Abstract Migraine is a complex disorder of the brain whose mechanisms are only now being unraveled. It is common, disabling and economically costly. The pain suggests an important role of the ...nociceptive activation, or the perception of activation, of trigeminal cranial, particularly intracranial afferents. Moreover, the involvement of a multi-sensory disturbance that includes light, sound and smells, as well as nausea, suggests the problem may involve central modulation of afferent traffic more broadly. Brain imaging studies in migraine point to the importance of sub-cortical structures in the underlying pathophysiology of the disorder. Migraine may thus be considered an inherited dysfunction of sensory modulatory networks with the dominant disturbance affecting abnormal processing of essentially normal neural traffic.
The TW ECG pattern constitutes a rare manifestation of STEMI and is associated with acute, severe and extensive transmural ischaemia and consequently an increased risk of ventricular ...fibrillation/ventricular tachycardia, cardiogenic shock and in-hospital mortality 2. The combination of new-onset RBBB and LPFB in acute anterior STEMI reflects extensive myocardial damage due to occlusion of the left anterior descending coronary artery proximal to the first septal perforator artery and concomitant severe disease in one or two additional coronary arteries. Furthermore, in the setting of acute coronary artery occlusion, cardiac arrest with an initial rhythm of pulseless electrical activity has been associated with pre-existing severe left ventricular systolic dysfunction 4.
Objective
To determine the measurement reproducibility of perfusion fraction
f
, pseudodiffusion coefficient
D
*
and diffusion coefficient
D
in colorectal liver metastases and normal liver.
Methods
...Fourteen patients with known colorectal liver metastases were examined twice using respiratory-triggered echo-planar DW-MRI with eight
b
values (0 to 900 s/mm
2
) 1 h apart. Regions of interests were drawn around target metastasis and normal liver in each patient to derive ADC (all
b
values), ADC
high
(
b
values ≥100 s/mm
2
) and intravoxel incoherent motion (IVIM) parameters
f
,
D
*
and
D
by least squares data fitting. Short-term measurement reproducibility of median ADC, ADC
high
,
f
,
D
*
and
D
values were derived from Bland–Altman analysis.
Results
The measurement reproducibility for ADC, ADC
high
and
D
was worst in colorectal liver metastases (−21 % to +25 %) compared with liver parenchyma (−6 % to +8 %). Poor measurement reproducibility was observed for the perfusion-sensitive parameters of
f
(−75 % to +241 %) and
D
*
(−89 % to +2,120 %) in metastases, and to a lesser extent the
f
(−24 % to +25 %) and
D*
(−31 % to +59 %) of liver.
Conclusions
Estimates of
f
and
D
*
derived from the widely used least squares IVIM fitting showed poor measurement reproducibility. Efforts should be made to improve the measurement reproducibility of perfusion-sensitive IVIM parameters.
Key Points
•
Quantitative diffusion-weighted MRI parameters are increasingly used for clinical management decisions.
•
However perfusion-sensitive intravoxel incoherent motion (IVIM) parameters showed poor measurement reproducibility.
•
Measurement reproducibility of IVIM parameters was worse in metastases than normal liver.
•
Efforts to improve measurement reproducibility of IVIM parameters should be explored.
The last decade has witnessed an explosion in novel findings relating to the molecules involved in mediating the sensation of pain in humans. Transient receptor potential (TRP) ion channels emerged ...as the greatest group of molecules involved in the transduction of various physical stimuli into neuronal signals in primary sensory neurons, as well as, in the development of pain. Here, we review the role of TRP ion channels in primary sensory neurons in the development of pain associated with peripheral pathologies and possible strategies to translate preclinical data into the development of effective new analgesics. Based on available evidence, we argue that nociception‐related TRP channels on primary sensory neurons provide highly valuable targets for the development of novel analgesics and that, in order to reduce possible undesirable side effects, novel analgesics should prevent the translocation from the cytoplasm to the cell membrane and the sensitization of the channels rather than blocking the channel pore or binding sites for exogenous or endogenous activators.
Linked Articles
This article is part of a themed section on the pharmacology of TRP channels. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue‐10
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•AI us can have three purposes: efficiency and profit, social control, or human flourishing.•There are three categories of ethical and human rights issues of AI.•Category 1 is ...specific issues of machine learning.•Category 2 is general questions about living in a digital world.•Category 3 is metaphysical questions.•Governance mechanisms can ensure that AI is conducive to human flourishing.
The technical and economic benefits of artificial intelligence (AI) are counterbalanced by legal, social and ethical issues. It is challenging to conceptually capture and empirically measure both benefits and downsides. We therefore provide an account of the findings and implications of a multi-dimensional study of AI, comprising 10 case studies, five scenarios, an ethical impact analysis of AI, a human rights analysis of AI and a technical analysis of known and potential threats and vulnerabilities. Based on our findings, we separate AI ethics discourse into three streams: (1) specific issues related to the application of machine learning, (2) social and political questions arising in a digitally enabled society and (3) metaphysical questions about the nature of reality and humanity. Human rights principles and legislation have a key role to play in addressing the ethics of AI. This work helps to steer AI to contribute to human flourishing.
Background
Initial evidence have shown the short-term efficacy of sTMS in the acute and preventive treatment of migraine. It is unknown whether this treatment approach in the long-term is effective ...and well tolerated in difficult-to-treat migraine.
Methods
This is a prospective, single centre, open-label, real-world analysis conducted in difficult-to-treat patients with high-frequency episodic migraine (HFEM) and chronic migraine (CM) with and without medication overuse headache (MOH), who were exposed to sTMS therapy. Patients responding to a three-month sTMS treatment, continued the treatment and were assessed again at month 12. The cut-off outcome for treatment continuation was reduction in the monthly moderate to severe headache days (MHD) of at least 30% (headache frequency responders) and/or a ≥ 4-point reduction in headache disability using the Headache Impact test-6 (HIT-6) (headache disability responders).
Results
One hundred fifty-three patients were included in the analysis (F:M = 126:27, median age 43, IQR 32.3–56.8). At month 3, 93 out of 153 patients (60%) were responders to treatment. Compared to baseline, the median reduction in monthly headache days (MHD) for all patients at month 3 was 5.0 days, from 18.0 (IQR: 12.0–26.0) to 13.0 days (IQR: 5.75–24.0) (
P
= 0.002,
r
= − 0.29) and the median reduction in monthly migraine days (MMD) was 4.0 days, from 13.0 (IQR: 8.75–22.0) to 9.0 (IQR: 4.0–15.25) (
P
= 0.002,
r
= − 0.29). Sixty-nine out of 153 patients (45%) reported a sustained response to sTMS treatment at month 12. The percentage of patients with MOH was reduced from 52% (
N
= 79/153) at baseline to 19% (
N
= 29/153) at month 3, to 8% (
N
= 7/87) at month 12. There was an overall median 4-point reduction in HIT-6 score, from 66 (IQR: 64–69) at baseline to 62 at month 3 (IQR: 56–65) (
P
< 0.001,
r
= − 0.51). A total of 35 mild/moderate adverse events were reported by 23 patients (15%). One patient stopped sTMS treatment due to scalp sensitivity.
Conclusions
This open label analysis suggests that sTMS may be an effective, well-tolerated treatment option for the long-term prevention of difficult-to-treat CM and HFEM.
This Letter presents the architecture implementation and testing of an single instruction multiple data (SIMD) processor for energy aware embedded morphological visual processing using the simplicial ...piece-wise linear approximation. The architecture comprises a linear array of 48 × 48 processing elements, each connected to an eight-neighbour clique operating on binary input and state data. The architecture is synthesised from a custom designed ultra low-voltage CMOS library and fabricated in a 55 nm CMOS technology. The chip is capable of dynamic voltage/frequency scaling with power supplies between 0.5 and 1.2 V. The fabricated chip achieves an overall performance of 293 TOPS/W with dynamic energy dissipation efficiency of 3.4 fJ per output operation at 0.6 V.
Aim To assess whether there is a significant difference in the incidence of patients with metastases of rectal carcinoma at 1 year follow-up between magnetic resonance imaging (MRI)-detected ...extramural venous invasion (EMVI) and those without. Materials and methods A search of our institution's cancer registry revealed 788 patients with rectal carcinoma between January 2007 and April 2012. Those who were initially staged using MRI and computed tomography (CT) chest/abdomen/pelvis, and followed-up with a CT chest/abdomen/pelvis examination at 1 year were included in this retrospective study. Patients with synchronous metastases were excluded, leaving a cohort of 202 cases. Two consultant radiologists reviewed all MRI images and gave a consensus opinion regarding EMVI grade and vessel size involved. All CT images were reviewed for metastases. Results were analysed using chi-squared and Fisher's exact tests. Results There were 53 cases (26.2%) of EMVI-positive rectal carcinoma. Of the patients with EMVI, 24.5% developed metastases at 1 year follow-up, compared to 6.7% of those without. There is a significant difference in prognosis between those patients with and those without MRI-detected EMVI (χ2 = 12.29, p < 0·001). Those with EMVI have a 3.7 times increased relative risk of developing metachronous metastases within 1 year of diagnosis. Conclusion MRI-detected EMVI-positive rectal carcinomas are associated with an increased risk of metachronous metastases within 1 year of diagnosis. Currently, EMVI status does not directly influence the initial management of rectal carcinoma. This available and potentially prognostic feature could be used to guide treatment pathways to increase disease-free survival.
The fifth cranial nerve in headaches Edvinsson, J. C. A.; Viganò, A.; Alekseeva, A. ...
Journal of headache and pain,
06/2020, Letnik:
21, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the ...brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.
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