Real-time motion artifact suppression using convolution neural networks with penalty in fNIRS.

Introduction: Removing motion artifacts (MAs) from functional near-infrared spectroscopy (fNIRS) signals is crucial in practical applications, but a standard procedure is not available yet. Artificial neural networks have found applications in diverse domains, such as voice and image processing, while their utility in signal processing remains limited.

Method: In this work, we introduce an innovative neural network-based approach for online fNIRS signals processing, tailored to individual subjects and requiring minimal prior experimental data.

Rituximab Therapy for Insulin Allergy in Type-1 Diabetes Mellitus.

Background/objective: Allergic reactions to insulin have decreased significantly since the introduction of human insulin preparation, but up to 2.4% of insulin-treated patients can still be affected. Rituximab is a monoclonal antibody against the surface antigen CD20 on B lymphocytes, and it is largely used to treat lymphoproliferative and rheumatological conditions.

Pedaling Asymmetry Reflected by Bilateral EMG Complexity in Chronic Stroke.

This study examines pedaling asymmetry using the electromyogram (EMG) complexity of six bilateral lower limb muscles for chronic stroke survivors. Fifteen unilateral chronic stroke and twelve healthy participants joined passive and volitional recumbent pedaling tasks using a self-modified stationary bike with a constant speed of 25 revolutions per minute. The fuzzy approximate entropy (fApEn) was adopted in EMG complexity estimation.

Peripheral focused ultrasound stimulation and its applications: From therapeutics to human-computer interaction.

Peripheral focused ultrasound stimulation (pFUS) has gained increasing attention in the past few decades, because it can be delivered to peripheral nerves, neural endings, or sub-organs. With different stimulation parameters, ultrasound stimulation could induce different modulation effects. Depending on the transmission medium, pFUS can be classified as body-coupled US stimulation, commonly used for therapeutics or neuromodulation, or as an air-coupled contactless US haptic system, which provides sensory inputs and allows distinct human-computer interaction paradigms.

Can Transcranial Electrical Stimulation Facilitate Post-stroke Cognitive Rehabilitation? A Systematic Review and Meta-Analysis.

Background: Non-invasive brain stimulation methods have been widely utilized in research settings to manipulate and understand the functioning of the human brain. In the last two decades, transcranial electrical stimulation (tES) has opened new doors for treating impairments caused by various neurological disorders. However, tES studies have shown inconsistent results in post-stroke cognitive rehabilitation, and there is no consensus on the effectiveness of tES devices in improving cognitive skills after the onset of stroke.

Accuracy of Continuous Glucose Monitors for Inpatient Diabetes Management.

Introduction: In hospitalized patients, continuous glucose monitoring (CGM) may improve glycemic control, prevent hypoglycemic events, and reduce staff workload compared with point-of-care (POC) capillary glucose monitoring.

Methods: To evaluate CGM accuracy and safety of use in the inpatient setting, two versions of CGM sensors were placed on 43 and 34 adult patients with diabetes admitted to non-intensive care unit (ICU) medical wards, respectively. CGM accuracy relative to POC and safety of use were measured by calculating mean absolute relative difference (MARD) and by Clarke Error Grid (CEG) analysis.

Effectiveness of Continuous Glucose Monitoring in Older Adults with Type 2 Diabetes Treated with Basal Insulin.

To evaluate the effectiveness and safety of real-time continuous glucose monitoring (CGM) in adults 65 years old and older with type 2 diabetes (T2D) using basal without bolus insulin. Using data from the MOBILE randomized trial comparing CGM versus blood glucose meter (BGM) monitoring for T2D treated with basal insulin, the treatment effect in participants ≥65 years (range: 65-79 years,  = 42) was compared with the treatment effect in participants <65 years (range: 33-64 years,  = 133). For participants ≥65 years old, mean change in hemoglobin A1c (HbA1c) was -1.

Disrupted cortico-peripheral interactions in motor disorders.

Motor disorders may arise from neurological damage or diseases at different levels of the hierarchical motor control system and side-loops. Altered cortico-peripheral interactions might be essential characteristics indicating motor dysfunctions. By integrating cortical and peripheral responses, top-down and bottom-up cortico-peripheral coupling measures could provide new insights into the motor control and recovery process.

The Effect of Discontinuing Continuous Glucose Monitoring in Adults With Type 2 Diabetes Treated With Basal Insulin.

Objective: To explore the effect of discontinuing continuous glucose monitoring (CGM) after 8 months of CGM use in adults with type 2 diabetes treated with basal without bolus insulin.

Research Design And Methods: This multicenter trial had an initial randomization to either real-time CGM or blood glucose monitoring (BGM) for 8 months followed by 6 months in which the BGM group continued to use BGM ( = 57) and the CGM group was randomly reassigned either to continue CGM ( = 53) or discontinue CGM with resumption of BGM for glucose monitoring ( = 53).

Results: In the group that discontinued CGM, mean time in range (TIR) 70-180 mg/dL, which improved from 38% before initiating CGM to 62% after 8 months of CGM, decreased after discontinuing CGM to 50% at 14 months (mean change from 8 to 14 months -12% [95% CI -21% to -3%], = 0.

Cortico-muscular interaction to monitor the effects of neuromuscular electrical stimulation pedaling training in chronic stroke.

Neuromuscular electrical stimulation (NMES) has been widely utilized in post-stroke motor restoration. However, its impact on the closed-loop sensorimotor control process remains largely unclear. This is the first study to investigate the directional changes in cortico-muscular interactions after repetitive rehabilitation training by measuring the noninvasive electroencephalogram (EEG) and electromyography (EMG) signals.

Effect of Continuous Glucose Monitoring on Glycemic Control in Patients With Type 2 Diabetes Treated With Basal Insulin: A Randomized Clinical Trial.

Importance: Continuous glucose monitoring (CGM) has been shown to be beneficial for adults with type 2 diabetes using intensive insulin therapy, but its use in type 2 diabetes treated with basal insulin without prandial insulin has not been well studied.

Objective: To determine the effectiveness of CGM in adults with type 2 diabetes treated with basal insulin without prandial insulin in primary care practices.

Design, Setting, And Participants: This randomized clinical trial was conducted at 15 centers in the US (enrollment from July 30, 2018, to October 30, 2019; follow-up completed July 7, 2020) and included adults with type 2 diabetes receiving their diabetes care from a primary care clinician and treated with 1 or 2 daily injections of long- or intermediate-acting basal insulin without prandial insulin, with or without noninsulin glucose-lowering medications.

Glycaemic profiles of diverse patients with type 2 diabetes using basal insulin: MOBILE study baseline data.

Basal insulin is often prescribed to patients with suboptimally controlled type 2 diabetes (T2D); however, its therapeutic efficacy is inadequate in many. During the MOBILE study's baseline phase, we evaluated 173 participants' continuous glucose monitoring (CGM) data (mean ± SD age 57 ± 9 years; 50% female; HbA1c 9.1% [range 7.

ROBOTIC PARAGANGLIOMA RESECTION IN A PREGNANT PATIENT.

Objective: Functional paragangliomas in pregnancy are rare; however, if not recognized and treated early, they can be life-threatening. New treatment approaches with robotic resection are promising.

Methods: We present a case of a pregnant female with a paraganglioma which was successfully resected during the second trimester using Da Vinci Xi robotic system.

Rewiring the Lesioned Brain: Electrical Stimulation for Post-Stroke Motor Restoration.

Electrical stimulation has been extensively applied in post-stroke motor restoration, but its treatment mechanisms are not fully understood. Stimulation of neuromotor control system at multiple levels manipulates the corresponding neuronal circuits and results in neuroplasticity changes of stroke survivors. This rewires the lesioned brain and advances functional improvement.

USE OF CONTINUOUS GLUCOSE MONITORING LEADS TO DIAGNOSIS OF HEMOGLOBIN C TRAIT IN A PATIENT WITH DISCREPANT HEMOGLOBIN A1C AND SELF-MONITORED BLOOD GLUCOSE.

Objective: Hemoglobin A1c (HbA1c) is a useful tool for the diagnosis and management of diabetes mellitus and generally an excellent marker of overall glycemic control for the preceding 8 to 12 weeks; however, the test is not without its pitfalls. A suspicion of falsely high or low HbA1c should prompt clinicians to evaluate for possible causes. Here, we present the novel use of continuous glucose monitoring (CGM) in a case of a 49-year-old African American woman with discrepant HbA1c and self-monitored blood glucose (SMBG).

Excitation Comparison between Multi-site Stimulation using Network-based tDCS and Focal Stimulation using High-definition tDCS.

Transcranial direct current stimulation (tDCS) has been developed rapidly in recent years and derived various forms which serve as therapeutic tools for neurological disorders. However, differences of stimulation effect among these stimulation strategies have not been fully explored. In this pilot study, we compared the stimulation effect between High-definition tDCS (HD-tDCS) and Network-based tDCS (NB-tDCS) on a healthy subject.

Pathway-specific modulatory effects of neuromuscular electrical stimulation during pedaling in chronic stroke survivors.

Background: Neuromuscular electrical stimulation (NMES) is extensively used in stroke motor rehabilitation. How it promotes motor recovery remains only partially understood. NMES could change muscular properties, produce altered sensory inputs, and modulate fluctuations of cortical activities; but the potential contribution from cortico-muscular couplings during NMES synchronized with dynamic movement has rarely been discussed.

Cortico-Muscular Coherence Modulated by High-Definition Transcranial Direct Current Stimulation in People With Chronic Stroke.

High-definition transcranial direct current stimulation (HD-tDCS) is a potential neuromodulation apparatus for stroke rehabilitation. However, its modulatory effects in stroke subjects is still not well understood. In this paper, the offline modulatory effects of HD-tDCS on the ipsilesional primary motor cortex were investigated by performing wrist isometric contraction tasks before and after HD-tDCS in eleven unilateral chronic stroke subjects using a synchronized HD-tDCS and electroencephalogram/electromyography measurement system.

Low Gamma Band Cortico-muscular Coherence Inter-Hemisphere Difference following Chronic Stroke.

Brain oscillation and motor control process would change due to chronic stroke. Inter-hemisphere brain activation patterns may relate to motor related recovery. This study employed cortico-muscular coherence to explore cortical motor control process during wrist isometric contraction experiments of both affected and unaffected hands from chronic stroke subjects.

A Case of Cushing's Syndrome due to Ectopic Adrenocorticotropic Hormone Secretion from Esthesioneuroblastoma with Long Term Follow-Up after Resection.

We present a case of a 52-year-old male who developed Cushing's Syndrome due to ectopic adrenocorticotrophic hormone (ACTH) secretion from a large esthesioneuroblastoma (ENB) of the nasal sinuses. The patient initially presented with polyuria, polydipsia, weakness, and confusion. Computed tomography scan of the head and magnetic resonance imaging showed a 7 cm skull base mass centered in the right cribriform plate without sella involvement.

Effects of differing antecedent increases of plasma cortisol on counterregulatory responses during subsequent exercise in type 1 diabetes.

Objective: Antecedent hypoglycemia can blunt neuroendocrine and autonomic nervous system responses to next-day exercise in type 1 diabetes. The aim of this study was to determine whether antecedent increase of plasma cortisol is a mechanism responsible for this finding.

Research Design And Methods: For this study, 22 type 1 diabetic subjects (11 men and 11 women, age 27 +/- 2 years, BMI 24 +/- 1 kg/m(2), A1C 7.

Stimulation of both type I and type II corticosteroid receptors blunts counterregulatory responses to subsequent hypoglycemia in healthy man.

Antecedent increases of corticosteroids can blunt counterregulatory responses to subsequent stress. Our aim was to determine whether prior activation of type I corticosteroid (mineralocorticoid) or type II corticosteroid (glucocorticoid) receptors blunts counterregulatory responses to subsequent hypoglycemia. Healthy volunteers participated in five randomized 2-day protocols.

Type B insulin resistance syndrome associated with systemic lupus erythematosus.

Objective: To document a case of type B insulin resistance syndrome associated with systemic lupus erythematosus.

Methods: We present the clinical course of a female patient with type B insulin resistance syndrome, from the onset, diagnosis, and empiric treatment until remission of her disease.

Results: A 40-year-old African American woman with systemic lupus erythematosus presented with a relatively acute onset of severe hyperglycemia in January 2004.