Machine Learning Identifies Chronic Low Back Pain Patients from an Instrumented Trunk Bending and Return Test.

Nowadays, the better assessment of low back pain (LBP) is an important challenge, as it is the leading musculoskeletal condition worldwide in terms of years of disability. The objective of this study was to evaluate the relevance of various machine learning (ML) algorithms and Sample Entropy (SampEn), which assesses the complexity of motion variability in identifying the condition of low back pain. Twenty chronic low-back pain (CLBP) patients and 20 healthy non-LBP participants performed 1-min repetitive bending (flexion) and return (extension) trunk movements. Analysis was performed using the time series recorded by three inertial sensors attached to the participants. It was found that SampEn was significantly lower in CLBP patients, indicating a loss of movement complexity due to LBP. Gaussian Naive Bayes ML proved to be the best of the various tested algorithms, achieving 79% accuracy in identifying CLBP patients. Angular velocity of flexion movement was the most discriminative feature in the ML analysis. This study demonstrated that: supervised ML and a complexity assessment of trunk movement variability are useful in the identification of CLBP condition, and that simple kinematic indicators are sensitive to this condition. Therefore, ML could be progressively adopted by clinicians in the assessment of CLBP patients.

Sample Entropy as a Tool to Assess Lumbo-Pelvic Movements in a Clinical Test for Low-Back-Pain Patients.

Low back pain (LBP) obviously reduces the quality of life but is also the world's leading cause of years lived with disability. Alterations in motor response and changes in movement patterns are expected in LBP patients when compared to healthy people. Such changes in dynamics may be assessed by the nonlinear analysis of kinematical time series recorded from one patient's motion. Since sample entropy (SampEn) has emerged as a relevant index measuring the complexity of a given time series, we propose the development of a clinical test based on SampEn of a time series recorded by a wearable inertial measurement unit for repeated bending and returns (b and r) of the trunk. Twenty-three healthy participants were asked to perform, in random order, 50 repetitions of this movement by touching a stool and another 50 repetitions by touching a box on the floor. The angular amplitude of the b and r movement and the sample entropy of the three components of the angular velocity and acceleration were computed. We showed that the repetitive b and r "touch the stool" test could indeed be the basis of a clinical test for the evaluation of low-back-pain patients, with an optimal duration of 70 s, acceptable in daily clinical practice.

Three-Dimensional Spinal Position With and Without Manual Distraction Load Increases Spinal Height.

OBJECTIVE: The purpose of this study was to investigate if spinal height increases using 3-dimensional (3-D) spinal position with and without manual distraction load and to assess the correlation between spine height changes and degrees of trunk rotation. METHODS: Fifty-six participants were randomly placed in one of two groups: (1) 3-D spinal position with manual distraction load, and (2) without manual distraction load. Spinal height was measured before and after the interventions using a stadiometer. For the statistical analysis, we used a 2 (Loading status: pre- versus post-intervention height) X 2 (3-D spinal position: with versus without manual distraction load) repeated measures Analysis of Variance (ANOVA) was used to identify significant interaction and main effects. Paired t-tests were used to calculate differences in spinal height changes between the two interventions. Pearson correlation coefficient was used to measure correlations between changes in spinal heights and degrees of trunk rotation. RESULTS: Mean spinal height increase with 3-D spinal position with and without manual distraction load was 6.30 mm (±6.22) and 5.69 mm (±4.13), respectively. No significant interaction effect was present between loading status and 3-D spinal position but a significant main effect in loading status was. Paired t-tests revealed significant differences in spinal heights between pre-and post-3-D spinal position with and without manual distraction load. No significant correlation was measured between trunk rotation and spinal height changes. CONCLUSION: 3-D spinal position with or without distraction load increased spinal height. This suggests that 3-D spinal positioning without manual distraction could be used in home settings to help maintain intervertebral disc (IVD) health.

Short-term increase in discs' apparent diffusion is associated with pain and mobility improvements after spinal mobilization for low back pain.

Pain perception, trunk mobility and apparent diffusion coefficient (ADC) within all lumbar intervertebral discs (IVDs) were collected before and shortly after posterior-to-anterior (PA) mobilizations in 16 adults with acute low back pain. Using a pragmatic approach, a trained orthopaedic manual physical therapist applied PA mobilizations to the participants' spine, in accordance with his examination findings. ADC all was computed from diffusion maps as the mean of anterior (ADC ant ), middle (ADC mid ), and posterior (ADC post ) portions of the IVD. After mobilization, pain ratings and trunk mobility were significantly improved and a significant increase in ADC all values was observed. The greatest ADC all changes were observed at the L3-L4 and L4-L5 levels and were mainly explained by changes in ADC ant and ADC post , respectively. No significant changes in ADC were observed at L5-S1 level. The reduction in pain and largest changes in ADC observed at the periphery of the hyperintense IVD region suggest that increased peripheral random motion of water molecules is implicated in the IVD nociceptive response modulation. Additionally, ADC changes were observed at remote IVD anatomical levels that did not coincide with the PA spinal mobilization application level.

Plasma functionalization of AFM tips for measurement of chemical interactions.

In this paper, a new, fast, reproducible technique for atomic force microscopy (AFM) tips functionalization used for chemical interaction measurements is described. Precisely, the deposition of an aminated precursor is performed through plasma-enhanced chemical vapor deposition (PECVD) in order to create amine functional groups on the AFM tip and cantilever. The advantages of the precursor, aminopropyltriethoxysilane (APTES), were recently demonstrated for amine layer formation through PECVD deposition on polymeric surfaces. We extended this procedure to functionalize AFM probes. Titration force spectroscopy highlights the successful functionalization of AFM tips as well as their stability and use under different environmental conditions.

Orientational analysis of dodecanethiol and p-nitrothiophenol SAMs on metals with polarisation-dependent SFG spectroscopy.

Polarisation-dependent sum frequency generation (SFG) spectroscopy is used to investigate the orientation of molecules on metallic surfaces. In particular, self-assembled monolayers (SAMs) of dodecanethiol (DDT) and of p-nitrothiophenol (p-NTP), grown on Pt and on Au, have been chosen as models to highlight the ability of combining ppp and ssp polarisations sets (representing the polarisation of the involved beams in the conventional order of SFG, Vis and IR beam) to infer orientational information at metallic interfaces. Indeed, using only the ppp set of data, as it is usually done for metallic surfaces, is not sufficient to determine the full molecular orientation. We show here that simply combining ppp and ssp polarisations enables both the tilt and rotation angles of methyl groups in DDT SAMs to be determined. Moreover, for p-NTP, while the SFG active vibrations detected with the ppp polarisation alone provide no orientational information, however, the combination with ssp spectra enables to retrieve the tilt angle of the p-NTP 1,4 axis. Though orientational information obtained by polarisation-dependent measurements has been extensively used at insulating interfaces, we report here their first application to metallic surfaces.

Theoretical simulation of vibrational sum-frequency generation spectra from density functional theory: application to p-nitrothiophenol and 2,4-dinitroaniline.

The molecular orientation of adsorbed molecules forming self-assembled monolayers can be determined by combining vibrational sum-frequency generation (SFG) measurements with quantum chemical calculations. Herein, we present a theoretical methodology used to simulate the SFG spectra for different combinations of polarizations. These simulations are based on calculations of the IR vectors and Raman tensors, which are obtained from density functional theory computations. The dependency of the SFG vibrational signature with respect to the molecular orientation is presented for the molecules p-nitrothiophenol and 2,4-dinitroaniline. It is found that a suitable choice of basis set as well as of exchange-correlation (XC) functional is mandatory to correctly simulate the SFG intensities and consequently provide an accurate estimation of the adsorbed molecule orientation. Comparison with experimental data shows that calculations performed at the B3LYP/6-311++G(d,p) level of approximation provide good agreement with experimental frequencies, and with IR and Raman intensities. In particular, it is demonstrated that polarization and diffuse functions are compulsory for reproducing the IR and Raman spectra, and consequently vibrational SFG spectra, of systems such as p-nitrothiophenol. Moreover, the investigated XC functionals reveal their influence on the relative intensities, which show rather systematic variations with the amount of Hartree-Fock exchange. Finally, further aspects of the modeling are revealed by considering the frequency dependence of the Raman tensors.

Another patient with a de novo deletion further delineates the 2q33.1 microdeletion syndrome.

A male patient, who had intra-uterine growth retardation, a low birth weight and hypotonia due to a chromosome 2q33.1 deletion, is described. At the age of 20 years, he displays short stature, microcephaly, a high forehead, microstomia, large teeth and is hypertonic. He is severely mentally retarded, has not developed speech, is hyperactive, anxious and at times aggressive. Full tiling array showed a de novo 14 Mb deletion at chromosome region 2q32.3q33.2, further delineating the 2q33.1 microdeletion syndrome.

Adsorption properties of the penicillin derivative DTPA on gold substrates.

Despite the large number of articles and patents dealing with penicillin and other beta-lactam antibiotics, there have been no reports about the self-assembly of such substances as monolayers on gold surfaces. The main reason stems from the high reactivity of the beta-lactam ring, which hinders the development of molecules possessing this entity together with a metal-anchoring function. Herein, we present the synthesis of a novel molecule, 6-[(R,S)-5-(1,2-dithiolan-3-yl)pentanoyl-amino]-penicillanic acid, which combines the beta-lactam ring and a metal-anchoring group. Using spectroscopic tools, we demonstrate the chemisorption of this compound on gold as self-assembled monolayers without any alteration of the penicillin pharmacophore and document its reactivity towards a penicillin-binding protein, BlaR-CTD. Our work is a preliminary step towards the development of new biosensors and well-ordered protein arrays, both based on the high affinity of penicillin for penicillin-binding proteins.

Sum-frequency generation spectroscopy of DNA monolayers.

The anchoring of thiolated single-stranded DNA (HS-ssDNA) monolayers onto platinum substrates was investigated by sum-frequency generation spectroscopy. Different buffer solutions were used for the preparation of the adlayers. Vibrational fingerprints in the 2700-3100 cm(-1) spectral range showed the intercalation of Tris/EDTA (TE) buffer molecules within the HS-ssDNA self-assembled monolayer. Buffer contribution to SFG can be quenched either by using SFG inactive molecules like KH(2)PO(4)/K(2)HPO(4)/NaCl (PBS) or by repeated rinsing of the DNA layer with pure water. Comparing the SFG spectra of HS-ssDNA and mercaptohexanol (MCH), which had been self-assembled onto the same substrate, enabled us to infer ordering of the anchor arms and strong disordering of the DNA strands of HS-ssDNA monolayers self-assembled on platinum.

Follow-up of adult males with chromosome 18p deletion.

The 18p- syndrome has been known for over 40 years, the first report being by de Grouchy et al. [Comptes Rendus Hebdomadaires Séances l'Acad Sci 256 (1963) 1028]. Mental retardation of varying severity is the most constant feature. Over 100 cases have been reported. The eldest patients have been 50 years [Hum Genet 63 (1983) 139; Clin Genet 2 (1971) 338]. Follow-up of two adult patients, then 22 and 42 years [Ann Génét 29 (1986) 107], now 42 and 62 years of age, is reported. Further case reports are required in order to better define the evolution of adult patients with the 18p- syndrome.

Use of specific functionalised tips with STM: a new identification method of ester groups and their molecular structure in self-assembled overlayers.

The influence of chemical modification of scanning tunnelling microscopy tips on image contrast is studied. This technique is applied to the identification of an ester functional group, hardly visible otherwise. Self-assembled overlayers of wax esters [CH3-(CH2)14-CO-O-(CH2)15-CH3], adsorbed at the interface between highly oriented pyrolitic graphite and a solution of phenyloctane, are imaged. The gold tips used are chemically modified by 4-mercaptobenzoic acid and 4-mercaptotoluene. The stability of the ordered overlayers formed facilitates the reproducible set of images with submolecular resolution. This allows the identification of the layer regular structure and of other features within molecules, which can be unambiguously related to the fingerprints of the COO bond. Moreover, we are interested in finding evidence of molecular motions observed at domain boundaries.

Probing ligand-protein recognition with sum-frequency generation spectroscopy: the avidin-biocytin case.

Infrared/visible sum-frequency generation (SFG) spectroscopy is used to study the recognition of a protein (avidin) by a derived vitamin (biocytin) adsorbed on a calcium fluoride substrate. The specificity of the process is tested by replacing avidin with bovine serum albumin or presaturated avidin. The SFG spectroscopy shows drastic modifications in the CH and NH spectral ranges only upon exposure of the biocytin film to avidin. The comparison of the SFG data with Fourier transform infrared reflection absorption spectra (FT-IRRAS) in the same spectral ranges illustrates the advantages of nonlinear spectroscopy for studying and detecting recognition between biomolecules.

Severe myoclonic epilepsy in infancy: toward an optimal treatment.

Severe myoclonic epilepsy in infancy, or Dravet syndrome, is one of the catastrophic epilepsy syndromes. In the past, treatment was mainly based on valproate and phenobarbital. Recently, some of the new antiepilepsy drugs, such as topiramate and stiripentol, have been shown to be promising in the treatment of this epilepsy syndrome. The treatment regimen of 12 children with Dravet syndrome and proven mutations in the alpha subunit of the sodium channel SCN1A is reported here. Five patients on the "traditional" treatment regimen are compared with seven children on an "optimal" treatment regimen based on a combination of valproate and topiramate. With respect to the literature and our own experience, we propose guidelines for "optimal" treatment of children with severe myoclonic epilepsy in infancy. This includes prevention of hyperthermia, rigorous treatment of fever, avoiding stressful situations, maintenance treatment based on a combination of only two antiepilepsy drugs (ie, valproate and topiramate), and a strict acute seizure treatment based on benzodiazepines. To prevent long-lasting periods of status epilepticus, this acute seizure treatment must be taught to parents and caregivers.

Picosecond laser for performance of efficient nonlinear spectroscopy from 10 to 21 microm.

Laser tunability from 10 to 21 microm is obtained by use of an optical parametric oscillator based on a KTP crystal followed by a difference-frequency stage with a CdSe crystal. An all-solid-state picosecond Nd:YAG oscillator mode locked by a frequency-doubling nonlinear mirror is used for synchronous pumping.

De novo SCN1A mutations are a major cause of severe myoclonic epilepsy of infancy.

Severe myoclonic epilepsy of infancy (SMEI or Dravet syndrome) is a rare disorder occurring in young children often without a family history of a similar disorder. The earliest disease manifestations are usually fever-associated seizures. Later in life, patients display different types of afebrile seizures including myoclonic seizures. Arrest of psychomotor development occurs in the second year of life and most patients become ataxic. Patients are resistant to antiepileptic drug therapy. Recently, we described de novo mutations of the neuronal sodium channel alpha-subunit gene SCN1A in seven isolated SMEI patients. To investigate the contribution of SCN1A mutations to the etiology of SMEI, we examined nine additional SMEI patients. We observed eight coding and one noncoding mutation. In contrast to our previous study, most mutations are missense mutations clustering in the S4-S6 region of SCN1A. These findings demonstrate that de novo mutations in SCN1A are a major cause of isolated SMEI.