Evolution of the Stethoscope: Advances with the Adoption of Machine Learning and Development of Wearable Devices

The stethoscope has long been used for the examination of patients, but the importance of auscultation has declined due to its several limitations and the development of other diagnostic tools. However, auscultation is still recognized as a primary diagnostic device because it is non-invasive and provides valuable information in real-time. To supplement the limitations of existing stethoscopes, digital stethoscopes with machine learning (ML) algorithms have been developed. Thus, now we can record and share respiratory sounds and artificial intelligence (AI)-assisted auscultation using ML algorithms distinguishes the type of sounds. Recently, the demands for remote care and non-face-to-face treatment diseases requiring isolation such as coronavirus disease 2019 (COVID-19) infection increased. To address these problems, wireless and wearable stethoscopes are being developed with the advances in battery technology and integrated sensors. This review provides the history of the stethoscope and classification of respiratory sounds, describes ML algorithms, and introduces new auscultation methods based on AI-assisted analysis and wireless or wearable stethoscopes

False Memory and Alzheimer’s Disease Pathology in Patients with Amnestic Mild Cognitive Impairment: A Study with Amyloid PET

Introduction: False memory, observed as intrusion errors or false positives (FPs), is prevalent in patients with Alzheimer’s disease, but has yet to be thoroughly investigated in patients with amnestic mild cognitive impairment (a-MCI) with Alzheimer’s disease pathology (ADP). We analyzed false versus veridical memory in individuals with a-MCI and measured the utility of false memory for ADP discrimination. Methods: Patients with a-MCI who received neuropsychological testing and amyloid PET were included. Patients were categorized into “with” and “without ADP” groups according to PET results. Memory tests assessed veridical and false memory, and the verity of patient responses was analyzed. A logistic regression model was used to evaluate false memory efficiency in discriminating ADP, and the sensitivity and specificity at the optimal level were estimated using the receiver-operating characteristic curve. Results: Thirty-seven ADP and 46 non-ADP patients were enrolled. The ADP group made more FPs in the recognition tests, and their response verity was significantly lower in every delayed memory test. No group difference, however, was observed in the veridical memory. The logistic regression analysis demonstrated that as the FPs increased, the risk of ADP increased 1.31 and 1.36 times in the verbal and visual recognition tests, respectively. The discriminatory accuracy of the FPs was estimated “low” to “moderate” in the visual and verbal recognition, respectively, with an optimal cutoff above 2.5. Conclusion: Increased false memory was the only feature to discriminate ADP from non-ADP in individuals with a-MCI. Further studies regarding false memory and its mechanism are warranted

Ethanol extract of Scutellaria baicalensis Georgi prevents oxidative damage and neuroinflammation and memorial impairments in artificial senescense mice

Aging is a progressive process related to the accumulation of oxidative damage and neuroinflammation. We tried to find the anti-amnesic effect of the Scutellaria baicalens Georgia (SBG) ethanol extract and its major ingredients. The antioxidative effect of SBG on the mice model with memory impairment induced by chronic injection of D-galactose and sodium nitrate was studied. The Y-maze test was used to evaluate the learning and memory function of mice. The activities of superoxide dismutase, catalase and the content of malondialdehyde in brain tissue were used for the antioxidation activities. Neuropathological alteration and expression of bcl-2 protein were investigated in the hippocampus by immunohistochemical staining. ROS, neuroinflammation and apoptosis related molecules expression such as Cox-2, iNOS, procaspase-3, cleaved caspase-3, 8 and 9, bcl-2 and bax protein and the products of iNOS and Cox-2, NO, PGE2, were studied using LPS-activated Raw 264.7 cells and microglia BV2 cells. The cognition of mice was significantly improved by the treatment of baicalein and 50 and 100 mg/kg of SBG in Y-maze test. Both SBG groups showed strong antioxidation, antiinflammation effects with significantly decreased iNOS and Cox-2 expression, NO and PGE2 production, increased bcl-2 and decreased bax and cleaved caspase-3 protein expression in LPS induced Raw 264.7 and BV2 cells. We also found that apoptotic pathway was caused by the intrinsic mitochondrial pathway with the decreased cleaved caspase-9 and unchanged cleaved caspase-8 expression. These findings suggest that SBG, especially high dose, 100 mg/kg, improved the memory impairments significantly and showed antioxidation, antiinflammation and intrinsic caspase-mediated apoptosis effects

A pilot study to evaluate the effect of Taeumjowi-tang on obesity in Korean adults: study protocol for a randomised, double-blind, placebo-controlled, multicentre trial

<p>Abstract</p> <p>Background</p> <p>Obesity, which is described as excessive or abnormal body fat, increases the risk of diet-related diseases. In Korea and around the world, the prevalence of obesity has grown annually from 1998 to 2008. This growth has continued despite various therapeutic efforts. The discovery of new and alternative treatments for obesity should be considered an important priority. Taeumjowi-tang (TJ001), a traditional Korean medicinal extract consisting of eight herbs, is a widely used herbal remedy for obesity in Korea. However, the efficacy and safety of TJ001 have not been fully investigated in a clinical trial. The purpose of this pilot study is to estimate obesity-related parameters and to assess the efficacy and safety of TJ001.</p> <p>Methods</p> <p>Our study is a randomised, double-blind, placebo-controlled, multicentre clinical trial of Taeumjowi-tang (TJ001). For this study, we will recruit obese Korean patients of both sexes, ages 18 to 65 years, from four university hospitals. A total of 104 subjects will be recruited. The participants will receive either 7 g of TJ001 or a placebo three times daily for 12 weeks. The primary end point will be the rate of subjects who lose at least 5% of their baseline body weight. The secondary end points will be changes in body weight, body mass index, waist circumference, hip circumference, waist/hip circumference ratio, lipid profiles, body fat composition, blood pressure, fasting glucose concentration, C-reactive protein and questionnaires related to the quality of life. The outcomes will be measured every 4 weeks. The study period will be 12 weeks and will include a total of five visits with each subject (at screening and at 0, 4, 8 and 12 weeks).</p> <p>Conclusions</p> <p>The results of our study will inform various estimates of TJ001 and will serve as the basis for a larger-scale trial. This study will assess the efficacy and safety of TJ001 as an alternative herbal remedy for obesity.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.controlled-trials.com/ISRCTN87153759">ISRCTN87153759</a></p

Opposing Regulation of PROX1 by Interleukin-3 Receptor and NOTCH Directs Differential Host Cell Fate Reprogramming by Kaposi Sarcoma Herpes Virus

Lymphatic endothelial cells (LECs) are differentiated from blood vascular endothelial cells (BECs) during embryogenesis and this physiological cell fate specification is controlled by PROX1, the master regulator for lymphatic development. When Kaposi sarcoma herpes virus (KSHV) infects host cells, it activates the otherwise silenced embryonic endothelial differentiation program and reprograms their cell fates. Interestingly, previous studies demonstrated that KSHV drives BECs to acquire a partial lymphatic phenotype by upregulating PROX1 (forward reprogramming), but stimulates LECs to regain some BEC-signature genes by downregulating PROX1 (reverse reprogramming). Despite the significance of this KSHV-induced bidirectional cell fate reprogramming in KS pathogenesis, its underlying molecular mechanism remains undefined. Here, we report that IL3 receptor alpha (IL3Rα) and NOTCH play integral roles in the host cell type-specific regulation of PROX1 by KSHV. In BECs, KSHV upregulates IL3Rα and phosphorylates STAT5, which binds and activates the PROX1 promoter. In LECs, however, PROX1 was rather downregulated by KSHV-induced NOTCH signal via HEY1, which binds and represses the PROX1 promoter. Moreover, PROX1 was found to be required to maintain HEY1 expression in LECs, establishing a reciprocal regulation between PROX1 and HEY1. Upon co-activation of IL3Rα and NOTCH, PROX1 was upregulated in BECs, but downregulated in LECs. Together, our study provides the molecular mechanism underlying the cell type-specific endothelial fate reprogramming by KSHV

Kaposin-B Enhances the PROX1 mRNA Stability during Lymphatic Reprogramming of Vascular Endothelial Cells by Kaposi's Sarcoma Herpes Virus

Kaposi's sarcoma (KS) is the most common cancer among HIV-positive patients. Histogenetic origin of KS has long been elusive due to a mixed expression of both blood and lymphatic endothelial markers in KS tumor cells. However, we and others discovered that Kaposi's sarcoma herpes virus (KSHV) induces lymphatic reprogramming of blood vascular endothelial cells by upregulating PROX1, which functions as the master regulator for lymphatic endothelial differentiation. Here, we demonstrate that the KSHV latent gene kaposin-B enhances the PROX1 mRNA stability and plays an important role in KSHV-mediated PROX1 upregulation. We found that PROX1 mRNA contains a canonical AU-rich element (ARE) in its 3′-untranslated region that promotes PROX1 mRNA turnover and that kaposin-B stimulates cytoplasmic accumulation of the ARE-binding protein HuR through activation of the p38/MK2 pathway. Moreover, HuR binds to and stabilizes PROX1 mRNA through its ARE and is necessary for KSHV-mediated PROX1 mRNA stabilization. Together, our study demonstrates that kaposin-B plays a key role in PROX1 upregulation during lymphatic reprogramming of blood vascular endothelial cells by KSHV

후각 시스템에서 cIAP1의 역할 규명 연구

cIAP1 (cellular inhibitor of apoptosis 1), the olfactory system, homeostasis, terminal differentiation, cell deathprohibitionCHAPTER 1. INTRODUCTION 1 1.1 cIAP1 1 1.1.1 IAPs (inhibitor of apoptosis proteins) 1 1.1.1.1 Structure of IAP family 1.1.1.2 Roles of IAP family 1.1.2 cIAP1 3 1.1.2.1 Functions of cIAP1 1.1.2.2 cIAP1, cIAP2 and XIAP 1.2 The olfactory system 5 1.2.1 The anatomy of the olfactory system 5 1.2.1.1 Olfactory epithelium 1.2.1.2 Olfactory bulb 1.2.2 Regeneration of the olfactory system 7 1.3 Purpose of the project 8 CHAPTER 2. MATERIALS AND METHODS 9 CHAPTER 3. RESULTS 12 3.1 cIAP1 KO mice 12 3.2 Protein activation 12 3.2.1 cell-death related proteins 3.3 Morphological observation 14 3.3.1 Cell death in the OE 3.3.2 Synaptic connection in the OB 3.4 Behavioral observation 20 CHAPTER 4. DISCUSSION 21 CHAPTER 5. FURTHER STUDIES 25 REFERENCES 26 ABSTRACT IN KOREAN 33MasterdCollectio

Die kinder- und jugendfreundliche Stadtentwicklung in Korea

Die vorliegende Arbeit hat die Absicht, den Bedarf der Umsetzung der Planungsidee ‚kinder- und jugendfreundliche Stadtentwicklung’ in Korea zu erforschen und Vorschläge für die Umsetzung zu machen. Darüber hinaus will sie herausfinden, warum man sich bezüglich der Durchführung der kinder- und jugendfreundlichen Stadtentwicklung zunächst auf die Schulen und deren Umgebungen konzentrieren soll. Deshalb widmet sich die Dissertation zuerst der Literaturrecherche, sowohl was den Begriff der kinder- und jugendfreundlichen Stadtentwicklung angeht als auch der Literatur bezüglich des Beitrags der Schulen zur Realisierung der kinder- und jugendfreundlichen Stadtentwicklung. Danach wird untersucht, ob das deutsche Instrument ‚Spielleitplanung‘ sich als Leitfaden für die gesamte Konzeption der koreanischen kinder- und jugendfreundlichen Stadtentwicklung eignet. Darüber hinaus werden Interviews mit koreanischen Experten aus Stadtplanung und Architektur, Pädagogik und öffentlicher Verwaltung als Forschungsmethode verwendet, um in Bezug auf die kinder- jungendfreundliche Stadtentwicklung den koreanischen Zustand zu analysieren. Zuletzt werden anhand der Untersuchungsergebnisse Handlungs-empfehlungen für die Durchführung der koreanischen kinder- und jugend-freundlichen Stadtentwicklung formuliert. Anhand dieser Forschung kann konstatiert werden, dass die kinder- und jugendfreundliche Stadtentwicklung eine wichtige Planungsidee ist, weil dadurch Stadtplanerinnen und Stadtplaner sowohl zum körperlichen und geistigen gesunden Aufwachsen von Kindern und Jugendlichen als auch zur Entwicklung ihrer sozialen Kompetenzen erheblich beitragen können. Vor allem soll man die koreanische kinder- und jugendfreundliche Stadtentwicklung zunächst auf den Schulen und den schulischen Umgebungen umsetzen. Denn dadurch lassen sich vielseitige eventuelle Hindernisse bei der Durchführung der kinder- und jugendfreundlichen Stadtentwicklung vermeiden. Ein weiterer Grund ist, dass die Schulen in Korea nicht nur in der Gesellschaft eine zentrale Rolle spielen, sondern auch im Rahmen der Stadtplanung. Auffällig ist, dass die kinder- und jugendfreundliche Stadtentwicklung sowohl auf die räumlichen Gestaltungen als auch auf die Beteiligung von Kindern und Jugendlichen in der städtischen Planung fokussiert ist. Allerdings werden bei der Stadtentwicklung die Kinder und Jugendliche in Korea noch nicht als wichtige Akteure angesehen. Darum soll man die Spielleitplanung in Korea einbeziehen, weil sie als Leitbild bei einer Konzeption der koreanischen kinder- und jugendlichen Stadtentwicklung fungieren kann. Jedoch müssen dabei die kulturellen Unterschiede zwischen Deutschland und Korea berücksichtigt werden. Weiterhin wurde durch die Interviews festgestellt, dass das Interesse und der Wille von Experten aus der Stadtplanung an Kinder- und Jugendfreundlichkeit die wichtigsten Voraussetzungen sind, um die kinder- und jugendfreundliche Stadtentwicklung in Korea zu verankern und zu verbreiten