Therapists' perspectives on a new portable hand telerehabilitation platform for home-based personalized treatment of stroke patients.

OBJECTIVE: Patients who have sustained a stroke suffer from residual motor impairments. Stroke can limit their ability to employ their impaired upper limb properly. Hand function is particularly one of the most frequently persisting consequences of stroke. This paper introduces a new portable hand telerehabilitation platform (PHTP) for home-based personalized treatment of stroke patients. The aims of this study are (1) to document the iterative design and development process of the PHTP, and (2) to explore the therapists' perspectives on implementing home-based treatment of stroke patients. MATERIALS AND METHODS: Local therapists were involved early in designing and developing the PHTP. We collected views of 84 therapists practicing in North America via an online survey. RESULTS: Therapists' perspectives on the introduced prototype support the use of the PHTP to provide home-based telerehabilitation for stroke patients. The System Usability Scale score was 70 for the PHTP, indicating that the platform is usable. The rest of the qualitative results obtained from custom questionnaires showed consistency in the platform design, high perceived usability and good acceptability among the therapists' community. CONCLUSIONS: In sum, the results encourage and support fine-tuning of the PHTP, commercializing it, and conducting prospective clinical studies.

Modeling of carrier dynamics in InGaAs/GaAs self-assembled quantum dot lasers.

In this study, a theoretical model is used to simulate the lasing characteristics of InGaAs/GaAs self-assembled quantum dot lasers. The rate equation for InGaAs/GaAs is numerically solved using the fourth-order Runge-Kutta method. We consider the homogeneous and inhomogeneous broadening of the optical gain, both with and without considering the nonlinear gain. The results indicate that for a certain injected current, there is a specific homogeneous broadening (HB) with the best lasing performance when HB is near, comparable, or equal to inhomogeneous broadening for every laser-injected current. We show that if the linear optical gain is replaced by the total gain, the output power will reduce a little and the peaks will be more broadened and the maximum of the gain spectrum decreases. The time evolution of the photon number for different currents and different HBs is shown. The results indicate that by increasing the HB, the number of photons in the steady state and the delay in the starting oscillation will increase. In addition, we show that there is threshold coverage for quantum dots to begin lasing and an optimum quantum dot coverage in which the self-assembled quantum dot lasers operate with the lowest possible threshold current and maximum output power.

Investigation of subwavelength grating structure for enhanced surface plasmon resonance detection.

A metallic subwavelength grating structure built on a thin gold film is studied for surface plasmon resonance (SPR) detection of refractive index variations of biological buffer solutions. By employing finite element analysis as a numerical method, characteristics of the angle interrogated SPR sensor were calculated and discussed in a broad operating wavelength varying from visible to near-infrared (NIR). The effects of grating structural parameters such as grating depth, grating period, and grating fill factor in different operating wavelengths have been evaluated on the sensor performance parameters of sensitivity, full width at half-minimum, minimum reflectance at resonance, and resonance angle. Numerical results indicate that adjusting grating geometrical parameters can enhance the performance parameters of the sensor especially in the NIR wavelengths. The enhanced sensor performance parameters for optimizing grating geometry have been explored in detail for visible and NIR wavelengths of 633 and 984 nm, respectively. These findings are important for developing localized surface plasmon sensors with enhanced performance.

Design study of nanograting-based surface plasmon resonance biosensor in the near-infrared wavelength.

A key issue with surface plasmon resonance (SPR) biosensors, which are the focus of many researchers, is improving their sensitivity to detect lower amounts of analyte in a solution. Most SPR developments have focused on the grating-based sensitivity-enhancement approach. In addition to sensitivity, a substantial enhancement of other sensor characteristics such as resolution and signal-to-noise ratio (SNR) is desired for designing a practical sensor. So, in this paper, the characteristics of surface plasmon polaritons sustained by 1D subwavelength metallic gratings on a thin metal slab (under the Krestchmann configuration) have been investigated numerically for the analyte-ligand interactions detection. Effects of different structural parameters, such as grating period, grating depth, metal film thickness, and fill factor have been evaluated on the sensor sensitivity as well as resolution and SNR. Numerical results indicate that the sensor working in the near-infrared wavelength has a better performance than that in the visible one. The result of numerical investigation has been used to design an optimized sensor with the best figure of merit.

In vivo microdialysis of glutamate in ventroposterolateral nucleus of thalamus following electrolytic lesion of spinothalamic tract in rats.

Central pain is one of the most important complications after spinal cord injury (SCI), and thereby, its treatment raises many challenges. After SCI, in a cascade of molecular events, a marked increase in glutamate at the injury site results in secondary changes which may impact on supraspinal regions, mainly ventroposterolateral (VPL). There is little information about the changes in glutamate metabolism in the VPL and whether it contributes to SCI-related central pain. The present study was performed to evaluate glutamate release in the VPL following electrolytic lesion of spinothalamic tract (STT). A laminectomy was performed at spinal segments of T9-T10 in male rats, and then, unilateral electrolytic lesions were made in the STT. Glutamate concentrations in ipsilateral VPL dialysate were measured by HPLC method at days 3, 7, 14, 21 and 28 post-injury. Tactile pain and motor activity were also examined. Glutamate levels were significantly increased in ipsilateral VPL of spinal-cord-injured rats 2 weeks after SCI and remained high up to day 28 post-surgery. The STT lesions had no marked effect on our measures of motor activity, but there was a significant decrease in paw withdrawal threshold in the hind paws at day 14 post-SCI. These findings suggest that an increased release of glutamate in VPL plays a role in secondary pathologic changes, leading to neuronal hyperexcitation and neuropathic pain after SCI.

Effect of consumption of fatty acids, calcium, vitamin D and boron with regular physical activity on bone mechanical properties and corresponding metabolic hormones in rats.

The consumption of fatty acids, nutrients, and regular physical activity, individually influence bone mechanical properties in rats. To investigate their effects in combination, male rats were divided into the seven groups: G1: regular food and drinking water; G2: same as Gr.1 + physical activity (Whole body vibration; WBV); G3: same as Gr.2 + Calcium, Vit. D, Boron; G4: same as Gr.3 + canola oil; G5: same as Gr.3 + sunflower oil; G6: same as Gr.3 + mix of sunflower oil and canola oil; and G7: same as Gr.3 + coconut oil; and treated for 8 weeks. Analysis between the control with the groups 2 and 3 revealed that vibration in the G2 increased the body weight (P = 0.04), with no other major difference in plasma and bone indices. Comparison between the control with the G4-G7 (the oil groups) revealed that the rats in the G5 had a lower body weight (15 % less) and a significant increase in plasma levels of Estradiol in the G7 was noted. In addition, levels of Testosterone in the G4 and G7, and Free Testosterone in the G7 had a remarkable increase. Similar trend was observed for plasma levels of Vit. D in the G4 and G5. The stiffness and the breaking strength of the femur in the G7, and the breaking strength of the lumbar in the G7 compared to the control and the G4 and G5 was significantly higher and tended to increase in comparison to the G6. Better and stronger measurements observed for coconut oil is warranted to further study its effect on biomechanical properties of bones.

Effect of combination therapy of fatty acids, calcium, vitamin D and boron with regular physical activity on cardiovascular risk factors in rat.

The effect of consumption of fatty acids and selected nutrients, along with regular physical activity, on cardiovascular risk factors in rats was investigated.Male rats were divided into the seven groups: Group 1: regular food and drinking water, Group 2: same as Group. 1 + physical activity (whole body vibration; WBV), Group 3: same as Group. 2 + calcium, vitamin D, boron, Group 4: same as Group. 3 + canola oil, Group 5: same as Group. 3 + sunflower oil, Group 6: same as Group. 3 + mix of sunflower oil and canola oil, Group 7: same as Group. 3 + coconut oil. Rats were treated for 8 weeks, and analysis of the frozen plasmas was performed. A- Analysis between the treatment groups and control revealed that vibration training in Group 2 increased body weight (P = 0.04), plasma creatin kinase (CK), (P = 0.02), and estradiol (E2), (P = 0.03). Rats in Group 5 consumed less food and plasma levels of cholesterol and LDL-cholesterol (LDL-C) increased significantly (P = 0.02) in Group 6 and in Group 7 (p<0.05). B- Analysis of data among Group 4 - 7 (the oil consuming groups) and Group 3 revealed significant differences in cholesterol (Chol), LDL-C, HDL-cholesterol (HDL-C), triglycerides (TG), C- reactive protein (hs-CRP), estradiol (E2), atherogenic index (AI), and risk factor (RF), (p<0.05). In addition, plasma levels of testosterone (T) and free testosterone (FT) in Group 7 had a remarkable but non-significant increase. As a result of vibration training, a similar trend was observed for vitamin D in Group 2-7. The findings show that WBV is effective in improving health status by influencing cardiovascular disease (CVD) risk factors. Moreover, canola oil and sunflower oil, separately, showed beneficial impacts on CVD risk factors; whereas their combination had negative impacts on lipid profile. Coconut oil revealed to be efficient to provide health benefits in terms of CVD treatments.

Whole body vibration is a safe exercise training method and induces no impaired alterations on rat plasma parameters.

UNLABELLED: Whole body vibration (WBV) has been regarded as an exercise training method and as a non-pharmacological supportive treatment option appearing to be efficient for chronic disease conditions, such as bone disorders and cardio-respiratory fitness. Since, data on the safety and efficacy of vibration on plasma parameters are lacking, therefore, it was decided to assess the effects of WBV on the plasma parameters in adult male Wistar rat model. METHODS: Male Wistar rats, weighing 140­180 g, were divided into control and the vibration group. Vibration training consisted of vertical sinusoidal whole body vibration for 8 weeks, followed by blood collection. RESULTS: The vibrated rats weighed more than the control group (approximately 14% more). Plasma CK, E2 and IL-6 levels were significantly higher in the vibration group compared with the controls. The mean of Vit. D level was 15% higher; hsCRP level was 11% lower and IL-6 level was 32% higher in the vibration group. No difference was observed for other selected plasma parameters. DISCUSSION: The potential effects of physiological responses of WBV on several physiological systems are without deteriorations in plasma parameters.

Comparison of transobturator tape (TOT) vs Burch method in treatment of stress urinary incontinence.

This study aim was to compare the efficacy of transobturator tape (TOT) as a new sling procedure, and Burch colposuspension as the gold standard surgical technique, in the treatment of stress urinary incontinence (SUI). This prospective randomised clinical trial was conducted on 62 women with SUI diagnosed with urodynamic test in Vali-e-Asr Hospital, Tehran, Iran. Patients were allocated into two surgery groups, randomly; TOT and Burch (31 patients in each group). After treatment, they were followed-up for long-term outcome. The average duration of follow-up was 22 and 28 months in the TOT and Burch group, respectively. Operation duration and hospital stay in the TOT group was significantly less than the Burch group (p=0.001). The rate of complete cure, improvement and failure in the TOT group was 90.3%, 9.7% and 0%, respectively, as well as 74.2%, 19.4% and 6.5% in the Burch group. In the TOT group, 90.3% of patients were very satisfied, 6.5% moderately satisfied and 3.2% were less satisfied; none of them were unsatisfied. It is concluded that the TOT procedure is a safe and effective option with less operation time and shorter in-hospital stay for SUI treatment.

High performances III-Nitride Quantum Dot infrared photodetector operating at room temperature.

In this paper we present a novel long wave length infrared quantum dot photodetector. A cubic shaped 6nm GaN quantum dot (QD) within a large 18 nm Al(0.2)Ga(0.8)N QD (capping layer) embedded in Al(0.8)Ga(0.2)N has been considered as the unit cell of the active layer of the device. Single band effective mass approximation has been applied in order to calculate the QD electronic structure. The temperature dependent behavior of the responsivity and dark current were presented and discussed for different applied electric fields. The capping layer has been proposed to improve upon the dark current of the detector. The proposed device has demonstrated exceptionally low dark current, therefore low noise, and high detectivity. Excellent specific detectivity (D*) up to approximately 3 x 10(8)CmHz(1/ 2)/W is achieved at room temperature.

Effects of short-term oral administration of trimethoprim-sulfamethoxazole on Schirmer II tear test results in clinically normal rabbits.

Fifteen New Zealand white rabbits were used in a study to determine whether oral administration of trimethoprim-sulfamethoxazole affects the rate of tear secretion in healthy rabbits. Ten rabbits received 40 mg/kg trimethoprim-sulfamethoxazole orally twice a day for 14 days; the other five rabbits were used as a control group and received a placebo during the study. The Schirmer II tear test (STT-II) was performed in both groups during administration of the drugs or placebo on the first, third, seventh and 14th days. Significant decreases in STT-II values were observed in the treatment group on the 14th day of the study in comparison with baseline values (P<0.001).

Type of cell death and the role of acetylcholinesterase activity in neurotoxicity induced by paraoxon in cultured rat hippocampal neurons.

Organophosphate (Ops) neurotoxicity is attributed both to its well-known cholinergic and non-cholinergic effects. In the present study we compared enzymatic and morphologic changes in neurons exposed to paraoxon during one day and one week. The effect of exposure time is important in neurotoxicity of Ops. The longer the exposure time is the more damage is observed in neurons, although there are few investigations about the effect in the post-exposure period. Hippocampal cells were obtained from rat neonates and cultured in Neurobasal/B27. Paraoxon at 50 and 100 microM were added. Inverted microscope and electron microscope were used to study cell morphology and Neutral Red staining was used to measure viability. We also assayed caspase-3 and (acetylcholinesterase) AChE activity. Hoechst staining was utilized to determine the type of cell death. Culture medium was replaced after 24 h in one-day group, however, tests were all carried out at the end of the first week in both group. The results indicate that paraoxon reduced the viability in a dose-dependent manner. Our results do not confirm apoptosis in either group; it seems that the cell death in one-day exposure group was not AChE dependent. In conclusion, present data imply that the toxicity of paraoxon is both dose and duration dependent, which may even remain after the cessation of exposure.

The correlation between Modified Ashworth Scale scores and the new index of alpha motoneurones excitability in post-stroke patients.

The Modified Ashworth Scale (MAS) is currently a widely used clinical scale to evaluate muscle spasticity. However, it lacks reliability and the validity, of the MAS as a clinical measure of muscle spasticity has been challenged. The aim of the present study was to examine the validity of the MAS in patients with wrist flexor spasticity after stroke by using the Hslope/Mslope (Hslp/Mslp) ratio as the new index of alpha motoneuron excitability. Twenty-seven adult patients (14 women and 13 men) with first ever stroke resulting in hemiplegia with a mean (SD, range) age of 57.9 (11.6, 37-75) were included in the study. The main outcome measures were the MAS for the clinical assessment of spasticity, and the Hslp/Mslp for the neurophysiological evaluation. There was not a significant correlation between the MAS scores and Hslp/Mslp ratio (r = 0.38, p > 0.05). The mean of the Hslp/Mslp did not show a hierarchical increase with the MAS scores. The findings indicate that the MAS is not a valid and ordinal level measure of muscle spasticity.

Neurophysiological examination of the Modified Modified Ashworth Scale (MMAS) in patients with wrist flexor spasticity after stroke.

The Modified Modified Ashworth Scale (MMAS) is a clinical test for the measurement of spasticity. The aim of the present study was to examine the validity of the MMAS in patients with wrist flexor spasticity after stroke. 27 adult patients (14 women and 13 men) with first ever stroke resulting in hemiplegia with a mean (SD, range) age of 57.9 (11.6, 37-75) were included in the study. The outcome measures were the MMAS for the clinical assessment of spasticity, the Hslope/Mslope (Hslp/Mslp), and the H(max)/M(max) ratio for the neurophysiological evaluation. The mean of the Hslp/Mslp and the H(max)/M(max) were higher in patients with worse MMAS grades but the differences were not statistically significant. There was a significant positive correlation between the MMAS scores and Hslp/Mslp ratio as the new index of alpha motoneurone excitability or traditional index of H(max)/M(max) ratio (r = 0.39, p = 0.04). It is concluded that the MMAS to be a valid measure of spasticity after stroke.

Modeling and simulation of ammonia removal from purge gases of ammonia plants using a catalytic Pd-Ag membrane reactor.

In this work, the removal of ammonia from synthesis purge gas of an ammonia plant has been investigated. Since the ammonia decomposition is thermodynamically limited, a membrane reactor is used for complete decomposition. A double pipe catalytic membrane reactor is used to remove ammonia from purge gas. The purge gas is flowing in the reaction side and is converted to hydrogen and nitrogen over nickel-alumina catalyst. The hydrogen is transferred through the Pd-Ag membrane of tube side to the shell side. A mathematical model including conservation of mass in the tube and shell side of reactor is proposed. The proposed model was solved numerically and the effects of different parameters on the rector performance were investigated. The effects of pressure, temperature, flow rate (sweep ratio), membrane thickness and reactor diameter have been investigated in the present study. Increasing ammonia conversion was observed by raising the temperature, sweep ratio and reducing membrane thickness. When the pressure increases, the decomposition is gone toward completion but, at low pressure the ammonia conversion in the outset of reactor is higher than other pressures, but complete destruction of the ammonia cannot be achieved. The proposed model can be used for design of an industrial catalytic membrane reactor for removal of ammonia from ammonia plant and reducing NO(x) emissions.

Determination of aluminum and zinc in Iranian consumed tea.

To determine aluminum and zinc in Iranian consumed tea, 31 tea samples were analysed for Al and Zn concentration of tea leaves and tea infusion. The results show that average concentration of Al and Zn in tea leaves was 326 and 50.7 mg. Kg(-1) respectively in this regard Nemoneh and Shahrzad show the highest and lowest concentration respectively in term of Al, also Debsh and Alkozi follow same situation in Zn concentration. Also the solubility of metals in the first infusion was significantly (Al, Zn: P < 0.01) higher than the second infusion and the solubility in the second infusion was also significantly higher than the third infusion (Al: P < 0.01; Zn: P < 0.05). Al leachate in the first infusion (2 min) for Mosama and Seilan tea was highest and lowest respectively. Also in the second and third infusion (5 and 10 min) Golkis and Nemoneh tea show the highest and lowest figures respectively. On the other hand, data from Zn transfer in tea infusion in the first infusion show that Mosama and Ahmad Atry tea have the highest and lowest leachate percentage respectively, while in the second and third infusion Mosama and Golkis tea follow the same situation. Calculation of percentage 'available' Al and Zn to the human system showed that 1 l of tea can provide 37.2% of the daily dietary intake of Al, the percentage 'available' for absorption in the intestine is only 1.78% for overall mean Al concentration. Also daily dietary intake of Zn was 2.13% while percentage available for absorption in the intestine was 0.72%.

Endoscopic lesions in low-to average-risk patients with minimal bright red bleeding from midline anal fissures. How much should we go in?

BACKGROUND: Anal fissure is a common condition in young patients, and the main symptoms include anal pain and bleeding. Our aim was to determine the need to perform lower gastrointestinal endoscopy on patients with midline anal fissure who present with minimal bright red rectal bleeding and who are at low risk for colorectal neoplasia. METHODS: Patients with midline anal fissure who reported small amounts of red blood on toilet paper, toilet bowl or stool after defecation were evaluated. Patients with alarm signs (recently altered bowel habit, weight loss, anemia and family or personal history of colorectal neoplasms) were excluded. A total of 134 patients (80 female and 54 male, aged 35.8+/-11.4 years) were studied. Patients younger than 40 years underwent flexible sigmoidoscopy and colonoscopy was used for older ones. RESULTS: Fissures were posterior in 106 cases (79.1%) and anterior in 27 cases (20.1%); one patient (0.7%) had both anterior and posterior fissures. The lower gastrointestinal endoscopy was normal in 120 patients (89.6%), and 36 patients (26.9%) had associated internal hemorrhoids. Adenomatous polyps were found in 4 cases (3.0%), ulcerative colitis in 8 (6.0%) and Crohn's disease in one patient (0.7%). There was no case of adenocarcinoma. CONCLUSIONS: Clinical evaluation plus rectoscopy might be the appropriate evaluation in this selected group of patients, if our results are confirmed by further studies.

A preliminary study into the criterion validity of the Modified Modified Ashworth Scale using the new measure of the alpha motoneuron excitability in spastic hemiplegia.

The Modified Ashworth Scale (MAS) is the most widely used clinical test for the measurement of muscle spasticity. This scale that suffers from limitations and lack of reliability and validity has recently been remodified. The aim of the present study is to investigate the criterion validity of the new Modified MAS(MMAS) in the upper limb in post-stroke hemiplegia, using the Hslope/Mslope (Hslp/Mslp) as a novel index of alpha motor neuron excitability. Prior to the validity study, the reliability of the MMAS was evaluated in 30 hemiplegic patients. The raters agreed on 23 patients (0. 76%). The MMAS had good inter-rater reliability (K= 0.63, SE = 0.11, p < 0.001) for the assessment of wrist flexors spasticity in hemiplegic patients. 12 adult patients (7 women and 5 men) with first ever stroke resulting in hemiplegia with a mean age of 58.9 +/- 11.9 years (range, 37-73) were included in the validity study. The outcome measures were the MMAS for the clinical assessment of spasticity, and the HslopelMslope and the Hmax/Mmax ratio for the electrophysiological evaluation. The results showed an increase in mean rank of Hslp / Mslp in patients with a score of 1, 2 or 3 on the MMAS. However, the difference among the groups was not significant (p > 0.05). There was also no relationship between the clinical scale of MMAS and either the traditional [Hmax / Mmax ratio (r = -0.06)] or the new index [Hslp / Mslp (r = 0.24)] of spinal excitability. This preliminary study recruited a small number of patients, and failed to confirm a linear correlation between these variables. A study with a large number of patients is suggested to clarify the outcome.

Paraoxon-induced ultrastructural growth changes of rat cultured hippocampal cells in neurobasal/B27.

Organophosphates (OPs) neurotoxicity is attributed both to their well-known cholinergic and recently attended non-cholinergic effects. Since parathion has been observed to be responsible for more cases of poisoning than any other OP insecticides, it is vitally important to investigate other mechanisms, besides cholinesterase inhibition, which can potentially contribute to the neurotoxicity of parathion (or its metabolite, paraoxon). In present study, hippocampal cells obtained from Wistar rat neonates were cultured in neurobasal medium supplemented with B27 serum where different doses of paraoxon were also introduced. The neuronal growth in the control group and those exposed to paraoxon was compared. Phase contrast microscopy, cell staining (Neutral Red) and computer assessment morphometric study (Motic) were used to study cell morphology, viability and type of cell death. Statistical analysis was carried out using one-way ANOVA. There was no clear morphologic differences between neurons in the control group and those exposed to 10 microM paraoxon; however, deformity of the soma was clear in pellets containing higher concentration of paraoxon. Ultrastructure of cells was markedly altered at 50 microM dose of paraoxon as evidenced by gradual discontinuation of cytoplasm, appearing of numerous vacuoles and intracytoplasmic myelin figure. The processes (neurites) did not grow in media containing 100 microM paraoxon or more. Viability decreased with increasing paraoxon especially above 100 microM. In conclusion, the present data reveal that paraoxon, in 30 microM or higher concentrations, induces a decrease in cell growth, followed by cell swelling and neuronal death (possibly necrosis).

Involvement of nucleus accumbens in L-arginine-induced conditioned place preference in rats.

In the present study, the effects of intraperitoneal, intra-accumbal and intra-ventral tegmental area administration of L-arginine and N(G)-nitro-L-arginine methyl-ester (L-NAME) on conditioned place preference behavior were studied. Intraperitoneal (i.p.; 0.5, 1 and 5 mg/kg) and intra-accumbal (intra-NAc; 0.3, 1 and 3 microg/rat), but not intra-ventral tegmental area (intra-VTA; 0.3, 1 and 3 microg/rat) administrations of L-arginine produced a significant place conditioning. Similar injections of L-NAME did not produce any response. However, intraperitoneal pretreatment of the animals with L-NAME (5, 10 and 20 mg/kg), 30 min before L-arginine administration, significantly abolished the acquisition of place conditioning induced by either intraperitoneal or intra-accumbal injection of L-arginine. Moreover, injection of L-NAME (5, 10 and 20 mg/kg) on the test day did not alter the L-arginine response. The results may indicate that L-arginine induces conditioned place preference via an increase in nitric oxide (NO) in the nucleus accumbens.