[Therapeutic strategy for totally thoracoscopic repeat mitral valve surgery under moderate hypothermia-induced ventricular fibrillation]

Objective: To examine the therapeutic strategy and its impacting factors by analyzing the perioperative outcomes of total thoracoscopic repeat mitral valve surgery under moderate hypothermia-induced ventricular fibrillation with cardiopulmonary bypass. Methods: This study is a retrospective case series. Totally 63 patients who underwent repeat mitral valve surgery by the same surgeon from January 2021 to December 2023 in Department of Cardiovascular Surgery, the First Medical Center of People's Liberation Army General Hospital were retrospectively enrolled. There were 28 males and 35 females with an age of (58.3±15.9) years (range: 13 to 84 years). Surgery was performed using a totally thoracoscopic approach under moderate hypothermia-induced ventricular fibrillation. Mitral valvuloplasty was completed in 32 cases and mitral valve replacement in 31 cases. Preoperative baseline data and perioperative outcomes of the patients were collected and Logistic regression was used to analyze independent influencing factors of premature ventricular contractions in the early postoperative period. Results: The intraoperative cardiopulmonary bypass time was (191.5±50.9) minutes (range: 95 to 286 minutes), and the hypothermic ventricular fibrillation time was (99.0±39.8) minutes (range: 34 to 203 minutes). The anal temperature before the start of cardiopulmonary bypass was (36.3±0.5) ℃ (range: 35.2 to 38.0 ℃), the lowest intraoperative anal temperature was (27.3±1.3) ℃(range: 23.7 to 30.1 ℃), and the anal temperature at the time of the cessation of cardiopulmonary bypass was (36.3±0.4) ℃ (range: 35.2 to 37.0 ℃), and excessive rewarming was observed in 33 cases. Six cases applied the artificial heart assist device. Seventeen cases developed premature ventricular contractions in the early postoperative period. Two cases developed neurologic complications. Five cases developed respiratory complications. One case developed urological systemic complications. Six cases were mechanically ventilated for more than 3 days, and the duration of ICU stay in 16 cases was more than 3 days and the postoperative discharge time of (M(IQR)) 8.0 (3.5) days (range: 3 to 26 days). Two cases died or were discharged voluntarily. Logistic regression results showed that persistent preoperative atrial fibrillation (OR=11.424, 95%CI: 1.477 to 144.564, P=0.033) and excessive rewarming (OR=15.249, 95%CI: 1.357 to 279.571, P=0.038) were independent risk factors for the appearance of premature ventricular contractions in the early postoperative period. Conclusions: The technique of total thoracoscopic surgery under induced moderate hypothermic ventricular fibrillation with cardiopulmonary bypass could be applied to repeated mitral valve surgeries with less trauma and faster recovery. Persistent preoperative atrial fibrillation and excessive rewarming are independent risk factors for the occurrence of premature ventricular contractions in the early postoperative period.

[Reappraisals of biological behaviors of PDGFRA mutant gastrointestinal stromal tumor]

Objective: To investigate the biological behavior spectrum of platelet-derived growth factor alpha receptor (PDGFRA)-mutant gastrointestinal stromal tumor (GIST), and to compare the clinical values of the Zhongshan method of benign and malignant evaluation with the modified National Institutes of Health (NIH) risk stratification. Methods: A total of 119 cases of GIST with PDGFRA mutation who underwent surgical resection at Zhongshan Hospital, Fudan University from 2009 to 2020 were collected. The clinicopathological data, follow-up records, and subsequent treatment were reviewed and analyzed statistically. Results: There were 79 males and 40 females. The patients ranged in age from 25 to 80 years, with a median age of 60 years. Among them, 115 patients were followed up for 1-154 months, and 13 patients progressed to disease. The 5-year disease-free survival (DFS) and overall survival (OS) were 90.1% and 94.1%, respectively. According to the modified NIH risk stratification, 8 cases, 32 cases, 38 cases, and 35 cases were very-low risk, low risk, intermediate risk, and high risk, and 5-year DFS were 100.0%, 95.6%, 94.3%, and 80.5%, respectively. There was no significant difference in prognosis among the non-high risk groups, only the difference between high risk and non-high risk groups was significant (P=0.029). However, the 5-year OS was 100.0%, 100.0%, 95.0% and 89.0%, and there was no difference (P=0.221). According to the benign and malignant evaluation Zhongshan method, 43 cases were non-malignant (37.4%), 56 cases were low-grade malignant (48.7%), 9 cases were moderately malignant (7.8%), and 7 cases were highly malignant (6.1%). The 5-year DFS were 100.0%, 91.7%, 77.8%, 38.1%, and the difference was significant (P<0.001). The 5-year OS were 100.0%, 97.5%, 77.8%, 66.7%, the difference was significant (P<0.001). Conclusions: GIST with PDGFRA gene mutation shows a broad range of biological behavior, ranging from benign to highly malignant. According to the Zhongshan method, non-malignant and low-grade malignant tumors are common, the prognosis after surgery is good, while the fewer medium-high malignant tumors showed poor prognosis after surgical resection. The overall biological behavior of this type of GIST is relatively inert, which is due to the low proportion of medium-high malignant GIST. The modified NIH risk stratification may not be effective in risk stratification for PDGFRA mutant GIST.

[Predictive value of aMAP risk score for early recurrence of small hepatocellular carcinoma after microwave ablation]

Objective: To explore the value of the aMAP risk score (age, male, albumin-bilirubin, and platelets) to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma. Methods: This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital, Southern Medical University from July 2016 to July 2021. The cohort enrolled 121 male and 21 female patients, including 110 patients that were <60 years old. All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging. The observation indices mainly included general data and imaging data of patients. Using the X-tile tools, patients were divided into two groups: a high aMAP score group and a low aMAP score group. Multivariate Cox regression analysis was conducted for comparison of independent risk factors. Results: Multivariate Cox regression showed that high aMAP score, maximum tumor diameter >20 mm, and high AFP were the independent risk factors of early recurrence (all P<0.05). Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group (P=0.001). Conclusions: The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation. Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..

Mixed-reality-based human-animal interaction can relieve mental stress

Introduction

Interacting with animals has been demonstrated to possess the healing benefits to humans. However, there are limitations in physical interaction due to COVID-19 and safety issues. Therefore, as an alternative, we created mixed-reality (MR)-based human-animal interaction (HAI) content and experimentally verified its effect on mental stress reduction.

Methods

We created three types of interactive content: observing the movement of a non-reactive virtual cat, interacting with a virtual cat whose responses can be seen, and interacting with a virtual cat whose responses can be both seen and heard. The experiment was performed by 30 healthy young women, and a mental arithmetic task was used to induce mild mental stress before experiencing each content. During the experiment, the subject's electrocardiogram was continuously recorded, and the psychological state was evaluated through a questionnaire.

Results

The results showed that MR-based virtual cat content significantly reduces mental stress and induces positive emotions after stressful situations. In particular, when the virtual cat provided audiovisual feedback, the activation amount of the parasympathetic nervous system and the increase of positive emotions were the greatest.

Discussion

Based on this encouraging research result, this method should be further investigated to see if it can replace real HAI for human mental health management.

[Predictive value of hemoglobin glycation index for chronic kidney disease]

Objective: To investigate the influence of hemoglobin glycation index (HGI) on the risk of incident chronic kidney disease (CDK) among nondiabetic patients. Methods: Prospective cohort study. At baseline, a total of 7 407 nondiabetic patients without a history of CKD from Pingguoyuan Community of the Shijingshan District in Beijing were included from December 2011 to August 2012, who were then divided into three groups according to the tertiles of their baseline HGI levels. The CKD incidence rate was compared among the different HGI groups at last follow-up. Cox multivariable regression was applied to evaluate whether HGI measures predicted CKD risk. Test for trend across tertiles were examined using ordinal values in separate models. Results: The mean age of the subjects was (56.4±7.5) years, and 4 933 (66.6%) were female. At mean follow-up of 3.23 years, 107 (1.4%) individuals developed CKD. The incidence of CKD was gradually increasing from the low to high HGI groups [1.1% (28/2 473) vs. 1.2% (31/2 564) vs. 2.0% (48/2 370), P=0.016]. In the multivariate Cox regression analysis, after adjustment for potential confounders, the high HGI group had a 68.5% increased risk of CKD compared with the low HGI group (HR=1.685, 95%CI 1.023 to 2.774). CKD risk increased with increasing HGI tertiles (P for trend=0.028). Conclusion: High HGI is associated with an increased risk for CKD in the nondiabetic population, indicating that HGI may help identify individuals at high risk for CKD.

Deep learning-based self-induced emotion recognition using EEG

Emotion recognition from electroencephalogram (EEG) signals requires accurate and efficient signal processing and feature extraction. Deep learning technology has enabled the automatic extraction of raw EEG signal features that contribute to classifying emotions more accurately. Despite such advances, classification of emotions from EEG signals, especially recorded during recalling specific memories or imagining emotional situations has not yet been investigated. In addition, high-density EEG signal classification using deep neural networks faces challenges, such as high computational complexity, redundant channels, and low accuracy. To address these problems, we evaluate the effects of using a simple channel selection method for classifying self-induced emotions based on deep learning. The experiments demonstrate that selecting key channels based on signal statistics can reduce the computational complexity by 89% without decreasing the classification accuracy. The channel selection method with the highest accuracy was the kurtosis-based method, which achieved accuracies of 79.03% and 79.36% for the valence and arousal scales, respectively. The experimental results show that the proposed framework outperforms conventional methods, even though it uses fewer channels. Our proposed method can be beneficial for the effective use of EEG signals in practical applications.

[Effect and influence factors of cardiopulmonary resuscitation in children with congenital heart disease in pediatric intensive care unit]

Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ²=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ²=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.

Predictions of tDCS treatment response in PTSD patients using EEG based classification

Transcranial direct current stimulation (tDCS) is an emerging therapeutic tool for treating posttraumatic stress disorder (PTSD). Prior studies have shown that tDCS responses are highly individualized, thus necessitating the individualized optimization of treatment configurations. To date, an effective tool for predicting tDCS treatment outcomes in patients with PTSD has not yet been proposed. Therefore, we aimed to build and validate a tool for predicting tDCS treatment outcomes in patients with PTSD. Forty-eight patients with PTSD received 20 min of 2 mA tDCS stimulation in position of the anode over the F3 and cathode over the F4 region. Non-responders were defined as those with less than 50% improvement after reviewing clinical symptoms based on the Clinician-Administered DSM-5 PTSD Scale (before and after stimulation). Resting-state electroencephalograms were recorded for 3 min before and after stimulation. We extracted power spectral densities (PSDs) for five frequency bands. A support vector machine (SVM) model was used to predict responders and non-responders using PSDs obtained before stimulation. We investigated statistical differences in PSDs before and after stimulation and found statistically significant differences in the F8 channel in the theta band (p = 0.01). The SVM model had an area under the ROC curve (AUC) of 0.93 for predicting responders and non-responders using PSDs. To our knowledge, this study provides the first empirical evidence that PSDs can be useful biomarkers for predicting the tDCS treatment response, and that a machine learning model can provide robust prediction performance. Machine learning models based on PSDs can be useful for informing treatment decisions in tDCS treatment for patients with PTSD.

[Perioperative safety and feasibility of simultaneous off-pump coronary artery bypass grafting with non-cardiac surgical procedures of moderate-to-severe severity]

Objective: To examine the perioperative safety and feasibility of simultaneous off-pump coronary artery bypass grafting (OPCAB) with non-cardiac surgical procedures of moderate-to-severe severity. Methods: The perioperative results of 54 patients underwent simultaneous OPCAB with non-cardiac surgical procedures from September 2013 to January 2019 at Department of Cardiac Surgery, Peking University First Hospital were assessed retrospectively. There were 46 males and 8 females, aging (65.8±8.8) years (range: 41 to 85 years). All simultaneous non-cardiac surgical procedures, including vascular (n=1), thoracic (n=26), general (n=12) and urologic surgical procedures (n=15), were assessed to be of moderate-to-severe grade by operative severity scoring system. Perioperative results were compared between the OPCAB patients who underwent simultaneous non-cardiac surgical procedures (n=54) and 1∶2 matched patients who underwent isolated OPCAB performed most recently by the same cardiac team with similar procedures accordingly (n=108), using t test, Mann-Whitney U test, χ² test or Fisher exact test. Results: All baseline factors were matched between the two groups, with no significant difference on European system for cardiac operative risk evaluation (EuroSCORE) Ⅱ (1.185(0.758)% vs. 1.215(0.905)%, Z=‒0.036, P=0.972). No perioperative death was observed in the two groups. Although patients underwent simultaneous non-cardiac surgical procedures showed prolonged operation duration time ((324.9±97.1) minutes vs. (166.7±36.7) minites, t=11.564, P<0.01) and increased intraoperaive blood loss ((462.2±269.6) ml vs. (304.5±177.8) ml, t=3.866, P<0.01), primary postoperative complications, including perioperative myocardial infarction, atrial fibrillation, perioperative stroke, acute renal failure, wound infection, and bleeding reoperation did not show significant differences between the two groups (all P>0.05), while total blood transfusion volume, mechanical ventilation time and intensive care unit residence time also showed no significant differences between the two groups (all P>0.05). Conclusion: Simultaneous OPCAB with non-cardiac surgical procedures of moderate-to-severe severity in patients with operative indications are safe and feasible, and are not associated with increased postoperative risks when compared with isolated OPCAB.

Prefrontal Functional Connectivity During the Verbal Fluency Task in Patients With Major Depressive Disorder: A Functional Near-Infrared Spectroscopy Study

Deviations in activation patterns and functional connectivity have been observed in patients with major depressive disorder (MDD) with prefrontal hemodynamics of patients compared with healthy individuals. The graph-theoretical approach provides useful network metrics for evaluating functional connectivity. The evaluation of functional connectivity during a cognitive task can be used to explain the neurocognitive mechanism underlying the cognitive impairments caused by depression. Overall, 31 patients with MDD and 43 healthy individuals completed a verbal fluency task (VFT) while wearing a head-mounted functional near-infrared spectroscopy (fNIRS) devices. Hemodynamics and functional connectivity across eight prefrontal subregions in the two groups were analyzed and compared. We observed a reduction in prefrontal activation and weaker overall and interhemispheric subregion-wise correlations in the patient group compared with corresponding values in the control group. Moreover, efficiency, the network measure related to the effectiveness of information transfer, showed a significant between-group difference [t (71.64) = 3.66, corrected p < 0.001] along with a strong negative correlation with depression severity (rho = -0.30, p = 0.009). The patterns of prefrontal functional connectivity differed significantly between the patient and control groups during the VFT. Network measures can quantitatively characterize the reduction in functional connectivity caused by depression. The efficiency of the functional network may play an important role in the understanding of depressive symptoms.

Effect of Daily Stress on Heart-Rate Variability during Stroop Color Word Task

It is important to care and manage daily stress, even for young healthy individuals. Conventional approach to investigate the effect of mental stress on our body usually utilizes a cognitive task as an induced stressor and compares the response with a resting state. During the process, the effects of daily stress are ignored. We hypothesized that the response to mental stress may differ depending on the daily stress level. As far as our knowledge, the effect of daily stress on cognitive ability and electrophysiological response has not yet been widely investigated. We designed and conducted an experiment to record ECGs while performing a Stroop color word task for 42 young healthy female subjects. We repeated the experiment for two different days with different levels of stress measured by self-report. As a result, we could find significant differences on behavior and heart-rate variability depending on the stress level. These findings may provide a new insight on how to understand the trend of heart-rate variability according to subject's daily stress.

Deep Cerebellar Low-Intensity Focused Ultrasound Stimulation Restores Interhemispheric Balance after Ischemic Stroke in Mice

Ischemic damage after stroke disrupts the complex balance of inhibitory and excitatory activity within cortical network causing brain functional asymmetry. Cerebellar deep nuclei with its extensive projections to cortical regions could be a prospective target for stimulation to restore inter-hemispheric balance and enhance neural plasticity after stroke. In our study, we repeatedly stimulated the lateral cerebellar nucleus (LCN) by low-intensity focused ultrasound (LIFU) for 3 days to enhance rehabilitation after middle cerebral artery occlusion (MCAO) in a mouse stroke model. The neural activity of the mice sensorimotor cortex was measured using epidural electrodes and analyzed with quantified electroencephalography (qEEG). Pairwise derived Brain Symmetry Index (pdBSI) and delta power were used to assess the neurorehabilitative effect of LIFU stimulation. Compared to the Stroke (non-treated) group, the LIFU group exhibited a decrease in cortical pathological delta activity, significant recovery in pdBSI and enhanced performance on the balance beam walking test. These results suggest that cerebellar LIFU stimulation could be a non-invasive method for stroke rehabilitation through the restoration of interhemispheric balance.

Deep Joint Spatiotemporal Network (DJSTN) for Efficient Facial Expression Recognition

Understanding a person's feelings is a very important process for the affective computing. People express their emotions in various ways. Among them, facial expression is the most effective way to present human emotional status. We propose efficient deep joint spatiotemporal features for facial expression recognition based on the deep appearance and geometric neural networks. We apply three-dimensional (3D) convolution to extract spatial and temporal features at the same time. For the geometric network, 23 dominant facial landmarks are selected to express the movement of facial muscle through the analysis of energy distribution of whole facial landmarks.We combine these features by the designed joint fusion classifier to complement each other. From the experimental results, we verify the recognition accuracy of 99.21%, 87.88%, and 91.83% for CK+, MMI, and FERA datasets, respectively. Through the comparative analysis, we show that the proposed scheme is able to improve the recognition accuracy by 4% at least.

[Does age affect the hidden blood loss of elderly intertrochanteric fracture patients fixed with combined external fixator?]

Objective: To evaluate the postoperatively hidden blood loss of elderly intertrochanteric fracture patients fixed with combined external fixator, and to explore the correlation between hidden blood loss and age. Methods: A retrospective analysis was conducted on 60 elderly intertrochanteric fracture patients who were admitted to the Department of Orthopedics of Hebei Provincial Hospital from January 2016 to May 2019. All the fractures were fixed with combined external fixators. The patients were divided into two groups according to the age: there were 31 cases in group A (60-80 years old) and 29 cases in group B (≥80 years old). The Gross equation and the Nandler formula were used to evaluate the amount of hidden blood loss based on changes in hematocrit (Hct) at the day preoperatively, 3 days postoperatively and the weight. The data were compared between the two groups by independent-sample t test. Results: The decreased Hct, hemoglobin(Hb) and the dominant blood loss and hidden blood loss in group A and B was 3.4%±1.7%, (13±7) g/L, (25±6) ml, (186±7) ml and 3.8%±1.2%, (13±3) g/L, (24±8) ml, (194±7) ml, respectively. There was no significant differences in the dominant and hidden blood loss between the groups (t=0.309, 0.883, both P>0.05). Conclusion: The age doesn't affect the hidden blood loss in elderly intertrochanteric fracture patients fixed with combined external fixator, which indicated that the operation is safe and reliable for such patients.

Stress Resilience Measurement With Heart-Rate Variability During Mental And Physical Stress

Stress management is particularly important for healthcare of modern people. In stress research, heart-rate variability (HRV), indicating the change of time intervals in successive heart beats, significantly contributed due to its close relationship with autonomic nervous system. However, the adaptive response to stress, also known as stress resilience, has not been studied much yet. We collected electrocardiogram during mental and physical stress, experimentally designed by mental arithmetic tasks and physical activities for 14 healthy subjects. As a result, we found that resting HRV parameters, particularly associated with the parasympathetic activity, had significant positive correlations with reactivity and recovery from mental and physical stress. These HRV parameters can be used as a measure of stress resilience quantitatively. Our findings suggest that these parameters can help one's stress management by enabling to predict the adaptive response to upcoming stressful events.

Extracapsular dissection versus partial superficial parotidectomy for the treatment of benign parotid tumours

The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial superficial parotidectomy (PSP). A comprehensive literature investigation was conducted by searching electronic databases. A systematic review and meta-analysis of comparative studies were performed to assess ECD and PSP for the treatment of BPTs with fixed-effects models. The outcomes analysed were transient or permanent facial nerve injury, Frey syndrome, recurrence rate, infection, and salivary fistula/sialocele. A total of 1641 patients from seven studies (1120 ECD-treated and 521 PSP-treated patients) were included in this meta-analysis. Transient facial nerve injury (odds ratio (OR)=0.28, 95% confidence interval (CI): 0.11-0.71; p=0.008) and Frey syndrome (OR=0.12, 95% CI: 0.03-0.48; p=0.003) were less prevalent in the ECD group. The rates of permanent facial nerve injury (OR=0.77, 95% CI: 0.35-1.70; p=0.520), recurrence rate (OR=0.17, 95% CI: 0.02-1.75; p=0.14), infection (OR=0.70, 95% CI: 0.07-6.67; p=0.76), and salivary fistula/sialocele (OR=0.40, 95% CI: 0.06-2.66; p=0.350) were similar in both groups. Although there was a trend that ECD showed a reduced risk for complications, the present results are not sufficient to conclude that ECD is more beneficial than PSP.

The Role of Heart-Rate Variability Parameters in Activity Recognition and Energy-Expenditure Estimation Using Wearable Sensors

Human-activity recognition (HAR) and energy-expenditure (EE) estimation are major functions in the mobile healthcare system. Both functions have been investigated for a long time; however, several challenges remain unsolved, such as the confusion between activities and the recognition of energy-consuming activities involving little or no movement. To solve these problems, we propose a novel approach using an accelerometer and electrocardiogram (ECG). First, we collected a database of six activities (sitting, standing, walking, ascending, resting and running) of 13 voluntary participants. We compared the HAR performances of three models with respect to the input data type (with none, all, or some of the heart-rate variability (HRV) parameters). The best recognition performance was 96.35%, which was obtained with some selected HRV parameters. EE was also estimated for different choices of the input data type (with or without HRV parameters) and the model type (single and activity-specific). The best estimation performance was found in the case of the activity-specific model with HRV parameters. Our findings indicate that the use of human physiological data, obtained by wearable sensors, has a significant impact on both HAR and EE estimation, which are crucial functions in the mobile healthcare system.

EEG-Based Classification of Implicit Intention During Self-Relevant Sentence Reading

From electroencephalography (EEG) data during self-relevant sentence reading, we were able to discriminate two implicit intentions: 1) "agreement" and 2) "disagreement" to the read sentence. To improve the classification accuracy, discriminant features were selected based on Fisher score among EEG frequency bands and electrodes. Especially, the time-frequency representation with Morlet wavelet transforms showed clear differences in gamma, beta, and alpha band powers at frontocentral area, and theta band power at centroparietal area. The best classification accuracy of 75.5% was obtained by a support vector machine classifier with the gamma band features at frontocentral area. This result may enable a new intelligent user-interface which understands users' implicit intention, i.e., unexpressed or hidden intention.

Intermartensitic Transformation and Enhanced Exchange Bias in Pd (Pt) -doped Ni-Mn-Sn alloys

In this work, we studied the phase transitions and exchange bias of Ni_50−xMn₃₆Sn₁₄T_x (T = Pd, Pt; x = 0, 1, 2, 3) alloys. An intermartensitic transition (IMT), not observed in Ni₅₀Mn₃₆Sn₁₄ alloy, was induced by the proper application of negative chemical pressure by Pd(Pt) doping in Ni_50−xMn₃₆Sn₁₄T_x (T = Pd, Pt) alloys. IMT weakened and was suppressed with the increase of applied field; it also disappeared with further increase of Pd(Pt) content (x = 3 for Pd and x = 2 for Pt). Another striking result is that exchange bias effect, ascribed to the percolating ferromagnetic domains coexisting with spin glass phase, is notably enhanced by nonmagnetic Pd(Pt) addition. The increase of unidirectional anisotropy by the addition of Pd(Pt) impurities with strong spin-orbit coupling was explained by Dzyaloshinsky-Moriya interactions in spin glass phase.

Implicit agreeing/disagreeing intention while reading self-relevant sentences: A human fMRI study

The true intentions of humans are sometimes difficult to ascertain exclusively from explicit expressions, such as speech, gestures, or facial expressions. In this experiment, functional magnetic resonance imaging (fMRI) was used to investigate implicit intentions that were generated while a subject was reading self-relevant sentences. Short sentences, which were presented visually, consisted of self-relevant statements and a substantive verb, which indicated sentence polarity as either affirmative or negative. Each sentence was divided into the contents and the sentence ending, and the subjects were asked to respond with either agreement or disagreement after the complete sentence was presented. The overall group analysis suggested that the intention of the sentence response was found even before the reading of the complete sentences. Increased neural activation was found in the left medial prefrontal cortex (MPFC) during feelings of agreement compared to feelings of disagreement during self-relevant decision-making. In addition, according to the sentence ending, the decision of a response activated the frontopolar cortex (FPC) in the switching condition. These findings indicated that the implicit intentions of responses to the given statements were internally generated before an explicit response occurred, and, hence, intentions can be used to predict a subject's future answer.

Critical role of calcium overloading in cadmium-induced apoptosis in mouse thymocytes

Cadmium (Cd) is a well-known environmental carcinogen and immunotoxin. Currently the direct cytotoxic effects of Cd on thymocytes are largely unexplored. The main objective of the present study was to investigate the apoptogenic property of Cd and the mechanisms involved, using primary cultured mouse thymocytes as a model. Cd-induced apoptosis in thymocytes was studied by TdT-mediated dUTP nick end-labeling assay and DNA gel electrophoresis. The results showed that Cd was able to cause apoptosis in mouse thymocytes in a time- and dose-dependent manner. Moreover, Cd exposure led to a rapid and sustained intracellular calcium (Ca2+) elevation, followed by caspase-3 activation and PARP cleavage, all of which preceded the characteristic DNA fragmentation. BAPTA-AM, a specific intracellular Ca2+ chelator, abolished Cd-induced Ca2+ overloading and subsequently inhibited caspase-3 activation, PARP cleavage, and apoptosis. It is believed that intracellular Ca2+ elevation may trigger caspase-3 activation either through mitochondria or through activation of Ca2+-dependent protease in Cd-treated thymocytes. Results from this study thus provide new information for a better understanding of the immunotoxic and immunomodulatory effects of Cd.

[The retrosigmoid approach surgery of trigeminal never]

OBJECTIVE

To explore the effect of retrosigmoid approach surgery of trigeminal never to treat trigeminal neuralgia.

METHOD

Twenty-six patients underwent the selective trigeminal neurectomy, among them 2 cases of surgical removal of the cerebellopontine angle cholesteatoma and 2 cases of trigeminal never branch No. I splitting; four patients underwent microvascular decompression.

RESULT

By 1-7 years of following up, only one case of microvascular decompression recurrence in all successful operations.

CONCLUSION

The effect of retrosigmoid approach surgery of trigeminal never is satisfactory. To know the management of the complications is very important too.

Translocation (12;14) in lipoma: a case report and review of the literature

We report a case of an intramuscular lipoma with the following karyotype: 46,XY,t(12;14) (q14-15;q24). To our knowledge, this is the third report of a t(12;14) as a sole abnormality in a lipoma.

[Effect of NO-like relaxing factor (NO-LRF) in rat tourniquet shock]

On tourniquet shock (ToS) rat model, it was found that the reactivity of isolated perfused aortic ring to noradrenaline was decreased, while the cGMP content of the aortic tissue was increased. These ToS-induced changes could be potentiated or attenuated respectively by perfusion with NO-precursor, L-arginine, or NO-synthesis inhibitor L-NNA independent of the presence of vascular endothelium. Guanylate cyclase inhibitor, methylene blue, could also attenuate the aortic reactivity. All these results suggest that the aortic musculature can produce a NO-LRF factor capable of lowering the vascular reactivity of the ToS animals. That L-arginine can ameliorate while L-NNA can exacerbate ToS, suggest that NO-LRF do play an adaptive role in the protective mechanism of the organism during ToS.

[Role of endothelin in the pathogenesis of rat experimental hypertension produced by aorta narrowing and saline uptake]

Endothelin is a bioactive polypeptide released from vascular endothelium, which has a strong action promoting vascular contraction, proliferation and hypertrophy of vascular smooth muscle cells. The present investigation was performed on the hypertensive rat produced by narrowing abdominal aorta and drinking saline. It was observed that the level of plasma endothelin in the hypertensive rats was doubled (9.70 +/- 0.68 vs. sham group 4.11 +/- 0.33 pg/ml, P < 0.01), and administration of specific endothelin-antiserum into hypertensive rats significantly attenuated the increase in the blood pressure (18.97 + 1.32 vs. 27.33 + 0.09 kPa in untreated hypertensive rats, P < 0.01), and dramatically ameliorated malfunction resulting from myocardial hypertrophy. The results suggest that endothelin is an important factor in the pathogenesis of hypertension, and that inhibition of endothelin action may be a new effective way in prevention and therapy of hypertension.

Renal metastases of choriocarcinoma. A clinicopathological study of 31 cases

From 1949 through 1978, 31 patients with renal metastasis were diagnosed in a total of 448 cases of choriocarcinoma admitted to our hospital, giving an incidence of 6.9%. Renal metastasis was invariably preceded by pulmonary metastases and usually accompanied by other visceral metastases, indicating that renal metastasis is the result of dissemination of tumor cells secondarily from lung metastasis through the general circulation and should be categorized as arterial metastasis. Pyelogram is useful in the presence of medullary invasion by the tumor. Renal metastatic tumors are very sensitive to chemotherapy. Good response to chemical agents may be due to high drug concentration attained in the kidney tissue during excretion. Since successful treatment of renal metastasis by chemotherapy alone may be obtained, patients can be spared a major operation without jeopardizing the prognosis.

Clinical significance of hysterography in the diagnosis of choriocarcinoma and invasive mole

From 1963 through 1988, a total of 194 hysterographies were performed for 111 patients. Three types of abnormalities were observed on the hysterogram: filling defect, intramural invasion of the uterine wall by the contrast medium; and intravasation of the contrast medium into the pelvic veins. The pathology and clinical significance of three types of abnormalities were studied. The results showed that hysterography demonstrated better images than pelvic arteriography and B-scan for the diagnosis of choriocarcinoma and invasive mole, especially when combined with B-scan/or pelvic arteriography, a greater accuracy was achieved.

Pregnancy outcomes after successful chemotherapy for choriocarcinoma and invasive mole: long-term follow-up

In order to preserve the fertility of young patients with choriocarcinoma and invasive mole, chemotherapy alone was given without hysterectomy in 265 cases from 1959 through 1980. By the end of 1985, 205 patients had become pregnant after recovery, with a total of 355 pregnancies. Among these, 23 were terminated by induced abortions, 26 as miscarriages, two as ectopic gestations, two as intrauterine deaths, and three as stillbirths. Among 303 livebirths (including four sets of twins), six infants died neonatally, three of whom were found to have congenital anomalies incompatible with life, and two died during infancy. All the remaining 295 children had normal growth and development, the oldest now being 25 years of age. The rates of fetal wastage, malformations, twin pregnancies, and neonatal and infantile deaths did not deviate from the normal. Cytogenetic study of the peripheral lymphocytes of 94 of the children revealed no increase of chromosomal aberrations. The rates of recurrence of disease and of death caused by recurrence of disease in these were not increased in comparison with those in patients who underwent hysterectomy. These data indicate that treatment of malignant trophoblastic neoplasms with chemotherapy alone is compatible with the preservation of fertility in most women.