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Microsystems & Nanoengineering 2024Targeted delivery of neurochemicals and biomolecules for neuromodulation of brain activity is a powerful technique that, in addition to electrical recording and...
Targeted delivery of neurochemicals and biomolecules for neuromodulation of brain activity is a powerful technique that, in addition to electrical recording and stimulation, enables a more thorough investigation of neural circuit dynamics. We have designed a novel, flexible, implantable neural probe capable of controlled, localized chemical stimulation and electrophysiology recording. The neural probe was implemented using planar micromachining processes on Parylene C, a mechanically flexible, biocompatible substrate. The probe shank features two large microelectrodes (chemical sites) for drug loading and sixteen small microelectrodes for electrophysiology recording to monitor neuronal response to drug release. To reduce the impedance while keeping the size of the microelectrodes small, poly(3,4-ethylenedioxythiophene) (PEDOT) was electrochemically coated on recording microelectrodes. In addition, PEDOT doped with mesoporous sulfonated silica nanoparticles (SNPs) was used on chemical sites to achieve controlled, electrically-actuated drug loading and releasing. Different neurotransmitters, including glutamate (Glu) and gamma-aminobutyric acid (GABA), were incorporated into the SNPs and electrically triggered to release repeatedly. An in vitro experiment was conducted to quantify the stimulated release profile by applying a sinusoidal voltage (0.5 V, 2 Hz). The flexible neural probe was implanted in the barrel cortex of the wild-type Sprague Dawley rats. As expected, due to their excitatory and inhibitory effects, Glu and GABA release caused a significant increase and decrease in neural activity, respectively, which was recorded by the recording microelectrodes. This novel flexible neural probe technology, combining on-demand chemical release and high-resolution electrophysiology recording, is an important addition to the neuroscience toolset used to dissect neural circuitry and investigate neural network connectivity.
PubMed: 38947533
DOI: 10.1038/s41378-024-00685-6 -
World Journal of Orthopedics Jun 2024Mazabraud's syndrome (MS) is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma,...
BACKGROUND
Mazabraud's syndrome (MS) is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma, and is thought to be associated with mutations of the gene. To date, only about 100 cases of MS have been reported in the literature, but its standard treatment strategy remains unclear.
CASE SUMMARY
We report two cases of MS in young women who underwent different treatments based on their symptoms and disease manifestations. The first patient, aged 37, received internal fixation and intravenous bisphosphonate for a pathological fracture of the right femoral neck, excision of a right vastus medialis myxoma was subsequently performed for pain control, and asymptomatic psoas myxomas were monitored without surgery. Genetic testing confirmed a gene mutation in this patient. The second patient, aged 24, underwent right vastus intermedius muscle myxoma resection, and conservative treatment for fibrous dysplasia of the ilium. These patients were followed-up for 17 months and 3 years, respectively, and are now in a stable condition.
CONCLUSION
Various treatments have been selected for MS patients who suffer different symptoms. The main treatment for myxomas is surgical resection, while fibrous dysplasia is selectively treated if the patient experiences pathological fracture or severe pain. However, given the documented instances of malignant transformation of fibrous dysplasia in individuals with MS, close follow-up is necessary.
PubMed: 38947265
DOI: 10.5312/wjo.v15.i6.593 -
Journal of Surgery and Research 2024Damage to the peripheral and central nervous systems is frequently irreversible. Surgically induced neurological damage and anesthesia may result in catastrophic...
Damage to the peripheral and central nervous systems is frequently irreversible. Surgically induced neurological damage and anesthesia may result in catastrophic situations for patients and their families. The incidence of significant neurological complications during the perioperative period is examined in this article. In contrast to other organs like the kidney, heart, liver, lungs, and skeletal system, native neurological function cannot be replaced with artificial parts or devices soon. Ignoring brain function during the perioperative period has been a systemic problem in anesthesiology, even though the central and peripheral nervous systems are crucial. This bold claim is intended to draw attention to the fact that, unlike the circulatory and respiratory systems, which have been routinely monitored for decades, the brain and other neural structures do not have a standard monitoring during surgery and anesthesia. Given that the brain and spinal cord are the principal therapeutic targets of analgesics and anesthetics, this deficiency in clinical care is even more alarming. Organs that are notoriously hard to repair or replace after damage have, up until now, received comparatively little attention. In this article, a succinct overview of five neurological complications associated with surgery and anesthesia is presented. After critically reviewing the literature on the subject, the article is focused to common (delirium), controversial (postoperative cognitive decline), and potentially catastrophic (stroke, spinal cord ischemia, or postoperative visual loss) adverse events in the neurological surgery setting. The findings will increase awareness of major neurological complications to the involved surgical and anesthesia team and enhance preventive and treatment strategies during the perioperative period.
PubMed: 38947250
DOI: No ID Found -
Biomedical Engineering Letters Jul 2024The thoracic nerves form a complex neural network that coordinates involuntary muscles such as breathing and the heart. Breathing has various patterns to maintain... (Review)
Review
UNLABELLED
The thoracic nerves form a complex neural network that coordinates involuntary muscles such as breathing and the heart. Breathing has various patterns to maintain homeostasis in the human body. This study analyzes changes in the cardiovascular system and breathing patterns induced by stress caused by various mechanical movements performed in daily life and ultimately, the goal is to propose effective breathing patterns and breathing control methods to maintain cardiovascular homeostasis. The participants' age was 26.97 ± 3.93 years, height was 170.24 ± 8.61 cm, and weight was 65.69 ± 13.55 Kg, and there were 62 men and 38 women. Breathing and electrocardiogram were obtained using HiCard+, a biometric monitoring device. The measured electrocardiogram was analyzed for heartbeat interval, which indicates changes in the cardiovascular system, and standard deviation of normal to normal interval (SDNN) and root mean square of the successive differences (rMSSD), which indicate the activity of the autonomic and parasympathetic nervous systems. For respiration, time changes were analyzed as patterns by calculating inspiration and exhalation times. As a result of this study, rapid changes in blood pressure increased SDNN and rMSSD from 0.053 ± 0.06 and 0.056 ± 0.087 to 0.109 ± 0.114 and 0.125 ± 0.170 s, and induced an increase in spontaneous inspiratory time from 1.46 to 1.51 s ( < 0.05). Ultimately, we hope that the results of this study will be used as a breathing control training technique to prevent and manage rapid cardiovascular changes.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s13534-024-00379-y.
PubMed: 38946807
DOI: 10.1007/s13534-024-00379-y -
Journal of Gastrointestinal and Liver... Jun 2024Endoscopy simulators are primarily designed to provide training in interventions performed during procedures. Peri-interventional tasks such as checking patient data,...
BACKGROUND AND AIMS
Endoscopy simulators are primarily designed to provide training in interventions performed during procedures. Peri-interventional tasks such as checking patient data, filling out forms for team time-out, patient monitoring, and performing sedation are often not covered. This study assesses the face, content, and construct validity of the ViGaTu (Virtual Gastro Tutor) immersive virtual reality (VR) simulator in teaching these skills.
METHODS
71 nurses and physicians were invited to take part in VR training. The participants experienced an immersive VR simulation of an endoscopy procedure, including setting up the endoscopic devices, checking sign-in and team time-out forms, placing monitoring devices, and performing sedation. The actions performed by the participants and their timing were continuously recorded. Face and content validity, as well as the System Usability Scale (SUS), were then assessed.
RESULTS
43 physicians and 28 nurses from 43 centers took a mean of 27.8 min (standard deviation ± 14.42 min) to complete the simulation. Seventy-five percent of the items for assessing face validity were rated as realistic, and 60% of items assessing content validity and usefulness of the simulation for different learning goals were rated as useful by the participants (four out of five on a Likert scale). The SUS score was 70, demonstrating a high degree of usability. With regard to construct validity, experienced endoscopy staff were significantly faster in setting up the endoscope tower and instruments than beginners.
CONCLUSIONS
This multicenter study presents a new type of interdisciplinary endoscopy training system featuring peri-interventional tasks and sedation in an immersive VR environment.
Topics: Humans; Virtual Reality; Clinical Competence; Simulation Training; Reproducibility of Results; Female; Adult; Male; Endoscopy, Gastrointestinal; Nurses; Middle Aged; Physicians
PubMed: 38944875
DOI: 10.15403/jgld-5440 -
International Journal of Cardiology Jun 2024Guidelines recommend insertable cardiac monitor (ICM) in the early phases of the evaluation of unexplained syncope (US) syncope, when an arrhythmic etiology is...
AIMS
Guidelines recommend insertable cardiac monitor (ICM) in the early phases of the evaluation of unexplained syncope (US) syncope, when an arrhythmic etiology is suspected. We examined the diagnostic yield of the last generation ICM (LG-ICM) to establish the causes of US, by assessing in the clinical practice the incidence of: relevant arrhythmia diagnosis, syncope recurrences and CM-guided cardiac electronic device (CIED) implantation. We investigated also baseline patient characteristics associated to an increased risk of relevant arrhythmias and of syncope recurrence.
METHODS
Data prospectively collected from consecutive patients receiving LG-ICM for investigation of US or presyncope in our institution between November 2020 and January 2023 were analyzed.
RESULTS
A total of 109 patients (mean age 64.4 ± 16.1 years, 40.4% women) with US or pre-syncope episodes underwent implantation of the LG-ICM. During a mean follow-up of 11.7 ± 8.1 months, LG-ICM diagnostic yield was 42% . In particular, LG-ICM detected cardiac arrhythmias in 29 (27%) patients (in 6 out of them during a syncope recurrence) and to exclude the arrhythmic origin of the syncope in additional 19 (17%) patients. LG-ICM guided the implantation of a CIED in 16 (15%) US patients, due to the diagnosis of asystole or severe bradycardia. Age ≥ 65 years (p = 0.012) and atrial arrhythmia history (p = 0.004) are significant independent predictors of arrhythmic diagnoses performed by LG-ICM, while CAD is predictor of syncope recurrence (bordering on statistical significance, p = 0.056).
CONCLUSIONS
The diagnostic yield of LG-ICM in US syncope is comparable to those of ILR and previous generation ICM. The advantages of LG-ICM should be sought in lower hospital workload necessary to manage ICM data. Age ≥ 65 years and atrial arrhythmia history are independent predictors of significant ICM-detected arrhythmias.
PubMed: 38944347
DOI: 10.1016/j.ijcard.2024.132301 -
Biomedicine & Pharmacotherapy =... Jun 2024The integration of biochips with AI opened up new possibilities and is expected to revolutionize smart healthcare tools within the next five years. The combination of... (Review)
Review
The integration of biochips with AI opened up new possibilities and is expected to revolutionize smart healthcare tools within the next five years. The combination of miniaturized, multi-functional, rapid, high-throughput sample processing and sensing capabilities of biochips, with the computational data processing and predictive power of AI, allows medical professionals to collect and analyze vast amounts of data quickly and efficiently, leading to more accurate and timely diagnoses and prognostic evaluations. Biochips, as smart healthcare devices, offer continuous monitoring of patient symptoms. Integrated virtual assistants have the potential to send predictive feedback to users and healthcare practitioners, paving the way for personalized and predictive medicine. This review explores the current state-of-the-art biochip technologies including gene-chips, organ-on-a-chips, and neural implants, and the diagnostic and therapeutic utility of AI-assisted biochips in medical practices such as cancer, diabetes, infectious diseases, and neurological disorders. Choosing the appropriate AI model for a specific biomedical application, and possible solutions to the current challenges are explored. Surveying advances in machine learning models for biochip functionality, this paper offers a review of biochips for the future of biomedicine, an essential guide for keeping up with trends in healthcare, while inspiring cross-disciplinary collaboration among biomedical engineering, medicine, and machine learning fields.
PubMed: 38943990
DOI: 10.1016/j.biopha.2024.116997 -
Korean Journal of Radiology Jul 2024In Korea, radiology has been positioned towards the early adoption of artificial intelligence-based software as medical devices (AI-SaMDs); however, little is known...
OBJECTIVE
In Korea, radiology has been positioned towards the early adoption of artificial intelligence-based software as medical devices (AI-SaMDs); however, little is known about the current usage, implementation, and future needs of AI-SaMDs. We surveyed the current trends and expectations for AI-SaMDs among members of the Korean Society of Radiology (KSR).
MATERIALS AND METHODS
An anonymous and voluntary online survey was open to all KSR members between April 17 and May 15, 2023. The survey was focused on the experiences of using AI-SaMDs, patterns of usage, levels of satisfaction, and expectations regarding the use of AI-SaMDs, including the roles of the industry, government, and KSR regarding the clinical use of AI-SaMDs.
RESULTS
Among the 370 respondents (response rate: 7.7% [370/4792]; 340 board-certified radiologists; 210 from academic institutions), 60.3% (223/370) had experience using AI-SaMDs. The two most common use-case of AI-SaMDs among the respondents were lesion detection (82.1%, 183/223), lesion diagnosis/classification (55.2%, 123/223), with the target imaging modalities being plain radiography (62.3%, 139/223), CT (42.6%, 95/223), mammography (29.1%, 65/223), and MRI (28.7%, 64/223). Most users were satisfied with AI-SaMDs (67.6% [115/170, for improvement of patient management] to 85.1% [189/222, for performance]). Regarding the expansion of clinical applications, most respondents expressed a preference for AI-SaMDs to assist in detection/diagnosis (77.0%, 285/370) and to perform automated measurement/quantification (63.5%, 235/370). Most respondents indicated that future development of AI-SaMDs should focus on improving practice efficiency (81.9%, 303/370) and quality (71.4%, 264/370). Overall, 91.9% of the respondents (340/370) agreed that there is a need for education or guidelines driven by the KSR regarding the use of AI-SaMDs.
CONCLUSION
The penetration rate of AI-SaMDs in clinical practice and the corresponding satisfaction levels were high among members of the KSR. Most AI-SaMDs have been used for lesion detection, diagnosis, and classification. Most respondents requested KSR-driven education or guidelines on the use of AI-SaMDs.
Topics: Humans; Republic of Korea; Artificial Intelligence; Surveys and Questionnaires; Societies, Medical; Radiology; Software
PubMed: 38942455
DOI: 10.3348/kjr.2023.1246 -
Journal of Colloid and Interface Science Jun 2024In this study, we present a nanocomposite hydrogel designed for skin motion sensing. The hydrogel is based on poly(acrylamide) crosslinked with gold nanoparticles...
In this study, we present a nanocomposite hydrogel designed for skin motion sensing. The hydrogel is based on poly(acrylamide) crosslinked with gold nanoparticles covalently bound to the polymer matrix, yielding a robust, highly elastic and conductive material. The choice of amino acid derivative - N,N'-diacryloylcystine salt (BISS) - as a crosslinker allows for the introduction of gold nanoparticles, due to the presence of sulfide groups in its structure. During the nanoparticle modification process, covalent bonds between gold and sulfur atoms are formed as the disulfide bond is cleaved. In result of this self-assembly process, a multifunctional Au-BISS crosslinker is formed, enhancing the material's mechanical properties and introducing electrical conductivity. To confer anti-freezing properties and limit water evaporation, a binary mixture of water and glycerol was used. The resultant hydrogel exhibits high elasticity, strain sensitivity across a wide strain range and various types of deformation (elongation, bending, compression) with exceptional response time (120 ms) and recovery time (90 ms). The material's cold-resistance, resilience, and conductivity make it well-suited for real-time monitoring of joint movements and speech recognition, with potential applications in electronic skin and healthcare monitoring devices.
PubMed: 38941933
DOI: 10.1016/j.jcis.2024.06.186 -
Journal of Chromatography. A Jun 2024The greater and more widespread use of chemicals, either from industry or daily use, is leading to an increase in the discharge of these substances into the environment.... (Review)
Review
The greater and more widespread use of chemicals, either from industry or daily use, is leading to an increase in the discharge of these substances into the environment. Some of these are known to be hazardous to humans and the environment and are regulated, but there is a large and increasing number of substances which pose a potential risk even at low concentration and are not controlled. In this context, new techniques and methodologies are being developed to deal with this concern. Miniaturized liquid chromatography (LC) emerges as a greener and more sensitive alternative to conventional LC. Furthermore, advances in instrument miniaturization have made possible the development of portable LC instrumentation which may become a promising tool for in-situ monitoring. This work reviews the environmental applications of miniaturized LC over the last 15 years and discusses the different instrumentation, including off- and on-line pretreatment techniques, chromatographic conditions, and contributions to the environmental knowledge.
PubMed: 38941795
DOI: 10.1016/j.chroma.2024.465101