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Purpose: Previous studies have reported that voice therapy via telepractice is useful for patients with nodules and muscle tension dysphonia. Nevertheless, telepractice for elderly patients with voice disorders has not yet been investigated. We conducted this study to examine the hypothesis that voice therapy via telepractice is not inferior to conventional voice therapy. Method: Eighty patients with dysphonia aged more than 55 years participated in this study from September 2016 to June 2018. After screening the inclusion and the exclusion criteria, 69 patients were randomized into telepractice (33 patients) and conventional (36 patients) groups. The outcome measurements included Voice Handicap Index-10, videolaryngostroboscopy, maximum phonation time, auditory-perceptual evaluation, and acoustic analysis. Paired \"t\" test, Wilcoxon signed-ranks test, and repeated measures analysis of variance were used to examine treatment outcomes. Results: The diagnoses of voice disorders included atrophy (n = 33), unilateral vocal paralysis (n = 13), muscle tension dysphonia (n = 7), nodules (n = 6), and polyps (n = 10). No significant differences were observed in age, sex, and baseline measurements between the two groups. Twenty-five patients in the telepractice group and 24 patients in the control group completed at least four weekly sessions. Significant improvements were observed for all the outcome measures (p < 0.05) in both groups. Improvements in Voice Handicap Index-10 in the telepractice group (24.84 ± 5.49 to 16.80 ± 8.94) were comparable to those in the conventional group (22.17 ± 7.29 to 13.46 ± 9.95, p = 0.764). Other parameters also showed comparable improvements between the two groups without statistically significant differences. Conclusions: This is the first randomized controlled trial comparing telepractice and conventional voice therapy in elderly patients with voice disorders. The results showed that the effectiveness of voice therapy via telepractice was not inferior to that of conventional voice therapy, indicating that telepractice can be used as an alternative to provide voice care for elderly patients with vocal disorders.

Objectives This study developed the Mandarin Chinese version of the Aging Voice Index (AVI), with preliminary validation of the scale for potential clinical applications. Study Design Scale development. Methods The experimental procedure involved: (1) cross‐cultural adaptation of the original AVI into the Mandarin Chinese version (CAVI); (2) evaluation by expert panel; (3) back translation; (4) pilot testing; (5) development of the final CAVI; (6) scale validation with 68 older adults of 60–89 years old (29 females and 39 males), 34 with voice disorders and 34 age‐matched with normal voice. Internal consistency reliability, test–retest reliability, content validity, criterion‐related validity, and discriminatory ability (diagnostic accuracy) of the CAVI were evaluated. Results There were high internal consistency (Cronbach's alpha = 0.9733), high test–retest reliability (intraclass correlation coefficient = 0.9578, p < 0.01), high content validity (content validity index = 0.9710), high criterion‐related validity (Pearson's r = 0.9439, p < 0.01 between CAVI and Voice Handicap Index‐10; r = 0.8070, p < 0.01 between CAVI and voice‐related quality of life [V‐RQOL]), and significant difference in CAVI scores between the two groups with huge effect size (t(34.69) = −11.59, Cohen's d = 2.81, p < 0.001). Receiver operating characteristic analysis revealed a high diagnostic accuracy of the CAVI, with an area under the curve of 0.9974 (p < 0.001) and a cut‐off score of 12.0 with 100% sensitivity and 97.1% specificity. Conclusion Our findings suggested that the CAVI could be a reliable and valid standardized self‐assessment questionnaire tool for clinical evaluation of the impact of voice problems specifically for Mandarin‐speaking older adults. Further studies should explore a full‐scale validation of the CAVI for being a standard clinical tool, including for older adults in Mainland China. Level of evidence 3b (case–control study). This study was a cross‐cultural adaptation of the Aging Voice Index (AVI) into the Mandarin Chinese version, with preliminary findings indicating that it could be a reliable and valid standardized self‐assessment tool for clinical evaluation of the specific and unique impact of voice problems in Mandarin‐speaking older adults.

Although 9.4 T magnetic resonance imaging (MRI) has been tested in healthy volunteers, its safety in diabetic patients is unclear. Furthermore, the effects of high static magnetic fields (SMFs), especially gradient vs. uniform fields, have not been investigated in diabetics. Here, we investigated the consequences of exposure to 1.0-9.4 T high SMFs of different gradients (>10 T/m vs. 0-10 T/m) on type 1 diabetic (T1D) and type 2 diabetic (T2D) mice. We found that 14 h of prolonged treatment of gradient (as high as 55.5 T/m) high SMFs (1.0-8.6 T) had negative effects on T1D and T2D mice, including spleen, hepatic, and renal tissue impairment and elevated glycosylated serum protein, blood glucose, inflammation, and anxiety, while 9.4 T quasi-uniform SMFs at 0-10 T/m did not induce the same effects. In regular T1D mice (blood glucose ≥16.7 mmol/L), the >10 T/m gradient high SMFs increased malondialdehyde (P<0.01) and decreased superoxide dismutase (P<0.05). However, in the severe T1D mice (blood glucose ≥30.0 mmol/L), the >10 T/m gradient high SMFs significantly increased tissue damage and reduced survival rate. In vitro cellular studies showed that gradient high SMFs increased cellular reactive oxygen species and apoptosis and reduced MS-1 cell number and proliferation. Therefore, this study showed that prolonged exposure to high-field (1.0-8.6 T) >10 T/m gradient SMFs (35-1 380 times higher than that of current clinical MRI) can have negative effects on diabetic mice, especially mice with severe T1D, whereas 9.4 T high SMFs at 0-10 T/m did not produce the same effects, providing important information for the future development and clinical application of SMFs, especially high-field MRI.

Acetaminophen (APAP), the most frequently used mild analgesic and antipyretic drug worldwide, is implicated in causing 46% of all acute liver failures in the USA and between 40% and 70% in Europe. The predominant pharmacological intervention approved for mitigating such overdose is the antioxidant N-acetylcysteine (NAC); however, its efficacy is limited in cases of advanced liver injury or when administered at a late stage. In the current study, we discovered that treatment with a moderate intensity static magnetic field (SMF) notably reduced the mortality rate in mice subjected to high-dose APAP from 40% to 0%, proving effective at both the initial liver injury stage and the subsequent recovery stage. During the early phase of liver injury, SMF markedly reduced APAPinduced oxidative stress, free radicals, and liver damage, resulting in a reduction in multiple oxidative stress markers and an increase in the antioxidant glutathione (GSH). During the later stage of liver recovery, application of vertically downward SMF increased DNA synthesis and hepatocyte proliferation. Moreover, the combination of NAC and SMF significantly mitigated liver damage induced by high-dose APAP and increased liver recovery, even 24 h post overdose, when the effectiveness of NAC alone substantially declines. Overall, this study provides a noninvasive non-pharmaceutical tool that offers dual benefits in the injury and repair stages following APAP overdose. Of note, this tool can work as an alternative to or in combination with NAC to prevent or minimize liver damage induced by APAP, and potentially other toxic overdoses.

Purpose: This study attempted to develop and to preliminarily validate the Mandarin Chinese version of the Vocal Fatigue Index (VFI) as a standardized self-assessment questionnaire tool for potential clinical applications. Method: The experimental procedure involved (a) cross-cultural adaptation of the VFI into the Mandarin Chinese version (CVFI), (b) evaluation by an expert panel, (c) back translation, (d) pilot testing, and (e) validation of the questionnaire by three participant groups: 50 with voice disorders, 50 occupational voice users (at-risk group), and 50 with normal voice (control group). Internal consistency, test--retest reliability, content validity, and convergent validity of the CVFI were examined, and discriminatory ability (diagnostic accuracy) for distinguishing between the groups was evaluated. Results: Results showed high internal consistency (Cronbach's alpha [greater than or equal to] 0.8817 for the total CVFI scores for all groups), high test-retest reliability (intraclass correlation coefficients [greater than or equal to] 0.9072, p < 0.001 for the total CVFI scores for all groups), high content validity (total content validity index = 0.9368), and high convergent validity (Pearson r [greater than or equal to] 0.8155, p < 0.001 between the total CVFI scores and Factors 1 and 2 scores). Significant differences between the three groups were found in all scores. Receiver operating characteristic analysis revealed a high diagnostic accuracy for distinguishing between the disorders group and the normal group (area under the curve [greater than or equal to] 0.927, p < 0.001 for the total CVFI scores and Factors 1 and 2 scores), with cutoff scores of [greater than or equal to] 36 (total CVFI score), [greater than or equal to] 23.5 (Factor 1 score), [greater than or equal to] 7.5 (Factor 2 score), and [greater than or equal to] 6.5 (Factor 3 score). Conclusions: These findings suggested that the CVFI could be a reliable and valid self-assessment tool for the clinical evaluation of vocal fatigue in Mandarin Chinese-speaking populations. A full-scale validation study of the CVFI is recommended to verify these results.

Background：Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base.Herein,we described a pure endoscopic transnasal or transoral approach （ETA） for the removal of intra-extracranial tumors in various skull base regions.Methods：Retrospectively,clinical data,major surgical complications,pre-and postoperative images,and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed.Results：Gross total tumor removal was achieved in 80/85 cases （94.1%） in this study.All 37 cases with tumors in anterior skull base and all 14 cases with tumors in jugular foramen received total tumor removal.Thirteen and three cases with tumors in clivus received total and subtotal tumor removal,respectively.Total and subtotal tumor removal was performed for 16 cases and 2 cases in lateral skull base,respectively.The complications in this study included：cerebrospinal fluid leakage （n =3）,meningitis （n =3）,and new cranial nerve deficits （n =3;recovered in 3 months after surgery）.In the follow-up period of40-151 months （median：77 months）,seven patients （8.8%） out of the 80 cases of total tumor removal experienced recurrence.Conclusions：Complete resection of intra-extracranial growing tumors in various skull base regions can be achieved via the pure ETA in one stage in selected cases.Surgical procedure for radical removal of tumors is feasible and safe.

研究目的：在小鼠模型中利用吲哚美辛阻断COX-1／2通路，探讨非甾体类抗炎药对肾缺血再灌注损伤的保护作用。创新要点：非甾体类抗炎药被认为具有肾毒性，本研究首次在小鼠模型中探讨非甾休类抗炎药对肾缺血再灌注损伤的保护作用。研究方法：重要结论：小鼠左侧肾蒂夹闭后，通过腹腔注射不同剂量的吲哚美辛，在肾缺血再灌注损伤24小时后，获取血液和肾脏标本。利用酶联免疫（ELISA）试剂盒测定血清肌酐和细胞因子浓度来评估肾功能，肾组织样本进行苏木精。伊红染色和免疫组化分析。腹腔注射吲哚美辛5mg／kg组的小鼠血清肌酐值与对照组相比显著降低，肾小管损伤也显著减轻（见图1和2）；腹腔注射5和7mg／kg吲哚美辛组的小鼠血清肾肿瘤坏死因子- α和白介素-6的浓度显著降低（见图3a和3b）；腹腔注射3和5mg／kg吲哚美辛组的小鼠血清血栓素B2与6-酮前列腺素F1α的比值明显降低（见图3e）；腹腔注射5mg／kg吲哚美辛组小鼠肾组织COX-1和COX-2染色较弱（见图4）。因此，吲哚美辛对小鼠肾缺血再灌注损伤的作用与其剂量相关，在某个特定的剂量范围内具有’肾保护作用。吲哚美辛对小鼠肾缺血再灌注损伤的保护作用与阻断COX-1／2有关。

The faithful storage and coherent manipulation of quantum states with matter-systems would enable the realization of large-scale quantum networks based on quantum repeaters. To achieve useful communication rates, highly multimode quantum memories are required to construct a multiplexed quantum repeater. Here, we present a demonstration of on-demand storage of orbital-angular-momentum states with weak coherent pulses at the single-photon-level in a rare-earth-ion-doped crystal. Through the combination of this spatial degree-of-freedom (DOF) with temporal and spectral degrees of freedom, we create a multiple-DOF memory with high multimode capacity. This device can serve as a quantum mode converter with high fidelity, which is a fundamental requirement for the construction of a multiplexed quantum repeater. This device further enables essentially arbitrary spectral and temporal manipulations of spatial-qutrit-encoded photonic pulses in real time. Therefore, the developed quantum memory can serve as a building block for scalable photonic quantum information processing architectures. Multiplexing of quantum memories would enable higher communication rate for repeater based quantum networks. Here, the authors demonstrate multiplexed storage of single-photon-level pulses using multiple degree-of-freedom, with the additional function of arbitrary manipulation of photonic pulses in real time.

Hexagonal boron nitride (hBN) is a remarkable two-dimensional (2D) material that hosts solid-state spins and has great potential to be used in quantum information applications, including quantum networks. However, in this application, both the optical and spin properties are crucial for single spins but have not yet been discovered simultaneously for hBN spins. Here, we realize an efficient method for arraying and isolating the single defects of hBN and use this method to discover a new spin defect with a high probability of 85%. This single defect exhibits outstanding optical properties and an optically controllable spin, as indicated by the observed significant Rabi oscillation and Hahn echo experiments at room temperature. First principles calculations indicate that complexes of carbon and oxygen dopants may be the origin of the single spin defects. This provides a possibility for further addressing spins that can be optically controlled. Optically active defects in hBN are promising for quantum sensing and information applications, however, coherent control of a single defect has not been achieved so far. By using an efficient method to produce arrays of defects in hBN, Guo et al. isolate a new carbon-related defect and show its coherent control.

Platinum-based transition metal dichalcogenides have been gaining renewed interest because of the development of a new method to synthesize thin film structures. Here, using first-principles calculation, we explore the electronic properties of PtX 2 (X = S, Se, and Te) with respect to film thickness. For bulk and layered structures (1 to 10 layers), octahedral 1T is the most stable. Surprisingly, we also find that the 3R structure has comparable stability relative to the 1T, implying possible synthesis of 3R. For a bulk 1T structure, PtS 2 is semiconducting with an indirect band gap of 0.25 eV, while PtSe 2 and PtTe 2 are both semi-metallic. Still, all their corresponding monolayers exhibit an indirect semiconducting phase with band gaps of 1.68, 1.18, and 0.40 eV for PtS 2 , PtSe 2 , and PtTe 2 , respectively. For the band properties, we observe that all these materials manifest decreasing/closing of indirect band gap with increasing thickness, a consequence of quantum confinement and interlayer interaction. Moreover, we discover that controlling the thickness and applying strain can manipulate van Hove singularity resulting to high density of states at the maximum valence band. Our results exhibit the sensitivity and tunability of electronic properties of PtX 2 , paving a new path for future potential applications. First-principles calculations: electronic properties of Pt-based dichalcogenides Layered Pt-based dichalcogenides possess thickness-dependent electronic band structures. A team led by Feng-Chuan Chuang at National Sun Yat-Sen University performed first-principles calculations to investigate the interplay between thickness and electronic properties of PtX 2 dichalcogenides, where X = S, Se, and Te. In bulk PtX 2 , the most stable configuration was found to be 1T, although the metastable 3R structure had comparable formation energy, indicating that both 1T and 3R polytypes could be synthesized experimentally. To explore the thickness-dependent properties of PtX 2 , bulk lattice constants were used to construct the layered structures from monolayer up to ten layers, followed by crystal structure relaxations, and it was consistently found that the electronic band gap decreases as the number of layers increases. Furthermore, PtS 2 possesses diverging density of states, indicative of possible presence of van Hove singularities.