Spinal cord stimulation and deep brain stimulation for disorders of consciousness: a systematic review and individual patient data analysis of 608 cases.

The application of spinal cord stimulation (SCS) and deep brain stimulation (DBS) for disorders of consciousness (DoC) has been increasingly reported. However, there is no sufficient evidence to determine how effective and safe SCS and DBS are for DoC owing to various methodological limitations. We conducted a systematic review to elucidate the safety and efficacy of SCS and DBS for DoC by systematically reviewing related literature by searching PubMed, EMBASE, Medline, and Cochrane Library. Twenty eligible studies with 608 patients were included in this study. Ten studies with 508 patients reported the efficacy of SCS for DoC, and the estimated overall effectiveness rate was 37%. Five studies with 343 patients reported the efficacy of SCS for VS, and the estimated effectiveness rate was 30%. Three studies with 53 patients reported the efficacy of SCS for MCS, and the estimated effectiveness rate was 63%. Five studies with 92 patients reported the efficacy of DBS for DoC, and the estimated overall effectiveness rate was 40%. Four studies with 63 patients reported the efficacy of DBS for VS, and the estimated effectiveness rate was 26%. Three studies with 19 patients reported the efficacy of DBS for MCS, and the estimated effectiveness rate was 74%. The adverse event rate of DoC was 8.1% and 18.2% after SCS and DBS, respectively. These results suggest that SCS and DBS can be considered reasonable treatments for DoC with considerable efficacy and safety.

Dynamic traversal of large gaps by insects and legged robots reveals a template.

It is well known that animals can use neural and sensory feedback via vision, tactile sensing, and echolocation to negotiate obstacles. Similarly, most robots use deliberate or reactive planning to avoid obstacles, which relies on prior knowledge or high-fidelity sensing of the environment. However, during dynamic locomotion in complex, novel, 3D terrains, such as a forest floor and building rubble, sensing and planning suffer bandwidth limitation and large noise and are sometimes even impossible. Here, we study rapid locomotion over a large gap-a simple, ubiquitous obstacle-to begin to discover the general principles of the dynamic traversal of large 3D obstacles. We challenged the discoid cockroach and an open-loop six-legged robot to traverse a large gap of varying length. Both the animal and the robot could dynamically traverse a gap as large as one body length by bridging the gap with its head, but traversal probability decreased with gap length. Based on these observations, we developed a template that accurately captured body dynamics and quantitatively predicted traversal performance. Our template revealed that a high approach speed, initial body pitch, and initial body pitch angular velocity facilitated dynamic traversal, and successfully predicted a new strategy for using body pitch control that increased the robot's maximal traversal gap length by 50%. Our study established the first template of dynamic locomotion beyond planar surfaces, and is an important step in expanding terradynamics into complex 3D terrains.