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ЗМІНИ КОГНІТИВНОЇ СФЕРИ У ПАЦІЄНТІВ У ВІДНОВНОМУ ТА РЕЗИДУАЛЬНОМУ ПЕРІОДАХ АНЕВРИЗМАЛЬНОГО СУБАРАХНОЇДАЛЬНОГО КРОВОВИЛИВУ
The aneurysmal subarachnoid haemorrhage (aSAH) is characterized by high mortality (from 32 up to 67 %), high frequency of neurological complications, significant disability of patients and decreasing of quality of life [1].
The statistical data indicate that changes in the cognitive sphere of patients, who have suffered aSAH, are exacerbated by the presence of depression, anxiety and sleep disturbances [10].
The aim of the study – to examine the changes of cognitive sphere in patients who suffered aSAH according to age, sex, severity of SAH in acute period (The Hunt and Hess Scale), clinic-anatomical type of haemorrhage, aneurysm localization and kind of surgical intervention.
Materials and Methods. A total of 114 patients were examined in age of 22–59 years, of whom 74 were men and 40 women. Cognitive impairment was assessed by means of Montreal Cognitive deficit Scale (test MoCA). The level of functional recovery and disability was measured by Modified Rankin Scale – mRS). In order to measure performance in activities of daily living (ADL) we used Barthel Activities of Daily Living Index. The state of the psychoemotional sphere was assessed using the Hospital Anxiety and Depression Scale (HADS).
Results and Discussion. Cognitive impairment of different severity ranges was found in 85.96 % cases: mild – in 43.86 %, moderate – in 23.69 %, dementia – in 18.42 %. Among all the items, major changes were discovered in visuospatial abilities, language and memory. Patients who had the depression showed lower MoCA-test results (r=-0.325; p=0,001). It was found the correlation between the overall Moca-test result and severity of SAH in acute period (Hunt-Hess Scale) - (r=-0.310; p=0.001) and Bathel index - (r=0.305; p=0.001). The statistically reliable difference in overall MoCA-test results was absent in groups of patients divided according to age, sex, aneurysm localization and kind of surgical intervention. However, significantly lower (p<0.01) MoCA-test results were observed in group of patients, who had subarachnoid haemorrhage accompanied by parenchymal and ventricular bleeding ((19.09±1.83) points) compared to a group of patients suffered from subarachnoid form of haemorrhage ((22 .84 ±0.43) points).
Conclusions. The average MoCA-test result was (21.71±0.37) points, that corresponds to a moderate cognitive impairment. According to the obtained data, the most significant changes were discovered in the visuospatial abilities, language and memory (p <0.05).Аневризмальное субарахноидальное кровоизлияние (аСАК) характеризуется высокой летальностью (от 32 до 67 %), значительной частотой неврологических осложнений, существенной инвалидностью пациентов и снижением качества жизни. Статистические данные свидетельствуют о том, что изменения в когнитивной сфере больных после перенесенного аСАК усугубляются при наличии у них депрессии, тревоги и нарушения сна.
Цель исследования – оценить изменения когнитивной сферы у пациентов, перенесших аСАК в зависимости от возраста, пола, тяжести кровоизлияния в остром периоде (шкала Hunt-Hess), клинико-анатомической формы перенесенного кровоизлияния, локализации аневризмы и метода ее оперативного исключения.
Материалы и методы. Обследовано 114 пациентов в возрасте от 22 до 59 лет, из них – 74 мужчин и 40 женщин. Оценку когнитивного функционирования проводили с использованием Монреальского Когнитивного Теста (MoCA). Степень функционального восстановления и инвалидизации определялся согласно модифицированной шкалы Рэнкина. Для оценки активности повседневной жизнедеятельности использовался индекс Бартела. Состояние психоэмоциональной сферы оценивали, используя Госпитальную шкалу тревожности и депрессии (HADS).
Результаты исследований и их обсуждение. Когнитивные расстройства различной степени выраженности были обнаружены в 85,96 %: легкое когнитивное снижение – в 43,86 %, умеренное – в 23,69 %, деменцию – 18,42 %. Из всех рубрик шкалы наибольшие изменения претерпели функции зрительно-конструктивных навыков, речи и памяти. Пациенты, у которых диагностировали депрессию, демонстрировали более низкие показатели шкалы MoCA (r=-0,325; p=0,001). Установлена корреляционная зависимость между результатом MoCA-теста и степенью тяжести в остром периоде (по шкале Hunt-Hess) – (r =-0,310; p=0,001), а также индексом Бартела – (r=0,305; p=0,001). Не было установлено достоверной разницы в результатах MoCA-теста в группах пациентов, разделенных по возрасту, полу, локализации аневризмы и методу ее оперативного исключения. Однако отмечено достоверно более низкие (p<0,01) показатели MoCA-теста у пациентов с субарахноидально-паренхиматозно-вентрикулярным кровоизлиянием ((19,09±1,83) балла) по сравнению с группой больных, перенесших субарахноидальное кровоизлияние ((22,84±0,43) балл).
Выводы. Средний балл по шкале MoCA составил (21,71±0,37) балла, что соответствует умеренному когнитивному нарушению. Согласно полученным данным наиболее выраженные изменения отмечались в рубриках зрительно-конструктивных навыков, речи и памяти (p<0,05).Аневризмальний субарахноїдальний крововилив (аСАК) характеризується високою летальністю (від 32 до 67 %), значною частотою неврологічних ускладнень, суттєвою інвалідністю пацієнтів та зниженням якості життя. Статистичні дані свідчать, що зміни у когнітивній сфері хворих після перенесеного аСАК поглиблюються при наявності у них депресії, тривоги та порушення сну.
Мета дослідження – оцінити зміни когнітивної сфери пацієнтів, які перенесли аСАК залежно від віку, статі, тяжкості крововиливу в гострому періоді (шкала Hunt-Hess), клініко-анатомічної форми перенесеного крововиливу, локалізації аневризми та методу її оперативного виключення.
Матеріали і методи. Обстежено 114 пацієнтів у віці від 22 до 59 років, з них – 74 чоловіки та 40 жінок. Оцінку когнітивного функціонування проводили з використанням Монреальського Когнітивного Тесту (MoCA). Ступінь функціонального відновлення та інвалідизації визначали відповідно до модифікованої шкали Ренкіна. Для оцінки активності повсякденної життєдіяльності використовували індекс Бартела. Стан психоемоційної сфери оцінювали, застосовуючи Госпітальну шкалу тривожності й депресії (HADS).
Результати досліджень та їх обговорення. Когнітивні розлади різного ступеня вираження було виявлено у 85,96 %: легке когнітивне зниження – у 43,86 %, помірне – в 23,69 %, деменцію – 18,42 %. З-поміж усіх рубрик шкали найбільших змін зазнали функції зорово-конструктивних навичок, мови та пам’яті. Пацієнти, у яких діагностували депресію, демонстрували нижчі показники шкали MoCA (r=-0,325; p=0,001). Встановлено кореляційну залежність між результатом MoCA-тесту та ступенем тяжкості у гострому періоді (за шкалою Hunt-Hess) – (r=-0,310; p=0,001), а також індексом Бартела – (r=0,305; p=0,001). Не було встановлено достовірної різниці у результатах MoCA-тесту в групах пацієнтів, яких поділили за віком, статтю, локалізацією аневризми та методом її оперативного виключення. Проте відмічено достовірно (p<0,01) нижчі показники MoCA-тесту в пацієнтів із субарахноїдально-паренхіматозно-вентрикулярним крововиливом ((19,09±1,83) бала), порівняно з групою хворих, які перенесли субарахноїдальний крововилив ((22,84±0,43) бала).
Висновки. Середній бал за шкалою MoCA становив (21,71±0,37) бала, що відповідає помірному когнітивному зниженню. Згідно з отриманими даними з-поміж усіх рубрик найбільших змін зазнали функції зорово-конструктивних навичок, мови та пам’яті (p<0,05)
Fluctuations in Polymer Translocation
We investigate a model of chaperone-assisted polymer translocation through a
nanopore in a membrane. Translocation is driven by irreversible random
sequential absorption of chaperone proteins that bind to the polymer on one
side of the membrane. The proteins are larger than the pore and hence the
backward motion of the polymer is inhibited. This mechanism rectifies Brownian
fluctuations and results in an effective force that drags the polymer in a
preferred direction. The translocated polymer undergoes an effective biased
random walk and we compute the corresponding diffusion constant. Our methods
allow us to determine the large deviation function which, in addition to
velocity and diffusion constant, contains the entire statistics of the
translocated length.Comment: 20 pages, 6 figure
Computational and Biological Analogies for Understanding Fine-Tuned Parameters in Physics
In this philosophical paper, we explore computational and biological
analogies to address the fine-tuning problem in cosmology. We first clarify
what it means for physical constants or initial conditions to be fine-tuned. We
review important distinctions such as the dimensionless and dimensional
physical constants, and the classification of constants proposed by
Levy-Leblond. Then we explore how two great analogies, computational and
biological, can give new insights into our problem. This paper includes a
preliminary study to examine the two analogies. Importantly, analogies are both
useful and fundamental cognitive tools, but can also be misused or
misinterpreted. The idea that our universe might be modelled as a computational
entity is analysed, and we discuss the distinction between physical laws and
initial conditions using algorithmic information theory. Smolin introduced the
theory of "Cosmological Natural Selection" with a biological analogy in mind.
We examine an extension of this analogy involving intelligent life. We discuss
if and how this extension could be legitimated.
Keywords: origin of the universe, fine-tuning, physical constants, initial
conditions, computational universe, biological universe, role of intelligent
life, cosmological natural selection, cosmological artificial selection,
artificial cosmogenesis.Comment: 25 pages, Foundations of Science, in pres
The compositional and evolutionary logic of metabolism
Metabolism displays striking and robust regularities in the forms of
modularity and hierarchy, whose composition may be compactly described. This
renders metabolic architecture comprehensible as a system, and suggests the
order in which layers of that system emerged. Metabolism also serves as the
foundation in other hierarchies, at least up to cellular integration including
bioenergetics and molecular replication, and trophic ecology. The
recapitulation of patterns first seen in metabolism, in these higher levels,
suggests metabolism as a source of causation or constraint on many forms of
organization in the biosphere.
We identify as modules widely reused subsets of chemicals, reactions, or
functions, each with a conserved internal structure. At the small molecule
substrate level, module boundaries are generally associated with the most
complex reaction mechanisms and the most conserved enzymes. Cofactors form a
structurally and functionally distinctive control layer over the small-molecule
substrate. Complex cofactors are often used at module boundaries of the
substrate level, while simpler ones participate in widely used reactions.
Cofactor functions thus act as "keys" that incorporate classes of organic
reactions within biochemistry.
The same modules that organize the compositional diversity of metabolism are
argued to have governed long-term evolution. Early evolution of core
metabolism, especially carbon-fixation, appears to have required few
innovations among a small number of conserved modules, to produce adaptations
to simple biogeochemical changes of environment. We demonstrate these features
of metabolism at several levels of hierarchy, beginning with the small-molecule
substrate and network architecture, continuing with cofactors and key conserved
reactions, and culminating in the aggregation of multiple diverse physical and
biochemical processes in cells.Comment: 56 pages, 28 figure
On decoding and rewriting genomes: a psychoanalytical reading of a scientific revolution
In various documents the view emerges that contemporary biotechnosciences are currently experiencing a scientific revolution: a massive increase of pace, scale and scope. A significant part of the research endeavours involved in this scientific upheaval is devoted to understanding and, if possible, ameliorating humankind: from our genomes up to our bodies and brains. New developments in contemporary technosciences, such as synthetic biology and other genomics and “post-genomics” fields, tend to blur the distinctions between prevention, therapy and enhancement. An important dimension of this development is “biomimesis”: i.e. the tendency of novel technologies and materials to mimic or plagiarize nature on a molecular and microscopic level in order to optimise prospects for the embedding of technological artefacts in natural systems such as human bodies and brains. In this paper, these developments are read and assessed from a psychoanalytical perspective. Three key concepts from psychoanalysis are used to come to terms with what is happening in research laboratories today. After assessing the general profile of the current revolution in this manner, I will focus on a particular case study, a line of research that may serve as exemplification of the vicissitudes of contemporary technosciences, namely viral biomaterials. Viral life forms can be genetically modified (their genomes can be rewritten) in such a manner that they may be inserted in human bodies in order to produce substances at specific sites such as hormones (testosterone), neurotransmitters (dopamine), enzymes (insulin) or bone and muscle tissue. Notably, certain target groups such as top athletes, soldiers or patients suffering from degenerative diseases may become the pioneers serving as research subjects for novel applications. The same technologies can be used for various purposes ranging from therapy up to prevention and enhancement
The Subcellular Distribution of Acyltransferases which Catalyze the Synthesis of Phosphoglycerides
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65213/1/j.1432-1033.1969.tb00602.x.pd
Two approaches to the study of the origin of life.
This paper compares two approaches that attempt to explain the origin of life, or biogenesis. The more established approach is one based on chemical principles, whereas a new, yet not widely known approach begins from a physical perspective. According to the first approach, life would have begun with - often organic - compounds. After having developed to a certain level of complexity and mutual dependence within a non-compartmentalised organic soup, they would have assembled into a functioning cell. In contrast, the second, physical type of approach has life developing within tiny compartments from the beginning. It emphasises the importance of redox reactions between inorganic elements and compounds found on two sides of a compartmental boundary. Without this boundary, ¿life¿ would not have begun, nor have been maintained; this boundary - and the complex cell membrane that evolved from it - forms the essence of life
Single-molecule experiments in biological physics: methods and applications
I review single-molecule experiments (SME) in biological physics. Recent
technological developments have provided the tools to design and build
scientific instruments of high enough sensitivity and precision to manipulate
and visualize individual molecules and measure microscopic forces. Using SME it
is possible to: manipulate molecules one at a time and measure distributions
describing molecular properties; characterize the kinetics of biomolecular
reactions and; detect molecular intermediates. SME provide the additional
information about thermodynamics and kinetics of biomolecular processes. This
complements information obtained in traditional bulk assays. In SME it is also
possible to measure small energies and detect large Brownian deviations in
biomolecular reactions, thereby offering new methods and systems to scrutinize
the basic foundations of statistical mechanics. This review is written at a
very introductory level emphasizing the importance of SME to scientists
interested in knowing the common playground of ideas and the interdisciplinary
topics accessible by these techniques. The review discusses SME from an
experimental perspective, first exposing the most common experimental
methodologies and later presenting various molecular systems where such
techniques have been applied. I briefly discuss experimental techniques such as
atomic-force microscopy (AFM), laser optical tweezers (LOT), magnetic tweezers
(MT), biomembrane force probe (BFP) and single-molecule fluorescence (SMF). I
then present several applications of SME to the study of nucleic acids (DNA,
RNA and DNA condensation), proteins (protein-protein interactions, protein
folding and molecular motors). Finally, I discuss applications of SME to the
study of the nonequilibrium thermodynamics of small systems and the
experimental verification of fluctuation theorems. I conclude with a discussion
of open questions and future perspectives.Comment: Latex, 60 pages, 12 figures, Topical Review for J. Phys. C (Cond.
Matt
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