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Modeling for neuromonitoring depth of anesthesia.

This article reviews the various modeling techniques for neuromonitoring depth of anesthesia (DOA). Traditional techniques such as parametric, predictive, optimal, and adaptive modeling, proportional, integral, derivative (PID) modeling, together with modern techniques such as bispectral-based, artificial neural-network-based, fuzzy logic, and neuro-fuzzy modeling, bring us to the current state of the art in DOA neuromonitoring. This article reviews historical information about each of the modern techniques and provides an example demonstrating its implementation; reviews drug pharmacokinetic/pharmacodynamic (PK/PD) and drug interaction PK/PD modeling techniques for a balanced total intravenous anesthesia (TIVA) administration; and discusses the existing technical problems and clinical challenges, suggesting new techniques necessary for the future development of a DOA monitoring and control system.

Anesthesia↗

[Comparing the effects of cataract surgery on vision function in the first eye with that in the second eye measured by the questionnaire of vision function].

PURPOSE: To compare the outcomes of phacoemulsification with intraocular lens implantation on vision function in the first eye with that in the second eye in one week after surgery measured by the questionnaire of vision function. METHODS: Forty-seven patients who underwent phacoemulsification with intraocular lens implantation in both eyes, were interviewed by the questionnaire of vision function. Meanwhile, the clinical outcomes were obtained before surgery and one week after surgery. RESULTS: The scores of vision function and its subscales in one week after the first eye surgery were higher than that before surgery, and in one week after the second eye surgery the scores of the vision function, peripheral vision and depth perception were higher than that before the second eye surgery. The scores of limitation in everyday activities and sensory adaptation didn't change significantly. CONCLUSION: The vision function improved after phacoemulsification with intraocular lens implantation in the first or the second eye surgery, and only the peripheral vision and depth perception improved after the second eye surgery.

Aged↗

The effect of monovision lenses on the near-point range of single binocular vision.

Monovision (MV) contact lenses are commonly used to provide optical correction for presbyopia. Based on their review of the literature on fusional mechanisms, Erickson and Schor predicted that monocular blur associated with MV should not be sufficient to disrupt binocular fusion. We found that fusional vergence ranges in presbyopes corrected with MV were not substantially different from those measured under full binocular nearpoint correction. There were small but statistically significant tendencies for the phoria and base-in vergences to be less exo under MV conditions. Comparisons of findings between a group of successfully adapted MV patients and a group of patients who were unsuccessful with MV indicated no significant differences, suggesting that there is no adaptation effect for these performance variables and that these tests are not effective predictors of MV success.

Adaptation, Ocular↗

Effects of monomeric and polymeric diets on small intestine following massive resection.

Since the introduction of long-term total parental nutrition, it has been possible to raise the survival rate in patients with massive intestinal resection. How to increase the remaining intestinal mucosa hyperplasia in these patients has become the focus of many studies. Early postoperative enteral feeding with exogenous intraluminal nutrition was considered to be one of the most essential factors. The best enteral food pattern, however, is still not conclusive. In this study, we used the animal model of rats with 60% small intestinal resection, giving them different kinds of enteral diets through gastrostomy tubes. The monomeric diet included amino acid, glucose, disaccharide, and triglyceride. The polymeric diet included the usual source of nutrition such as protein, polysaccharide, and fat. The rats were killed three weeks later. Histopathological changes of the remaining bowel and H3 thymidine incorporation to mucosal DNa were measured. We found: (1) hyperplasia of the remaining bowel in the 60% resected rats was definitely increased more than the rats of the sham operation; (2) from the protein content, the DNA content of mucosa cells, the villus height and crypt depth points of view, the polymeric diet fed rats had a better adaptation; (3) on the 21st postoperative day, the DNA synthetic rate was still very high in polymeric diet fed rats, but returned to preoperative levels in rats fed with a monomeric diet. Our conclusion of this study is that a polymeric diet can contribute to a better intestinal mucosa regeneration than a monomeric diet in the rats with massive intestinal resection.

Adaptation, Physiological↗

Near vision stress: vergence adaptation and accommodative fatigue.

Changes in the visual system following prolonged near work were investigated. Fifteen young, normal subjects undertook a severe, two hour long, binocular near visual task at 20 cm without any breaks. Fusional stress was assessed by near 'phoria change. Refractive change was measured with an autorefractometer to investigate whether transient myopia occurred and its subsequent recovery. The near task caused vergence adaptation which was primarily due to the fusional stress of the task (accounting for 67% of its variance). The 'phoria change was to a lesser extent (40%) dependent on the accommodative "stress" of the task. Fatigue of the accommodative system resulted in increased accommodative innervation to maintain the same accurate response. Increased innervation can continue after the task on subsequent distance viewing, resulting in transient myopia (mean 0.29 DS). This transient myopia was found to be due to a transient regression of the far point towards the subject's tonic accommodation level. This can be accounted for by a shift of the tonic level as well as an increased bias towards the pre-task tonic level.

Accommodation, Ocular↗

Burden and stress associated with spousal caregiving for individuals with heart failure.

The purpose of this study was to examine the level of caregiver burden and stress experienced by spouses of patients with heart failure. The population of those afflicted with heart failure is growing, and the home management regimen is becoming more complex. A nonprobability sample of 11 male and 30 female spouses participated in this descriptive survey. Participation included the completion of the Caregiving Demands Scale, the Brief Symptom Inventory and a demographic form. Results revealed that caregiving in this sample was burdensome and stressful. There was a significant correlation (r = 0.32), p = 0.04) between the number of helping behaviors performed and level of stress. Also, there was a significant relationship (r = 0.43, p = 0.01) between perceived difficulty in performing caregiving activities and level of stress. Female subjects reported performing more helping behaviors and more difficulty in performing them than the men. Women also identified items related to social participation and the relationship with spouse as most burdensome, whereas men reported activities related to supervision and responsibility as most difficult to manage. Future research on the demands and stressors for those caring for heart failure patients should include a qualitative component to assess the burden and strain in more depth.

Activities of Daily Living↗

[A study on neural regeneration after experimental epikeratophakia].

OBJECTIVE: To assess the effect of epikeratophakia (EKP) on corneal nerve regeneration and the recovery of corneal sensitivity. METHODS: 36 adult rabbits underwent epikeratophakia with either 0.2 mm or 0.3-0.35 mm circular trephination. A histochemical technique (acetylcholine esterase staining) was used to investigate the process of corneal nerve regeneration, and the recovery of corneal sensitivity was determined in 36 rabbits at various intervals after EKP. RESULTS: The corneal sensory nerves began to regenerate just peripheral to the host-donor interface 3 weeks following EKP, the nerve fibers traveled toward the stroma of the lenticules at 2 months, and formed a sparse subepithelial plexus at 8 months after surgery. A relative hyposthesia was found in the central zone of the lenticule when compared with its peripheral zone 4 months postoperatively. The sensitivity of the central zone remained lower at 5-8 months after EKP though it had remarkably increased. The density of re-innervated fibers was higher in the shallow incision than that in deeper one. CONCLUSION: It is suggested that the factors affecting the corneal innervation and the recovery of corneal sensitivity following EKP include; (1) the scar formation as a barrier; (2) the adaptation to the micro-environment around the lenticule; and (3) the depth of trephine cut. Therefore, a 0.2-0.25 mm depth of trephine incision is advantageous to the lamellar dissection, graft suturation and corneal nerve regeneration.

Animals↗

Bax is required for resection-induced changes in apoptosis, proliferation, and members of the extrinsic cell death pathways.

BACKGROUND AND AIMS: To define better the homeostatic mechanisms contributing to small intestinal adaptation following partial resection, the relative contributions of apoptosis, cell proliferation, and enterocyte migration and the comparative roles of the intrinsic (mitochondrial) and extrinsic (death receptor-mediated) apoptotic pathways were assessed. METHODS: After 50% jejunoileal resections or transections, adaptation was analyzed in duodenal-jejunal and ileal segments from C57BL/6 Bax(+/+) (16, 48, and 168 hours postoperative) and Bax(-/-) mice (168 hours). RESULTS: Basal apoptotic rates were equivalent in all mice. By 1-week postresection, villus heights and crypt depths were increased in the duodenal-jejunal and ileal remnants of both genotypes. In Bax(+/+) mice, adaptation occurred in concert with increased crypt proliferative and apoptotic indices. Bax(-/-) mice did not show increases in proliferation or apoptosis, yet adaptive increases in villus height were enhanced relative to Bax(+/+) mice. Enterocyte migration increased in both genotypes. Postresection, the expression of caspases and genes involved in death receptor-mediated apoptosis was decreased in Bax(-/-) compared with Bax(+/+) mice. CONCLUSIONS: Postresection adaptation involves parallel changes in crypt proliferation and apoptosis, but, as observed in Bax(-/-) mice, it can occur without increased proliferation. These studies demonstrate that spontaneous gut apoptosis is Bax independent, whereas adaptation-related apoptosis is Bax-dependent. Differences between resected Bax(+/+) and Bax(-/-) mice suggest that apoptosis in the adapting gut utilizes the extrinsic pathway, but this requires linkage to the mitochondrial pathway via Bax. The increased adaptive response in Bax(-/-) mice indicates that modulation of apoptosis may be useful for enhancing adaptation.

Adaptation, Physiological↗

Color vision of the coelacanth (Latimeria chalumnae) and adaptive evolution of rhodopsin (RH1) and rhodopsin-like (RH2) pigments.

The coelacanth, a "living fossil," lives at a depth of about 200 m near the coast of the Comoros archipelago in the Indian Ocean and receives only a narrow range of light at about 480 nm. To see the entire range of "color" the Comoran coelacanth appears to use only rod-specific RH1 and cone-specific RH2 visual pigments, with the optimum light sensitivities (lambda max) at 478 nm and 485 nm, respectively. These blue-shifted lambda max values of RH1 and RH2 pigments are fully explained by independent double amino acid replacements E122Q/A292S and E122Q/M207L, respectively. More generally, currently available mutagenesis experiments identify only 10 amino acid changes that shift the lambda max values of visual pigments more than 5 nm. Among these, D83N, E1220, M207L, and A292S are associated strongly with the adaptive blue shifts in the lambda max values of RH1 and RH2 pigments in vertebrates.

Adaptation, Physiological↗

Depth perception after prolonged usage of night vision goggles.

The present study was initiated following a report that a few helicopter pilots had failed a test of stereoscopic depth perception after a prolonged training flight employing night vision goggles (NVGs). In order to determine the cause of the loss, 12 helicopter pilots/copilots were assessed for depth perception, lateral and vertical phoria, and contrast sensitivity before and after training flights requiring the pilots to wear night vision goggles for the duration of the flight. Pilots flew one to three missions while wearing either PVS-5A or AN/AVS-6 goggles. Mission duration ranged from 1 to 4 h. The results indicate that contrast sensitivity and depth perception when monocular cues are present did not degrade over the course of the mission. Lateral phoria, however, did demonstrate an average exophoric shift of 1.5 prism diopters for 12 out of the 24 missions. The results indicate that the original report of a loss of depth perception based on a test of depth requiring stereopsis might have been caused by a shift in lateral phoria. It would be expected that as additional fusional effort is required, the minimum resolvable disparity degrades due to the increase in accommodation brought about through vergence accommodation. Possible causes for the phoria shift and future testing are discussed.

Accommodation, Ocular↗

The influence of depth segmentation on colour constancy.

In real scenes, surfaces in different depth planes often differ in the luminance and chromatic content of their illumination. Scene segmentation is therefore an important issue when considering the compensation of illumination changes in our visual perception (lightness and colour constancy). Chromatic adaptation is an important sensory component of colour constancy and has been shown to be linked to the two-dimensional spatial structure of a scene (Werner, 2003 Vision Research 43 1611 - 1623). Here, the question is posed whether this cooperation also extends to the organisation of a scene in depth. The influence of depth on colour constancy was tested by introducing stereo disparity, whereby the test patch and background were perceived in either the same or one of five different depth planes (1.9-57 min of arc). There were no additional cues to depth such as shadows or specular highlights. For consistent illumination changes, colour constancy was reduced when the test patch and background were separated in depth, indicating a reduction of contextual influences. An interaction was found between the influences of stereo depth and spatial frequency on colour constancy. In the case of an inconsistent illumination change, colour constancy was reduced if the test patch and background were in the same depth plane (2-D condition), but not if they were separated in depth (3-D condition). Furthermore, colour constancy was slightly better in the 3-D inconsistent condition than in the 2-D inconsistent condition. It is concluded that depth segmentation supports colour constancy in scenes with inconsistent illumination changes. Processes of depth segmentation are implemented at an early sensory stage of colour constancy, and they define visual regions within which the effects of illuminant changes are discounted for separately. The results support recent models that posit such implementation of scene segmentation in colour constancy.

Adaptation, Ocular↗

Closely related Prochlorococcus genotypes show remarkably different depth distributions in two oceanic regions as revealed by in situ hybridization using 16S rRNA-targeted oligonucleotides.

An in situ hybridization method was applied to the identification of marine cyanobacteria assignable to the genus Prochlorococcus using horseradish-peroxidase-labelled 16S rRNA-targeted oligonucleotide probes in combination with tyramide signal amplification (TSA). With this method very bright signals were obtained, in contrast to hybridizations with oligonucleotides monolabelled with fluorochromes, which failed to give positive signals. Genotype-specific oligonucleotides for high light (HL)- and low light (LL)-adapted members of this genus were identified by 16S rRNA sequence analyses and their specificities confirmed in whole-cell hybridizations with cultured strains of Prochlorococcus marinus Chisholm et al., 1992, Prochlorococcus sp. and Synechococcus sp. In situ hybridization of these genotype-specific probes to field samples from stratified water bodies collected in the North Atlantic Ocean and the Red Sea allowed a rapid assessment of the abundance and spatial distribution of HL- and LL-adapted Prochlorococcus. In both oceanic regions the LL-adapted Prochlorococcus populations were localized in deeper water whereas the HL-adapted Prochlorococcus populations were not only distinct in each region but also exhibited strikingly different depth distributions, HLI being confined to shallow water in the North Atlantic, in contrast to HLII, which was present throughout the water column in the Red Sea.

Colony Count, Microbial↗

Adaptation to telestereoscopic viewing measured by one-handed ball-catching performance.

A one-handed ball-catching task was used to study the disturbance of depth judgement induced by telestereoscopic viewing (ie viewing with increased effective interocular separation), the recovery of performance with experience in the telestereoscope, and the errors that subsequently arose when the telestereoscope was removed. The ball's trajectory was variable so that subjects had to control both the position and the timing of the grasp in order to catch the ball. On first wearing the telestereoscope, subjects closed the hand when the ball was approximately twice as far away from the eyes as the hand was. After fewer than twenty trials in the telestereoscope subjects were closing the hand at approximately the correct time and place, although rather more trials were needed for ball-catching performance to recover to normal. When the telestereoscope was removed there was an aftereffect, with subjects making the opposite errors to when they began the task. The existence of an aftereffect shows that the process of adaptation involves reevaluation rather than neglect of the misleading binocular information. Helmholtz's theory that telestereoscopes cause the world to be perceived as a scale model is considered. Initial misreaching is roughly consistent with this theory, but there are insufficient data to test it rigorously. Data from the aftereffect phase are clearly inconsistent with the theory. The results confirm the importance of binocular information in dynamic motor tasks, such as ball catching.

Adaptation, Ocular↗

Effects of light and darkness on oxygen distribution and consumption in the cat retina.

These experiments were done to investigate the effects of light and darkness on the oxygenation of the retina in anesthetized cats. Measurements were made with double-barreled oxygen microelectrodes capable of recording both oxygen tension (PO2) and local voltages. Diffuse white illumination presented to a dark-adapted retina led to an increase in PO2 of up to 30 mmHg in the outer half of the retina. Changes were maximal at approximately 75% depth, corresponding to the outer nuclear layer. No change or decrease in PO2 was observed in the inner retina. Light-evoked increases in outer retinal PO2 were graded with the duration and strength of illumination, and were maximal in response to 60 s of illumination at rod saturation. For these stimuli, the increase at the onset of illumination was slower (average half-time, 12.2 s) than the recovery at the end of illumination (average half-time, 5.9 s), but for stimuli above rod saturation, PO2 recovered much more slowly. The profile of PO2 was measured during electrode penetration and withdrawal and during light and dark adaptation. Dark-adapted profiles were characterized by a minimum PO2 of nearly 0 mmHg at depths of 65-85%, and a steep gradient from the minimum to the choroid. During light adaptation at rod saturation, PO2 was elevated in the outer half of the retina and the minimum was eliminated. Fits of the profiles to a one-dimensional model of oxygen diffusion indicated that light reduced the oxygen consumption of the outer retina to approximately 50% of its dark-adapted value.

Animals↗

Microbial aspects of the interaction between soil depth and biodegradation of the herbicide isoproturon.

Factors controlling change in biodegradation rate of the pesticide isoproturon with soil depth were investigated in a field with sandy-loam soil. Soil was sampled at five depths between 0-10 and 70-80 cm. Degradation rate declined progressively down the soil profile, with degradation slower, and relative differences in degradation rate between soil depths greater, in intact cores relative to sieved soil. Neither the maximum rate of degradation, or sorption, changed with soil depth, indicating that there was no variation in bioavailability. Differences in degradation rate between soil depths were not associated with the starting population size of catabolic organisms or the number of catabolic organisms proliferating following 100% degradation. Decreasing degradation rates with soil depth were associated with an increase in the length of the lag phase prior to exponential degradation, suggesting the time required for adaptation within communities controlled degradation rates. 16S rRNA PCR denaturing gradient gel electrophoresis showed that degradation in sub-soil between 40-50 and 70-80 cm depths was associated with proliferation of the same strains of Sphingomonas spp.

Biodegradation, Environmental↗

Divergent selection drives the adaptive radiation of crossbills.

Knowledge of how phenotype influences fitness is necessary if we are to understand the basis of natural selection and how natural selection contributes to adaptive radiations. Here I quantify selection on a wild population of red crossbills (Loxia curvirostra complex) in the South Hills, Idaho. Bill depth is the target of selection and selection on bill depth is stabilizing. I then show how fitness is related to both bill depth and performance. I use these and previously published relationships to estimate a fitness surface for five species of red crossbills that are part of an ongoing adaptive radiation in western North America. The fitness surface for crossbills has distinct peaks and valleys, with each crossbill species residing on or very near the summits. This work strongly supports a key tenet of the ecological theory of adaptive radiations; namely, divergent selection for utilizing alternative resources is the ultimate cause of adaptive radiations.

Adaptation, Biological↗

Adaptation in children with cancer: research with Roy's model.

This qualitative study was undertaken to establish a conceptual framework for the adaptation process of Taiwanese children with cancer. It was guided by Roy's adaptation model. Thirty-four pediatric cancer patients (23 boys and 11 girls) with different illness trajectories (from newly diagnosed to terminal stage) participated. Data were collected through individual in-depth interviews with patients and primary caregivers, observations, medical chart review, and researchers' reflective journals. The following five aspects of adaptation that emerged from the study were categorized according to different age groups: physiological and psychological, cognitive (self-concept), interdependence, and future orientation (self-concept and role). Comparison with Roy's adaptation theory is discussed.

Adaptation, Psychological↗