Digital screening method using social media advertising for the remote assessment of trigeminal neuralgia.

Objective: Global trends, such as improving accessibility to healthcare services through the Internet, and the COVID-19 pandemic are among the driving factors in the adoption of digital health. This study hypothesized that digital solutions can reach and gather data from a large number of patients with trigeminal neuralgia (TN), a commonly misdiagnosed neuropathic facial pain syndrome, and quickly and fast-track their diagnosis by suggesting them to consult a neurologist. We developed an accessible digital screening tool based on patient symptoms and history to test this hypothesis and used social media advertisement to screen a general population for TN. Methods: The standard diagnostic criteria, International Classification of Orofacial Pain, for facial pain is digitized as a web-based questionnaire that allows easy access to the evaluation for patients with suspected TN symptoms. Targeted search with relevant keywords and display campaigns on Google search engine and Facebook social media platform were used to reach large numbers of subjects. A report was autogenerated, which included a summary of a subject's symptoms, likely or likely not TN diagnosis, and information to seek appropriate medical assistance. Results: The website was live for seven weeks and generated 240 screening questionnaire submissions, with a total spending of $2482. Forty-four subjects (18.3%) that reported typical symptoms of TN experienced unilateral and episodic pain in one of the trigeminal nerve regions. Conclusions: We have demonstrated the feasibility of social media advertisement and digitally screening a general population for TN, gathering valuable clinical data, such as pain characteristics, through a web-based questionnaire. Based on these data, patients with similar symptoms of TN are suggested to consult a neurologist for diagnosis. This study provides a framework for using digital screening tools to improve the healthcare experience of patients who would spend several months before finding appropriate diagnosis for their specific conditions.

Modulation of Interhemispheric Synchronization and Cortical Activity in Healthy Subjects by High-Definition Theta-Burst Electrical Stimulation.

Background: Various forms of theta-burst stimulation (TBS) such as intermittent TBS (iTBS) and continuous TBS (cTBS) have been introduced as novel facilitation/suppression schemes during repetitive transcranial magnetic stimulation (rTMS), demonstrating a better efficacy than conventional paradigms. Herein, we extended the rTMS-TBS schemes to electrical stimulation of high-definition montage (HD-TBS) and investigated its neural effects on the human brain. Methods: In a within-subject design, fifteen right-handed healthy adults randomly participated in 10 min and 2 mA HD-TBS sessions: unilateral (Uni)-iTBS, bilateral (Bi)-cTBS/iTBS, and sham stimulation over primary motor cortex regions. A 20-channel near-infrared spectroscopy (NIRS) system was covered on the bilateral prefrontal cortex (PFC), sensory motor cortex (SMC), and parietal lobe (PL) for observing cerebral hemodynamic responses in the resting-state and during fast finger-tapping tasks at pre-, during, and poststimulation. Interhemispheric correlation coefficient (IHCC) and wavelet phase coherence (WPCO) from resting-state NIRS and concentration of oxyhemoglobin during fast finger-tapping tasks were explored to reflect the symmetry between the two hemispheres and cortical activity, respectively. Results: The IHCC and WPCO of NIRS data in the SMC region under Bi-cTBS/iTBS showed relatively small values at low-frequency bands III (0.06-0.15 Hz) and IV (0.02-0.06), indicating a significant desynchronization in both time and frequency domains. In addition, the SMC activation induced by fast finger-tapping exercise was significantly greater during Uni-iTBS as well as during and post Bi-cTBS/iTBS sessions. Conclusions: It appears that a 10 min and 2 mA Bi-cTBS/iTBS applied over two hemispheres within the primary motor cortex region could effectively modulate the interhemispheric synchronization and cortical activation in the SMC of healthy subjects. Our study demonstrated that bilateral HD-TBS approaches is an effective noninvasive brain stimulation scheme which could be a novel therapeutic for inducing effects of neuromodulation on various neurological disorders caused by ischemic stroke or traumatic brain injuries.

Evaluating interhemispheric synchronization and cortical activity in acute stroke patients using optical hemodynamic oscillations.

Objective.An understanding of functional interhemispheric asymmetry in ischemic stroke patients is a crucial factor in the designs of efficient programs for post-stroke rehabilitation. This study evaluates interhemispheric synchronization and cortical activities in acute stroke patients with various degrees of severity and at different post-stroke stages.Approach.Twenty-three patients were recruited to participate in the experiments, including resting-state and speed finger-tapping tasks at week-1 and week-3 post-stroke. Multichannel near-infrared spectroscopy (NIRS) was used to measure the changes in hemodynamics in the bilateral prefrontal cortex (PFC), the supplementary motor area (SMA), and the sensorimotor cortex (SMC). The interhemispheric correlation coefficient (IHCC) measuring the synchronized activities in time and the wavelet phase coherence (WPCO) measuring the phasic activity in time-frequency were used to reflect the symmetry between the two hemispheres within a region. The changes in oxyhemoglobin during the finger-tapping tasks were used to present cortical activation.Main results.IHCC and WPCO values in the severe-stroke were significantly lower than those in the minor-stroke at low frequency bands during week-3 post-stroke. Cortical activation in all regions in the affected hemisphere was significantly lower than that in the unaffected hemisphere in the moderate-severe stroke measured in week-1, however, the SMC activation on the affected hemisphere was significantly enhanced in week-3 post-stroke.Significance.In this study, non-invasive NIRS was used to observe dynamic synchronization in the resting-state based on the IHCC and WPCO results as well as hemodynamic changes in a motor task in acute stroke patients. The findings suggest that NIRS could be used as a tool for early stroke assessment and evaluation of the efficacy of post-stroke rehabilitation.

Injection Molded Liquid Crystal Polymer Package for Chronic Active Implantable Devices With Application to an Optogenetic Stimulator.

Implanted electronics require protection from the body's fluids to avoid moisture induced failure. This study presents an injection molded liquid crystal polymer (LCP) package to protect active implantable devices for chronic applications, such as in optogenetic research. The technology is applied and assessed through a custom package for a fully implantable optogenetic stimulation system, built on a versatile telemetry system that can incorporate additional stimulating and recording channels. An adapted quasi-steady state model predicts the lifetime of an enclosure, where the definition of the lifetime is the time before the internal relative humidity (RH) reaches a time constant, or 63%RH, a conservative limit to minimize the risk of corrosion. The lifetime of the LCP optogenetic device is 94 days, and can be extended to 326 days with the inclusion of 5% w/v silica gel desiccant. Samples of the LCP optogenetic device containing humidity sensors testing in saline at 38 °C support the RH change predictions. Desiccants inside the implant enclosure can store permeating moisture and prolong the life expectancy of LCP-based implants to years or decades. The results of this study demonstrates the feasibility of providing reliable protection for chronic optogenetic implants, and the technology can be transferred to other applications as an easily-manufactured, cost-effective, radiofrequency compatible alternative to hermetic packaging for chronic studies.

MicroRNA-146a suppresses rheumatoid arthritis fibroblast-like synoviocytes proliferation and inflammatory responses by inhibiting the TLR4/NF-kB signaling.

This study investigated whether microRNA-146a (miR-146a) mediating TLR4/NF-κB pathway affected proliferation and inflammatory responses of rheumatoid arthritis fibroblast-like synoviocytes from 12 RA patients (RA-FLSs). FLSs in the logarithmic growth phase were assigned into the control, miR-146a mimic miR-146a inhibitor, Tak-242 (treated with TLR4/NF-κB pathway inhibitor) and mimic + lipopolysaccharide (LPS) groups. Cell proliferation and apoptosis were detected using CCK-8 assay and flow cytometry. The expression of miR-146a, TLR4/NF-κB pathway-related proteins and cytokines were determined by RT-qPCR, western blotting and ELISA, and the release of NO by Greiss reaction. RA rat models were constructed and the primary cells were classified into the control, negative control (NC), miR-146a mimic, miR-146a inhibitor, Tak-242, mimic + LPS, and TLR4 groups. Immunohistochemistry was used to detect the expression of proliferating cell nuclear antigen (PCNA) and intercellular adhesion molecular-1 (ICAM-1). The results showed that miR-146a levels were lower in RA-FLSs than control fibroblasts. miR-146a mimic and Tak-242 decreased RA-FLS proliferation and increased RA-FLS apoptosis, while miR-146a inhibitor had an opposite trend. miR-146a mimic and Tak-242 also decreased expression of TLR4, NF-κB, IL-1ß, IL-6, IL-8, IL-17, COX-2, MMP-3, Seprase, and iNOS, as well as reduced NO level in RA-FLSs while miR-146a inhibitor and TLR4 increased them. TLR4 and NF-κB levels and the positive rates of PCNA and ICAM-1 expressions were lower in RA-FLSs from RA rats given miR-146a mimic from control or miR-146a inhibitor-treated rats. These results suggest that miR-146a inhibits the proliferation and inflammatory response of RA-FLSs by down-regulating TLR4/NF-κB pathway.

Pulse-Width Modulation of Optogenetic Photo-Stimulation Intensity for Application to Full-Implantable Light Sources.

Optogenetics allows control of neuronal activity with unprecedented spatiotemporal precision, and has enabled both significant advances in neuroscience and promising clinical prospects for some neurological, cardiac, and sensory disorders. The ability to chronically stimulate light-sensitive excitable cells is crucial for developing useful research tools and viable long-term treatment strategies. Popular optogenetic stimulation devices often rely on bench-top light-sources tethered via an optical fibre to the research animal, or significant componentry protruding externally from animal. These approaches are prone to infection, vulnerable to damage and restrict the experimental approaches that can be conducted. An ideal optogenetic stimulator would be contained entirely within the animal and provide precisely controlled optical output. However, existing prototypes of fully implantable devices rely on amplitude tuning of wireless power, which can vary strongly with environmental conditions. Here we show that pulse-width modulation (PWM) of the intensity of a light-emitting diode (LED) can enable control of photo-stimulation intensity equivalent to direct amplitude modulation. This result has significant implications for fully implantable light delivery tools, as PWM can be implemented with simple and miniaturized circuit architectures. We have modified a telemeter device previously developed by our group to include a small form-factor LED capable of generating sufficient optical power with manageable electrical power requirements and minimal heat generation. We have tested key device components in an in vitro mouse brain slice preparation and shown that pulse-width-modulation is an alternative method to modulate photo-stimulation intensity using a miniature circuit and providing easy control.

Integrated wireless fast-scan cyclic voltammetry recording and electrical stimulation for reward-predictive learning in awake, freely moving rats.

OBJECTIVE: Fast-scan cyclic voltammetry (FSCV) is commonly used to monitor phasic dopamine release, which is usually performed using tethered recording and for limited types of animal behavior. It is necessary to design a wireless dopamine sensing system for animal behavior experiments. APPROACH: This study integrates a wireless FSCV system for monitoring the dopamine signal in the ventral striatum with an electrical stimulator that induces biphasic current to excite dopaminergic neurons in awake freely moving rats. The measured dopamine signals are unidirectionally transmitted from the wireless FSCV module to the host unit. To reduce electrical artifacts, an optocoupler and a separate power are applied to isolate the FSCV system and electrical stimulator, which can be activated by an infrared controller. MAIN RESULTS: In the validation test, the wireless backpack system has similar performance in comparison with a conventional wired system and it does not significantly affect the locomotor activity of the rat. In the cocaine administration test, the maximum electrically elicited dopamine signals increased to around 230% of the initial value 20 min after the injection of 10 mg kg(-1) cocaine. In a classical conditioning test, the dopamine signal in response to a cue increased to around 60 nM over 50 successive trials while the electrically evoked dopamine concentration decreased from about 90 to 50 nM in the maintenance phase. In contrast, the cue-evoked dopamine concentration progressively decreased and the electrically evoked dopamine was eliminated during the extinction phase. In the histological evaluation, there was little damage to brain tissue after five months chronic implantation of the stimulating electrode. SIGNIFICANCE: We have developed an integrated wireless voltammetry system for measuring dopamine concentration and providing electrical stimulation. The developed wireless FSCV system is proven to be a useful experimental tool for the continuous monitoring of dopamine levels during animal learning behavior studies of freely moving rats.

[Analysis of the clinical efficacy of yiqi fumai injection combined hydroxychloroquine sulfate tablet for treating Sjogren's syndrome].

OBJECTIVE: To observe the clinical efficacy of Yiqi Fumai Injection (YFI) combined hydroxychloroquine sulfate tablet in the treatment of Sjogren's syndrome patients. METHODS: Eighty patients were randomly assigned to three groups. Forty patients in Group A were treated with YFI alone, 2. 6 g YFI added in 250 mL normal saline for intravenous dripping, once daily. Twenty patients in Group B took hydroxychloroquine sulfate alone, 0. 2 g each time, twice daily. Twenty patients in Group C were treated with YFI and hydroxychloroquine sulfate tablet (with the same dose and dosage as Group A and B). Fifteen days was taken as one course of treatment. The scores for dry mouth and dry eyes, the efficacy on salivary flow rate, Schirmer test, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and IgG, and so on were compared among the three groups before and after treatment. RESULTS: There was no significant difference in the laboratory parameters and clinical symptoms among the three groups before treatment. After treatment obvious improvement of the scores for dry mouth, the salivary flow rate, Schirmer test, ESR, CRP, and IgG was shown in all the 3 groups (P<0.05). Besides, the optimal effect was shown in Group C. Its total effective rate was 85% (17/20), better than that of Group A [80% (32/40)] and Group B [75% (15/20)], with no statistical difference (chi2 = 0.736 and 0. 695, P>0.05). CONCLUSION: YFU combined hydroxychloroquine sulfate tablet showed better effects in treating Sjogren's syndrome patients than using Chinese medicine or Western medicine alone.

[Spectrophotometry analysis of different valence state of vanadium in vanadium battery electrolyte].

In the present paper, oxalic acid was used to reduce V(V) ion to V(IV) ion, then its complex with V(IV) was formed. By this method, four valence states of vanadium ions had different characteristic absorption peaks in the UV-Visible range. Based on these characteristic absorption peaks, qualitative and quantitative spectrophotometric analysis methods for different valence states of vanadium in vanadium battery electrolyte were established. The results showed that the related coefficients of four standard curves of different valence states were greater than 0.999 0, linearity ranges were 0.326-2.445, 0.326 -2.445, 0.720-5.403, and 1.784-13.437 g x L(-1), respectively. The measurement of samples suggested that the spectrophotometric analysis method was suitable for analyzing the concentration of valence states of vanadium with the RSDs (n = 6) in the range of 0.594%-3.535%.