In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With ...In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With the global rise of T1DM,there is an increased burden on society and healthcare systems.Due to insulin therapy and islet dysfunction,T1DM patients are highly vulnerable to severe hypoglycemia,a leading cause of mortality.In healthy individuals,counterregulatory mechanisms restore blood glucose during hypoglycemia,but repeated episodes impair these responses.Jin et al demonstrated that overexpression of GLP-1 attenuates the sympathetic-adrenal reflex and disrupts the secretion of counterregulatory hormones such as glucagon during hypoglycemia,leading to counterregulatory dysfunction.These findings highlight the critical role of GLP-1 in the impaired counterregulatory response to hypoglycemia in T1DM patients and provide new insights into the potential application of GLP-1-related therapies in T1DM patients.展开更多
The purpose of this article is to introduce a new method with a self-adaptive stepsize for approximating a common solution of monotone inclusion problems and variational inequality problems in reflexive Banach spaces....The purpose of this article is to introduce a new method with a self-adaptive stepsize for approximating a common solution of monotone inclusion problems and variational inequality problems in reflexive Banach spaces.The strong convergence result for our method is established under some standard assumptions without any requirement of the knowledge of the Lipschitz constant of the mapping.Several numerical experiments are provided to verify the advantages and efficiency of proposed algorithms.展开更多
Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60...Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group,using a random number table method.The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery,while the observation group received an intravenous pump infusion of dexmedetomidine(1μg/kg,diluted to 4μg/ml with normal saline).The severity of cough(graded from 0 to 3)and vital signs,including heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse oxygen saturation(SpO₂),were recorded 5 minutes before extubation,at the time of extubation,and 5 minutes after extubation in both groups.Results:The severity of cough in the observation group was significantly milder than that in the control group(P<0.05),with a significantly higher proportion of grade 0 cough in the observation group(23.33%vs 3.33%).At extubation and five minutes post-extubation,the observation group exhibited significantly lower HR,SBP,and DBP than the control group(P<0.05).In contrast,SpO_(2)levels remained comparable between the groups(P>0.05).Conclusion:Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia,reduce the severity of cough,stabilize hemodynamic parameters,and has no significant impact on respiratory function,demonstrating good clinical safety.展开更多
BACKGROUND Multiple sclerosis(MS)is known to affect many sensory systems,yet most auditory research in MS has focused on the afferent pathways,with relatively few studies examining efferent function.The brainstem is a...BACKGROUND Multiple sclerosis(MS)is known to affect many sensory systems,yet most auditory research in MS has focused on the afferent pathways,with relatively few studies examining efferent function.The brainstem is a common site for MS plaques,and the medial olivocochlear(MOC)system is located in the superior olivary complex(SOC)of the brainstem.The cochlear nuclei are also involved in the MOC reflex arc.Additionally,the temporal cortex can modulate the SOC and cochlear nucleus,so lesions in the brainstem or temporal cortex may affect the MOC reflex in MS.AIM To investigate efferent auditory system activity in patients with multiple sclerosis via the MOC reflex.METHODS The study included 50 patients with MS and 50 healthy controls.Patients with MS were divided into three subgroups according to cranial magnetic resonance imaging findings:Patients with brainstem lesions(Group 1,n=20);patients with temporal cortex lesions without brainstem involvement(Group 2,n=20);and patients without any lesions in the brainstem or temporal cortex(Group 3,n=10).Tympanometry,acoustic stapedial reflex thresholds,pure-tone audiometry,and transientevoked otoacoustic emission(TEOAE)tests(with and without contralateral noise)were performed for all participants.RESULTS There was no significant difference in pure-tone hearing thresholds or baseline TEOAE amplitudes between the MS and control groups,indicating normal cochlear function in patients with MS;however,MOC reflex suppression was significantly reduced in patients with MS compared to controls(P=0.021).In particular,Group 1(MS with brainstem lesions)showed the lowest mean suppression values,which was significantly lower than that of Group 2 and the control group(P=0.002).By contrast,Group 2 and Group 3 did not significantly differ from controls.Additionally,patients with MS exhibited a sex difference in MOC function:Male patients had significantly lower suppression compared to female patients both within Group 1 and in the MS group as a whole.CONCLUSION The findings indicate that the efferent auditory system(specifically the MOC reflex)is affected by MS.MOC reflex activity was most significantly decreased in patients with MS with brainstem lesions,while temporal cortex lesions alone did not appear to notably impair the MOC reflex.Diminished MOC activity may underlie various auditory difficulties in patients with MS(e.g.,hearing in noise),and loss of efferent suppression could contribute to symptoms such as hyperacusis or tinnitus in this population.Further studies are needed to better understand the relationship between MOC dysfunction and auditory symptoms in MS,as well as the potential diagnostic value of MOC testing in MS.展开更多
The cylindrical virtual cathode reflex triode is a new type of pulsed hard X-ray load,which has the advantages of simple structure,high radiation conversion efficiency,and simplicity in seriesparallel operation.This p...The cylindrical virtual cathode reflex triode is a new type of pulsed hard X-ray load,which has the advantages of simple structure,high radiation conversion efficiency,and simplicity in seriesparallel operation.This paper presents a method to reduce the impedance of the triode using a multiring cathode.The average electric field on the ring-cathode emission surface is enhanced due to edge effect,and the beam intensity is greatly increased in proportion to the square of the electric field strength.Multi-ring cathode is used to enlarge the emission area.Therefore,the reflex triode can work at lower impedance and generate a stronger beam under the same anode-cathode gap.In addition,the electric field enhancement of the cathode reduces the cathode emission stabilization time and enhances the operation stability of the triode.The effects of parameters such as ring width and ring gap on the triode impedance are simulated and studied.The cathode emission stabilization time and the X-ray conversion efficiency are compared.The design basis of cathode structure parameters and the impedance control method of the cylindrical virtual cathode reflex triode are given according to the simulations.展开更多
Objective:This study aimed to develop and evaluate a novel software tool for robust analysis of the Visually Enhanced Vestibular-Ocular Reflex(VVOR)and video head impulse test(vHIT)saccades.Methods:A retrospective stu...Objective:This study aimed to develop and evaluate a novel software tool for robust analysis of the Visually Enhanced Vestibular-Ocular Reflex(VVOR)and video head impulse test(vHIT)saccades.Methods:A retrospective study was conducted on 94 patients with Meniere’s Disease(MD),unilateral vestibular hypofunction(UVH),and vestibular migraine(VM).The MATLAB-based VVOR Analysis System and Saccades All in One software were utilized for data processing.New techniques,VVOR_diff and VVOR_cycle,were deployed for saccade parameter extraction.Results:Saccade incidence rates,examined through vHIT,VVOR_diff,and VVOR_cycle,exhibited distinct patterns in MD,UVH,and VM patients.Frequent instances of multiple saccades within a single cycle were noted on the affected side in MD and UVH patients.Statistically significant differences in saccade gain and incidence rates between the affected and unaffected sides were evident in MD and UVH patients.Notably,high inter-method and intra-method correlations suggested consistency across different methods and potential interactions within one.Conclusion:The software proved effective in extracting saccades and reducing noise in VVOR data,thereby enhancing the evaluation of vestibular function and potentially improving diagnostic accuracy for vestibular disorders.展开更多
Prostate cancer (PCa) is the second leading cause of cancer-related death among men. Prostate-specific antigen (PSA) testing is used in screening programs for early detection with a consequent reduction of PCa-specifi...Prostate cancer (PCa) is the second leading cause of cancer-related death among men. Prostate-specific antigen (PSA) testing is used in screening programs for early detection with a consequent reduction of PCa-specific mortality at the cost of overdiagnosis and overtreatment of the nonaggressive PCa. Recently, several assays have been commercially developed to implement PCa diagnosis, but they have not been included in both screening and diagnosis of PCa. This review aims to describe the actual and novel commercially available molecular biomarkers that can be used in PCa management to implement and tailor the screening and diagnosis of PCa.展开更多
Background:Acute lateral ankle sprains(ALAS)are associated with long-term impairments and instability tied to altered neural excitability.Arthrogenic muscle inhibition(AMI)has been observed in this population;however,...Background:Acute lateral ankle sprains(ALAS)are associated with long-term impairments and instability tied to altered neural excitability.Arthrogenic muscle inhibition(AMI)has been observed in this population;however,relationships with injury-related impairments are unclear,potentially due to the resting,prone position in which AMI is typically measured.Assessing AMI during bipedal stance may provide a better understanding of this relationship.Methods:AMI was assessed in 38 young adults(19 ALAS within 72 h of injury:10 males,21.4±2.7 years;19 healthy controls:10 males,21.9±2.2 years;mean±SD)using the Hoffmann reflex(H-reflex)during bipedal stance.Electrical stimulation was administered to identify the _(max)imal H-reflex(H_(max))and _(max)imal motor response(M_(max))from the soleus,fibularis longus,and tibialis anterior muscles.The primary outcome measure was the H_(max)/M_(max) ratio.Secondary outcomes included acute symptoms(pain and swelling),postural control during bipedal stance,and self-reported function.Results:No significant group-by-limb interactions were observed for any muscle.However,a significant group main effect was observed in the soleus muscle(F(1,35)=6.82,p=0.013),indicating significantly lower H_(max)/M_(max) ratios following ALAS(0.38±0.20)compared to healthy controls(0.53±0.16).Furthermore,lower H_(max)/M_(max) ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control.Conclusion:This study supports previous evidence of AMI in patients with ALAS,providing insight into neurophysiologic impacts of musculoskeletal injury.Our results suggest that assessing AMI in a standing position following acute injury may provide valuable insight into how AMI develops and guide potential therapeutic options to curb and offset the formation of joint instability.展开更多
Pupil dynamics are the important characteristics of face spoofing detection.The face recognition system is one of the most used biometrics for authenticating individual identity.The main threats to the facial recognit...Pupil dynamics are the important characteristics of face spoofing detection.The face recognition system is one of the most used biometrics for authenticating individual identity.The main threats to the facial recognition system are different types of presentation attacks like print attacks,3D mask attacks,replay attacks,etc.The proposed model uses pupil characteristics for liveness detection during the authentication process.The pupillary light reflex is an involuntary reaction controlling the pupil’s diameter at different light intensities.The proposed framework consists of two-phase methodologies.In the first phase,the pupil’s diameter is calculated by applying stimulus(light)in one eye of the subject and calculating the constriction of the pupil size on both eyes in different video frames.The above measurement is converted into feature space using Kohn and Clynes model-defined parameters.The Support Vector Machine is used to classify legitimate subjects when the diameter change is normal(or when the eye is alive)or illegitimate subjects when there is no change or abnormal oscillations of pupil behavior due to the presence of printed photograph,video,or 3D mask of the subject in front of the camera.In the second phase,we perform the facial recognition process.Scale-invariant feature transform(SIFT)is used to find the features from the facial images,with each feature having a size of a 128-dimensional vector.These features are scale,rotation,and orientation invariant and are used for recognizing facial images.The brute force matching algorithm is used for matching features of two different images.The threshold value we considered is 0.08 for good matches.To analyze the performance of the framework,we tested our model in two Face antispoofing datasets named Replay attack datasets and CASIA-SURF datasets,which were used because they contain the videos of the subjects in each sample having three modalities(RGB,IR,Depth).The CASIA-SURF datasets showed an 89.9%Equal Error Rate,while the Replay Attack datasets showed a 92.1%Equal Error Rate.展开更多
Numerous studies from different international groups have demonstrated that sensations can be propagated along acupuncture channel pathways.The propagated sensation along the channel pathway(PSCP)can be elicited by el...Numerous studies from different international groups have demonstrated that sensations can be propagated along acupuncture channel pathways.The propagated sensation along the channel pathway(PSCP)can be elicited by electroacupuncture(EA),transcutaneous electrical nerve stimulation(TENS),manual acupuncture(MA),and heat applied to distal acupuncture points(acupoints).Nitric oxide(NO)levels were reported to be elevated in the gracile nucleus and skin regions near to the EA sites,with higher levels at acupoints associated with an enhanced expression of NO synthase and transient receptor potential vanilloid type 1.The stimuli,EA,MA,TENS,and heat,have been used to elicit axonal reflexes,which increase local release of NO and neuropeptides such as calcitonin gene related peptide.Furthermore,the sensation of PSCP along the body surface occurs only ipsilaterally to the stimulated acupoints in various human studies,which does not support the involvement of the spinal-thalamic pathway,which would involve cross over transmission of the signals.The gracile nucleus receives ascending input from the sciatic nerve and responds to somatosensory stimulation mainly on the ipsilateral side via the dorsal column pathway.EA at Zusanli(ST36)increases NO release and expression of NO synthase mainly in the ipsilateral side of the gracile nucleus,while the cardiovascular effects and analgesic responses to EA at ST36 are changed by influences of l-arginine-derived NO synthesis in the ipsilateral gracile nucleus in rats.The stimuli-induced release of NOergic molecules and neuropeptides exist high levels in the acupoints,which contain rich neuronal components and blood vessels.Enhanced NOergic molecules at acupoints cause axon reflexes during the stimuli,which elevate cutaneous blood flow.Elevated NOergic molecules and local blood flow may spread over acupoints one after another along the meridian lines differing from nerve pathways following the stimuli to induce PSCP.The same types of stimulation also elicit NO release in the gracile nucleus,which contributes to the somatosensory signal transduction of PSCP through the dorsal medulla-thalamic pathways.Other substances such as serotonin and catecholamines are proposed to mediate responses and certain effects of acupuncture-like stimulation but their mechanisms are poorly-understood.In this review we summarize the current understanding of the neurobiological processes of PSCP research with an emphasis on recent developments of NO mediating stimulation-evoked axon reflexes and somatosensory signal transduction for PSCP perceptions through the dorsal medulla-thalamic pathways.展开更多
In this paper,we study some dentabilities in Banach spaces which are closely related to the famous Radon-Nikodym property.We introduce the concepts of the weak^(*)-weak denting point and the weak^(*)-weak^(*)denting p...In this paper,we study some dentabilities in Banach spaces which are closely related to the famous Radon-Nikodym property.We introduce the concepts of the weak^(*)-weak denting point and the weak^(*)-weak^(*)denting point of a set.These are the generalizations of the weak^(*)denting point of a set in a dual Banach space.By use of the weak^(*)-weak denting point,we characterize the very smooth space,the point of weak^(*)-weak continuity,and the extreme point of a unit ball in a dual Banach space.Meanwhile,we also characterize an approximatively weak compact Chebyshev set in dual Banach spaces.Moreover,we define the nearly weak dentability in Banach spaces,which is a generalization of near dentability.We prove the necessary and sufficient conditions of the reflexivity by nearly weak dentability.We also obtain that nearly weak dentability is equivalent to both the approximatively weak compactness of Banach spaces and the w-strong proximinality of every closed convex subset of Banach spaces.展开更多
This article examines the critical integration of reflexivity,cultural sensitivity,and emergent design in qualitative psychiatry research focused on lived experiences.While quantitative methods offer essential clinica...This article examines the critical integration of reflexivity,cultural sensitivity,and emergent design in qualitative psychiatry research focused on lived experiences.While quantitative methods offer essential clinical insights,qualitative approaches provide a deeper understanding of the emotional,psychological,and social dimensions of mental health.Reflexivity enables researchers to remain aware of how their personal biases and professional backgrounds shape data interpretation.Cultural sensitivity ensures that mental health conditions are understood within their broader cultural contexts,helping avoid misrepresentation and promoting authentic participant expression.Emergent design offers flexibility in adapting the research process to evolving themes,particularly in the dynamic and multifaceted realm of psychiatric conditions.Together,these principles promote ethically sound,participant-centered research that captures the full complexity of lived experiences.The article also highlighted the practical implications of these principles for enhancing both academic knowledge and clinical practice in psychiatry.展开更多
Hepatitis D virus(HDV)can infect HBsAg-positive individuals,causing rapid fibrosis progression,early decompensation,increased hepatocellular carcinoma risk,and higher mortality than hepatitis B virus(HBV)mono-infectio...Hepatitis D virus(HDV)can infect HBsAg-positive individuals,causing rapid fibrosis progression,early decompensation,increased hepatocellular carcinoma risk,and higher mortality than hepatitis B virus(HBV)mono-infection.Most countries lack high-quality HDV prevalence data,and the collection techniques employed often bias published data.In recent meta-analyses,HDV prevalence in HBsAg-positive patients reaches 5%-15%and is even significantly higher in endemic areas.Since HBV vaccination programs were implemented,HDV prevalence has decreased among younger populations.However,owing to immigrant influx,it has increased in some Western countries.The current practice of HDV screening in HBsAg-positive individuals is stepwise,based on physician’s discretion,and limited to at-risk populations and may require numerous visits.Double reflex testing,which includes anti-HDV testing in all HBsAg-positive individuals and then HDV RNA testing for anti-HDV-positive ones,is uncommon.Reflex testing can identify more HDV infection cases and link identified patients to further care and follow-up.Moreover,laboratory-based double reflex screening is less biased than physician-led testing.Therefore,health-care providers should learn about reflex testing,and federal and provincial hepatitis control programs should implement laboratory-based double reflex testing to obtain reliable HDV prevalence estimates.The test’s cost-effectiveness depends on the number of HBV-positive patients screened to identify one HDV-positive patient.Such testing may be viable in areas with low HBsAg but high HDV prevalence.However,its economic impact on areas with low HDV prevalence needs further study.展开更多
Background: The QT interval shortens in response to sympathetic stimulation. Head-up tilt-table (HUT) testing is a straightforward way to achieve brisk sympathetic stimulation. There is not enough information about th...Background: The QT interval shortens in response to sympathetic stimulation. Head-up tilt-table (HUT) testing is a straightforward way to achieve brisk sympathetic stimulation. There is not enough information about the response of the QT interval to HUT, particularly, in patients with orthostatic hypotension (OH). Objective: Analyse the response of the RR, QT and QTc intervals in patients with OH and reflex syncope (NM) during HUT and find differences between groups. Methods: We reviewed the electrocardiograms and compare the RR and QT/QTc intervals during 1) baseline;2) HUT plus hyperventilation;3) positive test. Results: We studied 137 patients, 62 control group (no syncope and negative HUT). On average, the RR HUT interval was shorter than the resting RR by −171 ± 110.4 ms in controls;−228.6 ± 119.4 ms (NM) and −194 ± (OH) (P Conclusion: Significant differences between the reflex group and the OH during a positive test, the QTc decreased in the NM group, but in the OH population increased. This observation has not been described. We hypothesize that QTc prolongation could reflect autonomic nervous system downregulation and could explain to a degree, the increased mortality in this group.展开更多
This study outlines the essential nursing strategies employed in the care of 10 patients experiencing vascular vagal reflex, managed with artificial liver support systems. It highlights a holistic nursing approach tai...This study outlines the essential nursing strategies employed in the care of 10 patients experiencing vascular vagal reflex, managed with artificial liver support systems. It highlights a holistic nursing approach tailored to the distinct clinical manifestations of these patients. Key interventions included early detection of psychological issues prior to initiating treatment, the implementation of comprehensive health education, meticulous monitoring of vital signs throughout the therapy, prompt emergency interventions when needed, adherence to prescribed medication protocols, and careful post-treatment observations including venous catheter management. Following rigorous treatment and dedicated nursing care, 7 patients demonstrated significant improvement and were subsequently discharged.展开更多
Background: The prolonged slow expiratory (PSE) technique can induce sigh breaths related to the Hering-Breuer reflex in children.PSE is a specific chest physiotherapy technique often used in children to help with the...Background: The prolonged slow expiratory (PSE) technique can induce sigh breaths related to the Hering-Breuer reflex in children.PSE is a specific chest physiotherapy technique often used in children to help with the clearance of secretions, reduce pulmonary obstruction and decrease ventilatory effort. Purpose: The main objective of this review was to synthesize and clarify the existing knowledge of the physiological mechanism behind the Hering-Breuer reflex and its utility in the PSE technique. The secondary objective was to provide an overview of PSE which is probably the main mechanical feature for mucus clearance in infants and to identify gaps and any further research required. Method: A comprehensive literature search was performed using PubMed/MEDLINE and Ovid EMBASE, from 1968 to January 2024, using search terms relating to “Interaction of Hering-Breuer reflex and chest physiotherapy therapy, sigh breath in infants and prolonged slow expiration technique” to create an overview of the advances and gaps in current knowledge of PSE. Result: The data obtained following treatment with PSE maneuvers in infants with histories of recurrent wheezing shows that the presence of sighs could be the main active principle of treatment. Conclusion: Changes in volume induced by PSE technique and, effects from crying may stimulate the Hering-Breuer deflation reflex and sighs in turn improving alveolar ventilation as well as lung volume in infants.展开更多
In this paper, we definde the dual semimodule and reflexive semimodule in the category of semimodules and completely generalize the results of dual modules and reflexive modules to the dual semimodules and reflexive s...In this paper, we definde the dual semimodule and reflexive semimodule in the category of semimodules and completely generalize the results of dual modules and reflexive modules to the dual semimodules and reflexive semimodules.展开更多
基金Supported by the National Natural Science Foundation of China,No.82400966Guangdong Basic and Applied Basic Research Foundation,No.2021A1515111025Science and Technology Projects in Guangzhou,No.2024A04J5170.
文摘In this article,we review the study by Jin et al,which examined the role of intestinal glucagon-like peptide-1(GLP-1)in counterregulatory responses to hypoglycemia in patients with type 1 diabetes mellitus(T1DM).With the global rise of T1DM,there is an increased burden on society and healthcare systems.Due to insulin therapy and islet dysfunction,T1DM patients are highly vulnerable to severe hypoglycemia,a leading cause of mortality.In healthy individuals,counterregulatory mechanisms restore blood glucose during hypoglycemia,but repeated episodes impair these responses.Jin et al demonstrated that overexpression of GLP-1 attenuates the sympathetic-adrenal reflex and disrupts the secretion of counterregulatory hormones such as glucagon during hypoglycemia,leading to counterregulatory dysfunction.These findings highlight the critical role of GLP-1 in the impaired counterregulatory response to hypoglycemia in T1DM patients and provide new insights into the potential application of GLP-1-related therapies in T1DM patients.
基金Supported by NSFC(No.12171062)the Natural Science Foundation of Chongqing(No.CSTB2022NSCQ-JQX0004)+1 种基金the Chongqing Talent Support Program(No.cstc2024ycjh-bgzxm0121)Science and Technology Project of Chongqing Education Committee(No.KJZD-M202300503)。
文摘The purpose of this article is to introduce a new method with a self-adaptive stepsize for approximating a common solution of monotone inclusion problems and variational inequality problems in reflexive Banach spaces.The strong convergence result for our method is established under some standard assumptions without any requirement of the knowledge of the Lipschitz constant of the mapping.Several numerical experiments are provided to verify the advantages and efficiency of proposed algorithms.
文摘Objective:To investigate the suppressive effect of dexmedetomidine on the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia and its impact on vital signs.Methods:A total of 60 pediatric patients undergoing elective surgery admitted to our hospital from January to August 2025 were selected and randomly divided into an observation group and a control group,with 30 cases in each group,using a random number table method.The control group received an intravenous infusion of 0.9% sodium chloride injection 30 minutes before the end of surgery,while the observation group received an intravenous pump infusion of dexmedetomidine(1μg/kg,diluted to 4μg/ml with normal saline).The severity of cough(graded from 0 to 3)and vital signs,including heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),and pulse oxygen saturation(SpO₂),were recorded 5 minutes before extubation,at the time of extubation,and 5 minutes after extubation in both groups.Results:The severity of cough in the observation group was significantly milder than that in the control group(P<0.05),with a significantly higher proportion of grade 0 cough in the observation group(23.33%vs 3.33%).At extubation and five minutes post-extubation,the observation group exhibited significantly lower HR,SBP,and DBP than the control group(P<0.05).In contrast,SpO_(2)levels remained comparable between the groups(P>0.05).Conclusion:Dexmedetomidine can effectively suppress the cough reflex during tracheal extubation in pediatric patients undergoing general anesthesia,reduce the severity of cough,stabilize hemodynamic parameters,and has no significant impact on respiratory function,demonstrating good clinical safety.
文摘BACKGROUND Multiple sclerosis(MS)is known to affect many sensory systems,yet most auditory research in MS has focused on the afferent pathways,with relatively few studies examining efferent function.The brainstem is a common site for MS plaques,and the medial olivocochlear(MOC)system is located in the superior olivary complex(SOC)of the brainstem.The cochlear nuclei are also involved in the MOC reflex arc.Additionally,the temporal cortex can modulate the SOC and cochlear nucleus,so lesions in the brainstem or temporal cortex may affect the MOC reflex in MS.AIM To investigate efferent auditory system activity in patients with multiple sclerosis via the MOC reflex.METHODS The study included 50 patients with MS and 50 healthy controls.Patients with MS were divided into three subgroups according to cranial magnetic resonance imaging findings:Patients with brainstem lesions(Group 1,n=20);patients with temporal cortex lesions without brainstem involvement(Group 2,n=20);and patients without any lesions in the brainstem or temporal cortex(Group 3,n=10).Tympanometry,acoustic stapedial reflex thresholds,pure-tone audiometry,and transientevoked otoacoustic emission(TEOAE)tests(with and without contralateral noise)were performed for all participants.RESULTS There was no significant difference in pure-tone hearing thresholds or baseline TEOAE amplitudes between the MS and control groups,indicating normal cochlear function in patients with MS;however,MOC reflex suppression was significantly reduced in patients with MS compared to controls(P=0.021).In particular,Group 1(MS with brainstem lesions)showed the lowest mean suppression values,which was significantly lower than that of Group 2 and the control group(P=0.002).By contrast,Group 2 and Group 3 did not significantly differ from controls.Additionally,patients with MS exhibited a sex difference in MOC function:Male patients had significantly lower suppression compared to female patients both within Group 1 and in the MS group as a whole.CONCLUSION The findings indicate that the efferent auditory system(specifically the MOC reflex)is affected by MS.MOC reflex activity was most significantly decreased in patients with MS with brainstem lesions,while temporal cortex lesions alone did not appear to notably impair the MOC reflex.Diminished MOC activity may underlie various auditory difficulties in patients with MS(e.g.,hearing in noise),and loss of efferent suppression could contribute to symptoms such as hyperacusis or tinnitus in this population.Further studies are needed to better understand the relationship between MOC dysfunction and auditory symptoms in MS,as well as the potential diagnostic value of MOC testing in MS.
基金supported by National Natural Science Foundation of China(Nos.12027811 and 12275222)。
文摘The cylindrical virtual cathode reflex triode is a new type of pulsed hard X-ray load,which has the advantages of simple structure,high radiation conversion efficiency,and simplicity in seriesparallel operation.This paper presents a method to reduce the impedance of the triode using a multiring cathode.The average electric field on the ring-cathode emission surface is enhanced due to edge effect,and the beam intensity is greatly increased in proportion to the square of the electric field strength.Multi-ring cathode is used to enlarge the emission area.Therefore,the reflex triode can work at lower impedance and generate a stronger beam under the same anode-cathode gap.In addition,the electric field enhancement of the cathode reduces the cathode emission stabilization time and enhances the operation stability of the triode.The effects of parameters such as ring width and ring gap on the triode impedance are simulated and studied.The cathode emission stabilization time and the X-ray conversion efficiency are compared.The design basis of cathode structure parameters and the impedance control method of the cylindrical virtual cathode reflex triode are given according to the simulations.
基金supported by grants from National Science and Technology Ministry Key Research and Development Program–Project(2022YFC2402703).
文摘Objective:This study aimed to develop and evaluate a novel software tool for robust analysis of the Visually Enhanced Vestibular-Ocular Reflex(VVOR)and video head impulse test(vHIT)saccades.Methods:A retrospective study was conducted on 94 patients with Meniere’s Disease(MD),unilateral vestibular hypofunction(UVH),and vestibular migraine(VM).The MATLAB-based VVOR Analysis System and Saccades All in One software were utilized for data processing.New techniques,VVOR_diff and VVOR_cycle,were deployed for saccade parameter extraction.Results:Saccade incidence rates,examined through vHIT,VVOR_diff,and VVOR_cycle,exhibited distinct patterns in MD,UVH,and VM patients.Frequent instances of multiple saccades within a single cycle were noted on the affected side in MD and UVH patients.Statistically significant differences in saccade gain and incidence rates between the affected and unaffected sides were evident in MD and UVH patients.Notably,high inter-method and intra-method correlations suggested consistency across different methods and potential interactions within one.Conclusion:The software proved effective in extracting saccades and reducing noise in VVOR data,thereby enhancing the evaluation of vestibular function and potentially improving diagnostic accuracy for vestibular disorders.
文摘Prostate cancer (PCa) is the second leading cause of cancer-related death among men. Prostate-specific antigen (PSA) testing is used in screening programs for early detection with a consequent reduction of PCa-specific mortality at the cost of overdiagnosis and overtreatment of the nonaggressive PCa. Recently, several assays have been commercially developed to implement PCa diagnosis, but they have not been included in both screening and diagnosis of PCa. This review aims to describe the actual and novel commercially available molecular biomarkers that can be used in PCa management to implement and tailor the screening and diagnosis of PCa.
文摘Background:Acute lateral ankle sprains(ALAS)are associated with long-term impairments and instability tied to altered neural excitability.Arthrogenic muscle inhibition(AMI)has been observed in this population;however,relationships with injury-related impairments are unclear,potentially due to the resting,prone position in which AMI is typically measured.Assessing AMI during bipedal stance may provide a better understanding of this relationship.Methods:AMI was assessed in 38 young adults(19 ALAS within 72 h of injury:10 males,21.4±2.7 years;19 healthy controls:10 males,21.9±2.2 years;mean±SD)using the Hoffmann reflex(H-reflex)during bipedal stance.Electrical stimulation was administered to identify the _(max)imal H-reflex(H_(max))and _(max)imal motor response(M_(max))from the soleus,fibularis longus,and tibialis anterior muscles.The primary outcome measure was the H_(max)/M_(max) ratio.Secondary outcomes included acute symptoms(pain and swelling),postural control during bipedal stance,and self-reported function.Results:No significant group-by-limb interactions were observed for any muscle.However,a significant group main effect was observed in the soleus muscle(F(1,35)=6.82,p=0.013),indicating significantly lower H_(max)/M_(max) ratios following ALAS(0.38±0.20)compared to healthy controls(0.53±0.16).Furthermore,lower H_(max)/M_(max) ratios in the soleus significantly correlated with acute symptoms and self-reported function but not with postural control.Conclusion:This study supports previous evidence of AMI in patients with ALAS,providing insight into neurophysiologic impacts of musculoskeletal injury.Our results suggest that assessing AMI in a standing position following acute injury may provide valuable insight into how AMI develops and guide potential therapeutic options to curb and offset the formation of joint instability.
基金funded by Researchers Supporting Program at King Saud University (RSPD2023R809).
文摘Pupil dynamics are the important characteristics of face spoofing detection.The face recognition system is one of the most used biometrics for authenticating individual identity.The main threats to the facial recognition system are different types of presentation attacks like print attacks,3D mask attacks,replay attacks,etc.The proposed model uses pupil characteristics for liveness detection during the authentication process.The pupillary light reflex is an involuntary reaction controlling the pupil’s diameter at different light intensities.The proposed framework consists of two-phase methodologies.In the first phase,the pupil’s diameter is calculated by applying stimulus(light)in one eye of the subject and calculating the constriction of the pupil size on both eyes in different video frames.The above measurement is converted into feature space using Kohn and Clynes model-defined parameters.The Support Vector Machine is used to classify legitimate subjects when the diameter change is normal(or when the eye is alive)or illegitimate subjects when there is no change or abnormal oscillations of pupil behavior due to the presence of printed photograph,video,or 3D mask of the subject in front of the camera.In the second phase,we perform the facial recognition process.Scale-invariant feature transform(SIFT)is used to find the features from the facial images,with each feature having a size of a 128-dimensional vector.These features are scale,rotation,and orientation invariant and are used for recognizing facial images.The brute force matching algorithm is used for matching features of two different images.The threshold value we considered is 0.08 for good matches.To analyze the performance of the framework,we tested our model in two Face antispoofing datasets named Replay attack datasets and CASIA-SURF datasets,which were used because they contain the videos of the subjects in each sample having three modalities(RGB,IR,Depth).The CASIA-SURF datasets showed an 89.9%Equal Error Rate,while the Replay Attack datasets showed a 92.1%Equal Error Rate.
基金possible by National Institutes of Health Grant(No.AT002478,AT004620,and AT004504)from the National Center for Complementary and Integrative Medicine.
文摘Numerous studies from different international groups have demonstrated that sensations can be propagated along acupuncture channel pathways.The propagated sensation along the channel pathway(PSCP)can be elicited by electroacupuncture(EA),transcutaneous electrical nerve stimulation(TENS),manual acupuncture(MA),and heat applied to distal acupuncture points(acupoints).Nitric oxide(NO)levels were reported to be elevated in the gracile nucleus and skin regions near to the EA sites,with higher levels at acupoints associated with an enhanced expression of NO synthase and transient receptor potential vanilloid type 1.The stimuli,EA,MA,TENS,and heat,have been used to elicit axonal reflexes,which increase local release of NO and neuropeptides such as calcitonin gene related peptide.Furthermore,the sensation of PSCP along the body surface occurs only ipsilaterally to the stimulated acupoints in various human studies,which does not support the involvement of the spinal-thalamic pathway,which would involve cross over transmission of the signals.The gracile nucleus receives ascending input from the sciatic nerve and responds to somatosensory stimulation mainly on the ipsilateral side via the dorsal column pathway.EA at Zusanli(ST36)increases NO release and expression of NO synthase mainly in the ipsilateral side of the gracile nucleus,while the cardiovascular effects and analgesic responses to EA at ST36 are changed by influences of l-arginine-derived NO synthesis in the ipsilateral gracile nucleus in rats.The stimuli-induced release of NOergic molecules and neuropeptides exist high levels in the acupoints,which contain rich neuronal components and blood vessels.Enhanced NOergic molecules at acupoints cause axon reflexes during the stimuli,which elevate cutaneous blood flow.Elevated NOergic molecules and local blood flow may spread over acupoints one after another along the meridian lines differing from nerve pathways following the stimuli to induce PSCP.The same types of stimulation also elicit NO release in the gracile nucleus,which contributes to the somatosensory signal transduction of PSCP through the dorsal medulla-thalamic pathways.Other substances such as serotonin and catecholamines are proposed to mediate responses and certain effects of acupuncture-like stimulation but their mechanisms are poorly-understood.In this review we summarize the current understanding of the neurobiological processes of PSCP research with an emphasis on recent developments of NO mediating stimulation-evoked axon reflexes and somatosensory signal transduction for PSCP perceptions through the dorsal medulla-thalamic pathways.
基金supported by the National Natural Science Foundation of China(12271344)the Natural Science Foundation of Shanghai(23ZR1425800)。
文摘In this paper,we study some dentabilities in Banach spaces which are closely related to the famous Radon-Nikodym property.We introduce the concepts of the weak^(*)-weak denting point and the weak^(*)-weak^(*)denting point of a set.These are the generalizations of the weak^(*)denting point of a set in a dual Banach space.By use of the weak^(*)-weak denting point,we characterize the very smooth space,the point of weak^(*)-weak continuity,and the extreme point of a unit ball in a dual Banach space.Meanwhile,we also characterize an approximatively weak compact Chebyshev set in dual Banach spaces.Moreover,we define the nearly weak dentability in Banach spaces,which is a generalization of near dentability.We prove the necessary and sufficient conditions of the reflexivity by nearly weak dentability.We also obtain that nearly weak dentability is equivalent to both the approximatively weak compactness of Banach spaces and the w-strong proximinality of every closed convex subset of Banach spaces.
文摘This article examines the critical integration of reflexivity,cultural sensitivity,and emergent design in qualitative psychiatry research focused on lived experiences.While quantitative methods offer essential clinical insights,qualitative approaches provide a deeper understanding of the emotional,psychological,and social dimensions of mental health.Reflexivity enables researchers to remain aware of how their personal biases and professional backgrounds shape data interpretation.Cultural sensitivity ensures that mental health conditions are understood within their broader cultural contexts,helping avoid misrepresentation and promoting authentic participant expression.Emergent design offers flexibility in adapting the research process to evolving themes,particularly in the dynamic and multifaceted realm of psychiatric conditions.Together,these principles promote ethically sound,participant-centered research that captures the full complexity of lived experiences.The article also highlighted the practical implications of these principles for enhancing both academic knowledge and clinical practice in psychiatry.
文摘Hepatitis D virus(HDV)can infect HBsAg-positive individuals,causing rapid fibrosis progression,early decompensation,increased hepatocellular carcinoma risk,and higher mortality than hepatitis B virus(HBV)mono-infection.Most countries lack high-quality HDV prevalence data,and the collection techniques employed often bias published data.In recent meta-analyses,HDV prevalence in HBsAg-positive patients reaches 5%-15%and is even significantly higher in endemic areas.Since HBV vaccination programs were implemented,HDV prevalence has decreased among younger populations.However,owing to immigrant influx,it has increased in some Western countries.The current practice of HDV screening in HBsAg-positive individuals is stepwise,based on physician’s discretion,and limited to at-risk populations and may require numerous visits.Double reflex testing,which includes anti-HDV testing in all HBsAg-positive individuals and then HDV RNA testing for anti-HDV-positive ones,is uncommon.Reflex testing can identify more HDV infection cases and link identified patients to further care and follow-up.Moreover,laboratory-based double reflex screening is less biased than physician-led testing.Therefore,health-care providers should learn about reflex testing,and federal and provincial hepatitis control programs should implement laboratory-based double reflex testing to obtain reliable HDV prevalence estimates.The test’s cost-effectiveness depends on the number of HBV-positive patients screened to identify one HDV-positive patient.Such testing may be viable in areas with low HBsAg but high HDV prevalence.However,its economic impact on areas with low HDV prevalence needs further study.
文摘Background: The QT interval shortens in response to sympathetic stimulation. Head-up tilt-table (HUT) testing is a straightforward way to achieve brisk sympathetic stimulation. There is not enough information about the response of the QT interval to HUT, particularly, in patients with orthostatic hypotension (OH). Objective: Analyse the response of the RR, QT and QTc intervals in patients with OH and reflex syncope (NM) during HUT and find differences between groups. Methods: We reviewed the electrocardiograms and compare the RR and QT/QTc intervals during 1) baseline;2) HUT plus hyperventilation;3) positive test. Results: We studied 137 patients, 62 control group (no syncope and negative HUT). On average, the RR HUT interval was shorter than the resting RR by −171 ± 110.4 ms in controls;−228.6 ± 119.4 ms (NM) and −194 ± (OH) (P Conclusion: Significant differences between the reflex group and the OH during a positive test, the QTc decreased in the NM group, but in the OH population increased. This observation has not been described. We hypothesize that QTc prolongation could reflect autonomic nervous system downregulation and could explain to a degree, the increased mortality in this group.
文摘This study outlines the essential nursing strategies employed in the care of 10 patients experiencing vascular vagal reflex, managed with artificial liver support systems. It highlights a holistic nursing approach tailored to the distinct clinical manifestations of these patients. Key interventions included early detection of psychological issues prior to initiating treatment, the implementation of comprehensive health education, meticulous monitoring of vital signs throughout the therapy, prompt emergency interventions when needed, adherence to prescribed medication protocols, and careful post-treatment observations including venous catheter management. Following rigorous treatment and dedicated nursing care, 7 patients demonstrated significant improvement and were subsequently discharged.
文摘Background: The prolonged slow expiratory (PSE) technique can induce sigh breaths related to the Hering-Breuer reflex in children.PSE is a specific chest physiotherapy technique often used in children to help with the clearance of secretions, reduce pulmonary obstruction and decrease ventilatory effort. Purpose: The main objective of this review was to synthesize and clarify the existing knowledge of the physiological mechanism behind the Hering-Breuer reflex and its utility in the PSE technique. The secondary objective was to provide an overview of PSE which is probably the main mechanical feature for mucus clearance in infants and to identify gaps and any further research required. Method: A comprehensive literature search was performed using PubMed/MEDLINE and Ovid EMBASE, from 1968 to January 2024, using search terms relating to “Interaction of Hering-Breuer reflex and chest physiotherapy therapy, sigh breath in infants and prolonged slow expiration technique” to create an overview of the advances and gaps in current knowledge of PSE. Result: The data obtained following treatment with PSE maneuvers in infants with histories of recurrent wheezing shows that the presence of sighs could be the main active principle of treatment. Conclusion: Changes in volume induced by PSE technique and, effects from crying may stimulate the Hering-Breuer deflation reflex and sighs in turn improving alveolar ventilation as well as lung volume in infants.
文摘In this paper, we definde the dual semimodule and reflexive semimodule in the category of semimodules and completely generalize the results of dual modules and reflexive modules to the dual semimodules and reflexive semimodules.
