bluuebunny/crossref_metadata_2025 huggingface dataset:
A new score for airway assessment using clinical and ultrasound parameters
Authors: De Luis-Cabezón Nekari , Ly-Liu Diana , Renedo-Corcostegui Pablo , Santaolalla-Montoya Francisco , Zabala-Lopez de Maturana Aitor , Herrero-Herrero Jose Carlos , Martínez-Hurtado Eugenio , De Frutos-Parra Raúl , Bilbao-Gonzalez Amaia , Fernandez-Vaquero Miguel Angel
Published: February 2024

Background

Over the last few years, ultrasonography has been introduced as the fifth pillar to patient’s bedside physical examination. Clinical assessments aim to screen and look for airway difficulties to predict difficult intubations, but none have demonstrated a significant predictive capacity. Recent systematic reviews have established a correlation between ultrasound imaging and difficult direct laryngoscopy. The primary objective of this study was to determine whether the utilization of ultrasonography to examine the upper airway could accurately predict difficult direct laryngoscopy.

Methods

This is a prospective observational study including 102 adult patients that required general anesthesia for elective surgery. Preoperatively, clinical airway assessments were performed. Data such as Mallampati-Samsoon grade (MS), upper lip bite test (ULBT), thyromental (TMD) and sternomental distance (SMD), cervical circumference (CC) and the Arné risk index were collected. Ultrasound evaluation was taken at five different levels in two planes, parasagittal and transverse. Therefore, the following measurements were registered: distance from skin to hyoid bone (DSHB), distance from skin to thyrohyoid membrane (DSTHM), distance from skin to epiglottis (DSE), distance from skin to thyroid cartilage (DSTC) and distance from hyoid bone and thyroid cartilage (DHBTC). Patients were divided into two groups based on the difficulty to perform direct laryngoscopy, according to Cormack-Lehane (C-L) classification. Grades I and II were classified as easy laryngoscopy and grades III or IV as difficult. Logistic regression models and the Receiver Operating Characteristic (ROC) curve was employed to determine the diagnostic precision of ultrasound measurements to distinguish difficult laryngoscopy (DL).

Results

The following risk score for DL was obtained, DSTHM ≥ 1.60 cm (2 points), DSTC ≥ 0.78 cm (3 points) and gender (2 points for males). The score can range from 0 to 7 points, and showed and AUC (95% CI) of 0.84 (0.74–0.95). A score of 5 points or higher indicates a 34-fold increase in the risk of finding DL (p = 0.0010), sensitivity of 91.67, specificity of 75.56, positive predictive value of 33.33, and negative predictive value of 98.55.

Conclusion

The use of ultrasonography combined with classic clinical screening tests are useful tools to predict difficult direct laryngoscopy.
Detection of Mycobacterium bovis in nasal swabs from communal goats (Capra hircus) in rural KwaZulu-Natal, South Africa
Authors: Cooke Deborah M. , Clarke Charlene , Kerr Tanya J. , Warren Robin M. , Witte Carmel , Miller Michele A. , Goosen Wynand J.
Published: February 2024

Animal tuberculosis, caused by Mycobacterium bovis, presents a significant threat to both livestock industries and public health. Mycobacterium bovis tests rely on detecting antigen specific immune responses, which can be influenced by exposure to non-tuberculous mycobacteria, test technique, and duration and severity of infection. Despite advancements in direct M. bovis detection, mycobacterial culture remains the primary diagnostic standard. Recent efforts have explored culture-independent PCR-based methods for identifying mycobacterial DNA in respiratory samples. This study aimed to detect M. bovis in nasal swabs from goats (Capra hircus) cohabiting with M. bovis-infected cattle in KwaZulu-Natal, South Africa. Nasal swabs were collected from 137 communal goats exposed to M. bovis-positive cattle and 20 goats from a commercial dairy herd without M. bovis history. Swabs were divided into three aliquots for analysis. The first underwent GeneXpert® MTB/RIF Ultra assay (Ultra) screening. DNA from the second underwent mycobacterial genus-specific PCR and Sanger sequencing, while the third underwent mycobacterial culture followed by PCR and sequencing. Deep sequencing identified M. bovis DNA in selected Ultra-positive swabs, confirmed by region-of-difference (RD) PCR. Despite no other evidence of M. bovis infection, viable M. bovis was cultured from three communal goat swabs, confirmed by PCR and sequencing. Deep sequencing of DNA directly from swabs identified M. bovis in the same culture-positive swabs and eight additional communal goats. No M. bovis was found in commercial dairy goats, but various NTM species were detected. This highlights the risk of M. bovis exposure or infection in goats sharing pastures with infected cattle. Rapid Ultra screening shows promise for selecting goats for further M. bovis testing. These techniques may enhance M. bovis detection in paucibacillary samples and serve as valuable research tools.
Protocol for a randomized, placebo-controlled, double-blind phase IIa study of the safety, tolerability, and symptomatic efficacy of the ROCK-inhibitor Fasudil in patients with Parkinson’s disease (ROCK-PD)
Authors: Wolff Andreas W. , Bidner Helen , Remane Yvonne , Zimmer Janine , Aarsland Dag , Rascol Olivier , Wyse Richard K. , Hapfelmeier Alexander , Lingor Paul
Published: February 2024

Background

The Rho-kinase (ROCK) inhibitor Fasudil has shown symptomatic and disease-modifying effects in Parkinson’s disease (PD) models in vitro and in vivo. In Japan, Fasudil has been approved for the treatment of subarachnoid haemorrhage since 1995 and shows a favourable safety profile.

Objectives/design

To investigate the safety, tolerability, and symptomatic efficacy of ROCK-inhibitor Fasudil in comparison to placebo in a randomized, national, multicenter, double-blind phase IIa study in patients with PD.

Methods/analysis

We plan to include 75 patients with at least ‘probable’ PD (MDS criteria), Hoehn and Yahr stages 1–3, and age 30–80 years in 13 German study sites. Patients must be non-fluctuating and their response to PD medication must have been stable for 6 weeks. Patients will be randomly allocated to treatment with the oral investigational medicinal product (IMP) containing either Fasudil in two dosages, or placebo, for a total of 22 days. As primary analysis, non-inferiority of low/high dose of Fasudil on the combined endpoint consisting of occurrence of intolerance and/or treatment-related serious adverse events (SAEs) over 22 days will be assessed in a sequential order, starting with the lower dose. Secondary endpoints will include tolerability alone over 22 days and occurrence of treatment-related SAEs (SARs) over 22 and 50 days and will be compared on group level. Additional secondary endpoints include efficacy on motor and non-motor symptoms, measured on established scales, and will be assessed at several timepoints. Biomaterial will be collected to determine pharmacokinetics of Fasudil and its active metabolite, and to evaluate biomarkers of neurodegeneration.

Ethics/registration/discussion

After positive evaluation by the competent authority and the ethics committee, patient recruitment started in the 3rd quarter of 2023. ROCK-PD is registered with Eudra-CT (2021-003879-34) and clinicaltrials.gov (NCT05931575). Results of this trial can pave way for conducting extended-duration studies assessing both symptomatic efficacy and disease-modifying properties of Fasudil.
Design and assessment of a reconfigurable behavioral assistive robot: a pilot study
Authors: Shi Enming , Zhi Wenzhuo , Chen Wanxin , Han Yuhang , Zhang Bi , Zhao Xingang
Published: February 2024

Introduction

For patients with functional motor disorders of the lower limbs due to brain damage or accidental injury, restoring the ability to stand and walk plays an important role in clinical rehabilitation. Lower limb exoskeleton robots generally require patients to convert themselves to a standing position for use, while being a wearable device with limited movement distance.

Methods

This paper proposes a reconfigurable behavioral assistive robot that integrates the functions of an exoskeleton robot and an assistive standing wheelchair through a novel mechanism. The new mechanism is based on a four-bar linkage, and through simple and stable conformal transformations, the robot can switch between exoskeleton state, sit-to-stand support state, and wheelchair state. This enables the robot to achieve the functions of assisted walking, assisted standing up, supported standing and wheelchair mobility, respectively, thereby meeting the daily activity needs of sit-to-stand transitions and gait training. The configuration transformation module controls seamless switching between different configurations through an industrial computer. Experimental protocols have been developed for wearable testing of robotic prototypes not only for healthy subjects but also for simulated hemiplegic patients.

Results

The experimental results indicate that the gait tracking effect during robot-assisted walking is satisfactory, and there are no sudden speed changes during the assisted standing up process, providing smooth support to the wearer. Meanwhile, the activation of the main force-generating muscles of the legs and the plantar pressure decreases significantly in healthy subjects and simulated hemiplegic patients wearing the robot for assisted walking and assisted standing-up compared to the situation when the robot is not worn.

Discussion

These experimental findings demonstrate that the reconfigurable behavioral assistive robot prototype of this study is effective, reducing the muscular burden on the wearer during walking and standing up, and provide effective support for the subject's body. The experimental results objectively and comprehensively showcase the effectiveness and potential of the reconfigurable behavioral assistive robot in the realms of behavioral assistance and rehabilitation training.
Neuropeptide Y receptor 1 and galanin receptor 2 (NPY1R-GALR2) interactions in the dentate gyrus and their relevance for neurogenesis and cognition
Authors: Beltran-Casanueva Rasiel , Hernández-García Aracelis , de Amo García Paula , Blanco-Reina Encarnación , Serrano-Castro Pedro , García-Casares Natalia , Fuxe Kjell , Borroto-Escuela Dasiel O. , Narváez Manuel
Published: February 2024

Introduction

This study may unveil novel insights into the interactions between neuropeptide Y receptor 1 (NPY1R) and galanin receptor 2 (GALR2), in the dentate gyrus of the dorsal hippocampus, shedding light on their role in neurogenesis and cognitive functions. Existing literature highlights the potential of these interactions in enhancing learning and memory, yet detailed mechanisms remain underexplored.

Methods

Utilizing intracerebroventricular injections of GALR2 and NPY1R agonists in Sprague-Dawley male rats, we examined neurogenesis via markers PCNA and DCX, and memory consolidation through the object-in-place task over a three-week period.

Results

Significant increases in NPY1R-GALR2 co-localization and neuroblast proliferation were observed, alongside enhanced memory consolidation. These findings suggest a synergistic effect of NPY1R and GALR2 activation on cognitive functions.

Discussion

Our findings may foster the development of novel heterobivalent or multitargeting drugs, affecting NPY1R-GALR2 interaction, and suggest a future pharmacogical strategy for improving learning and memory found in many brain diseases. Further research is encouraged to explore these mechanisms in pathological models.
Loss of Ezh2 in the medial ganglionic eminence alters interneuron fate, cell morphology and gene expression profiles
Authors: Rhodes Christopher T. , Asokumar Dhanya , Sohn Mira , Naskar Shovan , Elisha Lielle , Stevenson Parker , Lee Dongjin R. , Zhang Yajun , Rocha Pedro P. , Dale Ryan K. , Lee Soohyun , Petros Timothy J.
Published: February 2024

Introduction

Enhancer of zeste homolog 2 (Ezh2) is responsible for trimethylation of histone 3 at lysine 27 (H3K27me3), resulting in repression of gene expression. Here, we explore the role of Ezh2 in forebrain GABAergic interneuron development.

Methods

We removedEzh2in the MGE by generatingNkx2-1Cre;Ezh2conditional knockout mice. We then characterized changes in MGE-derived interneuron fate and electrophysiological properties in juvenile mice, as well as alterations in gene expression, chromatin accessibility and histone modifications in the MGE.

Results

Loss ofEzh2increases somatostatin-expressing (SST+) and decreases parvalbumin-expressing (PV+) interneurons in the forebrain. We observe fewer MGE-derived interneurons in the first postnatal week, indicating reduced interneuron production. Intrinsic electrophysiological properties in SST+ and PV+ interneurons are normal, but PV+ interneurons display increased axonal complexity inEzh2mutant mice. Single nuclei multiome analysis revealed differential gene expression patterns in the embryonic MGE that are predictive of these cell fate changes. Lastly, CUT&Tag analysis revealed that some genomic loci are particularly resistant or susceptible to shifts in H3K27me3 levels in the absence ofEzh2, indicating differential selectivity to epigenetic perturbation.

Discussion

Thus, loss of Ezh2 in the MGE alters interneuron fate, morphology, and gene expression and regulation. These findings have important implications for both normal development and potentially in disease etiologies.
Fine tuned personalized machine learning models to detect insomnia risk based on data from a smart bed platform
Authors: Winger Trevor , Chellamuthu Vidhya , Guzenko Dmytro , Aloia Mark , Barr Shawn , DeFranco Susan , Gorski Brandon , Mushtaq Faisal , Garcia-Molina Gary
Published: February 2024

Introduction

Insomnia causes serious adverse health effects and is estimated to affect 10–30% of the worldwide population. This study leverages personalized fine-tuned machine learning algorithms to detect insomnia risk based on questionnaire and longitudinal objective sleep data collected by a smart bed platform.

Methods

Users of the Sleep Number smart bed were invited to participate in an IRB approved study which required them to respond to four questionnaires (which included the Insomnia Severity Index; ISI) administered 6 weeks apart from each other in the period from November 2021 to March 2022. For 1,489 participants who completed at least 3 questionnaires, objective data (which includes sleep/wake and cardio-respiratory metrics) collected by the platform were queried for analysis. An incremental, passive-aggressive machine learning model was used to detect insomnia risk which was defined by the ISI exceeding a given threshold. Three ISI thresholds (8, 10, and 15) were considered. The incremental model is advantageous because it allows personalized fine-tuning by adding individual training data to a generic model.

Results

The generic model, without personalizing, resulted in an area under the receiving-operating curve (AUC) of about 0.5 for each ISI threshold. The personalized fine-tuning with the data of just five sleep sessions from the individual for whom the model is being personalized resulted in AUCs exceeding 0.8 for all ISI thresholds. Interestingly, no further AUC enhancements resulted by adding personalized data exceeding ten sessions.

Discussion

These are encouraging results motivating further investigation into the application of personalized fine tuning machine learning to detect insomnia risk based on longitudinal sleep data and the extension of this paradigm to sleep medicine.
Transforming medicine: artificial intelligence integration in the peripheral nervous system
Authors: Qian Yue , Alhaskawi Ahmad , Dong Yanzhao , Ni Juemin , Abdalbary Sahar , Lu Hui
Published: February 2024

In recent years, artificial intelligence (AI) has undergone remarkable advancements, exerting a significant influence across a multitude of fields. One area that has particularly garnered attention and witnessed substantial progress is its integration into the realm of the nervous system. This article provides a comprehensive examination of AI’s applications within the peripheral nervous system, with a specific focus on AI-enhanced diagnostics for peripheral nervous system disorders, AI-driven pain management, advancements in neuroprosthetics, and the development of neural network models. By illuminating these facets, we unveil the burgeoning opportunities for revolutionary medical interventions and the enhancement of human capabilities, thus paving the way for a future in which AI becomes an integral component of our nervous system’s interface.
Patient-reported outcome measures in patients with familial cerebral cavernous malformations: results from the Treat_CCM trial
Authors: Meessen Jennifer M. T. A. , Abete-Fornara Giorgia , Zarino Barbara , Castori Marco , Tassi Laura , Carriero Maria R. , D'Alessandris Q. G. , Al-Shahi Salman R. , Blanda Adriana , Nicolis Enrico B. , Novelli Deborah , Caruana Maria , Vasamì Antonella , Lanfranconi Silvia , Latini Roberto
Published: February 2024

Background

The Phase 1/2 Treat_CCM randomized controlled trial for people with familial cerebral cavernous malformations (FCCMs) confirmed the safety of propranolol and suggested beneficial effects on intracerebral hemorrhage or new focal neurological deficits, but the effects on patient-reported outcome measures have not been reported.

Methods

Participants completed self-reported questionnaires at baseline, 1 and 2 years. Depression was assessed with the Beck Depression Inventory-II (BDI-2); Anxiety with the State–Trait Anxiety Inventory X1 and X2 (STAI X-1 and STAI X-2); and Quality of Life with the Short Form 36 (SF-36), split into the physical and mental component scales (PCS and MCS). Differences between treatment groups and the general population were assessed. Change over time by treatment was assessed by means of mixed models.

Results

In total, 71 participants (48 propranolol and 23 standard care) were enrolled, of whom 61 (73%) completed questionnaires at baseline and 2-year FU. At baseline, no differences between treatment groups for any of the questionnaires were present. Twenty (31.7%) patients were considered depressed at baseline, while this proportion was lower in the propranolol group after 2 years (28.6% vs. 55.5%, p = 0.047). The STAI X-1 and X-2 scores were stable over time. PCS was lower in FCCM patients as compared with the general Italian population, while the MCS was similar to the general population. No effect of propranolol was found for both PCS and MCS.

Conclusion

Depression is common among patients with FCCM. Patients randomized to propranolol had a lower proportion of participants with depression after 2 years.

Clinical trial registration: https://clinicaltrials.gov/, identifier (NCT03589014).
The effects of occipital and parietal tDCS on chronic visual field defects after brain injury
Authors: Diana Lorenzo , Casati Carlotta , Melzi Lisa , Bianchi Marzoli Stefania , Bolognini Nadia
Published: February 2024

Introduction

Homonymous visual field defects (HVFDs) following acquired brain lesions affect independent living by hampering several activities of everyday life. Available treatments are intensive and week- or month-long. Transcranial Direct current stimulation (tDCS), a plasticity-modulating non-invasive brain stimulation technique, could be combined with behavioral trainings to boost their efficacy or reduce treatment duration. Some promising attempts have been made pairing occipital tDCS with visual restitution training, however less is knows about which area/network should be best stimulated in association with compensatory approaches, aimed at improving exploratory abilities, such as multisensory trainings.

Methods

In a proof-of-principle, sham-controlled, single-blind study, 15 participants with chronic HVFDs underwent four one-shot sessions of active or sham anodal tDCS applied over the ipsilesional occipital cortex, the ipsilesional or contralesional posterior parietal cortex. tDCS was delivered during a compensatory multisensory (audiovisual) training. Before and immediately after each tDCS session, participants carried out a visual detection task, and two visual search tasks (EF and Triangles search tests). Accuracy (ACC) and response times (RTs) were analyzed with generalized mixed models. We investigated differences in baseline performance, clinical-demographic and lesion factors between tDCS responders and non-responders, based on post-tDCS behavioral improvements. Lastly, we conducted exploratory analyses to compare left and right brain-damaged participants.

Results

RTs improved after active ipsilesional occipital and parietal tDCS in the visual search tasks, while no changes in ACC were detected. Responders to ipsilesional occipital tDCS (Triangle task) had shorter disease duration and smaller lesions of the parietal cortex and the superior longitudinal fasciculus. On the other end, on the EF test, those participants with larger damage of the temporo-parietal cortex or the fronto-occipital white matter tracts showed a larger benefit from contralesional parietal tDCS. Overall, the visual search RTs improvements were larger in participants with right-sided hemispheric lesions.

Conclusion

The present result shows the facilitatory effects of occipital and parietal tDCS combined with compensatory multisensory training on visual field exploration in HVFDs, suggesting a potential for the development of new neuromodulation treatments to improve visual scanning behavior in brain-injured patients.
Causal association between depression and intracranial aneurysms: a bidirectional two-sample Mendelian randomization study
Authors: Wu Jujiang , Sun Hao , Ma Junqiang
Published: February 2024

Background

Although observational studies have suggested a bidirectional relation between depression and intracranial aneurysms (IAs), their causal relations remain unclear. Thus we aimed to assess the causal association between depression and IAs.

Methods

We conducted a bidirectional two-sample Mendelian randomization (MR) study using summary-level data from publicly available genome-wide association studies of depression (n = 500,199), IAs (n = 79,429), unruptured intracranial aneurysm (uIA) (n = 74,004), and subarachnoid hemorrhage (SAH) (n = 77,074). MR analyses included the inverse-variance weighted (IVW) method as the primary analytic, plus weighted-median, simple mode, weighted mode, MR-Egger, and MR PRESSO.

Results

Genetically predicted depression was strongly positively related to IAs (odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.19–2.39, p = 0.003), uIA (OR = 1.96, 95% CI 1.06–3.64, p = 0.032), and SAH (OR = 1.73, 95% CI 1.14–2.61, p = 0.009). Reverse MR analyses showed that while genetically predicted uIA was positively related to depression (OR = 1.02, 95% CI 1.00–1.05, p = 0.044), no causal relations were observed for either IAs or SAH for depression.

Conclusion

Our findings provide evidence of a causal effect of depression on IAs, uIA, and SAH. For the reverse MR analyses, we found a causal impact of uIA on depression, but no causal influence of either IAs or SAH for depression.
Predictive value of individual serum neurofilament light chain levels in short-term disease activity in relapsing multiple sclerosis
Authors: Solís-Tarazona Luis , Raket Lars Lau , Cabello-Murgui Javier , Reddam Salma , Navarro-Quevedo Silvia , Gil-Perotin Sara
Published: February 2024

Background

The assessment of serum neurofilament light chain (sNFL) has emerged as a diagnostic and prognostic tool in monitoring multiple sclerosis (MS). However, the application of periodic measurement in daily practice remains unclear.

Objective

To evaluate the predictive value of individual sNFL levels in determining disease activity in patients with relapsing MS (RMS).

Methods

In this two-year prospective study, 129 RMS patients underwent quarterly sNFL assessments and annual MRI scans. The study analyzed the correlation between individual NFL levels and past, current, and future disease activity. Group-level Z-scores were employed as a comparative measure.

Results

Among the 37 participants, a total of 61 episodes of disease activity were observed. sNFL levels proved valuable in distinct ways; they were confirmatory of previous and current clinical and/or radiological activity and demonstrated a high negative predictive value for future 90 days activity. Interestingly, Z-scores marginally outperformed sNFL levels in terms of predictive accuracy, indicating the potential for alternative approaches in disease activity assessment. In our cohort, sNFL cut-offs of 10.8 pg./mL (sensitivity 27%, specificity 90%) and 14.3 pg./mL (sensitivity 15%, specificity 95%) correctly identified 7 and 4 out of 26 cases of radiological activity within 90 days, respectively, with 14 and 15% false negatives. When using lower cut-off values, individuals with sNFL levels below 5 pg/mL (with a sensitivity of 92%, specificity of 25%, and negative predictive value of 94%) were less likely to experience radiological activity within the next 3 months.

Conclusion

Individual sNFL levels may potentially confirm prior or current disease activity and predict short-term future radiological activity in RMS. These findings underscore its periodic measurement as a valuable tool in RMS management and decision-making, enhancing the precision of clinical evaluation in routine practice.
Utility and limitations of EEG in the diagnosis and management of ALDH7A1-related pyridoxine-dependent epilepsy. A retrospective observational study
Authors: Arntsen Vibeke , Jamali Ahmed , Sikiric Alma , Kristensen Erle , Tangeraas Trine , Kupliauskiene Guste , Stefansdottir Sigurbjörg , Bindoff Laurence A. , Sand Trond , Brodtkorb Eylert
Published: February 2024

Purpose

Pyridoxine-dependent epilepsy due to ALDH7A1 variants (PDE-ALDH7A1) is a rare disorder, presenting typically with severe neonatal, epileptic encephalopathy. Early diagnosis is imperative to prevent uncontrolled seizures. We have explored the role of EEG in the diagnosis and management of PDE.

Methods

A total of 13 Norwegian patients with PDE-ALDH7A1 were identified, of whom five had reached adult age. Altogether 163 EEG recordings were assessed, 101 from the 1st year of life.

Results

Median age at seizure onset was 9 h (IQR 41), range 1 h-6 days. Median delay from first seizure to first pyridoxine injection was 2 days (IQR 5.5). An EEG burst suppression pattern was seen in eight patients (62%) during the first 5 days of life. Eleven patients had recordings during pyridoxine injections: in three, immediate EEG improvement correlated with seizure control, whereas in six, no change of epileptiform activity occurred. Of these six, one had prompt clinical effect, one had delayed effect (< 1 day), one had no effect, one had uncertain effect, and another had more seizures. A patient without seizures at time of pyridoxine trial remained seizure free for 6 days. Two patients with prompt clinical effect had increased paroxysmal activity, one as a conversion to burst suppression. Autonomic seizures in the form of apnoea appeared to promote respiratory distress and were documented by EEG in one patient. EEG follow-up in adult age did not show signs of progressing encephalopathy.

Conclusion

A neonatal burst suppression EEG pattern should raise the suspicion of PDE-ALDH7A1. Respiratory distress is common; isolated apnoeic seizures may contribute. EEG responses during pyridoxine trials are diverse, often with poor correlation to immediate clinical effect. Reliance on single trials may lead to under-recognition of this treatable condition. Pyridoxine should be continued until results from biomarkers and genetic testing are available.
A review: effects of neurofeedback on patients with mild cognitive impairment (MCI), and Alzheimer’s disease (AD)
Authors: Tazaki Miyako
Published: February 2024

Neurofeedback training (NFT) is a non-invasive method and has been shown to be effective for attention deficit/hyperactivity disorder (ADHD) and various psychiatric disorders. The aim of this paper is to evaluate the effectiveness of NFT for patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) or Vascular Diseases (VD), so that we searched research articles from four databases, using the keywords neurofeedback, elderly, MCI, AD, VD, and dementia. As a result, 13 articles were identified regarding the effectiveness of NFT in patients with MCI and AD. Although each study differed in study design, training protocol, electroencephalogram (EEG) electrode placement, and reward and inhibition frequency bands, all were shown to enhance memory, attention, and other cognitive abilities. Additional well-designed, randomized studies with sufficient power are needed to further confirm the effectiveness of NFT.
Modulations of stretch reflex by altering visuomotor contexts
Authors: Ito Sho , Gomi Hiroaki
Published: February 2024

Various functional modulations of the stretch reflex help to stabilize actions, but the computational mechanism behind its context-dependent tuning remains unclear. While many studies have demonstrated that motor contexts associated with the task goal cause functional modulation of the stretch reflex of upper limbs, it is not well understood how visual contexts independent of the task requirements affect the stretch reflex. To explore this issue, we conducted two experiments testing 20 healthy human participants (age range 20–45, average 31.3 ± 9.0), in which visual contexts were manipulated in a visually guided reaching task. During wrist flexion movements toward a visual target, a mechanical load was applied to the wrist joint to evoke stretch reflex of wrist flexor muscle (flexor carpi radialis). The first experiment (n = 10) examined the effect of altering the visuomotor transformation on the stretch reflex that was evaluated with surface electromyogram. We found that the amplitude of the stretch reflex decreased (p = 0.024) when a rotational transformation of 90° was introduced between the hand movement and the visual cursor, whereas the amplitude did not significantly change (p = 0.26) when the rotational transformation was accompanied by a head rotation so that the configuration of visual feedback was maintained in visual coordinates. The results suggest that the stretch reflex was regulated depending on whether the visuomotor mapping had already been acquired or not. In the second experiment (n = 10), we examined how uncertainty in the visual target or hand cursor affects the stretch reflex by removing these visual stimuli. We found that the reflex amplitude was reduced by the disappearance of the hand cursor (p = 0.039), but was not affected by removal of the visual target (p = 0.27), suggesting that the visual state of the body and target contribute differently to the reflex tuning. These findings support the idea that visual updating of the body state is crucial for regulation of quick motor control driven by proprioceptive signals.
MISNet: multi-source information-shared EEG emotion recognition network with two-stream structure
Authors: Gong Ming , Zhong Wei , Ye Long , Zhang Qin
Published: February 2024

Introduction

When constructing machine learning and deep neural networks, the domain shift problem on different subjects complicates the subject independent electroencephalography (EEG) emotion recognition. Most of the existing domain adaptation methods either treat all source domains as equivalent or train source-specific learners directly, misleading the network to acquire unreasonable transfer knowledge and thus resulting in negative transfer.

Methods

This paper incorporates the individual difference and group commonality of distinct domains and proposes a multi-source information-shared network (MISNet) to enhance the performance of subject independent EEG emotion recognition models. The network stability is enhanced by employing a two-stream training structure with loop iteration strategy to alleviate outlier sources confusing the model. Additionally, we design two auxiliary loss functions for aligning the marginal distributions of domain-specific and domain shared features, and then optimize the convergence process by constraining gradient penalty on these auxiliary loss functions. Furthermore, the pre-training strategy is also proposed to ensure that the initial mapping of shared encoder contains sufficient emotional information.

Results

We evaluate the proposed MISNet to ascertain the impact of several hyper-parameters on the domain adaptation capability of network. The ablation experiments are conducted on two publically accessible datasets SEED and SEED-IV to assess the effectiveness of each loss function.

Discussion

The experimental results demonstrate that by disentangling private and shared emotional characteristics from differential entropy features of EEG signals, the proposed MISNet can gain robust subject independent performance and strong domain adaptability.
Community perception and utilization of services for the severe wasted children aged 6–59 months in the Forcibly Displaced Myanmar Nationals and their nearest host communities in Bangladesh: a qualitative exploration
Authors: Rahman Mahfuzur , Naila Nurun Nahar , Islam Md. Munirul , Mahfuz Mustafa , Alam Aklima , Karmakar Gobinda , Ferdous Anjuman Tahmina , Siddique Muhammad Abu Bakr , Mustaphi Piyali , Ahmed Tahmeed
Published: February 2024

Introduction

There is a paucity of data on community perception and utilization of services for wasted children in Forcibly Displaced Myanmar Nationals (FDMN) and their nearest host communities.

Methods

We conducted a qualitative study to explore community perceptions and understand the utilization of services for severely wasted children among the FDMN and their nearest host communities in Teknaf, Cox’s Bazar. We carried out 13 focus group discussions and 17 in-depth interviews with the caregivers of the children of 6–59 months, and 8 key informant interviews.

Results

Caregivers’ perceived causes of severe wasting of their children included caregivers’ inattention, unhygienic practices, and inappropriate feeding practices. However, the context and settings of the FDMN camps shaped perceptions of the FDMN communities. Caregivers in both the FDMN and host communities sought care from healthcare providers for their children with severe acute malnutrition (SAM) when they were noticed and encouraged by their neighbors or community outreach workers, and when their SAM children suffered from diseases such as diarrhea and fever. Some caregivers perceived ready-to-use therapeutic food (RUTF) as a food to be shared and so they fed it to their non-SAM children.

Discussion

Caregivers of the children having SAM with complications, in the FDMN and host communities, were reluctant to stay in stabilization centers or complex respectively, due to their households’ chores and husbands’ unwillingness to grant them to stay. The findings of this study are expected to be used to design interventions using locally produced RUTF for the management of SAM children in the FDMN, as well as to inform the health sector working on SAM child management in the host communities.
The antioxidant activity of polysaccharides from Armillaria gallica
Authors: Su Peiwen , Qiu Honghao , Liang Lishan , Weng Luo , Liu Yingjie , Liu Jiajun , Wu Liyan , Meng Fanxin
Published: February 2024

The purpose of this study was to investigate the antioxidant activity of Armillaria gallica polysaccharides. It explored whether Armillaria gallica polysaccharides (AgP) could prevent HepG2 cells from H2O2-induced oxidative damage. The results demonstrated that HepG2 cells were significantly protected by AgP, and efficiently suppressed the production of reactive oxygen species (ROS) in HepG2 cells. Additionally, AgP significantly decreased the abnormal leakage of alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) caused by H2O2, protecting cell membrane integrity. It was discovered that AgP was also found to regulate the activities of antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX), while reducing malondialdehyde (MDA), thus protecting cells from oxidative damage. According to the flow cytometry analysis and measurement of caspase-3, caspase-8, and caspase-9 activities, AgP could modulate apoptosis-related proteins and attenuate ROS-mediated cell apoptosis.
Prevalence and predictive factors associated with stunting in preschool children in a governorate of Iraq: a community-based cross-sectional study
Authors: Mhamad Huda J. , Najmadden Zana B. , Hama Salih Kaihan H. , Hama Dlkhwaz A. , Abdullah Hiwa O. , Hasan Karzan M. , Kareem Honar O. , Mohammed Bilal A. , Fattah Fattah H. , Abdalla Berun A. , Kakamad Fahmi H. , Mohammed Shvan H.
Published: February 2024

Introduction

The prevalence and risk factors of stunting in various geographical regions have been well investigated. However, not enough data exists regarding the communities in Iraq. This study investigated the prevalence and risk factors of stunting in preschool children in Halabja governorate.

Methods

The required data for the study was collected through a structured questionnaire form from the children’s parents. Then, the height and weight of the children were measured. According to the World Health Organization Child Growth Standards and using the WHO Anthro Survey Analyser software, children were classified as “stunted” when their height-for-age z-score was below two standard deviations.

Results

A total of 646 children were included, of which 310 (48%) were male and 336 (52%) were female. The gestational age of 556 (86%) children was 9 months, while 84 (13%) were born between 7–9 months, and 6 (1%) were born in 7 months. Regarding feeding during the first 2 years of life, 229 children (35.4%) were exclusively breastfed, 93 (14.4%) were bottle-fed, and 324 (50.2%) had mixed feeding. The prevalence of stunting was 7.9% in the sample pool, with 4.6% of females and 3.3% of males. Among stunted children, 6.35% were term babies, and 1.55% were preterm babies. None of the studied factors had a significant association with stunting.

Conclusion

The prevalence of stunting in the studied population was 7.9%. However, we could not find any significant association between the studied factors and stunting. Thus, the factors that may significantly affect stunting in our area of study, especially the historical chemical warfare side effects, need to be more extensively investigated in future studies.
Predicting voxel-level dose distributions of single-isocenter volumetric modulated arc therapy treatment plan for multiple brain metastases
Authors: Huang Peng , Shang Jiawen , Hu Zhihui , Liu Zhiqiang , Yan Hui
Published: February 2024

Purpose

Brain metastasis is a common, life-threatening neurological problem for patients with cancer. Single-isocenter volumetric modulated arc therapy (VMAT) has been popularly used due to its highly conformal dose and short treatment time. Accurate prediction of its dose distribution can provide a general standard for evaluating the quality of treatment plan. In this study, a deep learning model is applied to the dose prediction of a single-isocenter VMAT treatment plan for radiotherapy of multiple brain metastases.

Method

A U-net with residual networks (U-ResNet) is employed for the task of dose prediction. The deep learning model is first trained from a database consisting of hundreds of historical treatment plans. The 3D dose distribution is then predicted with the input of the CT image and contours of regions of interest (ROIs). A total of 150 single-isocenter VMAT plans for multiple brain metastases are used for training and testing. The model performance is evaluated based on mean absolute error (MAE) and mean absolute differences of multiple dosimetric indexes (DIs), including (Dmax and Dmean) for OARs, (D98, D95, D50, and D2) for PTVs, homogeneity index, and conformity index. The similarity between the predicted and clinically approved plan dose distribution is also evaluated.

Result

For 20 tested patients, the largest and smallest MAEs are 3.3% ± 3.6% and 1.3% ± 1.5%, respectively. The mean MAE for the 20 tested patients is 2.2% ± 0.7%. The mean absolute differences of D98, D95, D50, and D2 for PTV60, PTV52, PTV50, and PTV40 are less than 2.5%, 3.0%, 2.0%, and 3.0%, respectively. The prediction accuracy of OARs for Dmax and Dmean is within 3.2% and 1.2%, respectively. The average DSC ranges from 0.86 to 1 for all tested patients.

Conclusion

U-ResNet is viable to produce accurate dose distribution that is comparable to those of the clinically approved treatment plans. The predicted results can be used to improve current treatment planning design, plan quality, efficiency, etc.
Shenfu injection: a review of pharmacological effects on cardiovascular diseases
Authors: Xu Fei-Fei , Xie Xiao-Fang , Hu Hai-Yan , Tong Rong-Sheng , Peng Cheng
Published: February 2024

Shenfu injection (SFI), composed of ginseng and aconite, is a Chinese patent developed from the classic traditional prescription Shenfu Decoction created more than 700 years ago. SFI has been widely used in China for over 30 years for treating cardiovascular diseases. The main components in it include ginsenosides and aconitum alkaloids. In recent years, the role of SFI in the treatment of cardiovascular diseases has attracted much attention. The pharmacological effects and therapeutic applications of SFI in cardiovascular diseases are summarized here, highlighting pharmacological features and potential mechanisms developments, confirming that SFI can play a role in multiple ways and is a promising drug for treating cardiovascular diseases.
Real-world data for the availability of pediatric medicines in Chinese hospitals: a multi-center survey and analysis
Authors: Ruan Wen-Yi , Chen Hui-Ying , Cai He-Ping , Wang Xiao-Ling , Zhao Zhi-Gang
Published: February 2024

Aim: No information exists on the availability of pediatric medicines in China. This study aimed to access the availability of different types of pediatric medicine and determine their ratio in medical institution drug catalogs.

Methods: Based on drug instructions, an expert meeting method was used to divide pediatric medicines into five categories: child-specific medicine (CSM), co-use medicine for adults and children (CMAC), other pediatric medicines (OCM), off-label medicine use (OMU), and non-child medicine (NM).

Results: A total of 60 hospitals nationwide participated in this survey, namely, 20 children’s hospitals (C-hosp), 14 maternal and child healthcare hospitals (MCHC-hosp), and 26 general hospitals (G-hosp). The average number of drug catalogs in G-hosp was significantly higher than that in C-hosp and MCHC-hosp. CSM accounted for 9.77% of the C-hosp catalog, 7.12% of the MCHC-hosp catalog, and 1% of the G-hosp catalog. The availability rate of CMAC was 49.63% in C-hosp and 40.87% and 31% in MCHC-hosp and G-hosp, respectively. The proportion of OCM in C-hosp (27.28%) was higher than that in MCHC-hosp (13.4%) and G-hosp (5%). The OMU occupied ratio in C-hosp, MCHC-hosp, and G-hosp is not negligible, which was 12.06%, 8.7%, and 10% respectively. The proportion of NM in C-hosp was almost negligible but was 29.91% and 53% in MCHC-hosp and G-hosp, respectively. Compared to the CSM and CMAC listed in China, the share of CSM in C-hosp was close to 40%, which was much higher than that of G-hosp and MCHC-hosp. In contrast, the share of CMAC in G-hosp was nearly 30%, which was significantly higher than that in C-hosp and MCHC-hosp. Health insurance covers most of these five types of pediatric medicines, with the proportion of insured medicines reaching close to 80% in C-hosp and approximately 85% in MCHC-hosp and G-hosp.

Discussion: The availability of specific medicines suitable for use in children is generally low, and even CSM in specialized hospitals such as C-hosp cannot meet the relatively high accessibility level of WHO evaluation standards. Policies and measures should be implemented to boost the research and development of pediatric medicines, as well as supplement safety information lacking in instruction manuals.
Gene editing improves endoplasmic reticulum-mitochondrial contacts and unfolded protein response in Friedreich’s ataxia iPSC-derived neurons
Authors: Mishra Priyanka , Sivakumar Anusha , Johnson Avalon , Pernaci Carla , Warden Anna S. , El-Hachem Lilas Rony , Hansen Emily , Badell-Grau Rafael A. , Khare Veenita , Ramirez Gabriela , Gillette Sydney , Solis Angelyn B. , Guo Peng , Coufal Nicole , Cherqui Stephanie
Published: February 2024

Friedreich ataxia (FRDA) is a multisystemic, autosomal recessive disorder caused by homozygous GAA expansion mutation in the first intron of frataxin (FXN) gene. FXN is a mitochondrial protein critical for iron-sulfur cluster biosynthesis and deficiency impairs mitochondrial electron transport chain functions and iron homeostasis within the organelle. Currently, there is no effective treatment for FRDA. We have previously demonstrated that single infusion of wild-type hematopoietic stem and progenitor cells (HSPCs) resulted in prevention of neurologic and cardiac complications of FRDA in YG8R mice, and rescue was mediated by FXN transfer from tissue engrafted, HSPC-derived microglia/macrophages to diseased neurons/myocytes. For a future clinical translation, we developed an autologous stem cell transplantation approach using CRISPR/Cas9 for the excision of the GAA repeats in FRDA patients’ CD34+ HSPCs; this strategy leading to increased FXN expression and improved mitochondrial functions. The aim of the current study is to validate the efficiency and safety of our gene editing approach in a disease-relevant model. We generated a cohort of FRDA patient-derived iPSCs and isogenic lines that were gene edited with our CRISPR/Cas9 approach. iPSC derived FRDA neurons displayed characteristic apoptotic and mitochondrial phenotype of the disease, such as non-homogenous microtubule staining in neurites, increased caspase-3 expression, mitochondrial superoxide levels, mitochondrial fragmentation, and partial degradation of the cristae compared to healthy controls. These defects were fully prevented in the gene edited neurons. RNASeq analysis of FRDA and gene edited neurons demonstrated striking improvement in gene clusters associated with endoplasmic reticulum (ER) stress in the isogenic lines. Gene edited neurons demonstrated improved ER-calcium release, normalization of ER stress response gene, XBP-1, and significantly increased ER-mitochondrial contacts that are critical for functional homeostasis of both organelles, as compared to FRDA neurons. Ultrastructural analysis for these contact sites displayed severe ER structural damage in FRDA neurons, that was undetected in gene edited neurons. Taken together, these results represent a novel finding for disease pathogenesis showing dramatic ER structural damage in FRDA, validate the efficacy profile of our FXN gene editing approach in a disease relevant model, and support our approach as an effective strategy for therapeutic intervention for Friedreich’s ataxia.
Hair cluster detection model based on dermoscopic images
Authors: Xiong Ya , Yu Kun , Lan Yujie , Lei Zeyuan , Fan Dongli
Published: February 2024

Introduction: Hair loss has always bothered many people, with numerous individuals potentially facing the issue of sparse hair.

Methods: Due to a scarcity of accurate research on detecting sparse hair, this paper proposes a sparse hair cluster detection model based on improved object detection neural network and medical images of sparse hair under dermatoscope to optimize the evaluation of treatment outcomes for hair loss patients. A new Multi-Level Feature Fusion Module is designed to extract and fuse features at different levels. Additionally, a new Channel-Space Dual Attention Module is proposed to consider both channel and spatial dimensions simultaneously, thereby further enhancing the model’s representational capacity and the precision of sparse hair cluster detection.

Results: After testing on self-annotated data, the proposed method is proven capable of accurately identifying and counting sparse hair clusters, surpassing existing methods in terms of accuracy and efficiency.

Discussion: Therefore, it can work as an effective tool for early detection and treatment of sparse hair, and offer greater convenience for medical professionals in diagnosis and treatment.