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1.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(10): 848-852, 2020 Oct 24.
Artigo em Chinês | MEDLINE | ID: mdl-33076622

RESUMO

Objective: To investigate the efficacy and safety of left bundle branch area pacing (LBBaP) with the new simplified approach (nine-partition method). Methods: A total of 118 patients with clinical indications and received pacemaker implantation from December 1, 2018 to December 31, 2019 in Beijing Anzhen Hospital were enrolled. LBBaP was performed with the nine-partition method (in the right anterior oblique 30° position, the ventriculogram was divided into nine partitions and the initial implant sites were located in the lower base 1/3 partitions). In X-ray image, the 3830 lead is located in the left bundle branch area, the unipolar pacing QRS wave is in the form of right bundle branch block, and the peak time from stimulation to left ventricular activation<90 ms is defined as successful operation. The clinical characters, such as the methods of venipuncture, electrode parameters, operation duration, fluoroscopy duration, the peak time from stimulation to left ventricular, pacemaker types, surgical success rate, complications, and immediate postoperative ECG parameters were collected. The patients were followed up after the operation, and the electrode parameters and postoperative complications were recorded. Results: This study is a retrospective study. There were 62 (52.5%) male patients in this cohort, the average age was (65.9±13.4) years old,and there were 49(41.5%) sick sinus syndrome, 6(5.1%) abnormal sinus node and atrioventricular node simultaneously, 63(53.4%) atrioventricular block, 26(22.0%) atrial fibrillation, 20(16.9%) cardiomyopathy; the baseline duration of QRS was (109.21±39.03) ms. Successful LBBaP was achieved in 109 patients with"nine-partition method"and the success rate was 92.4%; 104 patients (95.5%) were axillary vein puncture, 5 (4.6%) were subclavian vein puncture; the operation duration was (80.3±23.0) min, the fluoroscopy duration was (12.29±5.13) min; the QRS duration after LBBaP was (116.36±18.11) ms. The threshold of the left bundle branch (LBB) lead was (0.92±0.63) V, the R wave amplitude was (10.60±5.04) mV and the impedance was (798.71±194.90) Ω. In 1 V pacing, the peak time from stimulation to left ventricular activation was (67.91±12.15) ms, and in 5 V pacing was (67.52±12.45) ms; 1 case (0.9%) with a single-chamber pacemaker implanted, 106 cases (97.3%) with dual-chamber pacemaker and 2 cases (1.8%) with three-chamber pacemakers. There were no hematomas, pneumothorax, hemothorax, electrode dislocation, infection, and capsular hemorrhage and other serious surgery-related complications during the operation. A total of 97 patients (89.0%) were followed up for (6.21±2.90) months. The electrode parameters of all patients were stable and no complications observed. Conclusions: The LBBaP with nine-partition method is a simple, safe and effective physiological pacing approach. However, its long-term effect still needs to be further verified.


Assuntos
Bloqueio Atrioventricular , Estimulação Cardíaca Artificial , Idoso , Bloqueio de Ramo/terapia , Estudos de Viabilidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(10): 842-847, 2020 Oct 24.
Artigo em Chinês | MEDLINE | ID: mdl-33076621

RESUMO

Objective: We aimed to explore the feasibility and perioperative safety of performing catheter ablation and left atrial appendage closure (LAAC) in a single (one-stop) session in patients with atrial fibrillation (AF). Methods: This study is an observational study. Consecutive AF patients who underwent the combined procedure of catheter ablation and LAAC with Watchman device of Xinhua Hospital in Shanghai between March 2017 and May 2019 were prospectively enrolled. Baseline, intra-and peri-procedural parameters were evaluated. Results: A total of 358 AF patients (189 males, (69.0±8.0) years) underwent the one-stop procedure. The CHA2DS2-VASc score was 3.2±1.5 and HAS-BLED score was 2.4±1.1, respectively in this patient cohort. Pulmonary vein isolation was achieved in all patients, while additional linear ablation was applied in 180 (50.3%) patients, yielding immediate success rate of 99.7%. Successful Watchman implantation was achieved in all patients. The perioperative serious adverse event occurred in 14 cases (3.9%). including 6 pericardial effusions (1.7%), 1 stroke (0.3%) and 5 vascular complications (1.4%), yielding procedure-related complication rate of 3.4%. In addition, 2 (0.6%) new-onset heart failures occurred postoperatively. There was no major bleeding or death during the perioperative period. Conclusions: Combined catheter ablation and LAAC can be successfully and safely performed in AF patients with high stroke risk. Follow-up data are needed to evaluate the outcome of this one-stop procedure.


Assuntos
Apêndice Atrial , Ablação por Cateter , Idoso , Apêndice Atrial/cirurgia , China , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 863-869, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047720

RESUMO

OBJECTIVE: To explore the feasibility, safety and mid-term outcome of minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) surgery. METHODS: Data of patients who underwent MICS CABG between November 2015 and November 2017 in Peking University Third Hospital were retrospectively analyzed. Results were compared with the patients who underwent off-pump coronary aortic bypass grafting (OPCABG) surgery over the same period. The two groups were matched in propensity score matching method according to age, gender, left ventricular ejection fraction, body mass index, severity of coronary artery disease, smoking, diabetes mellitus, hypertension, hyperlipidemia, renal insufficiency, history of cerebrovascular accident, and history of chronic obstructive pulmonary disease (COPD). RESULTS: There were 85 patients in MICS CABG group, including 68 males (80.0%) and 17 females (20%), with an average age of (63.8±8.7) years; 451 patients were enrolled in OPCABG group, and 85 patients were matched by propensity score as control group (OPCABG group). There was no significant difference in general clinical characteristics (P>0.05). The average grafts of MICS CABG and OPCABG were 2.35±0.83 and 2.48±0.72 respectively (P=0.284). No conversion to thoracotomy in MICS CABG group or cardiopulmonary bypass in neither group occurred. There was no significant difference in the major adverse cardiovascular events (MACCEs, 1.17% vs. 3.52%), reoperation (2.34 vs. 3.52%), new-onset atrial fibrillation rate (4.70% vs. 3.52%) or new-onset renal insufficiency rate (1.17% vs. 0%) between MICS CABG group and OPCABG group (P>0.05). The operation time in MICS CABG group was longer than that in OPCABG group [(282.8±55.8) min vs. (246.8±56.9) min, P < 0.05], while the time of ventilator supporting(16.9 h vs. 29.6 h), hospitalization in ICU [(29.3±20.8) h vs. (51.5±48.3) h] and total hospitalization [(18.3±3.2) d vs. (25.7±4.2) d] in MICS CABG group were shorter than those in OPCABG group (P < 0.05). The total patency rate (A+B levels) of MICS CABG was 96.5% after surgery. There was no significant difference in MACCEs rate between the two groups [1.18%(1/85) vs. 3.61%(3/83), P>0.05] in 1-year follow up. CONCLUSION: The MICS CABG surgery is a safe and feasible procedure with good clinical results in early and mid-term follow-up.


Assuntos
Doença da Artéria Coronariana , Idoso , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Volume Sistólico , Resultado do Tratamento , Função Ventricular Esquerda
4.
Artigo em Inglês | MEDLINE | ID: mdl-33017935

RESUMO

Temporal enhanced ultrasound (TeUS) is a tissue characterization approach based on analysis of a temporal series of US data. Previously we demonstrated that intrinsic or external micro-motions of scatterers in the tissue contribute towards the tissue classification properties of TeUS. This property is beneficial to detect early stage cancer, for example, where changes in nuclei configuration (scatteres) dominate tissue properties. In this study, we propose an analytical derivation and experiments to acquire TeUS through manipulation of US imaging parameters, which may be simpler to translate to clinical applications. The feasibility of the proposed method is demonstrated on tissue-mimicking phantoms. Using an autoencoder classifier, we are able to classify phantoms of varying elasticities and scattering sizes.


Assuntos
Ultrassonografia , Elasticidade , Estudos de Viabilidade , Imagens de Fantasmas
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4624-4627, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019024

RESUMO

The Sports Concussion Assessment Tool (SCAT) is a pen and paper-based evaluation tool for use by healthcare professionals in the acute evaluation of suspected concussion. Here we present a feasibility study towards instrumented SCAT (iSCAT). Traditionally, a healthcare professional subjectively counts errors according to SCAT marking criteria matrix. It is hypothesized that an instrumented version of the test will be more accurate while providing additional digital-based parameters to better inform player management. The feasibility study focuses on the SCAT physical functioning tasks only: double leg stance, single-leg stance, tandem stance and tandem gait. Amateur university rugby players underwent iSCAT testing and data were recorded with 8 inertial units attached at different anatomical locations. Video data were gathered simultaneously as reference. An iSCAT algorithm was used to detect errors and quantify additional concussion-based time and frequency domain parameters to assess participant stability during balance and gait tasks. Future work aims to instrument other SCAT features such as hand-eye coordination while deploying methods within a large concussion project.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Futebol Americano , Atletas , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Estudos de Viabilidade , Humanos
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4632-4635, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019026

RESUMO

Various measurement systems can be used to obtain dynamic circumferences of the human upper body, but each of these systems has disadvantages. In this feasibility study we introduce a non-invasive and wearable thoracic belt to measure dynamic changes of circumferences of thorax or abdomen. To evaluate this approach, five subjects undertook various breaths of disparate tidal volumes, which were measured by the belt and simultaneously by a motion capture system which provided a reference metric.The results of the belt concurred with the reference system. A coefficient of determination (adjusted R2) of 0.99 and a mean squared error of less than 0.87 mm2 showed that the belt is capable of measuring changes accurately and a couple of respiratory parameters, such as the respiratory rate, can be obtained.Clinical Relevance-The introduced system links surface motions of the upper body with the underlying respiratory mechanics. Thus it provides some respiratory parameters without the disadvantages of a facemask or a mouthpiece. The system could allow the analysis of breathing status in some clinical applications and could be used for low-cost monitoring in homecare or to analyse respiratory parameters during sports.


Assuntos
Respiração , Tórax , Estudos de Viabilidade , Humanos , Projetos Piloto , Volume de Ventilação Pulmonar
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4652-4655, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019031

RESUMO

With rapid advancement in wearable biosensor technology, systems capable of real time, continuous and ambulatory monitoring of vital signs are increasingly emerging and their use can potentially help improve patient outcome. Monitoring continuous body temperature offers insights into its trend, allows early detection of fever and is critical in several diseases and clinical conditions including septicemia, infectious disease and others. There is a complex interaction between physiological and ambient parameters including heart rate, respiratory rate, muscle rigors and shivers, diaphoresis, local humidity, clothing, body, skin and ambient temperatures among others. This article presents feasibility analysis of a wireless biosensor patch device called as VitalPatch in capturing this physio-ambient-thermodynamic interaction to determine core body temperature, and details comparative performance assessments using oral thermometer and ingestible pill as reference devices. Based on a study on a cohort of 30 subjects with reference oral temperature, the proposed method showed a bias of 0.1 ± 0.37 °C, mean absolute error (MAE) of 0.29 ± 0.25 °C. Another cohort of 22 subjects with continuous core body temperature pill as reference showed a bias of 0.16 ± 0.38 °C and MAE of 0.42 ± 0.22 °C.Clinical Relevance- Non-invasive, continuous and real time body temperature monitoring can lead to earlier fever detection and provides remote patient monitoring that can result in improved patient and clinical outcome.


Assuntos
Temperatura Corporal , Dispositivos Eletrônicos Vestíveis , Estudos de Viabilidade , Humanos , Monitorização Ambulatorial , Taxa Respiratória
8.
Recenti Prog Med ; 111(10): 584-592, 2020 10.
Artigo em Italiano | MEDLINE | ID: mdl-33078008

RESUMO

INTRODUCTION: The MonCOVID study aimed to assess the feasibility of early home management and monitoring of patients with suspected or confirmed CoViD-19, and to evaluate if this would ensure a rapid and adequate transfer to hospital care. METHODS: This pilot, open-label, single-arm study included adult symptomatic patients with suspected or confirmed CoViD-19 for whom the general practitioner or other carer had decided not to proceed to hospitalization. Participants were monitored daily at home, by measuring the pulse oximetry (SpO2) at rest and after a rapid walking test. The study assessed feasibility outcomes (at least 80% of patients recommended to be sent to the competent emergency room actually transferred within 24 hours from reporting) and efficacy (SpO2 at emergency room admission). Patients with SpO2 values below 90% (86% if affected by chronic pulmonary diseases) at rest or with a decrease in SpO2 of five percentage points after a rapid walking test were recommended for hospital care. RESULTS: Thirty-seven participants reported by the local health unit of Alessandria and the Metropolitan City of Turin were included in the study. Enrollment, initially planned for two months to reach a target of 340, was interrupted early due to the drastic reduction in the number of cases. On average, each participant was monitored for 8.2 (median 6.0) days, for a total of 302 visits. The participants showed milder symptoms than those observed in the first phase of the epidemic, at least in terms of pulmonary impairment. No patient had a decrease in SpO2 of 5 percentage points or greater and only one patient required hospitalization due to a worsening of the disease. DISCUSSION: The cases collected were not sufficient to demonstrate or refute the hypothesis of the monitoring test effectiveness. However, the study showed the feasibility of such a program, and raised some elements of interest regarding hospital territory integration, the need to develop tools to support home care and the variability of the clinical manifestations of the CoViD-19 disease.


Assuntos
Infecções por Coronavirus/terapia , Serviços de Assistência Domiciliar , Oximetria , Pneumonia Viral/terapia , Teste de Caminhada , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/fisiopatologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Projetos Piloto , Pneumonia Viral/fisiopatologia , Adulto Jovem
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1290-1293, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018224

RESUMO

Intracranial hemorrhage (ICH) is a life-threatening condition, the outcome of which is associated with stroke, trauma, aneurysm, vascular malformations, high blood pressure, illicit drugs and blood clotting disorders. In this study, we presented the feasibility of the automatic identification and classification of ICH using a head CT image based on deep learning technique. The subtypes of ICH for the classification was intraparenchymal, intraventricular, subarachnoid, subdural and epidural. We first performed windowing to provide three different images: brain window, bone window and subdural window, and trained 4,516,842 head CT images using CNN-LSTM model. We used the Xception model for the deep CNN, and 64 nodes and 32 timesteps for LSTM. For the performance evaluation, we tested 727,392 head CT images, and found the resultant weighted multi-label logarithmic loss was 0.07528. We believe that our proposed method enhances the accuracy of ICH identification and classification and can assist radiologists in the interpretation of head CT images, particularly for brain-related quantitative analysis.


Assuntos
Hemorragias Intracranianas , Acidente Vascular Cerebral , Encéfalo , Estudos de Viabilidade , Humanos , Hemorragias Intracranianas/diagnóstico por imagem , Tomografia Computadorizada por Raios X
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2532-2535, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018522

RESUMO

Experiments with animal models of epilepsy have consistently shown that focal cooling of epilepsy-induced brain region reversibly suppresses or terminates epileptic discharge activity. Recently, we formulated a physiologically plausible temperature dependence in a neural mass model that can reproduce the effect of focal cooling on epileptic discharge activity. This can be used to implement a temperature control in an implantable cooling device for thermal neuromodulation of the epileptogenic zone in patients with partial epilepsy when seizure activity is detected. However, there have been no experiments that looked into the effect of focal cooling in animal models of epilepsy with secondary generalization in which the seizure activity spreads from the pathologic region to other regions of the brain. Using the temperature-dependent neural mass model and a physiological coupling model, we show that focal cooling stops the propagation of low-frequency discharge activity; on the other hand, it increases the amount of coupling required to propagate high-frequency discharge activity. Moreover, discharge activities that are propagated with cooling are lower in both magnitude and frequency compared to those propagated without cooling. These results suggest the feasibility of focal cooling as an effective alternative therapeutic treatment for medically intractable partial epilepsy even with secondary generalization.Clinical Relevance- The computational study establishes focal cooling of the brain region with partial epilepsy not only suppresses epileptic discharges but can also prevent its generalization to other brain regions.


Assuntos
Epilepsia Resistente a Medicamentos , Epilepsias Parciais , Animais , Encéfalo , Temperatura Baixa , Epilepsias Parciais/terapia , Estudos de Viabilidade , Humanos
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2841-2844, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018598

RESUMO

Multi-session robot-assisted stroke rehabilitation program requires patients to perform repetitive tasks. It is challenging for the patient to maintain concentration during training sessions. A novel intervention strategy using Electroencephalography (EEG) signals is proposed to maintain concentration during training by enhancing the engagement of stroke patients using robot-assisted multi-session rehabilitation. The approach is illustrated by applying it to one stroke patient undergoing 12 training sessions of hand motor training on the AMADEO rehabilitation device. AMADEO offers four modes of training programs of increased intensity comprising passive training, passive training with biofeedback, assistive training as well as active 2D training games. The EEG signals are measured over eight electrode sites: FC4, C4, CP4, FC3, C3, CP3, Cz, and CPz during each training day to extract movement-related cortical potential (MRCP) signals. Moreover, functional hand recovery parameters are determined using the AMADEO assessment tool. The patient's level of engagement is determined by the negative amplitude of the MRCP signal. The rehabilitation program is switched to a more intense training mode when a consistent decrease is observed in the negative amplitude of MRCP signals from the monitored electrodes. Using this approach, the rehabilitation program becomes patient-specific and adaptive. In addition, it is shown that each training mode exhibits a different recovery level of the affected hand and maximum recovery is achieved when MRCP signals indicate that the patient is actively participating in the training.


Assuntos
Robótica , Reabilitação do Acidente Vascular Cerebral , Eletroencefalografia , Estudos de Viabilidade , Mãos , Humanos
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3755-3758, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018818

RESUMO

Despite recent advancements in the field of pattern recognition-based myoelectric control, the collection of a high quality training set remains a challenge limiting its adoption. This paper proposes a framework for a possible solution by augmenting short training protocols with subject-specific synthetic electromyography (EMG) data generated using a deep generative network, known as SinGAN. The aim of this work is to produce high quality synthetic data that could improve classification accuracy when combined with a limited training protocol. SinGAN was used to generate 1000 synthetic windows of EMG data from a single window of six different motions, and results were evaluated qualitatively, quantitatively, and in a classification task. Qualitative assessment of synthetic data was conducted via visual inspection of principal component analysis projections of real and synthetic feature space. Quantitative assessment of synthetic data revealed 11 of 32 synthetic features had similar location and scale to real features (using univariate two-sample Lepage tests); whereas multivariate distributions were found to be statistically different (p <0.05). Finally, the addition of these synthetic data to a brief training set of real data significantly improved classification accuracy in a cross-validation testing scheme by 5.4% (p <0.001).


Assuntos
Eletromiografia , Detecção de Sinal Psicológico , Estudos de Viabilidade , Movimento (Física) , Análise de Componente Principal
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4008-4011, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018878

RESUMO

Research on biosignal (ExG) analysis is usually performed with expensive systems requiring connection with external computers for data processing. Consumer-grade low-cost wearable systems for bio-potential monitoring and embedded processing have been presented recently, but are not considered suitable for medical-grade analyses. This work presents a detailed quantitative comparative analysis of a recently presented fully-wearable low-power and low-cost platform (BioWolf) for ExG acquisition and embedded processing with two researchgrade acquisition systems, namely, ANTNeuro (EEG) and the Noraxon DTS (EMG). Our preliminary results demonstrate that BioWolf offers competitive performance in terms of electrical properties and classification accuracy. This paper also highlights distinctive features of BioWolf, such as real-time embedded processing, improved wearability, and energy-efficiency, which allows devising new types of experiments and usage scenarios for medical-grade biosignal processing in research and future clinical studies.


Assuntos
Técnicas Biossensoriais , Dispositivos Eletrônicos Vestíveis , Estudos de Viabilidade
14.
Nat Commun ; 11(1): 4935, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004797

RESUMO

Gramicidin A (1) is a peptide antibiotic that disrupts the transmembrane ion concentration gradient by forming an ion channel in a lipid bilayer. Although long used clinically, it is limited to topical application because of its strong hemolytic activity and mammalian cytotoxicity, likely arising from the common ion transport mechanism. Here we report an integrated high-throughput strategy for discovering analogues of 1 with altered biological activity profiles. The 4096 analogue structures are designed to maintain the charge-neutral, hydrophobic, and channel forming properties of 1. Synthesis of the analogues, tandem mass spectrometry sequencing, and 3 microscale screenings enable us to identify 10 representative analogues. Re-synthesis and detailed functional evaluations find that all 10 analogues share a similar ion channel function, but have different cytotoxic, hemolytic, and antibacterial activities. Our large-scale structure-activity relationship studies reveal the feasibility of developing analogues of 1 that selectively induce toxicity toward target organisms.


Assuntos
Antibacterianos/farmacologia , Descoberta de Drogas/métodos , Gramicidina/análogos & derivados , Ensaios de Triagem em Larga Escala/métodos , Animais , Antibacterianos/química , Linhagem Celular Tumoral , Química Farmacêutica , Eritrócitos , Estudos de Viabilidade , Bactérias Gram-Positivas/efeitos dos fármacos , Gramicidina/química , Gramicidina/farmacologia , Hemólise/efeitos dos fármacos , Concentração Inibidora 50 , Camundongos , Testes de Sensibilidade Microbiana , Estrutura Molecular , Coelhos , Relação Estrutura-Atividade , Espectrometria de Massas em Tandem
15.
Health Aff (Millwood) ; 39(10): 1792-1798, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017232

RESUMO

Motor vehicle crashes remain the leading cause of adolescent mortality and injury in the United States. For young drivers, crash risk peaks immediately after licensure and declines during the next two years, making the point of licensure an important safety intervention opportunity. Legislation in Ohio established a unique health-transportation partnership among the State of Ohio, Children's Hospital of Philadelphia, and Diagnostic Driving, Inc., to identify underprepared driver license applicants through a virtual driving assessment system. The system, a computer-based virtual driving test, exposes drivers to common serious crash scenarios to identify critical skill deficits and is delivered in testing centers immediately before the on-road examination. A pilot study of license applicants who completed it showed that the virtual driving assessment system accurately predicted which drivers would fail the on-road examination and provided automated feedback that informed drivers on their skill deficits. At this time, the partnership's work is informing policy changes around integrating the virtual driving assessment system into licensing and driver training with the aim of reducing crashes in the first months of independent driving. The system can be developed to identify deficits in safety-critical skills that lead to crashes in new drivers and to address challenges that the coronavirus disease 2019 pandemic has introduced to driver testing and training.


Assuntos
Condução de Veículo/legislação & jurisprudência , Infecções por Coronavirus/prevenção & controle , Licenciamento/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança/organização & administração , Interface Usuário-Computador , Adolescente , Infecções por Coronavirus/epidemiologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Veículos Automotores/estatística & dados numéricos , Ohio , Pandemias/estatística & dados numéricos , Philadelphia , Projetos Piloto , Pneumonia Viral/epidemiologia , Transportes/métodos , Adulto Jovem
17.
Hipertens. riesgo vasc ; 37(3): 108-114, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193519

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Las alteraciones del sistema nervioso autónomo fueron propuestas como precursoras en la génesis y perpetuación de la aterosclerosis hace ya mucho tiempo. Nuestro objetivo fue determinar si existe asociación entre la presencia de aterosclerosis carotídea y la función autonómica evaluada mediante la variabilidad de la frecuencia cardíaca. MÉTODOS: A través de un estudio prospectivo de casos y controles investigamos la variabilidad de la frecuencia cardíaca en 5 min y la presencia de aterosclerosis carotídea mediante ultrasonografía en 54 pacientes que dividimos en 2 grupos según la presencia (+) o ausencia (−) de placas ateroscleróticas en carótidas (ATE). Se analizó la variabilidad de frecuencia cardíaca en dominio de frecuencia en el espectro de alta frecuencia, baja frecuencia, cociente alta/baja frecuencia y potencia espectral total. RESULTADOS: Sobre una población de 54 individuos sin enfermedad cardiovascular establecida evaluados en forma consecutiva, se detectaron 26 individuos (48%) portadores de ATE+. Se observó una reducción en la variabilidad de la frecuencia cardíaca en el grupo ATE+ representada por el espectro de baja frecuencia (LF) (p < 0,0001). La actividad parasimpática específicamente representada por el componente espectral de alta frecuencia también resultó menor en el grupo ATE+en análisis univariado (p < 0,0001) al igual que la potencia espectral total (p < 0,0001), un índice de regulación autonómica integral. No se encontraron diferencias significativas cuando se analizó el balance autonómico de baja y alta frecuencia (LF/HF) (p = 0,1598). En un modelo de regresión logística solo la presión arterial sistólica y el poder espectral total resultaron predictores independientes de ATE+. CONCLUSIÓN: Verificamos una disminución en la variabilidad de la frecuencia cardíaca en sujetos con aterosclerosis carotídea, que se estableció tanto a través de sus componentes espectrales como de la potencia espectral total, no así a través de la valoración del balance autonómico. La potencia espectral total, en principio, sería un método correcto de evaluación autonómica en este grupo de pacientes


INTRODUCTION AND OBJECTIVES: Alterations of the sympathetic and parasympathetic nervous system have been proposed as precursors of the genesis and perpetuation of atherosclerosis for a long time. The objective of this study is to determine if there is an association between the presence of carotid atherosclerosis and the reduction in heart rate variability. METHODS: Using a prospective case-control design, the heart rate variability and the presence of carotid atherosclerosis was investigated in 54 patients, divided into 2 groups according to the presence or absence of carotid atherosclerosis. An analysis was made of the heart rate variability variables of the frequency (spectral) domain in high frequency band, low frequency band, parasympathetic autonomic balance, and the total spectral band. RESULTS: Of the 54 individuals evaluated without previous cardiovascular disease consecutively, 26 of them (48%) presented with subclinical carotid atherosclerosis (ATE+). A reduction in heart rate variability was observed in the ATE+group represented by the low frequency (LF) spectrum (P < .0001). The parasympathetic activity specifically represented in the high frequency (HF) band was also lower in the ATE+group in the univariate analysis (P < .0001), same as the total spectral power (P < .0001), an index of integral autonomic regulation. No significant differences were found in the LF/HF analysis (P = .1598). After analysing variables with significant differences in the univariate analysis with a logistic regression model, only systolic blood preassure and the total spectral power were shown to be independent predictors of ATE+. CONCLUSION: A reduction in heart rate variability was found in subjects with carotid atherosclerosis. Some spectral components of heart rate variability, like low frequency or total spectral power, were better predictors of carotid atherosclerosis than the parasympathetic autonomic balance. In this study it seems that total spectral power is an adequate measurement for analysing autonomic function


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Doenças do Sistema Nervoso Autônomo/diagnóstico , Sistema Nervoso Autônomo/fisiopatologia , Frequência Cardíaca , Aterosclerose/diagnóstico por imagem , Estudos de Viabilidade , Estudos Prospectivos , Modelos Logísticos , Pressão Sanguínea , Estudos de Casos e Controles , Antropometria , Hipolipemiantes/uso terapêutico , Índice de Massa Corporal , Hipertensão/terapia , Fatores de Risco
18.
PLoS Biol ; 18(8): e3000843, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32866143

RESUMO

Interactions between species generate the functions on which ecosystems and humans depend. However, we lack an understanding of the risk that interaction loss poses to ecological communities. Here, we quantify the risk of interaction loss for 4,330 species interactions from 41 empirical pollination and seed dispersal networks across 6 continents. We estimate risk as a function of interaction vulnerability to extinction (likelihood of loss) and contribution to network feasibility, a measure of how much an interaction helps a community tolerate environmental perturbations. Remarkably, we find that more vulnerable interactions have higher contributions to network feasibility. Furthermore, interactions tend to have more similar vulnerability and contribution to feasibility across networks than expected by chance, suggesting that vulnerability and feasibility contribution may be intrinsic properties of interactions, rather than only a function of ecological context. These results may provide a starting point for prioritising interactions for conservation in species interaction networks in the future.


Assuntos
Biota , Simbiose , Animais , Estudos de Viabilidade , Plantas/anatomia & histologia , Risco , Especificidade da Espécie
19.
Sensors (Basel) ; 20(17)2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32872310

RESUMO

The non-invasive estimation of blood oxygen saturation (SpO2) by pulse oximetry is of vital importance clinically, from the detection of sleep apnea to the recent ambulatory monitoring of hypoxemia in the delayed post-infective phase of COVID-19. In this proof of concept study, we set out to establish the feasibility of SpO2 measurement from the ear canal as a convenient site for long term monitoring, and perform a comprehensive comparison with the right index finger-the conventional clinical measurement site. During resting blood oxygen saturation estimation, we found a root mean square difference of 1.47% between the two measurement sites, with a mean difference of 0.23% higher SpO2 in the right ear canal. Using breath holds, we observe the known phenomena of time delay between central circulation and peripheral circulation with a mean delay between the ear and finger of 12.4 s across all subjects. Furthermore, we document the lower photoplethysmogram amplitude from the ear canal and suggest ways to mitigate this issue. In conjunction with the well-known robustness to temperature induced vasoconstriction, this makes conclusive evidence for in-ear SpO2 monitoring being both convenient and superior to conventional finger measurement for continuous non-intrusive monitoring in both clinical and everyday-life settings.


Assuntos
Meato Acústico Externo , Hipóxia/diagnóstico , Monitorização Fisiológica/instrumentação , Oximetria/instrumentação , Fotopletismografia/instrumentação , Dispositivos Eletrônicos Vestíveis , Adulto , Betacoronavirus/fisiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Estudos de Equivalência como Asunto , Estudos de Viabilidade , Feminino , Dedos , Humanos , Hipóxia/sangue , Masculino , Monitorização Fisiológica/métodos , Oximetria/métodos , Oxigênio/análise , Oxigênio/sangue , Pandemias , Fotopletismografia/métodos , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Adulto Jovem
20.
Nat Commun ; 11(1): 4523, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908125

RESUMO

Thousands of functional magnetic resonance imaging (fMRI) studies have provided important insight into the human brain. However, only a handful of these studies tested infants while they were awake, because of the significant and unique methodological challenges involved. We report our efforts to address these challenges, with the goal of creating methods for awake infant fMRI that can reveal the inner workings of the developing, preverbal mind. We use these methods to collect and analyze two fMRI datasets obtained from infants during cognitive tasks, released publicly with this paper. In these datasets, we explore and evaluate data quantity and quality, task-evoked activity, and preprocessing decisions. We disseminate these methods by sharing two software packages that integrate infant-friendly cognitive tasks and eye-gaze monitoring with fMRI acquisition and analysis. These resources make fMRI a feasible and accessible technique for cognitive neuroscience in awake and behaving human infants.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/diagnóstico por imagem , Desenvolvimento Infantil/fisiologia , Imagem por Ressonância Magnética/métodos , Vigília/fisiologia , Técnicas de Observação do Comportamento , Encéfalo/crescimento & desenvolvimento , Pré-Escolar , Cognição/fisiologia , Estudos de Coortes , Estudos de Viabilidade , Feminino , Humanos , Lactente , Masculino
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