Quantitative Complexity Theory Used in the Prediction of Head-Up Tilt Testing Outcome

Background. Head-up tilt testing (HUTT), a well-established tool in the diagnosis of vasovagal syncope, is time-consuming, and every provoked vasovagal reaction may result in consolidating the reflex mechanism. Therefore, identification of parameters that could shorten the duration of HUTT and prevent fainting is desirable. Quantitative complexity theory (QCT) may provide holistic information on the cardiovascular reaction in HUTT. The aim of the present article was to evaluate the prognostic value of complexity in comparison with traditional haemodynamic parameters (HR and BP) in predicting the HUTT outcome. Methods. Eighty-one healthy volunteers (74 men; mean age: 37.8 years) were included in this retrospective analysis of data collected within the project realized in Department of Cardiology and Internal Diseases, Military Institute of Medicine between January 2012 and October 2014. The subjects underwent HUTT, with beat-to-beat haemodynamic monitoring with a Niccomo™. The chosen haemodynamic parameters (including BP, HR, stroke volume, cardiac output, systemic vascular resistance) have been used in complexity analysis. Results. HUTT was positive in 54 (66.7%) study participants. The values of complexity were already higher in fainting subjects than those were in nonfainting ones 300 s before HUTT termination (HUTT_end), with a significant upward trend starting 150 s before (pre)syncope. An area under the curve (AUC) over 0.700 was observed for complexity from 120 s before HUTT_end, with a sensitivity of 63% and specificity of 78% at this time point. The prognostic value of complexity was superior to that of the HR and mean arterial pressure (MAP). Conclusions. Complexity has been shown to be a sensitive marker of cardiovascular haemodynamic response to orthostatic stress and proved to be superior over HR and BP in predicting HUTT outcomes.

Surgical treatment of stress urinary incontinence and activation of reflex mechanism of the pelvic floor

The study included a group of 133 women (average age 55 years) suffering from urinary incontinence and operated on by the synthetic sling method. A number of studies were performed before and after surgery, including non-invasive uroflow monitoring. The processing and analysis of the data obtained, including the results of urodynamic monitoring, made it possible to provide a mechanism of urinary retention, which is based on the activation of the 4th mating reflex of a forced change in the receptive field by an installed synthetic tape. Based on the reflex nature of the described mechanism, one should use any operation from the class of synthetic sling of limiting effectiveness, use an instrument for implantation, and the material itself is not of key importance for eliminating incontinence.

ORAL MOTOR MENINGKATKAN REFLEK HISAP BAYI BBLR DI RUANG NICU RS MUHAMMADIYAH LAMONGAN

BBLR didefinisikan sebagai bayi yang berat badan lahirnya pada saat kelahiran kurang dari 2500 gram (WHO,2011). Mekanisme reflek menghisap dan menelan belum berkembang dengan baik pada bayi BBLR. Reflek yaitu suatu gerakan yang terjadi secara otomatis dan spontan tanpa disadari pada bayi normal. Menghisap adalah refleks yang sangat penting pada bayi. Tujuan penelitian untuk mengidentifikasi pengaruh terapi oral motor exercise terhadap reflek hisap bayi BBLR. Desain penelitian pra eksperimental dengan pendekatan one Group Pretest-post test design dengan tehnik sampling consecutive. Dilakukan selama satu bulan pada 35 bayi BBLR dengan reflek hisap lemah. Tehnik pengumpulan data dengan lembar observasi menggunakan uji statistik paired t test. Hasil penelitian dari 35 bayi BBLR dengan reflek hisap lemah sebelum diberikan oral motor exersise didapatkan hampir seluruhnya bayi BBLR (88,6%) memiliki reflek hisap kuat setelah diberikan oral motor exersise 15 menit selama 7 hari. Dari hasil analisis uji statistic Paired t-test taraf signifikansi ? 0,05 dengan menggunakan Statistical Product and Service Solution atau SPSS for windows versi 16.0. diperoleh t= -16.233, p=0,000 dimana p<0,05 yang artinya H1 diterima yaitu ada pengaruh terapi oral motor exersise terhadap reflek hisap bayi BBLR. Berdasarkan hasil penelitian, terapi oral motor dapat digunakan sebagai salah satu intervensi bagi bayi BBLR untuk meningkatkan reflek hisap. LBW is defined as a baby whose birth weight is less than 2500 grams at birth (WHO, 2011). The reflex mechanism of sucking and swallowing is not well developed in LBW infants. Reflex is a movement that occurs automatically and spontaneously without being realized in normal babies. Sucking is a very important reflex in infants. The aim of the study was to identify the effect of oral motor exercise therapy on LBW infants' suction reflexes. Pre-experimental research design with one Group Pretest-post test design approach with consecutive sampling technique. Performed for one month on 35 LBW infants with weak suction reflexes. Data collection techniques with an observation sheet using paired t-test statistical tests. The results of the study of 35 LBW infants with weak suction reflexes before being given oral motor exercise found that almost all LBW infants (88.6%) had strong suction reflexes after being given oral motor exercise 15 minutes for 7 days. From the results of the statistical analysis of Paired t-test significance level ? 0.05 using Statistical Product and Service Solution or SPSS for windows version 16.0. obtained t = -16.233, p = 0.000 where p <0.05 which means H1 is accepted that there is an influence of oral motor exercise therapy on LBW infants suction reflexes. Based on the results of the study, oral motor therapy can be used as an intervention for LBW infants to improve suction reflexes

Pupillary Response to Light is Preserved in Patients without Brain Insult Undergoing Rapid Sequence Intubation

Objective of the Study: This paper has been aimed to determine whether the pharmacological neuromuscular blockade with rocuronium during emergency Rapid Sequence Intubation (RSI) affected pupillary response to light (PLR) in patients with brain insult as compared to patients who had non- neurological illness. Previous studies elucidated that RSI with pharmacological neuromuscular blockade does not affect PLR, except in patients with significant neurological lesion. Our objective is to examine the validity of existing but scarce literature on this subject, with further stratification of patients involved in this study into neurological and non-neurological disease groups. Methods: This was a prospective case-reference study of case group with brain insult patients compared with reference group of patients without neurological diseases undergoing RSI in emergency settings. It is single centered study, conducted from October 2019 till May 2020. A pair of a neurosurgeon and a medical officer assessed pupillary light response after administration of neuromuscular blockade and intubation, each blinded to other’s assessment of PLR. Cases without pupillary response before RSI intubation were excluded. The primary outcome measure was clinically observable Pupillary Light Response (PLR) following neuromuscular blockade with Rocuronium in each group. Results: We examined 50 patients undergoing RSI with Rocuronium, either in emergency department or Intensive Care Unit (ICU), 25 each in index and reference group respectively. All patients in the reference group showed PLR after RSI. Of case group patients receiving RSI, only15 of 25 (60%) demonstrated PLR after RSI. This was statistically significant (p value<0.05) when compared to number of patients with intact PLR after RSI in reference group. Cohen’s Kappa Coefficient (k) for inter-observer agreement was 0.70. Conclusion: Rocuronium does not appear to affect PLR after emergent RSI in patients without brain injury. Only in patients with known brain insult showed impaired PLR, suggesting impaired pupillary light reflex mechanism may be the culprit for this aberration, rather than pharmacological neuromuscular blockade.

Quick compensatory mechanisms for tongue posture stabilization during speech production

This study presents evidence of quick compensatory mechanisms in tongue motor control for speech production. The tongue posture is controlled not in relation to a specific tongue position, but to the shape of the tongue contour to achieve specific speech sounds. Modulation of compensatory responses due to task demands and mathematical simulations support the idea that the quick compensatory response is driven by a reflex mechanism.

The Three Stage Digital Evolution of Linguistic Humans

Digital Linguistics (DL) is an interdisciplinary study that identifies human language as a digital evolution of mammal analog vocal sign communications, founded on the vertebrate spinal sign reflex mechanism [Tokumaru 2017 a/b, 2018 a/b/c/d]. Analog signs are unique with their physical sound waveforms but limited in number, whilst human digital word signs are infinite by permutation of their logical property, phonemes. The first digital evolution took place 66,000 years ago with South African Neolithic industries, Howiesons Poort, when linguistic humans acquired a hypertrophied mandibular bone to house a descended larynx for vowel accented syllables containing logical properties of phonemes and morae. Morae made each syllable distinctive in the time axis and enabled grammatical modulation by alternately transmitting conceptual and grammatical syllables. The sign reflex mechanism is an unconscious self-protection and life-support mechanism, operated by immune cell networks inside the ventricle system. DL identified cellular and molecular structures for the sign (=concept) device as a B lymphocyte (or, in other words, Mobile Ad-Hoc Networking Neuron), connects to sensory, conceptual and networking memories, which consist of its meanings [Table 1]. Its antibodies can network with antigens of CSF-Contacting Neurons at the brainstem reticular formation and of Microglia cells at the neocortex [Figure 1]. It is plausible that the 3D structure of the antigen molecule takes the shape of word sound waveform multiplexing intensity and pitch, and that specifically pairing the antibody molecule consists of three CDRs (Complementality Defining Regions) in the Antibody Variable Region network with the logic of dichotomy and dualism. As sign reflex deals with survival issues such as food, safety and reproduction, it is stubborn, passive and inflexible: It does not spontaneously look for something new, and it is not designed to revise itself. These characteristics are not desirable for the development of human intelligence, and thus are to be overcome. All the word, sensory and network memories in the brain must be acquired postnatally through individual learning and thought. The reason and intelligence of humans depend on how correctly and efficiently humans learn new words and acquire appropriate meanings for them.

THE PHENOMENON OF NEUROPLASTICITY IN THE MECHANISMS OF REFLEXOTHERAPY

Reflexotherapy (acupuncture) is one of the most important and valuable part of mankind’s heritage. Reflexotherapy has a long history and was formed as a practical healing method. Reflexotherapy methods include: acupuncture (Chen); Chiu-method (cauterization or warming of acupuncture points by means of wormwood or coal cigars); multi-needle stimuli by a special hammer; vacuum effect on acupuncture points; acupressure; tsubo-therapy; and hirudotherapy. Modern modifications of reflexotherapy are applied: electroacupuncture, electropuncture, laser reflexotherapy, craniopuncture, magnetopuncture, cryotherapy, color and light therapy, and others. There are many theories about the mechanism of action of this method. The focus of the Kazan school is on the role of sensory interaction at different levels of the nervous system in the implementation of the relexotherapy effects. The reflex mechanism for the development of therapeutic effect is considered in this connection as part of a universal method of information processing — sensorimotor interaction. The therapeutic effects of reflexotherapy are realized through the formation of a local and background sensory flow, and their interaction at different levels of the nervous system. Afferent flow is processed at the peripheral, spinal-segmental, stem, subcortical levels, as well as at the level of the cortex. The realization of the positive effects of reflexotherapy occurs, including due to the phenomenon of neuroplasticity, which is implemented at the peripheral and central levels. Reflexotherapy methods can activate the phenomenon of brain neuroplasticity, leading to structural and functional changes that require further research in this direction.

Intelligent Deployable Mini Rover from the Mars Rover for Deep Narrow Scientific Investigation

The paper describes various issues faced by mini rover deployed from main rover in an alien environment and the ways to solve them. The rover features a rocker bogie mechanism with differential drive, collision free distance sensing, wireless XBee control and camera Vision. The rover features a flexible segmented body with a multipurpose arm, corresponding multi wheel mechanism and Kinect module integration for advanced image processing. The system control, for both the Rover as well the robotic arm integrated with it, is done using feasible yet extremely efficient microcontrollers and microprocessors such as Arduino, Raspberry pi etc. Inspired from nature, a reflex mechanism has also been integrated into the rover design to minimize damage, by automated safety reflexes. The six wheeled rocker bogie mechanism ensures that it can traverse over a considerable height greater than the chassis height which could be as much as twice the diameter of the wheels. The rocker bogie mechanism provides traction due to its body weight. The rover finds applications in the exploration of other planets and harsh environments. Such an effort may even prove to be instrumental in detection and study of biological activity in worlds other than ours.

Inhalation of electronic cigarette aerosol induces reflex bronchoconstriction by activation of vagal bronchopulmonary C-fibers

The electronic cigarette (e-cig) has been suggested as a safer alternative to tobacco cigarettes. However, the health effects of e-cigs on the airways have not been fully investigated. Nicotine, the primary chemical constituent of the e-cig aerosol, has been shown to stimulate vagal bronchopulmonary C-fiber sensory nerves, which upon activation can elicit vigorous pulmonary defense reflexes, including airway constriction. In this study, we investigated the bronchomotor response to e-cig inhalation challenge in anesthetized guinea pigs and the mechanisms involved in regulating these responses. Our results showed that delivery of a single puff of e-cig aerosol into the lung triggered immediately a transient bronchoconstriction that sustained for >2 min. The increase in airway resistance was almost completely abolished by a pretreatment with either intravenous injection of atropine or inhalation of aerosolized lidocaine, suggesting that the bronchoconstriction was elicited by cholinergic reflex mechanism and stimulation of airway sensory nerves was probably involved. Indeed, electrophysiological recording further confirmed that inhalation of e-cig aerosol exerted a pronounced stimulatory effect on vagal bronchopulmonary C-fibers. These effects on airway resistance and bronchopulmonary C-fiber activity were absent when the e-cig aerosol containing zero nicotine was inhaled, indicating a critical role of nicotine. Furthermore, a pretreatment with nicotinic acetylcholine receptor antagonists by inhalation completely prevented the airway constriction evoked by e-cig aerosol inhalation. In conclusion, inhalation of a single puff of e-cig aerosol caused a transient bronchoconstriction that was mediated through cholinergic reflex and triggered by a stimulatory effect of nicotine on vagal bronchopulmonary C-fiber afferents.