Characterising the Analgesic Effect of Different Targets for Deep Brain Stimulation in Trigeminal Anaesthesia Dolorosa

BACKGROUND: Several deep brain stimulation (DBS) targets have been explored for the alleviation of trigeminal anaesthesia dolorosa. We aimed to characterise the analgesia produced from the periaqueductal grey (PAG) and centromedian-parafascicular (CmPf) nucleus using a within-subject design. METHOD: We report a case series of 3 subjects implanted with PAG and CmPf DBS systems for the treatment of anaesthesia dolorosa. At follow-up, testing of onset and offset times, magnitude, and thermal and mechanical sensitivity was performed. RESULTS: The mean pain score of the cohort was acutely reduced by 56% (p < 0.05) with PAG and 67% (p < 0.01) with CmPf stimulation at mean time intervals of 38 and 16 min, respectively. The onset time was 12.5 min (p < 0.05) for PAG stimulation and 2.5 min (p < 0.01) for CmPf. The offset time was 2.5 min (p < 0.05) for PAG and 12.5 min (p < 0.01) for CmPf. The two targets were effective at different stimulation frequencies and were not antagonistic in effect. CONCLUSION: The mechanisms by which stimulation at these two targets produces analgesia are likely to be different. Certain pain qualities may respond more favourably to specific targets. Knowledge of onset and offset times for the targets can guide optimisation of stimulation settings. The use of more than one stimulation target may be beneficial and should be considered in anaesthesia dolorosa patients

Hybrid Energy Management System Consisting of Battery and Supercapacitor for Electric Vehicle

This paper is mainly focused on Hybrid Energy Management System (HEMS) consisting of Battery (BT) and Super capacitor (SC). Two energy sources connected in with same DC link in parallel manner with the help of Bidirectional DC-DC converter, which is used to separate control of power flow of each source. Here Permanent magnet dc motor (PMDC) motor used as a load and speed control of PMDC motor can be done by PWM method for this purpose chopper circuit is used. Input of chopper circuit is DC link and output of the chopper is given to PMDC motor. This method of energy management gives power splitting between two sources based on State of Charge (SOC) of each individual source during different state of vehicle such as acceleration, constant running and deceleration. Improved filter-based power splitting techniques is implemented. Three acceleration reference points were taken for power splinting at different SOC levels of both energy sources. Objective of this proposed method is best use of both the sources i.e. battery and supercapacitor and maximum use of supercapacitor energy at the time of transient conditions. Battery supply energy during normal running condition or very less load condition. Hence during transient condition SC directly react with system and gives peak power requirement, so stress on battery is reduces hence lifetime of battery is increase, also power available during braking is store in SC and battery, so independence of Electric Vehicle (EV) is increases. Because of less peak power requirement, batteries with less peak output power is used so it is reduced size and cost of batteries. Matlab- Simulink software is used for simulation and also small scale hardware is also implemented of proposed method

Hybrid Energy Management System Consisting of Battery and Supercapacitor for Electric Vehicle

This paper is mainly focused on Hybrid Energy Management System (HEMS) consisting of Battery (BT) and Super capacitor (SC). Two energy sources connected in with same DC link in parallel manner with the help of Bidirectional DC-DC converter, which is used to separate control of power flow of each source. Here Permanent magnet dc motor (PMDC) motor used as a load and speed control of PMDC motor can be done by PWM method for this purpose chopper circuit is used. Input of chopper circuit is DC link and output of the chopper is given to PMDC motor. This method of energy management gives power splitting between two sources based on State of Charge (SOC) of each individual source during different state of vehicle such as acceleration, constant running and deceleration. Improved filter-based power splitting techniques is implemented. Three acceleration reference points were taken for power splinting at different SOC levels of both energy sources. Objective of this proposed method is best use of both the sources i.e. battery and supercapacitor and maximum use of supercapacitor energy at the time of transient conditions. Battery supply energy during normal running condition or very less load condition. Hence during transient condition SC directly react with system and gives peak power requirement, so stress on battery is reduces hence lifetime of battery is increase, also power available during braking is store in SC and battery, so independence of Electric Vehicle (EV) is increases. Because of less peak power requirement, batteries with less peak output power is used so it is reduced size and cost of batteries. Matlab- Simulink software is used for simulation and also small scale hardware is also implemented of proposed method

Humanized Mice Are Instrumental to the Study of Plasmodium falciparum Infection

Research using humanized mice has advanced our knowledge and understanding of human haematopoiesis, non-adaptive and adaptive immunity, autoimmunity, infectious disease, cancer biology, and regenerative medicine. Challenges posed by the human-malaria parasite Plasmodium falciparum include its complex life cycle, the evolution of drug resistance against anti-malarials, poor diagnosis, and a lack of effective vaccines. Advancements in genetically engineered and immunodeficient mouse strains, have allowed for studies of the asexual blood stage, exoerythrocytic stage and the transition from liver-to-blood stage infection, in a single vertebrate host. This review discusses the process of “humanization” of various immunodeficient/transgenic strains and their contribution to translational biomedical research. Our work reviews the strategies employed to overcome the remaining-limitations of the developed human-mouse chimera(s)

Deep brain stimulation of the anterior nucleus of the thalamus in drug-resistant epilepsy in the MORE multicenter patient registry

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background and objectives: The efficacy of deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) in patients with drug-resistant epilepsy (DRE) was demonstrated in the double-blind Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy randomized controlled trial. The Medtronic Registry for Epilepsy (MORE) aims to understand the safety and longer-term effectiveness of ANT DBS therapy in routine clinical practice. Methods: MORE is an observational registry collecting prospective and retrospective clinical data. Participants were at least 18 years old, with focal DRE recruited across 25 centers from 13 countries. They were followed for at least 2 years in terms of seizure frequency (SF), responder rate (RR), health-related quality of life (Quality of Life in Epilepsy Inventory 31), depression, and safety outcomes. Results: Of the 191 patients recruited, 170 (mean [SD] age of 35.6 [10.7] years, 43% female) were implanted with DBS therapy and met all eligibility criteria. At baseline, 38% of patients reported cognitive impairment. The median monthly SF decreased by 33.1% from 15.8 at baseline to 8.8 at 2 years (p 10 implantations) had 42.8% reduction in median monthly SF by 2 years in comparison with 25.8% in low-volume center. In patients with cognitive impairment, the reduction in median monthly SF was 26.0% by 2 years compared with 36.1% in patients without cognitive impairment. The most frequently reported adverse events were changes (e.g., increased frequency/severity) in seizure (16%), memory impairment (patient-reported complaint, 15%), depressive mood (patient-reported complaint, 13%), and epilepsy (12%). One definite sudden unexpected death in epilepsy case was reported. Discussion: The MORE registry supports the effectiveness and safety of ANT DBS therapy in a real-world setting in the 2 years following implantation. Classification of evidence: This study provides Class IV evidence that ANT DBS reduces the frequency of seizures in patients with drug-resistant focal epilepsy.The MORE registry was sponsored and funded by Medtronic, plc.info:eu-repo/semantics/publishedVersio