Invasive Measurements Research Articles

Differential effects of two-hit models of acute and ventilator-induced lung injury on lung structure, function, and inflammation.

Acute respiratory distress syndrome (ARDS) and acute lung injury have a diverse spectrum of causative factors including sepsis, aspiration of gastric contents, and near drowning. Clinical management of severe lung injury typically includes mechanical ventilation to maintain gas exchange which can lead to ventilator-induced lung injury (VILI). The cause of respiratory failure is acknowledged to affect the degree of lung inflammation, changes in lung structure, and the mechanical function of the injured lung. However, these differential effects of injury and the role of etiology in the structure-function relationship are not fully understood. To address this knowledge gap we caused lung injury with intratracheal hydrochloric acid (HCL) or endotoxin (LPS) 2days prior to ventilation or with an injurious lavage (LAV) immediately prior to ventilation. These injury groups were then ventilated with high inspiratory pressures and positive end expiratory pressure (PEEP) = 0cmH2O to cause VILI and model the clinical course of ARDS followed by supportive ventilation. The effects of injury were quantified using invasive lung function measurements recorded during PEEP ladders where the end-expiratory pressure was increased from 0 to 15cm H2O and decreased back to 0cmH2O in steps of 3cmH2O. Design-based stereology was used to quantify the parenchymal structure of lungs air-inflated to 2, 5, and 10cmH2O. Pro-inflammatory gene expression was measured with real-time quantitative polymerase chain reaction and alveolocapillary leak was estimated by measuring bronchoalveolar lavage protein content. The LAV group had small, stiff lungs that were recruitable at higher pressures, but did not demonstrate substantial inflammation. The LPS group showed septal swelling and high pro-inflammatory gene expression that was exacerbated by VILI. Despite widespread alveolar collapse, elastance in LPS was only modestly elevated above healthy mice (CTL) and there was no evidence of recruitability. The HCL group showed increased elastance and some recruitability, although to a lesser degree than LAV. Pro-inflammatory gene expression was elevated, but less than LPS, and the airspace dimensions were reduced. Taken together, those data highlight how different modes of injury, in combination with a 2nd hit of VILI, yield markedly different effects.

What We Know About Intracranial Hypertension in Children With Syndromic Craniosynostosis.

A scoping review of literature about mechanisms leading to intracranial hypertension (ICH) in syndromic craniosynostosis (sCS) patients, followed by a narrative synopsis of whether cognitive and behavioral outcome in sCS is more related to genetic origins, rather than the result of ICH. The scoping review comprised of a search of keywords in EMBASE, MEDLINE, Web of science, Cochrane Central Register of Trials, and Google scholar databases. Abstracts were read and clinical articles were selected for full-text review and data were extracted using a structured template. A priori, the authors planned to analyze mechanistic questions about ICH in sCS by focusing on 2 key aspects, including (1) the criteria for determining ICH and (2) the role of component factors in the Monro-Kellie hypothesis/doctrine leading to ICH, that is, cerebral blood volume, cerebrospinal fluid (CSF), and the intracranial volume. Of 1893 search results, 90 full-text articles met criteria for further analysis. (1) Invasive intracranial pressure measurements are the gold standard for determining ICH. Of noninvasive alternatives to determine ICH, ophthalmologic ones like fundoscopy and retinal thickness scans are the most researched. (2) The narrative review shows how the findings relate to ICH using the Monro-Kellie doctrine. Development of ICH is influenced by different aspects of sCS: deflection of skull growth, obstructive sleep apnea, venous hypertension, obstruction of CSF flow, and possibly reduced CSF absorption. Problems in cognition and behavior are more likely because of genetic origin. Cortical thinning and problems in visual function are likely the result of ICH.

Interleukin-17A blockade with secukinumab results in decreased neutrophil infiltration in psoriasis: minimally-invasive measurement by tape stripping

Psoriasis is a well characterized interleukin (IL)-17A-driven skin disease with neutrophil infiltration and epidermal hyperkeratosis. Several biomarkers, most prominently β-defensin-2 (BD-2), have been identified using local andsystemic invasive measurements as responsive markers of IL-17A-driven skin pathology. We sought to determinewhether measurements of epidermal proteins by tape stripping could offer a minimally-invasive method to assess treatment responses. We compared the expression of 170 proteins in the epidermis (tape stripping) and dermis (open flowmicroperfusion) of 8 psoriatic subjects before and after administration of a single dose of subcutaneous (s.c.) antiIL-17A mAb secukinumab. Proteomic analyses of tape strips revealed a >3-fold decrease in 32 epidermal and inflammatory cell proteins in response to secukinumab. The epidermal proteins with the largest (>10-fold) decreases were: matrix metalloproteinase-8 (MMP-8, 15.68-fold, p<0.05); myeloperoxidase (MPO, 14.72-fold, p<0.005); IL-8 (11.93-fold, p<0.05); MMP-9 (10.81-fold, p<0.005); and IL-1β (10.35-fold, p<0.05). For these proteins, greater-fold protein changes were detected in the epidermis compared to dermis. Immunohistochemical analysis confirmed that neutrophils are the predominant cell type in psoriatic skin lesions that express MPO, MMP-8 and MMP-9, and that secukinumab treatment dramatically decreases neutrophil accumulation. Thus, tape stripping may be used to assess epidermal neutrophils, and protein biomarker responses to anti-IL-17A therapy in psoriasis.

Efficacy of radiological depth of invasion measurements on magnetic resonance images acquired at different magnetic field strengths and imaging sequences in predicting cervical lymph node metastasis and other outcomes in tongue cancer

We investigated the correlation between magnetic resonance imaging (MRI) parameters and tumor pathological depth of invasion (pDOI), between pDOI and radiological DOI (rDOI), between rDOI and duration between biopsy and MRI, and between rDOI and duration between MRI and surgery to determine the efficacy of rDOI in identifying small lesions and other conditions. We examined 36 adult patients who had been diagnosed histopathologically with cancer of the tongue and had undergone a glossectomy. Using 1.5 Tesla (T) and 3.0T MRI, we measured rDOI at the deepest infiltration point on 4 MRI sequences. We calculated the correlations between rDOI and the variables examined by Spearman rho analysis and evaluated the diagnostic performance of rDOI by receiver operating characteristic curve analysis. Axial T2-weighted images using 1.5T MRI provided the closest approximation of pDOI. Although the correlation between rDOI and pDOI was significant, rDOI showed poor or acceptable discrimination in identifying small lesions and other conditions. There were no significant correlations between rDOI and the time between biopsy and MRI or between MRI and surgery. The correlation between rDOI and pDOI is significant, but rDOI is ineffective in predicting malignancy and other conditions. Axial T2-weighted images using 1.5T MRI provide the closest approximation of pDOI.

Antiallergic Abdominal Belt for Human Glucose Level Measurement Using Microwave Active Sensor Antenna

In this paper, microwave active antenna sensor based MDBM meter is developed for continuous glucose measurement (CGM) in human body. MDBM meter consists of Antiallergic Abdominal belt with radar IC (RCWL0516) mixer IC (BFR520) and HSIS antenna sensor. Microwave active antenna sensor is H-shaped patch with I-shaped slot (HSIS), which is placed on human pancreas and acquires reflected microwave signals from dielectric materials in pancreas. Pancreas dielectric materials radiation property changes during insulin secretion. Existing CGM meter measure diabetic value using invasive sensor. Invasive sensor is prick type sensor and leads to infections. In human body, pricked sensor stays on body for 14 days. Non-invasive sensor based diabetic measurement meter never measures CGM, due to various problem such as sensor mounting on human body and skin crumbling effect. For above problems, MDBM meter is proposed. In MDBM meter, antenna receives reflected signals from dielectric minerals in pancreas through HSIS active sensor antenna process with microcontroller and predicts diabetic value based on machine learning. Return loss of HSIS antenna sensor is highly correlated with laboratory based diabetic measurement. MDBM meter based CGM is performed in 150 diabetic person with 410 samples data. From MDBM meter, fasting blood glucose test, accuracy is about 92.66%, glucose tolerance test, is about 91.33% accuracy, and random blood glucose test accuracy is about 91.88% were obtained. Proposed MDBM meter with HSIS antenna sensor measures fluctuating diabetic value with 91.85% accuracy, when compared to home based invasive glucometer measurement.

Bioethics and Informed Consent in Prenatal Diagnostics

Innovative methods of prenatal diagnosis allow us to see the development of the fetus and to detect early disorders of fetal development, which may lead to an early diagnosis and possible treatment, or to a woman’s decision to terminate the pregnancy. Therefore, it is very important to accurately inform a woman about the risks and consequences of this life-related issue, even before deciding to perform prenatal tests; and after the results, when a misinterpreted diagnosis may lead a woman to terminate her pregnancy. The obligation of doctors to inform patients is inseparable from the requirement to receive informed consent. The two parts are mandatory for any medical procedure and intervention. The main requirements for the informed consent include rationality, sufficient and clear information, free will, and the form of consent conforming to the legal acts. However, informed consent is not an absolute requirement, as the patient has a right to remain uninformed. Additionally, under certain circumstances, it might be impossible to inform patients, or to receive consent from patients or their duly authorized representatives. Prenatal testing is an integral part of ante-natal care that aims to verify the proper development of the fetus, or to identify potential hereditary or chromosomal diseases at the earliest possible stage. Prenatal testing can be classified as non-invasive or invasive measures, according to the types of procedures In addition to this, according to the aim of the procedure, into diagnostic prenatal testing with the aim of prenatal therapy, and purely diagnostic prenatal testing. Purely diagnostic prenatal testing is closely connected with the problem of selective abortion.
 Part of this article covers the main problems of informed consent in prenatal diagnostics, by outlining two stages of the process: conveyance before prenatal testing, and interpretation of the results alongside presentation of the possible choices. The legal implications we consider are based on information from other European countries: we name the main questions analyzed by courts, including cases of “wrongful birth” and “wrongful life”; inappropriate information regarding possibilities of abortion; the right of a woman to use all available diagnostic methods; and the allocation of damages to the claimants.

Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance.

Background Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circulation, supporting evidence is limited. We examined changes in venous capacitance surrogates pre- and post-SNM. Methods and Results This is a prespecified analysis of a prospective, open-label, single-arm interventional study evaluating the effects of percutaneous SNM with ropivacaine in chronic heart failure with elevated filling pressures at rest and with exercise. Patients underwent cardiopulmonary exercise testing with invasive hemodynamic assessment pre- and post-SNM. Blood pressure changes with modified Valsalva maneuver and hemoconcentration, pre- and post-SNM were compared using a repeated measures model. Inferior vena cava diameter and collapsibility (>50% decrease in size with inspiration), and presence of bendopnea pre- and post-SNM were also compared. Fifteen patients undergoing SNM (age 58 years, 47% women, 93% with left ventricular ejection fraction ≤35%) were included. After SNM, changes in systolic blood pressure during Valsalva (peak-to-trough) were greater (41 versus 48 mm Hg, P=0.025). Exercise-induced hemoconcentration was unchanged (0.63 versus 0.43 g/dL, P=0.115). Inferior vena cava diameter was reduced (1.59 versus 1.30 cm, P=0.034) with higher collapsibility (33% versus 73%, P=0.014). Bendopnea was less (47% versus 13%, P=0.025). Conclusions SNM resulted in increased venous capacitance, associated decreased cardiac preload, and decreased bendopnea. Minimally invasive measures of venous capacitance could serve as markers of successful SNM. Long-term effects of SNM on venous capacitance warrant further investigation for heart failure management. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03453151.

Evaluation of agreement between invasive and non-invasive blood pressure measurement using the PetMAP™ device in rabbits.

Measurement of arterial blood pressure is recommended in anaesthetized animals to guide perioperative treatment. Invasive blood pressure measurement is considered the gold standard, however it is also technically challenging, requires specialised equipment and carries certain risks. For these reasons, non-invasive blood pressure measurement devices are commonly used and are expected to provide accurate and reliable results. This requirement is particularly true for rabbits, in whom peri-anaesthetic hypotension is commonly observed and in whom perioperative mortality remains disproportionally high. Several authors have compared different non-invasive devices with invasive measurements in rabbits and have reported contrasting results. However, to date no comparison between invasive measurements and the PetMAP™ device, that has been designed specifically for veterinary medicine, has been reported. The aim of the study was the comparison of invasive blood pressure measurement with PetMAP™ in rabbits. We hypothesised that PetMAP™ would show acceptable agreement with the invasive measurements according to the American College of Veterinary Internal Medicine guidelines. Sixteen client-owned rabbits presenting for various surgical interventions were included in the study. Invasive measurements were performed by cannulation of an auricular artery. The PetMAP™ cuff was applied distal to the elbow according to the manufacturer's guidelines. For each measurement with PetMAP™, three invasive blood pressure values were recorded. The mean of the three invasive values was compared with one value measured with PetMAP™. Data collected from 16 rabbits were used for statistical analysis. In the clinical setting, the PetMAP™ device showed significant overestimation of systolic, diastolic and mean arterial pressure, which were measured in the auricular artery. In addition, the bias was not constant, implying that the device poorly predicted changes in blood pressure. The PetMAP™ device did not meet any of the American College of Veterinary Internal Medicine recommendations.

Finite-time quantum measurement cooling beyond the Carnot limit

We proposed the finite-time cycle model of a measurement-based quantum cooler, where the invasive measurement provides the power to drive the cooling cycle. Such a cooler may be regarded as an alternative thought experiment of Maxwell’s demon. The measurement-feedback information is capable of moving heat from the cold to hot bath without any work input and even making the maximum coefficient of performance larger than the Carnot limit. The causes that this seemingly paradoxical result does not violate the laws of thermodynamics can be clearly explained through the derivation of a generalized Clausius inequality including the mutual information.

Sex differences in prevalence and outcomes of the different endotypes of chronic coronary syndrome in symptomatic patients undergoing invasive coronary angiography: Insights from the global ILIAS invasive coronary physiology registry

Background and aimsThe management of chronic coronary syndrome (CCS) is informed by studies predominantly including men. This study investigated the relationship between patients sex and different endotypes of CCS, including sex-specific clinical outcomes. MethodsIn patients with CCS undergoing coronary angiography, invasive Fractional Flow Reserve (FFR) and Coronary Flow Reserve (CFR) were measured. Patients were stratified into groups: 1) obstructive coronary artery disease (oCAD) (FFR≤0.80, no revascularization), 2) undergoing revascularization, 3) non-obstructive coronary artery disease with coronary microvascular dysfunction (CMD) (FFR>0.80, CFR≤2.5), and 4) non-obstructive coronary artery disease without CMD (FFR>0.80 and CFR>2.5). Results1836 patients (2335 vessels) were included, comprising 1359 (74.0%) men and 477 (26.0%) women. oCAD was present in 14.1% and was significantly less prevalent in women than in men (10.3% vs 15.5%, respectively p < 0.01). Revascularization was present in 30.9% and was similarly prevalent in women and men (28.2% vs. 31.9%, respectively p = 0.13). CMD was present in 24.2% and was significantly more prevalent in women than men (28.6% vs 22.6%, respectively p < 0.01). Normal invasive measurements were found in 564 patients (33.0% women vs 30.0% men, p = 0.23). Male sex was associated with an increased risk of target vessel failure compared to women (HR.1.89, 95% CI 1.12–3.18, p = 0.018), regardless of CCS-endotype. ConclusionsSex differences exist in the prevalence and outcomes of different endotypes of CCS in symptomatic patients undergoing invasive coronary angiography. In particular, oCAD (and subsequent revascularization) were more prevalent in men. Conversely, CMD was more prevalent in women. Overall, men experienced a worse cardiovascular outcome compared to women, independent of any specific CCS endotype.

Echocardiographic pressure-strain loop-derived stroke work of the right ventricle: validation against the gold standard.

Commercially available integrated software for echocardiographic measurement of stroke work (SW) is increasingly used for the right ventricle, despite a lack of validation. We sought to assess the validity of this method [echo-based myocardial work (MW) module] vs. gold-standard invasive right ventricular (RV) pressure-volume (PV) loops. From the prospectively recruiting EXERTION study (NCT04663217), we included 42 patients [34 patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) and 8 patients with absence of cardiopulmonary disease] with RV echocardiography and invasive PV catheterization. Echocardiographic SW was assessed as RV global work index (RVGWI) generated via the integrated pressure-strain MW software. Invasive SW was calculated as the area bounded by the PV loop. An additional parameter derived from the MW module, RV global wasted work (RVGWW), was correlated with PV loop measures. RVGWI significantly correlated with invasive PV loop-derived RV SW in the overall cohort [rho=0.546 (P<0.001)] and the PAH/CTEPH subgroup [rho=0.568 (P<0.001)]. Overall, RVGWW correlated with invasive measures of arterial elastance (Ea), the ratio of end-systolic elastance (Ees)/Ea, and end-diastolic elastance (Eed) significantly. Integrated echo measurement of pressure-strain loop-derived SW correlates with PV loop-based assessment of RV SW. Wasted work correlates with invasive measures of load-independent RV function. Given the methodological and anatomical challenges of RV work assessment, evolution of this approach by incorporating more elaborated echo analysis data and an RV reference curve might improve its reliability to mirror invasively assessed RV SW.

Perturbation indicator for Hall effect thruster operating state based on statistical characteristics of breathing oscillation time scale signals

The failure of Hall effect thruster (HET) is usually the result of the accumulation of several tiny abnormal disturbances during operation. Timely and accurate early warning of perturbations is an important guarantee for the normal operation of thrusters. In this study, when the perturbation rate of HET signal (anode voltage or anode flow rate) is −4% to 4%, the time scale signal of breathing oscillation (BO) in the frequency range of 10 kHz to 100 kHz is statistically analyzed. Experiments show that when the signal is perturbed, the balance between ionization and acceleration of plasma in the discharge channel is destroyed, resulting in the dwell time of the wave peaks and valleys of BO in the far-zero region with the perturbation law, which visually shows that the number of scattered points at the corresponding current value changes regularly. According to the above statistical characteristics, this paper proposes a new condition monitoring index, namely the number of scattered points in the wave peaks side of the far-zero point area, and designs a perturbation indicator for the operating condition of the HET. Compared with direct monitoring of discharge current in engineering, this indicator can amplify the influence of the perturbation signal on BO, and has better identification and accuracy. Meanwhile, the indicator does not use invasive measurement and complex equipment, and is promising to be applied to the monitoring and diagnosis of the perturbation operation state of the on-orbit thruster.

Colorectal cancer screening: The role of MT-sDNA testing.

Because an estimated 10.5% of new colorectal cancer (CRC) cases occur in patients under age 50 years, the US Preventive Services Task Force in 2021 recommended CRC screening for adults ages 45 to 49 years. The prevalence of up-to-date CRC screening with any recommended test among patients age 45 years and older in the United States is only 59% in 2023, indicating that existing screening practices are ineffective. Screening options now include invasive and noninvasive measures. Multi-target stool DNA (MT-sDNA) testing is a simple, low-risk, noninvasive test that provides excellent sensitivity and specificity, is cost-effective, and may increase patient screening rates. CRC screening guideline recommendations and alternative screening methods may help improve patient outcomes and reduce morbidity and mortality. This article describes MT-sDNA testing, its effectiveness, recommended use, and potential expanding role as a screening option.

KUBAI: Sensor Fusion for Non-Invasive Fetal Heart Rate Tracking.

Fetal heart rate (FHR) is critical for perinatal fetal monitoring. However, motions, contractions and other dynamics may substantially degrade the quality of acquired signals, hindering robust tracking of FHR. We aim to demonstrate how use of multiple sensors can help overcome these challenges. We develop KUBAI1, a novel stochastic sensor fusion algorithm, to improve FHR monitoring accuracy. To demonstrate the efficacy of our approach, we evaluate it on data collected from gold standard large pregnant animal models, using a novel non-invasive fetal pulse oximeter. The accuracy of the proposed method is evaluated against invasive ground-truth measurements. We obtained below 6 beats-per-minute (BPM) root-mean-square error (RMSE) with KUBAI, on five different datasets. KUBAI's performance is also compared against a single-sensor version of the algorithm to demonstrate the robustness due to sensor fusion. KUBAI's multi-sensor estimates are found to give overall 23.5% to 84% lower RMSE than single-sensor FHR estimates. The mean ± SD of improvement in RMSE is 11.95 ±9.62 BPM across five experiments. Furthermore, KUBAI is shown to have 84% lower RMSE and ∼3 times higher R2 correlation with reference compared to another multi-sensor FHR tracking method found in literature. The results support the effectiveness of KUBAI, the proposed sensor fusion algorithm, to non-invasively and accurately estimate fetal heart rate with varying levels of noise in the measurements. The presented method can benefit other multi-sensor measurement setups, which may be challenged by low measurement frequency, low signal-to-noise ratio, or intermittent loss of measured signal.

A prospective comparison of invasive and non-invasive blood pressure in children undergoing cardiac catheterization.

Blood pressure measurement is a standard of monitoring during general anesthesia. Invasive measurement is considered the gold standard but is less commonly used than non-invasive. Automated oscillometric blood pressure devices measure the mean arterial pressure (MAP) and use an algorithm to determine the systolic and diastolic pressures. Few devices have been validated in children, particularly during anesthesia. Few studies have assessed the agreement between invasive and non-invasive blood pressure measurements in children. This was a multi-center prospective observational study of children under 16 years undergoing cardiac catheterization with general anesthesia. Paired invasive and non-invasive blood pressure measurements were recorded for each patient during stable periods of the procedure. Correlation within and between sites was assessed with Pearson's correlation coefficient, and agreement was examined using Bland-Altman methodology to determine bias. Agreement during episodes of hypotension and for age and weight was also determined. Bias greater than 5 mmHg and standard deviation greater than 8 mmHg was considered clinically significant. The primary end point was agreement of MAP measurements. A total of 683 paired blood pressure values were collected from 254 children in three pediatric hospitals. Median [IQR] age and weight were 3 [1-7] years and 13.9 [8-23] Kg. The overall bias (SD) for mean arterial pressure values was 7.2 (11.4) mmHg. During hypotension (190 readings), the bias (SD) was 15 (11.0) mmHg. The non-invasive MAP was frequently higher than invasive MAP during infancy, and lower in older children. Automated oscillometric blood pressure measurement is unreliable in anesthetized children during cardiac catheterization. Invasive pressure measurement should be considered for high-risk cases.

Validity and Reliability of Non-invasive Methods for Evaluating Kyphosis and Lordosis Curvatures: A Literature Review

Introduction: A few instruments are accessible for clinical estimation of the thoracic and lumbar curvatures. This methodical survey aims to identify the validity and reliability of non- invasive thoracic kyphosis and lumbar lordosis measurements.&#x0D; Materials and Methods: This research is a literature review. The process was performed on articles in credible databases, such as Medline, Embase, AMED, CINAHL, PubMed, and Biomedical Reference Collection, Expanded, Sport Discus, Science Direct, Web of Science, searching for the terms thoracic kyphosis, lordosis, spinal curvature, lordosis and reliability, lordosis and validity, kyphosis and reliability, kyphosis and validity, test, measure, flexi curve, radiograph, spinal mouse, inclinometer, kyphometer, image processing, Cobb, during 1960 to 2020.&#x0D; Results: The result of the systematic search revealed that ten methods among all related papers have inclusion criteria, 3D ultrasound, Arco meter, DE Brunner’s kyphometer, digital inclinometer, electro goniometer, goniometer, flexi curve angle, image processing, pantograph, and spinal mouse.&#x0D; Conclusion: The validity and reliability of non-invasive methods for estimating kyphosis and lordosis curvatures were indicated in 26 papers. Based on the current little evidence, non- invasive procedures have high to very high reliability and moderate to high validity.

ANALISIS SISTEM KERJA DAN PENGARUH NON INVASIVE BLOOD PRESSURE PADA PATIENT MONITOR

Patient Monitor is a device that monitors physiological conditions in the form of NIBP (Non-Ivasive Blood Pressure) blood pressure, temperature, respiration, SPO2 and the shape of the heart pulse continuously. The purpose of this study was to find out how the system works and the use of Non Iinvasive Blood Pressure is good in order to get maximum results. This research is a descriptive and qualitative method, namely by analyzing the Work System and the Effect of Noun Invasive Blood Pressure measurement on the Patient Monitor. The results obtained are the NIBP working system on the patient monitor device consisting of power supply, motor, air valve, microprocessor, display. The blood pressure measurement system uses a cuff with air pressure generated by a motor. The conclusion of this study is that the NIBP works using a pneumatic system, namely using air pressure, where the cuff is inflated until the pressure reaches a maximum above systolic pressure, where the arteries are effectively blocked. Then the cuff pressure is reduced to a constant level, the pressure traducer provides an analog signal to the digital hardware during the process of obtaining the systolic, diastolic and mean pressures.

Bilateral bone marrow edema syndrome of the humeral head mimicking avascular necrosis: a case report

BackgroundBone marrow edema syndrome (BMES), previously referred to as transient osteoporosis, is an uncommon and underdiagnosed self-limiting condition typically affecting the weight-bearing joints of the hip and lower limb. Its occurrence in upper limb or non-weight bearing joints is particularly rare.Case presentationWe report the case of an otherwise healthy 42-year-old man who gradually developed severe and disabling left shoulder pain over the course of 6 months. Nine months after onset, he presented clinically with bilateral involvement and radiologically (magnetic resonance imaging, MRI) with diffuse BME associated with a subchondral insufficiency fracture, suggestive of proximal humeral avascular necrosis. Clinical evidence of subacromial shoulder impingement and MRI findings of bilateral subchondral bursitis and tenosynovitis with effusion of the biceps tendons likely resulted from primary BME, as musculoskeletal sonography confirmed the absence of rotator cuff tears. Repeated MRI findings at 2, 12, and 18 months documented near complete resolution of both edema and fracture, consistent with BMES of the proximal humerus. During this time, the patient reported a gradual improvement in both pain symptoms and range of motion. The clinical picture of insidious shoulder pain, exacerbated by activity and improved by load relief, in the absence of predisposing factors for osteonecrosis or antecedent trauma in patients of middle age, should indicate the possibility of the diagnosis of BMES.ConclusionsThis unprecedented report documents a rare case of bilateral BMES of the humeral head mimicking avascular necrosis. The correct diagnosis of BMES within an atypical anatomical location avoids invasive measures in the affected bone. The misdiagnosis of secondary BME and idiopathic osteonecrosis can be avoided by recognizing the characteristics of BME and subchondral fractures of the humeral head in the absence of rotator cuff tears, as well as their evolution on serial MRI.

Towards Voice Reconstruction from EEG during Imagined Speech

Translating imagined speech from human brain activity into voice is a challenging and absorbing research issue that can provide new means of human communication via brain signals. Efforts to reconstruct speech from brain activity have shown their potential using invasive measures of spoken speech data, but have faced challenges in reconstructing imagined speech. In this paper, we propose NeuroTalk, which converts non-invasive brain signals of imagined speech into the user's own voice. Our model was trained with spoken speech EEG which was generalized to adapt to the domain of imagined speech, thus allowing natural correspondence between the imagined speech and the voice as a ground truth. In our framework, an automatic speech recognition decoder contributed to decomposing the phonemes of the generated speech, demonstrating the potential of voice reconstruction from unseen words. Our results imply the potential of speech synthesis from human EEG signals, not only from spoken speech but also from the brain signals of imagined speech.

Real-Time Quantitative Measurement of Tumor Cell Migration and Invasion Following Synthetic mRNA Transfection

Tumor cells are highly motile and invasive and display altered gene expression patterns. Knowledge of how changes in gene expression regulate tumor cell migration and invasion is essential for understanding the mechanisms of tumor cell infiltration into neighboring healthy tissues and metastasis. Previously, it was demonstrated that gene knockdown followed by the impedance-based real-time measurement of tumor cell migration and invasion enables the identification of the genes required for tumor cell migration and invasion. Recently, the mRNA vaccines against SARS-CoV-2 have increased interest in using synthetic mRNA for therapeutic purposes. Here, the method using synthetic mRNA was revised to study the effect of gene overexpression on tumor cell migration and invasion. This study demonstrates that elevated gene expression with synthetic mRNA transfection followed by impedance-based real-time measurement may help identify the genes that stimulate tumor cell migration and invasion. This method paper provides important details on the procedures for examining the effect of altered gene expression on tumor cell migration and invasion.