MHz range. The results from these experiments indicate significant potential for future flexible, high frequency ultrasonic devices utilizing low temperature 0-3 composite piezoelectric materials on temperature sensitive substrates.

Advances in Catchment Science, Hydrochemistry, and Aquatic Ecology Enabled by High-Frequency Water Quality Measurements

High-frequency water quality measurements in streams and rivers have expanded in scope and sophistication during the last two decades. Existing technology allows in situ automated measurements of water quality constituents, including both solutes and particulates, at unprecedented frequencies from seconds to subdaily sampling intervals. This detailed chemical information can be combined with measurements of hydrological and biogeochemical processes, bringing new insights into the sources, transport pathways, and transformation processes of solutes and particulates in complex catchments and along the aquatic continuum. Here, we summarize established and emerging high-frequency water quality technologies, outline key high-frequency hydrochemical data sets, and review scientific advances in key focus areas enabled by the rapid development of high-frequency water quality measurements in streams and rivers. Finally, we discuss future directions and challenges for using high-frequency water quality measurements to bridge scientific and management gaps by promoting a holistic understanding of freshwater systems and catchment status, health, and function.

Magnetic Energy Losses and Temperature Control System for Giant Magnetostrictive Transducer

The giant magnetostrictive transducer (GMT) can be widely used in ultra-precision machining in precision-fluid-control fields. The temperature stability of GMT is critical for the reliable generation of output characteristics. This study presents a magnetic-energy-losses method for the GMT working at high frequency, and designs a temperature-stable control system to improve energy transmission and heat dissipation. Based on the loss-separation theory and experimental data, the temperature-rise characteristics of the transducer are analyzed. The temperature rise considers the effects of hysteresis loss, the eddy-current loss, the anomalous loss and the Joule heat. A constitutive relation among losses, frequency and magnetic-flux density is given. The temperature distribution of the transducer can be quickly and accurately calculated, using the constitutive equation. According to the convective heat-transfer and the thermal-compensation method, a temperature-control system is designed. A prototype of the system is then fabricated and tested to verify the feasibility and efficacy of the proposed design methods. The results demonstrate that the output- displacement deviation can be controlled at less than 0.65 μm, and the temperature difference is less than 3 °C.

Neuronavigated Repetitive Transcranial Stimulation Improves Neurocognitive Functioning in Veterans with Schizophrenia: A Possible Role of BDNF Polymorphism

It has been reported in the previous literatures that high-frequency (HF) neuronavigated repetitive transcranial magnetic stimulation (rTMS) may improve neurocognitive functioning in patients with schizophrenia. Nonetheless, the heterogeneity of the research findings with regards to the effectiveness of HF-rTMS on the neurocognitive functioning in patients with schizophrenia greatly hinders its clinical application. The current study was designed to determine the predictive role of BDNF variants for neurocognitive improvements after rTMS administration in veterans with schizophrenia. 109 hospitalized veterans with schizophrenia were randomly allocated to active HF-rTMS (n=63) or sham stimulation (n=46) over left DLPFC for 4 consecutive weeks. Neurocognitive functions were assessed by using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) at baseline and at the end of week 4. BDNF polymorphism was genotyped by the technicians. Compared with sham stimulation sessions, the immediate memory performance was significantly increased in active sessions after neuronavigated HF-rTMS administration. In addition, patients with the CC homozygotes demonstrated greater improvement of immediate memory after rTMS treatment, while T allele carriers showed no significant improvement in immediate memory domain relative to baseline performance of immediate memory. Our findings suggest that add-on neuronavigated HF-rTMS is beneficial on immediate memory only in patients with CC homozygotes, but not in T allele carriers. This pilot study provides further evidence for BDNF as a promise biomarker in predicting the clinical response to rTMS stimulation.

Descriptive Analysis of Footplate Position After Myopic Implantable Collamer Lens Implantation Using a Very High-Frequency Ultrasound Robotic Scanner

Purpose

To assess the position of the haptics of the implantable collamer lens (ICL) in myopic eyes using a high-frequency ultrasound robotic scanner.

Methods

This was a prospective, single-arm, observational study carried out at the Instituto Zaldivar SA (Mendoza, Argentina) in a sample of 52 eyes who have been submitted to successful ICL implantation prior to enrollment. Images of the eyes were obtained using a very-high frequency digital ultrasound robotic scanner (VHFDU) to establish the position of the ICL in the posterior chamber and its relation to the ciliary sulcus. New parameters for lens position analysis were also described.

Results

In 81% of cases (42 eyes), the ICL rests on the ciliary body (CB) in both temporal and nasal sides, being slightly lower than 6% (3 eyes) those that rest on the sulcus in both sides, with significant correlations between ICL position and vault values (p<0.05). Cases in which the ICL position was CB-CB yielded central vault values across the whole range determined within the sample, but most of the eyes where the ICL rests on both the sulcus in one side and the CB in the other yield greater central vault values. Correlation was significant between ICL position and retroposition distance on the temporal side (Spearman's rho -0.487, p<0.001). A significant but weaker correlation was also found between ICL position and retroiridian space (p<0.05).

Conclusion

ICL for myopia footplates tend to locate outside of the sulcus in a significant percentage of patients after successful implantation. VHFDU assessment in eyes implanted with an ICL to properly study the lens footplate position and posterior anatomical relations provides important additional information besides post-surgery vault.

The processing network of high-frequency acoustoelectric signal in the living rat brain

Objective.Acoustoelectric brain imaging (ABI) is a potential noninvasive electrophysiological neuroimaging method with high spatiotemporal resolution. At the focal spot of the focused ultrasound, with the couple of acoustic and electric fields, high-frequency acoustoelectric (HF AE) signal is generated. Because the brain is a volume conductor, HF AE signal can be detected in other brain cortex. The processing of HF AE signal is critical for improving decoding precision, further improving the spatial resolution performance of ABI. This study investigates the processing network of HF AE signal in the living rat brain.Approach.When HF AE generated on the left primary visual cortex (V1-L), low-frequency (LF) electroencephalography and HF AE signals on different cortex were recorded at the same time. Firstly, AE signal on different sides of the brain cortex were compared, including prefrontal cortex (FrA) and primary somatosensory cortex (S1FL). Then, we constructed and analyzed functional networks of two signals.Main results.In the same cortex, HF AE signal on the right side had stronger intensity. And compared with LF networks, HF AE network had larger global efficiency and shorter characteristic path length, denoting the stronger processing and transmission of AE signal. Additionally, in HF AE network, the node had significantly increased local properties and the connection were concentrated in the occipital lobe, reflecting the occipital lobe plays an important role in the processing.Significance.Experiment results demonstrate that, compared with LF network, HF AE network is more efficient and had stronger transmission capabilities. And the connection of HF AE network is concentrated in the occipital lobe. This work preliminarily reveals the HF AE signal processing, which is significant for improving the ABI quality and provides a new insight for understanding the brain HF signal.

Systematic Review and Meta-Analysis of High-Frequency rTMS over the Dorsolateral Prefrontal Cortex .on Chronic Pain and Chronic-Pain-Accompanied Depression

The effect of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) on the dorsolateral prefrontal cortex (DLPFC) can relieve chronic pain and accompanying depressive symptoms. However, in recent years, some high-quality studies have challenged this view. Therefore, it is necessary to update the data and analyze the effects of HF rTMS on the DLPFC on chronic pain and accompanying depression. We performed a systematic review and meta-analysis to evaluate the effect of HF rTMS on the DLPFC on chronic pain and accompanying depression. We searched PubMed, Medline, Web of Science, and Cochrane through September 2021. The search strings searched were : "pain" AND ("TMS" OR "transcranial magnetic stimulation") AND "prefrontal cortex". The inclusion criteria according to PICOS was as follows: P, patient with chronic pain; I, HF (≥5 Hz) rTMS on the DLPFC; C, included a sham treatment condition; O, pain indicators; S, pre-/poststudies, crossover, or parallel-group. We extracted the pain and accompanying depression evaluation indicators. The short-term analgesic effect of HF rTMS over the left DLPFC is not significant (WMD = 0.34, 95% CI: [-1.60, 2.28]) but has a significant mid-term and long-term analgesic effect on chronic pain (WMD = -0.50, 95% CI: [-0.99, -0.01]; WMD = -1.10, 95% CI: [-2.00, -0.19], respectively). HF rTMS over the DLPFC can effectively alleviate the depressive symptoms of patients with chronic pain (WMD = -0.83, 95% CI: [-3.01, 1.36]). Thus, HF rTMS on the left DLPFC can relieve chronic pain and accompanying depressive symptoms.

Ultra-Wide Range Vibration Frequency Detection Sensors Based on Elastic Steel Triboelectric Nanogenerators for Intelligent Machinery Monitoring

Vibration measurement and analysis play an important role in diagnosing mechanical faults, but existing vibration sensors are limited by issues such as dependence on external power sources and high costs. To overcome these challenges, the use of triboelectric nanogenerator (TENG)-based vibration sensors has recently attracted attention. These vibration sensors measure a small range of vibration frequencies and are not suitable for measuring high-frequency vibrations. Herein, a self-powered vibration sensor based on an elastic steel triboelectric nanogenerator (ES-TENG) is proposed. By optimizing the elastic steel sheet structure and combining time-frequency transformation and filtering processing methods, the measurement of medium- and high-frequency vibrations is achieved. These results demonstrate that the ES-TENG can perform vibration measurements in the range of 2-10,000 Hz, with a small average error (~0.42%) between the measured frequency and external vibration frequency values. Therefore, the ES-TENG can be used as a self-powered, highly-accurate vibration sensor for intelligent machinery monitoring.

Update on Hedgehog Pathway Inhibitor Therapy for Patients with Basal Cell Naevus Syndrome or High-frequency Basal Cell Carcinoma

Some patients with basal cell carcinoma develop a large number of basal cell carcinomas during their lives. The most common underlying genetic disease that causes multiple basal cell carcinomas is basal cell naevus syndrome. Basal cell naevus syndrome is caused by a germline mutation in patched-1 (PTCH1), a tumour suppressor gene of the hedgehog signalling pathway. However, in a significant portion of patients with multiple basal cell carcinomas, no underlying genetic cause is found. Nevertheless, these patients can experience a treatment burden comparable to that of patients with basal cell naevus syndrome. They are referred to as high-frequency basal cell carcinoma patients. Hedgehog pathway inhibitors were the first group of targeted therapy for basal cell carcinomas. This study reviews the literature on hedgehog pathway inhibitor therapy for patients with basal cell naevus syndrome and high-frequency basal cell carcinoma, to provide an overview on efficacy, safety, dosing regimens, tumour resistance and reoccurrence, and health-related quality of life.

Effectiveness of Electrostatic Shielding in High-Frequency Electromagnetic Induction Soil Sensing

High-frequency electromagnetic induction (HFEMI) sensors, operating in the frequency range from 300 kHz to 30 MHz, have been proposed for the measurement of soil electrical conductivity and dielectric permittivity that are related to the physical and chemical properties of soil. Because of the high-frequency operation, the capacitive coupling between the sensor transmitter and receiver coils is comparable to inductive coupling, creating the need for electrostatic shielding. The remnant capacitive coupling after the implementation of shielding can lead to significant difficulties in the sensor signal interpretation, because both coupling mechanisms are highly dependent on the geometry of the HFEMI sensor and applied shield. In this paper, we introduce the discussion on the relationship between the sensor geometry, shielding and the coupling mechanisms for HFEMI soil sensing. We theoretically and experimentally evaluate a typical HFEMI sensor and its shielding in the frequency range of up to 20 MHz and propose a method for evaluating the effectiveness of a shield configuration. In the case study, we experimentally analyze the HFEMI sensor above a saline solution for two shield configurations. The results agree well with the results of a finite element method analysis.

The Minimal Subcortical Electronic Threshold Predicts the Motor Deficit and Survivals in Non-Awake Surgery for Gliomas Involving the Motor Pathway

Purpose

Direct subcortical motor mapping is the golden criterion to detect and monitor the motor pathway during glioma surgery. Minimal subcortical monopolar threshold (MSCMT) means the minimal distance away from the motor pathway and is critical to decide to continue or interrupt glioma resection. However, the optimal cutoff value of MSCMT for glioma resection in non-awake patients has not been reported discreetly. In this study, we try to establish the safe cutoff value of MSCMT for glioma resection and analyzed its relationship with postoperative motor deficit and long-term survivals.

Methods

We designed this prospective study with high-frequency electronic stimulus method. The cutoff MSCMT of postoperative motor deficits was statistically calculated by receiver operating characteristic (ROC) curve, and its relationship with motor deficit and survivals was analyzed by logistic and Cox regression, respectively.

Results

The cutoff MSCMT to predict motor deficit after surgery was 3.9 mA on day 1, 3.7 mA on day 7, 5.2 mA at 3 months, and 5.2 mA at 6 months. MSCMT ≤3.9 mA and MSCMT ≤5.2 mA independently predicted postoperative motor deficits at four times after surgery (P < 0.05) but had no effect on the removal degree of tumor (P > 0.05). In high-grade gliomas, MSCMT ≤3.9 mA independently predicted shorter progression-free survival [odds ratio (OR) = 3.381 (1.416–8.076), P = 0.006] and overall survival [OR = 3.651 (1.336–9.977), P = 0.012]. Power model has the best fitness for paired monopolar and bipolar high-frequency thresholds.

Conclusions

This study showed strong cause–effect relation between MSCMT and postoperative motor deficit and prognoses. The cutoff MSCMT was dug out to avoid postoperative motor deficit. Further studies are needed to establish the results above.

Treatment of nonsurgical refractory back pain with high-frequency spinal cord stimulation at 10 kHz: 12-month results of a pragmatic, multicenter, randomized controlled trial

OBJECTIVE

Spinal cord stimulation (SCS) at 10 kHz (10-kHz SCS) is a safe and effective therapy for treatment of chronic low-back pain. However, it is unclear from existing evidence whether these findings can be generalized to patients with chronic back pain that is refractory to conventional medical management (CMM) and who have no history of spine surgery and are not acceptable candidates for spine surgery. The authors have termed this condition "nonsurgical refractory back pain" (NSRBP) and conducted a multicenter, randomized controlled trial to compare CMM with and without 10-kHz SCS in this population.

METHODS

Patients with NSRBP, as defined above and with a spine surgeon consultation required for confirmation, were randomized 1:1 to patients undergoing CMM with and without 10-kHz SCS. CMM included nonsurgical treatment for back pain, according to physicians' best practices and clinical guidelines. Primary and secondary endpoints included the responder rate (≥ 50% pain relief), disability (Oswestry Disability Index [ODI]), global impression of change, quality of life (EQ-5D-5L), and change in daily opioid use and were analyzed 3 and 6 months after randomization. The protocol allowed for an optional crossover at 6 months for both arms, with observational follow-up over 12 months.

RESULTS

In total, 159 patients were randomized; 76 received CMM, and 69 (83.1%) of the 83 patients who were assigned to the 10-kHz SCS group received a permanent implant. At the 3-month follow-up, 80.9% of patients who received stimulation and 1.3% of those who received CMM were found to be study responders (primary outcome, ≥ 50% pain relief; p < 0.001). There was also a significant difference between the treatment groups in all secondary outcomes at 6 months (p < 0.001). In the 10-kHz SCS arm, outcomes were sustained, including a mean 10-cm visual analog scale score of 2.1 ± 2.3 and 2.1 ± 2.2 and mean ODI score of 24.1 ± 16.1 and 24.0 ± 17.0 at 6 and 12 months, respectively (p = 0.9). In the CMM arm, 74.7% (56/75) of patients met the criteria for crossover and received an implant. The crossover arm obtained a 78.2% responder rate 6 months postimplantation. Five serious adverse events occurred (procedure-related, of 125 total permanent implants), all of which resolved without sequelae.

CONCLUSIONS

The study results, which included follow-up over 12 months, provide important insights into the durability of 10-kHz SCS therapy with respect to chronic refractory back pain, physical function, quality of life, and opioid use, informing the current clinical practice for pain management in patients with NSRBP.

The Challenge of Converting "Failed Spinal Cord Stimulation Syndrome" Back to Clinical Success, Using SCS Reprogramming as Salvage Therapy, through Neurostimulation Adapters Combined with 3D-Computerized Pain Mapping Assessment: A Real Life Retrospective Study

While paresthesia-based Spinal Cord Stimulation (SCS) has been proven effective as treatment for chronic neuropathic pain, its initial benefits may lead to the development of "Failed SCS Syndrome' (FSCSS) defined as decrease over time related to Loss of Efficacy (LoE) with or without Loss of Coverage (LoC). Development of technologies associating new paresthesia-free stimulation waveforms and implanted pulse generator adapters provide opportunities to manage patients with LoE. The main goal of our study was to investigate salvage procedures, through neurostimulation adapters, in patients already implanted with SCS and experiencing LoE. We retrospectively analyzed a cohort of patients who were offered new SCS programs/waveforms through an implanted adapter between 2018 and 2021. Patients were evaluated before and at 1-, 3-, 6- and 12-month follow-ups. Outcomes included pain intensity rating with a Visual Analog Scale (VAS), pain/coverage mappings and stimulation preferences. Last follow-up evaluations (N = 27) showed significant improvement in VAS (p = 0.0001), ODI (p = 0.021) and quality of life (p = 0.023). In the 11/27 patients with LoC, SCS efficacy on pain intensity (36.89%) was accompanied via paresthesia coverage recovery (55.57%) and pain surface decrease (47.01%). At 12-month follow-up, 81.3% preferred to keep tonic stimulation in their waveform portfolio. SCS conversion using adapters appears promising as a salvage solution, with an emphasis on paresthesia recapturing enabled via spatial retargeting. In light of these results, adapters could be integrated in SCS rescue algorithms or should be considered in SCS rescue.

Baseline Clinical and Neuroimaging Biomarkers of Treatment Response to High-Frequency rTMS Over the Left DLPFC for Resistant Depression

BACKGROUND

Repetitive transcranial magnetic stimulation (rTMS) has proven to be an efficient treatment option for patients with treatment-resistant depression (TRD). However, the success rate of this method is still low, and the treatment outcome is unpredictable. The objective of this study was to explore clinical and structural neuroimaging factors as potential biomarkers of the efficacy of high-frequency (HF) rTMS (20 Hz) over the left dorso-lateral pre-frontal cortex (DLPFC).

METHODS

We analyzed the records of 131 patients with mood disorders who were treated with rTMS and were assessed at baseline at the end of the stimulation and at 1 month after the end of the treatment. The response is defined as a 50% decrease in the MADRS score between the first and the last assessment. Each of these patients underwent a T1 MRI scan of the brain, which was subsequently segmented with FreeSurfer. Whole-brain analyses [Query, Design, Estimate, Contrast (QDEC)] were conducted and corrected for multiple comparisons. Additionally, the responder status was also analyzed using binomial multivariate regression models. The explored variables were clinical and anatomical features of the rTMS target obtained from T1 MRI: target-scalp distance, DLPFC gray matter thickness, and various cortical measures of interest previously studied.

RESULTS

The results of a binomial multivariate regression model indicated that depression type (p = 0.025), gender (p = 0.010), and the severity of depression (p = 0.027) were found to be associated with response to rTMS. Additionally, the resistance stage showed a significant trend (p = 0.055). Whole-brain analyses on volume revealed that the average volume of the left part of the superior frontal and the caudal middle frontal regions is associated with the response status. Other MRI-based measures are not significantly associated with response to rTMS in our population.

CONCLUSION

In this study, we investigated the clinical and neuroimaging biomarkers associated with responsiveness to high-frequency rTMS over the left DLPFC in a large sample of patients with TRD. Women, patients with bipolar depressive disorder (BDD), and patients who are less resistant to HF rTMS respond better. Responders present a lower volume of the left part of the superior frontal gyrus and the caudal middle frontal gyrus. These findings support further investigation into the use of clinical variables and structural MRI as possible biomarkers of rTMS treatment response.

Numerical Evaluation of the Effect of Geometric Tolerances on the High-Frequency Performance of Graphene Field-Effect Transistors

The interest in graphene-based electronics is due to graphene’s great carrier mobility, atomic thickness, resistance to radiation, and tolerance to extreme temperatures. These characteristics enable the development of extremely miniaturized high-performing electronic devices for next-generation radiofrequency (RF) communication systems. The main building block of graphene-based electronics is the graphene-field effect transistor (GFET). An important issue hindering the diffusion of GFET-based circuits on a commercial level is the repeatability of the fabrication process, which affects the uncertainty of both the device geometry and the graphene quality. Concerning the GFET geometrical parameters, it is well known that the channel length is the main factor that determines the high-frequency limitations of a field-effect transistor, and is therefore the parameter that should be better controlled during the fabrication. Nevertheless, other parameters are affected by a fabrication-related tolerance; to understand to which extent an increase of the accuracy of the GFET layout patterning process steps can improve the performance uniformity, their impact on the GFET performance variability should be considered and compared to that of the channel length. In this work, we assess the impact of the fabrication-related tolerances of GFET-base amplifier geometrical parameters on the RF performance, in terms of the amplifier transit frequency and maximum oscillation frequency, by using a design-of-experiments approach.

Effects of extended high frequency bandwidth in osseointegrated bone conduction device users

High-frequency hearing above 5000 Hz improves the detection and discrimination of high frequency phonemes. Improved access to high-frequency hearing may be particularly advantageous in unilaterally deafened listeners who experience reduced access to high frequency speech cues on their impaired side and decreased speech perception abilities in competing noise. This study aimed to investigate the effects of extended high-frequency bandwidth on speech perception in unilaterally deafened osseointegrated bone conduction hearing device recipients. To study the effect of extended high-frequency bandwidth, participants underwent aided testing in narrow bandwidth and extended high-frquency bandwidth BCD listening conditions. Aided word and phoneme recognition in quiet was assessed at soft and conversational speech levels with the better ear plugged. Aided thresholds and Ling 6 phoneme sounds were also assessed in quiet with the better ear plugged. Speech perception in noise was assessed at ± 90° and co-located at 0° using the adaptive Hearing in Noise Test. Findings demonstrate a significant improvement in speech perception outcomes when listening with extended high-frequency bandwidth. Extended high-frequency bandwidth significantly improved word and phoneme recognition for soft and average conversational speech. The largest effects were observed for voiceless phonemes. Results suggest use of bone conduction devices with extended high-frequency bandwidth result in improved hearing outcomes when compared with narrow bandwidth bone conduction devices.

A pilot study verifying the effectiveness of high-frequency repetitive transcranial magnetic stimulation in combination with intensive speech-language-hearing therapy in patients with chronic aphasia

BACKGROUND

A lot of research on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in patients with aphasia in the chronic stage deals with low-frequency stimulation, and reports on high-frequency stimulation (HF-rTMS) are scarce.

OBJECTIVE

The purpose of this study was to evaluate retrospectively the effectiveness of high-frequency rTMS in combination with intensive speech-language-hearing therapy (ST) following the identification of the stimulation site using functional magnetic resonance imaging (fMRI) before, after the procedure and at 3 months in patients with aphasia in the chronic stage.

METHODS

20 patients with aphasia in the chronic stage who met the eligibility criteria for rTMS therapy and who underwent HF-rTMS for the first time were included in the present study. All patients received fMRI before hospitalization, and the stimulation site was decided accordingly.

RESULTS

There was a significant improvement in all patients, rTMS to the left hemisphere, fluent and non-fluent groups by the evaluation of pre- and post- treatment by hospitalization. All groups had a significant improvement in total Standard Language Test of Aphasia score at 3 months when compared with the time of hospitalization.

CONCLUSIONS

The current study indicates that HF-rTMS in combination with intensive ST is an effective therapeutic approach for patients with aphasia in the chronic stage.

Effects of Particle Size on the Dielectric, Mechanical, and Thermal Properties of Recycled Borosilicate Glass-Filled PTFE Microwave Substrates

Low dielectric loss and low-cost recycled borosilicate (BRS) glass-reinforced polytetrafluoroethylene (PTFE) composites were fabricated for microwave substrate applications. The composites were prepared through a dry powder processing technique by dispersing different micron sizes (25 µm, 45 µm, 63 µm, 90 µm, and 106 µm) of the recycled BRS filler in the PTFE matrix. The effect of the filler sizes on the composites' thermal, mechanical, and dielectric properties was studied. The dielectric properties of the composites were characterised in the frequency range of 1-12 GHz using an open-ended coaxial probe (OCP) connected to a vector network analyser (VNA). XRD patterns confirmed the phase formation of PTFE and recycled BRS glass. The scanning electron microscope also showed good filler dispersion at larger filler particle sizes. In addition, the composites' coefficient of thermal expansion and tensile strength decreased from 12.93 MPa and 64.86 ppm/°C to 7.12 MPa and 55.77 ppm/°C when the filler size is reduced from 106 μm to 25 μm. However, moisture absorption and density of the composites increased from 0.01% and 2.17 g/cm3 to 0.04% and 2.21 g/cm3. The decrement in filler size from 106 μm to 25 μm also increased the mean dielectric constant and loss tangent of the composites from 2.07 and 0.0010 to 2.18 and 0.0011, respectively, while it reduced the mean signal transmission speed from 2.088 × 108 m/s to 2.031 × 108 m/s. The presented results showed that PTFE/recycled BRS composite exhibited comparable characteristics with commercial high-frequency laminates.

Evaluation of Anti-Adhesion Characteristics of Diamond-Like Carbon Film by Combining Friction and Wear Test with Step Loading and Weibull Analysis

Anti-adhesion characteristics are important requirements for diamond-like carbon (DLC) films. The failure load corresponding to the anti-adhesion capacity varies greatly on three types of DLC film (hydrogen-free amorphous carbon film (a-C), hydrogenated amorphous carbon film (a-C:H), and tetrahedral hydrogen-free amorphous carbon film (ta-C)) in the friction and wear test with step loading using a high-frequency, linear-oscillation tribometer. Therefore, a new method that estimates a representative value of the failure load was developed in this study by performing a statistical analysis based on the Weibull distribution based on the assumption that the mechanism of delamination of a DLC film obeys the weakest link model. The failure load at the cumulative failure probabilities of 10% and 50% increased in the order ta-C < a-C:H < a-C and ta-C < a-C < a-C:H, respectively. The variation of the failure load, represented by the Weibull slope, was minimum on ta-C and maximum on a-C:H. The rank of the anti-adhesion capacity of each DLC film with respect to the load obtained by a constant load test agreed with the rank of the failure load on each DLC film at the cumulative failure probability of 10% obtained by Weibull analysis. It was found to be possible to evaluate the anti-adhesion capacity of a DLC film under more practical conditions by combining the step loading test and Weibull analysis.

Supramaximal-Exercise Training Improves Heart Rate Variability in Association With Reduced Catecholamine in Obese Adults

This study investigates the effect of 6 weeks of supramaximal exercise training (SET) on heart rate variability (HRV) and associated factors in sedentary obese (OB) and normal-weight (NW) adults. In this study, 19 OB [22.9 (8.4) years; body mass index (BMI) 33.4 (1.4) kg/m²] and 18 NW [23.2 (4.4) years; BMI 23.3 (1.2) kg/m²] adults completed a 6-week SET intervention. Anthropometric and aerobic indicators as well the homeostasis model assessment index for insulin resistance index (HOMA-IR) were assessed at baseline and after SET. The low- and high-frequency [(LF (0.03–0.15 Hz) in ms² and HF (0.15–0.4 Hz) in ms²)] analysis of HRV as well as adrenaline (A in nmol/l) and noradrenaline (NA in nmol/l) responses were assessed at resting condition and during ventilatory threshold 1 (VT1) of a graded maximal test at baseline and after SET. At baseline, resting HF, LF and the LF/HF ratio were different among groups (P < 0.01, respectively) and were significantly associated with waist-to-hip ratio (β = −0.26; p = 0.01, β = −0.12; p = 0.01 and, β = 0.21; p = 0.01). During exertion at VT1, only LF/HF ratio was associated with NA responses (β = 0.23; p = 0.01). After SET, the frequency domain marker improved significantly for both groups in comparison to baseline. These improvements are manifested by LF and HF increases and LF/HF ratio decreases in the rest condition (p < 0.01, respectively) and during exertion at VT1 (p < 0.01, respectively). The improvement in LH and HF were associated with VO₂max increases (β = 0.22 p = 0.01 and β = 0.33; p = 0.01). The decreases observed for the LF/HF ratio are mainly associated to NA decreases observed at rest (β = 0.31; p = 0.001) and at VT1 (β = 0.38; p = 0.001). Obese adults have altered HRV, and 6 weeks of SET improves HRV variables at rest and during VT1 exertion. While LF and HF improvement were associated with VO2max increases, the LF/HF ratio was mainly associated with noradrenaline decreases observed at rest and at VT1.

Development of Broadband High-Frequency Piezoelectric Micromachined Ultrasonic Transducer Array

Piezoelectric micromachined ultrasonic transducers (PMUT) are promising elements to fabricate a two-dimensional (2D) array with a pitch small enough (approximately half wavelength) to form and receive arbitrary acoustic beams for medical imaging. However, PMUT arrays have so far failed to combine the wide, high-frequency bandwidth needed to achieve a high axial resolution. In this paper, a polydimethylsiloxane (PDMS) backing structure is introduced into the PMUTs to improve the device bandwidth while keeping a sub-wavelength (λ) pitch. We implement this backing on a 16 × 8 array with 75 µm pitch (3λ/4) with a 15 MHz working frequency. Adding the backing nearly doubles the bandwidth to 92% (−6 dB) and has little influence on the impulse response sensitivity. By widening the transducer bandwidth, this backing may enable using PMUT ultrasonic arrays for high-resolution 3D imaging.

High-Frequency Spinal Cord Stimulation at 10 kHz for the Treatment of Nonsurgical Refractory Back Pain: Design of a Pragmatic, Multicenter, Randomized Controlled Trial

BACKGROUND

Spinal cord stimulation (SCS) has been shown to provide pain relief for chronic back and leg pain due to failed back surgery syndrome. But many patients with chronic back pain have not had major back surgery or are not good candidates for surgery, and conventional medical management (CMM) provides limited relief. We have termed this condition nonsurgical refractory back pain (NSRBP). Level 1 evidence does not yet exist showing the therapeutic benefit of SCS for NSRBP.

OBJECTIVE

To compare 10-kHz SCS plus CMM (10-kHz SCS + CMM) to CMM alone for treatment of NSRBP in terms of clinical and cost effectiveness.

STUDY DESIGN

Multicenter, randomized controlled trial (RCT), with subjects randomized 1:1 to either 10-kHz SCS + CMM or CMM alone. Optional crossover occurs at 6 months if treatment does not achieve ≥50% pain relief.

METHODS

Patients with NSRBP as defined above may be enrolled if they are ineligible for surgery based on surgical consultation. Subjects randomized to 10-kHz SCS + CMM will receive a permanent implant if sufficient pain relief is achieved in a temporary trial. Both groups will receive CMM per standard of care and will undergo assessments at baseline and at follow-ups to 12 months. Self-report outcomes include pain, disability, sleep, mental health, satisfaction, healthcare utilization, and quality of life.

RESULTS

Enrollment was initiated on September 10, 2018. Prespecified independent interim analysis at 40% of the enrollment target indicated the sample size was sufficient to show superiority of treatment at the primary endpoint; therefore, enrollment was stopped at 211.

CONCLUSIONS

This large multicenter RCT will provide valuable evidence to guide clinical decisions in NSRBP.

Idiopathic Sudden Sensorineural Hearing Loss in Patients with Obstructive Sleep Apnea

PURPOSE

Obstructive sleep apnea (OSA) is characterized by recurring hypoxic-apneic events during sleep, and labyrinthine vascular compromise is a pathophysiologic hallmark of idiopathic sudden sensorineural hearing loss (ISSNHL). Some reports have discussed the relationship between OSA and hearing impairment; however, few have examined hearing prognosis in OSA and patients without OSA with ISSNHL. We aimed to investigate clinical manifestations of ISSNHL in patients with OSA, including severity of hearing loss and response to treatment.

PATIENTS AND METHODS

A case-control study was conducted by extracting data from the sleep center and cochlea center databases of the Chang Gung Memorial Hospital. A retrospective chart review was performed to include confirmed adult OSA patients diagnosed with unilateral ISSNHL. Age and sex-matched patients without OSA with ISSNHL were enrolled as controls. Pure-tone average (PTA) thresholds were measured at specific frequencies. Changes in PTA before and after standard treatment with oral prednisolone (1mg/kg/day for 5 days, then tapered) and between participants with OSA and without OSA were compared. Standard treatment was given to all ISSNHL patients.

RESULTS

Twenty-eight out of 8500 (0.33%) OSA patients experienced subsequent ISSNHL in 9 years. Patients with OSA (n=28) had poorer high-frequency perception in the unaffected ear than the patients without OSA (n=120), although the difference was not significant. Hearing in the affected ear among patients with OSA was comparable to that patients without OSA at individual frequencies and average, suggesting no difference in hearing loss in the affected ear between the two groups. In terms of high-frequencies (4000 and 8000 Hz) perception, patients with OSA had significantly poorer responses to steroid treatment than patients without OSA.

CONCLUSION

ISSNHL may be one of the auditory complications associated with OSA. Patients with OSA had poorer prednisolone related hearing improvement in high frequencies than patients without OSA. Despite study limitations, OSA-related hypoxia and snoring noise is hazardous to hearing and standard treatments with CPAP is suggested in OSA patients for both holistic and auditory health.

Mechanisms and mode of action of spinal cord stimulation in chronic neuropathic pain

Tonic spinal cord stimulation (SCS) has been used as a treatment for chronic neuropathic pain ever since its discovery in late 1960s. Despite its clinical successes in a subset of chronic neuropathic pain syndromes, several limitations such as insufficient pain relief and uncomfortable paresthesias have led to the development of new targets, the dorsal root ganglion, and new stimulation waveforms, such as burst and high frequency. The aim of this review is to provide a brief overview of the main mechanisms behind the mode of action of the different SCS paradigms. Tonic SCS mainly acts via a segmental spinal mechanism where it induces GABA-release from inhibitory interneurons in the spinal dorsal horn. Tonic SCS concurrently initiates neuropathic pain modulation through a supraspinal-spinal feedback loop and serotonergic descending fibers. Mechanisms of stimulation of the DRG as well as those related to new SCS paradigms are now under investigation, where it seems that burst SCS not only stimulates sensory, discriminative aspects of pain (like Tonic SCS) but also emotional, affective, and motivational aspects of pain. Initial long-term study results on closed-loop SCS systems hold promise for improvement of future SCS treatment.

Compressive Neuropathy of the Facial Nerve Presenting as Bell's Palsy in a Pediatric Patient on High-Frequency Oscillatory Ventilation

A three-year eight-month-old female with Werdnig Hoffman disease presented with an acute onset of respiratory failure secondary to influenza infection. The patient required conventional mechanical ventilation (CMV). Due to worsening hypoxemia on maximal support, high-frequency oscillatory ventilation (HFOV) was initiated. On recovery from her respiratory failure, she was noted to have developed a left-sided Bell's palsy. A pressure ulcer in the left mastoid area through which the facial nerve transverses was noted, with no evidence of mastoiditis. The patient fully recovered after a course of oral steroid therapy. We postulate that compression pressure might have contributed to the palsy. However, it is unclear what role the acute viral illness played in this case.

Poststimulation Block of Pudendal Nerve Conduction by High-Frequency (kHz) Biphasic Stimulation in Cats

OBJECTIVE

To determine the relationship between various parameters of high-frequency biphasic stimulation (HFBS) and the recovery period of post-HFBS block of the pudendal nerve in cats.

MATERIALS AND METHODS

A tripolar cuff electrode was implanted on the pudendal nerve to deliver HFBS in ten cats. Two hook electrodes were placed central or distal to the cuff electrode to stimulate the pudendal nerve and induce contractions of external urethral sphincter (EUS). A catheter was inserted toward the distal urethra to slowly perfuse the urethra and record the back-up pressure generated by EUS contractions. After determining the block threshold (T), HFBS (6 or 10 kHz) of different durations (1, 5, 10, 20, 30 min) and intensities (1T or 2T) was used to produce the post-HFBS block.

RESULTS

HFBS at 10 kHz and 1T intensity must be applied for at least 30 min to induce post-HFBS block. However, 10 kHz HFBS at a higher intensity (2T) elicited post-HFBS block after stimulation of only 10 min; and 10 kHz HFBS at 2T for 30 min induced a longer-lasting (1-3 h) post-HFBS block that fully recovered with time. HFBS of 5-min duration at 6 kHz produced a longer period (20.4 ± 2.1 min, p < 0.05, N = 5 cats) of post-HFBS block than HFBS at 10 kHz (9.5 ± 2.1 min).

CONCLUSION

HFBS of longer duration, higher intensity, and lower frequency can produce longer-lasting reversible post-HFBS block. This study is important for developing new methods to block nerve conduction by HFBS.

Design and Fabrication of a High-Frequency Single-Directional Planar Underwater Ultrasound Transducer

This paper describes the fabrication of 1-3 piezoelectric composites by using PZT5-A pure piezoelectric ceramics and the preparation of a high-frequency single-directional planar underwater ultrasound transducer by using the developed composites. First, three material models of the same size were designed and simulated by ANSYS finite element simulation software. Next, based on the simulation results, the 1-3 piezoelectric composites were developed. Finally, a high-frequency single-directional planar underwater ultrasound transducer was fabricated by encapsulating and gluing the 1-3 piezoelectric composites. The performance of the transducer was tested, and results showed that the device was characterized by single-mode operation in the working frequency band, a high transmitting voltage response, and single directivity.

Effects of High-Frequency Transcranial Magnetic Stimulation for Cognitive Deficit in Schizophrenia: A Meta-Analysis

Objective: Repetitive transcranial magnetic stimulation (rTMS) has been applied to dorsolateral prefrontal cortex (DLPFC) to improve cognitive function of patients with schizophrenia (SZs). The aim of this meta-analysis was to evaluate whether a high-frequency rTMS course could enhance cognitive function in SZs. Methods: Studies published in PubMed, Cochrane Library, Embase, ScienceDirect, and Web of science were searched until April 2018. The search terms included: "repetitive transcranial magnetic stimulation" or "Rtms," "SZ," or "schizophrenia," and "neuro-cognition" or "neurocognitive performance" or "cognitive effects" or "cognitive" or "cognition" or "working memory" or "executive function" or "language function" or "processing speed," After screening the literatures according to inclusion and exclusion criteria, extracting data, and evaluating the methodological quality of the included studies, a meta-analysis was performed using RevMan 5.3 software (The Cochrane Collaboration, USA). Results: A total of 9 studies on cognitive dysfunction of SZs were included and involved 351 patients. A significant efficacy of high-frequency rTMS on working memory in SZs was found compared to sham stimulation [p = 0.009, standardized mean difference (SMD) = 0.34]. Specifically, rTMS treatment positioned on the left DLPFC, with a total pluses <30,000 was more significantly more effective in improving the working memory (SMD = 0.33, p = 0.03). No improvement was found in other cognitive domains such as executive function, attention, processing speed, and language function. For the follow-up observations, high-frequency rTMS had long-lasting sustained effects on working memory (SMD = 0.45, p = 0.01) and language function (SMD = 0.77, p = 0.02) in SZs. Conclusions: High-frequency rTMS over the left DLPFC with a total pulses <30,000 stimulation could significantly improve working memory in SZs for an extended period of time.

Effect of the application of high-frequency mechanical vibration on tooth length concurrent with orthodontic treatment using clear aligners: A retrospective study

OBJECTIVES:

To evaluate the possible change in teeth lengths as an indicator of orthodontically induced tooth root resorption (OITRR) after high-frequency mechanical vibration (HFV) treatment concurrent with Invisalign Smart Track® aligners as evaluated by cone beam computed tomography (CBCT).

MATERIALS AND METHODS:

The sample, composed of 30 patients with an average age of 26 ± 11 years and Class I malocclusion with an initial anterior crowding ranging from 3 to 5 mm, was divided equally into two groups; Group I received adjunctive high-frequency mechanical vibration (HFV); Group II, the control, did not receive adjunctive mechanical treatment. The maxillary incisor's teeth lengths were measured using Mimics software before (T1) and after (T2) treatment. All data were analyzed using Student's t-test. Reliability testing was completed by randomly selecting 10 patients’ CBCTs, and their teeth lengths were measured twice by the same investigator over a 15-day interval and compared confirming intra-operator accuracy.

RESULTS:

The control group showed a statistically significant decrease in tooth lengths compared to the HFV group which showed nonstatistically significant change of tooth lengths.

CONCLUSION:

Patients treated with HFV showed minimum tooth length changes after treatment, which may indicate that HFV can reduce OITRR with treatment using clear aligners.

Effects of signal bandwidth on listening effort in young- and middle-aged adults

OBJECTIVE

The purpose of this study was to assess the effects of signal bandwidth, noise and signal predictability on listening effort among younger and middle-aged individuals with normal hearing, where YNH = young normal hearing and ONH = older normal hearing. It was of interest to determine if a reduction in high-frequency energy would differentially influence performance between the two groups.

DESIGN

A mixed-model design was used, where listening effort, word identification and effort ratings served as the within-subject factors and listener group served as the between-subject factor.

STUDY SAMPLE

Twenty listeners aged 18-25 years (YNH group) and 20 listeners aged 40-55 years (ONH group) participated in the experiment.

RESULTS

Results showed significantly poorer word recall and significantly higher perceived effort among the ONH group. Increasing the signal bandwidth from 2 to 8 kHz significantly improved word recall and decreased listening effort ratings. Effort ratings from both groups matched word recall performance in that when word recall was lower perceived effort was higher and when word recall was higher perceived effort was lower.

CONCLUSIONS

In general, providing additional high-frequency energy up to 8 kHz reduced listening effort among both groups of listeners. However, the ONH group, experienced additional effort when completing the tasks.

Enhancing High-Frequency Dielectric Properties of Beta-SiC Filled Nanocomposites from Synergy between Percolation and Polarization

Promising comprehensive properties, including high permittivity, low dielectric loss, high breakdown strength, low electrical conductivity, and high thermal conductivity, are very hard to simultaneously obtain in high-frequency applicable polymer nanocomposite dielectrics. Instead of traditional electric percolation, in this work, a novel route based on a synergy between electric percolation and induced polarization has been raised to prepare 0⁻3 type nanocomposites with an enhanced high permittivity (high-k) property and low loss at high frequency. This work aimed at optimizing that synergy to achieve the favorable properties mentioned above in composite dielectrics used at high frequencies such as 1 MHz and 1 GHz. Conductive beta-SiC nanoparticles with a particle size of ~30 nm were employed as filler and both insulating poly(vinyl alcohol) and polyvinyl chloride were employed as polymer matrices to construct two composite systems. Utilizing polyvinyl chloride rather than poly(vinyl alcohol) realizes higher comprehensive electrical properties in composites, ascribed to optimization of that synergy. The optimization was achieved based on a combination of mild induced polarization and polarization-assisted electric percolation. Therefore, this work might open the way for large-scale production of high-frequency applicable composite dielectrics with competitive comprehensive electrical properties.

An Invasive Method for the Activation of the Mouse Dentate Gyrus by High-frequency Stimulation

Electrical high-frequency stimulation (HFS), using implanted electrodes targeting various brain regions, has been proven as an effective treatment for various neurological and psychiatric disorders. HFS in the deep region of the brain, also named deep-brain stimulation (DBS), is becoming increasingly important in clinical trials. Recent progress in the field of high-frequency DBS (HF-DBS) surgery has begun to spread the possibility of utilizing this invasive technique to other situations, such as treatment for major depression disorder (MDD), obsessive-compulsive disorder (OCD), and so on. Despite these expanding indications, the underlying mechanisms of the beneficial effects of HF-DBS remain enigmatic. To address this question, one approach is to use implanted electrodes that sparsely activate distributed subpopulations of neurons by HFS. It has been reported that HFS in the anterior nucleus of the thalamus could be used for the treatment of refractory epilepsy in the clinic. The underlying mechanisms might be related to the increased neurogenesis and altered neuronal activity. Therefore, we are interested in exploring the physiological alterations by the detection of neuronal activity as well as neurogenesis in the mouse dentate gyrus (DG) before and after HFS treatment. In this manuscript, we describe methodologies for HFS to target the activation of the DG in mice, directly or indirectly and in an acute or chronic manner. In addition, we describe a detailed protocol for the preparation of brain slices for c-fos and Notch1 immunofluorescent staining to monitor the neuronal activity and signaling activation and for bromodeoxyuridine (BrdU) labeling to determine the neurogenesis after the HF-DBS induction. The activation of the neuronal activity and neurogenesis after the HF-DBS treatment provides direct neurobiological evidence and potential therapeutic benefits. Particularly, this methodology can be modified and applied to target other interested brain regions such as the basal ganglia and subthalamic regions for specific brain disorders in the clinic.

High-Frequency Repetitive Magnetic Stimulation Enhances the Expression of Brain-Derived Neurotrophic Factor Through Activation of Ca2+-Calmodulin-Dependent Protein Kinase II-cAMP-Response Element-Binding Protein Pathway

Repetitive transcranial magnetic stimulation (rTMS) can be used in various neurological disorders. However, neurobiological mechanism of rTMS is not well known. Therefore, in this study, we examined the global gene expression patterns depending on different frequencies of repetitive magnetic stimulation (rMS) in both undifferentiated and differentiated Neuro-2a cells to generate a comprehensive view of the biological mechanisms. The Neuro-2a cells were randomly divided into three groups—the sham (no active stimulation) group, the low-frequency (0.5 Hz stimulation) group, and high-frequency (10 Hz stimulation) group—and were stimulated 10 min for 3 days. The low- and high-frequency groups of rMS on Neuro-2a cells were characterized by transcriptome array. Differentially expressed genes were analyzed using the Database of Annotation Visualization and Integrated Discovery program, which yielded a Kyoto Encyclopedia of Genes and Genomes pathway. Amphetamine addiction pathway, circadian entrainment pathway, long-term potentiation (LTP) pathway, neurotrophin signaling pathway, prolactin signaling pathway, and cholinergic synapse pathway were significantly enriched in high-frequency group compared with low-frequency group. Among these pathways, LTP pathway is relevant to rMS, thus the genes that were involved in LTP pathway were validated by quantitative real-time polymerase chain reaction and western blotting. The expression of glutamate ionotropic receptor N-methyl d-aspartate 1, calmodulin-dependent protein kinase II (CaMKII) δ, and CaMKIIα was increased, and the expression of CaMKIIγ was decreased in high-frequency group. These genes can activate the calcium (Ca²⁺)–CaMKII–cAMP-response element-binding protein (CREB) pathway. Furthermore, high-frequency rMS induced phosphorylation of CREB, brain-derived neurotrophic factor (BDNF) transcription via activation of Ca²⁺–CaMKII–CREB pathway. In conclusion, high-frequency rMS enhances the expression of BDNF by activating Ca²⁺–CaMKII–CREB pathway in the Neuro-2a cells. These findings may help clarify further therapeutic mechanisms of rTMS.

Anesthetic management of a neonate with congenital diaphragmatic hernia under high-frequency oscillatory ventilation

Perioperative management of a neonate with congenital diaphragmatic hernia (CDH) is challenging because of pulmonary hypoplasia, pulmonary hypertension, and respiratory insufficiency. In this report, we present our intra-operative experience in a 4-days old and 3070 grams CDH neonate. He was admitted to neonatal intensive care unit and intubated due to severe respiratory insufficiency. He showed signs of severe pulmonary hypoplasia and his echocardiography revealed a cardiac dextroversion. The patient was relatively stabilized after four days under combined high-frequency oscillatory ventilation (HFOV) and inhaled nitric oxide (iNO). A corrective surgical intervention was sustained with dopamine, dobutamine, fentanyl and midazolam infusions. Ventilator settings were: 9 cmH²O MAP; 15-Hz frequency; 30 cmH₂O amplitude and 55% FiO₂. Venous-blood gas analysis indicated pH:7.38 pO₂:36.2, pCO₂:39.2 with SpO₂:98%. We believe that HFOV and iNO combination is an effective alternative for the anesthetic management of CDH cases as it provides better gas exchange and less volutrauma.

Identification of potential key genes and high-frequency mutant genes in prostate cancer by using RNA-Seq data

The aim of the present study was to identify potential key genes and single nucleotide variations (SNVs) in prostate cancer. RNA sequencing (RNA-seq) data, GSE22260, were downloaded from the Gene Expression Omnibus database, including 4 prostate cancer samples and 4 normal tissues samples. RNA-Seq reads were processed using Tophat and differentially-expressed genes (DEGs) were identified using the Cufflinks package. Gene Ontology enrichment analysis of DEGs was performed. Subsequently, Seqpos was used to identify the potential upstream regulatory elements of DEGs. SNV was analyzed using Genome Analysis Toolkit. In addition, the frequency and risk-level of mutant genes were calculated using VarioWatch. A total of 150 upregulated and 211 downregulated DEGs were selected and 25 upregulated and 17 downregulated potential upstream regulatory elements were identified, respectively. The SNV annotations of somatic mutations revealed that 65% were base transition and 35% were base transversion. At frequencies ≥2, a total of 17 mutation sites were identified. The mutation site with the highest frequency was located in the folate hydrolase 1B (FOLH1B) gene. Furthermore, 20 high-risk mutant genes with high frequency were identified using VarioWatch, including ribosomal protein S4 Y-linked 2 (RPS4Y2), polycystin 1 transient receptor potential channel interacting (PKD1) and FOLH1B. In addition, kallikrein 1 (KLK1) and PKD1 are known tumor suppressor genes. The potential regulatory elements and high-frequency mutant genes (RPS4Y2, KLK1, PKD1 and FOLH1B) may have key functions in prostate cancer. The results of the present study may provide novel information for the understanding of prostate cancer development.

Role of Hippocampal CA2 Region in Triggering Sharp-Wave Ripples

Sharp-wave ripples (SPW-Rs) in the hippocampus are implied in memory consolidation, as shown by observational and interventional experiments. However, the mechanism of their generation remains unclear. Using two-dimensional silicon probe arrays, we investigated the propagation of SPW-Rs across the hippocampal CA1, CA2, and CA3 subregions. Synchronous activation of CA2 ensembles preceded SPW-R-related population activity in CA3 and CA1 regions. Deep CA2 neurons gradually increased their activity prior to ripples and were suppressed during the population bursts of CA3-CA1 neurons (ramping cells). Activity of superficial CA2 cells preceded the activity surge in CA3-CA1 (phasic cells). The trigger role of the CA2 region in SPW-R was more pronounced during waking than sleeping. These results point to the CA2 region as an initiation zone for SPW-Rs.

Automated Classification of Vowel Category and Speaker Type in the High-Frequency Spectrum

The high-frequency region of vowel signals (above the third formant or F3) has received little research attention. Recent evidence, however, has documented the perceptual utility of high-frequency information in the speech signal above the traditional frequency bandwidth known to contain important cues for speech and speaker recognition. The purpose of this study was to determine if high-pass filtered vowels could be separated by vowel category and speaker type in a supervised learning framework. Mel frequency cepstral coefficients (MFCCs) were extracted from productions of six vowel categories produced by two male, two female, and two child speakers. Results revealed that the filtered vowels were well separated by vowel category and speaker type using MFCCs from the high-frequency spectrum. This demonstrates the presence of useful information for automated classification from the high-frequency region and is the first study to report findings of this nature in a supervised learning framework.

High-frequency Audiometry Hearing on Monitoring of Individuals Exposed to Occupational Noise: A Systematic Review

Introduction

 The literature reports on high-frequency audiometry as one of the exams used on hearing monitoring of individuals exposed to high sound pressure in their work environment, due to the method́s greater sensitivity in early identification of hearing loss caused by noise. The frequencies that compose the exam are generally between 9 KHz and 20KHz, depending on the equipment.

Objective

 This study aims to perform a retrospective and secondary systematic revision of publications on high-frequency audiometry on hearing monitoring of individuals exposed to occupational noise.

Data Synthesis

 This systematic revision followed the methodology proposed in the Cochrane Handbook, focusing on the question: “Is High-frequency Audiometry more sensitive than Conventional Audiometry in the screening of early hearing loss individuals exposed to occupational noise?” The search was based on PubMed data, Base, Web of Science (Capes), Biblioteca Virtual em Saúde (BVS), and in the references cited in identified and selected articles. The search resulted in 6059 articles in total. Of these, only six studies were compatible with the criteria proposed in this study.

Conclusion

 The performed meta-analysis does not definitively answer the study's proposed question. It indicates that the 16 KHz high frequency audiometry (HFA) frequency is sensitive in early identification of hearing loss in the control group (medium difference (MD = 8.33)), as well as the 4 KHz frequency (CA), this one being a little less expressive (MD = 5.72). Thus, others studies are necessary to confirm the HFA importance for the early screening of hearing loss on individuals exposed to noise at the workplace.

Conduction block in myelinated axons induced by high-frequency (kHz) non-symmetric biphasic stimulation

This study used the Frankenhaeuser-Huxley axonal model to analyze the effects of non-symmetric waveforms on conduction block of myelinated axons induced by high-frequency (10-300 kHz) biphasic electrical stimulation. The results predict a monotonic relationship between block threshold and stimulation frequency for symmetric waveform and a non-monotonic relationship for non-symmetric waveforms. The symmetric waveform causes conduction block by constantly activating both sodium and potassium channels at frequencies of 20-300 kHz, while the non-symmetric waveforms share the same blocking mechanism from 20 kHz up to the peak threshold frequency. At the frequencies above the peak threshold frequency the non-symmetric waveforms block axonal conduction by either hyperpolarizing the membrane (if the positive pulse is longer) or depolarizing the membrane (if the negative pulse is longer). This simulation study further increases our understanding of conduction block in myelinated axons induced by high-frequency biphasic electrical stimulation, and can guide future animal experiments as well as optimize stimulation parameters that might be used for electrically induced nerve block in clinical applications.

A study of the high-frequency hearing thresholds of dentistry professionals

INTRODUCTION

 In the dentistry practice, dentists are exposed to harmful effects caused by several factors, such as the noise produced by their work instruments. In 1959, the American Dental Association recommended periodical hearing assessments and the use of ear protectors. Aquiring more information regarding dentists', dental nurses', and prosthodontists' hearing abilities is necessary to propose prevention measures and early treatment strategies.

OBJECTIVE

 To investigate the auditory thresholds of dentists, dental nurses, and prosthodontists.

METHOD

 In this clinical and experimental study, 44 dentists (Group I; GI), 36 dental nurses (Group II; GII), and 28 prosthodontists (Group III; GIII) were included, , with a total of 108 professionals. The procedures that were performed included a specific interview, ear canal inspection, conventional and high-frequency threshold audiometry, a speech reception threshold test, and an acoustic impedance test.

RESULTS

 In the 3 groups that were tested, the comparison between the mean hearing thresholds provided evidence of worsened hearing ability relative to the increase in frequency. For the tritonal mean at 500 to 2,000 Hz and 3,000 to 6,000 Hz, GIII presented the worst thresholds. For the mean of the high frequencies (9,000 and 16,000 Hz), GII presented the worst thresholds.

CONCLUSION

 The conventional hearing threshold evaluation did not demonstrate alterations in the 3 groups that were tested; however, the complementary tests such as high-frequency audiometry provided greater efficacy in the early detection of hearing problems, since this population's hearing loss impaired hearing ability at frequencies that are not tested by the conventional tests. Therefore, we emphasize the need of utilizing high-frequency threshold audiometry in the hearing assessment routine in combination with other audiological tests.

Gender and vocal production mode discrimination using the high frequencies for speech and singing

Humans routinely produce acoustical energy at frequencies above 6 kHz during vocalization, but this frequency range is often not represented in communication devices and speech perception research. Recent advancements toward high-definition (HD) voice and extended bandwidth hearing aids have increased the interest in the high frequencies. The potential perceptual information provided by high-frequency energy (HFE) is not well characterized. We found that humans can accomplish tasks of gender discrimination and vocal production mode discrimination (speech vs. singing) when presented with acoustic stimuli containing only HFE at both amplified and normal levels. Performance in these tasks was robust in the presence of low-frequency masking noise. No substantial learning effect was observed. Listeners also were able to identify the sung and spoken text (excerpts from "The Star-Spangled Banner") with very few exposures. These results add to the increasing evidence that the high frequencies provide at least redundant information about the vocal signal, suggesting that its representation in communication devices (e.g., cell phones, hearing aids, and cochlear implants) and speech/voice synthesizers could improve these devices and benefit normal-hearing and hearing-impaired listeners.