Blood Oxygen Research Articles

Associations of Intermittent Hypoxia Burden with Gut Microbiota Dysbiosis in Adult Patients with Obstructive Sleep Apnea.

Clinical studies focusing on the association between the gut microbiota and obstructive sleep apnea (OSA) are limited. This study aimed to explore the relationship between intermittent hypoxia and the composition of gut microbiota in adults by analyzing the differences in the characteristics and functional distribution of gut microbiota between patients with different severities of OSA and healthy individuals. A cohort of 113 individuals from the First Affiliated Hospital of Sun Yat-sen University underwent overnight polysomnography from July 2019 to August 2021. The individuals included 16 healthy controls and 97 patients with OSA, categorized by the apnea-hypopnea index into mild, moderate, and severe groups. Fecal samples were analyzed using high-throughput sequencing of the 16S rRNA V3-V4 region to assess gut microbiota composition and function. Correlation analysis was used to evaluate the association between clinical indicators and microbiota markers. In patients with OSA, the gut microbiota diversity and the abundance of specific microbes that produce short-chain fatty acids decreased (P<0.05). The phyla Verrucomicrobia and Candidatus Saccharibacteria, genera Gemmiger and Faecalibacterium, and the species Gemmiger formicilis exhibited decreasing abundance with increasing OSA severity. Correlation analysis revealed a robust association between the proportion of total sleep time, characterized by nighttime blood oxygen saturation below 90%, and the alterations in the gut microbiota, demonstrating that elevated levels of desaturation are correlated with pronounced microbiota dysbiosis (P<0.05). Compared to the control group, the intermittent hypoxia exhibited by patients with OSA may be related to alterations in the composition and structure of the gut microbiota. Our results demonstrate the importance of monitoring hypoxia indicators in future clinical practice.

Exploring the Utility of a Functional Magnetic Resonance Imaging Cannabis Cue-Reactivity Paradigm in Treatment-Seeking Adults With Cannabis Use Disorder

BackgroundFunctional magnetic resonance imaging studies examining cue reactivity in cannabis use disorder (CUD) either have had small sample sizes or have involved non–treatment-seeking participants. As a secondary analysis, we administered a functional magnetic resonance imaging cue-reactivity task to participants with CUD enrolled in 2 separate clinical trials (varenicline or repetitive transcranial magnetic stimulation) to determine the task activation patterns for treatment-seeking participants with CUD. We aimed to determine the activation patterns for the total sample and behavioral correlates. We additionally compared studies to determine if patterns were consistent. MethodsTreatment-seeking participants with moderate or severe CUD had behavioral craving measured at baseline using the Marijuana Craving Questionnaire–Short Form and completed a visual cannabis cue-reactivity task during functional magnetic resonance imaging (measuring the blood oxygen level–dependent response) following 24 hours of cannabis abstinence. ResultsThe sample included 65 participants (n = 37: varenicline trial; n = 28: repetitive transcranial magnetic stimulation trial; 32% female; mean age = 30.4 ± 9.9 years). When comparing cannabis images versus matched neutral images, participants showed greater blood oxygen level–dependent response in bilateral ventromedial-prefrontal, dorsolateral-prefrontal, anterior cingulate, and visual cortices as well as the striatum. There was stronger task-based functional connectivity between the medial prefrontal cortex and both the amygdala and the visual cortex. Craving negatively correlated with blood oxygen level–dependent response in the left ventral striatum (R2 = −0.32; p = .01) in the full sample. There were no significant differences in either activation or task-based functional connectivity between studies. ConclusionsIn 2 separate treatment-seeking groups with CUD, there was increased cannabis cue reactivity and task-based functional connectivity in regions related to executive function and reward processing. Cannabis craving was negatively associated with cue reactivity in the left ventral striatum.

Smart Wearable Device for Enhancing Safety and Efficiency of Coal Miners

The task of ensuring worker safety in underground coal mines has never been simple. It has always been challenging to ensure worker safety in underground coal mines. Coal miners are seriously injured or killed as a result of numerous fatal and non-fatal accidents all over the world. Accidents occur as a result of lack of monitoring of mining areas and failure to implement proper safety measures. In this review, the coal miner's smart wearable safety device is implemented. A smart wearable safety device that will monitor the miner's health and provides precautionary measures for the miner's safety has been developed with the advent of the Industrial Internet of Things (IIoT). Integrating smart wearable safety devices with various health sensors such as a pulse rate sensor, temperature sensor, blood oxygen sensor, gas sensor, and camera, and then connecting it to Node MCU, and the internet enhances the safety of coal miners. Sensors constantly transmit sensor data to the cloud, and if an unusual situation arises, it notifies the responsible person in the control room as well as the miners. Since deep underground mining is especially susceptible to toxic gases, low levels of oxygen, and hazardous gases, the MQ gas sensor family can detect them. The proposed system is primarily used to improve working conditions inside coal mines and to ensure workers' safety.

Study on the Effects of Acupuncture with the "Yizhi Tiaoshen" Acupoint Formula on Blood Oxygen Metabolism and Neural Function in Key Brain Regions of AD Rats.

Exploring the effects of acupuncture at the "Yizhi Tiaoshen" acupoint on blood oxygen metabolism and neurological function changes in the brain regions of AD model rats. The AD model was replicated by intraperitoneal injection of D-galactose combined with bilateral hippocampal CA1 injection of Okadaic acid (OA). Thirty rats with successfully replicated model were selected through Morris water maze experiment and randomly divided into model group, donepezil hydrochloride group, and acupuncture group, with 10 rats in each group. After treatment, fNIRs were used to detect changes in Oxy Hb, Deoxy Hb, and Total Hb in the cerebral cortex of rats in each group, in order to evaluate the neurological function changes in key brain areas. The escape latency of the donepezil hydrochloride group and the acupuncture group was shortened, the number of crossings through the original platform increased, and the duration of stay in the quadrant where the original platform was located was prolonged. Based on fNIRs detection, the main differential channels of blood oxygen metabolism in AD rats were identified as 2-2 and 8-7, corresponding to the prefrontal and parietal lobes, respectively. The concentrations of Oxy Hb and Total Hb were significantly increased in both treatment groups, while the concentration of Deoxy Hb was significantly decreased. Acupuncture with the "Yizhi Tiaoshen" acupoint formula and donepezil hydrochloride can improve the learning and memory function of AD rats, and its mechanism may be related to improving blood oxygen metabolism in the prefrontal and parietal regions and protecting neuronal function.

Elevation and distraction of the Tibial periosteum in the management of chronic ischemic lower limb diseases.

This study investigates the effectiveness of tibia periosteum distraction (TPD) applied to the tibial periosteum, an innovative approach grounded in Ilizarov's tension-stress theory, for the treatment of ischemic diabetic foot and vasculitic foot conditions. A retrospective analysis was conducted on 33 patients (36 limbs) who underwent TPD between June 2019 and May 2022. The study comprised 21 males (23 limbs) and 12 females (13 limbs), aged 41 to 80 years (mean age: 63.4 years). Diabetic foot accounted for 27 cases, thromboangiitis obliterans for 2 cases, and arterial occlusive disease for 4 cases. The distribution of affected limbs included 15 left feet and 21 right feet. Periosteum traction commenced on the third postoperative day at a rate of approximately 0.75mm/day, adjusted biweekly. The traction device was removed after two weeks. Evaluation included capillary refill and wound healing assessment, along with pre- and postoperative analysis of foot skin temperature, ankle-brachial index (ABI), visual analogue scale (VAS) pain scores, and peripheral blood oxygen saturation. CT angiography (CTA) was utilized to assess vascular conditions in both lower limbs. All 33 patients were successfully followed up for a duration ranging from 4 to 24 weeks (mean: 11.03 weeks). VAS pain scores significantly decreased from preoperative (5.09 ± 1.70, range: 2-8) to postoperative two weeks (2.24 ± 0.90, range: 1-4) (t = 9.44, p < .001). Oxygen saturation levels increased from 83.88% ± 11.82% (range: 58%-97%) preoperatively to 91.36% ± 5.69% (range: 76%-98%) at two weeks postoperatively (t = -4.21, p < .001). Foot skin temperature also showed a significant increase (t = -3.98, p < .001). Capillary refill test at two weeks postoperatively demonstrated notable improvement. CTA revealed evident neovascularization in the operated limbs compared to preoperative conditions. Wound improvement was significant in all 33 patients within two months postoperatively. TPD emerges as a promising technique for chronic ischemic lower limb diseases, demonstrating favorable preliminary outcomes in wound healing promotion and amputation rate reduction. Nevertheless, large-scale randomized controlled trials are essential to further validate its efficacy.

Dynamic Peripheral Hemoperfusion Distribution Monitoring Based on Janus Flexible Sensor System.

Peripheral vascular disease is a worldwide leading health concern. Real-time peripheral hemoperfusion monitoring during treatment is essential to plan treatment strategies to improve circulatory enhancement effects. The present work establishes a Janus flexible perfusion (JFP) sensor system for dynamic peripheral hemoperfusion monitoring. We develop a Janus structure with different Young's modulus to improve the mechanical properties for motion artifacts suppression. Besides, we propose a peripheral perfusion index (PPI) based on an optical perfusion model that is experimentally verified using an in-vitro model. The effectiveness of the system is assessed in three experimental scenarios, including motion artifact-robust test, induced vascular occlusion, and peripheral hemoperfusion monitoring with the intermittent pneumatic compression treatment. The noise level of the traditional rigid sensor is five times that of the JFP sensor within the effective signal frequency domain when there is movement. The PPI can effectively discriminate between different peripheral hemoperfusion states and has a correlation coefficient of 0.92 with the Laser Doppler flowmetry (LDF) mean values. The kappa statistic between the JFP sensor and LDF is 0.78, indicating substantial agreement to estimate the peripheral hemoperfusion improvements. The sensor system we proposed can monitor peripheral hemoperfusion variation in real-time and is insensitive to motion artifacts. The proposed sensing system provides a functional module for real-time estimation of peripheral hemoperfusion during clinical interventions.

Long-lasting effects of post-traumatic stress disorder in Yazidi women living in Northern Iraqi camps

The severity of post-traumatic stress disorder and its long-lasting effects among the Yazidi population has not yet been investigated. ObjectivesThis study evaluated the impact of PTSD severity and chronicity on physiological and anthropometric parameters in women survivors of the genocide-related events after the so-called Islamic State of Iraq and Syria (ISIS) attack in 2014. MethodsThe diagnosis PTSD was assessed using PTSD Checklist for DSM-5 (PCL-5). Participants were divided into: External control (healthy individuals living outside the camps), Internal control (healthy individuals living in the camps), and PTSD group (individuals diagnosed with PTSD). The PTSD group was subdivided according to chronicity <2 years, 2–5 years, and >5 years and subdivided according to PTSD severity into “Moderate”, “Severe” and “Extreme”. Systolic blood pressure (SBP), diastolic blood pressure (DBP), blood oxygen saturation (SPO2) and heart rate (HR) were evaluated. Weight, height and waist circumference were measured. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. ResultsThe PTSD group showed significant increases in SBP, DBP, heart rate, BMI, WC, weight, and WHtR compared to the control groups. SPO2 values decreased in the PTSD group. As the disease progressed, there were further increases in SBP, DBP, heart rate, BMI, WC, WHtR, and weight. Similar increases were observed with the severity of the disease. ConclusionOur data indicates that a long-term impact on physiological and anthropometric parameters is present in women diagnosed with PTSD which might be aggravated by the severity and chronicity of the disease.

The relationship between COVID-19 and hyperglycemia: screening and monitoring hospitalized patients

BackgroundElevated blood glucose concentration, also known as hyperglycemia, has been identified as a significant factor influencing the prognosis of COVID-19, alongside the impact of the SARS-CoV-2 infection itself.MethodsThis research is a cross-sectional investigation that examined the relationship between COVID-19 and hyperglycemia in patients admitted to Afzalipour Hospital in Kerman, Iran, from July to September 2021. A standardized data sheet was used to capture demographic data (age, gender) and laboratory information (blood sugar, arterial blood oxygen saturation, and C-reactive protein (CRP)) upon admission.ResultsThe present research evaluated a total of 300 individuals diagnosed with COVID-19, with an average age of 50.19 ± 15.55 years. Among these patients, the majority were male, accounting for 51.67% of the total. Hyperglycemia was seen in 21.67% of patients, but less than 20% had new-onset diabetes. Individuals exhibiting hyperglycemia were typical of advanced age (P < 0.001). Furthermore, there was a slight but statistically significant association between advanced age and elevated blood glucose concentration (R = 0.254, P < 0.001). Gender had no significant impact on the occurrence of hyperglycemia (P = 0.199). There was no significant association between CRP levels and blood glucose concentration (P = 0.524) or the incidence of hyperglycemia (P = 0.473). Although there was no significant disparity in blood oxygen saturation between individuals with or without hyperglycemia (P = 0.06), higher blood glucose concentration was correlated with lower blood oxygen saturation (R = -0.151, P < 0.001).ConclusionConsidering the correlation between blood glucose concentration, advanced age, and disease severity, it is recommended to carefully screen and monitor all COVID-19 patients for hyperglycemia and new-onset diabetes. Effective management of these complications could enhance the control of patients’ overall prognosis and subsequent complications.

Numerical and in vitro experimental studies for assessing the blood hematocrit and oxygenation with the dual-wavelength photoacoustics

Assessing the blood hematocrit (Hct) and oxygenation (SO2) levels are essential for diagnosing numerous blood-related diseases. This study examines the ability of the photoacoustic (PA) technique for quantitative evaluation of these parameters. We conducted the Monte Carlo and k-Wave simulations to compute PA signals at four different optical wavelengths from test blood samples followed by rigorous in vitro experiments. This method can estimate the Hct and SO2 levels faithfully with ≥95% and ≥93% accuracies, respectively in the physiologically relevant hematocrits utilizing PA signals generated at 700 and 1000 nm optical wavelengths. A 2% decrease in the scattering anisotropy factor demotes SO2 estimation by ≈ 27%. This study provides sufficient insight into how the opto-chemical parameters of blood impact PA emission and may help to develop a PA setup for in vitro characterization of human blood.

A novel deterioration prediction system for mild COVID-19 patients in Korea: a retrospective study

The ongoing coronavirus disease 2019 (COVID-19) pandemic presents serious public health threats. Omicron, the current most prevalent strain of COVID-19, has a low fatality rate and very high transmissibility, so the number of patients with mild symptoms of COVID-19 is rapidly increasing. This change of pandemic challenges medical systems worldwide in many aspects, including sharp increases in demands for hospital infrastructure, critical shortages in medical equipment, and medical staff. Predicting deterioration in mild patients could alleviate these problems. A novel scoring system was proposed for predicting the deterioration of patients whose condition may worsen rapidly and those who all still mild or asymptomatic. Retrospective cohorts of 954 and 2,035 patients that quarantined in the Residential Treatment Center were assembled for derivation and external validation of mild COVID-19, respectively. Deterioration was defined as transfer to a local hospital due to worsening condition of the patients during the 2-week isolation period. A total of 15 variables: sex, age, seven pre-existing conditions (diabetes, hypertension, cardiovascular disease, respiratory disease, liver disease, kidney disease, and organ transplant), and five vital signs (systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), body temperature, and oxygen saturation (SpO2)) were collected. A scoring system was developed using seven variables (age, pulse rate, SpO2, SBP, DBP, temperature, and hypertension) with significant differences between the transfer and not transfer groups in logistic regression. The proposed system was compared with existing scoring systems that assess the severity of patient conditions. The performance of the proposed scoring system to predict deterioration in patients with mild COVID-19 showed an area under the receiver operating characteristic (AUC) of 0.868. This is a statistically significant improvement compared to the performance of the previous patient condition assessment scoring systems. During external validation, the proposed system showed the best and most robust predictive performance (AUC = 0.768; accuracy = 0.899). In conclusion, we proposed a novel scoring system for predicting patients with mild COVID-19 who will experience deterioration which could predict the deterioration of the patient’s condition early with high predictive performance. Furthermore, because the scoring system does not require special calculations, it can be easily measured to predict the deterioration of a patients’ condition. This system can be used as effective tool for early detection of deterioration in mild COVID-19 patients.

Characterization of myocardial perfusion imaging systems - an extension of quality metrics

PurposeThe aim of this study was to evaluate the performance of myocardial perfusion imaging (MPI) systems in detecting perfusion defects (PDs). The defect perfusion index (DPI) was introduced to extend and further advance the current MPI quality metrics. MethodsAn anthropomorphic phantom simulating normal and pathological myocardial perfusion conditions was imaged by various NaI-crystal detector systems with and without corrections for scatter (SC) and attenuation (AC) (Symbia, Symbia + SC, Symbia IQ + SCAC, Symbia IQ), and cadmium-zinc-telluride detector systems without corrections (DSPECT, D530c). The extent of PD and the summed score (SS) were obtained by comparing polar maps with ad hoc normal databases created for each MPI system by using phantom polar maps with normal perfusion. The segmental uptake (SU) and the global uniformity (GU) were evaluated. The DPI was calculated on segments included in the PD to minimize attenuation artifacts outside the PD. The 17 segmental model was used. ResultsThe highest level of uniformity of polar map was obtained for Symbia IQ + SCAC. D530c showed the highest extent of PD and dependence of the extent on the PD position. It showed in general the lowest SU values and the highest GU due to attenuation artifacts. Nevertheless, D530c outperforms other MPI systems in terms of PD detection, showing the highest DPI value. DSPECT system showed the lowest SS value, and DPI values comparable to NaI-crystal detector systems. ConclusionThe DPI can be evaluated to investigate the intrinsic ability of MPI systems to detect PDs, whatever the quantitative post-processing software used.

The level of partial pressure of carbon dioxide affects organ perfusion in respiratory failure patients undergoing pressure support ventilation with venovenous extracorporeal membrane oxygenation: a prospective study

BackgroundWe evaluated the influence of different partial carbon dioxide pressure (PaCO2) levels on organ perfusion in patients with respiratory failure receiving pressure-support ventilation with veno-venous extracorporeal membrane oxygenation (V-V ECMO).MethodsIn this twelve patients prospective study, ECMO gas-flow was decreased from baseline (PaCO2 < 40 mmHg) until PaCO2 increased by 5–10 mmHg (High-CO2 phase). Resistance indices of gut, spleen, and snuffbox artery, the peripheral perfusion index (PPI), and heart rate variability were measured at baseline and High-CO2 phase.ResultsWhen PaCO2 increased from 36 (36–37) mmHg at baseline to 42 (41–43) mmHg in the High-CO2 phase (p < 0.001), PPI decreased significantly (p = 0.026). The snuffbox artery (p = 0.022), superior mesenteric artery (p = 0.042), and spleen (p = 0.012) resistance indices increased significantly. The root mean square of successive differences (RMSSD) decreased from 19.5(18.1–22.7) to 15.9(14.4–18.6) ms (p = 0.034), and the ratio of low-frequency to high-frequency components(LF/HF) increased from 0.47 ± 0.23 to 0.70 ± 0.38 (p = 0.013).ConclusionsHigh PaCO2 might cause decreased peripheral tissue and visceral organ perfusion through autonomic nervous system in patients with respiratory failure undergoing PSV with V-V ECMO.

Contrast-Enhanced Ultrasound Reveals Superior Gluteus Medius Muscle Vitality After Total Hip Arthroplasty in a Minimally Invasive Anterolateral Versus Lateral Surgical Approach

ObjectiveTotal hip arthroplasty (THA) is essential for treating severe osteoarthritis. With various surgical approaches available, there has been a shift toward techniques that offer quicker recovery and fewer complications. In this study, contrast-enhanced ultrasound was used to evaluate the impact of the minimally invasive anterolateral versus conventional lateral approach in THA on the gluteus medius muscle, focusing on muscle vitality and functional outcomes. MethodsA retrospective, cross-sectional analysis of 64 patients who underwent unilateral THA (26 lateral and 38 anterolateral) was conducted. Muscle strength was measured alongside joint flexibility and patient-reported outcome measures. Contrast-enhanced ultrasound (CEUS) examinations were conducted to visualize gluteus medius microperfusion. CEUS data were analyzed using VueBox 7.1 software and microperfusion parameters were calculated using peak enhancement (PE), wash-in perfusion index (WiPI) and rise time for muscle vitality evaluation. ResultsPatients from the anterolateral group exhibited higher relative muscle strength in the operated hip compared with the healthy side (96 ± 23% vs. 86 ± 23%, p = 0.048). CEUS revealed superior gluteus medius microperfusion in the anterolateral group (PE 36,300 ± 42,000 arbitrary units [a.u.] vs. 20,400 ± 20,200 a.u., p = 0.024; WiPI 23,600 ± 27,300 a.u. vs. 13,500 ± 13,300 a.u., p = 0.027). A positive Trendelenburg sign was evident in 2 out of 26 patients in the lateral group compared with none in the anterolateral group (χ2 = 0.082), indicating higher rates of gluteal insufficiency in the lateral approach group. ConclusionSignificantly higher muscle perfusion parameters in the anterolateral group, alongside improved muscle strength recovery, hint at a subtle but important advantage regarding post-operative recovery of the anterolateral approach. These findings support the ongoing trend toward minimally invasive surgical approaches in THA.

Real-time fMRI neurofeedback of the anterior insula using arterial spin labelling.

Arterial spin labelling (ASL) is the only non-invasive technique that allows absolute quantification of perfusion and is increasingly used in brain activation studies. Contrary to the blood oxygen level-dependent (BOLD) effect ASL measures the cerebral blood flow (CBF) directly. However, the ASL signal has a lower signal-to-noise ratio (SNR), than the BOLD signal, which constrains its utilization in neurofeedback studies. If successful, ASL neurofeedback can be used to aid in the rehabilitation of health conditions with impaired blood flow, for example, stroke. We provide the first ASL-based neurofeedback study incorporating a double-blind, sham-controlled design. A pseudo-continuous ASL (pCASL) approach with background suppression and 3D GRASE readout was combined with a real-time post-processing pipeline. The real-time pipeline allows to monitor the ASL signal and provides real-time feedback on the neural activity to the subject. In total 41 healthy adults (19-56 years) divided into three groups underwent a neurofeedback-based emotion imagery training of the left anterior insula. Two groups differing only in the explicitness level of instruction received real training and a third group received sham feedback. Only those participants receiving real feedback with explicit instruction showed significantly higher absolute CBF values in the trained region during neurofeedback than participants receiving sham feedback. However, responder analyses of percent signal change values show no differences in activation between the three groups. Persisting limitations, such as the lower SNR, confounding effects of arterial transit time and partial volume effects still impact negatively the implementation of ASL neurofeedback.

Research on the mechanism of motor muscle control based on optical EEG images

The study of motor muscle control mechanisms can improve rehabilitation therapy and human-computer interaction technology. The limitations of traditional electroencephalography (EEG) limit the comprehensive understanding of motor muscle control mechanisms. Therefore, this study aims to explore the mechanism of motor muscle control based on optical EEG images, in order to expand the understanding of the process of motor control. The study selected optical EEG imaging technology as the main data acquisition tool. Optical EEG images have higher spatiotemporal resolution and can provide more detailed neural activity information. This technology combines optical imaging with EEG images to obtain spatiotemporal information of brain activity in a short period of time. The device is composed of multiple optical sensors and can measure blood oxygen concentration and neuronal activity in the cerebral cortex. Preprocess EEG image data using image processing and signal processing techniques, then use computational methods and algorithms to detect activated regions, and evaluate their relationships using correlation analysis and statistical methods. By comparing EEG image data and motor muscle activity data under different motor tasks. The research results show that optical EEG imaging technology can provide more detailed information on brain neural activity and accurately capture the activity patterns of different motor muscles. These results provide new perspectives and methods for further studying the control mechanisms of motor muscles.

Dynamic causal modelling highlights the importance of decreased self-inhibition of the sensorimotor cortex in motor fatigability.

Motor fatigability emerges when challenging motor tasks must be maintained over an extended period of time. It is frequently observed in everyday life and affects patients as well as healthy individuals. Motor fatigability can be measured using simple tasks like finger tapping at maximum speed for 30s. This typically results in a rapid decrease of tapping frequency, a phenomenon called motor slowing. In a previous study (Bächinger et al, eLife, 8 (September), https://doi.org/10.7554/eLife.46750 , 2019), we showed that motor slowing goes hand in hand with a gradual increase in blood oxygen level dependent signal in the primary sensorimotor cortex (SM1), supplementary motor area (SMA), and dorsal premotor cortex (PMd). It is unclear what drives the activity increase in SM1 caused by motor slowing and whether motor fatigability affects the dynamic interactions between SM1, SMA, and PMd. Here, we performed dynamic causal modelling (DCM) on data of 24 healthy young participants collected during functional magnetic resonance imaging to answer this question. The regions of interest (ROI) were defined based on the peak activation within SM1, SMA, and PMd. The model space consisted of bilateral connections between all ROI, with intrinsic self-modulation as inhibitory, and driving inputs set to premotor areas. Our findings revealed that motor slowing was associated with a significant reduction in SM1 self-inhibition, as uncovered by testing the maximum à posteriori against 0 (t(23)=-4.51, p < 0.001). Additionally, the model revealed a significant decrease in the driving input to premotor areas (t(23) > 2.71, p < 0.05) suggesting that structures other than cortical motor areas may contribute to motor fatigability.

The Pleth Variability Index as a Guide to Fluid Therapy in Dogs Undergoing General Anesthesia: A Preliminary Study.

The aim of this prospective, randomized clinical trial was to evaluate the use of the pleth variability index (PVi) to guide the rate of intraoperative fluid therapy compared to a traditional fixed-fluid-rate approach in ASA 1-2 dogs undergoing surgery. Twenty-seven dogs met the inclusion criteria and were randomly assigned to the conventional fluid management group (CFM, n = 12) or the PVi-guided group (PVi, n = 15). The CFM group received a fixed rate of 5 mL kg-1 h-1 of crystalloid solution, while in the PVi group the rate was continuously adjusted based on the PVi: PVi < 14% = 3 mL kg-1 h-1; 14% ≤ PVi ≥ 20% = 10 mL kg-1 h-1; and PVi > 20% = 15 mL kg-1 h-1. Hypotension (MAP < 65 mmHg) in the CFM was treated with a maximum of two fluid boluses (5 mL kg-1 in 10 min) and in the case of no response, dobutamine (1-3 mcg kg-1 min-1) was administered. In the PVi group, the treatment of hypotension was similar, except when the PVi > 14%, when dobutamine was started directly. Total fluid volume was significantly lower in the PVI group (0.056 ± 0.027 mL kg-1 min-1) compared to the CFM group (0.132 ± 0.115 mL kg-1 min-1), and the incidence of hypotension was lower (p = 0.023) in the PVi group (0%) compared to the CFM group (41%). The mean arterial pressure (MAP) was significantly higher in the PVi group during surgery. Dobutamine was never administered in either group. Preliminary data suggest that the PVi may be considered as a potential target to guide fluid therapy in dogs; larger studies are needed, especially in cases of cardiovascular instability.

Changes in indicators of cerebral metabolic stress following treatment with voxelotor in children and adolescents with sickle cell anemia

AbstractVoxelotor is a small molecule that reduces the polymerization of sickle hemoglobin by increasing its affinity for oxygen. In patients with sickle cell anemia, it has been postulated that increasing hemoglobin‐oxygen affinity could limit oxygen offloading from hemoglobin, causing an increase in cerebral metabolic stress. To investigate this hypothetical concern, we used multimodal brain imaging to define the effects of voxelotor on cerebral blood flow and oxygen extraction. We followed four patients for 2–5 months during and/or after voxelotor therapy. This study showed no observable increase in cerebral blood flow or oxygen extraction fraction during treatment.

XU-NetI: Simple U-shaped encoder-decoder network for accurate imputation of multivariate missing data

Patients in intensive care unit (ICU) often have multiple vital signs monitored continuously. However, missing data is common in ICU settings, negatively impacting clinical decision-making and patient outcomes. In this study propose a multivariate data imputation method based on simple U-Shaped encoder-decoder network imputation (XU-NetI) method to learn the underlying patterns in the data and generate imputations for missing values of vital signs data with ICU patients. To evaluate the performance of this study's imputation methods, this study employed a publicly available database such the medical information mart for intensive care III (MIMIC III) v1.4. In this study proposed model has been developed to analyze 219.281 vital sign worth of data, focusing on eight essential vital sign features: body temperature, heart rate, respiration rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, oxygen saturation, and glucose. The evaluation results demonstrates the effectiveness of the imputation techniques in improving the accuracy of predictive models. This study compared the XU-NetI approach to other state-of-the-art imputation methods including Autoencoder and Convolutional Neural Networks. As a result found, the technique using XU-NetI architecture outperformed them, in terms of root mean square error (RSME) by approximately 0.01, mean absolute error (MAE) by approximately 0.009, and R square (R2) by approximately 0.99. The XU-NetI method has the potential to enhance clinical decision-making and improve patient outcomes.

The Long-Term Impact of Cardiac Rehabilitation on Cognitive Function in Older Patients With Myocardial Infarction: A Systematic Review.

Myocardial Infarction (MI) isan obstruction in the coronary arteries, resulting in restricted blood flow and oxygen supply to the heart, leading to damage to the heart's tissues. Beyond the cardiovascular system, the impact of MI extends to potentially affecting cognitive abilities, especially in elderly populations. To optimize patient recovery and long-term outcomes, timely cardiac interventions and subsequent rehabilitation programs are essential. This systematic review aims to assess the potential benefits of cardiac rehabilitation (CR) in enhancing cognitive function among elderly individuals who have experienced an MI. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and utilizes PubMed, PubMed Central, Cochrane, Google Scholar, and ScienceDirect databases. Studies included in the review encompass meta-analyses, controlled trials, systematic/narrative reviews, randomized/nonrandomized trials, observational studies, and research articles published within the past five years. Only accessible, full-text English-language studies meeting the inclusion criteria are selected, while books, documents over five years old, animal studies, and individuals under 65 are excluded. Following a predefined template, the initial search identifies 4,915 studies. From this pool, 27 free full-text articles are then selected for quality appraisal based on relevance. After performing a quality assessment on each survey, 12 high-quality studies are included in this systematic review. The research studies demonstrate notable cognitive improvements among elderly patients who have experienced an MI and participated in CR programs. Additional clinical trial studies are recommended to substantiate these findings further and advance our understanding.