Towards Visual-Tactile Integration of Shoulder and Hand Using Immersive Virtual Reality.

Shoulder-controlled hand neuroprostheses are wearable devices designed to assist hand function in people with cervical spinal cord injury (SCI). They use preserved shoulder movements to control artificial actuators. Due to the concurrent afferent (i.e., shoulder proprioception) and visual (i.e., hand response) feedback, these wearables may affect the user's body somatosensory representation. To investigate this effect, we propose an experimental paradigm that uses immersive virtual reality (VR) environment to emulate the use of a shoulder-controlled hand neuroprostheses and an adapted version of a visual-tactile integration task (i.e., Crossmodal Congruency Task) as an assessment tool. Data from seven non-disabled participants validates the experimental setup, with preliminary statistical analysis revealing no significant difference across the means of VR and visual-tactile integration tasks. The results serve as a proof-of-concept for the proposed paradigm, paving the way for further research with improvements in the experimental design and a larger sample size.

Analysis of Motor Control and Learning in Human-Robot Interaction during Game Guided Movements.

Robotic devices can be used in upper limb rehabilitation in order to help the total or partial functional recovery. Robots can perform repetitive activities for a long period of time, which may be beneficial for rehabilitation processes. In this context, this study uses a bi-manual robotic device to investigate motor learning and control for the upper limbs among different game guided tasks, and inspect the user's grip force exerted in response to perturbations. The robotic device resembles a bicycle handlebar, instrumented with load cells to measure torques and grip forces. It is equipped with a DC motor to apply external torques to the guiding system. A game was developed containing in-game and physical perturbations to the natural movement of the handlebar. Tests were carried out with 16 healthy subjects that were instructed to move the handlebar guiding a character displayed on the screen with the objective of collecting tokens to get the higher score in the game. During the trials, corresponding data from the game and the load cells were collected and used to infer the learning process, the mean error in the trajectory and the variations in the force applied to the handles of the handlebar. Analyses showed that there was learning in the first repetitions, and the learning was retained further. The higher values of the grip force occurred when there was a physical perturbation to the handlebar's natural movement. The larger errors in the trajectories occurred immediately after the perturbations ended. In conclusion, there was a performance improvement, probably related to learning. The increase of the mean error at the transitions of the perturbations indicates the need for adaptation to the new conditions of the task.

Soft robotics and functional electrical stimulation advances for restoring hand function in people with SCI: a narrative review, clinical guidelines and future directions.

BACKGROUND: Recovery of hand function is crucial for the independence of people with spinal cord injury (SCI). Wearable devices based on soft robotics (SR) or functional electrical stimulation (FES) have been employed to assist the recovery of hand function both during activities of daily living (ADLs) and during therapy. However, the implementation of these wearable devices has not been compiled in a review focusing on the functional outcomes they can activate/elicit/stimulate/potentiate. This narrative review aims at providing a guide both for engineers to help in the development of new technologies and for clinicians to serve as clinical guidelines based on the available technology in order to assist and/or recover hand function in people with SCI. METHODS: A literature search was performed in Scopus, Pubmed and IEEE Xplore for articles involving SR devices or FES systems designed for hand therapy or assistance, published since 2010. Only studies that reported functional outcomes from individuals with SCI were selected. The final collections of both groups (SR and FES) were analysed based on the technical aspects and reported functional outcomes. RESULTS: A total of 37 out of 1101 articles were selected, 12 regarding SR and 25 involving FES devices. Most studies were limited to research prototypes, designed either for assistance or therapy. From an engineering perspective, technological improvements for home-based use such as portability, donning/doffing and the time spent with calibration were identified. From the clinician point of view, the most suitable technical features (e.g., user intent detection) and assessment tools should be determined according to the particular patient condition. A wide range of functional assessment tests were adopted, moreover, most studies used non-standardized tests. CONCLUSION: SR and FES wearable devices are promising technologies to support hand function recovery in subjects with SCI. Technical improvements in aspects such as the user intent detection, portability or calibration as well as consistent assessment of functional outcomes were the main identified limitations. These limitations seem to be be preventing the translation into clinical practice of these technological devices created in the laboratory.

Handlebar Robotic System for Bimanual Motor Control and Learning Research.

Robotic devices can be used for motor control and learning research. In this work, we present the construction, modeling and experimental validation of a bimanual robotic device. We tested some hypotheses that may help to better understand the motor learning processes involved in the interlimb coordination function. The system emulates a bicycle handlebar with rotational motion, thus requiring bilateral upper limb control and a coordinated sequence of joint sub-movements. The robotic handlebar is compact and portable and can register in a fast rate both position and forces independently from arms, including prehension forces. An impedance control system was implemented in order to promote a safer environment for human interaction and the system is able to generate force fields, suitable for implementing motor learning paradigms. The novelty of the system is the decoupling of prehension and manipulation forces of each hand, thus paving the way for the investigation of hand dominance function in a bimanual task. Experiments were conducted with ten healthy subjects, kinematic and dynamic variables were measured during a rotational set of movements. Statistical analyses showed that movement velocity decreased with practice along with an increase in reaction time. This suggests an increase of the task planning time. Prehension force decreased with practice. However, an unexpected result was that the dominant hand did not lead the bimanual task, but helped to correct the movement, suggesting different roles for each hand during a cooperative bimanual task.

Correlation between Type of Clefting and the Incidence of Otitis Media among Children with Lip and/or Palate Clefts.

INTRODUCTION: Otitis media is a frequent condition among children with high morbidity. Orofacial clefts are undoubtedly one of the most well-established risk factors for otitis media during childhood. The clinical spectrum of disease in orofacial clefting is broad according to the subtype of malformation. This study aims to correlate the occurrence of otitis media among lip and/or palate cleft children with clinical and epidemiological parameters, in particular with the subtypes of malformation diagnosed. METHODS: This is a clinical, retrospective, case-control type of study. Epidemiological and clinical data were obtained from medical records of children born between 2005 and 2008 and attending a multidisciplinary center for cleft patients. RESULTS: 53% of the patients had registers of middle ear disorder during follow-up, and secretory otitis media was the most frequently diagnosed condition. Five children (1.39%) had chronic otitis media during the study period. Those patients with malformations including involvement of structures located posteriorly to the incisive foramen were more frequently diagnosed with otitis media than those with isolated pre-foramen cleft (p value < 0.001, odds ratio: 5.33). Gender and bilateral malformations did not correlate with increased occurrence of middle ear disease (p value > 0.05). CONCLUSION: Otitis media is frequent among lip and/or palate cleft children, although the grade of middle ear involvement seems to vary widely within this population. Post-foraminal malformations are clearly associated with increased incidence of otitis media, as well as with more severe diseases.

Preserving fibre health: reducing oxidative stress throughout the life of the hair fibre.

Hair health is an important attribute to women globally--specifically attributes such as shine, healthy tips, frizz-free and strength. However, many women will claim to have at least moderate hair damage caused by habits and practices such as washing, combing and brushing, use of heated implements and regular use of chemical treatments. The objective of this work was to investigate two mechanisms of damage--hair colouring and UV exposure--where oxidative processes are involved. The role of copper in these oxidative processes was then investigated: its presence in hair and its consequent impact on hair damage via free radical formation. Finally, the role of chelants N,N'-ethylene diamine disuccinic acid (EDDS) and histidine in preventing free radical formation was investigated and shown to improve hair health.

Collection and preparation of blood products.

Blood-component therapy has become an integral part of veterinary practice. Although access to veterinary blood banks has increased, practitioners may prefer to create their own blood-donor program to provide for their blood-product needs or to respond to an emergent need. Before embarking on such an endeavor, it is important to understand the techniques and requirements for such a program. This article will discuss issues in donor selection and management, supplies and techniques of blood-component acquisition, and supplies and techniques of blood-component preparation.

Roles of hilC and hilD in regulation of hilA expression in Salmonella enterica serovar Typhimurium.

Sequences between -332 and -39 upstream of the hilA promoter are required for repression of hilA. An unidentified repressor is thought to bind these upstream repressing sequences (URS) to inhibit hilA expression. Two AraC-like transcriptional regulators encoded on Salmonella pathogenicity island 1 (SPI1), HilC and HilD, bind to the URS to counteract the repression of hilA. The URS is required for regulation of hilA by osmolarity, oxygen, PhoP/PhoQ, and SirA/BarA. Here, we show that FadD, FliZ, PhoB, and EnvZ/OmpR also require the URS to regulate hilA. These environmental and regulatory factors may affect hilA expression by altering the expression or activity of HilC, HilD, or the unknown repressor. To begin investigating these possibilities, we tested the effects of environmental and regulatory factors on hilC and hilD expression. We also examined hilA regulation when hilC or hilD was disrupted or expressed to a high level. Although hilC is regulated by all environmental conditions and regulatory factors that modulate hilA expression, hilC is not required for the regulation of hilA by any conditions or factors except EnvZ/OmpR. In contrast, hilD is absolutely required for hilA expression, but environmental conditions and regulatory factors have little or no effect on hilD expression. We speculate that EnvZ/OmpR regulates hilA by altering the expression and/or activity of hilC, while all other regulatory conditions and mutations regulate hilA by modulating hilD posttranscriptionally. We also discuss models in which the regulation of hilA expression is mediated by modulation of the expression or activity of one or more repressors.

Unravelling the mysteries of virulence gene regulation in Salmonella typhimurium.

Salmonella typhimurium, which causes gastroenteritis in calves and humans as well as a typhoid-like disease in mice, uses numerous virulence factors to infect its hosts. Genes encoding these factors are regulated by many environmental conditions and regulatory pathways in vitro. Many virulence genes are specifically induced at particular sites during infection or in cultured host cells. The complex regulation of virulence genes observed in vitro may be necessary to restrict their expression to specific locations within the host. In vitro and in vivo studies provide clues about how virulence genes might be regulated in vivo. Future studies must assess the actual environmental signals and regulators that modulate each virulence gene in vivo and determine how multiple regulatory pathways are integrated to co-ordinate the appropriate expression of virulence factors at specific sites in vivo.

Multiple factors independently regulate hilA and invasion gene expression in Salmonella enterica serovar typhimurium.

HilA activates the expression of Salmonella enterica serovar Typhimurium invasion genes. To learn more about regulation of hilA, we isolated Tn5 mutants exhibiting reduced hilA and/or invasion gene expression. In addition to expected mutations, we identified Tn5 insertions in pstS, fadD, flhD, flhC, and fliA. Analysis of the pstS mutant indicates that hilA and invasion genes are repressed by the response regulator PhoB in the absence of the Pst high-affinity inorganic phosphate uptake system. This system is required for negative control of the PhoR-PhoB two-component regulatory system, suggesting that hilA expression may be repressed by PhoR-PhoB under low extracellular inorganic phosphate conditions. FadD is required for uptake and degradation of long-chain fatty acids, and our analysis of the fadD mutant indicates that hilA is regulated by a FadD-dependent, FadR-independent mechanism. Thus, fatty acid derivatives may act as intracellular signals to regulate hilA expression. flhDC and fliA encode transcription factors required for flagellum production, motility, and chemotaxis. Complementation studies with flhC and fliA mutants indicate that FliZ, which is encoded in an operon with fliA, activates expression of hilA, linking regulation of hilA with motility. Finally, epistasis tests showed that PhoB, FadD, FliZ, SirA, and EnvZ act independently to regulate hilA expression and invasion. In summary, our screen has identified several distinct pathways that can modulate S. enterica serovar Typhimurium's ability to express hilA and invade host cells. Integration of signals from these different pathways may help restrict invasion gene expression during infection.

Co-ordinate regulation of Salmonella typhimurium invasion genes by environmental and regulatory factors is mediated by control of hilA expression.

During infection of their hosts, salmonellae enter intestinal epithelial cells. It has been proposed that when Salmonella typhimurium is present in the intestinal lumen, several environmental and regulatory conditions modulate the expression of invasion factors required for bacterial entry into host cells. We report here that the expression of six different S. typhimurium invasion genes encoded on SPI1 (Salmonella pathogenicity island 1) is co-ordinately regulated by oxygen, osmolarity, pH, PhoPQ, and HilA. HilA is a transcriptional activator of the OmpR/ToxR family that is also encoded on SPI1. We have found that HilA plays a central role in the co-ordinated regulation of invasion genes by environmental and regulatory conditions. HilA can activate the expression of two invasion gene-lacZY fusions on reporter plasmids in Escherichia coll, suggesting that HilA acts directly at invasion-gene promoters in S. typhimurium. We have found that the regulation of invasion genes by oxygen, osmolarity, pH, and PhoPQ is indirect and is mediated by regulation of hilA expression by these environmental and regulatory factors. We hypothesize that the complex and co-ordinate regulation of Invasion genes by HilA is an important feature of salmonella pathogenesis and allows salmonellae to enter intestinal epithelial cells.

Astroglia proliferate in response to oxytocin and vasopressin.

The effects of the peptides oxytocin and vasopressin on the proliferation of cultured cortical and hypothalamic astroglia were assessed by two corroborative methods. Both hemocytometer cell counts, and immunocytochemistry for bromodeoxyuridine (BrdU) incorporation and glial fibrillary acidic protein (GFAP) expression indicate that oxytocin increases the rate of proliferation of both cortical and hypothalamic astroglia. While vasopressin also had an effect on cortical cells, no conclusive evidence for vasopressin affecting proliferation of hypothalamic astroglia was found.