Citations

Background Despite improvements in military aircraft safety, many aviation incidents are attributed to hypoxia. The correlation between moderate hypoxia and cognitive function are well studied but results remain controversial. Comparatively, the effects of severe hypoxia are still not well understood. In the present study, we examined the executive cognitive function and physiological indices under both moderate and severe hypoxia conditions. Purpose To examine the relationship between executive function and physiological indices during acute hypoxia exposure. Methods Ten young healthy participants (4M/6F, 29±4 years) completed two different levels of hypoxia: 1) 10 minute moderate hypoxia (MH; F i O 2 = 0.118) and 2) 3 minute severe hypoxia (SH; F i O 2 = 0.077) following 3 minute baseline (BL; F i O 2 =0.209). Reaction time and errors of commission (defined as a response to a non‐target stimulus) were evaluated continuously using a custom Go/No‐go test at baseline and throughout hypoxia exposure. In this Go/No‐go test, participants were required to push a key when upper case “A” or “@” appeared but not when lower case “a” appeared on a computer monitor as quick and as accurately as possible. The stimuli were presented one at a time at any one of nine differing locations across the screen. Cerebral oxygenation (rSO 2 ) was continuously monitored with near‐infrared spectroscopy (NIRS) positioned above the left supraorbital ridge. Finger oxygen saturation (S p O 2 ) was continuously assessed using a pulse oximetry. Data were analyzed in every 30 seconds and are presented as mean±SE. Two‐way ANOVA and Bonferroni test for multiple comparisons was used to evaluate significant differences. Results Both S p O 2 and rSO 2 were reduced with SH (S p O 2 %, BL: 99.3±0.1% vs. SH: 70.7±1.5%, P<0.01; rSO 2 %, BL: 70±4% vs. SH: 58±4%, P<0.01). In SH, correlations of S p O 2 and rSO 2 were significant to the number of errors during the cognitive performance task (S p O 2 ; R= −0.65, rSO 2 ; R= −0.58, Both P<0.01). SH significantly increased errors of commission of the last 30 seconds in 3 minute hypoxic exposure. (BL: 0.6±0.2 errors vs. SH: 1.7±0.5 errors, P<0.01). SH significantly decreased reaction time over hypoxic exposure (BL: 0.43±0.01 sec vs. SH: 0.41±0.01 sec, P<0.01). Comparatively, MH did not elicit an increase in the number of errors of commission nor a decrease in reaction time (Both, P>0.05). Conclusion Executive function deteriorated during severe hypoxia. Oxygenation of the prefrontal lobe which controls inhibition may be related to the increase in commission errors. Devices that monitor physiological indices such as S p O 2 or rSO 2 might be beneficial for a model to predict executive deterioration. Support or Funding Information This project was funded by the Office of Naval Research (ONR), grant number N00014‐18‐D‐7001‐TO1.

Background Cognitive deficits resulting from mild hypoxia are difficult to quantify and reproduce consistently. The changes in executive function during acute hypoxia are still controversial. The purpose of present study was to assess changes in executive function during acute moderate hypoxia using a continuous performance test (Connors’ Continuous Performance test, CCPT‐II). Methods Nine young, healthy adults (7 women; 28 ± 1 years; BMI: 24.5 ± 3.0 kg·m −2 ) performed two sets of CCPT‐II during two different conditions: 1) 7 minutes of baseline (fraction of inspired oxygen (F i O 2 ) = 0.21) and 2) 10 minutes of hypoxia (F i O 2 =0.118). The CCPT‐II is a test of executive cognitive function which requires subjects to strike a key when any letter except the letter X appeared on a computer monitor as quickly and accurately as possible. Reaction time, commission errors (response to X), and omission errors (failure to respond to a letter other than X) were recorded for each 140s of the CCPT‐II block. Arterial oxygen concentration (P a O 2 ) was measured during the last 30sec of baseline and hypoxia from brachial artery catheter samples. Results P a O 2 was reduced in hypoxia ( baseline : 103.1 ± 1.5 mmHg vs. hypoxia : 43.2 ± 1.0 mmHg, P <0.01). During the trials of the CCPT‐II performed during hypoxia, reaction time was lower (i.e. faster) than during baseline ( baseline : 451 ± 18 ms. vs. hypoxia : 437 ± 13 ms., P<0.01). Additionally, the number of commission errors was greater in hypoxia ( baseline : 1.3 ± 0.6 errors·block −1 vs. hypoxia : 2.1 ± 0.8 errors·block −1 , P<0.01). However, the number of omission errors was not different between the two conditions ( baseline : 0.4 ± 0.2 errors·block −1 vs. hypoxia : 0.2 ± 0.1 errors·block −1 , P=0.92). Conclusions The number of commission errors increased and the reaction time decreased during the CCPT‐II test performed in moderate hypoxia compared to baseline, demonstrating a decline in cognitive function during hypoxia. The faster and less accurate responses during hypoxia suggest a suppression of inhibitory pathways in the prefrontal or motor cortex that may contribute to the observed acute reduction in executive cognitive function. Support or Funding Information This project was funded by the Office of Naval Research (ONR), grant number N00014‐18‐D‐7001‐TO1.

Optoacoustic, or photoacoustic, imaging combines the penetration capabilities of ultrasound imaging with the contrast mechanism of optical absorption related to the photoacoustic effect. To enable modeling of photoacoustic measurements and imaging applications, the problem can be divided into modeling of the optical photon propagation and the resulting acoustic wave propagation. In highly scattering media such as soft tissues, Monte Carlo (MC) methods are used to evaluate photon propagation, absorption and the subsequent generation of a heat source that produces the photoacoustic effect. Acoustic wave equations are then used to model the propagation of the sound in the medium. However, if the appropriate physics could be modeled with a single tool, there would be advantages of consistency in spatial and temporal domains as well as easier integration of the optical and acoustic simulations. We propose using MC methods for optical photon propagation and for the acoustic wave propagation. The simulations are split into two stages for the optical photon propagation and the acoustic phonon propagation. We describe how the same MC framework is used to model photon propagation and acoustic phonon propagation. We will then demonstrate this new combined MC framework in models of photoacoustic problems in homogeneous and heterogeneous cases. These results will be compared with results from using k-Wave models for the acoustic wave propagation. The correspondence between k-Wave the acoustic MC model are shown to be in good agreement.

Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States, with less than half of patients living >5 years from diagnosis. A major challenge in treating ovarian cancer is that most patients have advanced disease at initial diagnosis. The best outcomes are observed in patients whose primary treatment includes complete resection of all visible disease plus combination platinum-based chemotherapy. Research efforts are focused on primary neoadjuvant treatments that may improve resectability, as well as systemic therapies providing improved long-term survival. These NCCN Guidelines Insights focus on recent updates to neoadjuvant chemotherapy recommendations, including the addition of hyperthermic intraperitoneal chemotherapy, and the role of PARP inhibitors and bevacizumab as maintenance therapy options in select patients who have completed primary chemotherapy.