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Balkan Medical Journal Dec 2017Chronobiology is a field that studies the effects of time on biological systems. Periodicity is of particular interest. The master biological clock in the... (Review)
Review
Chronobiology is a field that studies the effects of time on biological systems. Periodicity is of particular interest. The master biological clock in the suprachiasmatic nucleus controls daily rhythms of core body temperature, rest-activity cycle, physiological and behavioral functions, psychomotor functions and mood in humans. The clock genes are involved in the generation of the circadian rhythms and the biological clock is synchronized to solar day by direct photic inputs. Various circadian rhythm abnormalities have been demonstrated in mood disorders such as unipolar depression, bipolar depression and seasonal affective disorder. Hypotheses involving circadian rhythm abnormalities related to the etiology of mood disorders have been raised. The resulting circadian rhythm changes can be measured and evaluated that these techniques can be used to identify subtypes of mood disorders associated with circadian rhythm changes. The data obtained from chronobiological studies reveal methods that manipulate circadian rhythms. The effects of light and melatonin on circadian rhythms are determined by these studies. Chronobiological research has been applied to the psychiatric clinic and light therapy has been used as a chronotherapeutic in the treatment of mood disorders. On the other hand, chronotherapeutic approaches with effects on circadian rhythms such as sleep deprivation therapy have been used in the treatment of mood disorders too. As a good example of translational psychiatry, chronobiological studies have been projected in the psychiatry clinic. It may be possible, the data obtained from the basic sciences are used in the diagnosis of mood disorders and in the treatment of psychiatric disorders as chronotherapeutic techniques. Developments in the field of chronobiology and data obtained from chronotherapeutics may enable the development of evidence-based diagnosis and treatment in psychiatry.
Topics: Actigraphy; Chronobiology Phenomena; Chronotherapy; Combined Modality Therapy; Evidence-Based Medicine; Humans; Mood Disorders; Phototherapy; Research Design; Sleep; Sleep Deprivation
PubMed: 29072179
DOI: 10.4274/balkanmedj.2017.1280 -
International Journal of Computer... Jan 2018Effective and safe performance of cardiovascular interventions requires excellent catheter/guidewire manipulation skills. These skills are currently mainly gained...
PURPOSE
Effective and safe performance of cardiovascular interventions requires excellent catheter/guidewire manipulation skills. These skills are currently mainly gained through an apprenticeship on real patients, which may not be safe or cost-effective. Computer simulation offers an alternative for core skills training. However, replicating the physical behaviour of real instruments navigated through blood vessels is a challenging task.
METHODS
We have developed VCSim3-a virtual reality simulator for cardiovascular interventions. The simulator leverages an inextensible Cosserat rod to model virtual catheters and guidewires. Their mechanical properties were optimized with respect to their real counterparts scanned in a silicone phantom using X-ray CT imaging. The instruments are manipulated via a VSP haptic device. Supporting solutions such as fluoroscopic visualization, contrast flow propagation, cardiac motion, balloon inflation, and stent deployment, enable performing a complete angioplasty procedure.
RESULTS
We present detailed results of simulation accuracy of the virtual instruments, along with their computational performance. In addition, the results of a preliminary face and content validation study conveyed on a group of 17 interventional radiologists are given.
CONCLUSIONS
VR simulation of cardiovascular procedure can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. VCSim3 is still a prototype, yet the initial results indicate that it provides promising foundations for further development.
Topics: Cardiovascular Surgical Procedures; Catheterization; Clinical Competence; Computer Simulation; Humans; Phantoms, Imaging; User-Computer Interface
PubMed: 29079992
DOI: 10.1007/s11548-017-1679-1 -
Journal of the American Society of... Jan 2020Patients with ESKD who would benefit from a kidney transplant face a critical and continuing shortage of kidneys from deceased human donors. As a result, such patients... (Review)
Review
Patients with ESKD who would benefit from a kidney transplant face a critical and continuing shortage of kidneys from deceased human donors. As a result, such patients wait a median of 3.9 years to receive a donor kidney, by which time approximately 35% of transplant candidates have died while waiting or have been removed from the waiting list. Those of blood group B or O may experience a significantly longer waiting period. This problem could be resolved if kidneys from genetically engineered pigs offered an alternative with an acceptable clinical outcome. Attempts to accomplish this have followed two major paths: deletion of pig xenoantigens, as well as insertion of "protective" human transgenes to counter the human immune response. Pigs with up to nine genetic manipulations are now available. In nonhuman primates, administering novel agents that block the CD40/CD154 costimulation pathway, such as an anti-CD40 mAb, suppresses the adaptive immune response, leading to pig kidney graft survival of many months without features of rejection (experiments were terminated for infectious complications). In the absence of innate and adaptive immune responses, the transplanted pig kidneys have generally displayed excellent function. A clinical trial is anticipated within 2 years. We suggest that it would be ethical to offer a pig kidney transplant to selected patients who have a life expectancy shorter than the time it would take for them to obtain a kidney from a deceased human donor. In the future, the pigs will also be genetically engineered to control the adaptive immune response, thus enabling exogenous immunosuppressive therapy to be significantly reduced or eliminated.
Topics: Animals; Animals, Genetically Modified; Clinical Trials as Topic; Kidney Transplantation; Models, Animal; Patient Selection; Primates; Swine; Tissue and Organ Procurement; Transplantation, Heterologous
PubMed: 31792154
DOI: 10.1681/ASN.2019070651 -
The Journal of Pain Feb 2016Expectation and previous experience are both well established key mediators of placebo and nocebo effects. However, the investigation of their respective contribution to...
UNLABELLED
Expectation and previous experience are both well established key mediators of placebo and nocebo effects. However, the investigation of their respective contribution to placebo and nocebo responses is rather difficult because most placebo and nocebo manipulations are contaminated by pre-existing treatment expectancies resulting from a learning history of previous medical interventions. To circumvent any resemblance to classical treatments, a purely psychological placebo-nocebo manipulation was established, namely, the "visual stripe pattern-induced modulation of pain." To this end, experience and expectation regarding the effects of different visual cues (stripe patterns) on pain were varied across 3 different groups, with either only placebo instruction (expectation), placebo conditioning (experience), or both (expectation + experience) applied. Only the combined manipulation (expectation + experience) revealed significant behavioral and physiological placebo-nocebo effects on pain. Two subsequent experiments, which, in addition to placebo and nocebo cues, included a neutral control condition further showed that especially nocebo responses were more easily induced by this psychological placebo and nocebo manipulation. The results emphasize the great effect of psychological processes on placebo and nocebo effects. Particularly, nocebo effects should be addressed more thoroughly and carefully considered in clinical practice to prevent the accidental induction of side effects.
PERSPECTIVE
Even purely psychological interventions that lack any resemblance to classical pain treatments might alter subjective and physiological pain correlates. A manipulation of treatment expectation and actual treatment experience were mandatory to elicit this effect. Nocebo effects were especially induced, which indicated the necessity for prevention of accidental side effects besides exploitation of placebo responses.
Topics: Adult; Conditioning, Psychological; Cues; Female; Galvanic Skin Response; Humans; Male; Nocebo Effect; Pain; Pain Perception; Placebo Effect; Random Allocation; Young Adult
PubMed: 26523863
DOI: 10.1016/j.jpain.2015.10.010 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Nov 2018To investigate the efficacy of manipulation combined with electrical stimulation and biofeedback on the treatment of female sexual dysfunction. Methods: Seventy-two... (Clinical Trial)
Clinical Trial
To investigate the efficacy of manipulation combined with electrical stimulation and biofeedback on the treatment of female sexual dysfunction. Methods: Seventy-two female patients with sexual dysfunction were recruited from the Third Xiangya Hospital of Central South University from January 2014 to December 2015. Subjects were randomly divided into three groups (A, B, and C). Patients in group A and group B received manipulation therapy and electrical stimulation biofeedback therapy, respectively, while patients in group C received manipulation combined with biofeedback electrical stimulation treatment for 30 days. The strength and fatigue degree of the type I and the type II muscle fiber of the pelvic muscles in all groups were evaluated before and one month after the treatment for further comparison. Questionnaire survey was used to investigate the frequency of sexual life and orgasm before and after treatment. Results: The strength and fatigue degree of patients in group C was significantly better than those of the other two groups (P<0.05). Conclusion: Manipulation therapy combined with electrical stimulation and biofeedback can effectively enhance the recovery of sexual dysfunction in postpartum women and improve the quality of sexual life for patients with postpartum sexual dysfunction. It therefore can be spread in clinical practice.
Topics: Biofeedback, Psychology; Electric Stimulation; Female; Humans; Physical Therapy Modalities; Quality of Life; Random Allocation; Sexual Dysfunction, Physiological; Surveys and Questionnaires
PubMed: 30643069
DOI: 10.11817/j.issn.1672-7347.2018.11.011 -
PloS One 2023Bodily awareness arises from somatosensory, vestibular, and visual inputs but cannot be reduced to these incoming sensory signals. Cognitive factors are known to also...
Bodily awareness arises from somatosensory, vestibular, and visual inputs but cannot be reduced to these incoming sensory signals. Cognitive factors are known to also impact bodily awareness, though their specific influence is poorly understood. Here we systematically compared the effects of sensory (bottom-up) and cognitive (top-down) manipulations on the estimated size of body parts. Toward this end, in a repeated-measures design, we sought to induce the illusion that the right index finger was elongating by vibrating the biceps tendon of the left arm whilst participants grasped the tip of their right index finger (Lackner illusion; bottom-up) and separately by hypnotic suggestion (top-down), with a sham version of the Lackner illusion as an active control condition. The effects of these manipulations were assessed with perceptual and motor tasks to capture different components of the representation of body size. We found that hypnotic suggestion significantly induced the illusion in both tasks relative to the sham condition. The magnitudes of these effects were stronger than those in the Lackner illusion condition, which only produced a significantly stronger illusion than the sham condition in the perceptual task. We further observed that illusion magnitude significantly correlated across tasks and conditions, suggesting partly shared mechanisms. These results are in line with theories of separate but interacting representational processes for perception and action and highlight the influence of cognitive factors on low-level body representations.
Topics: Humans; Illusions; Body Size; Fingers; Hypnotics and Sedatives; Research Design
PubMed: 37699046
DOI: 10.1371/journal.pone.0291493 -
Micromachines Mar 2022Cardiovascular diseases (CVDs) are the deadliest diseases worldwide. Master-slave robotic systems have been widely used in vascular interventional surgery with the...
Cardiovascular diseases (CVDs) are the deadliest diseases worldwide. Master-slave robotic systems have been widely used in vascular interventional surgery with the benefit of high safety, efficient operation, and procedural facilitation. This paper introduces a remote-controlled vascular interventional robot (RVIR) that aims to enable surgeons to perform complex vascular interventions reliably and accurately under a magnetic resonance imaging (MRI) environment. The slave robot includes a guidewire manipulator (GM) and catheter manipulator (CM) that are mainly composed of a hollow driving mechanism and a linear motion platform. The hollow driving mechanism is based on a traveling wave-type hollow ultrasonic motor (HUM) which has high positional precision, fast response, and magnetic interference resistance and realizes the cooperation of the guidewire and catheter by omitting the redundant transmission mechanism and maintaining good coaxiality. The HUM stator, the core part of the RVIR, is optimized by an adaptive genetic algorithm for better quality and greater amplitude of traveling waves, which are beneficial to the drive efficiency and precision. The robot system features great cooperating performance, small hysteresis, and high kinematic accuracy and has been experimentally verified for its capability to precisely manipulate the guidewire and catheter.
PubMed: 35334702
DOI: 10.3390/mi13030410 -
Bioinformatics (Oxford, England) Dec 2023statistics from genome-wide association studies enable many valuable downstream analyses that are more efficient than individual-level data analysis while also reducing... (Meta-Analysis)
Meta-Analysis
MOTIVATION
statistics from genome-wide association studies enable many valuable downstream analyses that are more efficient than individual-level data analysis while also reducing privacy concerns. As growing sample sizes enable better-powered analysis of gene-environment interactions, there is a need for gene-environment interaction-specific methods that manipulate and use summary statistics.
RESULTS
We introduce two tools to facilitate such analysis, with a focus on statistical models containing multiple gene-exposure and/or gene-covariate interaction terms. REGEM (RE-analysis of GEM summary statistics) uses summary statistics from a single, multi-exposure genome-wide interaction study to derive analogous sets of summary statistics with arbitrary sets of exposures and interaction covariate adjustments. METAGEM (META-analysis of GEM summary statistics) extends current fixed-effects meta-analysis models to incorporate multiple exposures from multiple studies. We demonstrate the value and efficiency of these tools by exploring alternative methods of accounting for ancestry-related population stratification in genome-wide interaction study in the UK Biobank as well as by conducting a multi-exposure genome-wide interaction study meta-analysis in cohorts from the diabetes-focused ProDiGY consortium. These programs help to maximize the value of summary statistics from diverse and complex gene-environment interaction studies.
AVAILABILITY AND IMPLEMENTATION
REGEM and METAGEM are open-source projects freely available at https://github.com/large-scale-gxe-methods/REGEM and https://github.com/large-scale-gxe-methods/METAGEM.
Topics: Gene-Environment Interaction; Genome-Wide Association Study; Models, Statistical; Sample Size; Data Interpretation, Statistical; Polymorphism, Single Nucleotide; Phenotype
PubMed: 38039147
DOI: 10.1093/bioinformatics/btad730 -
AJOB Empirical Bioethics 2017Voluntary consent/assent with adolescents invited to participate in research raises challenging problems. No studies to date have attempted to manipulate autonomy in... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Voluntary consent/assent with adolescents invited to participate in research raises challenging problems. No studies to date have attempted to manipulate autonomy in relation to assent/consent processes. This study evaluated the effects of an autonomy-enhanced individualized assent/consent procedure embedded within a randomized pediatric asthma clinical trial.
METHODS
Families were randomly assigned to remain together or separated during a consent/assent process; the latter we characterize as an autonomy-enhanced assent/consent procedure. We hypothesized that separating adolescents from their parents would improve adolescent assent by increasing knowledge and appreciation of the clinical trial and willingness to participate.
RESULTS
Sixty-four adolescent-parent dyads completed procedures. The together versus separate randomization made no difference in adolescent or parent willingness to participate. However, significant differences were found in both parent and adolescent knowledge of the asthma clinical trial based on the assent/consent procedure and adolescent age. The separate assent/consent procedure improved knowledge of study risks and benefits for older adolescents and their parents but not for the younger youth or their parents. Regardless of the assent/consent process, younger adolescents had lower comprehension of information associated with the study medication and research risks and benefits, but not study procedures or their research rights and privileges.
CONCLUSIONS
The use of an autonomy-enhanced assent/consent procedure for adolescents may improve their and their parent's informed assent/consent without impacting research participation decisions. Traditional assent/consent procedures may result in a "diffusion of responsibility" effect between parents and older adolescents, specifically in attending to key information associated with study risks and benefits.
Topics: Adolescent; Asthma; Biomedical Research; Child; Comprehension; Decision Making; Female; Health Knowledge, Attitudes, Practice; Humans; Informed Consent By Minors; Male; Parent-Child Relations; Parental Consent; Parents; Personal Autonomy; Research Design; Risk
PubMed: 28949898
DOI: 10.1080/23294515.2016.1251507 -
Psychonomic Bulletin & Review Dec 2021Randomised assignment of individuals to treatment and controls groups is often considered the gold standard to draw valid conclusions about the efficacy of an...
Randomised assignment of individuals to treatment and controls groups is often considered the gold standard to draw valid conclusions about the efficacy of an intervention. In practice, randomisation can lead to accidental differences due to chance. Researchers have offered alternatives to reduce such differences, but these methods are not used frequently due to the requirement of advanced statistical methods. Here, we recommend a simple assignment procedure based on variance minimisation (VM), which assigns incoming participants automatically to the condition that minimises differences between groups in relevant measures. As an example of its application in the research context, we simulated an intervention study whereby a researcher used the VM procedure on a covariate to assign participants to a control and intervention group rather than controlling for the covariate at the analysis stage. Among other features of the simulated study, such as effect size and sample size, we manipulated the correlation between the matching covariate and the outcome variable and the presence of imbalance between groups in the covariate. Our results highlighted the advantages of VM over prevalent random assignment procedure in terms of reducing the Type I error rate and providing accurate estimates of the effect of the group on the outcome variable. The VM procedure is valuable in situations whereby the intervention to an individual begins before the recruitment of the entire sample size is completed. We provide an Excel spreadsheet, as well as scripts in R, MATLAB, and Python to ease and foster the implementation of the VM procedure.
Topics: COVID-19; Humans; Research Design
PubMed: 34244982
DOI: 10.3758/s13423-021-01970-5