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1.
Anaesthesia ; 79(2): 147-155, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38059394

ABSTRACT

The COVID-19 pandemic has highlighted the importance of environmental ventilation in reducing airborne pathogen transmission. Carbon dioxide monitoring is recommended in the community to ensure adequate ventilation. Dynamic measurements of ventilation quantifying human exhaled waste gas accumulation are not conducted routinely in hospitals. Instead, environmental ventilation is allocated using static hourly air change rates. These vary according to the degree of perceived hazard, with the highest change rates reserved for locations where aerosol-generating procedures are performed, where medical/anaesthetic gases are used and where a small number of high-risk infective or immunocompromised patients may be isolated to reduce cross-infection. We aimed to quantify the quality and distribution of ventilation in hospital by measuring carbon dioxide levels in a two-phased prospective observational study. First, under controlled conditions, we validated our method and the relationship between human occupancy, ventilation and carbon dioxide levels using non-dispersive infrared carbon dioxide monitors. We then assessed ventilation quality in patient-occupied (clinical) and staff break and office (non-clinical) areas across two hospitals in Scotland. We selected acute medical and respiratory wards in which patients with COVID-19 are cared for routinely, as well as ICUs and operating theatres where aerosol-generating procedures  are performed routinely. Between November and December 2022, 127,680 carbon dioxide measurements were obtained across 32 areas over 8 weeks. Carbon dioxide levels breached the 800 ppm threshold for 14% of the time in non-clinical areas vs. 7% in clinical areas (p < 0.001). In non-clinical areas, carbon dioxide levels were > 800 ppm for 20% of the time in both ICUs and wards, vs. 1% in operating theatres (p < 0.001). In clinical areas, carbon dioxide was > 800 ppm for 16% of the time in wards, vs. 0% in ICUs and operating theatres (p < 0.001). We conclude that staff break, office and clinical areas on acute medical and respiratory wards frequently had inadequate ventilation, potentially increasing the risks of airborne pathogen transmission to staff and patients. Conversely, ventilation was consistently high in the ICU and operating theatre clinical environments. Carbon dioxide monitoring could be used to measure and guide improvements in hospital ventilation.


Subject(s)
COVID-19 , Carbon Dioxide , Humans , Pandemics , Respiratory Aerosols and Droplets , Hospitals
2.
Plast Reconstr Surg ; 149(6): 1149e-1154e, 2022 06 01.
Article in English | MEDLINE | ID: mdl-35404335

ABSTRACT

SUMMARY: Without meaningful and intuitive sensory feedback, even the most advanced prosthetic limbs remain insensate and impose an enormous cognitive burden during use. The regenerative peripheral nerve interface can serve as a novel bidirectional motor and sensory neuroprosthetic interface. In previous human studies, regenerative peripheral nerve interfaces demonstrated stable high-amplitude motor electromyography signals with excellent signal-to-noise ratio for prosthetic control. In addition, they can treat and prevent postamputation pain by mitigating neuroma formation. In this study, the authors investigated whether electrical stimulation applied to regenerative peripheral nerve interfaces could produce appreciable proprioceptive and/or tactile sensations in two participants with upper limb amputations. Stimulation of the interfaces resulted in both participants reporting proprioceptive sensations in the phantom hand. Specifically, stimulation of participant 1's median nerve regenerative peripheral nerve interface activated a flexion sensation in the thumb or index finger, whereas stimulation of the ulnar nerve interface evoked a flexion sensation of the ring or small finger. Likewise, stimulation of one of participant 2's ulnar nerve interfaces produced a sensation of flexion at the ring finger distal interphalangeal joint. In addition, stimulation of participant 2's other ulnar nerve interface and the median nerve interface resulted in perceived cutaneous sensations that corresponded to each nerve's respective dermatome. These results suggest that regenerative peripheral nerve interfaces have the potential to restore proprioceptive and cutaneous sensory feedback that could significantly improve prosthesis use and embodiment.


Subject(s)
Artificial Limbs , Amputation, Surgical , Humans , Peripheral Nerves/physiology , Proprioception , Upper Extremity/surgery
3.
Rev Sci Instrum ; 92(11): 114101, 2021 Nov 01.
Article in English | MEDLINE | ID: mdl-34852501

ABSTRACT

The mechanotransduction pathways that mediate cellular responses to contact forces are better understood than those that mediate response to distance forces, especially the force of gravity. Removing or reducing gravity for significant periods of time involves either sending samples to space, inducing diamagnetic levitation with high magnetic fields, or continually reorienting samples for a period, all in a manner that supports cell culturing. Undesired secondary effects due to high magnetic fields or shear forces associated with fluid flow while reorienting must be considered in the design of ground-based devices. We have developed a lab-friendly and compact random positioning machine (RPM) that fits in a standard tissue culture incubator. Using a two-axis gimbal, it continually reorients samples in a manner that produces an equal likelihood that all possible orientations are visited. We contribute a new control algorithm by which the distribution of probabilities over all possible orientations is completely uniform. Rather than randomly varying gimbal axis speed and/or direction as in previous algorithms (which produces non-uniform probability distributions of orientation), we use inverse kinematics to follow a trajectory with a probability distribution of orientations that is uniform by construction. Over a time period of 6 h of operation using our RPM, the average gravity is within 0.001 23% of the gravity of Earth. Shear forces are minimized by limiting the angular speed of both gimbal motors to under 42 °/s. We demonstrate the utility of our RPM by investigating the effects of simulated microgravity on adherent human osteoblasts immediately after retrieving samples from our RPM. Cytoskeletal disruption and cell shape changes were observed relative to samples cultured in a 1 g environment. We also found that subjecting human osteoblasts in suspension to simulated microgravity resulted in less filamentous actin and lower cell stiffness.


Subject(s)
Weightlessness , Cells, Cultured , Humans , Mechanotransduction, Cellular , Osteoblasts , Weightlessness Simulation
4.
Article in English | MEDLINE | ID: mdl-34516377

ABSTRACT

Sensory feedback from body-powered and myoelectric prostheses are limited, but in different ways. Currently, there are no empirical studies on how incidental feedback differs between body-powered and myoelectric prostheses, or how these differences impact grasping. Thus, the purpose of this study was to quantify differences in grasping performance between body-powered and myoelectric prosthesis users when presented with different forms of feedback. Nine adults with upper limb loss and nine without (acting as controls) completed two tasks in a virtual environment. In the first task, participants used visual, vibration, or force feedback to assist in matching target grasp apertures. In the second task, participants used either visual or force feedback to identify the stiffness of a virtual object. Participants using either prosthesis type improved their accuracy and reduced their variability compared to the no feedback condition when provided with any form of feedback (p < 0.001). However, participants using body-powered prostheses were significantly more accurate and less variable at matching grasp apertures than those using myoelectric prostheses across all feedback conditions. When identifying stiffness, body-powered prosthesis users were more accurate using force feedback (64% compared to myoelectric users' 39%) while myoelectric users were more accurate using visual feedback (65% compared to body-powered users' 53%). This study supports previous findings that body-powered prosthesis users receive limited force and proprioceptive feedback, while myoelectric prosthesis users receive almost no force or proprioceptive feedback from their device. This work can inform future supplemental feedback that enhances rather than reproduces existing incidental feedback.


Subject(s)
Amputees , Artificial Limbs , Adult , Electromyography , Feedback , Feedback, Sensory , Hand Strength , Humans , Prosthesis Design
5.
Proc Biol Sci ; 287(1931): 20200922, 2020 07 29.
Article in English | MEDLINE | ID: mdl-33043867

ABSTRACT

Most of the world's crops depend on pollinators, so declines in both managed and wild bees raise concerns about food security. However, the degree to which insect pollination is actually limiting current crop production is poorly understood, as is the role of wild species (as opposed to managed honeybees) in pollinating crops, particularly in intensive production areas. We established a nationwide study to assess the extent of pollinator limitation in seven crops at 131 locations situated across major crop-producing areas of the USA. We found that five out of seven crops showed evidence of pollinator limitation. Wild bees and honeybees provided comparable amounts of pollination for most crops, even in agriculturally intensive regions. We estimated the nationwide annual production value of wild pollinators to the seven crops we studied at over $1.5 billion; the value of wild bee pollination of all pollinator-dependent crops would be much greater. Our findings show that pollinator declines could translate directly into decreased yields or production for most of the crops studied, and that wild species contribute substantially to pollination of most study crops in major crop-producing regions.


Subject(s)
Agriculture , Crops, Agricultural , Pollination , Animals , Bees , Food Supply , United States
6.
Sci Transl Med ; 12(533)2020 03 04.
Article in English | MEDLINE | ID: mdl-32132217

ABSTRACT

Peripheral nerves provide a promising source of motor control signals for neuroprosthetic devices. Unfortunately, the clinical utility of current peripheral nerve interfaces is limited by signal amplitude and stability. Here, we showed that the regenerative peripheral nerve interface (RPNI) serves as a biologically stable bioamplifier of efferent motor action potentials with long-term stability in upper limb amputees. Ultrasound assessments of RPNIs revealed prominent contractions during phantom finger flexion, confirming functional reinnervation of the RPNIs in two patients. The RPNIs in two additional patients produced electromyography signals with large signal-to-noise ratios. Using these RPNI signals, subjects successfully controlled a hand prosthesis in real-time up to 300 days without control algorithm recalibration. RPNIs show potential in enhancing prosthesis control for people with upper limb loss.


Subject(s)
Amputees , Artificial Limbs , Electromyography , Hand , Humans , Peripheral Nerves , Upper Extremity
7.
J Pediatr ; 211: 146-151, 2019 08.
Article in English | MEDLINE | ID: mdl-31079855

ABSTRACT

OBJECTIVE: To determine whether maternal and paternal exposure to adverse childhood experiences (ACEs) has an association with offspring healthcare use by 2 years of age. STUDY DESIGN: A retrospective cohort study was performed on 454 patients at a large suburban pediatric primary care practice whose mother (n = 374) or father (n = 156) or both (n = 123) completed an ACE survey between October 2012 and June 2014. The association between self-reported parental ACEs and healthcare use by 2 years of age, including number of missed well-child visits, sick visits, and delayed or missed immunizations, was modeled using multivariable negative binomial regression. All analyses adjusted for child sex, payer source, and preterm birth. RESULTS: Maternal, but not paternal, ACE exposure was significantly associated with missed well-child visits by 2 years of age. For each additional maternal ACE, there was a significant 12% increase in the incidence rate of missed well-child visits (relative risk, 1.12; 95% CI, 1.03-1.22; P = .010). Maternal and paternal ACE scores were not significantly associated with increased sick visits or delayed or missed immunizations. CONCLUSIONS: The ACE exposure of mothers is negatively associated with adherence to preventive healthcare visits among their children early in life. Future research is needed to elucidate the mechanisms of this association and to develop and implement family-based intervention strategies.


Subject(s)
Adult Survivors of Child Adverse Events , Parents , Pediatrics , Primary Health Care/statistics & numerical data , Child, Preschool , Cohort Studies , Female , Humans , Infant , Male , Office Visits/statistics & numerical data , Oregon , Patient Compliance/statistics & numerical data , Retrospective Studies , Vaccination/statistics & numerical data
8.
IEEE Trans Haptics ; 12(2): 205-216, 2019.
Article in English | MEDLINE | ID: mdl-30582553

ABSTRACT

The study of haptic perception often makes use of haptic rendering to display the variety of impedances needed to run an experiment. Unacknowledged in many cases is the influence of the selected device hardware on what the user will feel, particularly in interactions featuring frequencies above the control bandwidth. While human motion is generally limited to 10 Hz, virtual environments with unilateral constraints are subject to excitation of a wider frequency spectrum through contact transitions. We employ the effective impedance decomposition to discuss the effects of parasitics outside the rendering bandwidth. We also introduce an analysis of the admittance and impedance controllers with respect to sensitivity to load cell noise. We explore these effects using a single degree-of-freedom device that can be configured for either a low or high mechanical advantage in a perceptual experiment, with experimental conditions designed through application of the effective impedance decomposition. We find that the excitation of high frequencies through contact transitions negatively impacts humans' ability to distinguish between stiffnesses.


Subject(s)
Touch Perception/physiology , Electric Impedance , Humans , User-Computer Interface
9.
Restor Neurol Neurosci ; 36(6): 693-708, 2018.
Article in English | MEDLINE | ID: mdl-30400120

ABSTRACT

BACKGROUND: Robotic rehabilitation is a highly promising approach to recover lost functions after stroke or other neurological disorders. Unfortunately, robotic rehabilitation currently suffers from "motor slacking", a phenomenon in which the human motor system reduces muscle activation levels and movement excursions, ostensibly to minimize metabolic- and movement-related costs. Consequently, the patient remains passive and is not fully engaged during therapy. To overcome this limitation, we envision a new class of body-powered robots and hypothesize that motor slacking could be reduced if individuals must provide the power to move their impaired limbs via their own body (i.e., through the motion of a healthy limb). OBJECTIVE: To test whether a body-powered exoskeleton (i.e. robot) could reduce motor slacking during robotic training. METHODS: We developed a body-powered robot that mechanically coupled the motions of the user's elbow joints. We tested this passive robot in two groups of subjects (stroke and able-bodied) during four exercise conditions in which we controlled whether the robotic device was powered by the subject or by the experimenter, and whether the subject's driven arm was engaged or at rest. Motor slacking was quantified by computing the muscle activation changes of the elbow flexor and extensor muscles using surface electromyography. RESULTS: Subjects had higher levels of muscle activation in their driven arm during self-powered conditions compared to externally-powered conditions. Most notably, subjects unintentionally activated their driven arm even when explicitly told to relax when the device was self-powered. This behavior was persistent throughout the trial and did not wane after the initiation of the trial. CONCLUSIONS: Our findings provide novel evidence indicating that motor slacking can be reduced by self-powered robots; thus demonstrating promise for rehabilitation of impaired subjects using this new class of wearable system. The results also serve as a foundation to develop more sophisticated body-powered robots (e.g., with controllable transmissions) for rehabilitation purposes.


Subject(s)
Exercise Therapy/instrumentation , Exercise Therapy/methods , Robotics , Stroke Rehabilitation/methods , Stroke , Upper Extremity/physiology , Adolescent , Adult , Aged , Analysis of Variance , Electromyography , Female , Humans , Male , Middle Aged , Muscle, Skeletal/physiopathology , Proof of Concept Study , Range of Motion, Articular , Young Adult
10.
J Neuroeng Rehabil ; 15(1): 108, 2018 11 20.
Article in English | MEDLINE | ID: mdl-30458876

ABSTRACT

INTRODUCTION: Regenerative peripheral nerve interfaces (RPNIs) are biological constructs which amplify neural signals and have shown long-term stability in rat models. Real-time control of a neuroprosthesis in rat models has not yet been demonstrated. The purpose of this study was to: a) design and validate a system for translating electromyography (EMG) signals from an RPNI in a rat model into real-time control of a neuroprosthetic hand, and; b) use the system to demonstrate RPNI proportional neuroprosthesis control. METHODS: Animals were randomly assigned to three experimental groups: (1) Control; (2) Denervated, and; (3) RPNI. In the RPNI group, the extensor digitorum longus (EDL) muscle was dissected free, denervated, transferred to the lateral thigh and neurotized with the residual end of the transected common peroneal nerve. Rats received tactile stimuli to the hind-limb via monofilaments, and electrodes were used to record EMG. Signals were filtered, rectified and integrated using a moving sample window. Processed EMG signals (iEMG) from RPNIs were validated against Control and Denervated group outputs. RESULTS: Voluntary reflexive rat movements produced signaling that activated the prosthesis in both the Control and RPNI groups, but produced no activation in the Denervated group. Signal-to-Noise ratio between hind-limb movement and resting iEMG was 3.55 for Controls and 3.81 for RPNIs. Both Control and RPNI groups exhibited a logarithmic iEMG increase with increased monofilament pressure, allowing graded prosthetic hand speed control (R2 = 0.758 and R2 = 0.802, respectively). CONCLUSION: EMG signals were successfully acquired from RPNIs and translated into real-time neuroprosthetic control. Signal contamination from muscles adjacent to the RPNI was minimal. RPNI constructs provided reliable proportional prosthetic hand control.


Subject(s)
Artificial Limbs , Electromyography/methods , Nerve Regeneration , Signal Processing, Computer-Assisted , Animals , Hindlimb/innervation , Male , Movement/physiology , Muscle, Skeletal/physiology , Nerve Regeneration/physiology , Peripheral Nerves/physiology , Rats
11.
S Afr Med J ; 108(2): 138-143, 2018 Feb 01.
Article in English | MEDLINE | ID: mdl-29429447

ABSTRACT

BACKGROUND: A community-based prevalence survey performed in two suburbs in Cape Town, South Africa (SA), in 2005, using the international Burden of Obstructive Lung Disease (BOLD) method, confirmed a prevalence of chronic airflow obstruction (CAO) in 23.1% of adults aged >40 years. OBJECTIVES: To study the clinical course and prognosis over 5 years of patients with CAO identified in the 2005 survey. METHODS: Patients with CAO in 2005 were invited to participate. Standard BOLD and modified questionnaires were completed. Spirometry was performed using spirometers of the same make as in 2005. RESULTS: Of 196 eligible participants from BOLD 2005, 45 (23.0%) had died, 8 from respiratory causes, 10 from cardiovascular causes and 6 from other known causes, while in 21 cases the cause of death was not known. On multivariate analysis, only age and Global initiative for Obstructive Lung Disease (GOLD) stage 4 disease at baseline were significantly associated with death. Of the 151 survivors, 11 (5.6% of the original cohort) were unavailable and 33 (16.8%) declined or had medical exclusions. One hundred and seven survivors were enrolled in the follow-up study (54.6%, median age 63.1 years, 45.8% males). Post-bronchodilator spirometry performed in 106 participants failed to confirm CAO, defined as a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio of <0.7, in 16 participants (15.1%), but CAO was present in 90. The median decline in FEV1 was 28.9 mL/year (interquartile range -54.8 - 0.0) and was similar between GOLD stages. The median total decline in FVC was 75 mL, and was significantly greater in GOLD stage 1 (-350 mL) than in stages 2 or 3 (-80  mL and +140 mL, respectively; p<0.01). Fifty-eight participants with CAO in 2005 (64.4%) remained in the same GOLD stage, while 21 (23.3%) deteriorated and 11 (12.2%) improved by ≥1 stage. Only one-third were receiving any treatment for chronic obstructive pulmonary disease (COPD). CONCLUSIONS: The prevalence, morbidity and mortality of CAO and COPD in SA are high and the level of appropriate treatment is very low, pointing to underdiagnosis and inadequate provision of and access to effective treatments and preventive strategies for this priority chronic non-communicable disease.

12.
IEEE Trans Haptics ; 11(3): 476-481, 2018.
Article in English | MEDLINE | ID: mdl-29035226

ABSTRACT

Refreshable displays for tactile graphics are typically composed of pins that have smaller diameters and spacing than standard braille dots. We investigated configurations of high-density pins to form braille text on such displays using non-refreshable stimuli produced with a 3D printer. Normal dot braille (diameter 1.5 mm) was compared to high-density dot braille (diameter 0.75 mm) wherein each normal dot was rendered by high-density simulated pins alone or in a cluster of pins configured in a diamond, X, or square; and to "blobs" that could result from covering normal braille and high-density multi-pin configurations with a thin membrane. Twelve blind participants read MNREAD sentences displayed in these conditions. For high-density simulated pins, single pins were as quickly and easily read as normal braille, but diamond, X, and square multi-pin configurations were slower and/or harder to read than normal braille. We therefore conclude that as long as center-to-center dot spacing and dot placement is maintained, the dot diameter may be open to variability for rendering braille on a high density tactile display.


Subject(s)
Blindness/psychology , Reading , Sensory Aids , Touch Perception , Adult , Equipment Design , Female , Humans , Male , Middle Aged , Physical Stimulation , Touch , User-Computer Interface , Visually Impaired Persons
13.
IEEE Trans Robot ; 34(3): 748-763, 2018 Jun.
Article in English | MEDLINE | ID: mdl-30662378

ABSTRACT

In this paper, we develop theoretical foundations for a new class of rehabilitation robot: body powered devices that route power between a user's joints. By harvesting power from a healthy joint to assist an impaired joint, novel bimanual and self-assist therapies are enabled. This approach complements existing robotic therapies aimed at promoting recovery of motor function after neurological injury. We employ hydraulic transmissions for routing power, or equivalently for coupling the motions of a user's joints. Fluid power routed through flexible tubing imposes constraints within a limb or between homologous joints across the body. Variable transmissions allow constraints to be steered on the fly, and simple valve switching realizes free space and locked motion. We examine two methods for realizing variable hydraulic transmissions: using valves to switch among redundant cylinders (digital hydraulics) or using an intervening electromechanical link. For both methods, we present a rigorous mathematical framework for describing and controlling the resulting constraints. Theoretical developments are supported by experiments using a prototype fluid-power exoskeleton.

14.
J Neuroeng Rehabil ; 14(1): 33, 2017 04 24.
Article in English | MEDLINE | ID: mdl-28438166

ABSTRACT

BACKGROUND: Regenerative Peripheral Nerve Interfaces (RPNIs) are neurotized muscle grafts intended to produce electromyographic signals suitable for motorized prosthesis control. Two RPNIs producing independent agonist/antagonist signals are required for each control axis; however, it is unknown whether signals from adjacent RPNIs are independent. The purpose of this work was to determine signaling characteristics from two adjacent RPNIs, the first neurotized by a foot dorsi-flexor nerve and the second neurotized by a foot plantar-flexor nerve in a rodent model. METHODS: Two Control group rats had electrodes implanted onto the soleus (tibial nerve) and extensor digitorum longus (peroneal nerve) muscles in the left hind limb. Two Dual-RPNI group rats had two separate muscles grafted to the left thigh and each implanted with electrodes: the extensor digitorum longus was neurotized with a transected fascicle from the tibial nerve, and the tibialis anterior was implanted with a transected peroneal nerve. Four months post-surgery, rats walked on a treadmill, were videographed, and electromyographic signals were recorded. Amplitude and periodicity of all signals relative to gait period were quantified. To facilitate comparisons across groups, electromyographic signals were expressed as a percent of total stepping cycle activity for each stance and swing gait phase. Independence between peroneal and tibial nerve activations were assessed by statistical comparisons between groups during stance and swing. RESULTS: Electromyographic activity for Control and Dual-RPNI rats displayed alternating activation patterns coinciding with stance and swing. Significant signal amplitude differences between the peroneal and tibial nerves were found in both the Control and Dual-RPNI groups. Non-inferiority tests performed on Dual-RPNI group signal confidence intervals showed that activation was equivalent to the Control group in all but the peroneal RPNI construct during stance. The similar electromyographic activity obtained for Control and RPNI suggests the latter constructs activate independently during both stance and swing, and contain minimal crosstalk. CONCLUSIONS: In-vivo myoelectric RPNI activity encodes neural activation patterns associated with gait. Adjacent RPNIs neurotized with agonist/antagonist nerves display activity amplitudes similar to Control during voluntary walking. The distinct and expected activation patterns indicate the RPNI may provide independent signaling in humans, suitable for motorized prosthesis control.


Subject(s)
Nerve Regeneration/physiology , Peripheral Nerves/physiology , Walking/physiology , Animals , Electrodes, Implanted , Electromyography , Foot/innervation , Foot/physiology , Gait/physiology , Hindlimb/innervation , Hindlimb/physiology , Male , Muscle, Skeletal/innervation , Muscle, Skeletal/physiology , Peroneal Nerve/physiology , Rats , Rats, Inbred F344 , Tibial Nerve/physiology
15.
IEEE Trans Neural Syst Rehabil Eng ; 25(3): 215-226, 2017 03.
Article in English | MEDLINE | ID: mdl-27101614

ABSTRACT

Myoelectric prostheses have many advantages over body-powered prostheses, yet the absence of sensory feedback in myoelectric devices is one reason body-powered devices are often preferred by amputees. While considerable progress has been made in the mechanical design and control of myoelectric prostheses, research on haptic feedback has not had a similar impact. In this study, we seek to develop a fundamental understanding of the utility of force feedback and vision in the functional operation of a body-powered upper-limb prosthesis. Using a custom body-powered prosthesis in which force feedback can be conditionally removed, we asked N=10 non-amputee participants to identify objects based on stiffness in four separate conditions with and without visual and/or force feedback. Results indicate that the combination of visual and force feedback allows for the best accuracy, followed by force feedback only, then visual feedback only. In addition, combining force feedback with visual feedback does not significantly affect identification timing compared to visual feedback alone. These findings suggest that consideration should be given to the development of force feedback displays for myoelectric prostheses that function like a Bowden cable, coupling the amputee's control input to the resulting feedback.


Subject(s)
Artificial Limbs , Exoskeleton Device , Feedback, Sensory , Models, Biological , Psychomotor Performance , Touch , Amputees/rehabilitation , Equipment Failure Analysis , Humans , Prosthesis Design
16.
Eye (Lond) ; 30(9): 1175-81, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27315345

ABSTRACT

PurposeIn addition to environmental causes such as TORCH infection, trauma and drug or chemical exposure, childhood cataracts (CC) frequently have a genetic basis. They may be isolated or syndromic and have been associated with mutations in over 110 genes. We have recently demonstrated that next-generation sequencing (NGS), a high throughput sequencing technique that enables the parallel sequencing of multiple genes, is ideally suited to the investigation of bilateral CC. This study assesses the diagnostic outcomes of traditional routine investigations and compares this with outcomes of NGS testing.MethodsA retrospective review of the medical records of 27 consecutive patients with bilateral CC presenting in 2010-2012 was undertaken. The outcomes of routine investigations in these patients, including TORCH screen, urinalysis, karyotyping, and urinary and plasma organic amino acids, were collated. The success of routine genetic investigations undertaken over 10 years (2000-2010) was also assessed.ResultsBy April 2014, the underlying cause of bilateral CC had been identified in just one of 27 patients despite 44% (n=12) receiving a full 'standard' investigative work-up and 22% (n=6) investigations in addition to the standard work-up. Fifteen of these patients underwent NGS testing and nine (60%) of these received a diagnosis for their CC.ConclusionThe frequency of patients receiving a diagnosis for their CC after standard care and the time taken to diagnosis was disappointing. NGS testing improved diagnostic rates and time to diagnosis, as well as changing clinical management. These data serve as a baseline for future evaluation of novel diagnostic modalities.


Subject(s)
Cataract/diagnosis , Cataract/genetics , Eye Proteins/genetics , High-Throughput Nucleotide Sequencing , Mutation , Cataract/congenital , Child , Child, Preschool , DNA Mutational Analysis , Female , Genetic Testing , Humans , Infant , Infant, Newborn , Karyotype , Male , Retrospective Studies
17.
IEEE Trans Haptics ; 9(3): 387-96, 2016.
Article in English | MEDLINE | ID: mdl-27101616

ABSTRACT

An important goal of haptic display is to make available the action/reaction relationships that define interactions between the body and the physical world. While in physical world interactions reaction cues invariably impinge on the same part of the body involved in action (reaction and action are colocated), a haptic interface is quite capable of rendering feedback to a separate body part than that used for producing exploratory actions (non-colocated action and reaction). This most commonly occurs with the use of vibrotactile display, in which a cutaneous cue has been substituted for a kinesthetic cue (a kind of sensory substitution). In this paper, we investigate whether non-colocated force and displacement cues degrade the perception of compliance. Using a custom non-colocated kinesthetic display in which one hand controls displacement and the other senses force, we ask participants to discriminate between two virtual springs with matched terminal force and adjustable non-linearity. An additional condition includes one hand controlling displacement while the other senses force encoded in a vibrotactile cue. Results show that when the terminal force cue is unavailable, and even when sensory substitution is not involved, non-colocated kinesthetic displays degrade compliance discrimination relative to colocated kinesthetic displays. Compliance discrimination is also degraded with vibrotactile display of force. These findings suggest that non-colocated kinesthetic displays and, likewise, cutaneous sensory substitution displays should be avoided when discrimination of compliance is necessary for task success.


Subject(s)
Kinesthesis/physiology , Mechanical Phenomena , Perception/physiology , Adult , Cues , Feedback , Female , Hand , Humans , Male
18.
J Neural Eng ; 13(2): 026012, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26859115

ABSTRACT

OBJECTIVE: Regenerative peripheral nerve interfaces (RPNIs) are neurotized free autologous muscle grafts equipped with electrodes to record myoelectric signals for prosthesis control. Viability of rat RPNI constructs have been demonstrated using evoked responses. In vivo RPNI characterization is the next critical step for assessment as a control modality for prosthetic devices. APPROACH: Two RPNIs were created in each of two rats by grafting portions of free muscle to the ends of divided peripheral nerves (peroneal in the left and tibial in the right hind limb) and placing bipolar electrodes on the graft surface. After four months, we examined in vivo electromyographic signal activity and compared these signals to muscular electromyographic signals recorded from autologous muscles in two rats serving as controls. An additional group of two rats in which the autologous muscles were denervated served to quantify cross-talk in the electrode recordings. Recordings were made while rats walked on a treadmill and a motion capture system tracked the hind limbs. Amplitude and periodicity of signals relative to gait were quantified, correlation between electromyographic and motion recording were assessed, and a decoder was trained to predict joint motion. MAIN RESULTS: Raw RPNI signals were active during walking, with amplitudes of 1 mVPP, and quiet during standing, with amplitudes less than 0.1 mVPP. RPNI signals were periodic and entrained with gait. A decoder predicted bilateral ankle motion with greater than 80% reliability. Control group signal activity agreed with literature. Denervated group signals remained quiescent throughout all evaluations. SIGNIFICANCE: In vivo myoelectric RPNI activity encodes neural activation patterns associated with gait. Signal contamination from muscles adjacent to the RPNI is minimal, as demonstrated by the low amplitude signals obtained from the Denervated group. The periodicity and entrainment to gait of RPNI recordings suggests the transduced signals were generated via central nervous system control.


Subject(s)
Electromyography/methods , Gait/physiology , Muscle, Skeletal/physiology , Muscle, Skeletal/transplantation , Nerve Regeneration/physiology , Peripheral Nerves/physiology , Animals , Electrodes, Implanted , Hindlimb/innervation , Hindlimb/physiology , Male , Muscle, Skeletal/innervation , Rats , Rats, Inbred F344 , Transplants/innervation , Transplants/physiology , Walking/physiology
19.
Proc Biol Sci ; 283(1824)2016 Feb 10.
Article in English | MEDLINE | ID: mdl-26865301

ABSTRACT

During the Pleistocene, Australia and New Guinea supported a rich assemblage of large vertebrates. Why these animals disappeared has been debated for more than a century and remains controversial. Previous synthetic reviews of this problem have typically focused heavily on particular types of evidence, such as the dating of extinction and human arrival, and have frequently ignored uncertainties and biases that can lead to misinterpretation of this evidence. Here, we review diverse evidence bearing on this issue and conclude that, although many knowledge gaps remain, multiple independent lines of evidence point to direct human impact as the most likely cause of extinction.


Subject(s)
Birds/physiology , Extinction, Biological , Mammals/physiology , Reptiles/physiology , Animals , Australia , Humans , New Guinea , Paleontology
20.
Ann Biomed Eng ; 44(9): 2760-73, 2016 09.
Article in English | MEDLINE | ID: mdl-26817456

ABSTRACT

Functional strength training is becoming increasingly popular when rehabilitating individuals with neurological injury such as stroke or cerebral palsy. Typically, resistance during walking is provided using cable robots or weights that are secured to the distal shank of the subject. However, there exists no device that is wearable and capable of providing resistance across the joint, allowing over ground gait training. In this study, we created a lightweight and wearable device using eddy current braking to provide resistance to the knee. We then validated the device by having subjects wear it during a walking task through varying resistance levels. Electromyography and kinematics were collected to assess the biomechanical effects of the device on the wearer. We found that eddy current braking provided resistance levels suitable for functional strength training of leg muscles in a package that is both lightweight and wearable. Applying resistive forces at the knee joint during gait resulted in significant increases in muscle activation of many of the muscles tested. A brief period of training also resulted in significant aftereffects once the resistance was removed. These results support the feasibility of the device for functional strength training during gait. Future research is warranted to test the clinical potential of the device in an injured population.


Subject(s)
Electromyography , Gait/physiology , Knee Joint/physiology , Muscle, Skeletal/physiology , Physical Fitness/psychology , Biomechanical Phenomena , Electromyography/instrumentation , Electromyography/methods , Female , Humans , Male
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