Articles: human.
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Randomized Controlled Trial
Does trans-spinal direct current stimulation alter phrenic motoneurons and respiratory neuromechanical outputs in humans? A double-blind, sham-controlled, randomized, crossover study.
Although compelling evidence has demonstrated considerable neuroplasticity in the respiratory control system, few studies have explored the possibility of altering descending projections to phrenic motoneurons (PMNs) using noninvasive stimulation protocols. The present study was designed to investigate the immediate and long-lasting effects of a single session of transcutaneous spinal direct current stimulation (tsDCS), a promising technique for modulating spinal cord functions, on descending ventilatory commands in healthy humans. Using a double-blind, controlled, randomized, crossover approach, we examined the effects of anodal, cathodal, and sham tsDCS delivered to the C3-C5 level on (1) diaphragm motor-evoked potentials (DiMEPs) elicited by transcranial magnetic stimulation and (2) spontaneous ventilation, as measured by respiratory inductance plethysmography. ⋯ This suggests that tsDCS-induced aftereffects did not occur at brainstem or cortical levels and were likely not attributable to direct polarization of cranial nerves or ventral roots. Instead, we argue that tsDCS could induce sustained changes in PMN output. Increased tidal volume after cathodal tsDCS opens up the perspective of harnessing respiratory neuroplasticity as a therapeutic tool for the management of several respiratory disorders.
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Over recent years evidence from animal studies strongly suggests that a decrease in local inhibitory signaling is necessary for synaptic plasticity to occur. However, the role of GABAergic modulation in human motor plasticity is less well understood. Here, we summarize the techniques available to quantify GABA in humans, before reviewing the existing evidence for the role of inhibitory signaling in human motor plasticity. We discuss a number of important outstanding questions that remain before the role of GABAergic modulation in long-term plasticity in humans, such as that underpinning recovery after stroke, can be established.
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Because of the complexity of the shapes of the structures of buildings, the glass curtain walls of such buildings have different geometries; some of these glass curtain walls have high reflectivity and can strongly focus incident solar light. Under ideal conditions, the solar radiation flux incident onto the glass curtain wall and the solar flux reflected from the glass curtain wall can be theoretically determined. ⋯ Using field measurements to measure the reflected sunlight of two types of glass curtain walls, the energy distributions of the light reflected from these two different glass curtain walls are determined. This paper focuses on analysis of the experimental results and the cause of the visual masking effect due to the reflection of sunlight from a glass curtain wall and on the method of quantitative calculation of the visual masking effect.
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The objective of this study is to analyze the differences in clinical presentation and outcome of community-onset bacteremia between human immunodeficiency virus (HIV)-infected adults and HIV-uninfected adults visiting the emergency department (ED). ⋯ This study demonstrated that the clinical characteristics, the severity, and the character of bacteremia in HIV-infected and uninfected patients varied among community-onset bacteremic patients visiting the ED, despite the limited impact of HIV infection on short-term outcomes.