Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.822
Filtrar
1.
A A Pract ; 15(8): e01508, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34388136

RESUMO

The trigeminocardiac reflex (TCR) is triggered by stimulation of a branch of the trigeminal nerve and results in vagally mediated bradycardia, hypotension, apnea, and gastrointestinal hypermotility. In the operating theatre, patients susceptible to TCR are typically under general anesthesia; thus, cardiac abnormalities are the most common manifestation. Our case highlights the less common intraoperative manifestations of gastric hypermotility and apnea in a patient undergoing awake craniotomy for tumor resection. Prompt recognition, removal of stimuli, and airway management prevented catastrophic complications while facilitating completion of the procedure.


Assuntos
Reflexo Trigêmino-Cardíaco , Bradicardia/etiologia , Craniotomia/efeitos adversos , Humanos , Complicações Intraoperatórias/etiologia , Vigília
2.
Crit Care ; 25(1): 305, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429131

RESUMO

BACKGROUND: Awake prone position is an emerging rescue therapy applied in patients undergoing noninvasive ventilation (NIV) for acute hypoxemic respiratory failure (ARF) related to novel coronavirus disease (COVID-19). Although applied to stabilize respiratory status, in awake patients, the application of prone position may reduce comfort with a consequent increase in the workload imposed on respiratory muscles. Thus, we primarily ascertained the effect of awake prone position on diaphragmatic thickening fraction, assessed through ultrasound, in COVID-19 patients undergoing NIV. METHODS: We enrolled all COVID-19 adult critically ill patients, admitted to intensive care unit (ICU) for hypoxemic ARF and undergoing NIV, deserving of awake prone positioning as a rescue therapy. Exclusion criteria were pregnancy and any contraindication to awake prone position and NIV. On ICU admission, after NIV onset, in supine position, and at 1 h following awake prone position application, diaphragmatic thickening fraction was obtained on the right side. Across all the study phases, NIV was maintained with the same setting present at study entry. Vital signs were monitored throughout the entire study period. Comfort was assessed through numerical rating scale (0 the worst comfort and 10 the highest comfort level). Data were presented in median and 25th-75th percentile range. RESULTS: From February to May 2021, 20 patients were enrolled and finally analyzed. Despite peripheral oxygen saturation improvement [96 (94-97)% supine vs 98 (96-99)% prone, p = 0.008], turning to prone position induced a worsening in comfort score from 7.0 (6.0-8.0) to 6.0 (5.0-7.0) (p = 0.012) and an increase in diaphragmatic thickening fraction from 33.3 (25.7-40.5)% to 41.5 (29.8-50.0)% (p = 0.025). CONCLUSIONS: In our COVID-19 patients assisted by NIV in ICU, the application of awake prone position improved the oxygenation at the expense of a greater diaphragmatic thickening fraction compared to supine position. Trial registration ClinicalTrials.gov, number NCT04904731. Registered on 05/25/2021, retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04904731 .


Assuntos
COVID-19/terapia , Ventilação não Invasiva/métodos , Posicionamento do Paciente , Decúbito Ventral , Respiração Artificial/métodos , Vigília , Adulto , Diafragma , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Estudos Prospectivos
3.
J Forensic Leg Med ; 82: 102222, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34358925

RESUMO

Women who wake from sleep during sexual assault commonly report confusion and disorientation. Confusion and disorientation, with impaired decision making after waking, are symptoms of 'sleep inertia', and part of the normal transition from sleep to full wakefulness which is maximal in the minutes after wakening and can be prolonged. In this study of 305 adult females (median age 26, range 18-68), who presented for a sexual assault forensic medical examination, 38 (12%) (median age 27, range 18-51) woke to find sexual acts already in progress. For 25 of these women (25/38 for 66%), an act of penile-vaginal penetration was already occurring when the woman woke. Of the 38 women (12%) who woke during the sexual assault, several had factors known to enhance the impairment of sleep inertia including forced arousal (38/38, 100%) and age under 25 (15/38, 39%). 17 (17/38 for 45%) of these women who woke had consumed varying amounts of alcohol prior to sleep and these 17 woke fully during the assault and then stayed awake. A further 16 women, (16/38 for 42%) woke during the sexual assault but returned to sleep during or after the assault, and all these 16 gave a history of intoxication by drugs or alcohol prior to sleep. Importantly 5, (5/38 for 13%) of the women who woke during the assault had consumed no intoxicating substances. A further 68 (23%) of the 305 women, (median age 26, range 18-58) had no memory on waking of the alleged sexual assault despite having other reasons to believe that a sexual assault had occurred. Forensic medical examiners can assist both the justice process, and patient care, by considering the possibility of sleep inertia among victims who report disorientation and slow or confused decision making on waking during a sexual assault.


Assuntos
Vítimas de Crime/psicologia , Delitos Sexuais , Sono , Vigília , Adolescente , Adulto , Idoso , Vítimas de Crime/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , New South Wales , Estudos Retrospectivos , Adulto Jovem
4.
Sensors (Basel) ; 21(16)2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34450727

RESUMO

This article describes the design of a smart steering wheel intended for use in unobtrusive health and drowsiness monitoring. The aging population, cardiovascular disease, personalized medicine, and driver fatigue were significant motivations for developing a monitoring platform in cars because people spent much time in cars. The purpose was to create a unique, comprehensive monitoring system for the driver. The crucial parameters in health or drowsiness monitoring, such as heart rate, heart rate variability, and blood oxygenation, are measured by an electrocardiograph and oximeter integrated into the steering wheel. In addition, an inertial unit was integrated into the steering wheel to record and analyze the movement patterns performed by the driver while driving. The developed steering wheel was tested under laboratory and real-life conditions. The measured signals were verified by commercial devices to confirm data correctness and accuracy. The resulting signals show the applicability of the developed platform in further detecting specific cardiovascular diseases (especially atrial fibrillation) and drowsiness.


Assuntos
Condução de Veículo , Idoso , Eletrocardiografia , Humanos , Monitorização Fisiológica , Oximetria , Vigília
5.
Sensors (Basel) ; 21(16)2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34450999

RESUMO

Road vehicle accidents are mostly due to human errors, and many such accidents could be avoided by continuously monitoring the driver. Driver monitoring (DM) is a topic of growing interest in the automotive industry, and it will remain relevant for all vehicles that are not fully autonomous, and thus for decades for the average vehicle owner. The present paper focuses on the first step of DM, which consists of characterizing the state of the driver. Since DM will be increasingly linked to driving automation (DA), this paper presents a clear view of the role of DM at each of the six SAE levels of DA. This paper surveys the state of the art of DM, and then synthesizes it, providing a unique, structured, polychotomous view of the many characterization techniques of DM. Informed by the survey, the paper characterizes the driver state along the five main dimensions-called here "(sub)states"-of drowsiness, mental workload, distraction, emotions, and under the influence. The polychotomous view of DM is presented through a pair of interlocked tables that relate these states to their indicators (e.g., the eye-blink rate) and the sensors that can access each of these indicators (e.g., a camera). The tables factor in not only the effects linked directly to the driver, but also those linked to the (driven) vehicle and the (driving) environment. They show, at a glance, to concerned researchers, equipment providers, and vehicle manufacturers (1) most of the options they have to implement various forms of advanced DM systems, and (2) fruitful areas for further research and innovation.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Automação , Humanos , Inquéritos e Questionários , Vigília
6.
Sensors (Basel) ; 21(16)2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34451059

RESUMO

Tasks which require sustained attention over a lengthy period of time have been a focal point of cognitive fatigue research for decades, with these tasks including air traffic control, watchkeeping, baggage inspection, and many others. Recent research into physiological markers of mental fatigue indicate that markers exist which extend across all individuals and all types of vigilance tasks. This suggests that it would be possible to build an EEG model which detects these markers and the subsequent vigilance decrement in any task (i.e., a task-generic model) and in any person (i.e., a cross-participant model). However, thus far, no task-generic EEG cross-participant model has been built or tested. In this research, we explored creation and application of a task-generic EEG cross-participant model for detection of the vigilance decrement in an unseen task and unseen individuals. We utilized three different models to investigate this capability: a multi-layer perceptron neural network (MLPNN) which employed spectral features extracted from the five traditional EEG frequency bands, a temporal convolutional network (TCN), and a TCN autoencoder (TCN-AE), with these two TCN models being time-domain based, i.e., using raw EEG time-series voltage values. The MLPNN and TCN models both achieved accuracy greater than random chance (50%), with the MLPNN performing best with a 7-fold CV balanced accuracy of 64% (95% CI: 0.59, 0.69) and validation accuracies greater than random chance for 9 of the 14 participants. This finding demonstrates that it is possible to classify a vigilance decrement using EEG, even with EEG from an unseen individual and unseen task.


Assuntos
Aviação , Aprendizado Profundo , Atenção , Eletroencefalografia , Humanos , Vigília
8.
Sensors (Basel) ; 21(15)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34372329

RESUMO

Driver drowsiness is a major cause of fatal accidents throughout the world. Recently, some studies have investigated steering wheel grip force-based alternative methods for detecting driver drowsiness. In this study, a driver drowsiness detection system was developed by investigating the electromyography (EMG) signal of the muscles involved in steering wheel grip during driving. The EMG signal was measured from the forearm position of the driver during a one-hour interactive driving task. Additionally, the participant's drowsiness level was also measured to investigate the relationship between muscle activity and driver's drowsiness level. Frequency domain analysis was performed using the short-time Fourier transform (STFT) and spectrogram to assess the frequency response of the resultant signal. An EMG signal magnitude-based driver drowsiness detection and alertness algorithm is also proposed. The algorithm detects weak muscle activity by detecting the fall in EMG signal magnitude due to an increase in driver drowsiness. The previously presented microneedle electrode (MNE) was used to acquire the EMG signal and compared with the signal obtained using silver-silver chloride (Ag/AgCl) wet electrodes. The results indicated that during the driving task, participants' drowsiness level increased while the activity of the muscles involved in steering wheel grip decreased concurrently over time. Frequency domain analysis showed that the frequency components shifted from the high to low-frequency spectrum during the one-hour driving task. The proposed algorithm showed good performance for the detection of low muscle activity in real time. MNE showed highly comparable results with dry Ag/AgCl electrodes, which confirm its use for EMG signal monitoring. The overall results indicate that the presented method has good potential to be used as a driver's drowsiness detection and alertness system.


Assuntos
Condução de Veículo , Dispositivos Eletrônicos Vestíveis , Eletrodos , Eletromiografia , Força da Mão , Humanos , Vigília
9.
Respir Care ; 66(9): 1477-1484, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34408081

RESUMO

BACKGROUND: Dyspnea is a common symptom in patients with COPD. It causes physical inactivity and impaired health-related quality of life. Although optimal breathing methods alleviate dyspnea, it is unclear whether breathing instability has a clinical impact on patients with COPD. This study aimed to investigate whether resting breathing instability during wakefulness was associated with dyspnea assessed by the modified Medical Research Council (mMRC) dsypnea scale and whether breathing instability can be a novel predictor of clinical outcomes. METHODS: Forty-four subjects with stable COPD were enrolled (mean age, 71.0 y). Resting breathing was monitored for 15 min by using respiratory inductance plethysmography. Breathing instability was evaluated with the coefficient of variation for breath-by-breath respiratory duration and tidal volume ([Formula: see text]) by using an artifact-free respiratory signal for 5 min. Pulmonary function testing and blood gas analysis were performed (mean FEV1 percent of predicted, 68.5%). Questionnaires with regard to dyspnea and health-related quality of life were also completed. Exacerbations were recorded prospectively for 1 year after the initial assessment. RESULTS: The coefficients of variation for [Formula: see text] were significantly higher in the subjects with an mMRC dyspnea scale score ≥ 2 versus those with an mMRC dyspnea scale score < 2 (26.4 ± 7.4% vs 20.3 ± 6.4%, P = .006) . The coefficients of variation for respiratory duration and VT were not associated with age, body mass index, and pulmonary function variables. In multivariate analysis, FEV1 percent of predicted and coefficient of variation for [Formula: see text] remained significant predictors for an mMRC dyspnea scale score ≥ 2 (P = .004 and P = .01, respectively). Coefficient of variation values were also correlated with several health-related quality of life domains. The exacerbation frequency was associated with the coefficient of variation for [Formula: see text]. CONCLUSIONS: Resting breathing pattern during wakefulness is a novel assessment tool for severity of dyspnea, which can be one of the predictors for exacerbation in patients with COPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Idoso , Dispneia/etiologia , Humanos , Doença Pulmonar Obstrutiva Crônica/complicações , Respiração , Índice de Gravidade de Doença , Vigília
10.
Nat Commun ; 12(1): 4646, 2021 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-34330901

RESUMO

Microglia are important for brain homeostasis and immunity, but their role in regulating vigilance remains unclear. We employed genetic, physiological, and metabolomic methods to examine microglial involvement in the regulation of wakefulness and sleep. Microglial depletion decreased stable nighttime wakefulness in mice by increasing transitions between wakefulness and non-rapid eye movement (NREM) sleep. Metabolomic analysis revealed that the sleep-wake behavior closely correlated with diurnal variation of the brain ceramide, which disappeared in microglia-depleted mice. Ceramide preferentially influenced microglia in the thalamic reticular nucleus (TRN), and local depletion of TRN microglia produced similar impaired wakefulness. Chemogenetic manipulations of anterior TRN neurons showed that they regulated transitions between wakefulness and NREM sleep. Their firing capacity was suppressed by both microglial depletion and added ceramide. In microglia-depleted mice, activating anterior TRN neurons or inhibiting ceramide production both restored stable wakefulness. These findings demonstrate that microglia can modulate stable wakefulness through anterior TRN neurons via ceramide signaling.


Assuntos
Potenciais de Ação/fisiologia , Neurônios GABAérgicos/fisiologia , Microglia/fisiologia , Sono/fisiologia , Núcleos Talâmicos/fisiologia , Vigília/fisiologia , Algoritmos , Animais , Eletroencefalografia/métodos , Eletromiografia/métodos , Feminino , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Modelos Neurológicos , Núcleos Talâmicos/citologia
11.
J Pharm Biomed Anal ; 204: 114240, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246879

RESUMO

Energy metabolism and neurotransmission are necessary for sustaining normal life activities. Hence, neurological or psychiatric disorders are always associated with changes in neurotransmitters and energy metabolic states in the brain. Most studies have only focused on the most important neurotransmitters, particularly GABA and Glu, however, other metabolites such as NAA and aspartate which are also very important for cerebral function are rarely investigated. In this study, most of the metabolic kinetics information of different brain regions was investigated in awake rats using the [1H-13C]-NMR technique. Briefly, rats (n = 8) were infused [1-13C] glucose through the tail vein for two minutes. After 20 min of glucose metabolism, the animals were sacrificed and the brain tissue was extracted and treated. Utilizing the 1H observed/13C-edited nuclear magnetic resonance (POCE-NMR), the enrichment of neurochemicals was detected which reflected the metabolic changes in different brain regions and the metabolic connections between neurons and glial cells in the brain. The results suggest that the distribution of every metabolite differed from every brain region and the metabolic rate of NAA was relatively low at 8.64 ± 2.37 µmol/g/h. In addition, there were some correlations between several 13C enriched metabolites, such as Glu4-Gln4 (p = 0.062), Glu4-GABA2 (p < 0.01), Glx2-Glx3 (p < 0.001), Asp3-NAA3 (p < 0.001). This correlativity reflects the signal transmission between astrocytes and neurons, as well as the potential interaction between energy metabolism and neurotransmission. In conclusion, the current study systematically demonstrated the metabolic kinetics in the brain which shed light on brain functions and the mechanisms of various pathophysiological states.


Assuntos
Encéfalo , Vigília , Animais , Glucose , Cinética , Espectroscopia de Ressonância Magnética , Ratos , Ratos Sprague-Dawley
12.
eNeuro ; 8(4)2021.
Artigo em Inglês | MEDLINE | ID: mdl-34193511

RESUMO

There is molecular, electrophysiological, and ultrastructural evidence that a net increase in synaptic strength occurs in many brain circuits during spontaneous wake (SW) or short sleep deprivation, reflecting ongoing learning. Sleep leads instead to a broad but selective weakening of many forebrain synapses, thus preventing synaptic saturation and decreasing the energy cost of synaptic activity. Whether synaptic potentiation can persist or further increase after long sleep deprivation is unknown. Whether synaptic renormalization can occur during chronic sleep restriction (CSR) is also unknown. Here, we addressed these questions by measuring an established ultrastructural measure of synaptic strength, the axon-spine interface (ASI), in the primary motor cortex (M1) of (1) one-month-old adolescent mice CSR using a paradigm that decreases NREM and REM sleep by two/thirds; (2) in two-week-old mouse pups sleep deprived for 15 h, or allowed afterward to recover for 16 h. Both groups were compared with mice of the same age that were asleep or awake for a few hours (both sexes). The ASI size of CSR mice (n = 3) was comparable to that measured after SW or short sleep deprivation and larger than after sleep (n = 4/group). In pups, the ASI size increased after short sleep loss (n = 3) relative to sleep (n = 4), fell below sleep levels after long sleep deprivation (n = 4), and remained low after recovery (n = 3). Long sleep deprived pups also lost some weight. These results suggest that (1) severe sleep restriction is incompatible with synaptic renormalization; (2) very young mice cannot maintain high synaptic strength during prolonged wake.


Assuntos
Sono , Vigília , Animais , Axônios , Feminino , Masculino , Camundongos , Privação do Sono , Sinapses
13.
eNeuro ; 8(4)2021.
Artigo em Inglês | MEDLINE | ID: mdl-34301724

RESUMO

The capacity of human brain to sustain complex cortical dynamics appears to be strongly associated with conscious experience and consistently drops when consciousness fades. For example, several recent studies in humans found a remarkable reduction of the spatiotemporal complexity of cortical responses to local stimulation during dreamless sleep, general anesthesia, and coma. However, this perturbational complexity has never been directly estimated in non-human animals in vivo previously, and the mechanisms that prevent neocortical neurons to engage in complex interactions are still unclear. Here, we quantify the complexity of electroencephalographic (EEG) responses to intracranial electrical stimulation in rats, comparing wakefulness to propofol, sevoflurane, and ketamine anesthesia. The evoked activity changed from highly complex in wakefulness to far simpler with propofol and sevoflurane. The reduced complexity was associated with a suppression of high frequencies that preceded a reduced phase-locking, and disruption of functional connectivity and pattern diversity. We then showed how these parameters dissociate with ketamine and depend on intensity and site of stimulation. Our results support the idea that brief periods of activity-dependent neuronal silence can interrupt complex interactions in neocortical circuits, and open the way for further mechanistic investigations of the neuronal basis for consciousness and loss of consciousness across species.


Assuntos
Estado de Consciência , Eletroencefalografia , Anestesia Geral , Animais , Estimulação Elétrica , Humanos , Ratos , Vigília
14.
Neuroscience ; 471: 51-60, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34293415

RESUMO

Sleep deprivation critically affects vigilant attention. Previous neuroimaging studies have revealed altered inter-regional functional connectivity after sleep deprivation, which may disrupt topological properties of brain functional networks. However, little is known about alterations in the topology of intrinsic connectivity and its involvement in attention performance after sleep deprivation. In the current study, we investigated the topological properties of brain networks derived from resting-state functional magnetic resonance imaging of 26 healthy men in rested wakefulness (RW) state and after 36 h of total sleep deprivation (TSD). In the predefined sparsity threshold range, both global and nodal network properties were evaluated based on graph theory analysis. Vigilant attention was assessed using the psychomotor vigilance test (PVT) before and after TSD. Furthermore, Pearson's correlation analyses were conducted to explore the association between altered network properties and changed PVT performance after TSD. At the global level, the brain functional networks in the TSD state showed a significantly lower small-world coefficient than RW, with decreased global efficiency. At the nodal level, the altered regions were selectively distributed in frontoparietal networks, sensorimotor networks, temporal regions, and salience networks. More specifically, the altered clustering coefficient in the posterior superior temporal sulcus (pSTS) and insula, and altered local efficiency in pSTS were further associated with PVT performance after TSD. Our results suggest that the topological properties of brain functional networks are disrupted, and aberrant topology of temporal networks and salience networks may act as neural signatures underlying the vigilant attention impairments after TSD.


Assuntos
Privação do Sono , Vigília , Atenção , Encéfalo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Desempenho Psicomotor
15.
J Psychiatr Res ; 141: 301-308, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34304033

RESUMO

Posttraumatic stress disorder-related sleep disturbances may increase daytime sleepiness and compromise performance in individuals with posttraumatic stress disorder. We investigated nighttime sleep predictors of sleepiness in Veterans with and without posttraumatic stress disorder. Thirty-seven post-9/11 Veterans with posttraumatic stress disorder and 47 without posttraumatic stress disorder (Control) completed a 48-h lab stay. Nighttime quantitative EEG and sleep architecture parameters were collected with polysomnography. Data from daytime sleepiness batteries assessing subjective sleepiness (global vigor questionnaire), objective sleepiness (Multiple Sleep Latency Tests) and alertness (psychomotor vigilance task) were included in analyses. Independent samples t-tests and linear regressions were performed to identify group differences in sleepiness and nighttime sleep predictors of sleepiness in the overall sample and within each group. Participants with posttraumatic stress disorder had higher subjective sleepiness (t = 4.20; p < .001) and lower alertness (psychomotor vigilance task reaction time (t = -3.70; p < .001) and lapses: t = -2.13; p = .04) than the control group. Objective daytime sleepiness did not differ between groups (t = -0.79, p = .43). In the whole sample, higher rapid eye movement delta power predicted lower alertness quantified by psychomotor vigilance task reaction time (ß = 0.372, p = .013) and lapses (ß = 0.388, p = .013). More fragmented sleep predicted higher objective sleepiness in the posttraumatic stress disorder group (ß = -.467, p = .005) but no other nighttime sleep measures influenced the relationship between group and sleepiness. Objective measures of sleep and sleepiness were not associated with the increased subjective sleepiness and reduced alertness of the posttraumatic stress disorder group.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Atenção , Humanos , Desempenho Psicomotor , Sono , Sonolência , Transtornos de Estresse Pós-Traumáticos/complicações , Vigília
16.
Sensors (Basel) ; 21(14)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34300572

RESUMO

Drowsiness when in command of a vehicle leads to a decline in cognitive performance that affects driver behavior, potentially causing accidents. Drowsiness-related road accidents lead to severe trauma, economic consequences, impact on others, physical injury and/or even death. Real-time and accurate driver drowsiness detection and warnings systems are necessary schemes to reduce tiredness-related driving accident rates. The research presented here aims at the classification of drowsy and non-drowsy driver states based on respiration rate detection by non-invasive, non-touch, impulsive radio ultra-wideband (IR-UWB) radar. Chest movements of 40 subjects were acquired for 5 m using a lab-placed IR-UWB radar system, and respiration per minute was extracted from the resulting signals. A structured dataset was obtained comprising respiration per minute, age and label (drowsy/non-drowsy). Different machine learning models, namely, Support Vector Machine, Decision Tree, Logistic regression, Gradient Boosting Machine, Extra Tree Classifier and Multilayer Perceptron were trained on the dataset, amongst which the Support Vector Machine shows the best accuracy of 87%. This research provides a ground truth for verification and assessment of UWB to be used effectively for driver drowsiness detection based on respiration.


Assuntos
Condução de Veículo , Humanos , Redes Neurais de Computação , Taxa Respiratória , Máquina de Vetores de Suporte , Vigília
17.
BMJ Open ; 11(7): e047306, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34290067

RESUMO

INTRODUCTION: The main surgical dilemma during glioma resections is the surgeon's inability to accurately identify eloquent areas when the patient is under general anaesthesia without mapping techniques. Intraoperative stimulation mapping (ISM) techniques can be used to maximise extent of resection in eloquent areas yet simultaneously minimise the risk of postoperative neurological deficits. ISM has been widely implemented for low-grade glioma resections backed with ample scientific evidence, but this is not yet the case for high-grade glioma (HGG) resections. Therefore, ISM could thus be of important value in HGG surgery to improve both surgical and clinical outcomes. METHODS AND ANALYSIS: This study is an international, multicenter, prospective three-arm cohort study of observational nature. Consecutive HGG patients will be operated with awake mapping, asleep mapping or no mapping with a 1:1:1 ratio. Primary endpoints are: (1) proportion of patients with National Institute of Health Stroke Scale deterioration at 6 weeks, 3 months and 6 months after surgery and (2) residual tumour volume of the contrast-enhancing and non-contrast-enhancing part as assessed by a neuroradiologist on postoperative contrast MRI scans. Secondary endpoints are: (1) overall survival and (2) progression-free survival at 12 months after surgery; (3) oncofunctional outcome and (4) frequency and severity of serious adverse events in each arm. Total duration of the study is 5 years. Patient inclusion is 4 years, follow-up is 1 year. ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee (METC Zuid-West Holland/Erasmus Medical Center; MEC-2020-0812). The results will be published in peer-reviewed academic journals and disseminated to patient organisations and media. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov ID number NCT04708171 (PROGRAM-study), NCT03861299 (SAFE-trial).


Assuntos
Neoplasias Encefálicas , Glioma , Mapeamento Encefálico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Estudos de Coortes , Glioma/diagnóstico por imagem , Glioma/cirurgia , Humanos , Estudos Multicêntricos como Assunto , Estudos Observacionais como Assunto , Estudos Prospectivos , Vigília
18.
Commun Biol ; 4(1): 854, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244598

RESUMO

Current state-of-the-art functional magnetic resonance imaging (fMRI) offers remarkable imaging quality and resolution, yet, the intrinsic dimensionality of brain dynamics in different states (wakefulness, light and deep sleep) remains unknown. Here we present a method to reveal the low dimensional intrinsic manifold underlying human brain dynamics, which is invariant of the high dimensional spatio-temporal representation of the neuroimaging technology. By applying this intrinsic manifold framework to fMRI data acquired in wakefulness and sleep, we reveal the nonlinear differences between wakefulness and three different sleep stages, and successfully decode these different brain states with a mean accuracy across participants of 96%. Remarkably, a further group analysis shows that the intrinsic manifolds of all participants share a common topology. Overall, our results reveal the intrinsic manifold underlying the spatiotemporal dynamics of brain activity and demonstrate how this manifold enables the decoding of different brain states such as wakefulness and various sleep stages.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/fisiologia , Imageamento por Ressonância Magnética/métodos , Rede Nervosa/fisiologia , Sono/fisiologia , Vigília/fisiologia , Algoritmos , Encéfalo/diagnóstico por imagem , Eletroencefalografia/métodos , Humanos , Modelos Neurológicos , Rede Nervosa/diagnóstico por imagem , Neuroimagem/métodos , Fases do Sono/fisiologia
19.
Commun Biol ; 4(1): 855, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244604

RESUMO

The spatial-temporal sequence of cerebral blood flow (CBF), cerebral blood volume (CBV) and blood velocity changes triggered by neuronal activation is critical for understanding functional brain imaging. This sequence follows a stereotypic pattern of changes across different zones of the vasculature in the olfactory bulb, the first relay of olfaction. However, in the cerebral cortex, where most human brain mapping studies are performed, the timing of activity evoked vascular events remains controversial. Here we utilized a single whisker stimulation model to map out functional hyperemia along vascular arbours from layer II/III to the surface of primary somatosensory cortex, in anesthetized and awake Thy1-GCaMP6 mice. We demonstrate that sensory stimulation triggers an increase in blood velocity within the mid-capillary bed and a dilation of upstream large capillaries, and the penetrating and pial arterioles. We report that under physiological stimulation, response onset times are highly variable across compartments of different vascular arbours. Furthermore, generating transfer functions (TFs) between neuronal Ca2+ and vascular dynamics across different brain states demonstrates that anesthesia decelerates neurovascular coupling (NVC). This spatial-temporal pattern of vascular events demonstrates functional diversity not only between different brain regions but also at the level of different vascular arbours within supragranular layers of the cerebral cortex.


Assuntos
Encéfalo/fisiologia , Córtex Cerebral/fisiologia , Circulação Cerebrovascular/fisiologia , Acoplamento Neurovascular/fisiologia , Córtex Somatossensorial/fisiologia , Animais , Encéfalo/irrigação sanguínea , Mapeamento Encefálico/métodos , Capilares/fisiologia , Córtex Cerebral/irrigação sanguínea , Feminino , Humanos , Masculino , Camundongos Endogâmicos C57BL , Neuroimagem/métodos , Neurônios/fisiologia , Bulbo Olfatório/irrigação sanguínea , Bulbo Olfatório/fisiologia , Córtex Somatossensorial/irrigação sanguínea , Vibrissas/fisiologia , Vigília/fisiologia
20.
Artigo em Russo | MEDLINE | ID: mdl-34283539

RESUMO

Visual hallucinations have a negative effect on the course of Parkinson's disease (PD), being a source of stress for the patients themselves and caregivers. The article discusses the basic theories and pathogenetic mechanisms of the development of visual hallucinations in PD consisting of the following components: impairment of the visual information received from the retina with subsequent disruption of its processing in the central parts of the visual system; lack of suppression of internally generated images through the ponto-geniculo-occipital system; the invasion of REM sleep patterns in wakefulness; decreased ability of the brain stem structures to implement appropriate information filtering as well as excessive drug-induced activation of the mesolimbic system. Particular attention is paid to visual impairment and changes in the transmission of information along the retino-hypothalamic tract. In this connection, dysfunction in the «retina - hypothalamus¼ system can also be considered as one of the factors that determines the time and rhythm of occurrence or exacerbation of visual hallucinations in PD. Attracting attention to this aspect opens new therapeutic possibilities where the circadian system can be positioned as a target of additional exposure in the treatment of visual hallucinations in PD.


Assuntos
Doença de Parkinson , Encéfalo , Alucinações/etiologia , Humanos , Doença de Parkinson/complicações , Vigília
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...