Application of generative adversarial network in magnetic resonance image reconstruction / 生物医学工程学杂志

Magnetic resonance imaging (MRI) is an important medical imaging method, whose major limitation is its long scan time due to the imaging mechanism, increasing patients' cost and waiting time for the examination. Currently, parallel imaging (PI) and compress sensing (CS) together with other reconstruction technologies have been proposed to accelerate image acquisition. However, the image quality of PI and CS depends on the image reconstruction algorithms, which is far from satisfying in respect to both the image quality and the reconstruction speed. In recent years, image reconstruction based on generative adversarial network (GAN) has become a research hotspot in the field of magnetic resonance imaging because of its excellent performance. In this review, we summarized the recent development of application of GAN in MRI reconstruction in both single- and multi-modality acceleration, hoping to provide a useful reference for interested researchers. In addition, we analyzed the characteristics and limitations of existing technologies and forecasted some development trends in this field.

Design and Research of Wearable Fall Protection Device for the Elderly / 中国医疗器械杂志

A protective device was designed that can be worn on the elderly, which consists of protective airbag, control box and protective mechanism. The combined acceleration, combined angular velocity and human posture angle are selected as the parameters to determine the fall, and the threshold algorithm and SVM algorithm are used to detect the fall. The protective mechanism is an inflatable device based on CO2 compressed air cylinder, and the equal-width cam structure is applied to its transmission part to improve the puncture efficiency of the compressed gas cylinder. A fall experiment was designed to obtain the combined acceleration and angular velocity eigenvalues of fall actions (forward fall, backward fall and lateral fall) and daily activities (sitting-standing, walking, jogging and walking up and down stairs), showing that the specificity and sensitivity of the protection module reached 92.1% and 84.4% respectively, which verified the feasibility of the fall protection device.

Comparison of drop jump force-time profiles of team sport athletes and active controls

Abstract Aim: Lower-body non-contact injuries in team sport athletes (TSAs) are associated when absorbing force, during cutting and landing movements due to a lack of eccentric strength and decreased neuromuscular control leading to excessively higher joint forces. Thus, this project aimed to identify if TSAs had different acceleration and deceleration force profiles compared to a control group (non-TSA) when performing drop jumps (DJs). Methods: University TSAs (n = 15) and non-TSAs (n = 10) performed a series of DJs from a 39 cm box onto a force-plate. All data were normalized to the individual's body mass. Between-group differences in ground reaction force (GRF), rate of force development (RFD), and propulsive and breaking impulses were compared via t-tests and standardized differences. Results: TSAs had significantly, and meaningfully greater RFD than the non-TSAs (p < 0.01, Hedges' g (ES) = 1.24, 53%). While not statistically significant, the non-TSA group produced practically larger mean GRFs than TSAs (p = .09, ES = 0.72, 12.1%). No significant or meaningful between-group differences were detected for propulsive impulse (p = 0.08, ES = 0.41, 9.1%), braking impulse (p = 0.85, ES = 0.25, 4.6%), or impulse ratio (p = 0.35, ES = 0.21, 6.7%). Conclusions: This study shows the presence of significant RFD differences during the DJ in TSAs compared to non-TSAs. Furthermore, this investigation also showed there was no difference between TSA and students in GRF and impulse metrics. Implications from these findings suggest that TSAs can produce force rapidly, but deceleration metrics were not different from untrained students.

Association between anthropometric and physical data of university soccer players from different positions / Associação entre dados antropométricos e físicos de jogadores universitários de futebol de diferentes posições

ABSTRACT The present study aimed to check if there is an association between fitness performance variables and to analyze the variation of fitness levels between playing positions university soccer players. Twenty university soccer players were selected (20.95 ± 1.84 years; 71.60 ± 11.65 kg; 176.85 ± 7.28 m) divided into defenders, midfielders and attackers. Body composition was assessed in a cross-sectional analysis that correlated fat mass, lean mass and fat-free mass by DXA with the physical capacity tests. The main results of the present study revealed that both 10-m and 20-m accelerations had moderate-to-large correlations with agility tests across the playing positions, however these accelerations were largely inversely correlated with YoYo intermittent recovery test in defenders and largely positively in midfielders. The agility test was moderately correlated with YoYo intermittent recovery test across the different playing positions. In conclusion, there the acceleration and the agility had a positive association with the different positions of the soccer players.

RESUMO O objetivo do presente estudo foi verificar se existe associção entre as variáveis de desempenho físico e analisar a variação dos níveis de aptidão física entre as posições de jogador de futebol universitário. Foram selecionados 20 jogadores de futebol universitário (20,95 ± 1,84 anos; 71,60 ± 11,65 kg; 176,85 ± 7,28 m) divididos em zagueiros, meio-campistas e atacantes. Mensurou-se a composição corporal em uma análise transversal e correlacionou-se a massa gorda, massa magra e massa livre de gordura por meio do DXA com os testes de capacidade física. As principais evidências do presente estudo revelaram que as acelerações de 10 e 20 m tiveram correlações de moderada a grande com o teste de agilidade nas posições de jogo, porém essas acelerações foram inversamente correlacionadas com o teste de recuperação intermitente nos defensores e amplamente positiva nos meio-campistas. O teste de agilidade foi moderadamente correlacionado com o teste de recuperação intermitente YoYo nas diferentes posições de jogo. Em conclusão, a aceleração e a agilidade tiveram uma associação positiva com as diferentes posições dos jogadores de futebol.

Comfort optimization of a new type of foot mechanism for lower extremity exoskeleton / 生物医学工程学杂志

In order to reduce the impact caused by the contact between the foot and the ground when wearing the lower extremity exoskeleton under the condition of high load, this paper proposed an exoskeleton foot mechanism for improving the foot comfort, and optimized the key index of its influence on the comfort. Firstly, the physical model of foot mechanism was established based on the characteristics of foot stress in gait period, and then the mathematical model of vibration was abstracted. The correctness of the model was verified by the finite element analysis software ANSYS. Then, this paper analyzed the influence of vibration parameters on absolute transmissibility based on vibration mathematical model, and optimized vibration parameters with MATLAB genetic algorithm toolbox. Finally, this paper took white noise to simulate the road elevation as the vibration input, and used the visual simulation tool Simulink in MATLAB and the vibration equation to construct the acceleration simulation model, and then calculated the vibration weighted root mean square acceleration value of the foot. The results of this study show that this foot comfort mechanism can meet the comfort indexes of vibration absorption and plantar pressure, and this paper provides a relatively complete method for the design of exoskeleton foot mechanism, which has reference significance for the design of other exoskeleton foot and ankle joint rehabilitation mechanism.

Peripheral blood immune cell-based biomarkers in anti-PD-1/PD-L1 therapy

Immune checkpoint blockade targeting PD-1 and PD-L1 has resulted in unprecedented clinical benefit for cancer patients. Anti-PD-1/PD-L1 therapy has become the standard treatment for diverse cancer types as monotherapy or in combination with other anti-cancer therapies, and its indications are expanding. However, many patients do not benefit from anti-PD-1/PD-L1 therapy due to primary and/or acquired resistance, which is a major obstacle to broadening the clinical applicability of anti-PD-1/PD-L1 therapy. In addition, hyperprogressive disease, an acceleration of tumor growth following anti-PD-1/PD-L1 therapy, has been proposed as a new response pattern associated with deleterious prognosis. Anti-PD-1/PD-L1 therapy can also cause a unique pattern of adverse events termed immune-related adverse events, sometimes leading to treatment discontinuation and fatal outcomes. Investigations have been carried out to predict and monitor treatment outcomes using peripheral blood as an alternative to tissue biopsy. This review summarizes recent studies utilizing peripheral blood immune cells to predict various outcomes in cancer patients treated with anti-PD-1/PD-L1 therapy.

A Wearable System for Cervical Spondylosis Prevention Based on Artificial Intelligence / 中国医疗器械杂志

Accompanied by changes in modern work and lifestyle, the incidence of cervical spondylosis has increased year by year. In view of the fact long-term fixed posture of the head and neck is one of the main causes of cervical spondylosis, a set of wearable cervical spondylosis prevention system is developed. The system comprises a head and neck movement collection module based on the acceleration sensor and a head and neck motion recognition module based on artificial intelligence. Experimental results showed that the system can accurately identify long-term posture of the head and neck, and guide users to complete effective exercise therapy under the supervision of motion recognition module. Using this system can be beneficial for the prevention of cervical spondylosis.

Feasibility of Simultaneous Multislice Acceleration Technique in Diffusion-Weighted Magnetic Resonance Imaging of the Rectum

Valoración de ecuaciones derivadas del flujo pulmonar y regurgitación tricuspídea: utilidad en el test de vasoreactividad pulmonar / Valuation of equations derived from Pulmonary Flow and Tricuspid Regurgitation: usefulness in Pulmonary Vasoreactivity Testing

RESUMEN: Antecedentes: La presión media arterial pulmonar (PMAP) es una variable hemodinámica indispensable para el diagnóstico, clasificación y pronóstico de la Hipertensión Pulmonar (HP). Su cuantificación se realiza en forma invasiva por cateterismo cardíaco derecho (CCD) y no invasivamente por ecocardiografía Doppler. Masuyama propuso su medición mediante el gradiente transvalvular pulmonar diastólico derivado de la velocidad máxima inicial de la regurgitación pulmonar (∆RPi2) correspondiendo cercanamente a la medición invasiva. Objetivos: Revalidar 3 métodos ecocardiográficos que estiman la PMAP y valorar la utilidad del método de Chemla en el Test de Reactividad Vascular Pulmonar (TRVP). Métodos: Estudio prospectivo, observacional, doble ciego divido en dos etapas. A) o I) 30 pacientes se realizó ecocardiografía Doppler diagnóstica en nuestro centro. Se midieron regurgitación tricuspídea (RT) y tiempo de aceleración pulmonar (TAP) para derivar las siguientes ecuaciones: 1) 0.61xPSAP+1.95 (Chemla) 2) Gradiente presión media RT (∆PmRT) +PAD (presión-aurícula derecha) (Aduen) y 3) 79-0.45xTAP o 90-0.60xTAP, según sea el valor del TAP. B) o II) 10 pacientes enrolados para realizar el TRVP comparando la medición ecocardiográfica (Chemla) con CCD. Resultados: En la primera parte del estudio se encontró alta correlación entre las 3 ecuaciones: ChemlaAduen, R2=0.91; Chemla-Kitabatake, R2=0.87; Aduen-Kitabatake, R2=0,91. En la segunda parte comparando la PMAP-Chemla y Cateterismo derecho (CD) obtuvimos alta correlación: en tiempo 0, 30 min y recuperación:(R2=0.87, 0.99, 0.98, respectivamente). Ambas partes del estudio mostraron límites de concordancia satisfactoria con valor medio de la diferencia entre los métodos cercano a 1 en el t30 y tR del TRVP. Conclusión: los métodos dependientes de la medición de la RT son efectivos y confiables para estimar la PMAP. El método de Chemla es útil en el TRVP.

ABSTRACTS: Background: Mean Pulmonary arterial pressure (PMAP)is an indispensable hemodynamic variable for the diagnosis, classification and prognosis of Pulmonary Hypertension (PH). Its quantification is performed invasively by cardiac catheterization and non-invasively by Doppler echocardiography. Masuyama proposed its measurement by the transvalvular diastolic pulmonary gradient derived from the initial maximum velocity of pulmonary regurgitation(ΔPRi2) corresponding closely to the invasive measurement. Objectives: to compare 3 known echocardiographic methods to estimate MPAP and demonstrate the usefulness of the Chemla method in the Pulmonary Vascular Reactivity Test (PVRT). Methods: prospective, observational, double-blind study divided into two stages. A) 30 patients underwent diagnostic Doppler echocardiography. Tricuspid regurgitation (TR) and pulmonary acceleration time (PAT) were measured to derive the equations: 1) 0.61xSPAP + 1.95 (Chemla) 2) Gradient mean pressure TR (ΔPmTR) + RAP (right atrium pressure) (Aduen).3) 79-0.45xPAT o 90-0.60xPAT depending on the value of PAT. B) 10 patients enrolled to PVRT comparing the echocardiographic measurement (Chemla) with right catheterization. Results: in the first part of the study a high correlation between the 3 equations was found : ChemlaAduen, R2 = 0.91; Chemla-Kitabatake, R2=0.87; Aduen-Kitabatake, R2=0.91. In the second part comparing the MPAP-Chemla and RHC we obtained a high correlation in time 0, 30 min and recovery: (R2=0.87,0,99,0.98, respectively). Both parts of the study showed satisfactory limits concordance with mean value of the difference between the methods close to 1 in the t30 and tR of the TRVP. Conclusion: the methods dependent on the measurement of the TR are effective and reliable for estimating MPAP. The Chemla method is useful in the PVRT.

Growth Hormone and Aging: Updated Review

Role of growth hormone (GH) in mammalian aging is actively explored in clinical, epidemiological, and experimental studies. The age-related decline in GH levels is variously interpreted as a symptom of neuroendocrine aging, as one of causes of altered body composition and other unwelcome symptoms of aging, or as a mechanism of natural protection from cancer and other chronic diseases. Absence of GH signals due to mutations affecting anterior pituitary development, GH secretion, or GH receptors produces an impressive extension of longevity in laboratory mice. Extension of healthspan in these animals and analysis of survival curves suggest that in the absence of GH, aging is slowed down or delayed. The corresponding endocrine syndromes in the human have no consistent impact on longevity, but are associated with remarkable protection from age-related disease. Moreover, survival to extremely old age has been associated with reduced somatotropic (GH and insulin-like growth factor-1) signaling in women and men. In both humans and mice, elevation of GH levels into the supranormal (pathological) range is associated with increased disease risks and reduced life expectancy likely representing acceleration of aging. The widely advertised potential of GH as an anti-aging agent attracted much interest. However, results obtained thus far have been disappointing with few documented benefits and many troublesome side effects. Possible utility of GH in the treatment of sarcopenia and frailty remains to be explored.

Real-Time Computed Tomography Volume Visualization with Ambient Occlusion of Hand-Drawn Transfer Function Using Local Vicinity Statistic / 대한의료정보학회지

OBJECTIVES: In this paper, we present an efficient method to visualize computed tomography (CT) datasets using ambient occlusion, which is a global illumination technique that adds depth cues to the output image. We can change the transfer function (TF) for volume rendering and generate output images in real time. METHODS: In preprocessing, the mean and standard deviation of each local vicinity are calculated. During rendering, the ambient light intensity is calculated. The calculation is accelerated on the assumption that the CT value of the local vicinity of each point follows the normal distribution. We approximate complex TF forms with a smaller number of connected line segments to achieve additional acceleration. Ambient occlusion is combined with the existing local illumination technique to produce images with depth in real time. RESULTS: We tested the proposed method on various CT datasets using hand-drawn TFs. The proposed method enabled real-time rendering that was approximately 40 times faster than the previous method. As a result of comparing the output image quality with that of the conventional method, the average signal-to-noise ratio was approximately 40 dB, and the image quality did not significantly deteriorate. CONCLUSIONS: When rendering CT images with various TFs, the proposed method generated depth-sensing images in real time.

Accelerated Time-of-Flight Magnetic Resonance Angiography with Sparse Undersampling and Iterative Reconstruction for the Evaluation of Intracranial Arteries

OBJECTIVE: To compare the image quality of three-dimensional time-of-flight (TOF) magnetic resonance angiography (MRA) with sparse undersampling and iterative reconstruction (sparse TOF) with that of conventional TOF MRA. MATERIALS AND METHODS: This study included 56 patients who had undergone sparse TOF MRA for intracranial artery evaluation on a 3T MR scanner. Conventional TOF MRA scans were also acquired from 29 patients with matched acquisition times and another 27 patients with matched scanning parameters. The image quality was scored using a five-point scale based on the delineation of arterial vessel segments, artifacts, overall vessel visualization, and overall image quality by two radiologists independently, and the data were analyzed using the non-parametric Wilcoxon signed-rank test. Contrast ratios (CRs) of vessels were compared using the paired t test. Interobserver agreement was calculated using the kappa test. RESULTS: Compared with conventional TOF at the same spatial resolution, sparse TOF with an acceleration factor of 3.5 could reduce acquisition time by 40% and showed comparable image quality. In addition, when compared with conventional TOF with the same acquisition time, sparse TOF with an acceleration factor of 5 could also achieve higher spatial resolution, better delineation of vessel segments, fewer artifacts, higher image quality, and a higher CR (p < 0.05). Good-to-excellent interobserver agreement (κ: 0.65–1.00) was obtained between the two radiologists. CONCLUSION: Compared with conventional TOF, sparse TOF can achieve equivalent image quality in a reduced duration. Furthermore, using the same acquisition time, sparse TOF could improve the delineation of vessels and decrease image artifacts.

High-Resolution Magnetic Resonance Imaging Using Compressed Sensing for Intracranial and Extracranial Arteries: Comparison with Conventional Parallel Imaging

OBJECTIVE: To compare conventional sensitivity encoding (SENSE) to compressed sensing plus SENSE (CS) for high-resolution magnetic resonance imaging (HR-MRI) of intracranial and extracranial arteries. MATERIALS AND METHODS: HR-MRI was performed in 14 healthy volunteers. Three-dimensional T1-weighted imaging (T1WI) and proton density-weighted imaging (PD) were acquired using CS or SENSE under the same total acceleration factors (AF(t))-5.5, 6.8, and 9.7 for T1WI and 3.2, 4.0, and 5.8 for PD-to achieve reduced scanning times in comparison with the original imaging sequence (SENSE T1WI, AF(t) 3.5; SENSE PD, AF(t) 2.0) using the 3-tesla system. Two neuroradiologists measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and used visual scoring systems to assess image quality. Acceptable imaging was defined as a visual score ≥ 2. Repeated measures analysis of variance and Cochran's Q test were performed. RESULTS: CS yielded better image quality and vessel delineation than SENSE in T1WI with AF(t) of 5.5, 6.8, and 9.7, and in PD with AF(t) of 5.8 (p 0.05). SNR and CNR in CS were higher than they were in SENSE, but lower than they were in the original images (p < 0.05). CS yielded higher proportions of acceptable imaging than SENSE (CS T1WI with AF(t) of 6.8 and PD with AF(t) of 5.8; p < 0.0167). CONCLUSION: CS is superior to SENSE, and may be a reliable acceleration method for vessel HR-MRI using AF(t) of 5.5 for T1WI, and 3.2 and 4.0 for PD.

High Acceleration Three-Dimensional T1-Weighted Dual Echo Dixon Hepatobiliary Phase Imaging Using Compressed Sensing-Sensitivity Encoding: Comparison of Image Quality and Solid Lesion Detectability with the Standard T1-Weighted Sequence

OBJECTIVE: To compare a high acceleration three-dimensional (3D) T1-weighted gradient-recalled-echo (GRE) sequence using the combined compressed sensing (CS)-sensitivity encoding (SENSE) method with a conventional 3D GRE sequence using SENSE, with respect to image quality and detectability of solid focal liver lesions (FLLs) in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced liver MRI. MATERIALS AND METHODS: A total of 217 patients with gadoxetic acid-enhanced liver MRI at 3T (54 in the preliminary study and 163 in the main study) were retrospectively included. In the main study, HBP imaging was done twice using the standard mDixon-3D-GRE technique with SENSE (acceleration factor [AF]: 2.8, standard mDixon-GRE) and the high acceleration mDixon-3D GRE technique using the combined CS-SENSE technique (CS-SENSE mDixon-GRE). Two abdominal radiologists assessed the two MRI data sets for image quality in consensus. Three other abdominal radiologists independently assessed the diagnostic performance of each data set and its ability to detect solid FLLs in 117 patients with 193 solid nodules and compared them using jackknife alternative free-response receiver operating characteristics (JAFROC). RESULTS: There was no significant difference in the overall image quality. CS-SENSE mDixon-GRE showed higher image noise, but lesser motion artifact levels compared with the standard mDixon-GRE (all p < 0.05). In terms of lesion detection, reader-averaged figures-of-merit estimated with JAFROC was 0.918 for standard mDixon-GRE, and 0.953 for CS-SENSE mDixon-GRE (p = 0.142). The non-inferiority of CS-SENSE mDixon-GRE over standard mDixon-GRE was confirmed (difference: 0.064 [−0.012, 0.081]). CONCLUSION: The CS-SENSE mDixon-GRE HBP sequence provided comparable overall image quality and non-inferior solid FFL detectability compared with the standard mDixon-GRE sequence, with reduced acquisition time.

Reconstruction of Vehicle-pedestrian Collision Road Traffic Accidents Based on PC-Crash Software / 法医学杂志

Objective To discuss the application value of vehicle-pedestrian collision road traffic accidents reconstruction based on PC-Crash software in forensic identification. Methods A case of vehicle-pedestrian collision was chosen based on a tachograph, then PC-Crash software was applied to construct a vehicle-pedestrian collision model, and reconstruct the vehicle-pedestrian collision road traffic accident. Finally, the process of vehicle-pedestrian collision was reproduced. Results In accident reconstruction, when the car speed was lower than 50km/h, the landing point of the pedestrian after collision was in the front of the car. When the car speed was higher than 50 km/h, after collision, the pedestrian flipped towards the car roof and landed behind the car. With the increase of vehicle speed, throwing distance of the pedestrian increased continuously. When the vehicle collision speed reached 60 km/h, the experimental results in this case were basically consistent with the actual situation of the case. Head acceleration of the pedestrian was at the maximum （1 655.70 m/s2） at 0.080 s. Chest acceleration of the pedestrian increased from 597.63 m/s2 to the peak 675.52 m/s2 at 0.055-0.060 s. Tibia acceleration of the pedestrian increased from 759.26 m/s2 to the first peak 1 367.06 m/s2, then reached the maximum speed （1 718.19 m/s2） at 1.225 s. Conclusion The process of vehicle-pedestrian collision road traffic accidents can be reconstructed based on PC-Crash software under a situation of limited conditions, and can further clarify the speed of the vehicle, the location and degree of human body injury as well as the mechanism of damage of the pedestrian in the accident. Therefore, PC-Crash software has a certain practical value in forensic identification of road traffic accidents.

Response Patterns of Nursing Unit Managers regarding Workplace Bullying: A Q Methodology Approach

PURPOSE: The purpose of this study was to identify the response patterns of nursing unit managers regarding workplace bullying. METHODS: Q methodology was used to identify the response patterns. Thirty-six Q samples were selected from the Q population of 210 that included literature reviews and in-depth interviews with clinical nurses and nursing managers. Participants were 30 nursing unit managers who had experience managing workplace bullying and they classified the Q samples into a normal distribution frame measured on a nine-point scale. The data were analyzed using the PC-QUANL program. RESULTS: Five types of response patterns were identified: (1) sympathetic-understanding acceleration, (2) harmonious-team approach, (3) preventive-organizational management, (4) passive observation, and (5) leading-active intervention. The preventive-organizational management type was most frequently used by the nursing unit managers. CONCLUSION: The results of this study indicated that nursing unit managers attempted to prevent and solve workplace bullying in various ways. Therefore, it is necessary to develop and conduct leadership training and intervention programs that appropriately address the response patterns of nursing unit managers, such as those identified in this study.

Unconstrained detection of ballistocardiogram and heart rate based on vibration acceleration / 生物医学工程学杂志

The requirement for unconstrained monitoring of heartbeat during sleep is increasing, but the current detection devices can not meet the requirements of convenience and accuracy. This study designed an unconstrained ballistocardiogram (BCG) detection system using acceleration sensor and developed a heart rate extraction algorithm. BCG is a directional signal which is stronger and less affected by respiratory movements along spine direction than in other directions. In order to measure the BCG signal along spine direction during sleep, a 3-axis acceleration sensor was fixed on the bed to collect the vibration signals caused by heartbeat. An approximate frequency range was firstly assumed by frequency analysis to the BCG signals and segmental filtering was conducted to the original vibration signals within the frequency range. Secondly, to identify the true BCG waveform, the accurate frequency band was obtained by comparison with the theoretical waveform. The J waves were detected by BCG energy waveform and an adaptive threshold method was proposed to extract heart rates by using the information of both amplitude and period. The accuracy and robustness of the BCG detection system proposed and the algorithm developed in this study were confirmed by comparison with electrocardiogram (ECG). The test results of 30 subjects showed a high average accuracy of 99.21% to demonstrate the feasibility of the unconstrained BCG detection method based on vibration acceleration.

Development of a Novel Intraoperative Neuromonitoring System Using an Accelerometer Sensor in Thyroid Surgery: A Porcine Model Study

OBJECTIVES: The sensitivity and positive predictive value of widely used intraoperative neuromonitoring (IONM) using electromyography (EMG) of the vocalis muscle in thyroid surgery are controversial. Thus, we developed a novel IONM system with an accelerometer sensor that uses the piezoelectric effect instead of EMG to detect laryngeal twitching. The objective of this study was to evaluate the feasibility and safety of this novel IONM system during thyroid surgery in a porcine model. METHODS: We developed an accelerometer sensor that uses the piezoelectric effect to measure laryngeal twitching in three dimensions. This novel accelerometer sensor was placed in the anterior neck skin (transcutaneous) or postcricoid area. Stimulus thresholds, amplitude, and latency of laryngeal twitching measured using the accelerometer sensor were compared to those measured through EMG of the vocalis muscle. RESULTS: The amplitudes of the accelerometer sensor at the anterior neck and postcricoid area were significantly lower than those of EMG because of differences in the measurement method used to evaluate laryngeal movement. However, no significant differences in stimulus thresholds between the EMG endotracheal tube and transcutaneous or postcricoid accelerometer sensors were observed. CONCLUSION: Accelerometer sensors located at the anterior neck or postcricoid area were able to identify laryngeal twitching. The stimulus intensity measured with these sensors was equivalent to that from conventional vocalis EMG. Our novel IONM system with an accelerometer sensor that checks changes in surface acceleration can be an alternative to EMG of the vocalis muscle for IONM in the future.

Methylphenidate and Central Precocious Puberty: A Probable Side Effect among Seven Children with the Attention Deficit Hyperactivity Disorder

Methylphenidate (MPH) is the most preferred drug for treatment of the attention deficit hyperactivity disorder (ADHD). Here, we aimed to discuss the possible effects and mechanisms of MPH on precocious puberty (PP) via a case series with seven children who had normal body mass index. In this case series we evaluated seven children with ADHD, who had received MPH for at least 6 months (0.5 mg/kg/dose three times a day, maximum 60 mg) and admitted to Department of Pediatric Endocrinology with PP symptoms. The mean age was 8.16 years. Basal hormonal levels (luteinizing hormone [LH], follicle stimulating hormone, and estrogen/testosterone) were within normal range. Results of LH-releasing hormone stimulation tests demonstrated central pubertal responses. Glutamine, dopamine and noradrenaline are most important excitatory neurotransmitters that have a role at the beginning of puberty. The effect of MPH, cumulating dopamine and noradrenaline in the synaptic gap could be associated with the acceleration of puberty with the excitatory effect of dopamine’s gonadotropin-releasing hormone (GnRH) release, excitatory effect of noradrenaline’s GnRH release and the disappearance of GnRH receptor expression suppressor effect on prolactin disinhibitory effect.

Muscle activity during low-speed rear impact / 中华创伤杂志(英文版)

PURPOSE@#Whiplash associated disorders remain a major health problem in terms of impact on health care and on societal costs. Aetiology remains controversial including the old supposition that the cervical muscles do not play a significant role. This study examined the muscle activity from relevant muscles during rear-end impacts in an effort to gauge their influence on the aetiology of whiplash associated disorders.@*METHODS@#Volunteers were subjected to a sub-injury level of rear impact. Surface electromyography (EMG) was used to record cervical muscle activity before, during and after impact. Muscle response time and EMG signal amplitude were analysed. Head, pelvis, and T1 acceleration data were recorded.@*RESULTS@#The activities of the cervical muscles were found to be significant. The sternocleidomastoideus, trapezius and erector spinae were activated on average 59 ms, 73 ms and 84 ms after the impact stimulus, respectively, prior to peak head acceleration (113 ms).@*CONCLUSION@#The cervical muscles reacted prior to peak head acceleration, thus in time to influence whiplash biomechanics and possibly injury mechanisms. It is recommended therefore, that muscular influences be incorporated into the development of the new rear-impact crash test dummy in order to make the dummy as biofidelic as possible.