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- Hazay, Máté, et al.
(författare)
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Engineering optimization of decompressive craniectomy based on finite element simulations
- 2020
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Ingår i: Acta of bioengineering and biomechanics. - : Wroclaw University of Technology. - 1509-409X .- 1509-409X. ; 22:4, s. 109-122
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The optimal execution of decompressive craniectomy in terms of the size and location of the skull opening is not straightforward. Our main goals are twofold: (1) constructing a design optimization method which can be applied to determine optimal skull opening for individual patient-specific cases and (2) performing a large-scale parametric optimization study to give some guidance in general about the optimal skull opening in case of oedematous brain tissue.Methods: A large number of virtual experiments performed by finite element simulations were applied to determine tendencies of tissue behaviour during surgery. The multiobjective optimization is performed by Goal Programming and Physical Programming methods.Results: Our results show that the postoperative pressure has an approximately linear dependence on the preoperative pressure and the skull opening area, while the damaged brain volume could have a more complex nonlinear dependence on the input data. Based on the averaged results of the parametric optimization study, the optimal skull opening has been determined in the function of the preoperative pressure and the relative importance of the pressure reduction. These results show that the optimal size of the unilateral skull opening is usually between 130-180 cm² and these openings are more beneficial than the currently analysed bifrontal openings.Conclusions: The optimal skull opening is patient-specific and depends on several input data. The presented methodology can be applied to optimize surgery based on these input parameters for different injury types. Based on the results of large-scale parametric study generally applicable approximate results have been provided.
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2. |
- Meltzoff, Andrew N., et al.
(författare)
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Eliciting imitation in early infancy
- 2019
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Ingår i: Developmental Science. - : Wiley-Blackwell. - 1363-755X .- 1467-7687. ; 22:2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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3. |
- Meltzoff, Andrew N., et al.
(författare)
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Re-examination of Oostenbroek etal. (2016): evidence for neonatal imitation of tongue protrusion
- 2018
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Ingår i: Developmental Science. - : Wiley. - 1363-755X .- 1467-7687. ; 21:4
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Tidskriftsartikel (refereegranskat)abstract
- The meaning, mechanism, and function of imitation in early infancy have been actively discussed since Meltzoff and Moores (1977) report of facial and manual imitation by human neonates. Oostenbroek etal. (2016) claim to challenge the existence of early imitation and to counter all interpretations so far offered. Such claims, if true, would have implications for theories of social-cognitive development. Here we identify 11 flaws in Oostenbroek etal.s experimental design that biased the results toward null effects. We requested and obtained the authors raw data. Contrary to the authors conclusions, new analyses reveal significant tongue-protrusion imitation at all four ages tested (1, 3, 6, and 9 weeks old). We explain how the authors missed this pattern and offer five recommendations for designing future experiments. Infant imitation raises fundamental issues about action representation, social learning, and brain-behavior relations. The debate about the origins and development of imitation reflects its importance to theories of developmental science.
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4. |
- Münch, Andreas, et al.
(författare)
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Budesonide as induction therapy for incomplete microscopic colitis : A randomised, placebo-controlled multicentre trial
- 2021
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Ingår i: United European Gastroenterology journal. - : Sage Publications. - 2050-6406 .- 2050-6414. ; 9:7, s. 837-847
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Incomplete microscopic colitis (MCi) is a subtype of microscopic colitis (MC). Budesonide is recommended as a first-line treatment for MC. However, randomised trials on efficacy of treatment in MCi are missing. We therefore performed a randomised, placebo-controlled trial to evaluate budesonide as induction therapy for MCi.Methods: Patients with active MCi were randomly assigned to either budesonide 9 mg once daily or placebo for 8 weeks in a double-blind, double-dummy design. The primary endpoint was clinical remission, defined as a mean of <3 stools/day and a mean of <1 watery stool/day in the 7 days before week 8.Results: Due to insufficient patient recruitment, the trial was discontinued prematurely. The intention-to-treat analysis included 44 patients (21 budesonide and 23 placebo). The primary endpoint of clinical remission at week 8 was obtained by 71.4% on budesonide and 43.5% on placebo (p = 0.0582). All clinical secondary endpoints were in favour of budesonide. Budesonide decreased the number of soft or watery stools (16.3 vs. 7.7, p = 0.0186) and improved health-related quality of life for all four dimensions of the short health scale. Adverse events with a suspected relation to study drug were reported in one patient in the budesonide group and two patients in the placebo group. Neither serious nor severe adverse events occurred during the double-blind phase.Conclusions: Budesonide decreased the frequency of soft or watery stools and improved the patients' quality of life significantly in MCi, but the primary endpoint was not met due to the low sample size (type 2 error). Budesonide was safe and well tolerated during the 8-weeks treatment course.
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