Hasil untuk "By period"

Mark A. Warner, M. Warner, J. G. Weber

Maurizio Inghilleri, A. Berardelli, G. Cruccu et al.

1. The silent period evoked in the first dorsal interosseous (FDI) muscle after electrical and magnetic transcranial stimulation (TCS), electrical stimulation of the cervicomedullary junction and ulnar nerve stimulation was studied in ten healthy subjects. 2. With maximum‐intensity shocks, the average duration of the silent period was 200 ms after electrical TCS, 300 ms after magnetic TCS, 43 ms after stimulation at the cervicomedullary junction and 100 ms after peripheral nerve stimulation. 3. The duration of the silent period, the amplitude of the motor‐evoked potential, and the twitch force produced in the muscle were compared at increasing intensities of magnetic TCS. When the stimulus strength was increased from 30 to 70% of the stimulator output, the duration of the silent period lengthened as the amplitude of the motor potential and force of the muscle twitch increased. At 70 to 100% of the output, the amplitude of the motor potential and force of the muscle twitch saturated, whereas the duration of the silent period continued to increase. 4. Proximal arm muscle twitches induced by direct electrical stimulation of the biceps and extensor wrist muscles produced no inhibition of voluntary activity in the contracting FDI muscle. 5. The level of background activation had no effect on the duration of the silent period recorded in the FDI muscle after magnetic TCS. 6. Corticomotoneurone excitability after TCS was studied by means of a single magnetic conditioning shock and a test stimulus consisting either of one single magnetic shock or single and double electrical shocks (interstimulus interval 1.8 ms) in the relaxed muscle. A conditioning magnetic shock completely suppressed the response evoked by a second magnetic shock, reduced the size of the response evoked by a single electrical shock but did not affect the response evoked by double electrical shocks. Inhibition of the test magnetic shock was also present during muscle contraction. 7. Our findings indicate that the first 50 ms of the silent period after TCS are produced mainly by spinal mechanisms such as after‐hyperpolarization and recurrent inhibition of the spinal motoneurones. If descending inhibitory fibres contribute, their contribution is small. Changes in proprioceptive input probably have a minor influence. From 50 ms onwards the silent period is produced mainly by cortical inhibitory mechanisms.

Leif R. Nelson, D. O. Hodge, W. M. Bourne

X. Shu, Lin Zhang, I. Bennion

M. Vitaterna, C. Selby, Takeshi Todo et al.

Z. Sun, U. Albrecht, O. Zhuchenko et al.

Matheus Alexandre de Vasconcelos, Júlia Audrem Gomes de Oliveira Fadul, Vitor da Silva de Souza et al.

This study investigated the fabrication and characterization of biodegradable monofilament suture threads based on cellulose acetate (CA), plasticized with triethyl citrate (TC) and reinforced with poly(lactic acid) (PLA), produced by twin-screw micro-extrusion for potential dental surgical applications. The effects of TC content (25, 30, and 35 wt%) and PLA incorporation (15 wt%) on processability, thermal behavior, morphology, mechanical properties, and biocompatibility were systematically evaluated. The sutures were characterized by thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), scanning electron microscopy (SEM), tensile testing, and in vitro biological assays using RAW 264.7 macrophages. The results showed that TC effectively reduced the glass transition temperature of CA, enhancing flexibility and processability, while PLA incorporation influenced thermal stability and promoted morphological changes, including increased porosity and elasticity. SEM analyses revealed smooth and homogeneous surfaces for CA/TC monofilaments and slightly rougher, more porous morphologies for CA/PLA/TC blends, which may favor tissue interaction. In vitro assays confirmed cytocompatibility, with no cytotoxic effects or nitric oxide induction observed over a 7-day exposure period. Although most formulations did not fully meet the tensile strength requirements specified by NBR 13904/2003, the formulation containing 25 wt% TC and 15 wt% PLA (A4) exhibited the best mechanical performance, approaching normative values while maintaining suitable handling characteristics. Overall, the results indicate that CA/TC/PLA-based sutures represent a promising, sustainable, and biocompatible alternative for absorbable surgical sutures, although further optimization is required to fully comply with mechanical regulatory standards.

Yannan Cao, Yixin Wang, Hang Liu et al.

With the development of artificial intelligence (AI), AI-related technologies are being applied in many fields of medicine. Anesthesia is now widely used in surgery, emergency resuscitation, pain treatment and other fields. However, different from some other common biomedical signals, such as the electrocardiogram (ECG), electroencephalogram (EEG), and some other medical imaging or biomarkers could be easily processed and analyzed by AI-related models, how to collect the relevant data in the anesthesia process is still a challenge, that has led to little current work on combining AI and anesthesia. However, it can be foreseen that the combination of AI and anesthesia will become increasingly important. This paper presents a comprehensive review of anesthesia with AI based methods which have been now used in the preoperative phase, intraoperative phase, and postoperative phase. We first overview some crucial concepts of artificial intelligence, then discuss the related applications of artificial intelligence used in different phases of the anesthesia period, finally, we look forward to the future development of intelligent anesthesia. We hope through this review, we can provide comprehensive and objective guidance in AI-related anesthesia process to help anesthesiologists use more advanced AI techniques to diagnose and treat patients during the anesthesia period.

Derya Unal, MD, Semra Demir, MD, Sacide Rana Işik, MD et al.

Background: We aimed to assess knowledge of emergency department (ED) physicians regarding the classification and treatment of angioedema and to evaluate the impact of a training program on this knowledge base. Methods: A total of 11 questions about angioedema and its types were posed to ED physicians from various hospitals, either in person or via e-mail, before the implementation of an educational module on the subject (pre-test). Following a brief training period, the ED physicians were presented with the same set of questions once again (post-test). The reliability between the repeated tests were estimated using intraclass correlation coefficients (ICC). Item difficulty was calculated separately for each question in both the pre-test and post-test. Results: A total of 541 ED physicians participated in the pre-test survey, and 162 of them declined to participate in the post-test survey. The remaining 379 participated in the post-test survey as well. The ICC between the repeated tests indicated a moderate level of reliability (mean ICC = 0.5; 0.42–0.57; lower and upper 95% confidence intervals). The mean item difficulty was 0.36 in the pre-test, indicating that the items had an appropriate level of difficulty. In the post-test, the mean item difficulty increased to 0.57, suggesting that the items were generally easier, likely reflecting improved knowledge or skills following the intervention. The level of knowledge regarding the clinical features of different types of angioedema was found to be inadequate. Following the training period, there was a notable increase in the number of correct answers, with a statistically significant difference (p = 0.002). Similarly, a remarkable increase was observed in the number of respondents who indicated that bradykinin-mediated-angioedema should be considered in cases of unresponsiveness to antihistamine and-corticosteroid treatment (p < 0.001). Regarding queries about hereditary angioedema (HAE), the majority of ED physicians had no prior experience in treating a patient with HAE, and only a small number were familiar with the symptoms of HAE. Following the training ED physicians demonstrated enhanced knowledge of HAE symptoms and diagnostic criteria (p < 0.001). Similarly, a notable enhancement in familiarity with HAE attack treatments was observed when the inquiries related to these treatments were compared between the pre-test and post-test phases (p < 0.001). Conclusion: In light of the potential lethality of attacks mediated by bradykinin, a training program should include the recognition of rare types of angioedema, with a particular emphasis on HAE disease.

Haiquan Kang, Haiquan Kang, Ziling Wang et al.

Bloodstream infections (BSIs) are a critical medical concern, characterized by elevated morbidity, mortality, extended hospital stays, substantial healthcare costs, and diagnostic challenges. The clinical outcomes for patients with BSI can be markedly improved through the prompt identification of the causative pathogens and their susceptibility to antibiotics and antimicrobial agents. Traditional BSI diagnosis via blood culture is often hindered by its lengthy incubation period and its limitations in detecting pathogenic bacteria and their resistance profiles. Surface-enhanced Raman scattering (SERS) has recently gained prominence as a rapid and effective technique for identifying pathogenic bacteria and assessing drug resistance. This method offers molecular fingerprinting with benefits such as rapidity, sensitivity, and non-destructiveness. The objective of this study was to integrate deep learning (DL) with SERS for the rapid identification of common pathogens and their resistance to drugs in BSIs. To assess the feasibility of combining DL with SERS for direct detection, erythrocyte lysis and differential centrifugation were employed to isolate bacteria from blood samples with positive blood cultures. A total of 12,046 and 11,968 SERS spectra were collected from the two methods using Raman spectroscopy and subsequently analyzed using DL algorithms. The findings reveal that convolutional neural networks (CNNs) exhibit considerable potential in identifying prevalent pathogens and their drug-resistant strains. The differential centrifugation technique outperformed erythrocyte lysis in bacterial isolation from blood, achieving a detection accuracy of 98.68% for pathogenic bacteria and an impressive 99.85% accuracy in identifying carbapenem-resistant Klebsiella pneumoniae. In summary, this research successfully developed an innovative approach by combining DL with SERS for the swift identification of pathogenic bacteria and their drug resistance in BSIs. This novel method holds the promise of significantly improving patient prognoses and optimizing healthcare efficiency. Its potential impact could be profound, potentially transforming the diagnostic and therapeutic landscape of BSIs.

T. Kitamura, Y. Saitoh, N. Takashima et al.

S. Siepka, S. Yoo, Jung Park et al.

K. Hagihara, Naoyuki Yokotani, Y. Umakoshi

V. Agarwal, N. Naik

H. Brenner

Yu-Yan Li, Jun-Jie Chen, Meng-Yao Liu et al.

Improved knowledge on the regulation of reproductive diapause in Coccinella septempunctata, an important predator of aphids, is crucial for improving shelf-life and mass production of the ladybeetles. In many insects, the absence of juvenile hormone (JH) is a central regulator of reproductive diapause. JH is principally degraded by JH esterase (JHE) and JH epoxide hydrolase (JHEH). Previous studies have shown that genes encoding these enzymes were upregulated in early diapause of C. septempunctata, but whether increased JH degradation contributes to the reduction of JH levels and facilitates reproductive diapause remains unknown. Here, we investigate the role of JH and JH degradation genes during reproductive diapause in C. septempunctata females. Applying methoprene, a JH analogue, to the diapause preparation females clearly elevated JH signaling and reversed diapause program, suggesting that a lower level of JH is critical for the induction of reproductive diapause in the ladybeetle. Full-length cDNA sequences of JHE and JHEH were cloned and characterized, and their deduced proteins contain all the conserved active domains and typical motifs as identified in other insects. The expressions of JHE and JHEH were both significantly increased in diapause preparation and remained at a high level for a period throughout diapause, and then decreased after the termination of diapause. Knocking down these JH degradation genes clearly increased the expression levels of JH-inducible genes Krüppel-homolog 1 (Kr-h1) and vitellogenin (Vg), indicating an elevated JH level. Simultaneously, silencing JH degradation genes distinctly reduced diapause-related features and promotes reproduction, indicated by accelerated ovary growth, yolk deposition, and suppressed lipid accumulation. These results indicate that the enhanced JH degradation plays a critical role in regulating reproductive diapause of C. septempunctata.

B. Carstensen

Biao Li, Jinzeng Yang, Yan Gong et al.

Liver is an important metabolic organ of mammals. During each transitional period of life, liver metabolism is programmed by a complex molecular regulatory system for multiple physiological functions, many pathways of which are regulated by hormones and cytokines, nuclear receptors, and transcription factors. To gain a comprehensive and unbiased molecular understanding of liver growth and development in Ningxiang pigs, we analyzed the mRNA, microRNA (miRNA), and proteomes of the livers of Ningxiang pigs during lactation, nursery, and fattening periods. A total of 22,411 genes (19,653 known mRNAs and 2758 novel mRNAs), 1122 miRNAs (384 known miRNAs and 738 novel miRNAs), and 1123 unique proteins with medium and high abundance were identified by high-throughput sequencing and mass spectrometry. We show that the differences in transcriptional, post-transcriptional, or protein levels were readily identified by comparing different time periods, providing evidence that functional changes that may occur during liver development are widespread. In addition, we found many overlapping differentially expressed genes (DEGs)/differentially expressed miRNAs (DEMs)/differentially expressed proteins (DEPs) related to glycolipid metabolism in any group comparison. These overlapping DEGs/DEMs/DGPs may play an important role in functional transformation during liver development. Short Time-series Expression Miner (STEM) analysis revealed multiple expression patterns of mRNA, miRNA, and protein in the liver. Furthermore, several diverse key Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, including immune defense, glycolipid metabolism, protein transport and uptake, and cell proliferation and development, were identified by combined analysis of DEGs and DGPs. A number of predicted miRNA–mRNA–protein pairs were found and validated by qRT-PCR and parallel reaction monitoring (PRM) assays. The results provide new and important information about the genetic breeding of Ningxiang pigs, which represents a foundation for further understanding the molecular regulatory mechanisms of dynamic development of liver tissue, functional transformation, and lipid metabolism.

A.G. Reznikov

The review highlights current views and hypotheses on the pathogenetic role of natural and xenoestrogens in the disorders of programming of neuroendocrine regulation of reproduction, alaptation, and various forms of instinctive behavior (reproductive, eating, parental, etc.) in the perinatal period of development of the female brain. Catecholestrogens, which are formed in the brain as a result of sequential metabolic conversions of testosterone, are involved in exogenous or endogenous androgen-induced defeminization of hypothalamic control of ovulation in early female ontogenesis. In the research on female animals with a knocked out gene of alpha-fetoprotein, the protective role of this protein against the possible pathogenic effect of placental estrogens on the developing brain of female fetuses was proved. The damaging effect of phytoestrogens (genistein, coumestrol) in the early postnatal period on the formation of ovulatory cycles has been shown. Evidence from studies in rodents and other animal species, supported by clinical observations, indicate the potential damaging effect of exposure to low levels of environmental xenoestrogens on the developing brain, in particular on its sexual differentiation and the hypothalamic-pituitary-adrenal axis. The potential hazard of the perinatal exposure to low doses of bisphenol A for the formation of estrogen receptors in the hypothalamus and amygdala of the female brain, sexual behavior and ovulation is discussed. Special attention is paid to the possible physiological role of natural estrogens in the formation of the female neuroendocrine system during puberty. It was concluded that in the early stages of female life, estrogens play a different role in the programming of the neuroendocrine system and behavior, depending on the period of individual development.

Aria Darbandi, Christina Chopra

Background: Gallbladder disease confers a significant economic toll on the United States healthcare system. This study aims to characterize current trends and features of the cholecystectomy population and identify factors that influence the length of stay and total charges. Methods: Case information was extracted for laparoscopic and open cholecystectomies from 2013-2016 using the New York Statewide Planning and Research Cooperative System (SPARCS) database. Descriptive, comparative, and multivariable linear regression analysis was conducted on 58,141 cases assessing age group, race, gender, admission presentation, surgical technique, insurance status, year of operation and severity of illness by the length of stay and total charges. Results: Of all procedures, 91.6% were laparoscopic, and 79.4% were emergent on admission. Total procedures trended down, while laparoscopic and emergent cases steadily increased (p<0.0001). Total charges increased during the study period, while the length of stay decreased (p<0.0001). Open and emergent procedures were associated with a higher cost and longer inpatient stays (p<0.0001). Open procedures were proportionally more common among elderly, male patients, and in elective cases (p<0.0001). Emergent presentation was more common in females, non-whites, and younger patients (p<0.0001). Regression model showed that male gender, open operation, Black race, and emergent presentation were independent predictors for a longer stay and greater total charges (p<0.0001). Medicare insurance predicted lower total charges but longer length of stay (p<0.0001). Conclusion: Race, insurance, procedure type, and patient presentation influence hospital charges and stays following cholecystectomy. Understanding these trends will allow policymakers and providers to limit the healthcare burden of cholecystectomy.