Variation in the μ-opioid receptor gene (OPRM1) moderates the influence of early maternal care on fearful attachment

There is evidence that both early experience and genetic variation play a role in influencing sensitivity to social rejection. In this study, we aimed at ascertaining if the A118G polymorphism of the k-opioid receptor gene (OPRM1) moderates the impact of early maternal care on fearful attachment, a personality trait strongly related to rejection sensitivity. In 112 psychiatric patients, early maternal care and fearful attachment were measured using the Parental Bonding Inventory and the Relationship Questionnaire (RQ), respectively. The pattern emerging from the RQ data was a crossover interaction between genotype and maternal caregiving. Participants expressing the minor 118 G allele had similar and relatively high scores on fearful attachment regardless of the quality of maternal care. By contrast, early experience made a major difference for participants carrying the A/A genotype. Those who recalled higher levels of maternal care reported the lowest levels of fearful attachment whereas those who recalled lower levels of maternal care scored highest on fearful attachment. Our data fit well with the differential susceptibility model which stipulates that plasticity genes would make some individuals more responsive than others to the negative consequences of adversity and to the benefits of environmental support and enrichment

Classification of Sensory Neural Signals through Deep Learning Methods

The recording and analysis of peripheral neural signals can be beneficial to provide feedback to prosthetic limbs and recover the sensory functionality in people with nerve injuries. Nevertheless, the interpretation of sensory recordings extracted from the nerve is not trivial, and only few studies have applied classifiers on sequences of neural signals without previous feature extraction. This paper evaluates the classification performance of two deep learning (DL) models (CNN and ConvLSTM) applied to the electroneurographic (ENG) activity recorded from the sciatic nerve of rats. The ENG signals, available from two public datasets, were recorded using multi-channel cuff electrodes in response to four sensory inputs (plantarflexion, dorsiflexion, nociception, and touch) elicited in response to mechanical stimulation applied to the hind paw of the rats. Different temporal lengths of the signals were considered (2.5 s, 1 s, 500 ms, 200 ms, and 100 ms), Both the two DL models proved to correctly discriminate sensory stimuli without the need of hand-engineering feature extraction. Moreover, ConvLSTM outperformed state-of-the-art results in classifying sensory ENG activity (more than 90% F1-score for sequences greater than 500 ms), and it showed promising results for real-time application scenarios

Opioid-free anesthesia—dexmedetomidine as adjuvant in erector spinae plane block: a case series

Background: Laparoscopic pain is related to the stretching of the peritoneum and peritoneal irritation caused by insufflation of the parietal peritoneum with carbon dioxide. In 2017, erector spinae plane block (ESPB) was described for management of postoperative pain following open and laparoscopic abdominal surgery. The use of multimodal anesthesia reduces both intraoperative and postoperative opioid use and improves analgesia. The addition of dexmedetomidine to the anesthetic mixture significantly prolongs analgesia, without clinically significant side effects. Case Presentation: We describe a series of three Caucasian women cases that illustrate the efficacy of bilateral ESPB performed at the level of the T7 transverse process to provide intraoperative and postoperative analgesia for laparoscopic gynecological surgery. Conclusion: Further investigation is recommended to establish the potential for ESPB with dexmedetomidine as adjuvant as an opioid-free anesthetic modality in laparoscopic gynecological surgery

Infliximab in recalcitrant severe atopic eczema associated with contact allergy.

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Understanding eye movements in face recognition with hidden Markov model

Fulltext in: http://mindmodeling.org/cogsci2013/papers/0085/paper0085.pdfIn this paper we propose a hidden Markov model (HMM)-based method to analyze eye movement data. We conducted a simple face recognition task and recorded eye movements and performance of the participants. We used a variational Bayesian framework for Gaussian mixture models to estimate the distribution of fixation locations and modelled the fixation and transition data using HMMs. We showed that using HMMs, we can describe individuals’ eye movement strategies with both fixation locations and transition probabilities. By clustering these HMMs, we found that the strategies can be categorized into two subgroups; one was more holistic and the other was more analytical. Furthermore, we found that correct and wrong recognitions were associated with distinctive eye movement strategies. The difference between these strategies lied in their transition probabilities

Early vs. Late tracheostomy in patients with traumatic brain injury: Systematic review and meta-analysis

Introduction. Tracheostomy can help weaning in long-term ventilated patients, reducing the duration of mechanical ventilation and intensive care unit length of stay, and decreasing complications from prolonged tracheal intubation. In traumatic brain injury (TBI), ideal timing for tracheostomy is still debated. We performed a systematic review and meta-analysis to evaluate the effects of timing (early vs. late) of tracheostomy on mortality and incidence of VAP in traumatic brain-injured patients. Methods. This study was conducted in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We performed a search in PubMed, using an association between heading terms: early, tracheostomy, TBI, prognosis, recovery, impact, mortality, morbidity, and brain trauma OR brain injury. Two reviewers independently assessed the methodological quality of eligible studies using the Newcastle–Ottawa Scale (NOS). Comparative analyses were made among Early Tracheostomy (ET) and late tracheostomy (LT) groups. Our primary outcome was the odds ratio of mortality and incidence of VAP between the ET and LT groups in acute brain injury patients. Secondary outcomes included the standardized mean difference (MD) of the duration of mechanical ventilation, ICU length of stay (LOS), and hospital LOS. Results. We included two randomized controlled trials, three observational trials, one cross-sectional study, and three retrospective cohort studies. The total number of participants in the ET group was 2509, while in the LT group it was 2597. Early tracheostomy reduced risk for incidence of pneumonia, ICU length of stay, hospital length of stay and duration of mechanical ventilation, but not mortality. Conclusions. In TBI patients, early tracheostomy compared with late tracheostomy might reduce risk for VAP, ICU and hospital LOS, and duration of mechanical ventilation, but increase the risk of mortality

Fragility index and fragility quotient in randomized controlled trials on corticosteroids in ards due to covid-19 and non-covid-19 etiology

Background: The effectiveness of corticosteroids in acute respiratory distress syndrome (ARDS) and COVID-19 still remains uncertain. Since ARDS is due to a hyperinflammatory response to a direct injury, we decided to perform a meta-analysis and an evaluation of robustness of randomised clinical trials (RCTs) investigating the impact of corticosteroids on mortality in ARDS in both COVID19 and non-COVID-19 patients. We conducted a systematic search of the literature from inception up to 30 October 2020, using the MEDLINE database and the PubMed interface. We evaluated the fragility index (FI) of the included RCTs using a two-by-two contingency table and the p-value produced by the Fisher exact test; the fragility quotient (FQ) was calculated by dividing the FI score by the total sample size of the trial. Results: Thirteen RCTs were included in the analysis; five of them were conducted in COVID-19 ARDS, including 7692 patients, while 8 RCTS were performed in non-COVID ARDS with 1091 patients evaluated. Three out of eight RCTs in ARDS had a FI > 0 while 2 RCTs out of five in COVID-19 had FI > 0. The median of FI for ARDS was 0.625 (0.47) while the median of FQ was 0.03 (0.014). The median of FI for COVID-19 was 6 (2) while the median of FQ was 0.059 (0.055). In this systematic review, we found that FI and FQ of RCTs evaluating the use of corticosteroids in ARDS and COVID-19 were low