Typical value ranges and signal patterns in patients with neurogenic bladder: Quality control in urodynamics using an air-charged catheter system.

PURPOSE: To establish typical value ranges (TVRs) of the air-charged catheter (ACC) system, and analyze the typical signal patterns (TSPs) of cough under different bladder volumes for quality control of a urodynamic study using the ACC system. MATERIALS AND METHODS: The urodynamic traces of 1977 patients with neurogenic bladder (NB) were analyzed for intravesical pressure (pves ), abdominal pressure (pabd ), and detrusor pressure (pdet ) in the cough test at our center from July 2017 to December 2021. The pdet cough signals were described and classified. The pdet cough signal patterns in different bladder volumes and postures were analyzed. RESULTS: The 50% range of the initial resting pves , pabd , and pdet in the supine and sitting positions were 7-15, 7-14, and 0-0 cmH2 O, and 24-33, 24-33, and 0-0 cmH2 O, respectively. The cough amplitudes for pves and pabd were similar in the 50% range, as follows: 10-27 and 8-25 cmH2 O in the supine position, respectively; and 18-43 and 17-40 cmH2 O in the sitting position, respectively. The cough amplitude of pves and pabd was not related to bladder volume (p > 0.05). The cough spikes of pdet were divided into three types: type I, in which pdet has a minimal change (<5 cmH2 O); type II, a monophasic cough spike, in which could be a positive (IIa, ≥5 cmH2 O) or negative spike (IIb, ≥5 cmH2 O); and type III, a biphasic spike, in which could be a positive-to-negative biphasic (IIIa) or negative-to-positive spike (IIIb). Under different bladder volumes, the cough signals of pdet were all expressed as type I, II, or III, and the cough signals were unrelated to bladder volume (p > 0.05). CONCLUSIONS: TVRs of the initial resting state in patients with NB were established to provide guidance for quantitative quality control of the ACC system. The TSPs of the pdet cough signal under different bladder volume and posture were described, which could be used for qualitative quality control of the ACC system.

Sacral Neuromodulation Improves Abnormal Prefrontal Brain Activity in Patients with Overactive Bladder: A Possible Central Mechanism.

PURPOSE: We explored the central pathogenesis of overactive bladder (OAB) and the central mechanism of action of sacral neuromodulation (SNM). MATERIALS AND METHODS: We prospectively enrolled patients with OAB who chose SNM and healthy controls (HCs). At baseline, all subjects completed a 72-hour voiding diary, OAB symptom score and prefrontal cortex functional near-infrared spectroscopy scan synchronous urodynamic monitoring. All OAB patients were tested after implantation of the SNM electrode, and both success and failure groups were reevaluated. NIRS_KIT software was used to analyze prefrontal activity (p <0.05 and corrected by false discovery rate). SPSS® 22.0 was used to analyze clinical parameters, and p <0.05 was considered statistically significant. RESULTS: A total of 16 HC and 20 OAB patients were enrolled. SNM treatment was successful in 18 OAB patients and failed in 2. The parameters of the voiding diary, OAB symptom score and urodynamic monitoring of OAB group were significantly improved after SNM treatment in success group, not in the failure group. Compared with HCs, Brodmann's area 9 (left dorsolateral prefrontal cortex [DLPFC]) was significantly deactivated in the preoperative OAB success group and significantly activated after SNM treatment. Before surgery, compared with the success group, the failure group showed significantly deactivated Brodmann's area 9 (left DLPFC). CONCLUSIONS: Our study provides novel neuroimaging evidence for the possible central pathogenesis of OAB (ie abnormal deactivation of the left DLPFC) and the possible central mechanism of action of SNM (ie restore activation of the left DLPFC).

Abnormal functional connectivity within the prefrontal cortex in interstitial cystitis/bladder pain syndrome (IC/BPS): A pilot study using resting state functional near-infrared spectroscopy (rs-fNIRS).

PURPOSE: To investigate the abnormalities of functional connectivity (FC) within the prefrontal cortex (PFC) of patients with interstitial cystitis/bladder pain syndrome (IC/BPS) based on resting state functional near-infrared spectroscopy (rs-fNIRS) data using FC matrix analysis. MATERIALS AND METHODS: Ten patients with IC/BPS (females, 9; mean age, 56.9 ± 12.432 years) and 15 age- and gender-matched healthy controls (HC) (females, 12; mean age, 55.067 ± 7.46 years) participated in this rs-fNIRS study. Two rs-fNIRS scans were performed (when the bladder was empty and when the desire to void was strong). The Pearson's correlation coefficient between the time series of the 22 channels was calculated to obtain a 22 × 22 FC matrix for each subject. A two-sample t-test (p < .05) was performed to compare group differences in the FC matrix between patients with IC/BPS and HC. RESULTS: FC was significantly decreased within the PFC in the IC/BPS group based on a two-sample t-test (p < .05) compared with HC. FC decreased in a wider range of brain regions during the strong desire to void state (4 brain regions and 28 edges) when compared with the empty bladder state (3 brain regions and 18 edges). CONCLUSION: FC abnormalities in IC/BPS patients may lead to frontal lobe disorders involved in processing sensory integration, motivation drive, emotional control, and decision-making whether to urinate, leading to urinary control dysfunction manifested as typical clinical IC/BPS symptoms. Our results may provide new insight into the pathogenesis of IC/BPS and new brain biomarkers for diagnosis.

Brain functional network alterations caused by a strong desire to void in healthy adults: a graph theory analysis study.

PURPOSE: This resting-state functional magnetic resonance imaging (fMRI) study determined the functional connectivity (FC) changes and topologic property alterations of the brain functional network provoked by a strong desire to void in healthy adults using a graph theory analysis (GTA). MATERIALS AND METHODS: Thirty-four healthy, right-handed subjects filled their bladders by drinking water. The subjects were scanned under an empty bladder and a strong desire to void states. The Pearson's correlation coefficients were calculated among 90 brain regions in the automated anatomical labeling (AAL) atlas to construct the brain functional network. A paired t test (P < .05, after false discovery rate [FDR] correction) was used to detect significant differences in the FC, topologic properties (small-world parameters [gamma, sigma], Cp, Lp, Eglob, Eloc, and Enodal) between the two states in all subjects. RESULTS: Both the two states showed small-world network properties. The clustering coefficient (Cp) and local efficiency (Eloc) in the whole brain network decreased, while the FC within the default mode network (DMN) increased during the strong desire to void compared with the empty bladder state. Moreover, an increased nodal efficiency (Enodal) was detected in the basal ganglia (BG), DMN, sensorimotor-related network (SMN), and visual network (VN). CONCLUSION: We detected FC changes and topologic property alterations in brain functional networks caused by a strong desire to void in healthy and suggest that the micturition control may be a process dominated by DMN and coordinated by multiple sub-networks (such as, BG, SMN, and VN), which could serve as a baseline for understanding the pathologic process underlying bladder dysfunction and be useful to improve targeted therapy in the future.

Direct femtosecond laser ablation of large-area TaSe2, SnS2, and TiS2 thick films by a back ablation procedure.

Direct ablation of large-area graphene-like two-dimensional (2D) materials, i.e., tantalum diselenide (TaSe2), stannic disulfide (SnS2), and titanium disulfide (TiS2), by the back ablation method with a femtosecond laser with a repetition rate of 50 MHz and pulse width of 200 fs is studied for the first time to our knowledge. The ablation thresholds of the three kinds of materials are discussed. In addition, the optimization and ablation of narrow grooves on the films are demonstrated. Our work demonstrates the direct femtosecond laser ablation processing of the graphene-like 2D-material films and the potential of 2D-material-film-based devices.

Chromatic annuli formation and sample oxidation on copper thin films by femtosecond laser.

We report an experimental investigation on the irradiation of copper thin films with high repetition rate femtosecond laser pulses (1040 nm, 50 MHz), in ambient air and liquid water. We observe a novel, striking phenomenon of chromatic copper oxides (CuO and Cu2O) annuli generation. The characteristic features of the chromatic copper oxide annuli are studied by exploiting micro-Raman spectroscopy, optical and scanning electron microscopies. In the case of irradiation in water, the seldom investigated effects of the immersion time, tw, after irradiation with a fixed number of pulses are analyzed, and an intriguing dependence of the color of the chromatic annuli on tw is observed. This remarkable behavior is explained by proposing an interpretation scenario addressing the various processes involved in the process. Our experimental findings show that Cu2O nanoparticles (size of ≈20 nm) and Cu2O nanocubes (nanocube edges of ≈30, ≈60 nm) can be effectively generated by exploiting high repetition rate laser-assisted oxidation.

Functional brain imaging and central control of the bladder in health and disease.

Central control of the bladder is a complex process. With the development of functional imaging technology and analysis methods, research on brain-bladder control has become more in-depth. Here, we review previous functional imaging studies and combine our latest findings to discuss brain regions related to bladder control, interactions between these regions, and brain networks, as well as changes in brain function in diseases such as urgency urinary incontinence, idiopathic overactive bladder, interstitial cystitis/bladder pain syndrome, urologic chronic pain syndrome, neurogenic overactive bladder, and nocturnal enuresis. Implicated brain regions include the pons, periaqueductal grey, thalamus, insula, prefrontal cortex, cingulate cortex, supplementary motor area, cerebellum, hypothalamus, basal ganglia, amygdala, and hippocampus. Because the brain is a complex information transmission and processing system, these regions do not work in isolation but through functional connections to form a number of subnetworks to achieve bladder control. In summarizing previous studies, we found changes in the brain functional connectivity networks related to bladder control in healthy subjects and patients involving the attentional network, central executive network or frontoparietal network, salience network, interoceptive network, default mode network, sensorimotor network, visual network, basal ganglia network, subcortical network, cerebella, and brainstem. We extend the working model proposed by Griffiths et al. from the brain network level, providing insights for current and future bladder-control research.

Responses of functional brain networks to bladder control in healthy adults: a study using regional homogeneity combined with independent component analysis methods.

OBJECTIVE: A functional magnetic resonance imaging (fMRI) study was performed during urodynamic examination in healthy adults to determine the responses of functional brain networks to bladder control during urine storage. METHODS: The brain imaging was performed in empty and full bladder states during urodynamic examination. First, we used independent component analysis (ICA) to obtain several resting state network masks, then the brain regions with significantly different regional homogeneity (ReHo) values between the two states were determined using a paired t test (p < 0.05; Gaussian random field correction [GRF]: voxel p < 0.01 and cluster p < 0.05) and presented in their corresponding resting state network (RSN) masks. RESULTS: Data sets obtained from the remaining 20 subjects were analyzed after motion correction. Nine RSNs were identified by group-ICA, including the salience network (SN), default mode network (DMN), central executive network (CEN), dorsal attention network (dAN), auditory network (AN), sensorimotor network (SMN), language network (LN), visual network (VN), and cerebellum network (CN). The ReHo values were significantly increased (p < 0.05, GRF corrected) within the SN, DMN, and CEN in the full bladder state compared with the empty bladder state. CONCLUSION: Significant changes within the three functional brain networks were demonstrated when the bladder was full, suggesting that SN provides bladder sensation and DMN may provide self-reference, self-reflection, and decision-making about whether to void after assessment of the external environment, while CEN may provide support related to episodic memory, which provides new insight into the processing of bladder control and could serve as a premise to further explore the pathologic process underlying bladder dysfunction.

[Effectiveness and safety of sacral neuromodulation on neurogenic bladder and bowel dysfunction in patients with spina bifida].

OBJECTIVE: To evaluate the effectiveness and safety of sacral neuromodulation (SNM) in the treatment of neurogenic bladder and bowel dysfunction in patients with spina bifida. METHODS: The clinical data of 33 patients with neurogenic bladder and bowel dysfunction caused by spina bifida treated with SNM between July 2012 and May 2021 were retrospectively analyzed. There were 19 males and 14 females, with an average age of 26.0 years (range, 18.5-36.5 years). The disease duration ranged from 12 to 456 months, with an average of 195.8 months. The types of spina bifida included 8 cases of occult spina bifida and 25 cases of meningocele/myelomeningocele. Clinical symptoms included 19 cases of urgency-frequent urination, 18 cases of urinary incontinence, 27 cases of chronic urinary retention, and 29 cases of bowel dysfunction. Image urodynamics showed that 4 patients had detrusor overactivity (DO) and 29 patients had detrusor underactivity (DU). Vesicoureteral reflux (VUR) was found in 5 ureters (4 patients). SNM procedure was divided into experiential treatment and permanent implantation. Patients who were evaluated as successful or willing to be permanently implanted after experiential treatment would implant the permanent pulse generator. RESULTS: The duration of experiential treatment was 14-28 days, with an average of 19.2 days; there was no complication during this period, and the overall success rate was 69.69% (23/33). At the end of experiential treatment, the urination frequency in 24 hours, urine volume per time, urinary urgency score, and urine leakage of patients were significantly improved when compared with those before experiential treatment ( P<0.05); there was no significant difference in postvoid residual volume between before and after experiential treatment ( t=1.383, P=0.179). The success rate of patients with chronic urinary retention after experiential treatment (25.93%) was significantly lower than that of urgency-frequent urination (63.16%) and urinary incontinence (61.11%) ( χ 2=7.260, P=0.064). Compared with those before experiential treatment, the maximum cystometric capacity and compliance increased and the maximum detrusor pressure during filling decreased significantly ( P<0.05). Among the 4 patients with DO before experiential treatment, DO disappeared in 2 cases; 27 patients with DU before experiential treatment did not recover the normal contraction of detrusor during micturition. Among the 5 ureters with VUR before experiential treatment, 2 VUR disappeared at the end of experiential treatment, and the VUR grade or the bladder volume before VUR of the other 3 ureters were improved. At the end of experiential treatment, the neurogenic bowel dysfunction (NBD) score and the grade of bowel dysfunction significantly improved ( P<0.05). A total of 19 patients received permanent implantation, of which 11 patients needed to empty the bladder in combination with intermittent catheterization. CONCLUSION: SNM is effective for neurogenic bladder and bowel dysfunction in patients with spina bifida. At the same time, it can significantly improve the urodynamic parameters during urine storage and avoid upper urinary tract damage.

Combining Visual Rating Scales for Medial Temporal Lobe Atrophy and Posterior Atrophy to Identify Amnestic Mild Cognitive Impairment from Cognitively Normal Older Adults: Evidence Based on Two Cohorts.

BACKGROUND: Visual rating scales for medial temporal lobe atrophy (MTA) and posterior atrophy (PA) have been reported to be useful for Alzheimer's disease diagnosis in routine clinical practice. OBJECTIVE: To investigate the efficacy of combined MTA and PA visual rating scales to discriminate amnestic mild cognitive impairment (aMCI) patients from healthy controls. METHODS: This study included T1-weighted MRI images from two different cohorts. In the first cohort, we recruited 73 patients with aMCI and 48 group-matched cognitively normal controls for training and validation. Visual assessments of MTA and PA were carried out for each participant. Global gray matter volume and density were estimated using voxel-based morphometry analysis as the objective reference. We investigated the discriminative power of a single visual rating scale and the combination of the MTA and PA rating scales for identifying aMCI. The second cohort, consisting of 33 aMCI patients and 45 controls, was used to verify the reliability of the visual assessments. RESULTS: Compared with the single visual rating scale, the combination of the MTA and PA exhibited the best discriminative power, with an AUC of 0.818±0.041, which was similar to the diagnostic accuracy of the gray matter volumetric measures. The discriminative power of the combined MTA and PA was verified in the second cohort (AUC 0.824±0.058). CONCLUSION: The combined MTA and PA rating scales demonstrated practical diagnostic value for distinguishing aMCI patients from controls, suggesting its potential to serve as a convenient and reproducible method to assess the degree of atrophy in clinical settings.

Theoretical analysis of a noncollinear phase-matched optical parametric amplifier seeded by an optical parametric generation.

We have theoretically analyzed the characteristics of an optical parametric amplifier system seeded by an optical parametric generation. We investigated the influences of the energy, pulse duration, material dispersion, and the third-order nonlinear effect in beta-barium borate. The group-velocity mismatch (GVM) becomes the most important factor for the amplification of bandwidths. Even though tilting the wave front of the pump can decrease the GVM, it seems impossible to generate pulses smaller than 10-fs with 400-nm pumping. However, 10-fs pulses can be achieved with a 30-fs pump duration with pumping at 800 nm.

Spatial chirp and angular dispersion of a laser crystal for a four-mirror cavity Kerr-lens mode-locked laser.

We describe oscillating loops in a laser cavity and optical paths in a laser crystal of different wavelength rays for a four-mirror cavity Kerr-lens mode-locked laser. The relation between different wavelength ray paths and laser resonator parameters is deduced. The analytical expressions of second- and third-order dispersion including angular dispersion of the crystal are presented. The variations of group-delay dispersion (GDD) and third-order dispersion (TOD) with cavity parameters are calculated exactly. The calculation shows that GDD and TOD increase rapidly when the spacing between two folding mirrors approaches the boundary of a cavity stability zone. The rapid dispersion increase influences the mode-locked pulse width and the mode-locked stability.