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ELife Jul 2024The sensorimotor system can recalibrate itself without our conscious awareness, a type of procedural learning whose computational mechanism remains undefined. Recent...
The sensorimotor system can recalibrate itself without our conscious awareness, a type of procedural learning whose computational mechanism remains undefined. Recent findings on implicit motor adaptation, such as over-learning from small perturbations and fast saturation for increasing perturbation size, challenge existing theories based on sensory errors. We argue that perceptual error, arising from the optimal combination of movement-related cues, is the primary driver of implicit adaptation. Central to our theory is the increasing sensory uncertainty of visual cues with increasing perturbations, which was validated through perceptual psychophysics (Experiment 1). Our theory predicts the learning dynamics of implicit adaptation across a spectrum of perturbation sizes on a trial-by-trial basis (Experiment 2). It explains proprioception changes and their relation to visual perturbation (Experiment 3). By modulating visual uncertainty in perturbation, we induced unique adaptation responses in line with our model predictions (Experiment 4). Overall, our perceptual error framework outperforms existing models based on sensory errors, suggesting that perceptual error in locating one's effector, supported by Bayesian cue integration, underpins the sensorimotor system's implicit adaptation.
Topics: Humans; Bayes Theorem; Adaptation, Physiological; Cues; Male; Adult; Young Adult; Female; Psychomotor Performance; Learning; Visual Perception; Proprioception
PubMed: 38963410
DOI: 10.7554/eLife.94608 -
The International Journal of... Jul 2024In recent years, exercise has been increasingly recognised as an effective and promising non-pharmacological intervention to improve physical function in patients with...
In recent years, exercise has been increasingly recognised as an effective and promising non-pharmacological intervention to improve physical function in patients with Parkinson's disease (PD). Cardiorespiratory fitness (CRF) is an objective measure of a person's ability to perform aerobic exercise. Therefore, it is necessary to evaluate the CRF of patients with PD.However, the CRF of Chinese patients with PD is deficient.This study is to evaluate cardiorespiratory fitness in patients with early to mid-stage PD by cardiopulmonary exercise test(CPET) on a stationary cycle ergometer; :To compare the differences in each index of the CPET between the two groups of subjects; general data such as disease duration, medication use and exercise habits were also collected.:1)Finally, 36 PD patients and 12 healthy controls successfully completed the CPET without any adverse events.2)The V'Opeak, Metspeak, RERpeak, MVVpeak, Wpeak, HRpeak, HRpeak/pre,percentage of HRR-1 min decay > 12 bpm,SBPpeak in the PD group were lower than those in the control group(p < 0.05,each). Detailed data:V'O2peak(15.7 ± 4.5vs21.5 ± 3.6ml/kg/min,p < 0.01),Metspeak(4.5 ± 1.3 vs 6.1 ± 1.0,p < 0.01),RERpeak(1.04 ± 0.10 vs 1.15 ± 0.10,p = 0.001),MVVpeak(37.22 ± 11.58 vs 53.00 ± 16.85L/min,p = 0.009),Wpeak(49.17 ± 29.72vs49.17 ± 29.72W,p < 0.01),HRpeak(111.08 ± 16.67 vs111.08 ± 16.67bpm,p < 0.01),HRpeak/pre(71.19 ± 10.06 vs96.00 ± 21.13,p = 0.002),percentage of HRR-1min decay > 12bpm(33.3% vs 100%,p < 0.01),SBP(155.81 ± 31.83 vs 175.83 ± 17.84mmHg,p = 0.01).3)Divided PD patients into high V'Opeak group(V'Opeak ≥ 15 mL/kg/min) and low V'Opeak group(V'Opeak < 15 mL/kg/min). The age of patients, Hoehn-Yahr grade and incidence of symptom fluctuation in high V'Opeak group were lower(p < 0.05,respectively),percentage of males and percentage of HRR-1 min decay > 12 bpm were higher(p < 0.05,respectively);p < 0.05 is considered a statistically significant difference.Detailed data:age of patients(61.05 ± 6.93vs68.57 ± 7.99years,p = 0.005),Hoehn-Yahr grade(1.75 ± 0.48 vs 2.18 ± 0.64,p = 0.028),incidence of symptom fluctuation(59.1 vs 92.9%,p = 0.03),percentage of males(77.7 vs 42.9%,p = 0.041),percentage of HRR-1 min decay > 12 bpm(50 vs 7.1%,p = 0.008). :CPET were safe to perform and the cardiorespiratory fitness is significantly reduced in patients with early and middle stage Parkinson's disease.Patients with PD presented blunted HR and SBP responses to exercise test. Females, older age, fluctuating symptoms, high H-Y staging, and higher ADL may be associated with lower oxygen uptake.
PubMed: 38963402
DOI: 10.1080/00207454.2024.2377140 -
Scandinavian Cardiovascular Journal :... Dec 2024Despite advancements in surgical techniques, operations for infective endocarditis (IE) remain associated with relatively high mortality. The aim of this study was to...
OBJECTIVE
Despite advancements in surgical techniques, operations for infective endocarditis (IE) remain associated with relatively high mortality. The aim of this study was to develop a nomogram model to predict the early postoperative mortality in patients undergoing cardiac surgery for infective endocarditis based on the preoperative clinical features.
METHODS
We retrospectively analyzed the clinical data of 357 patients with IE who underwent surgeries at our center between January 2007 and June 2023. Independent risk factors for early postoperative mortality were identified using univariate and multivariate logistic regression models. Based on these factors, a predictive model was developed and presented in a nomogram. The performance of the nomogram was evaluated through the receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA). Internal validation was performed utilizing the bootstrapping method.
RESULTS
The nomogram included nine predictors: age, stroke, pulmonary embolism, albumin level, cardiac function class IV, antibotic use <4weeks, vegetation size ≥1.5 cm, perivalvular abscess and preoperative dialysis. The area under the ROC curve (AUC) of the model was 0.88 (95%CI:0.80-0.96). The calibration plot indicated strong prediction consistency of the nomogram with satisfactory Hosmer-Lemeshow test results (χ2 = 13.490, = 0.142). Decision curve analysis indicated that the nomogram model provided greater clinical net benefits compared to "operate-all" or "operate-none" strategies.
CONCLUSIONS
The innovative nomogram model offers cardiovascular surgeons a tool to predict the risk of early postoperative mortality in patients undergoing IE operations. This model can serve as a valuable reference for preoperative decision-making and can enhance the clinical outcomes of IE patients.
Topics: Humans; Nomograms; Retrospective Studies; Male; Female; Middle Aged; Cardiac Surgical Procedures; Risk Factors; Risk Assessment; Predictive Value of Tests; Endocarditis; Time Factors; Aged; Treatment Outcome; Decision Support Techniques; Adult; Reproducibility of Results; Clinical Decision-Making
PubMed: 38963397
DOI: 10.1080/14017431.2024.2373084 -
Annals of Cardiac Anaesthesia Jul 2024
Topics: Humans; Coronary Artery Bypass; Tattooing; Anesthesiologists; Male
PubMed: 38963378
DOI: 10.4103/aca.aca_41_24 -
Annals of Cardiac Anaesthesia Jul 2024
Topics: Humans; Mitral Valve Stenosis; Bronchiectasis; Male; Echocardiography, Transesophageal; Female; Middle Aged
PubMed: 38963372
DOI: 10.4103/aca.aca_155_23 -
Annals of Cardiac Anaesthesia Jul 2024
Topics: Humans; Echocardiography, Transesophageal; Coronary Artery Bypass; Monitoring, Intraoperative; Male; Aged
PubMed: 38963371
DOI: 10.4103/aca.aca_213_23 -
Annals of Cardiac Anaesthesia Jul 2024Pregnancy in a patient with pulmonary hypertension carries a high risk of mortality. It poses multiple problems in the management of pregnancy, labor, and postpartum,...
Pregnancy in a patient with pulmonary hypertension carries a high risk of mortality. It poses multiple problems in the management of pregnancy, labor, and postpartum, thereby emphasizing the need for a multidisciplinary team for a successful outcome. We describe the successful management of a case of Eisenmenger syndrome who developed pre-eclampsia during her 28 weeks of pregnancy. As far as our knowledge, this is the first case report that describes the use of milrinone in a parturient for a successful outcome.
Topics: Humans; Milrinone; Female; Pregnancy; Eisenmenger Complex; Perioperative Care; Pre-Eclampsia; Adult; Pregnancy Complications, Cardiovascular; Vasodilator Agents; Cesarean Section
PubMed: 38963369
DOI: 10.4103/aca.aca_191_23 -
Annals of Cardiac Anaesthesia Jul 2024Isolated persistent left superior vena cava (PLSVC) is a very rare congenital thoracic venous system anomaly and is commonly an incidental finding, usually detected...
Ischemic Heart Disease with In-Stent Re-Stenosis with Complete Heart Block and Isolated Persistent Left Superior Vena Cava - Rare Case Report with Challenges and Clinical Implications.
Isolated persistent left superior vena cava (PLSVC) is a very rare congenital thoracic venous system anomaly and is commonly an incidental finding, usually detected during central venous access, cardiac catheterization, or cardiothoracic surgeries. This is a rare case report wherein the patient is a known case of ischemic heart disease with s/p percutaneous transluminal coronary angioplasty (PTCA) with a stent to left anterior descending (LAD) artery with in-stent re-stenosis presented with complete heart block and had an unanticipated discovery of isolated PLSVC on facing difficulty during the transvenous approach of permanent pacemaker implantation (PPI). In this case report, we inspect the challenges associated with and various clinical implications of isolated PLSVC.
Topics: Humans; Stents; Myocardial Ischemia; Heart Block; Persistent Left Superior Vena Cava; Male; Angioplasty, Balloon, Coronary; Vena Cava, Superior; Middle Aged
PubMed: 38963367
DOI: 10.4103/aca.aca_166_23 -
Annals of Cardiac Anaesthesia Jul 2024Postpneumonectomy syndrome (PPS) is a rare, life-threatening complication characterized by dynamic airway obstruction due to mediastinal rotation at any time point...
Postpneumonectomy syndrome (PPS) is a rare, life-threatening complication characterized by dynamic airway obstruction due to mediastinal rotation at any time point following pneumonectomy. This can produce life-threatening respiratory and cardiovascular complications. We report a case who developed PPS following right pneumonectomy in a 55-year-old female patient with small cell carcinoma (SCC) right lung.
Topics: Humans; Female; Pneumonectomy; Middle Aged; Lung Neoplasms; Postoperative Complications; Syndrome; Airway Obstruction; Small Cell Lung Carcinoma; Carcinoma, Small Cell; Tomography, X-Ray Computed
PubMed: 38963366
DOI: 10.4103/aca.aca_201_23 -
Annals of Cardiac Anaesthesia Jul 2024Intraoperative aortic dissection is a life-threatening emergency. The prognosis of patients with aortic dissection has markedly improved in recent years due to prompt...
Intraoperative aortic dissection is a life-threatening emergency. The prognosis of patients with aortic dissection has markedly improved in recent years due to prompt diagnosis and the institution of effective medical and surgical therapy. Transesophageal echocardiography (TEE) is helpful in the evaluation of this life-threatening disorder.
Topics: Humans; Aortic Dissection; Echocardiography, Transesophageal; Aorta; Intraoperative Complications; Aortic Aneurysm; Male; Female; Middle Aged
PubMed: 38963365
DOI: 10.4103/aca.aca_144_23