Δευτέρα, 26 Φεβρουαρίου 2018

Response to letter to the editor by Finn et al. (2018)

Abstract

In their letter to the editor regarding our recent paper, Finn and colleagues, propose that the heightened motoneurone responsiveness in chronic hypoxia (CH) compared to acute hypoxia (AH) may relate primarily to greater peripheral fatigue in AH than CH, rather than motoneuronal adaptations to hypoxia.

This article is protected by copyright. All rights reserved



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Airborne gamma-ray spectra processing: Extracting photopeaks

Publication date: July 2018
Source:Journal of Environmental Radioactivity, Volume 187
Author(s): Eugene Druker
The acquisition of information from the airborne gamma-ray spectra is based on the ability to evaluate photopeak areas in regular spectra from natural and other sources. In airborne gamma-ray spectrometry, extraction of photopeaks of radionuclides from regular one-second spectra is a complex problem. In the region of higher energies, difficulties are associated with low signal level, i.e. low count rates, whereas at lower energies difficulties are associated with high noises due to a high signal level. In this article, a new procedure is proposed for processing the measured spectra up to and including the extraction of evident photopeaks. The procedure consists of reducing the noise in the energy channels along the flight lines, transforming the spectra into the spectra of equal resolution, removing the background from each spectrum, sharpening the details, and transforming the spectra back to the original energy scale. The resulting spectra are better suited for examining and using the photopeaks. No assumptions are required regarding the number, locations, and magnitudes of photopeaks. The procedure does not generate negative photopeaks. The resolution of the spectrometer is used for the purpose. The proposed methodology, apparently, will contribute also to study environmental problems, soil characterization, and other near-surface geophysical methods.



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Anesthesia of thoracic surgery in children

Summary

Providing anesthesia in children with thoracic disease is a challenging task. The effects of the underlying disease, the surgical interventions, and preexisting condition of the patient need to be considered when planning perioperative care. The perioperative care for children undergoing thoracic surgery requires specific techniques adapted to the pediatric physiology and anatomy. This review is focused on anesthetic strategies for thoracic surgery with an emphasis on perioperative analgesia including neuraxial techniques.



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Intentional tracheoesophageal fistula cannulation for gastric decompression in type C esophageal atresia

Summary

We describe a nonsurgical technique for managing gastric distention in infants with type C esophageal atresia, involving intubating the trachea with an umbilical catheter and entering the stomach through the fistula as soon as a flexible bronchoscope found its wide-open orifice. This technique might have a special role when gastric distention precedes other commonly used preventive measures.



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Distances from vocal cords to mid-trachea for optimizing endotracheal tubes depth markers according to gestational age

Summary

Background

Adequate endotracheal tube positioning in preterm infants is complicated by the short length of the airway. Distal markers were designed to help with the insertion of endotracheal tubes at an appropriate depth below the vocal cords. However, those markers are not standardized between manufacturers, each tube size displays only one (sometimes 2) markers to provide information for infants of various gestational ages, and indicated distances are often too long for extremely preterm infants.

Aims

The study aims to describe vocal cords to mid-tracheal distance for different gestational ages and determine if depth markers should be adjusted accordingly.

Methods

Half the tracheal length added to the height of the posterior lamina of the cricoids approximates the distance between vocal cords and mid-trachea. Those dimensions were retrospectively retrieved from a database of laryngo-tracheal measurements obtained during autopsies of fetuses and newborn infants free of upper airway malformations. The equation of correlation between gestational age and distance from vocal cords to mid-trachea was used to calculate those distances for different gestational ages.

Results

Data were derived from 114 patients. Vocal cords to mid-trachea distance is linearly correlated with gestational age (r = .90; distance = 2.831 + 0.6208 × gestational age). We suggest depth markers at 17.7, 19.0, 20.8, 22.7, 24.6, and 26.4 mm for gestational ages of 24, 26, 29, 32, 35, and 38 weeks, respectively, indicated by contrasting colors.

Conclusion

The linear relationship between laryngo-tracheal size and gestational age offers the opportunity to revise endotracheal tube depth markers for the smallest patients. Trials comparing those suggested markers with those currently in use are needed before implementation.



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Deficiency of the BMP Type I receptor ALK3 partly protects mice from anemia of inflammation

Inflammatory stimuli induce the hepatic iron regulatory hormone hepcidin, which contributes to anaemia of inflammation (AI). Hepcidin expression is regulated by the bone morphogenetic protein (BMP) and the int...

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Bony ingrowth potential of 3D printed porous titanium alloy: a direct comparison of interbody cage materials in an in vivo ovine lumbar fusion model

There is significant variability in the materials commonly used for interbody cages in spine surgery. It is theorized that 3-D printed interbody cages utilizing porous titanium material can provide more consistent bone ingrowth and biological fixation.

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A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine

Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery.

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Clinical outcomes of percutaneous suction aspiration and drainage for the treatment of infective spondylodiscitis with paravertebral and/or epidural abscess

Patients with infective spondylodiscitis who failed conservative treatment are generally indicated for open surgery. However, some patients are poor candidates for standard surgery, hence the need to evaluate less invasive approaches. Good outcomes were previously reported for percutaneous suction aspiration and drainage (PSAD) in the treatment of infective spondylodiscitis resistant to conservative therapy. We recently extended the surgical approach of PSAD to allow drainage of paravertebral or epidural abscesses in patients with progressive infective spondylodiscitis.

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The in vivo response to a novel ti coating compared to PEEK: evaluation of the periphery and inner surfaces of an implant

Context: Increasing bone ongrowth and ingrowth of PEEK interbody fusion devices has the potential to improve clinical outcomes.

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Variation in costs among surgeons for lumbar spinal stenosis

Lumbar spinal stenosis is a common condition in the elderly for which costs vary substantially by region. Comparing differences between surgeons from a single institution, thereby omitting regional variation, could aid in identifying factors associated with higher costs and individual drivers of costs. The use of decision aids (DAs) has been suggested as one of the possible tools for diminishing costs and cost variation.

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Comparing spiking and slow wave activity from invasive electroencephalography in patients with and without seizures

Seizures have long been defined as paroxysmal events typified by abnormally excessive or synchronous brain activity (Fisher et al., 2005). Seizures can occur in healthy brain, or can be the result of disease. By definition, epilepsy requires an increased probability of seizures. Seizure threshold is a clinically useful concept expressing a time-varying probability of seizures. Despite clinical relevance, there remains no clear way of quantitatively assessing seizure probability. As a result, epilepsy patients often undergo long therapy titrations or never have their therapy appropriately optimized.

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Interictal regional paroxysmal fast activity on scalp EEG is common in patients with underlying gliosis

The morphology and the distribution of interictal epileptiform discharges (IEDs) on scalp EEG provide useful information about the syndromic diagnosis of epilepsy and its localization in cases of focal epilepsy (Niedermeyer, 1999). Traditionally, IEDs are considered to have a limited specificity with regard to the underlying etiology of epilepsy. However, certain EEG patterns in the form of continuous or semi-continuous rhythmic IEDs and interictal regional polyspikes on intraoperative electrocorticography and scalp EEG have been demonstrated more commonly in patients with focal cortical dysplasia (FCD) (Ferrier et al., 2006; Gambardella et al., 1996; Noachtar et al., 2008; Palmini et al., 1995; Rosenow et al., 1998).

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Intra-operative characterisation of subthalamic oscillations in Parkinson’s disease

There is growing interest in the nature of local field potential (LFP) activities recorded from the subthalamic nucleus (STN) of patients with Parkinson's disease (PD) undergoing neurosurgery for deep brain stimulation (DBS). This is fueled by the evidence that oscillatory activity in the beta frequency band is unduly synchronized and strong in these patients and that this relates to deficiency of dopamine in the basal ganglia (Hammond et al, 2007). Thus, the power of beta activity is correlated with the motor impairment in PD and the changes of power engendered by levodopa treatment or DBS correlate with improvements in bradykinesia and rigidity (Ray et al., 2008; Kühn et al., 2008 and 2009; Eusebio et al., 2011).

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Does Acute Radio-Frequency Electromagnetic Field Exposure Affect Visual Event-Related Potentials in Healthy Adults?

It is well established that waking electroencephalogram (EEG) power in the alpha (8-12 Hz) band (Croft et al., 2002; D'Costa et al., 2003; Curcio et al., 2005; Regel et al., 2007; Croft et al., 2010), and sleep EEG in the sleep spindle range (Borbely et al., 1999) are both affected by radio-frequency electromagnetic field (RF-EMF) exposure. These effects persist even after RF-EMF exposure cessation for sleep EEG (Huber et al., 2002; Loughran et al., 2005; Loughran et al., 2012), and also possibly for the waking EEG (Curcio et al., 2005).

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When Fear of Childbirth is Pathological: The Fear Continuum

Abstract

Objectives

Given that prepartum psychiatric symptoms have been reported to be associated with postpartum disorders, focusing on the prepartum period appears of prime importance. The aim of the current study was threefold: (a) to identify the prevalence rates of women suffering from fear of childbirth (FOC) and tokophobia (b) to explore the association between FOC, obstetrical and psychopathological variables and (c) to identify the independent predictors of the intensity of FOC symptoms, FOC and tokophobia.

Methods

at 36 weeks' gestation, 98 women completed questionnaires assessing FOC, pretraumatic stress, fear of pain, depressive and anxiety symptomatology as well as perceived social support. Socio-demographic and gynecological data were also gathered.

Results

22.45% of women reported a probable FOC and 20.41% suffered from a potential tokophobia. Epidural anesthesia (ß = 5.62, p < 0.05), and the intensity of pretraumatic stress symptoms (ß= 0.69, p < 0.05), were independently associated with the intensity of FOC symptoms. Planning a c-section was significantly related to FOC (β = 0.09, p = 0.03). Planning an epidural anesthesia was also an independent predictor of both FOC and tokophobia (β = 1.33, p = 0.03; β = 1.26, p = 0.04, respectively).

Conclusions

Given the high rates of FOC and tokophobia highlighted, developing an appropriate preparation to childbirth is of great relevance. Longitudinal studies should be developed in order to provide an in-depth examination of the course of prepartum psychiatric disorders, maintenance of symptoms and their impact on subsequent infant development.



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Foundational insights into the estimation of whole-body metabolic rate

Abstract

Since 2013, this journal has promoted the publication of thematic reviews (Taylor in Eur J Appl Physiol 113:1634, 2013), where leading groups were invited to review the critical literature within each of several sub-topics. The current theme is historically based, and is focussed on estimating the metabolic rate in humans. This review charts the development of our understanding of those methods, from the discovery of oxygen and carbon dioxide, to the introduction of highly sophisticated modern apparatus to examine the composition of expired gas and determine respiratory minute volume. An historical timeline links the six thematic vignettes on this theme. Modern advances have greatly enhanced data collection without significant decrements in measurement accuracy. At the same time, however, conceptual errors, particularly steady-state requirements, are too often ignored. Indeed, it is recognised that we often neglect the past, leading to errors in research design, experimental observations and data interpretation, and this appears to be increasingly prevalent within the open-access literature. Accordingly, the Editorial Board, in recognition of a widening gap between our experimental foundations and contemporary research, embarked on developing a number of thematic review series, of which this series is the first. The intent of each accompanying overview is to introduce and illuminate seminal investigations that led to significant scientific or intellectual breakthroughs, and to thereby whet the appetite of readers to delve more deeply into the historical literature; for it is only when the foundations are understood that we can best understand where we are now, and in which directions we should head.



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Design of a Shaping System for Stereolithography with High Solid Loading Ceramic Suspensions

3D Printing and Additive Manufacturing , Vol. 0, No. 0.


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Nicotine and exercise performance: another tool in the arsenal or curse for anti-doping?



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Cost-Effectiveness of a Behavioral Psychosocial Treatment Integrated Across Home and School for Pediatric ADHD-Inattentive Type

Abstract

We conducted a cost-effectiveness analysis (CEA) of two behavioral psychosocial interventions for children with ADHD-inattentive type: Child Life and Attention Skills (CLAS) program and parent-focused treatment (PFT) compared to community-based treatment as usual (TAU). The CEA evaluated cost per ADHD case resolved measured by parent and teacher reports of ADHD inattentive symptoms. Total cost per patient for CLAS, PFT, and TAU were $1559, $710, and $0. CLAS, the costliest treatment, was more effective than PFT and TAU. The incremental cost-effectiveness ratios (ICER) per disordered case resolved are: $3997 for CLAS versus TAU, $3227 for PFT versus TAU, and $4994 for CLAS versus PFT. PFT is the more cost-effective option based on initial CEA. However, CLAS may be comparably cost-effective by streamlining the model, which resulted in an ICER of $29 compared to PFT. Notably, cost for CLAS is substantially below the annual cost for unresolved ADHD.



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Gene expression: Developmental enhancers in action

Gene expression: Developmental enhancers in action

Gene expression: Developmental enhancers in action, Published online: 26 February 2018; doi:10.1038/nrg.2018.13

Gene expression: Developmental enhancers in action

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Integrative omics for health and disease

Integrative omics for health and disease

Integrative omics for health and disease, Published online: 26 February 2018; doi:10.1038/nrg.2018.4

This article discusses how integrating different omics data types — such as DNA sequencing, transcriptomics and metabolomics — can provide a rich view of healthy and disease states, including novel clinical diagnoses. The authors discuss the value of the different data types, as well as strategies, considerations and challenges for multi-omic integration in various disease contexts.

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Stretching the limits: from homeostasis to stem cell plasticity in wound healing and cancer

Stretching the limits: from homeostasis to stem cell plasticity in wound healing and cancer

Stretching the limits: from homeostasis to stem cell plasticity in wound healing and cancer, Published online: 26 February 2018; doi:10.1038/nrg.2018.9

Adult stem cells are essential for the maintenance of tissue homeostasis and wound repair, but cancer can hijack their tissue regenerative functions to promote malignancy. Ge and Fuchs review recent insights into the determinants and general principles underlying stem cell plasticity under homeostasis, stress and cancer.

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Neural Decoding of Robot-Assisted Gait during Rehabilitation after Stroke

AbstractObjectiveAdvancements in robot-assisted gait rehabilitation and brain-machine interfaces (BMI) may enhance stroke physiotherapy by engaging patients while providing information about robot-induced cortical adaptations. We investigate the feasibility of decoding walking from brain activity in stroke survivors during therapy using a powered exoskeleton integrated with an electroencephalography (EEG)-based BMI.DesignThe H2 powered exoskeleton was designed for overground gait training with actuated hip, knee and ankle joints. It was integrated with active-electrode EEG and evaluated in hemiparetic stroke survivors over 12 sessions/4 weeks. A continuous-time Kalman decoder operating on delta-band EEG was designed to estimate gait kinematics.ResultsFive chronic stroke patients completed the study with improvements in walking distance and speed training over 4 weeks, correlating with increased offline decoding accuracy. Accuracies of predicted joint angles improved with session and gait speed, suggesting an improved neural representation for gait, and the feasibility to design an EEG-based BMI to monitor brain activity or control a rehabilitative exoskeleton.ConclusionThe Kalman decoder showed increased accuracies as the longitudinal training intervention progressed in the stroke participants. These results demonstrate the feasibility of studying changes in patterns of neuroelectric cortical activity during post-stroke rehabilitation and represent the first step in developing a BMI for controlling powered exoskeletons. Objective Advancements in robot-assisted gait rehabilitation and brain-machine interfaces (BMI) may enhance stroke physiotherapy by engaging patients while providing information about robot-induced cortical adaptations. We investigate the feasibility of decoding walking from brain activity in stroke survivors during therapy using a powered exoskeleton integrated with an electroencephalography (EEG)-based BMI. Design The H2 powered exoskeleton was designed for overground gait training with actuated hip, knee and ankle joints. It was integrated with active-electrode EEG and evaluated in hemiparetic stroke survivors over 12 sessions/4 weeks. A continuous-time Kalman decoder operating on delta-band EEG was designed to estimate gait kinematics. Results Five chronic stroke patients completed the study with improvements in walking distance and speed training over 4 weeks, correlating with increased offline decoding accuracy. Accuracies of predicted joint angles improved with session and gait speed, suggesting an improved neural representation for gait, and the feasibility to design an EEG-based BMI to monitor brain activity or control a rehabilitative exoskeleton. Conclusion The Kalman decoder showed increased accuracies as the longitudinal training intervention progressed in the stroke participants. These results demonstrate the feasibility of studying changes in patterns of neuroelectric cortical activity during post-stroke rehabilitation and represent the first step in developing a BMI for controlling powered exoskeletons. Equal contributions, Magdo Bortole and Fangshi Zhu. Correspondence: Jose L Contreras- Vidal, Noninvasive Brain-Machine Interface Systems Laboratory, Department of Electrical and Computer Engineering, University of Houston, N308 Engineering Building I, 77204-4005 Houston, USA. School of Engineering, Tecnologico de Monterrey, Monterrey, Mexico. kcnathan@uh.edu Competing interests: The authors declare that they have no competing interests. Funding: This work has been partially supported by the Noninvasive Brain-Machine Interface Lab at the University of Houston, the Monterrey Institute of Technology, and the HYPER Project (Hybrid Neuroprosthetic and Neurorobotic Devices for Functional Compensation and Rehabilitation of Motor Disorders). Ministerio de Ciencia y Innovación, Spain (CSD2009 - 00067 CONSOLIDER INGENIO 2010). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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