Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Δευτέρα 9 Νοεμβρίου 2020

Epigenetic Regulation of the Clinical Signs of Friedreich’s Disease

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Objectives. To study the methylation profile of the FXN gene and its influence on the formation of the clinical presentation of Friedreich's disease (FD). Materials and methods. The promoter area and intron 1 of the FXN gene up to the GAA expansion (UP-GAA) and after the GAA expansion (DOWN-GAA) regions were studied in 17 patients with FD, with analysis of a total of 45 CpG sites. Results. Studies of genetic-epigenetic interactions identified correlations between the extent of methylation of a series of CpG sites in the UP-GAA and DOWN-GAA and the number of GAA repeats in both expanded alleles of the FXN gene in patients with FD. We also found a link between methylation and the presence of the extraneural sign s of FD: cardiomyopathy was more likely to be present when the CpG site of the promoter region was hypermethylated, while impairments to carbohydrate metabolism were more common in hypomethylation of CpG sites in the DOWN-GAA area. Conclusions. The data obtained here provide evidence that epigenetic modifications of the FXN gene make a significant contribution to forming the clinical picture of FD.

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Lohxa LLC Issues Voluntary Nationwide Recall of Chlorhexidine Gluconate Oral Rinse USP, 0.12% Due to Microbial Contamination

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Audience: Consumer, Patient, Health Professional, Pharmacy November 09, 2020 -- Lohxa, LLC is voluntarily recalling Chlorhexidine Gluconate Oral Rinse USP, 0.12% Alcohol free (NDC:70166-027-15) products bearing an expiration date from 01/31/21...
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Prognostic Factors After Neoadjuvant Imatinib for Newly Diagnosed Primary Gastrointestinal Stromal Tumor

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Abstract

Introduction

Neoadjuvant imatinib (Neo-IM) therapy may facilitate R0 resection in primary gastrointestinal stromal tumors (GISTs) that are large or in difficult anatomic locations. While response to preoperative tyrosine kinase inhibitors is associated with better outcome in metastatic GIST, little is known about prognostic factors after Neo-IM in primary GIST.

Study Design

Patients with primary GIST with or without synchronous metastases who underwent Neo-IM were retrospectively analyzed from a prospective maintained institutional database for Response Evaluation Criteria in Solid Tumors (RECIST), tumor viability, and mitotic rate. Overall survival (OS) was estimated by Kaplan-Meier and compared by log-rank test. Cox proportionate hazard models were used for univariate and multivariate analysis.

Results

One hundred and fifty patients were treated for a median of 7.1 months (range 0.2–160). By RECIST, partial response, stable disease, and progressive disease were seen in 40%, 51%, and 9%, respectively. By pathologic analysis, ≤ 50% of the tumor was viable in 72%, and the mitotic rate was ≤ 5/50HPF in 74%. On multivariate analysis, RECIST response and tumor viability were not associated with OS, while post-treatment high mitotic rate (hazard ratio (HR) for death 5.3, CI 2.3–12.4), R2 margins (HR 6.0, CI 2.3–15.5), and adjuvant imatinib (HR 0.4, CI 0.2–0.9) were (p < 0.05). Five-year OS was 81 vs. 38% for low vs. high mitotic rate; 81, 59, and 39% for R0, R1, and R2 margins; and 75 vs 61% for adjuvant vs. no adjuvant imatinib therapy (p < 0.05).

Conclusions

In primary GIST undergoing Neo-IM therapy, progression was uncommon, but substantial down-sizing occurred in the minority. High tumor mitotic rate and incomplete resection following Neo-IM were associated with poor outcome, while adjuvant imatinib was associated with prolonged survival.

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The Myokinetic Control Interface: How Many Magnets Can be Implanted in an Amputated Forearm? Evidence From a Simulated Environment

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We recently introduced the concept of a new human-machine interface (the myokinetic control interface) to control hand prostheses. The interface tracks muscle contractions via permanent magnets implanted in the muscles and magnetic field sensors hosted in the prosthetic socket. Previously we showed the feasibility of localizing several magnets in non-realistic workspaces. Here, aided by a 3D CAD model of the forearm, we computed the localization accuracy simulated for three different below-elbow amputation levels, following general guidelines identified in early work. To this aim we first identified the number of magnets that could fit and be tracked in a proximal (T1), middle (T2) and distal (T3) representative amputation, starting from 18, 20 and 23 eligible muscles, respectively. Then we ran a localization algorithm to estimate the poses of the magnets based on the sensor readings. A sensor selection strategy (from an initial grid of 840 sensors) was also implemented to opti mize the computational cost of the localization process. Results showed that the localizer was able to accurately track up to 11 (T1), 13 (T2) and 19 (T3) magnetic markers (MMs) with an array of 154, 205 and 260 sensors, respectively. Localization errors lower than 7% the trajectory travelled by the magnets during muscle contraction were always achieved. This work not only answers the question: "how many magnets could be implanted in a forearm and successfully tracked with a the myokinetic control approach?", but also provides interesting insights for a wide range of bioengineering applications exploiting magnetic tracking.
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Classification of Rhythmic Cortical Activity Elicited by Whole-Body Balance Perturbations Suggests the Cortical Representation of Direction-Specific Changes in Postural Stability

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Postural responses that effectively recover balance following unexpected postural changes need to be tailored to the characteristics of the postural change. We hypothesized that cortical dynamics involved in top-down regulation of postural responses carry information about directional postural changes (i.e., sway) imposed by sudden perturbations to standing balance (i.e., support surface translations). To test our hypothesis, we evaluated the single-trial classification of perturbation-induced directional changes in postural stability from high-density EEG. We analyzed EEG recordings from six young able-bodied individuals and three older individuals with chronic hemiparetic stroke, which were acquired while individuals reacted to low-intensity balance perturbations. Using common spatial patterns for feature extraction and linear discriminant analysis or support vector machines for classification, we achieved classification accuracies above random level (p < 0.05; cross-valid ated) for the classification of four different sway directions (one vs. the rest scheme). Screening of spectral features (3-50 Hz) revealed that the highest classification performance occurred when low-frequency (3-10 Hz) spectral features were used. Strikingly, the participant-specific classification results were qualitatively similar between young able-bodied individuals and older individuals with chronic hemiparetic stroke. Our findings demonstrate that low-frequency spectral components, corresponding to the cortical theta rhythm, carry direction-specific information about changes in postural stability. Our work presents a new perspective on the cortical representation of postural stability and the possible role of the theta rhythm in the modulation of (directional) reactive balance responses. Importantly, our work provides preliminary evidence that the cortical encoding of direction-specific changes in postural stability is present in chronic hemiparetic stroke.
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Multiplayer Interaction Platform With Gaze Tracking for Individuals With Autism

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Deficits in interpersonal communication along with difficulty in putting oneself into the shoes of others characterizes individuals with Autism Spectrum Disorder (ASD). Additionally, they exhibit atypical looking pattern causing them to miss aspects related to understanding other's preference for a context that is crucial for effective social communication. Prior research studies show the use of multiplayer platforms can improve interaction among these individuals. However, these multiplayer platforms do not demand players to understand each other's preference, important for effective social interaction. In this work, we have developed a multiplayer interaction platform using virtual reality augmented with eye-tracking technology. Thirty-six participants comprising of individuals with ASD (n = 18; GroupASD) and typically developing (TD) individuals (n = 18; GroupTD) interacted in pairs within each participant group using our platform. Results indicate that both GroupASD and GroupTD showed improvement in performance across the tasks with the GroupTD performing better than the GroupASD. Additionally, the eye-gaze data indicated an underlying relationship between one's looking pattern and task performance that was differentiated between the GroupASD and GroupTD. The current results indicate a potential of our multiplayer interaction platform to serve as a complementary tool in the hands of the interventionist promoting social reciprocity and interaction among individuals with ASD.
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Targeted Stimulation of Retinal Ganglion Cells in Epiretinal Prostheses: A Multiscale Computational Study

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Retinal prostheses aim at restoring partial sight to patients that are blind due to retinal degenerative diseases by electrically stimulating the surviving healthy retinal neurons. Ideally, the electrical stimulation of the retina is intended to induce localized, focused, percepts only; however, some epiretinal implant subjects have reported seeing elongated phosphenes in a single electrode stimulation due to the axonal activation of retinal ganglion cells (RGCs). This issue can be addressed by properly devising stimulation waveforms so that the possibility of inducing axonal activation of RGCs is minimized. While strategies to devise electrical stimulation waveforms to achieve a focal RGCs response have been reported in literature, the underlying mechanisms are not well understood. This article intends to address this gap; we developed morphologically and biophysically realistic computational models of two classified RGCs: D1-bistratified and A2-monostratified. Computational r esults suggest that the sodium channel band (SOCB) is less sensitive to modulations in stimulation parameters than the distal axon (DA), and DA stimulus threshold is less sensitive to physiological differences among RGCs. Therefore, over a range of RGCs distal axon diameters, short-pulse symmetric biphasic waveforms can enhance the stimulation threshold difference between the SOCB and the DA. Appropriately designed waveforms can avoid axonal activation of RGCs, implying a consequential reduction of undesired strikes in the visual field.
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Computer Vision to Automatically Assess Infant Neuromotor Risk

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An infant's risk of developing neuromotor impairment is primarily assessed through visual examination by specialized clinicians. Therefore, many infants at risk for impairment go undetected, particularly in under-resourced environments. There is thus a need to develop automated, clinical assessments based on quantitative measures from widely-available sources, such as videos recorded on a mobile device. Here, we automatically extract body poses and movement kinematics from the videos of at-risk infants (N = 19). For each infant, we calculate how much they deviate from a group of healthy infants (N = 85 online videos) using a Naïve Gaussian Bayesian Surprise metric. After pre-registering our Bayesian Surprise calculations, we find that infants who are at high risk for impairments deviate considerably from the healthy group. Our simple method, provided as an open-source toolkit, thus shows promise as the basis for an automated and low-cost assessment of risk based on video rec ordings.
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Interhemispheric Functional Reorganization and its Structural Base After BCI-Guided Upper-Limb Training in Chronic Stroke

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Brain–computer interface (BCI)-guided robot-assisted upper-limb training has been increasingly applied to stroke rehabilitation. However, the induced long-term neuroplasticity modulation still needs to be further characterized. This study investigated the functional reorganization and its structural base after BCI-guided robot-assisted training using resting-state fMRI, task-based fMRI, and diffusion tensor imaging (DTI) data. The clinical improvement and the neurological changes before, immediately after, and six months after 20-session BCI-guided robot hand training were explored in 14 chronic stroke subjects. The structural base of the induced functional reorganization and motor improvement were also investigated using DTI. Repeated measure ANOVA indicated long-term motor improvement was found (F[2, 26] = 6.367, p = 0.006). Significantly modulated functional connectivity (FC) was observed between ipsilesional motor regions (M1 and SMA) and some contralesional areas (SMA, P Md, SPL) in the seed-based analysis. Modulated FC with ipsilesional M1 was significantly correlated with motor function improvement (r = 0.6455, p = 0.0276). Besides, increased interhemispheric FC among the sensorimotor area from resting-state data and increased laterality index from task-based data together indicated the re-balance of the two hemispheres during the recovery. Multiple linear regression models suggested that both motor function improvement and the functional change between ipsilesional M1 and contralesional premotor area were significantly associated with the ipsilesional corticospinal tract integrity. The results in the current study provided solid support for stroke recovery mechanism in terms of interhemispheric interaction and its structural substrates, which could further enhance the understanding of BCI training in stroke rehabilitation. This- study was registered at https://clinicaltrials.gov (NCT02323061).
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Functional Brain Connectivity Analysis in Intellectual Developmental Disorder During Music Perception

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Intellectual Developmental Disorder (IDD) is a neurodevelopmental disorder involving impairment of general cognitive abilities. This disorder impacts the conceptual, social, and practical skills adversely. There is a growing interest in exploring the neurological behavior associated with these disorders. Assessment of functional brain connectivity and graph theory measures have emerged as powerful tools to aid these research goals. The current research contributes by comparing brain connectivity patterns of IDD individuals to those typical controls. Considering the intellectual deficits linked to the IDD population, we hypothesized an atypical connectivity pattern in the IDD group. Brain signals were recorded by a dry-electrode Electroencephalography (EEG) system during the rest and music states observed by the subjects. We studied a group of seven IDD subjects and seven healthy controls to understand the connectivity within the human brain during the resting-state vis-à-vis w hile listening to music. Findings of this research emphasize (1) hyper-connected functional brain networks and increased modularity as potential characteristics of the IDD group, (2) the ability of soothing music to reduce the resting state hyper-connected pattern in the IDD group, and (3) the effect of soothing music in the lower frequency bands of the control group compared to the higher frequency bands of the IDD group.
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Resilient EMG Classification to Enable Reliable Upper-Limb Movement Intent Detection

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Reliable control of assistive devices using surface electromyography (sEMG) remains an unsolved task due to the signal's stochastic behavior that prevents robust pattern recognition for real-time control. Non-representative samples lead to inherent class overlaps that generate classification ripples for which the most common alternatives rely on post-processing and sample discard methods that insert additional delays and often do not offer substantial improvements. In this paper, a resilient classification pipeline based on Extreme Learning Machines (ELM) was used to classify 17 different upper-limb movements through sEMG signals from a total of 99 trials derived from three different databases. The method was compared to a baseline ELM and a sample discarding (DISC) method and proved to generate more stable and consistent classifications. The average accuracy boost of ≈ 10% in all databases lead to average weighted accuracy rates higher as 53,4% for amputees and 89,0% for n on-amputee volunteers. The results match or outperform related works even without sample discards.
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If you want to be happy, make someone else happy. If you want to find the right person in your life, be the right person. If you want to see change in the world, become the change you want to see. Deepak Chopra

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A brain-computer interface (BCI) based on motor imagery (MI) translates human intentions into computer commands by recognizing the electroencephalogram (EEG) patterns of different imagination tasks. However, due to the scarcity of MI commands and the long calibration time, using the MI-based BCI system in practice is still challenging. Zero-shot learning (ZSL), which can recognize objects whose instances may not have been seen during training, has the potential to substantially reduce the calibration time. Thus, in this context, we first try to use a new type of motor imagery task, which is a combination of traditional tasks and propose a novel zero-shot learning model that can recognize both known and unknown categories of EEG signals. This is achieved by first learning a non-linear projection from EEG features to the target space and then applying a novelty detection method to differentiate unknown classes from known classes. Applications to a dataset collected from nine subj ects confirm the possibility of identifying a new type of motor imagery only using already obtained motor imagery data. Results indicate that the classification accuracy of our zero-shot based method accounts for 91.81% of the traditional method which uses all categories of data.
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