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
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
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
Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assess...Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.展开更多
Objective:Anesthetics are of great importance in avoiding severe pain and suffering in animals and ensuring experimental progress.This study was aimed at elucidating the anesthesia score of phenobarbital sodium as a g...Objective:Anesthetics are of great importance in avoiding severe pain and suffering in animals and ensuring experimental progress.This study was aimed at elucidating the anesthesia score of phenobarbital sodium as a general anesthetic at different concentrations and doses in BALB/c mice,and finding the suitable anesthesia strategies for experimental surgeries.Methods:Phenobarbital sodium was administrated intraperitoneally at the doses of 75,100,125,150,and 200 mg/kg and randomly in different concentrations(2%,5%,and 10%)to female BALB/c mice.The anesthesia score was evaluated based on the stimulus index including tail-pinch,front and hind limb withdrawal,and eyelid reflexes.The speed and duration of anesthesia in different groups were recorded per the occurrence and duration of the righting reflex.Results:The anesthetic effect of phenobarbital sodium on female BALB/c mice showed an obvious dose-dependency.Respiratory suppression caused by high-dose anesthesia may lead to mouse death.Based on the anesthesia score,when the phenobarbital sodium treatment was greater than or equal to five percent or 200 mg/kg,more than 80%mice meet the anesthesia depth that surgical operation needed.The rates of achieving surgical anesthesia depth(standard-reaching rate)in mice treated with 2%sodium phenobarbital were 0%in the 75 mg/kg group,0%in the 100 mg/kg group,50%in the 125 mg/kg group,66.7%in the 150 mg/kg group,and 100%in the 200 mg/kg group.The standard-reaching rate of mice treated with 5%concentration of phenobarbital sodium were:0%in the 75 mg/kg group,0%in the 100 mg/kg group,83.33%in the 125 mg/kg group,100%in the 150 mg/kg group,and 100%in the 200 mg/kg group.The standard-reaching rate of mice treated with 10%concentration of phenobarbital sodium were:50%in the 75 mg/kg group,66.7%in the 100 mg/kg group,100%in the 125 mg/kg group,100%in the 150mg/kg group,and 100%in the 200 mg/kg group.Sedation and hypnosis were induced in the low-concentration dose group,and anesthesia was induced in the high-concentration dose group.In the 5%and 125 mg/kg phenobarbital sodium groups,the mortality rate of mice was 0,the anesthesia induction time was(35.5±7.92)minutes,and the anesthesia duration was(106±39.59)minutes.In the 5%and 150 mg/kg phenobarbital sodium groups,the mortality rate of mice was 0,the anesthesia induction time was(34.83±5.27)minutes,and the anesthesia duration was(131.7±36.75)minutes.Conclusion:Phenobarbital sodium alone can provide appropriate general anesthesia in female BALB/c mice.Both the concentration and dose of phenobarbital sodium can affect the anesthetic effect.On the basis of our findings,we recommend the 5%and 125 mg/kg and 5%and 150 mg/kg concentration–dose combinations of phenobarbital sodium for anesthetizing mice according to the surgical requirement.展开更多
Background: The utricular macula is located on the floor of the utricle, approximately in the plane of the lateral semicircular canal, and is oriented to respond best to lateral tilts and side-to-side or fore-and-aft ...Background: The utricular macula is located on the floor of the utricle, approximately in the plane of the lateral semicircular canal, and is oriented to respond best to lateral tilts and side-to-side or fore-and-aft translations of the head. However, the details of the otolith ocular reflex are unknown. Pathophysiology of transient direction-changing geotropic positional nystagmus is a canalolithiasis in the lateral semicircular canal. The principle of affected-ear-up 90° maneuver is moving debris from a long arm to the utricle, therefore debris stimulates the utricular macula in the sitting position after the treatment. Objective: To clarify whether nystagmus occurs by the stimulation to the macula of the utricle. Methods: The subjects were 10 patients with lateral semicircular canal canalolithiasis. After the diagnosis, we performed affected-ear-up 90° maneuver immediately. We observed eye movements in the sitting position (chin-down 30°) just after the treatment. Results: No one showed nystagmus in the sitting position after the treatment. In all patients, positional nystagmus disappeared within 7 days after the treatment. Conclusion: Nystagmus does not occur by the stimulation to the macula of the utricle. Hence, we cannot assess the function of the utricle by the analysis of eye movements, and ocular counter-rolling is considered to be a semicircular canal ocular reflex.展开更多
In this paper, we investigate local properties in the system of completely 1-summing mapping spaces. We introduce notions of injectivity, local reflexivity, exactness, nuclearity and finite-representability in the sys...In this paper, we investigate local properties in the system of completely 1-summing mapping spaces. We introduce notions of injectivity, local reflexivity, exactness, nuclearity and finite-representability in the system of completely 1-summing mapping spaces. First we obtain that if V has WEP, V is locally reflexive in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)) if and only if it is locally reflexive in the system (Ⅰ(⋅,⋅), t(⋅)). Furthermore we prove that an operator space V ⊆ B(H) is exact in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)) if and only if V is finitely representable in {M<sub>n</sub>}<sub>n∈N</sub> in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)). At last, we show that an operator space V is finitely representable in {M<sub>n</sub>}<sub>n∈N</sub> in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)) if and only if V = C.展开更多
Background: We have been performing a canalith repositioning procedure for benign paroxysmal positional vertigo. When we adopted the Epley maneuver for posterior semicircular canal type, and affected-ear-up 90° m...Background: We have been performing a canalith repositioning procedure for benign paroxysmal positional vertigo. When we adopted the Epley maneuver for posterior semicircular canal type, and affected-ear-up 90° maneuver for lateral semicircular canal type, we noticed that no nystagmus occurred in the sitting position just after treatment. Despite direct excitation to the utricle by the pathological debris, none of the subjects complained of dizziness. Thus, we hypothesized that nystagmus and dizziness do not occur by stimulation of the otolith organs. Objective: The aim of the study was to observe and record the eye movements induced by the otolith organs to confirm our hypothesis. Materials and Methods: Twelve healthy humans were tested. In the sitting position, the head was tilted to the right ear by 45° and vice versa. Afterward, the head was bent forward by 90° (nose-down), and the subject’s seat was reclined to the head-hanging position. Each position was kept for five seconds. We interviewed the subjects to assess their dizziness. Results: None of the subjects showed nystagmus and complained of dizziness in every position. Conclusions: Nystagmus does not occur by the stimulation to the otolith organs;therefore, ocular counter-rolling is a semicircular canal ocular reflex.展开更多
Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertai...Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.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
In this paper, wavelet transform and entropy are evaluated using the mathematical analysis concepts of reflexibility, regularity and series obtention, these concepts remark the reason to make a selective reference fra...In this paper, wavelet transform and entropy are evaluated using the mathematical analysis concepts of reflexibility, regularity and series obtention, these concepts remark the reason to make a selective reference framework for power quality applications. With this idea the paper used the same treatment for the two algorithms (Multiresolution and Multiscale Entropy). The wavelet is denoted to have the most power full consistence to the light off the reflexibility, regularity and series obtention. The paper proposes a power quality technique namely MpqAT.展开更多
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.
基金This study was supported by the Pediatric Heart Center at Skåne University Hospital Lund and Lund University,and by the Swedish Children’s Heart Association.
文摘Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.
基金National Natural Science Foundation of China(No.81660270)Natural Science Foundation of Hainan Province(No.823RC497)+1 种基金"Nanhai Series"Talent Education ProgramKey Discipline Project of Pathophysiology of Hainan Medical University。
文摘Objective:Anesthetics are of great importance in avoiding severe pain and suffering in animals and ensuring experimental progress.This study was aimed at elucidating the anesthesia score of phenobarbital sodium as a general anesthetic at different concentrations and doses in BALB/c mice,and finding the suitable anesthesia strategies for experimental surgeries.Methods:Phenobarbital sodium was administrated intraperitoneally at the doses of 75,100,125,150,and 200 mg/kg and randomly in different concentrations(2%,5%,and 10%)to female BALB/c mice.The anesthesia score was evaluated based on the stimulus index including tail-pinch,front and hind limb withdrawal,and eyelid reflexes.The speed and duration of anesthesia in different groups were recorded per the occurrence and duration of the righting reflex.Results:The anesthetic effect of phenobarbital sodium on female BALB/c mice showed an obvious dose-dependency.Respiratory suppression caused by high-dose anesthesia may lead to mouse death.Based on the anesthesia score,when the phenobarbital sodium treatment was greater than or equal to five percent or 200 mg/kg,more than 80%mice meet the anesthesia depth that surgical operation needed.The rates of achieving surgical anesthesia depth(standard-reaching rate)in mice treated with 2%sodium phenobarbital were 0%in the 75 mg/kg group,0%in the 100 mg/kg group,50%in the 125 mg/kg group,66.7%in the 150 mg/kg group,and 100%in the 200 mg/kg group.The standard-reaching rate of mice treated with 5%concentration of phenobarbital sodium were:0%in the 75 mg/kg group,0%in the 100 mg/kg group,83.33%in the 125 mg/kg group,100%in the 150 mg/kg group,and 100%in the 200 mg/kg group.The standard-reaching rate of mice treated with 10%concentration of phenobarbital sodium were:50%in the 75 mg/kg group,66.7%in the 100 mg/kg group,100%in the 125 mg/kg group,100%in the 150mg/kg group,and 100%in the 200 mg/kg group.Sedation and hypnosis were induced in the low-concentration dose group,and anesthesia was induced in the high-concentration dose group.In the 5%and 125 mg/kg phenobarbital sodium groups,the mortality rate of mice was 0,the anesthesia induction time was(35.5±7.92)minutes,and the anesthesia duration was(106±39.59)minutes.In the 5%and 150 mg/kg phenobarbital sodium groups,the mortality rate of mice was 0,the anesthesia induction time was(34.83±5.27)minutes,and the anesthesia duration was(131.7±36.75)minutes.Conclusion:Phenobarbital sodium alone can provide appropriate general anesthesia in female BALB/c mice.Both the concentration and dose of phenobarbital sodium can affect the anesthetic effect.On the basis of our findings,we recommend the 5%and 125 mg/kg and 5%and 150 mg/kg concentration–dose combinations of phenobarbital sodium for anesthetizing mice according to the surgical requirement.
文摘Background: The utricular macula is located on the floor of the utricle, approximately in the plane of the lateral semicircular canal, and is oriented to respond best to lateral tilts and side-to-side or fore-and-aft translations of the head. However, the details of the otolith ocular reflex are unknown. Pathophysiology of transient direction-changing geotropic positional nystagmus is a canalolithiasis in the lateral semicircular canal. The principle of affected-ear-up 90° maneuver is moving debris from a long arm to the utricle, therefore debris stimulates the utricular macula in the sitting position after the treatment. Objective: To clarify whether nystagmus occurs by the stimulation to the macula of the utricle. Methods: The subjects were 10 patients with lateral semicircular canal canalolithiasis. After the diagnosis, we performed affected-ear-up 90° maneuver immediately. We observed eye movements in the sitting position (chin-down 30°) just after the treatment. Results: No one showed nystagmus in the sitting position after the treatment. In all patients, positional nystagmus disappeared within 7 days after the treatment. Conclusion: Nystagmus does not occur by the stimulation to the macula of the utricle. Hence, we cannot assess the function of the utricle by the analysis of eye movements, and ocular counter-rolling is considered to be a semicircular canal ocular reflex.
文摘In this paper, we investigate local properties in the system of completely 1-summing mapping spaces. We introduce notions of injectivity, local reflexivity, exactness, nuclearity and finite-representability in the system of completely 1-summing mapping spaces. First we obtain that if V has WEP, V is locally reflexive in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)) if and only if it is locally reflexive in the system (Ⅰ(⋅,⋅), t(⋅)). Furthermore we prove that an operator space V ⊆ B(H) is exact in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)) if and only if V is finitely representable in {M<sub>n</sub>}<sub>n∈N</sub> in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)). At last, we show that an operator space V is finitely representable in {M<sub>n</sub>}<sub>n∈N</sub> in the system (Ⅱ<sub>1</sub>(⋅,⋅), π<sub>1</sub>(⋅)) if and only if V = C.
文摘Background: We have been performing a canalith repositioning procedure for benign paroxysmal positional vertigo. When we adopted the Epley maneuver for posterior semicircular canal type, and affected-ear-up 90° maneuver for lateral semicircular canal type, we noticed that no nystagmus occurred in the sitting position just after treatment. Despite direct excitation to the utricle by the pathological debris, none of the subjects complained of dizziness. Thus, we hypothesized that nystagmus and dizziness do not occur by stimulation of the otolith organs. Objective: The aim of the study was to observe and record the eye movements induced by the otolith organs to confirm our hypothesis. Materials and Methods: Twelve healthy humans were tested. In the sitting position, the head was tilted to the right ear by 45° and vice versa. Afterward, the head was bent forward by 90° (nose-down), and the subject’s seat was reclined to the head-hanging position. Each position was kept for five seconds. We interviewed the subjects to assess their dizziness. Results: None of the subjects showed nystagmus and complained of dizziness in every position. Conclusions: Nystagmus does not occur by the stimulation to the otolith organs;therefore, ocular counter-rolling is a semicircular canal ocular reflex.
文摘Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.
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.
文摘In this paper, wavelet transform and entropy are evaluated using the mathematical analysis concepts of reflexibility, regularity and series obtention, these concepts remark the reason to make a selective reference framework for power quality applications. With this idea the paper used the same treatment for the two algorithms (Multiresolution and Multiscale Entropy). The wavelet is denoted to have the most power full consistence to the light off the reflexibility, regularity and series obtention. The paper proposes a power quality technique namely MpqAT.