Trans-Defect Underlay Watertight Duraplasty for Traumatic Anterior Skull Base Dural Defect: Technical Report.

BACKGROUND: Watertight duraplasty is essential for surgical management of traumatic anterior skull base (ASB) dural defect but challenging in the deep and narrow operative corridor. Here, the authors report a trans-defect underlay watertight duraplasty (TDUWD) technique for traumatic ASB dural defect. METHODS: TDUWD was performed by inserting a free pericranium graft under the dural defect. The diameter of the pericranium graft was larger than the dural defect. The pericranium graft was sutured to the dural defect watertightly in an "inside-to-outside" direction, with the needle not penetrating the inner layer of pericranium graft. The pedicled pericranium flap was used as a second layer of reconstruction. The characteristics, complications, and outcomes of patients who received TDUWD are reported. RESULTS: A total of 29 patients received TDUWD. Immediate postoperative cessation of cerebrospinal fluid (CSF) leak occurred in 28 patients. One patient recovered after lumber drainage. No patient needed a second operation or reported delayed recurrence of CSF leak. No complication related to the surgical technique was observed. CONCLUSIONS: Use of TDUWD for traumatic ASB dural defect results in an immediate, 1-stage, and definitive correction of CSF leak and seems to be simple, safe, and reliable for large and deeply located dural defects.

Effects of Polycyclic Aromatic Hydrocarbon Exposure and Telomere Length and their Interaction on Blood Lipids in Coal Miners.

OBJECTIVE: This study aimed to investigate the effects of polycyclic aromatic hydrocarbon (PAH) exposure and telomere length on lipids in coal miners. METHODS: Basic personal information of 637 coal miners was collected by questionnaire survey. Logistic regression, the Bayesian kernel machine regression model, and weighted quantile sum regression were used to analyze the effects of PAH metabolites and telomere length and their interactions on blood lipids. RESULTS: High exposure to 9-hydroxyphenanthrene (OR = 1.586, 95% CI: 1.011-2.487) and telomere shortening (OR = 1.413, 95% CI: 1.005-1.985) were associated with dyslipidemia. Weighted quantile sum results showed that 9-hydroxyphenanthrene accounted for the largest proportion of dyslipidemia (weight = 0.66). The interaction results showed that high 9-hydroxyphenanthrene exposure and short telomeres were risk factors for dyslipidemia in coal miners (OR = 2.085, 95% CI: 1.121-3.879). Conclusions: Our findings suggest that 9-hydroxyphenanthrene and shorter telomeres are risk factors for dyslipidemia, and their interaction increases the risk of dyslipidemia.

Effect of powdered vancomycin on stopping surgical site wound infections in neurosurgery: A meta-analysis.

We performed a meta-analysis to evaluate the effect of powdered vancomycin on stopping surgical site wound infections in neurosurgery. A systematic literature search up to July 2022 was performed and 24 137 subjects with neurosurgery at the baseline of the studies; 10 496 of them were using the powdered vancomycin, and 13 641 were not using the powdered vancomycin as a control. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated to assess the effect of powdered vancomycin on stopping surgical site wound infections in neurosurgery using dichotomous methods with a random or fixed-effect model. The powdered vancomycin had significantly lower surgical site wound infections after spinal surgery (OR, 0.53; 95% CI, 0.41-0.70, P < .001), deep surgical site wound infections after spinal surgery (OR, 0.45; 95% CI, 0.35-0.57, P < .001), superficial surgical site wound infections after spinal surgery (OR, 0.60; 95% CI, 0.43-0.83, P = .002), and surgical site wound infections after cranial surgery (OR, 0.37; 95% CI, 0.22-0.61, P < .001) compared to control in subjects with neurosurgery. The powdered vancomycin had significantly lower surgical site wound infections after spinal surgery, deep surgical site wound infections after spinal surgery, superficial surgical site wound infections after spinal surgery, and surgical site wound infections after cranial surgery compared to control in subjects with neurosurgery. The analysis of outcomes should be done with caution even though the low number of studies with low sample size, 3 out of the 42 studies, in the meta-analysis, and a low number of studies in certain comparisons.

Intracranial-Pressure-Monitoring-Assisted Management Associated with Favorable Outcomes in Moderate Traumatic Brain Injury Patients with a GCS of 9-11.

Objective: With a mortality rate of 10−30%, a moderate traumatic brain injury (mTBI) is one of the most variable traumas. The indications for intracranial pressure (ICP) monitoring in patients with mTBI and the effects of ICP on patients' outcomes are uncertain. The purpose of this study was to examine the indications of ICP monitoring (ICPm) and its effects on the long-term functional outcomes of mTBI patients. Methods: Patients with Glasgow Coma Scale (GCS) scores of 9−11 at Tangdu hospital, between January 2015 and December 2021, were enrolled and treated in this retrospective cohort study. We assessed practice variations in ICP interventions using the therapy intensity level (TIL). Six-month mortality and a Glasgow Outcome Scale Extended (GOS-E) score were the main outcomes. The secondary outcome was neurological deterioration (ND) events. The indication and the estimated impact of ICPm on the functional outcome were investigated by using binary regression analyses. Results: Of the 350 patients, 145 underwent ICP monitoring-assisted management, and the other 205 patients received a standard control based on imaging or clinical examinations. A GCS ≤ 10 (OR 1.751 (95% CI 1.216−3.023), p = 0.003), midline shift (mm) ≥ 2.5 (OR 3.916 (95% CI 2.076−7.386) p < 0.001), and SDH (OR 1.772 (95% CI 1.065−2.949) p = 0.028) were predictors of ICP. Patients who had ICPm (14/145 (9.7%)) had a decreased 6-month mortality rate compared to those who were not monitored (40/205 (19.5%), p = 0.011). ICPm was linked to both improved neurological outcomes at 6 months (OR 0.815 (95% CI 0.712−0.933), p = 0.003) and a lower ND rate (2 = 11.375, p = 0.010). A higher mean ICP (17.32 ± 3.52, t = −6.047, p < 0.001) and a more significant number of ICP > 15 mmHg (27 (9−45.5), Z = −5.406, p < 0.001) or ICP > 20 mmHg (5 (0−23), Z = −4.635, p < 0.001) 72 h after injury were associated with unfavorable outcomes. The best unfavorable GOS-E cutoff value of different ICP characteristics showed that the mean ICP was >15.8 mmHg (AUC 0.698; 95% CI, 0.606−0.789, p < 0.001), the number of ICP > 15 mmHg was >25.5 (AUC 0.681; 95% CI, 0.587−0.774, p < 0.001), and the number of ICP > 20 mmHg was >6 (AUC 0.660; 95% CI, 0.561−0.759, p < 0.001). The total TIL score during the first 72 h post-injury in the non-ICP group (9 (8, 11)) was lower than that of the ICP group (13 (9, 17), Z = −8.388, p < 0.001), and was associated with unfavorable outcomes. Conclusion: ICPm-assisted management was associated with better clinical outcomes six months after discharge and lower incidences of ND for seven days post-injury. A mean ICP > 15.8 mmHg, the number of ICP > 15 mmHg > 25.5, or the number of ICP > 20 mmHg > 6 implicate an unfavorable long-term prognosis after 72 h of an mTBI.

Predicting Neurological Deterioration after Moderate Traumatic Brain Injury: Development and Validation of a Prediction Model Based on Data Collected on Admission.

Moderate traumatic brain injury (mTBI) is a heterogeneous entity that is poorly defined in the literature. Patients with mTBI have a high rate of neurological deterioration (ND), which is usually accompanied by poor prognosis and no definitive methods to predict. The purpose of this study is to develop and validate a prediction model that estimates the ND risk in patients with mTBI using data collected on admission. Data for 479 patients with mTBI collected retrospectively in our department were analyzed by logistic regression models. Bivariable logistic regression identified variables with a p < 0.05. Multi-variable logistic regression modeling with backward stepwise elimination was used to determine reduced parameters and establish a prediction model. The discrimination efficacy, calibration efficacy, and clinical utility of the prediction model were evaluated. The prediction model was validated using data for 176 patients collected from another hospital. Eight independent prognostic factors were identified: hypertension, Marshall scale (types III and IV), subdural hemorrhage (SDH), location of contusion (frontal and temporal contusions), Injury Severity Score >13, D-dimer level >11.4 mg/L, Glasgow Coma Scale score ≤10, and platelet count ≤152 × 109/L. A prediction model was established and was shown as a nomogram. Using bootstrapping, internal validation showed that the C-statistic of the prediction model was 0.881 (95% confidence interval [CI]: 0.849-0.909). The results of external validation showed that the nomogram could predict ND with an area under the curve of 0.827 (95% CI: 0.763-0.880). The present model, based on simple parameters collected on admission, can predict the risk of ND in patients with mTBI accurately. The high discriminative ability indicates the potential of this model for classifying patients with mTBI according to ND risk.

The Impact of Nonminimum-Phase Zeros on Human-in-the-Loop Control Systems.

We present results from an experiment in which 33 human subjects interact with a dynamic system 40 times over a one-week period. The subjects are divided into three groups. For each interaction, a subject performs a command-following task, where the reference command is the same for all trials and all subjects. However, each group interacts with a different dynamic system, which is represented by a transfer function. The transfer functions have the same poles but different zeros. One has a minimum-phase zero , another has a nonminimum-phase zero , and the last has a slower (i.e., closer to the imaginary axis) nonminimum-phase zero zsn ∈ (0,zn) . The experimental results show that nonminimum-phase zeros tend to make dynamic systems more difficult for humans to learn to control. We use a subsystem identification algorithm to identify the control strategy that each subject uses on each trial. The identification results show that the identified feedforward controllers approximate the inverse dynamics of the system with which the subjects interact better on the last trial than on the first trial. However, the subjects interacting with the minimum-phase system are able to approximate the inverse dynamics in feedforward more accurately than the subjects interacting with the nonminimum-phase system. This observation suggests that nonminimum-phase zeros are an impediment to approximating inverse dynamics in feedforward. Finally, we provide evidence that humans rely on feedforward-step-like-control strategies with systems (e.g., nonminimum-phase systems) for which it is difficult to approximate the inverse dynamics in feedforward.

The Impact of Command-Following Task on Human-in-the-Loop Control Behavior.

This article presents results from an experiment in which 44 human subjects interact with a dynamic system 40 times over a one-week period. The subjects are divided into four groups. All groups interact with the same dynamic system, but each group performs a different sequence of command-following tasks. All reference commands have frequency content between 0 and 0.5 Hz. We use a subsystem identification algorithm to estimate the control strategy (feedback and feedforward) that each subject uses on each trial. The experimental and identification results are used to examine the impact of the command-following tasks on the subjects' performance and the control strategies that the subjects learn. Results demonstrate that certain reference commands (e.g., a sum of sinusoids) are more difficult for subjects to learn to follow than others (e.g., a chirp), and the difference in difficulty is related to the subjects' ability to match the phase of the reference command. In addition, the identification results show that differences in command-following performance for different tasks can be attributed to three aspects of the subjects' identified controllers: 1) compensating for time delay in feedforward; 2) using a comparatively accurate approximation of the inverse dynamics in feedforward; and 3) using a feedback controller with comparatively high gain. Results also demonstrate that subjects generalize their control strategy when the command changes. Specifically, when the command changes, subjects maintain relatively high gain in feedback and retain their feedforward internal model of the inverse dynamics. Finally, we provide evidence that subjects use prediction of the command (if possible) to improve performance but that subjects can learn to improve performance without prediction. Specifically, subjects learn to use feedback controllers with comparatively high gain to improve performance even though the command is unpredictable.

A multifunctional nanocellulose-based hydrogel for strain sensing and self-powering applications.

Ionic conductive hydrogel with multifunctional properties have shown promising application potential in various fields, including electronic skin, wearable devices and sensors. Herein, a highly stretchable (up to 2800% strain), tough, adhesive ionic conductive hydrogel are prepared using cationic nanocellulose (CCNC) to disperse/stabilize graphitic carbon nitride (g-C3N4), forming CCNC-g-C3N4 complexes and in situ radical polymerization process. The ionic interactions between CNCC and g-C3N4 acted as sacrificial bonds enabled highly stretchability of the hydrogel. The hydrogel showed high sensitivity (gauge factor≈5.6, 0-1.6% strain), enabling the detection of human body motion, speech and exhalation. Furthermore, the hydrogel based self-powered device can charge 2.2 µF capacitor up to 15 V from human motion. This multifunctional hydrogel presents potential applications in self-powered wearable electronics.

Monolithic Integration of Vertical Thin-Film Transistors in Nanopores for Charge Sensing of Single Biomolecules.

We propose and fabricate solid-state nanopore devices that monolithically integrate solution-gated, vertical thin-film transistors (TFTs) inside the nanopores for charge-based sensing of translocating biomolecules. The TFTs consist of zinc oxide semiconductor channels and aluminum oxide gate dielectrics, which are both conformally deposited along the inner surfaces of the nanopores via atomic layer deposition. The resultant TFT channel lengths and nanopore diameters both reach the ∼10 nm range. In translocation experiments using λ-DNAs or bovine serum antibody (BSA) proteins, the TFT-nanopore devices demonstrate concurrent detection of the ion conductance blockade signals and modulation signals in the TFT electrical current. The TFT signals show opposite signs for the negatively charged DNAs and positively charged BSAs as well as staircase signal shapes that correspond to the folding and knotting of λ-DNAs. Further experiments under various electrical biases and solution ionic strengths show that the ion blockade signals and the TFT signals have different dependence upon these experimental conditions. The TFT signals are analyzed to be consistent with the field effect sensing of the biomolecular charge, and the induced mirror charge is estimated from the signal amplitudes. This study could be a step forward to achieve charge-based single-biomolecular technology for basic research as well as for biosensing applications. It may also stimulate the development of TFT technologies for conformal integration of semiconductor electronics at the front end of nanostructures.

Long non-coding RNA MIR22HG inhibits glioma progression by downregulating microRNA-9/CPEB3.

Glioma is one of the most common and aggressive malignant intracranial tumors worldwide. Recently, non-coding RNAs have been found to play critical roles in the development of glioma. However, the exact mechanisms have not been fully elucidated. In the present study, reverse transcription-quantitative PCR was used to determine the expression level of the long non-coding RNA MIR22HG and microRNA (miR)-9, while western blot analysis was used to detect the protein expression level of CPEB3. The potential binding sites were predicted using the StarBase v2.0 online tool and the hypothesis was verified using a luciferase reporter assay. A Cell Counting Kit-8 assay was used to assess cell viability, while wound healing and Matrigel assays were used to determine the migration and invasion ability of glioma cancer cells. The results showed that MIR22HG expression level was decreased but miR-9 expression level was elevated in glioma tissues and cell lines. Furthermore, MIR22HG was found to sponge miR-9, while CPEB3 was the direct target of miR-9 in the glioma cell line. Functionally, MIR22HG regulated the proliferation, invasion and migration of the glioma cell line by targeting miR-9. CPEB3 may be involved in the progression of the glioma cell line. Taken together, these findings confirmed that MIR22HG suppressed glioma development by inhibiting the miR-9/CPEB3 axis and provides a novel therapeutic strategy for glioma treatment.

Mussel-inspired biocompatible polydopamine/carboxymethyl cellulose/polyacrylic acid adhesive hydrogels with UV-shielding capacity.

Hydrogels are attractive due to their various applications in the fields of biomedical materials, cosmetics, and biosensors. To enhance UV protection and prevent skin penetration behaviors, inspired by the mussel adhesive proteins, the functional polydopamine (PDA) is employed herein to fabricate polydopamine/carboxymethyl cellulose/polyacrylic acid (PDA/CMC/PAA) adhesive hydrogels. To disperse PDA nanoparticles well in the PAA matrix, dopamine was self-polymerized in CMC solution to form PDA/CMC complex. Acrylic acid was polymerized in PDA/CMC complex solution and cross-linked to construct UV-resistant PDA/CMC/PAA hydrogel. The morphology, rheological behavior, mechanical properties and adhesion strength of PDA/CMC/PAA hydrogels were studied by scanning electron microscopy, rotational rheometer, universal test machine. Owing to the hydrogen bonding interaction between the PDA/CMC complex and PAA, the PDA/CMC/PAA hydrogels showed high resilience and compressive strength to withstand large deformation. The hydrogels exhibited strong adhesion to various substrate surfaces, such as stainless steel, aluminum, glass and porcine skin. The biocompatibility and UV-shielding properties were investigated through culture of cells and UV irradiation test. The adhesiveness of PDA promoted cell adhesion and provided the PDA/CMC/PAA hydrogels good biocompatibility with 96% of relative cell viability. The hydrogels possessed excellent UV-shielding ability to prevent collagen fibers from being destroyed during UV irradiation, which has promising potential in the practical applications for UV filtration membrane and skin care products.

Implementation of PPI with Nano Amorphous Oxide Semiconductor Devices for Medical Applications.

BACKGROUND: Electronic devices which mimic the functionality of biological synapses are a large step to replicate the human brain for neuromorphic computing and for numerous medical research investigations. One of the representative synaptic behaviors is paired-pulse facilitation (PPF). It has been widely investigated because it is regarded to be related to biological memory. However, plasticity behavior is only part of the human brain memory behavior. METHODS: Here, we present a phenomenon which is opposite to PPF, i.e., paired-pulse inhibition (PPI), in nano oxide devices for the first time. The research here suggests that rather than being enhanced, the phenomena of memory loss would also be possessed by such electronic devices. The device physics mechanism behind memory loss behavior was investigated. This mechanism is sustained by historical memory and degradation manufactured by device trauma to regulate characteristically stimulated origins of artificial transmission behaviors. RESULTS: Under the trauma of a memory device, both the signal amplitude and signal time stimulated by a pulse are lower than the first signal stimulated by a previous pulse in the PPF, representing a new scenario in the struggle for memory. In this way, more typical human brain behaviors could be simulated, including the effect of age on latency and error generation, cerebellar infarct, trauma and memory loss pharmacological actions (such as those caused by hyoscines and nitrazepam). CONCLUSION: Thus, this study developed a new approach for implementing the manner in which the brain works in semiconductor devices for improving medical research.

Temperature Dependence Of AOS Thin Film Nano Transistors For Medical Applications.

BACKGROUND: A novel temperature dependent amorphous nano oxide semiconductor (AOS) thin-film transistor (TFT) is reported here for the first time, which is vastly different from conventional behavior. In the literature, the threshold voltage of TFTs decreases with increasing temperature. Here, the threshold voltage increased at higher temperatures, which is different from previously reported results and was repeated on different samples. METHODS: Electrical experiments (such as I-V measurements and photoelectron spectrometer experiments) were performed in order to explain such behavior. Double sweeping gate voltage measurements were performed to investigate the mechanism for the temperature dependent behavior. RESULTS: It was found that there was a change of trap charge under thermal stress, which was released after the stress. CONCLUSION: Non-Arrhenius behaviors (including a linear behavior) were obtained for the amorphous nano oxide thin-film transistors within 303~425 K, suggesting their potential to be adjusted by measurement processes and be applied as temperature sensors for numerous medical applications.

Carbon Nanotube Complementary Gigahertz Integrated Circuits and Their Applications on Wireless Sensor Interface Systems.

Along with ultralow-energy delay products and symmetric complementary polarities, carbon nanotube field-effect transistors (CNT FETs) are expected to be promising building blocks for energy-efficient computing technology. However, the work frequencies of the existing CNT-based complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) are far below the requirement (850 MHz) in state-of-art wireless communication applications. In this work, we fabricated deep submicron CMOS FETs with considerably improved performance of n-type CNT FETs and hence significantly promoted the work frequency of CNT CMOS ICs to 1.98 GHz. Based on these high-speed and sensitive voltage-controlled oscillators, we then presented a wireless sensor interface circuit with working frequency up to 1.5 GHz spectrum. As a preliminary demonstration, an energy-efficient wireless temperature sensing interface system was realized combining a 150 mAh flexible Li-ion battery and a flexible antenna (center frequency of 915 MHz). In general, the CMOS-logic high-speed CNT ICs showed outstanding energy efficiency and thus may potentially advance the application of CNT-based electronics.

Change Of Nano Material Electrical Characteristics For Medical System Applications.

Amorphous nano oxides (AO) are intriguing advanced materials for a wide variety of nanosystem medical applications including serving as biosensors devices with p-n junctions, nanomaterial-enabled wearable sensors, artificial synaptic devices for AI neurocomputers and medical mimicking research. However, p-type AO with reliable electrical properties are very difficult to obtain according to the literature. Based on the oxide thin film transistor, a phenomenon that could change an n-type material into a p-type semiconductor is proposed and explained here. The typical In-Ga-Zn-O material has been reported to be an n-type semiconductor, which can be changed by physical conditions, such as in processing or bias. In this way, here, we have identified a manner to change nano material electrical properties among n-type and p-type semiconductors very easily for medical application like biosensors in artificial skin.

Propoxyphene Mediates Oxyhemoglobin-Induced Injury in Rat Cortical Neurons Through Up-Regulation of Active-ß-Catenin.

Wnt/ß-catenin signaling is involved in various biological processes, including the development of the central nervous system. The dysfunction of mitochondria has been shown to participate in the progress of subarachnoid hemorrhage (SAH). Traumatic subarachnoid hemorrhage (tSAH) is a serious complication in acute craniocerebral trauma. Opioids can activate the canonical Wnt/ß-catenin signaling pathway. c-Myc, a downstream protein of Wnt/ß-catenin signaling, contributes to the fusion of mitochondria. Here, we investigated the protective roles of Propoxyphene (Pro) against Oxyhemoglobin (OxyHb)-induced primary cultured neuron apoptosis. The data indicated that Pro rescued active-ß-catenin from OxyHb-induced decline. Furthermore, Pro attenuated OxyHb-induced apoptosis and fission of mitochondria in primary cortical neurons. However, the protective effects were abrogated under active-ß-catenin-deficient conditions. Together, the data presented here showed that Pro, a weak opioid analgesic drug, attenuates OxyHb-induced mitochondria-dependent apoptosis in an active-ß-catenin-c-Myc-dependent manner.

Surgical Evacuation of Spontaneous Cerebellar Hemorrhage: Comparison of Safety and Efficacy of Suboccipital Craniotomy, Stereotactic Aspiration, and Thrombolysis and Endoscopic Surgery.

BACKGROUND: Current surgical therapies for spontaneous intracerebellar hemorrhage (SCH) include suboccipital craniotomy (SC), stereotactic aspiration and thrombolysis (SAT), and endoscopic surgery (ES). Evidence comparing the therapeutic effects of these 3 methods is scarce. The safety and efficacy of SC, SAT, and ES for SCH are still uncertain. METHODS: 75 patients with SCH who received SC, SAT, or ES were reviewed retrospectively. Baseline parameters before the operation, evacuation rate, perihematoma edema, postoperative complications, and cumulative case fatalities were collected. Also, 12 months after ictus, the long-term functional outcomes in patients with regard to fourth ventricle compression and age were judged, respectively, by the modified Rankin Scale (mRS). RESULTS: The SAT was less effective in evacuating hematoma than were SC and ES. The perihematoma edema on postoperative day 7 and surgical complications were highest in the SC group. The functional outcome represented by mRS was better in the SAT group than in the SC and ES groups for patients with fourth ventricle compression grade 1. For patients with fourth ventricle compression grades 2 and 3, the ES group achieved the best functional outcome. Patients older than 60 years benefited less from SC than from ES and SAT. CONCLUSIONS: SAT may be suitable for SCH patients with fourth ventricle compression grade 1, and ES may be suitable for SCH patients with fourth ventricle compression grades 2 and 3. Aged patients benefit less from SC than from SAT and ES.

Computed Tomography Angiography Spot Sign as an Indicator for Ultra-Early Stereotactic Aspiration of Intracerebral Hemorrhage.

BACKGROUND: Ultra-early surgical clot removal relieves mechanical compression on adjacent normal brain tissue and limits the toxic effects of a hematoma, which might improve the outcomes in patients with intracerebral hemorrhage (ICH); however, hematoma expansion frequently occurs within 20 hours after the ictus, and this limits the use of ultra-early surgery. Computed tomography angiography spot sign was recently validated as an important predictor of hematoma expansion in patients with ICH. METHODS: Fifty-nine patients with ICH and negative spot sign who received ultra-early stereotactic aspiration (<6 hours after ictus; n = 32 [Ultra-early group]) or routine stereotactic aspiration (≥6 hours after ictus; n = 27 [Routine group]) were included in retrospective analysis. RESULTS: The percentage of rebleeding was not significantly different between the 2 groups. Perihematoma edema 7 days after surgery in the Ultra-early group was significantly less frequent than that in the Routine group. For long-term outcomes, the proportion of patient fatalities and Glasgow Outcome Scale score were not significantly different between the 2 groups; however, for patients with severe symptoms, the rate of good neurological outcome in the Ultra-early group was higher than that in the Routine group. CONCLUSIONS: Ultra-early stereotactic aspiration might decrease the volume of perihematoma edema and improve the functional outcomes to some extent, without increasing the recurrence of ICH and patient fatalities. Our findings suggest that using negative spot sign as an indicator for performing ultra-early stereotactic aspiration could be a safe and effective protocol for ICH patients.

The Roles of Feedback and Feedforward as Humans Learn to Control Unknown Dynamic Systems.

We present results from an experiment in which human subjects interact with an unknown dynamic system 40 times during a two-week period. During each interaction, subjects are asked to perform a command-following (i.e., pursuit tracking) task. Each subject's performance at that task improves from the first trial to the last trial. For each trial, we use subsystem identification to estimate each subject's feedforward (or anticipatory) control, feedback (or reactive) control, and feedback time delay. Over the 40 trials, the magnitudes of the identified feedback controllers and the identified feedback time delays do not change significantly. In contrast, the identified feedforward controllers do change significantly. By the last trial, the average identified feedforward controller approximates the inverse of the dynamic system. This observation provides evidence that a fundamental component of human learning is updating the anticipatory control until it models the inverse dynamics.