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1.
J Neurosci ; 43(46): 7780-7798, 2023 11 15.
Artículo en Inglés | MEDLINE | ID: mdl-37709539

RESUMEN

Animal studies have established that the mediodorsal nucleus (MD) of the thalamus is heavily and reciprocally connected with all areas of the prefrontal cortex (PFC). In humans, however, these connections are difficult to investigate. High-resolution imaging protocols capable of reliably tracing the axonal tracts linking the human MD with each of the PFC areas may thus be key to advance our understanding of the variation, development, and plastic changes of these important circuits, in health and disease. Here, we tested in adult female and male humans the reliability of a new reconstruction protocol based on in vivo diffusion MRI to trace, measure, and characterize the fiber tracts interconnecting the MD with 39 human PFC areas per hemisphere. Our protocol comprised the following three components: (1) defining regions of interest; (2) preprocessing diffusion data; and, (3) modeling white matter tracts and tractometry. This analysis revealed largely separate PFC territories of reciprocal MD-PFC tracts bearing striking resemblance with the topographic layout observed in macaque connection-tracing studies. We then examined whether our protocol could reliably reconstruct each of these MD-PFC tracts and their profiles across test and retest sessions. Results revealed that this protocol was able to trace and measure, in both left and right hemispheres, the trajectories of these 39 area-specific axon bundles with good-to-excellent test-retest reproducibility. This protocol, which has been made publicly available, may be relevant for cognitive neuroscience and clinical studies of normal and abnormal PFC function, development, and plasticity.SIGNIFICANCE STATEMENT Reciprocal MD-PFC interactions are critical for complex human cognition and learning. Reliably tracing, measuring and characterizing MD-PFC white matter tracts using high-resolution noninvasive methods is key to assess individual variation of these systems in humans. Here, we propose a high-resolution tractography protocol that reliably reconstructs 39 area-specific MD-PFC white matter tracts per hemisphere and quantifies structural information from diffusion MRI data. This protocol revealed a detailed mapping of thalamocortical and corticothalamic MD-PFC tracts in four different PFC territories (dorsal, medial, orbital/frontal pole, inferior frontal) showing structural connections resembling those observed in tracing studies with macaques. Furthermore, our automated protocol revealed high test-retest reproducibility and is made publicly available, constituting a step forward in mapping human MD-PFC circuits in clinical and academic research.


Asunto(s)
Núcleo Talámico Mediodorsal , Corteza Prefrontal , Adulto , Animales , Humanos , Masculino , Femenino , Reproducibilidad de los Resultados , Corteza Prefrontal/diagnóstico por imagen , Tálamo , Cognición , Macaca , Vías Nerviosas/diagnóstico por imagen
2.
Comput Methods Programs Biomed ; 214: 106568, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34883382

RESUMEN

PURPOSE: Cardiac arrest (CA) is the most serious death-related event in critically ill patients and the early detection of CA is beneficial to reduce mortality according to clinical research. This study aims to develop and verify a real-time, interpretable machine learning model, namely cardiac arrest prediction index (CAPI), to predict CA of critically ill patients based on bedside vital signs monitoring. METHODS: A total of 1,860 patients were analyzed retrospectively from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Based on vital signs, we extracted a total of 43 features for building machine learning model. Extreme Gradient Boosting (XGBoost) was used to develop a real-time prediction model. Three-fold cross validation determined the consistency of model accuracy. SHAP value was used to capture the overall and real-time interpretability of the model. RESULTS: On the test set, CAPI predicted 95% of CA events, 80% of which were identified more than 25 min in advance, resulting in an area under the receiver operating characteristic curve (AUROC) of 0.94. The sensitivity, specificity, area under the precision-recall curve (AUPRC) and F1-score were 0.86, 0.85, 0.12 and 0.05, respectively. CONCLUSION: CAPI can help predict patients with CA in the vital signs monitoring at bedside. Compared with previous studies, CAPI can give more timely notifications to doctors for CA events. However, current performance was at the cost of alarm fatigue. Future research is still needed to achieve better clinical application.


Asunto(s)
Enfermedad Crítica , Paro Cardíaco , Paro Cardíaco/diagnóstico , Humanos , Aprendizaje Automático , Estudios Retrospectivos , Signos Vitales
3.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-928860

RESUMEN

Physiological parameter monitoring is essential to medical staff to evaluate, diagnose and treat patients in neonatal intensive care unit (NICU). Monitoring in NICU includes basic vital signal monitoring and functional monitoring. Basic vital signal monitoring (including ECG, respiration, SpO2, blood pressure, temperature) is advanced and focus on study of usability, continuity and anti-interference. Functional monitoring (including respiratory function, circulatory function, cerebral function) still focus on study of monitoring precision and reliability. Meanwhile, video monitoring and artifact intelligence have presented well performance on improving monitoring precision and anti-interference. In this article, the main parameters and relevant measurement technology for monitoring critical neonates were described.


Asunto(s)
Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Monitoreo Fisiológico , Reproducibilidad de los Resultados , Respiración , Tecnología , Signos Vitales
4.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-888644

RESUMEN

OBJECTIVE@#The patient monitors were used to explore the alarm fatigue in a cardiac care unit and to investigate the awareness and reaction of nurse to alarms.@*METHODS@#A semi-structured survey was taken to acquire nurses' feeling and knowledge about monitoring alarm. Three full-time researchers were scheduled to track the alarms with annotations, and analyze the alarm data of 12 patient monitors using central monitoring system.@*RESULTS@#A total of 72 310 unique alarms occurred in the 67-day study period. About 75.7% of them were physiological alarms and less than 10% of medium-low alarms were false positives. The average alarm rate was 128 alarms/patient-day.@*CONCLUSIONS@#There remains alarm fatigue in CCU, the alarm accuracy has improved than the past by applying new technologies. In some cases, clinicians will pay more attention to trend alarm and combination alarm.


Asunto(s)
Humanos , Arritmias Cardíacas , Alarmas Clínicas , Electrocardiografía , Monitoreo Fisiológico , Encuestas y Cuestionarios
5.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-922079

RESUMEN

Physiological parameters monitoring is essential to direct medical staff to evaluate, diagnose and treat critical patients quantitatively. ECG, blood pressure, SpO2, respiratory rate and body temperature are the basic vital signs of patients in the ICU. The measuring methods are relatively mature at present, and the trend is to be wireless and more accurate and comfortable. Hemodynamics, oxygen metabolism and microcirculation should be taken seriously during the treatment of acute critical patients. The related monitoring technology has made significant progress in recent years, the trend is to reduce the trauma and improve the accuracy and usability. With the development of machine vision and data fusion technology, the identification of patient behavior and deterioration has become hot topics. This review is focused on current parameters monitoring technologies, aims to provide reference for future related research.


Asunto(s)
Humanos , Unidades de Cuidados Intensivos , Monitoreo Fisiológico , Saturación de Oxígeno , Tecnología , Signos Vitales
6.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-922064

RESUMEN

OBJECTIVE@#The patient monitors were used to explore the alarm actuality in a ICU and NICU to investigate the awareness and reaction of medical staff to alarms.@*METHODS@#A series of surveys and interviews were taken to acquire clinicians' feelings and attitudes to monitoring alarms. The researchers were scheduled to track the alarms with annotations, and collect the alarm data of patient monitors using central monitoring system.@*RESULTS@#A total of 235 387 and 67 783 alarms occurred in ICU and NICU respectively. The average alarm rate was about 142 alarms/patient-day in ICU and 96 alarms/patient-day in NICU.@*CONCLUSIONS@#There remains alarm fatigue in ICU and NICU, the main reason is the large number of false alarms and clinically irrelevant alarms. In addition, patient monitor is still in the level of threshold alarms or combined alarms, the data integrity and intelligence level need to be improved in future.


Asunto(s)
Humanos , Recién Nacido , Alarmas Clínicas , Electrocardiografía , Unidades de Cuidado Intensivo Neonatal , Monitoreo Fisiológico
7.
Preprint en Inglés | bioRxiv | ID: ppbiorxiv-361576

RESUMEN

The COVID-19 pandemic is a widespread and deadly public health crisis. The pathogen SARS-CoV-2 replicates in the lower respiratory tract and causes fatal pneumonia. Although tremendous efforts have been put into investigating the pathogeny of SARS-CoV-2, the underlying mechanism of how SARS-CoV-2 interacts with its host is largely unexplored. Here, by comparing the genomic sequences of SARS-CoV-2 and human, we identified five fully conserved elements in SARS-CoV-2 genome, which were termed as "human identical sequences (HIS)". HIS are also recognized in both SARS-CoV and MERS-CoV genome. Meanwhile, HIS-SARS-CoV-2 are highly conserved in the primate. Mechanically, HIS-SARS-CoV-2, behaving as virus-derived miRNAs, directly target to the human genomic loci and further interact with host enhancers to activate the expression of adjacent and distant genes, including cytokines gene and angiotensin converting enzyme II (ACE2), a well-known cell entry receptor of SARS-CoV-2, and hyaluronan synthase 2 (HAS2), which further increases hyaluronan formation. Noteworthily, hyaluronan level in plasma of COVID-19 patients is tightly correlated with severity and high risk for acute respiratory distress syndrome (ARDS) and may act as a predictor for the progression of COVID-19. HIS antagomirs, which downregulate hyaluronan level effectively, and 4-Methylumbelliferone (MU), an inhibitor of hyaluronan synthesis, are potential drugs to relieve the ARDS related ground-glass pattern in lung for COVID-19 treatment. Our results revealed that unprecedented HIS elements of SARS-CoV-2 contribute to the cytokine storm and ARDS in COVID-19 patients. Thus, blocking HIS-involved activating processes or hyaluronan synthesis directly by 4-MU may be effective strategies to alleviate COVID-19 progression.

8.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-880395

RESUMEN

OBJECTIVE@#In order to solve alarm fatigue, the algorithm optimization strategies were researched to reduce false and worthless alarms.@*METHODS@#A four-lead arrhythmia analysis algorithm, a multiparameter fusion analysis algorithm, an intelligent threshold reminder, a refractory period delay technique were proposed and tested with collected 28 679 alarms in multi-center study.@*RESULTS@#The sampling survey indicate that the 80.8% of arrhythmia false alarms were reduced by the four-lead analysis, the 55.9% of arrhythmia and pulse false alarms were reduced by the multi-parameter fusion analysis, the 28.0% and 29.8% of clinical worthless alarms were reduced by the intelligent threshold and refractory period delay techniques respectively. Finally, the total quantity of alarms decreased to 12 724.@*CONCLUSIONS@#To increase the dimensionality of parametric analysis and control the alarm limits and delay time are conducive to reduce alarm fatigue in intensive care units.


Asunto(s)
Humanos , Fatiga de Alerta del Personal de Salud/prevención & control , Arritmias Cardíacas/diagnóstico , Alarmas Clínicas , Unidades de Cuidados Intensivos , Monitoreo Fisiológico
9.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-772516

RESUMEN

Sleep posture recognition is the core index of diagnosis and treatment of positional sleep apnea syndrome. In order to detect body postures noninvasively, we developed a portable approach for sleep posture recognition using BCG signals with their morphological difference. A type of piezo-electric polymer film sensor was applied to the mattress to acquire BCG, the discrete wavelet transform with cubic B-spline was used to extract characteristic parameters and a naive Bayes learning phase was adapted to predict body postures. Eleven healthy subjects participated in the sleep simulation experiments. The results indicate that the mean error obtained from heart rates was 0.04±1.3 beats/min (±1.96 SD). The final recognition accuracy of four basic sleep postures exceeded 97%, and the average value was 97.9%. This measuring system is comfortable and accurate, which can be streamlined for daily sleep monitoring application.


Asunto(s)
Humanos , Teorema de Bayes , Lechos , Polisomnografía , Postura , Sueño , Síndromes de la Apnea del Sueño , Diagnóstico
10.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-310238

RESUMEN

According to the characteristics of low cost, high performance, high integration and long battery life of wearable medical devices, the mainstream low-power microcontroller(MCU) series were compared, and came to the conclusion that the MCU series based on ARM Cortex-M0+ architecture were suitable for the development of wearable medical devices. In aspects of power consumption, operational performance, integrated peripherals and cost, the MCU series based on Cortex-M0+ architecture of primary semiconductor companies were compared, aimed at providing the guides of MCU selection for wearable medical devices.


Asunto(s)
Equipo Médico Durable , Suministros de Energía Eléctrica , Monitoreo Ambulatorio
11.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-476745

RESUMEN

Objective To investigate the efficacy of disodium pamidronate in treatment of bone metastasis cancer .Methods 50 cases of bone metastasis cancer were divided into control group and experimental group according to different medication, 25 cases in each group.Control group was treated by chemotherapy, experimental group was treated on the basis of control group with disodium pamidronate 45 mg+0.9%sodium chloride solution 500 mL, intravenous drip.Pain maintenance time, patient pain grading and serum NTx levels were compared after treatment.ResuIts Compared with control group,pain maintenance time of experimental group was longer(P <0.05),pain level overall score was lower,NTx was lower(P <0.05). ConcIusion Disodium pamidronate can inhibit bone metastasis cancer patients with the degree of pain, reduce the levels of serum NTx.

12.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-310328

RESUMEN

Based on the 32-bit ultra low power microcontroller STM32L151RBT6 using ARM Cortex-M3 kernel, the portable ambulatory blood pressure monitor powered by two AA batteries was designed. In order to insure the stability of power supply and prevent overpressure of cuff, super capacitor technology and new kind of safety logic circuits were used. The experimental result shows that: this solution is accurate and stable, which has high safety coefficient and a great clinical application value.


Asunto(s)
Humanos , Monitoreo Ambulatorio de la Presión Arterial , Diseño de Equipo , Programas Informáticos
13.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-259894

RESUMEN

Around the features of low power and high integration of portable electronic medical equipment design, the primary low power MCU series from the current semiconductor manufacturers were compared. The analysis results showed that the 32-bit MCUs based on the low cost and high energy efficient ARM Cortex-M architectures, have comprehensive advantages on power level, operational performance and integrated peripherals obviously.


Asunto(s)
Electrónica Médica , Diseño de Equipo
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