Medical Devices Evidence and Research,
Год журнала:
2025,
Номер
Volume 18, С. 97 - 106
Опубликована: Фев. 1, 2025
Sedatives
and
anesthetics
can
modify
airway
tone
induce
respiratory
depression,
exacerbating
the
gas
exchange
impairments
associated
with
obesity.
In
obese
patients
undergoing
gastrointestinal
endoscopy,
upper
obstruction
hypoventilation
are
prevalent,
leading
to
frequent
occurrences
of
hypoxemia
during
procedure.
This
study
aims
investigate
effects
nasopharyngeal
in
mitigating
via
alleviating
outpatients
painless
endoscopy
is
a
prospective
single-center
randomized
controlled
study.
After
signing
written
informed
consent,
eligible
scheduled
for
will
be
randomly
allocated
into
group
(group
N)
control
C),
88
each
group.
Patients
N
undergo
intubation
prior
examination,
whereas
C
receive
oxygen
therapy
through
an
endoscopic
mask
at
flow
rate
10
L/min
All
two
groups
propofol
opioids
procedural
sedation.
The
primary
outcome
incidence
hypoxemia.
secondary
outcomes
epistaxis,
suspended
examination
due
hypoxemia,
manual
ventilation,
times
attempt
nasopharynx
insertion,
duration
insertion
airway,
tracheal/laryngeal
intubation,
adverse
cardiovascular
events,
complications,
VAS
score
pain
after
removing
satisfaction
patients,
endoscopist
anesthesiologists.
evaluates
on
caused
by
sedation
endoscopy.
results
this
expected
provide
evidence
use
outpatients.
ChiCTR2300078892.
Annual Review of Neuroscience,
Год журнала:
2022,
Номер
45(1), С. 223 - 247
Опубликована: Март 9, 2022
Breathing
is
a
vital
rhythmic
motor
behavior
with
surprisingly
broad
influence
on
the
brain
and
body.
The
apparent
simplicity
of
breathing
belies
complex
neural
control
system,
central
pattern
generator
(bCPG),
that
exhibits
diverse
operational
modes
to
regulate
gas
exchange
coordinate
an
array
behaviors.
In
this
review,
we
focus
selected
advances
in
our
understanding
bCPG.
At
core
bCPG
preBötzinger
(preBötC),
which
drives
inspiratory
rhythm
via
unexpectedly
sophisticated
emergent
mechanism.
Synchronization
dynamics
underlying
preBötC
rhythmogenesis
imbue
system
robustness
lability.
These
are
modulated
by
inputs
from
throughout
generate
rhythmic,
patterned
activity
widely
distributed.
connectivity
emerging
literature
support
link
between
breathing,
emotion,
cognition
becoming
experimentally
tractable.
bring
great
potential
for
elucidating
function
dysfunction
other
mammalian
circuits.
Nature Communications,
Год журнала:
2023,
Номер
14(1)
Опубликована: Сен. 21, 2023
Causal
inference
in
complex
systems
has
been
largely
promoted
by
the
proposal
of
some
advanced
temporal
causation
models.
However,
models
have
serious
limitations
when
time
series
data
are
not
available
or
present
insignificant
variations,
which
causes
a
common
challenge
for
earth
system
science.
Meanwhile,
there
few
spatial
fully
exploring
rich
cross-sectional
Earth
systems.
The
generalized
embedding
theorem
proves
that
observations
can
be
combined
together
to
construct
state
space
dynamic
system,
and
if
two
variables
from
same
they
causally
linked.
Inspired
this,
here
we
show
Geographical
Convergent
Cross
Mapping
(GCCM)
model
causal
with
data-based
cross-mapping
prediction
reconstructed
space.
Three
typical
cases,
where
clearly
existing
causations
cannot
measured
through
models,
demonstrate
GCCM
could
detect
weak-moderate
correlation
is
significant.
When
coupling
between
significant
strong,
advantageous
identifying
primary
direction
better
revealing
bidirectional
asymmetric
causation,
overcoming
mirroring
effect.
Pharmacology & Therapeutics,
Год журнала:
2021,
Номер
233, С. 108019 - 108019
Опубликована: Окт. 11, 2021
Overdose
deaths
are
often
viewed
as
the
leading
edge
of
opioid
epidemic
which
has
gripped
United
States
over
past
two
decades
(Skolnick,
2018a).
This
emphasis
is
perhaps
unsurprising
because
overdose
both
number-one
cause
death
for
individuals
between
25
and
64
years
old
(Dezfulian
et
al.,
2021)
a
significant
contributor
to
decline
in
average
lifespan
(Dowell
2017).
Exacerbated
by
COVID
19
pandemic,
it
was
estimated
there
were
93,400
drug
during
12
months
ending
December
2020,
with
more
than
69,000
(that
is,
>74%)
these
fatalities
attributed
(Ahmad
2021).
However,
focus
on
mortality
statistics
2021;
Shover
2020)
tends
obscure
broader
medical
impact
nonfatal
overdose.
Analyses
multiple
databases
indicate
that
each
opioid-induced
fatality,
6.4
8.4
non-fatal
overdoses,
exacting
burden
individual
society.
Over
7-8
years,
been
an
alarming
increase
misuse
synthetic
opioids
("synthetics"),
primarily
fentanyl
related
piperidine-based
analogs.
Within
2-3
structurally
unrelated
class
high
potency
synthetics,
benzimidazoles
exemplified
etonitazene
isotonitazene
("iso"),
have
also
appeared
illicit
markets
(Thompson,
2020;
Ujvary
al.
In
80%
fatal
overdoses
now
involve
synthetics
The
unique
physicochemical
pharmacological
properties
described
this
review
responsible
morbidity
associated
their
well
widespread
availability.
dramatic
referred
"3rd
wave"
(Pardo
2019;
Volkow
Blanco,
epidemic.
Among
consequences
resulting
from
potent
need
higher
doses
competitive
antagonist,
naloxone,
reverse
development
effective
reversal
agents
such
those
essential
component
tripartite
strategy
(Volkow
Collins,
2017)
reduce
biopsychosocial
"synthetic
era".
The
analgesic
utility
of
opioid-based
drugs
is
limited
by
the
life-threatening
risk
respiratory
depression.
Opioid-induced
depression
(OIRD),
mediated
μ-opioid
receptor
(MOR),
characterized
a
pronounced
decrease
in
frequency
and
regularity
inspiratory
rhythm,
which
originates
from
medullary
preBötzinger
Complex
(preBötC).
To
unravel
cellular-
network-level
consequences
MOR
activation
preBötC,
MOR-expressing
neurons
were
optogenetically
identified
manipulated
transgenic
mice
vitro
vivo.
Based
on
these
results,
model
OIRD
was
developed
silico.
We
conclude
that
hyperpolarization
-
expressing
preBötC
alone
does
not
phenocopy
OIRD.
Instead,
effects
are
twofold:
(1)
pre-inspiratory
spiking
reduced
(2)
excitatory
synaptic
transmission
suppressed,
thereby
disrupting
network-driven
rhythmogenesis.
These
dual
mechanisms
opioid
action
act
synergistically
to
make
normally
robust
rhythm-generating
network
particularly
prone
collapse
when
challenged
with
exogenous
opioids.
The Journal of Comparative Neurology,
Год журнала:
2022,
Номер
530(10), С. 1658 - 1699
Опубликована: Фев. 8, 2022
Abstract
Diverse
neurons
in
the
parabrachial
nucleus
(PB)
communicate
with
widespread
brain
regions.
Despite
evidence
linking
them
to
a
variety
of
homeostatic
functions,
it
remains
difficult
determine
which
PB
influence
functions
because
their
subpopulations
intermingle
extensively.
An
improved
framework
for
identifying
these
intermingled
would
help
advance
our
understanding
neural
circuit
linked
this
region.
Here,
we
present
foundation
developmental‐genetic
ontology
that
classifies
based
on
intrinsic,
molecular
features.
By
combining
transcription
factor
labeling
Cre
fate‐mapping,
find
is
blend
two,
developmentally
distinct
macropopulations
glutamatergic
neurons.
Neurons
first
macropopulation
express
Lmx1b
(and,
lesser
extent,
Lmx1a
)
and
are
mutually
exclusive
those
second
macropopulation,
derive
from
precursors
expressing
Atoh1
.
This
second,
‐derived
includes
many
Foxp2
‐expressing
neurons,
but
also
identifies
subset
Kölliker–Fuse
(KF)
population
GABAergic
ventrolateral
(“caudal
KF”).
Immediately
ventral
PB,
Phox2b
(some
coexpressing
occupy
KF,
supratrigeminal
nucleus,
reticular
formation.
We
show
organizes
subsidiary
patterns
adult
gene
expression
(including
Satb2
,
Calca
Grp
Pdyn
predicts
output
projections
amygdala
(
),
hypothalamus
hindbrain
/
).
Using
organize,
interpret,
PB‐related
information
could
accelerate
translation
experimental
findings
animal
models
human
patients.
Nature Communications,
Год журнала:
2023,
Номер
14(1)
Опубликована: Фев. 21, 2023
Abstract
Breathing
is
regulated
automatically
by
neural
circuits
in
the
medulla
to
maintain
homeostasis,
but
breathing
also
modified
behavior
and
emotion.
Mice
have
rapid
patterns
that
are
unique
awake
state
distinct
from
those
driven
automatic
reflexes.
Activation
of
medullary
neurons
control
does
not
reproduce
these
patterns.
By
manipulating
transcriptionally
defined
parabrachial
nucleus,
we
identify
a
subset
express
Tac1
,
Calca
gene
exerts
potent
precise
conditional
awake,
anesthetized,
via
projections
ventral
intermediate
reticular
zone
medulla.
Activating
drives
frequencies
match
physiological
maximum
through
mechanisms
differ
underlie
breathing.
We
postulate
this
circuit
important
for
integration
with
state-dependent
behaviors
emotions.