Σάββατο, 7 Οκτωβρίου 2017

Genetic parameters for growth performance, fillet traits, and fat percentage of male Nile tilapia ( Oreochromis niloticus )

Abstract

Improvement of fillet traits and flesh quality attributes are of great interest in farmed tilapia and other aquaculture species. The main objective of this study was to estimate genetic parameters for fillet traits (fillet weight and fillet yield) and the fat content of fillets from 1136 males combined with 2585 data records on growth traits (body weight at 290 days, weight at slaughter, and daily weight gain) of 1485 males and 1100 females from a third generation of the Aquaamerica tilapia strain. Different models were tested for each trait, and the best models were used to estimate genetic parameters for the fat content, fillet, and growth traits. Genetic and phenotypic correlations were estimated using two-trait animal models. The heritability estimates were moderate for the fat content of fillets and fillet yield (0.2–0.32) and slightly higher for body weight at slaughter (0.41). The genetic correlation between fillet yield and fat was significant (0.6), but the genetic correlations were not significant between body weight and fillet yield, body weight and fat content, daily weight gain and fillet yield, and daily weight gain and fat content (− 0.032, − 0.1, − 0.09, and − 0.4, respectively). Based on the genetic correlation estimates, it is unlikely that changes in fillet yield and fat content will occur when using growth performance as a selection criterion, but indirect changes may be expected in fat content if selecting for higher fillet yield.



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Eye movements in genetic parkinsonisms affecting the α-synuclein, PARK9, and manganese network

Specific saccadic abnormalities follow basal ganglia dysfunction. Eye movements are indeed often analyzed to differentiate parkinsonian syndromes and to provide new insights into the modulatory role of the basal ganglia. Nevertheless, the oculomotor description of most inherited parkinsonisms is still lacking. Here, we analyzed the eye movement characteristics of three inherited parkinsonian syndromes (genetic Parkinson's disease, PDG): Parkinson's disease 9 (or Kufor-Rakeb syndrome, PARK9, #606693), due to recessive mutations in ATP13A2 encoding the lysosomal P-type ATPase PARK9 (Ramirez et al., 2006; Gitler et al., 2009); hypermanganesemia with dystonia, polycythemia, and cirrhosis (HMNDYT1, #613280) due to recessive mutations in SLC30A10 leading to manganese accumulation in the liver, bone marrow, and nervous system (Quadri et al., 2012), and Parkinson's disease 1 (PARK1, #168601) associated with dominant mutations in SNCA encoding α-synuclein (Golbe et al., 1990).

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Was Mesopithecus a seed eating colobine? Assessment of cracking, grinding and shearing ability using dental topography

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Publication date: November 2017
Source:Journal of Human Evolution, Volume 112
Author(s): Ghislain Thiery, Geoffrey Gillet, Vincent Lazzari, Gildas Merceron, Franck Guy
Extant colobine monkeys have been historically described as specialized folivores. However, reports on both their behavior and dental metrics tend to ascribe a more varied diet to them. In particular, several species, such as Pygathrix nemaeus and Rhinopithecus roxellana, are dedicated seasonal seed eaters. They use the lophs on their postcanine teeth to crack open the hard endocarp that protects some seeds. This raises the question of whether the bilophodont occlusal pattern of colobine monkeys first evolved as an adaptation to folivory or sclerocarpic foraging. Here, we assess the sclerocarpic foraging ability of the oldest European fossil colobine monkey, Mesopithecus. We use computed microtomograpy to investigate the three-dimensional (3D) dental topography and enamel thickness of upper second molars ascribed to the late Miocene species Mesopithecus pentelicus from Pikermi, Greece. We compare M. pentelicus to a sample of extant Old World monkeys encompassing a wide range of diets. Furthermore, we combine classic dietary categories such as folivory with alternative categories that score the ability to crack, grind and shear mechanically challenging food. The 3D dental topography of M. pentelicus predicts an ability to crack and grind hard foods such as seeds. This is consistent with previous results obtained from dental microwear analysis. However, its relatively thin enamel groups M. pentelicus with other folivorous cercopithecids. We interpret this as a morphological trade-off between the necessity to avoid tooth failure resulting from hard food consumption and the need to process a high amount of leafy material. Our study demonstrates that categories evaluating the cracking, grinding or shearing ability, traditional dietary categories, and dental topography combine well to make a powerful tool for the investigation of diet in extant and extinct primates.



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Ruminants (Giraffidae and Bovidae) from Kanapoi

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Publication date: Available online 6 October 2017
Source:Journal of Human Evolution
Author(s): Denis Geraads, René Bobe
We update here our recent revision of the Kanapoi ruminants and describe recently collected material. We now regard the occurrence of reduncins as doubtful, we revise the identification of a large raphicerin as being more probably Gazella, and we add Gazella cf. janenschi and the Cephalophini to the faunal list. New material of Tragelaphus kyaloi suggests that this species held its head unlike other tragelaphins, and was not an exclusive dedicated browser, but Kanapoi pre-dates the Pliocene change of Sivatherium, Aepyceros, Alcelaphini, and even Tragelaphini toward more grazing diets. Kanapoi shares several ruminant taxa with sites in Ethiopia and Tanzania, attesting to latitudinal exchanges.



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Sparks of the CRISPR explosion: Applications in medicine and agriculture

Publication date: 20 September 2017
Source:Journal of Genetics and Genomics, Volume 44, Issue 9
Author(s): Ji-Long Liu




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Cardiac and hemodynamic influence on carotid artery longitudinal wall motion

Abstract

Carotid artery longitudinal wall motion (CALM) has recently attracted interest as an indicator of arterial health; however, the regulation of CALM is poorly understood. We conducted a series of studies aimed at manipulating pulse pressure (PP), left ventricular (LV) motion, and carotid shear rate, which have been previously suggested to regulate various components of CALM pattern and magnitude. To determine the regulatory influences on CALM, fifteen healthy males (22 ± 2 years) were exposed to three acute interventions: the Serial Subtraction Test (SST), the Cold Pressor Test (CPT), and exposure to sublingual nitroglycerine (NTG). The SST elicited increases in PP (< 0.01), apical LV rotation (< 0.01), and carotid shear rate (< 0.01), with no changes in CALM (P > 0.05). Similarly, the CPT elicited increases in PP (P = 0.01), basal LV rotation (P = 0.04) and carotid shear rate (P = 0.01), with no changes in CALM (> 0.05). Conversely, exposure to NTG elicited no change in PP (P = 0.22), basal (P = 0.65) or apical LV rotation (P = 0.45), but did decrease carotid shear rate (< 0.01), without altering CALM (> 0.05). Considerable individual variability in CALM responses prompted further analyses where all three interventions were pooled for change scores. Changes in LV basal rotation were related to changes systolic retrograde CALM (B = −0.025, P = 0.03), while changes in carotid shear rate were related to changes in diastolic CALM displacement (B = 0.0009, P = 0.01). The interventions were underpinned by relationships between CALM and both LV basal rotation and local shear rate at the individual level, indicating that cardiac and hemodynamic factors may influence CALM in humans.

This article is protected by copyright. All rights reserved



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Effects of normoxic and hypoxic exercise regimens on lymphocyte apoptosis induced by oxidative stress in sedentary males

Abstract

Purpose

Oxidative stress-induced lymphocyte apoptosis is linked to hypoxemic individuals suffering from cardiopulmonary disorders or exposed to hypoxic environments. What kind of the exercise strategy under hypoxic condition improves exercise performance and simultaneously minimizes lymphocyte dysfunction caused by oxidative stress has not yet been established. This study elucidates how various exercises regimens with/without hypoxia affect lymphocyte apoptosis induced by oxidative stress.

Methods

A total of 60 sedentary males were randomly divided into five groups. Each group (n = 12) received one of the five interventions: hypoxic-absolute exercise (HAT, 50%W max under 15%O2), hypoxic-relative exercise (HRT, 50% heart rate reserve under 15%O2), normoxic exercise (NT, 50%W max under 21%O2), hypoxic control (HC, resting under 15%O2), or normoxic control (NC, resting under 21%O2) for 30 min/day, 5 days/week for 4 weeks.

Results

Before the intervention, the graded exercise test (GXT, progressive exercise up to VO2max) decreased the surface thiol level on lymphocytes and subsequently augmented the extents of H2O2-induced mitochondria transmembrane potential (MTP) diminishing, caspase 3/8/9 activations, and phosphotidyl serine (PS) exposure in lymphocytes. However, 4 weeks of NT, HRT, or HAT reduced the extents of surface thiol decreasing on lymphocytes and H2O2-induced MTP diminishing, caspase 3/8/9 activations, and PS exposure in lymphocytes following GXT. Moreover, the HAT group exhibited greater improvements in pulmonary ventilation and VO2max than either NT or HRT group did.

Conclusions

Exercise training with/without hypoxic exposure effectively alleviates lymphocyte apoptosis induced by oxidative stress following strenuous exercise. However, the HAT is superior to the NT or HRT for enhancing aerobic capacity.



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Long-term effects of sport concussion on cognitive and motor performance: A review

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Publication date: Available online 7 October 2017
Source:International Journal of Psychophysiology
Author(s): Douglas N. Martini, Steven P. Broglio
Motor and cognitive dysfunction is intractable sequela in the acute stage of concussion. While typical concussion recovery occurs in two weeks, empirical evidence suggests that some sequela persist beyond this period, though there is inconsistency surrounding the duration the sequela persist. In part, confusion around the issue is limited by the volume of literature evaluating those with a concussion history, permitting vast interpretations of significance. The purpose of this paper is to review the concussion history literature, summarizing the long-term effects of concussion history on motor and cognitive performance. Additionally, this review intends to provide direction and options of future investigations addressing the long-term effects of concussion on motor and cognitive performance.



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Global cognitive profile and different components of reaction times in obstructive sleep apnea syndrome: Effects of continuous positive airway pressure over time

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Publication date: Available online 6 October 2017
Source:International Journal of Psychophysiology
Author(s): Maria Devita, Andrea Zangrossi, Maurizio Marvisi, Paola Merlo, Maria Luisa Rusconi, Sara Mondini
Obstructive sleep apnea syndrome (OSAS) has been recurrently associated with cognitive and psychomotor impairments. However, the occurrence and possible reversibility of these deficits are still extremely controversial, also as a result of different methodologies adopted used by scholars. The aim of the present study was to compare over time the global cognitive profile of patients with OSAS undergoing the continuous positive airway pressure treatment (CPAP; N=23) with that of patients with OSAS who were not (N=10). A group of healthy participants (N=30) was also included. This study adopted a specific methodological approach allowing the researchers to distinguish between the cognitive and the motor component of reaction times (RTs). After baseline assessment, the same tests were administered after three and six months. No significant differences emerged between groups at each time point. On the other hand, the analysis of cognitive score trajectory over time revealed differences between groups. While healthy controls and OSAS patients undergoing CPAP showed increased MoCA test scores after three months, patients not undergoing CPAP improved their scores only after six months. In addition, patients treated with CPAP also showed significantly faster psychomotor response in motor RTs over time. Results seem to conceivably support a global cognitive vulnerability of non-treated OSAS patients. Conversely, the RT response of treated patients can be increased over time by CPAP, at least in the motor component of RTs. Therefore, our study suggests that CPAP may play an important role by slowing down the negative effects of OSAS, and by fostering sufficient cognitive functioning and adequate psychomotor speed.



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Insight into the neuroendocrine basis of signal evolution: a case study in foot-flagging frogs

Abstract

A hallmark of sexual selection is the evolution of elaborate male sexual signals. Yet, how the physiology of an animal changes to support a new or modified signal is a question that has remained largely unanswered. Androgens are important in regulating male reproductive behavior, therefore, selection for particular signals may drive the evolution of increased androgenic sensitivity in the neuro-motor systems underlying their production. Studies of the neuroendocrine mechanisms of anuran sexual signaling provide evidence to support this idea. Here, we highlight two such cases: first, a large body of work in Xenopus frogs demonstrates that sexually dimorphic androgen receptor (AR) expression in the laryngeal nerves and muscles underlies sexually dimorphic vocal behavior, and second, our own work showing that the recent evolution of a hind limb signal (known as the "foot flag") in Staurois parvus is accompanied by a dramatic increase in androgenic sensitivity of the thigh muscles that control limb movement. Together, these examples illustrate that the evolutionary modification or gain of a sexual signal is linked with a novel pattern of AR expression in the tissues that support it. We suggest that such co-evolution of AR expression and sex-specific or species-specific signaling behavior exists across vertebrates.



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Journal of Pediatric Gastroenterology and Nutrition 2017 Reviewer Acknowledgement.

No abstract available

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Electron Microscopy of Dural and Arachnoid Disruptions After Subarachnoid Block.

Background: It has been customary to attribute postdural puncture headache (PDPH) incidence and severity to size and nature of the dural hole produced during major neuraxial blockade or diagnostic dural puncture. Needle orientation in relation to the direction of dural fibers was thought to be of importance because of the propensity for horizontal bevel placement to cause cutting rather than splitting of the dural fibers. Methods: In vitro punctures of stringently quality-controlled human dural sac specimens were obtained with 27-gauge (27G) Whitacre needle (n = 33), with 29G Quincke used parallel to the spinal axis (n = 30), and with 29G Quincke in perpendicular approach (n = 40). The samples were studied with a scanning electron microscope, and the perimeter, appearance, and area (%) of the lesion were calculated. Results: When using small 27G to 29G needles, neither needle tip characteristics nor needle orientation had a substantial bearing on the damage to dural fibers in the dural lesion. Of ultimate importance was the characteristic and size of the hole in the arachnoid. Arachnoid layer lesions produced by different types of spinal needles were not markedly different. Conclusions: Accepted theories of the etiology of PDPH need to be revised. This article marks the first time that arachnoid layer damage has been quantified. Dural fibers tend to have sufficient "memory" to close back the hole created by a spinal needle, whereas arachnoid has diminished capacity to do so. The pathogenesis of PDPH and its resolution algorithm are a far more complex process that involves many more "stages" of development than hitherto imagined. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Dose-Response Curves for Intrathecal Bupivacaine, Levobupivacaine, and Ropivacaine Given for Labor Analgesia in Nulliparous Women.

Background and Objectives: Bupivacaine, levobupivacaine, and ropivacaine are often given intrathecally for labor analgesia, but limited data are available for their dose-response properties in this context. The objective of this study was to describe the dose-response curves of these local anesthetics when given intrathecally for labor analgesia, to determine values for D50 (dose producing a 50% response) and to compare the calculated values of D50 for levobupivacaine and ropivacaine with those for bupivacaine. Methods: With ethics approval and written consent, we randomized 270 nulliparous laboring patients requesting neuraxial analgesia at 5-cm cervical dilation or less to receive a single dose of intrathecal local anesthetic without opioid as part of a combined spinal-epidural technique. Patients received either bupivacaine, levobupivacaine, or ropivacaine at a dose of 0.625, 1.0, 1.5, 2.5, 4.0, or 6.25 mg (n = 15 per group). Visual analog scale pain scores were measured for 15 minutes, after which further analgesia and management were at the clinician's discretion. The primary end point was percentage reduction of pain score at 15 minutes. Logistic sigmoidal dose-response curves were fitted to the data using nonlinear regression, and D50 values were calculated for each drug. Results: Data were analyzed from 270 patients. Patient characteristics were similar between groups. The calculated D50 and 95% confidence interval values were as follows: bupivacaine, 1.56 mg (1.25-1.94 mg); ropivacaine, 1.95 mg (1.57-2.43 mg); and levobupivacaine, 2.20 mg (1.76-2.73 mg). Conclusions: The results of this study support previous work showing that intrathecal levobupivacaine and ropivacaine are less potent than bupivacaine. Clinical Trial Registration: Chinese Clinical Trial Registry (identifier: ChiCTR-TRC-09000773) and Centre of Clinical Trials Clinical Registry of the Chinese University of Hong Kong (identifier: CUHK_CCT00245). Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Determination of ED50 and ED95 of 0.5% Ropivacaine in Adductor Canal Block to Produce Quadriceps Weakness: A Dose-Finding Study.

Background and Objectives: Adductor canal block (ACB) is popular for knee analgesia because of its favorable effect on quadriceps strength. The aim of this study was to find the minimum volume of local anesthetic, which can be injected into the ACB that would result in quadriceps weakness. Methods: This nonrandomized study used an up-and-down sequential allocation design. Twenty-six patients scheduled to undergo arthroscopic knee surgery received an ultrasound-guided ACB preoperatively. The initial volume of ropivacaine 0.5% injected was 30 mL, which was subsequently increased or decreased by 2 mL, depending on whether the previous subject had a 30% reduction in quadriceps function. The minimum effective volume in 50% of patients was determined using Dixon-Massey up-and-down method. The effective volume in 95% of patients was then calculated using probit transformation. Results: The ED50 (minimum effective anesthetic volume in 50% of the subjects) needed for a 30% decrease in quadriceps power was 46.5 mL (95% confidence interval, 45.01-50.43 mL), and estimated ED95 (minimum effective anesthetic volume in 95% of the subjects) was 50.32 mL (95% confidence interval, 48.66-67.26 mL). The local anesthetic volume injected correlated with degree of quadriceps weakness at 20 minutes postblock (P

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Neuronal activity patterns in the ventral thalamus: comparison between Parkinson’s disease and cervical dystonia

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Publication date: Available online 7 October 2017
Source:Clinical Neurophysiology
Author(s): Dmitriy Devetiarov, Ulia Semenova, Svetlana Usova, Alexey Tomskiy, Vladimir Tyurnikov, Dinara Nizametdinova, Artem Gushcha, Elena Belova, Alexey Sedov
ObjectiveThe aim of this study was to distinguish neuronal activity patterns in the human ventral thalamus and reveal common and disease-specific features in patients with Parkinson's disease (PD) and cervical dystonia (CD).MethodsSingle unit activity of neurons was recorded during microelectrode-guided thalamotomies. We classified neurons of surgical target and surrounding area into patterns and compared their characteristics and responsiveness to voluntary movement between PD and CD patients.ResultsWe distinguished five patterns of neuronal activity: single, LTS burst, mixed, non-LTS burst and longburst patterns. The burst and mixed patterns showed significant differences in several basic and burst characteristics. We showed that there were no disease-specific patterns or significant differences in pattern distribution between studied patients. However, burst patterns had an unbalanced distribution between disease conditions. In addition, we found difference in LTS burst characteristics between surgical targets and surrounding nuclei. All identified patterns, except the long burst pattern, were reactive to the motor tasks and to contraction of the pathological muscles.ConclusionsThe ventral thalamus was characterised by common neuronal activity patterns which differed in characteristics between PD and CD.SignificanceOur findings highlight patterns of neuronal activity of the human ventral thalamus and specific pathological features.



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Progression of adverse effects over consecutive sessions of transcranial direct current stimulation

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Publication date: Available online 7 October 2017
Source:Clinical Neurophysiology
Author(s): Aaron Kortteenniemi, Amir-Homayoun Javadi, Jan Wikgren, Soili M. Lehto




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Super-selective cervical nerve root stimulation in contralateral C7 transfer: an intraoperative study

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Publication date: Available online 7 October 2017
Source:Clinical Neurophysiology
Author(s): Nora Franziska Dengler, Gregor Antoniadis, Christian Heinen, Brigitta Grolik, Christian Rainer Wirtz, Ralph König, Maria Teresa Pedro
ObjectiveWe designed this study using super-selective intraoperative cervical nerve root stimulation aiming to support decision making about complete or partial contralateral C7 (cC7) nerve root transfer in patients with multiple cervical root avulsion injury.MethodsSuper-selective intraoperative stimulations of anterior, lateral, medial and posterior aspect of C5 to C8 nerve roots were performed. Compound muscle action potentials (CMAP) were recorded in the lateral part of the deltoid (DM), long head of biceps brachii (BCM), brachioradial (BRM), long head of triceps brachii (TCM), and extensor digitorum communis (EDC) muscle. Muscle strength was documented immediately after cC7 transfer procedures and on scheduled follow-up visits according to the Medical Research Council (MRC) scale.ResultsIn the DM, stimulation of the posterior aspect of C5 resulted in the largest CMAP amplitudes (2.0 mV ±1.9; 80% ± 28.3). The BCM CMAPs induced by the different aspects of C6 all revealed homogenous stimulation results. Stimulation of the lateral aspect of C7 induced the largest amplitude of TCM CMAPs (1.3 mV ± 1.0; 67.1% ± 43.3). CMAP amplitudes of individual muscles and individual contributions of cervical nerve roots to the TCM varied between subjects. Overall donor side morbidity was low, no permanent motor deficit occurred.ConclusionA super-selective intraoperative cervical nerve root stimulation may help minimize donor side morbidity in transfer procedures. Individual differences of cervical nerve root innervation pattern need to be addressed in future electrophysiological studies.SignificanceOur study outlines individual differences of cervical nerve root innervation pattern.



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Added clinical value of the inferior temporal EEG electrode chain

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Publication date: Available online 7 October 2017
Source:Clinical Neurophysiology
Author(s): Anders Bach Justesen, Ann Berit Eskelund Johansen, Noomi Ida Martinussen, Danielle Wasserman, Daniella Terney, Pirgit Meritam, Elena Gardella, Sándor Beniczky
ObjectiveTo investigate the diagnostic added value of supplementing the 10-20 EEG array with six electrodes in the inferior temporal chain.MethodsEEGs were recorded with 25 electrodes: 19 positions of the 10-20 system, and six additional electrodes in the inferior temporal chain (F9/10, T9/10, P9/10). Five-hundred consecutive standard and sleep EEG recordings were reviewed using the 10-20 array and the extended array. We identified the recordings with EEG abnormalities that had peak negativities at the inferior temporal electrodes, and those that only were visible at the inferior temporal electrodes.ResultsFrom the 286 abnormal recordings, the peak negativity was at the inferior temporal electrodes in 81 cases (28.3%) and only visible at the inferior temporal electrodes in eight cases (2.8%). In the sub-group of patients with temporal abnormalities (n=134), these represented 59% (peak in the inferior chain) and 6% (only seen at the inferior chain).ConclusionsAdding six electrodes in the inferior temporal electrode chain to the 10-20 array improves the localization and identification of EEG abnormalities, especially those located in the temporal region.SignificanceOur results suggest that inferior temporal electrodes should be added to the EEG array, to increase the diagnostic yield of the recordings.



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iMAX: a new tool to assess peripheral motor axonal hypoexcitability

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Publication date: Available online 7 October 2017
Source:Clinical Neurophysiology
Author(s): Christophe Milants, Karim Benmouna, François Charles Wang




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Learned control over spinal nociception: Transfer and stability of training success in a long-term study

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Publication date: Available online 6 October 2017
Source:Clinical Neurophysiology
Author(s): Maximilian Bäumler, Moritz Feller, Stefanie Krafft, Manuela Schiffer, Jens Sommer, Andreas Straube, Fabian Weinges, Ruth Ruscheweyh
ObjectiveHealthy subjects can learn to use cognitive-emotional strategies to suppress their spinal nociception, quantified by the nociceptive flexor reflex (RIII reflex), when given visual RIII feedback. This likely reflects learned activation of descending pain inhibition. Here, we investigated if training success persists 4 and 8 months after the end of RIII feedback training, and if transfer (RIII suppression without feedback) is possible.Methods18 and 8 subjects who had successfully completed feedback training were investigated 4 and 8 months later.ResultsAt 4 months, RIII suppression during feedback and transfer was similar to that achieved at the final RIII feedback training session (to 50±22%, 53±21% and 52±21% of baseline, all differences n.s.). At 8 months, RIII suppression was somewhat (not significantly) smaller in the feedback run (to 64±17%) compared to the final training session (56±19%). Feedback and transfer runs were similar (to 64±17% vs. 68±24%, n.s.). Concomitant reductions in pain intensity ratings were stable at 4 and 8 months.ConclusionsRIII feedback training success was completely maintained after 4 months, and somewhat attenuated 8 months after training. Transfer was successful.SignificanceThese results are an important pre-requisite for application of RIII feedback training in the context of clinical pain.



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Analgesia Nociception Index Monitoring During Supratentorial Craniotomy.

Background: Objective monitoring of pain during and after surgery has been elusive. Recently, Analgesia Nociception Index (ANI) monitor based on the high frequency component of heart rate variability has been launched into clinical practice. We monitored analgesia during craniotomy using ANI monitor and compared it with cardiovascular parameters and response entropy (RE) of entropy monitor. Materials and Methods: In 21 patients undergoing a craniotomy for a supratentorial lesion, we monitored ANI, heart rate (HR), mean arterial pressure (MAP), state entropy, and RE throughout the surgery. Also, ANI, hemodynamic variables and spectral entropy values were noted at the times of maximal stimulation, such as induction, intubation, head pin fixation, skin incision, craniotomy, durotomy, and skin closure. We also compared ANI with RE during administration of bolus doses of fentanyl. Results: There was an inverse correlation between ANI values and the hemodynamic changes. When the HR and MAP increased, ANI decreased suggesting a good correlation between hemodynamics and ANI values during the times of maximal stimulation. State entropy and RE did not change significantly in response to bolus doses of fentanyl administered during the course of surgery, while ANI increased significantly. Conclusion: In neurosurgical patients undergoing elective supratentorial craniotomy, ANI measures response to noxious stimuli with at least as much reliability as hemodynamic variables and changes in ANI parallel the changes in HR and MAP. ANI is superior to RE for measurement of response to noxious stimuli. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved

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Hemodynamic Instability and Cardiovascular Events After Traumatic Brain Injury Predict Outcome After Artifact Removal With Deep Belief Network Analysis.

Background: Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the signals. A machine-learning model for the elimination of artifactual events shows promising results for improving signal quality. However, the actual impact of the improvements on the performance of the clinical parameters after the elimination of the artifacts is not well studied. Materials and Methods: The arterial blood pressure of 99 subjects with traumatic brain injury was continuously measured for 5 consecutive days, beginning on the day of admission. The machine-learning deep belief network was constructed to automatically identify and remove false incidences of hypotension, hypertension, bradycardia, tachycardia, and alterations in cerebral perfusion pressure (CPP). Results: The prevalences of hypotension and tachycardia were significantly reduced by 47.5% and 13.1%, respectively, after suppressing false incidents (P=0.01). Hypotension was particularly effective at predicting outcome favorability and mortality after artifact elimination (P=0.015 and 0.027, respectively). In addition, increased CPP was also statistically significant in predicting outcomes (P=0.02). Conclusions: The prevalence of false incidents due to signal artifacts can be significantly reduced using machine-learning. Some clinical events, such as hypotension and alterations in CPP, gain particularly high predictive capacity for patient outcomes after artifacts are eliminated from physiological signals. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved

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Red Cell Distribution Width After Subarachnoid Hemorrhage.

Background: High red cell distribution width (RDW) values have been associated with increased hospital mortality in critically ill patients, but few data are available for subarachnoid hemorrhage (SAH). Methods: We analyzed an institutional database of adult (>18 y) patients admitted to the Department of Intensive Care after nontraumatic SAH between January 2011 and May 2016. RDW (normal value, 10.9% to 13.4%) was obtained daily from admission for a maximum of 7 days, from routine blood analysis. We recorded the occurrence of delayed cerebral ischemia (DCI), and neurological outcome (assessed using the Glasgow Outcome Scale [GOS]) at 3 months. Results: A total of 270 patients were included (median age 54 y-121/270 male [45%]), of whom 96 (36%) developed DCI and 109 (40%) had an unfavorable neurological outcome (GOS, 1 to 3). The median RDW on admission was 13.8 [13.3 to 14.5]% and the highest value during the intensive care unit (ICU) stay 14.2 [13.6 to 14.8]%. The RDW was high (>13.4%) in 177 patients (66%) on admission and in 217 (80%) at any time during the ICU stay. Patients with a high RDW on admission were more likely to have an unfavorable neurological outcome. In multivariable regression analysis, older age, a high WFNS grade on admission, presence of DCI or intracranial hypertension, previous neurological disease, vasopressor therapy and a high RDW (OR, 1.1618 [95% CI, 1.213-2.158]; P=0.001) during the ICU stay were independent predictors of unfavorable neurological outcome. Conclusions: High RDW values were more likely to result in an unfavorable outcome after SAH. This information could help in the stratification of SAH patients already on ICU admission. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved

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