Monitoring and evaluation of anesthesia depth status data based on neuroscience.

Monitoring and analysis of anesthesia depth status data refers to evaluating the anesthesia depth status of patients during the surgical process by monitoring their physiological index data, and conducting analysis and judgment. The depth of anesthesia is crucial for the safety and success of the surgical process. By monitoring the state of anesthesia depth, abnormal conditions of patients can be detected in a timely manner and corresponding measures can be taken to prevent accidents from occurring. Traditional anesthesia monitoring methods currently include computer tomography, electrocardiogram, respiratory monitoring, etc. In this regard, traditional physiological indicator monitoring methods have certain limitations and cannot directly reflect the patient's neural activity status. The monitoring and analysis methods based on neuroscience can obtain more information from the level of brain neural activity. PURPOSE: In this article, the monitoring and analysis of anesthesia depth status data would be studied through neuroscience. METHODS: Through a controlled experiment, the monitoring accuracy of traditional anesthesia status monitoring algorithm and neuroscience-based anesthesia status monitoring algorithm was studied, and the information entropy and oxygen saturation of electroencephalogram signals in patients with different anesthesia depth were explored. RESULTS: The experiment proved that the average monitoring accuracy of the traditional anesthesia state monitoring algorithm in patients' blood drug concentration and oxygen saturation reached 95.55 and 95.00%, respectively. In contrast, the anesthesia state monitoring algorithm based on neuroscience performs better, with the average monitoring accuracy of drug concentration and oxygen saturation reaching 98.00 and 97.09%, respectively. This experimental result fully proved that the monitoring performance of anesthesia state monitoring algorithms based on neuroscience is better. CONCLUSION: The experiment proved the powerful monitoring ability of the anesthesia state monitoring algorithm based on neuroscience used in this article, and explained the changing trend of brain nerve signals and oxygen saturation of patients with different anesthesia depth states, which provided a new research method for the monitoring and analysis technology of anesthesia depth state data.

Fast Blood Oxygenation through Hemocompatible Asymmetric Polymer of Intrinsic Microporosity Membranes.

Membrane technology has attracted considerable attention for chemical and medical applications, among others. Artificial organs play important roles in medical science. A membrane oxygenator, also known as artificial lung, can replenish O2 and remove CO2 of blood to maintain the metabolism of patients with cardiopulmonary failure. However, the membrane, a key component, is subjected to inferior gas transport property, leakage propensity, and insufficient hemocompatibility. In this study, we report efficient blood oxygenation by using an asymmetric nanoporous membrane that is fabricated using the classic nonsolvent-induced phase separation method for polymer of intrinsic microporosity-1. The intrinsic superhydrophobic nanopores and asymmetric configuration endow the membrane with water impermeability and gas ultrapermeability, up to 3,500 and 1,100 gas permeation units for CO2 and O2, respectively. Moreover, the rational hydrophobic-hydrophilic nature, electronegativity, and smoothness of the surface enable the substantially restricted protein adsorption, platelet adhesion and activation, hemolysis, and thrombosis for the membrane. Importantly, during blood oxygenation, the asymmetric nanoporous membrane shows no thrombus formation and plasma leakage and exhibits fast O2 and CO2 transport processes with exchange rates of 20 to 60 and 100 to 350 ml m-2 min-1, respectively, which are 2 to 6 times higher than those of conventional membranes. The concepts reported here offer an alternative route to fabricate high-performance membranes and expand the possibilities of nanoporous materials for membrane-based artificial organs.

Excellent response of refractory triple-negative breast cancer to sintilimab plus chemotherapy: a case report.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with a high propensity for invasion and a high incidence of lymph node metastasis. Systemic chemotherapy is considered the primary treatment for patients with TNBC; however, immune checkpoint inhibitors in addition to chemotherapy have been associated with better outcomes. Sintilimab, an anti-PD-1 antibody, was developed in China. Herein, the authors report a 49-year-old woman diagnosed with TNBC with extensive lung and sternal metastases. Treatment with sintilimab plus paclitaxel and carboplatin was found highly effective after failure of first-line chemotherapy. This combinational therapy can be considered for the treatment of TNBC after necessary investigations and clinical trials.

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that has no target for endocrine or targeted therapy, and the standard treatment for patients with TNBC was chemotherapy alone. Recent studies have suggested that immune checkpoint inhibitors plus chemotherapy might be effective and safe for advanced TNBC. Pembrolizumab and atezolizumab have been approved by the US FDA for the treatment of PD-L1-positive TNBC patients. Sintilimab, a Chinese immune checkpoint inhibitor, has not been reported in the treatment of TNBC. This case report presents excellent outcomes of a patient with TNBC who received sintilimab plus chemotherapy after the failure of standard chemotherapy. This combinational therapy can be considered for the treatment of TNBC after necessary investigations and clinical trials.

Pramipexole Protects Against Traumatic Brain Injury-Induced Blood-Brain Barrier (BBB) Dysfunction.

Traumatic brain injury (TBI) is a severe disease of brain damage accompanied by blood-brain barrier (BBB) dysfunction. The BBB is composed of brain microvascular endothelial cells (BMECs), astrocyte terminus, pericytes, and a basement membrane. Tight junction proteins expressed by BMECs play important roles in preserving BBB integrity. Pramipexole is a selective dopamine agonist applied for treating Parkinson's disease and has been recently claimed with neuroprotective capacity. This study will further explore the impact of Pramipexole on tight junctions and BBB integrity to provide the potential treatment strategy for TBI-induced BBB damage. The TBI model was established in mice and was identified by the promoted brain water content, declined Garcia scores, reduced latency of the rotarod test, aggravated pathological changes in the brain cortex, and excessively released inflammatory factors. After treatment with Pramipexole, the neurofunctional deficits, behavioral disability, and aggravated pathological changes were dramatically reversed, accompanied by the alleviated BBB permeability, and upregulated occludin, an important tight junction protein. TBI model cells were established by the scratching bEnd.3 cells method. Cells were stimulated with 10 and 20 µM Pramipexole, followed by exposure to TBI. Increased fluorescence intensity of FITC-dextran, reduced value of TEER, and downregulated occludin and KLF2 were observed in TBI-exposed cells, all of which were greatly reversed by 10 and 20 µM Pramipexole. Furthermore, in KLF2-silenced bEnd.3 cells, the protective ability of Pramipexole against endothelial permeability and the expression level of occludin were dramatically abolished. Collectively, our results suggest that Pramipexole protected against TBI-induced BBB dysfunction by mediating KLF2.

Empagliflozin Ameliorates Diabetic Cardiomyopathy via Attenuating Oxidative Stress and Improving Mitochondrial Function.

Diabetic cardiomyopathy (DCM) is considered to be a critical contributor to the development of heart failure. Empagliflozin (EMPA), a sodium-glucose cotransporter 2 inhibitor, has been shown to prevent cardiovascular events and reduce the incidence of heart failure in randomized clinical trials. However, the mechanism of how EMPA prevents DCM is poorly understood. To study the potential mechanisms involved in the therapeutic effects of EMPA, we assessed the protective effects of EMPA on myocardial injury in type 2 diabetic db/db mice and H9C2 cardiomyocytes. 9-10-week-old male db/db mice were treated with EMPA (10 mg/kg) via oral gavage daily for 20 weeks. Afterward, cardiac function of treated mice was evaluated by echocardiography, and pathological changes in heart tissues were determined by histopathological examination and western blot assay. EMPA markedly reduced blood glucose levels, improved insulin tolerance, and enhanced insulin sensitivity of db/db mice. In addition, EMPA significantly prevented cardiac dysfunction, inhibited cardiac hypertrophy and fibrosis, and reduced glycogen deposition in heart tissues. Furthermore, EMPA improved diabetes-induced oxidative stress and mitochondrial dysfunction in both heart tissues of db/db mice and palmitate exposed H9C2 cells. EMPA significantly increased the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream genetic targets in cardiac tissue of type 2 diabetic db/db mice and H9C2 cells. EMPA also downregulated the expression of mitochondrial fission-related proteins and upregulated the expression of mitochondrial fusion-related proteins. Collectively, these findings indicate that EMPA may prevent DCM via attenuating oxidative stress and improving mitochondrial function in heart tissue.

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis.

LAY ABSTRACT: Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11-17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7-10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures.

Analysis of the Key Factors Affecting the Productivity of Coalbed Methane Wells: A Case Study of a High-Rank Coal Reservoir in the Central and Southern Qinshui Basin, China.

In the present study, three CBM blocks in the central and southern Qinshui Basin, China, including Fanzhuang, Zhengzhuang, and Changzhi blocks, were selected. Combined with the data, such as the physical properties of coal reservoirs, logging, hydrofracture operation, injection/drawdown well testing, microseismic fracture monitoring technology, and over 2000 days gas production rate, the key factors affecting the gas production rate of CBM wells were analyzed comprehensively and systematically. Unimodal and bimodal models can be identified according to the long-term gas production rate data. The unimodal model corresponds to a declining pump pressure curve, meaning that caprock integrity is destroyed during hydrofracture operations, commonly causing poor gas production performance. The bimodal model is associated with fluctuating-rising and stable pump pressure curves, indicating good hydrofracture consequences. On the premise of the relatively high gas content, the gas saturation/critical-reservoir pressure ratio, permeability, and coal deformation are the major geological factors that affect the long-term gas production performance of CBM wells. Engineering factors, including pollution by the drilling fluid and cement paste, the type of the fracturing fluid, tonstein intercalation, coal deformation, and in situ stress, affect gas production performances via the following four mechanisms: the effect of hydrofracture operations on caprock integrity, the effect of fluids pumped on the pore-fracture system, the initiation and propagation of artificially induced fractures, and the performances of proppants pumped. This work can provide guidelines for the optimization and development of high-rank CBM blocks.

Formation Environment and Development Models for the Lower Cambrian Source Rocks of the Southern North China Plate, China.

In this article, the lower Cambrian marine shale of the southern part of the Ordos basin is taken as an example to investigate the formation environment and development models of source rocks with high organic abundance in the ancient strata of the southern North China plate. The lower Cambrian shale source rocks had a thickness of 10-80 m, with high total organic carbon contents (an average of 2.68% and maximum of 9.39%) and favorable organic matter types-mainly sapropelinite macerals-and yet low S1, S2, and hydrogen index, which indicate that the source rocks have relatively high thermal maturity. Therefore, it is demonstrated that marine shale of the lower Cambrian proves to be excellent gas source rocks at the southern part of the Ordos basin and are presently distributed mainly in the south part of the North China plate. During the early Cambrian period, paleoproductivity was relatively high, as indicated by the rich C27 sterane contents, high sterane/hopane ratios, and high tricyclic terpane/hopane ratios in biomarkers and high P and Ba values in trace elements. The tectonic setting promoted the formation of highly abundant source rocks with favorable preservation conditions, as suggested by the relatively high V/Cr ratios and low Zr/Rb and Pr/Ph ratios. Thus, the paleoproductivity and preservation conditions were the main factors controlling the occurrence of highly abundant source rocks. The formation of highly abundant source rocks was under the joint effects of the tectonic setting and the undercompensation environments of the passive continental marginal slope of the Paleo-Qinling Ocean and deepwater bays. The paleo-geomorphologic troughs and/or fault depressions (because of tectonic movement) and deepwater bay environments together influenced the development scale of highly abundant source rocks, whereas the deepwater shelf environment of the continental marginal slope ensured the high quality of the source rocks.

Indicated Prevention Interventions in the Workplace for Depressive Symptoms: A Systematic Review and Meta-analysis.

CONTEXT: Depressive symptoms are highly prevalent and cause substantive morbidities and loss of functioning among employees. Depression may be prevented at its early stages. However, there is a paucity of information regarding indicated preventive interventions for depression among employees. The objective of this review is to examine the effectiveness of indicated interventions for the reduction of depressive symptoms in the workplace. EVIDENCE ACQUISITION: A systematic review and meta-analysis of articles published between January 2000 and September 2017 was conducted using major electronic databases, including PubMed/MEDLINE, PsycINFO, EMBASE, SOCINDEX, and ABI/ProQuest. Studies were selected based on a set of predefined inclusion criteria. Primary outcome measures were depressive symptomatology, and the interventions were preventive in nature. Studies were pooled based on the intervention type and the effect size was measured using the standardized mean difference. EVIDENCE SYNTHESIS: A computer and hand search of the literature yielded 4,462 papers, from which 16 trials were identified to be suitable for meta-analysis. Eight of 16 studies reported significant effects for workplace preventive interventions targeting depressive symptoms in which six were cognitive behavioral therapy (CBT)-based interventions and two were non-CBT-based interventions. Small to medium effect sizes were found for both CBT- and non-CBT-based interventions (standardized mean difference= -0.44, 95% CI= -0.61, -0.26, I2=62.1% and standardized mean difference= -0.32, 95% CI= -0.59, -0.06, I2=58%, respectively). CONCLUSIONS: This review demonstrates that indicated interventions can significantly reduce the level of depressive symptoms among workers. The implementation of evidence-based workplace interventions should consequently be considered to prevent the development of depressive symptoms among employees.

Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials.

Common mental health problems (CMHPs), such as depression, anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) are internalizing disorders with high comorbidity. University and college students are under many stressors and transitional events, and students fall within the age range when CMHPs are at their developmental peak. Compared to the expanded effort to explore and treat CMHPs, there has been no a meta-analysis that comprehensively reviewed the interventions for CMHPs and examined the effects of interventions for CMHPs in college students. The objective of this review is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining interventions for CMHPs among university and college students and to estimate their post-intervention effect size (ES), as well as follow-up ES, for depression, anxiety disorder, OCD and PTSD separately. Meta-analytic procedures were conducted in accordance with PRISMA guidelines. We reviewed 7768 abstracts from which 331 full-text articles were reviewed and 51 RCTs were included in the analysis. We found moderate effect sizes for both depression (Hedges' g = -0.60) and anxiety disorder (Hedges' g = -0.48). There was no evidence that existing interventions for OCD or PTSD were effective in this population. For interventions with high number of papers, we performed subgroup analysis and found that cognitive behavioral therapy (CBT) and mindfulness-based interventions were effective for both depression and generalized anxiety disorder (GAD), and attention/perception modification was effective for GAD; other interventions (i.e. art, exercise and peer support) had the highest ES for both depression and GAD among university and college students.

Effects of different CYP2C19 genotypes on prognosis of patients complicated with atrial fibrillation taking clopidogrel after PCI.

The effects of different cytochrome P450 2C19 (CYP2C19) genotypes on the prognosis of clopidogrel resistance in patients complicated with atrial fibrillation taking clopidogrel after percutaneous coronary intervention (PCI) were investigated. Eighty patients who were complicated with atrial fibrillation and treated with clopidogrel antiplatelet therapy after PCI in Meizhou Hospital Affiliated to Zhongshan University from September 2015 to January 2017 were selected, and divided into two groups according to the CYP2C19 genotype: extensive metabolism (EM) group and poor metabolism (PM) group. The related risk factors of clopidogrel resistance were determined, and the platelet aggregation rate and clopidogrel resistance rate were compared between the two groups during treatment. Non-fatal myocardial infarction and serious life-threatening complications in the two groups were observed. The increased total cholesterol level and the history of smoking and drinking were the independent risk factors of atrial fibrillation after PCI. The platelet aggregation rates in the EM group at 1, 3 and 12 months after medication were significantly lower than those in the PM group in the same period (P<0.05). The clopidogrel resistance rates in EM group before medication and at 1, 3 and 12 months after medication were higher than those in PM group in the same period (P<0.05). The onset time of non-fatal myocardial infarction in EM group was earlier than that in PM group (P<0.05), the infarct area was larger than that in PM group (P<0.05), and the left ventricular ejection fraction (EF) after onset was lower than that in PM group (P<0.05). In conclusion, the increased total cholesterol level and the history of smoking and drinking are the independent risk factors of clopidogrel resistance in patients complicated with atrial fibrillation after PCI. The incidence rates of cardiac complications are increased significantly in patients with PM CYP2C19 genotype.

Relevant and independent multi-block approach for plant-wide process and quality-related monitoring based on KPCA and SVDD.

Due to prior knowledge being often unavailable in practice, a multi-block strategy totally based on data-driven analytics is an appropriate alternative for plant-wide processes. However, most recent multi-block methods are relatively vague or insufficient for dividing up the process space and lack the comprehensive fault information for quality-related monitoring. This work intends to develop a more reasonable multi-block method and demonstrate the negative impacts of quality-unrelated variables. Both motivations are entirely dependent on the correlation between variables. A major innovation is to determine those independent or related sets of variables, and to provide a more precise indication for those quality-related faults. Sub-blocks with related variables are each modeled by the KPCA, and the rest of the independent variables are treated as an input for a SVDD model. Finally, all of the statistical indicators are aggregated into a single statistic through Bayesian inference. The benefits of the proposed multi-block scheme (MKPCA-SVDD) are elaborated on in detail using numerical simulation, TE benchmark and industrial p-xylene oxidation process.

The effect of transient glare on shape discrimination threshold in myopic adults.

BACKGROUND: The aim was to evaluate the effect of transient glare on shape discrimination threshold (SDT) in myopic adults. METHODS: A total of 162 myopic subjects were enrolled. Of these, 121 had low to mid myopia (-1.00 D to -6.00 D) and 41 had high myopia (-6.13 D to -10.25 D). All subjects had corrected visual acuity of 6/6 or better, and only data for the right eye were included in the study. SDTs were measured with circular D4 (fourth derivative of Gaussian) radial frequency patterns with a radial frequency of four, peak spatial frequency of three cpds, and mean radius of 1.5 degrees. SDTs were measured under two conditions, with and without the presence of transient glare while the stimulus was displayed (duration = 500 ms). RESULTS: Without transient glare, SDTs were not different between the low-mid (23.84 ± 6.02 arcsec) and high myopia groups (25.17 ± 5.98 arcsec, p = 0.16, Mann-Whitney test). With transient glare, SDTs in all subjects became significantly higher (p < 0.001, Wilcoxon signed-rank test). SDTs in the high myopia group (55.53 ± 18.59 arcsec) became significantly higher than those in the low to mid myopia group (47.55 ± 15.06 arcsec, p = 0.014, Mann-Whitney test). The increments were significantly higher in the high myopia group (28.94 arcsec versus 20.88 arcsec, p = 0.031, Mann-Whitney test). Multiple regression showed that SDTs with glare were significantly associated with SDTs without glare (p < 0.001) and the presence of high myopia (p = 0.015). CONCLUSIONS: Transient glare significantly increased SDTs in all myopic subjects, with the increment in subjects with high myopia being significantly larger than those in subjects with low to mid myopia.

Physical fitness status of children and adolescents in Tianjin of China during past three decades: a cross-sectional study.

BACKGROUND: Significant changes in the society and lifestyle have been observed in China, which influences the physical fitness status of children and adolescents. This study aimed to estimate the physical fitness status in Tianjin during the past three decades. METHODS: Cross sectional survey was used in this study. The data were derived from the Chinese National Students' Physical Health Survey database (1985-2010) using stratified cluster randomized sampling method. A total of 58,006 subjects aged 7-21 were recruited. The ethics approval was obtained from the Ethics Committee of Tianjin Medical University before collecting data from the children and adolescents, and/or their parents/guardians on behalf of them. Also written informed consent was obtained before collecting data from the patients. The secular trend of the physical fitness status, Levels of height, weight, body mass index, and chest circumference in China were calculated. The increase velocity of according indexes were analyzed, gender and rural/urban difference were discussed afterwards. SPSS16.0 was used in the analysis. RESULTS: Levels of height, weight, body mass index, and chest circumference were obviously increased in 2010 compared to those levels in 1985, especially in the 9-13 age group. It was observed that the increase in the two crosses for height velocity between two genders of rural students was disappeared and the age of seven was important for the physical development. CONCLUSIONS: The circumstance was good for the physical development of the children and adolescents. The disappearance of the two crosses for height velocity between two genders of rural students in this study might be associated with factors such as nutritional status.