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Sample records for hybrid assistive limb

  1. Use of Hybrid Assistive Limb (HAL®) for a postoperative patient with cerebral palsy: a case report.

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    Mataki, Yuki; Kamada, Hiroshi; Mutsuzaki, Hirotaka; Shimizu, Yukiyo; Takeuchi, Ryoko; Mizukami, Masafumi; Yoshikawa, Kenichi; Takahashi, Kazushi; Matsuda, Mayumi; Iwasaki, Nobuaki; Kawamoto, Hiroaki; Wadano, Yasuyoshi; Sankai, Yoshiyuki; Yamazaki, Masashi

    2018-03-27

    The Hybrid Assistive Limb (HAL ® ) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. There have been several studies on HAL intervention effects in stroke, spinal cord injury, and cerebral palsy. However, no study has investigated HAL intervention for patients with cerebral palsy after surgery. We report a case of using HAL in a postoperative patient with cerebral palsy. A 15-year-old boy was diagnosed with spastic diplegia cerebral palsy Gross Motor Function Classification System level IV, with knee flection contracture, equinus foot, and paralysis of the right upper extremity with adduction contracture. He underwent tendon lengthening of the bilateral hamstrings and Achilles tendons. Although the flexion contractures of the bilateral knees and equinus foot improved, muscle strength decreased after the soft tissue surgery. HAL intervention was performed twice during postoperative months 10 and 11. Walking speed, stride, and cadence were increased after HAL intervention. Post HAL intervention, extension angles of the knee in stance phase and hip in the pre-swing phase were improved. In the gait cycle, the proportion of terminal stance in the stance and swing phase was increased. Hybrid Assistive Limb intervention for postoperative patients with cerebral palsy whose muscle strength decreases can enhance improvement in walking ability. Further studies are needed to examine the safety and potential application of HAL in this setting.

  2. Clinical application of the Hybrid Assistive Limb (HAL) for gait training-a systematic review.

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    Wall, Anneli; Borg, Jörgen; Palmcrantz, Susanne

    2015-01-01

    The aim of this study was to review the literature on clinical applications of the Hybrid Assistive Limb system for gait training. A systematic literature search was conducted using Web of Science, PubMed, CINAHL and clinicaltrials.gov and additional search was made using reference lists in identified reports. Abstracts were screened, relevant articles were reviewed and subject to quality assessment. Out of 37 studies, 7 studies fulfilled inclusion criteria. Six studies were single group studies and 1 was an explorative randomized controlled trial. In total, these studies involved 140 participants of whom 118 completed the interventions and 107 used HAL for gait training. Five studies concerned gait training after stroke, 1 after spinal cord injury (SCI) and 1 study after stroke, SCI or other diseases affecting walking ability. Minor and transient side effects occurred but no serious adverse events were reported in the studies. Beneficial effects on gait function variables and independence in walking were observed. The accumulated findings demonstrate that the HAL system is feasible when used for gait training of patients with lower extremity paresis in a professional setting. Beneficial effects on gait function and independence in walking were observed but data do not allow conclusions. Further controlled studies are recommended.

  3. Hybrid Assistive Limb (HAL) Rehabilitation in Patients with Acute Hemorrhagic Stroke.

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    Ogata, Toshiyasu; Abe, Hiroshi; Samura, Kazuhiro; Hamada, Omi; Nonaka, Masani; Iwaasa, Mitsutoshi; Higashi, Toshio; Fukuda, Hiroyuki; Shiota, Etsuji; Tsuboi, Yoshio; Inoue, Tooru

    2015-01-01

    The efficacy of hybrid assistive limb (HAL) rehabilitation in the acute phase of stroke remains unclear. The purpose of this study was to evaluate the outcomes of patients with acute intracranial hemorrhage (ICH) who were treated with or without HAL rehabilitation. Among 270 patients with acute ICH from 2009 to 2014, 91 patients with supratentorial ICH were included in this retrospective study. Of these, 14 patients (HAL group) received HAL rehabilitation at approximately 1 week after ICH occurrence, while the remaining 77 patients received usual rehabilitation without HAL (N-HAL group). We obtained various patient data from the hospitals where the patients were moved to for further rehabilitation. Statistical comparisons were performed for the characteristics of the ICH patients, and outcomes between the HAL and N-HAL groups. There were no differences in outcomes between the HAL and N-HAL groups. However, patients with right ICH in the HAL group exhibited a significant association with a functional independence measure (FIM) score of ≥ 110 compared with patients in the N-HAL group (HAL group: 81.8%, N-HAL group: 43.9%, P = 0.04). In patients with right ICH, HAL rehabilitation was associated with improved outcomes as evaluated by the FIM score. Thus, HAL rehabilitation may improve outcomes of acute ICH in appropriately selected patients.

  4. Gait training using a hybrid assistive limb (HAL) attenuates head drop: A case report.

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    Miura, Kousei; Koda, Masao; Kadone, Hideki; Kubota, Shigeki; Shimizu, Yukiyo; Kumagai, Hiroshi; Nagashima, Katsuya; Mataki, Kentaro; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Abe, Tetsuya; Sankai, Yoshiyuki; Yamazaki, Masashi

    2018-03-31

    Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. A standardized treatment strategy for DHS has not been established. To our knowledge, this is the first case report describing the efficacy of gait training using a hybrid assistive limb (HAL) for DHS. A 75-year-old man showed apparent head drop in a standing position, resulting in passively reducible chin-on-chest deformity. A radiograph image showed apparent cervical kyphosis. Center of gravity of the head (CGH)-C7 SVA was +115 mm, CL was -40°, and T1S 39°. The patient underwent a treatment program using HAL, in which gait training was mainly performed, 60 min a day, 5 days a week for 2 weeks (10 sessions). After 2-3 sessions, dropped head started to attenuate. At the end of 10 sessions, the patient was able to walk with normal posture and radiograph images showed cervical kyphosis dramatically decreased because of HAL training. CGH-C7 SVA was 42 mm, CL was -1.7°, and T1S was 30°. Three months' outpatient follow-up revealed a slight deterioration of cervical alignment. However, the patient was able to maintain a better cervical alignment than before HAL training and keep walking with forward vision. There were no complications in any HAL treatment session. In conclusion, gait training using HAL is an option for treatment of DHS in addition to previously reported neck extensor muscle training. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Immediate effects of a single session of robot-assisted gait training using Hybrid Assistive Limb (HAL) for cerebral palsy.

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    Matsuda, Mayumi; Mataki, Yuki; Mutsuzaki, Hirotaka; Yoshikawa, Kenichi; Takahashi, Kazushi; Enomoto, Keiko; Sano, Kumiko; Mizukami, Masafumi; Tomita, Kazuhide; Ohguro, Haruka; Iwasaki, Nobuaki

    2018-02-01

    [Purpose] Robot-assisted gait training (RAGT) using Hybrid Assistive Limb (HAL, CYBERDYNE) was previously reported beneficial for stroke and spinal cord injury patients. Here, we investigate the immediate effect of a single session of RAGT using HAL on gait function for cerebral palsy (CP) patients. [Subjects and Methods] Twelve patients (average age: 16.2 ± 7.3 years) with CP received a single session of RAGT using HAL. Gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle were assessed before, during, and immediately after HAL intervention. [Results] Compared to baseline values, single-leg support per gait cycle (64.5 ± 15.8% to 69.3 ± 12.1%), hip extension angle in mid-stance (149.2 ± 19.0° to 155.5 ± 20.1°), and knee extension angle in mid-stance (137.6 ± 20.2° to 143.1 ± 19.5°) were significantly increased immediately after intervention. Further, the knee flexion angle in mid-swing was significantly decreased immediately after treatment (112.0 ± 15.5° to 105.2 ± 17.1°). Hip flexion angle in mid-swing also decreased following intervention (137.2 ± 14.6° to 129.7 ± 16.6°), but not significantly. Conversely, gait speed, step length, and cadence were unchanged after intervention. [Conclusion] A single-time RAGT with HAL improved single-leg support per gait cycle and hip and knee joint angle during gait, therapeutically improving gait function in CP patients.

  6. The effect of a hybrid assistive limb® on sit-to-stand and standing patterns of stroke patients

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    Kasai, Rie; Takeda, Sunao

    2016-01-01

    [Purpose] The Hybrid Assistive Limb® (HAL®) robot suit is a powered exoskeleton that can assist a user’s lower limb movement. The purpose of this study was to assess the effectiveness of HAL® in stroke rehabilitation, focusing on the change of the sit-to-stand (STS) movement pattern and standing posture. [Subjects and Methods] Five stroke patients participated in this study. Single leg HAL® was attached to each subject’s paretic lower limb. The subjects performed STS three times both with and without HAL® use. A tri-axial accelerometer was used to assess the STS movement pattern. Forward-tilt angle (FTA) and the time required for STS were measured with and without HAL® use. Surface electromyography (EMG) of STS and standing were recorded to assess the vastus medialis muscle activities of the paretic limb. [Results] The average FTA without HAL® use was 35° and it improved to 43° with HAL® use. The time required for STS was longer for all subjects with HAL® use (without HAL® use: 3.42 s, with HAL® use: 5.11 s). The integrated EMGs of HAL® use compared to those without HAL®, were 83.6% and 66.3% for STS and standing, respectively. [Conclusion] HAL® may be effective in improving STS and standing patterns of stroke patients. PMID:27390416

  7. Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

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    Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

    2016-01-01

    This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

  8. Biofeedback effect of hybrid assistive limb in stroke rehabilitation: A proof of concept study using functional near infrared spectroscopy.

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    Kazuya Saita

    Full Text Available Robot-assisted rehabilitation has been increasingly drawing attention in the field of neurorehabilitation. The hybrid assistive limb (HAL is an exoskeleton robot developed based on the "interactive biofeedback" theory, and several studies have shown its efficacy for patients with stroke. We aimed to investigate the mechanisms of the facilitative effect of neurorehabilitation using a single-joint HAL (HAL-SJ and functional near-infrared spectroscopy (fNIRS.Subacute stroke patients admitted to our hospital were assessed in this study for HAL eligibility. We evaluated motor-related cortical activity using an fNIRS system at baseline and immediately after HAL-SJ treatment on the same day. Cortical activity was determined through the relative changes in the hemoglobin concentrations. For statistical analysis, we compared the number of flexion/extension movements before and immediately after HAL-SJ treatment using paired t-test. fNIRS used both the methods of statistical parametric mapping and random effect analysis.We finally included 10 patients (eight men, two women; mean age: 66.8 ± 12.0 years. The mean number of flexion/extension movements within 15 s increased significantly from 4.2 ± 3.1 to 5.3 ± 4.1 immediately after training. fNIRS showed increased cortical activation in the primary motor cortex of the ipsilesional hemisphere immediately after HAL-SJ treatment compared to the baseline condition.This study is the first to support the concept of the biofeedback effect from the perspective of changes in cortical activity measured with an fNIRS system. The biofeedback effect of HAL immediately increased the task-related cortical activity, and this may address the functional recovery. Further studies are warranted to support our findings.

  9. Active elbow flexion is possible in C4 quadriplegia using hybrid assistive limb (HAL®) technology: A case study.

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    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Ikumi, Akira; Abe, Tetsuya; Marushima, Aiki; Ueno, Tomoyuki; Endo, Ayumu; Kawamoto, Hiroaki; Saotome, Kousaku; Matsushita, Akira; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2017-07-01

    Patients with complete quadriplegia after high cervical spinal cord injury are fully dependent with activities of daily living. Assistive technology can improve their quality of life. We examined the use of a hybrid assistive limb for single joints (HAL-SJ) in a 19-year-old man with complete C4 quadriplegia due to chronic spinal cord injury to restore function of active elbow flexion. This is the first report on the use of the HAL-SJ in a patient with spinal cord injury. The HAL-SJ intervention for each elbow was administered in 10 sessions. Clinical assessment using surface EMG was conducted to evaluate muscle activity of the trapezius, biceps brachii, infraspinatus, and triceps brachii muscle before, and during the 2nd, 3rd, 6th, and 9th interventions. Surface electromyography (EMG) before intervention showed no contraction in the upper arms, but in the bilateral trapezius. The HAL-SJ used motion intention from the right trapezius for activation. After the 6th and 7th session, respectively, biceps EMG showed that voluntary contraction and right elbow flexion could be performed by motion intention from the right biceps. After the 10th session, voluntary bicep contraction was possible. HAL-SJ treatment on the left elbow was performed using the same protocol with a similar outcome. After completing treatment on both upper extremities, both biceps contracted voluntarily, and he could operate a standard wheelchair for a short distance independently. HAL-SJ intervention is feasible and effective in restoring elbow flexor function in a patient with C4 chronic spinal cord injury and complete quadriplegia.

  10. Interactive Bio-feedback Therapy Using Hybrid Assistive Limbs for Motor Recovery after Stroke: Current Practice and Future Perspectives.

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    Morishita, Takashi; Inoue, Tooru

    2016-10-15

    Interactive bio-feedback (iBF) was initially developed for the rehabilitation of motor function in patients with neurological disorders, and subsequently yielded the development of the hybrid assistive limb (HAL). Here, we provide a review of the theory underlying HAL treatment as well as our clinical experience and recommendations for future clinical studies using HAL in acute stroke patients. We performed a PubMed-based literature search, a retrospective data review of our acute stroke case series, and included a sample case report of our findings. Given past animal studies and functional imaging results, iBF therapy using the HAL in the acute phase of stroke seems an appropriate approach for preventing learned non-use and interhemispheric excitation imbalances. iBF therapy may furthermore promote appropriate neuronal network reorganization. Based on experiences in our stroke center, HAL rehabilitation is a safe and effective treatment modality for recovering motor impairments after acute stroke, and allows the design of tailored rehabilitation programs for individual patients. iBF therapy through the HAL system seems to be an effective and promising approach to stroke rehabilitation; however, the superiority of this treatment to conventional rehabilitation remains unclear. Further clinical studies are warranted. Additionally, the formation of a patient registry will permit a meta-analysis of HAL cases and address the problems associated with a controlled trial (e.g., the heterogeneity of an acute stroke cohort). The development of robotic engineering will improve the efficacy of HAL rehabilitation and has the potential to standardize patient rehabilitation practice.

  11. Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report.

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    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Saotome, Kousaku; Ueno, Tomoyuki; Abe, Tetsuya; Marushima, Aiki; Watanabe, Hiroki; Endo, Ayumu; Tsurumi, Kazue; Ishimoto, Ryu; Matsushita, Akira; Koda, Masao; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2018-01-19

    We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.

  12. The voluntary driven exoskeleton Hybrid Assistive Limb (HAL) for postoperative training of thoracic ossification of the posterior longitudinal ligament: a case report.

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    Fujii, Kengo; Abe, Tetsuya; Kubota, Shigeki; Marushima, Aiki; Kawamoto, Hiroaki; Ueno, Tomoyuki; Matsushita, Akira; Nakai, Kei; Saotome, Kosaku; Kadone, Hideki; Endo, Ayumu; Haginoya, Ayumu; Hada, Yasushi; Matsumura, Akira; Sankai, Yoshiyuki; Yamazaki, Masashi

    2017-05-01

    The hybrid assistive limb (HAL) is a wearable robot suit that assists in voluntary control of knee and hip joint motion by detecting bioelectric signals on the surface of the skin with high sensitivity. HAL has been reported to be effective for functional recovery in motor impairments. However, few reports have revealed the utility of HAL for patients who have undergone surgery for thoracic ossification of the posterior longitudinal ligament (thoracic OPLL). Herein, we present a postoperative thoracic OPLL patient who showed remarkable functional recovery after training with HAL. A 63-year-old woman, who could not walk due to muscle weakness before surgery, underwent posterior decompression and fusion. Paralysis was re-aggravated after the initial postoperative rising. We diagnosed that paralysis was due to residual compression from the anterior lesion and microinstability after posterior fixation, and prescribed bed rest for a further 3 weeks. The incomplete paralysis gradually recovered, and walking training with HAL was started on postoperative day 44 in addition to standard physical therapy. The patient underwent 10 sessions of HAL training until discharge on postoperative day 73. Results of a 10-m walk test were assessed after every session, and the patient's speed and cadence markedly improved. At discharge, the patient could walk with 2 crutches and no assistance. Furthermore, no adverse events associated with HAL training occurred. HAL training for postoperative thoracic OPLL patients may enhance improvement in walking ability, even if severe impairment of ambulation and muscle weakness exist preoperatively.

  13. Decrease of spasticity after hybrid assistive limb® training for a patient with C4 quadriplegia due to chronic SCI.

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    Ikumi, Akira; Kubota, Shigeki; Shimizu, Yukiyo; Kadone, Hideki; Marushima, Aiki; Ueno, Tomoyuki; Kawamoto, Hiroaki; Hada, Yasushi; Matsumura, Akira; Sankai, Yoshiyuki; Yamazaki, Masashi

    2017-09-01

    Recently, locomotor training with robotic assistance has been found effective in treating spinal cord injury (SCI). Our case report examined locomotor training using the robotic suit hybrid assistive limb (HAL) in a patient with complete C4 quadriplegia due to chronic SCI. This is the first report examining HAL in complete C4 quadriplegia. The patient was a 19-year-old man who dislocated C3/4 during judo 4 years previously. Following the injury, he underwent C3/4 posterior spinal fusion but remained paralyzed despite rehabilitation. There was muscle atrophy under C5 level and no sensation around the anus, but partial sensation of pressure remained in the limbs. The American Spinal Injury Association impairment scale was Grade A (complete motor C4 lesion). HAL training was administered in 10 sessions (twice per week). The training sessions consisted of treadmill walking with HAL. For safety, 2 physicians and 1 therapist supported the subject for balance and weight-bearing. The device's cybernic autonomous control mode provides autonomic physical support based on predefined walking patterns. We evaluated the adverse events, walking time and distance, and the difference in muscle spasticity before and after HAL-training using a modified Ashworth scale (mAs). No adverse events were observed that required discontinuation of rehabilitation. Walking distance and time increased from 25.2 meters/7.6 minutes to 148.3 meter/15 minutes. The mAs score decreased after HAL training. Our case report indicates that HAL training is feasible and effective for complete C4 quadriplegia in chronic SCI.

  14. Hybrid Assistive Limb Exoskeleton HAL in the Rehabilitation of Chronic Spinal Cord Injury: Proof of Concept; the Results in 21 Patients.

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    Jansen, Oliver; Grasmuecke, Dennis; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Wessling, Martin; Schildhauer, Thomas A; Fisahn, Christian; Aach, Mirko

    2018-02-01

    The use of mobile exoskeletons is becoming more and more common in the field of spinal cord injury (SCI) rehabilitation. The hybrid assistive limb (HAL) exoskeleton provides a tailored support depending on the patient's voluntary drive. After a pilot study in 2014 that included 8 patients with chronic SCI, this study of 21 patients with chronic SCI serves as a proof of concept. It was conducted to provide further evidence regarding the efficacy of exoskeletal-based rehabilitation. Functional assessment included walking speed, distance, and time on a treadmill, with additional analysis of functional mobility using the following tests: 10-meter walk test (10MWT), timed up and go (TUG) test, 6-minute walk test (6MWT), and the walking index for SCI II (WISCI-II) score. After a training period of 90 days, all 21 patients significantly improved their functional and ambulatory mobility without the exoskeleton. Patients were assessed by the 6MWT, the TUG test, and the 10MWT, which also indicated an increase in the WISCI-II score along with significant improvements in HAL-associated walking speed, distance, and time. Although, exoskeletons are not yet an established treatment in the rehabilitation of spinal cord injuries, the devices will play a more important role in the future. The HAL exoskeleton training enables effective, body weight-supported treadmill training and is capable of improving ambulatory mobility. Future controlled studies are required to enable a comparison of the new advances in the field of SCI rehabilitation with traditional over-ground training. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Treatment of critical lower limb ischemia using a hybrid technique

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    Ricardo Wagner da Costa Moreira

    2014-09-01

    Full Text Available Critical ischemia of a lower limb is a condition that threatens its viability and must be treated promptly to avoid major amputation. Revascularization is the most effective treatment method and is performed using surgical or endovascular techniques. For patients with thoracoabdominal aortic aneurysms, combining these two approaches into a "hybrid technique" makes it possible to treat patients who could not be adequately treated by either technique in isolation. We report on a case of lower limb critical ischemia treated using a combination of surgery and endovascular techniques, in an application of the hybrid technique in a different arterial bed.

  16. Against the odds: what to expect in rehabilitation of chronic spinal cord injury with a neurologically controlled Hybrid Assistive Limb exoskeleton. A subgroup analysis of 55 patients according to age and lesion level.

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    Grasmücke, Dennis; Zieriacks, Amrei; Jansen, Oliver; Fisahn, Christian; Sczesny-Kaiser, Matthias; Wessling, Martin; Meindl, Renate C; Schildhauer, Thomas A; Aach, Mirko

    2017-05-01

    Objective Age and lesion level are believed to represent outcome predictors in rehabilitation of patients with chronic spinal cord injury (SCI). The Hybrid Assistive Limb (HAL) exoskeleton enables patients to perform a voluntary controlled gait pattern via an electromyography-triggered neuromuscular feedback system, and has been introduced as a temporary gait training tool in patients with SCI. The aim of this prospective pre- and postintervention study was to examine functional outcomes as a function of age and lesion level in patients with chronic incomplete SCI (iSCI) or chronic complete SCI (cSCI) with zones of partial preservation (ZPP) by using the HAL as a temporary training tool. Methods Fifty-five participants with chronic iSCI or cSCI (mean time since injury 6.85 ± 5.12 years) were classified according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS) and divided by age (training paradigm consisted of 12 weeks of HAL-assisted treadmill training (5 times/week). Baseline status was documented prior to intervention by using the AIS grade, Walking Index for SCI II (WISCI II) score, the 10-meter walk test (10MWT), and the 6-minute walk test (6MinWT). Training effects were assessed after 6 and 12 weeks of therapy, without HAL assistance. Results Overall, a time reduction of 47% in the 10MWT, self-selected speed (10MWTsss) (negative influence on the 10MWTsss. Despite a few nonsignificant subgroup differences, participants improved across all tests. Namely, patients with iSCI who had spastic motor behavior improved to a nonsignificant, lesser extent in the 6MinWT. Conclusions The HAL-assisted treadmill training leads to functional improvements in chronic iSCI or cSCI, both in and out of the exoskeleton. An improvement of approximately 50% in the 10MWTsss and in gait endurance (6MinWT) can be expected from such training. The influences of SCI lesion level and age on functional outcome were nonsignificant in the present study. Older age (

  17. Impact of locomotion training with a neurologic controlled hybrid assistive limb (HAL) exoskeleton on neuropathic pain and health related quality of life (HRQoL) in chronic SCI: a case study (.).

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    Cruciger, Oliver; Schildhauer, Thomas A; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Citak, Mustafa; Aach, Mirko

    2016-08-01

    Chronic neuropathic pain (CNP) is a common condition associated with spinal cord injury (SCI) and has been reported to be severe, disabling and often treatment-resistant and therefore remains a clinical challenge for the attending physicians. The treatment usually includes pharmacological and/or nonpharmacological approaches. Body weight supported treadmill training (BWSTT) and locomotion training with driven gait orthosis (DGO) have evolved over the last decades and are now considered to be an established part in the rehabilitation of SCI patients. Conventional locomotion training goes along with improvements of the patients' walking abilities in particular speed and gait pattern. The neurologic controlled hybrid assistive limb (HAL®, Cyberdyne Inc., Ibraki, Japan) exoskeleton, however, is a new tailored approach to support motor functions synchronously to the patient's voluntary drive. This report presents two cases of severe chronic and therapy resistant neuropathic pain due to chronic SCI and demonstrates the beneficial effects of neurologic controlled exoskeletal intervention on pain severity and health-related quality of life (HRQoL). Both of these patients were engaged in a 12 weeks period of daily HAL®-supported locomotion training. In addition to improvements in motor functions and walking abilities, both show significant reduction in pain severity and improvements in all HRQoL domains. Although various causal factors likely contribute to abatement of CNP, the reported results occurred due to a new approach in the rehabilitation of chronic spinal cord injury patients. These findings suggest not only the feasibility of this new approach but in conclusion, demonstrate the effectiveness of neurologic controlled locomotion training in the long-term management of refractory neuropathic pain. Implications for Rehabilitation CNP remains a challenge in the rehabilitation of chronic SCI patients. Locomotion training with the HAL exoskeleton seems to improve CNP

  18. Development of an Upper Limb Motorized Assistive-Rehabilitative Robot

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    Amiri, Masoud; Casolo, Federico

    While the number of people requiring help for the activities of daily living are increasing, several studies have been shown the effectiveness of robot training for upper limb functionality recovery. The robotic system described in this paper is an active end-effector based robot which can be used for assisting and rehabilitating of human upper limb. The robot is able to take into account desire of the patient for the support that patient needs to complete the task.

  19. Design and control of hybrid actuation lower limb exoskeleton

    Directory of Open Access Journals (Sweden)

    Hipolito Aguilar-Sierra

    2015-06-01

    Full Text Available In this article, two types of actuators are applied for a lower limb exoskeleton. They are DC motors with the harmonic drive and the pneumatic artificial muscles. This combination takes advantages of both the harmonic drive and the pneumatic artificial muscle. It provides both high accuracy position control and high ratio of strength and weight. The shortcomings of the two actuators are overcome by the hybrid actuation, for example, low control accuracy and modeling difficult of pneumatic artificial muscle, compactness, and structural flexibility of DC motors. The design and modeling processes are discussed to show the proposed exoskeleton can increase the strength of human lower limbs. Experiments and analysis of the exoskeleton are given to evaluate the effectiveness of the design and modeling.

  20. Computer assisted surgery for malunited fractures in upper limb

    International Nuclear Information System (INIS)

    Yoneda, Masahiro; Kazuki, Kenichi; Uemura, Takuya; Okada, Mitsuhiro; Takaoka, Kunio

    2006-01-01

    Our objective was to evaluate the usefulness of computer-assisted preoperative simulation of malunited fractures in the upper limb. Ten patients with malunited fractures underwent multislice computed tomography of both upper limbs with reconstruction of three-dimensional bone models using three-dimensional (3D) software. Preoperative simulation was comprised of four main procedures: performance of virtual corrective osteotomy, matching of reposition with a mirror-image model of the unaffected side, creating new data for the bone defect, and machining of an hydroxyapatite block as bone graft. In addition, we used full-sized three-dimensional virtual reality modeling with a rapid prototyping molding device, and performed preoperative rehearsals of osteotomies using plaster models. All patients tolerated the surgical procedure well. This technique permits the surgeon to recognize and correct three-dimensional deformities of malunited fracture with both accuracy and precision. (author)

  1. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

    International Nuclear Information System (INIS)

    Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J

    2009-01-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  2. Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

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    Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J [Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

    2009-02-01

    In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

  3. A Neuromuscular Electrical Stimulation (NMES) and robot hybrid system for multi-joint coordinated upper limb rehabilitation after stroke.

    Science.gov (United States)

    Rong, Wei; Li, Waiming; Pang, Mankit; Hu, Junyan; Wei, Xijun; Yang, Bibo; Wai, Honwah; Zheng, Xiaoxiang; Hu, Xiaoling

    2017-04-26

    It is a challenge to reduce the muscular discoordination in the paretic upper limb after stroke in the traditional rehabilitation programs. In this study, a neuromuscular electrical stimulation (NMES) and robot hybrid system was developed for multi-joint coordinated upper limb physical training. The system could assist the elbow, wrist and fingers to conduct arm reaching out, hand opening/grasping and arm withdrawing by tracking an indicative moving cursor on the screen of a computer, with the support from the joint motors and electrical stimulations on target muscles, under the voluntary intention control by electromyography (EMG). Subjects with chronic stroke (n = 11) were recruited for the investigation on the assistive capability of the NMES-robot and the evaluation of the rehabilitation effectiveness through a 20-session device assisted upper limb training. In the evaluation, the movement accuracy measured by the root mean squared error (RMSE) during the tracking was significantly improved with the support from both the robot and NMES, in comparison with those without the assistance from the system (P joint and inter-joint muscular co-contractions measured by EMG were significantly released when the NMES was applied to the agonist muscles in the different phases of the limb motion (P < 0.05). After the physical training, significant improvements (P < 0.05) were captured by the clinical scores, i.e., Modified Ashworth Score (MAS, the elbow and the wrist), Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Wolf Motor Function Test (WMFT). The EMG-driven NMES-robotic system could improve the muscular coordination at the elbow, wrist and fingers. ClinicalTrials.gov. NCT02117089 ; date of registration: April 10, 2014.

  4. Development of a hybrid strength training technique for paretic lower-limb muscles

    NARCIS (Netherlands)

    Bennett, T. L.; Glaser, R. M.; Janssen, T. W J; Couch, W. P.; Herr, C. J.; Almeyda, J. W.; Petrofsky, S. H.; Akuthota, P.

    1996-01-01

    A hybrid resistance exercise technique for strength training of patients with lower-limb paresis was developed. It consists of electrical stimulation-induced contractions (ESIC) superimposed on voluntary contractions to increase recruitment of motor units and the functional load capability of

  5. Upper limb contributions to frontal plane balance control in rollator-assisted walking.

    Science.gov (United States)

    Tung, James Y; Gage, William H; Poupart, Pascal; McIlroy, William E

    2014-01-01

    While assisting with balance is a primary reason for rollator use, few studies have examined how the upper limbs are used for balance. This study examines upper limb contributions to balance control during rollator-assisted walking. We hypothesized that there would be an increased upper limb contribution, measured by mean vertical loading (Fz) and variation in frontal plane center-of-pressure (COPhigh), when walking balance is challenged/impaired. Experiment 1 compared straight-line and beam-walking in young adults (n = 11). As hypothesized, Fz and COPhighincreased in beam-walking compared to baseline (mean Fz: 13.7 vs. 9.1% body weight (BW), p < 0.001, RMS COPhigh: 1.35 vs. 1.07 cm, p < 0.001). Experiment 2 compared older adults who regularly use rollators (RU, n = 10) to older adult controls (CTL, n = 10). The predicted higher upper limb contribution in the RU group was not supported. However, when individuals were grouped by balance impairment, those with the lowest Berg Balance scores (< 45) demonstrated greater speed-adjusted COPhigh than those with higher scores (p = 0.013). Furthermore, greater COPhigh and Fz were correlated to greater reduction in step width, supporting the role of upper limb contributions to frontal plane balance. This work will guide studies assessing reliance on rollators by providing a basis for measurement of upper limb balance contributions.

  6. Hybrid robotic systems for upper limb rehabilitation after stroke: A review.

    Science.gov (United States)

    Resquín, Francisco; Cuesta Gómez, Alicia; Gonzalez-Vargas, Jose; Brunetti, Fernando; Torricelli, Diego; Molina Rueda, Francisco; Cano de la Cuerda, Roberto; Miangolarra, Juan Carlos; Pons, José Luis

    2016-11-01

    In recent years the combined use of functional electrical stimulation (FES) and robotic devices, called hybrid robotic rehabilitation systems, has emerged as a promising approach for rehabilitation of lower and upper limb motor functions. This paper presents a review of the state of the art of current hybrid robotic solutions for upper limb rehabilitation after stroke. For this aim, studies have been selected through a search using web databases: IEEE-Xplore, Scopus and PubMed. A total of 10 different hybrid robotic systems were identified, and they are presented in this paper. Selected systems are critically compared considering their technological components and aspects that form part of the hybrid robotic solution, the proposed control strategies that have been implemented, as well as the current technological challenges in this topic. Additionally, we will present and discuss the corresponding evidences on the effectiveness of these hybrid robotic therapies. The review also discusses the future trends in this field. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  7. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton.

    Science.gov (United States)

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    Brain-machine interface-controlled (BMI) neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion (ROM) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related ROM and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton) in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. NMES was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD) and electromyography (EMG) activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e., induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p = 0.028) or EMG (p = 0.021) modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related ROM (p = 0.009) and the movement-related brain modulation (p = 0.019). Combining a hybrid BMI with neuromuscular stimulation

  8. Hybrid Neuroprosthesis for the Upper Limb: Combining Brain-Controlled Neuromuscular Stimulation with a Multi-Joint Arm Exoskeleton

    Science.gov (United States)

    Grimm, Florian; Walter, Armin; Spüler, Martin; Naros, Georgios; Rosenstiel, Wolfgang; Gharabaghi, Alireza

    2016-01-01

    Brain-machine interface-controlled (BMI) neurofeedback training aims to modulate cortical physiology and is applied during neurorehabilitation to increase the responsiveness of the brain to subsequent physiotherapy. In a parallel line of research, robotic exoskeletons are used in goal-oriented rehabilitation exercises for patients with severe motor impairment to extend their range of motion (ROM) and the intensity of training. Furthermore, neuromuscular electrical stimulation (NMES) is applied in neurologically impaired patients to restore muscle strength by closing the sensorimotor loop. In this proof-of-principle study, we explored an integrated approach for providing assistance as needed to amplify the task-related ROM and the movement-related brain modulation during rehabilitation exercises of severely impaired patients. For this purpose, we combined these three approaches (BMI, NMES, and exoskeleton) in an integrated neuroprosthesis and studied the feasibility of this device in seven severely affected chronic stroke patients who performed wrist flexion and extension exercises while receiving feedback via a virtual environment. They were assisted by a gravity-compensating, seven degree-of-freedom exoskeleton which was attached to the paretic arm. NMES was applied to the wrist extensor and flexor muscles during the exercises and was controlled by a hybrid BMI based on both sensorimotor cortical desynchronization (ERD) and electromyography (EMG) activity. The stimulation intensity was individualized for each targeted muscle and remained subthreshold, i.e., induced no overt support. The hybrid BMI controlled the stimulation significantly better than the offline analyzed ERD (p = 0.028) or EMG (p = 0.021) modality alone. Neuromuscular stimulation could be well integrated into the exoskeleton-based training and amplified both the task-related ROM (p = 0.009) and the movement-related brain modulation (p = 0.019). Combining a hybrid BMI with neuromuscular stimulation

  9. Upper limb stroke rehabilitation: the effectiveness of Stimulation Assistance through Iterative Learning (SAIL).

    Science.gov (United States)

    Meadmore, Katie L; Cai, Zhonglun; Tong, Daisy; Hughes, Ann-Marie; Freeman, Chris T; Rogers, Eric; Burridge, Jane H

    2011-01-01

    A novel system has been developed which combines robotic therapy with electrical stimulation (ES) for upper limb stroke rehabilitation. This technology, termed SAIL: Stimulation Assistance through Iterative Learning, employs advanced model-based iterative learning control (ILC) algorithms to precisely assist participant's completion of 3D tracking tasks with their impaired arm. Data is reported from a preliminary study with unimpaired participants, and also from a single hemiparetic stroke participant with reduced upper limb function who has used the system in a clinical trial. All participants completed tasks which involved moving their (impaired) arm to follow an image of a slowing moving sphere along a trajectory. The participants' arm was supported by a robot and ES was applied to the triceps brachii and anterior deltoid muscles. During each task, the same tracking trajectory was repeated 6 times and ILC was used to compute the stimulation signals to be applied on the next iteration. Unimpaired participants took part in a single, one hour training session and the stroke participant undertook 18, 1 hour treatment sessions composed of tracking tasks varying in length, orientation and speed. The results reported describe changes in tracking ability and demonstrate feasibility of the SAIL system for upper limb rehabilitation. © 2011 IEEE

  10. Hybrid neuroprosthesis for the upper limb: combining brain-controlled neuromuscular stimulation with a multi-joint arm exoskeleton

    Directory of Open Access Journals (Sweden)

    Florian Grimm

    2016-08-01

    .019. Combining a hybrid BMI with neuromuscular stimulation and antigravity assistance augments upper limb function and brain activity during rehabilitation exercises and may thus provide a novel restorative framework for severely affected stroke patients.

  11. Evolution of upper limb kinematics four years after subacute robot-assisted rehabilitation in stroke patients.

    Science.gov (United States)

    Pila, Ophélie; Duret, Christophe; Gracies, Jean-Michel; Francisco, Gerard E; Bayle, Nicolas; Hutin, Émilie

    2018-04-25

    To assess functional status and robot-based kinematic measures four years after subacute robot-assisted rehabilitation in hemiparesis. Twenty-two patients with stroke-induced hemiparesis underwent a ≥3-month upper limb combined program of robot-assisted and occupational therapy from two months post-stroke, and received community-based therapy after discharge. Four years later, 19 (86%) participated in this follow-up study. Assessments 2, 5 and 54 months post-stroke included Fugl-Meyer (FM), Modified Frenchay Scale (MFS, at Month 54) and robot-based kinematic measures of targeting tasks in three directions, north, paretic and non-paretic: distance covered, velocity, accuracy (root mean square (RMS) error from straight line) and smoothness (number of velocity peaks; upward changes in accuracy and smoothness represent worsening). Analysis was stratified by FM score at two months: ≥17 (Group 1) or Kinematic changes (three directions pooled) were: distance -1[-17;2]% (ns); velocity, -8[-32;28]% (ns); accuracy, +6[-13;98]% (ns); smoothness, +44[-6;126]% (p robot-assisted upper limb training during subacute post-stroke phase, movement kinematics deteriorated despite community-based therapy, especially in more severely impaired patients. EudraCT 2016-005121-36. Registration: 2016-12-20. Date of enrolment of the first participant to the trial: 2009-11-24.

  12. Electrical potential-assisted DNA hybridization. How to mitigate electrostatics for surface DNA hybridization.

    Science.gov (United States)

    Tymoczko, Jakub; Schuhmann, Wolfgang; Gebala, Magdalena

    2014-12-24

    Surface-confined DNA hybridization reactions are sensitive to the number and identity of DNA capture probes and experimental conditions such as the nature and the ionic strength of the electrolyte solution. When the surface probe density is high or the concentration of bulk ions is much lower than the concentration of ions within the DNA layer, hybridization is significantly slowed down or does not proceed at all. However, high-density DNA monolayers are attractive for designing high-sensitivity DNA sensors. Thus, circumventing sluggish DNA hybridization on such interfaces allows a high surface concentration of target DNA and improved signal/noise ratio. We present potential-assisted hybridization as a strategy in which an external voltage is applied to the ssDNA-modified interface during the hybridization process. Results show that a significant enhancement of hybridization can be achieved using this approach.

  13. Current status of robotic stroke rehabilitation and opportunities for a cyber-physically assisted upper limb stroke rehabilitation

    NARCIS (Netherlands)

    Li, C.; Rusak, Z.; Horvath, I.; Ji, L.; Hou, Y.

    2014-01-01

    In the last two decades, robotics-assisted stroke reha-bilitation has been wide-spread, in particular for movement rehabilitation of upper limbs. Several studies have reported on the clinical effectiveness of this kind of therapy. The results of these studies show that robot assisted therapy can be

  14. Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation.

    Science.gov (United States)

    Cortés, Camilo; de Los Reyes-Guzmán, Ana; Scorza, Davide; Bertelsen, Álvaro; Carrasco, Eduardo; Gil-Agudo, Ángel; Ruiz-Salguero, Oscar; Flórez, Julián

    2016-01-01

    Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury). The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension). Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage). The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types.

  15. Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation

    Directory of Open Access Journals (Sweden)

    Camilo Cortés

    2016-01-01

    Full Text Available Robot-Assisted Rehabilitation (RAR is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury. The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension. Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage. The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types.

  16. Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation

    Science.gov (United States)

    Cortés, Camilo; de los Reyes-Guzmán, Ana; Scorza, Davide; Bertelsen, Álvaro; Carrasco, Eduardo; Gil-Agudo, Ángel; Ruiz-Salguero, Oscar; Flórez, Julián

    2016-01-01

    Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury). The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension). Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage). The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types. PMID:27403420

  17. A Hybrid Neuromechanical Ambulatory Assist System

    Science.gov (United States)

    2016-08-01

    volitionally assisted knee flexion. SCI evaluation of HKC – The SCI subject initiated steps by pressing a finger switch to activate a pre-programmed...Prototype servo based proportional valve - In the absence of commercially available industrial valves that provide sufficient resolution, a...cycled until stopped or initiated by a sensor. When STOP button was pressed during walking, the stimulation pattern transitioned into the standing

  18. Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial.

    Science.gov (United States)

    Gilliaux, Maxime; Renders, Anne; Dispa, Delphine; Holvoet, Dominique; Sapin, Julien; Dehez, Bruno; Detrembleur, Christine; Lejeune, Thierry M; Stoquart, Gaëtan

    2015-02-01

    Several pilot studies have evoked interest in robot-assisted therapy (RAT) in children with cerebral palsy (CP). To assess the effectiveness of RAT in children with CP through a single-blind randomized controlled trial. Sixteen children with CP were randomized into 2 groups. Eight children performed 5 conventional therapy sessions per week over 8 weeks (control group). Eight children completed 3 conventional therapy sessions and 2 robot-assisted sessions per week over 8 weeks (robotic group). For both groups, each therapy session lasted 45 minutes. Throughout each RAT session, the patient attempted to reach several targets consecutively with the REAPlan. The REAPlan is a distal effector robot that allows for displacements of the upper limb in the horizontal plane. A blinded assessment was performed before and after the intervention with respect to the International Classification of Functioning framework: body structure and function (upper limb kinematics, Box and Block test, Quality of Upper Extremity Skills Test, strength, and spasticity), activities (Abilhand-Kids, Pediatric Evaluation of Disability Inventory), and participation (Life Habits). During each RAT session, patients performed 744 movements on average with the REAPlan. Among the variables assessed, the smoothness of movement (P robotic group than in the control group. This single-blind randomized controlled trial provides the first evidence that RAT is effective in children with CP. Future studies should investigate the long-term effects of this therapy. © The Author(s) 2014.

  19. An Upper-Limb Power-Assist Exoskeleton Using Proportional Myoelectric Control

    Science.gov (United States)

    Tang, Zhichuan; Zhang, Kejun; Sun, Shouqian; Gao, Zenggui; Zhang, Lekai; Yang, Zhongliang

    2014-01-01

    We developed an upper-limb power-assist exoskeleton actuated by pneumatic muscles. The exoskeleton included two metal links: a nylon joint, four size-adjustable carbon fiber bracers, a potentiometer and two pneumatic muscles. The proportional myoelectric control method was proposed to control the exoskeleton according to the user's motion intention in real time. With the feature extraction procedure and the classification (back-propagation neural network), an electromyogram (EMG)-angle model was constructed to be used for pattern recognition. Six healthy subjects performed elbow flexion-extension movements under four experimental conditions: (1) holding a 1-kg load, wearing the exoskeleton, but with no actuation and for different periods (2-s, 4-s and 8-s periods); (2) holding a 1-kg load, without wearing the exoskeleton, for a fixed period; (3) holding a 1-kg load, wearing the exoskeleton, but with no actuation, for a fixed period; (4) holding a 1-kg load, wearing the exoskeleton under proportional myoelectric control, for a fixed period. The EMG signals of the biceps brachii, the brachioradialis, the triceps brachii and the anconeus and the angle of the elbow were collected. The control scheme's reliability and power-assist effectiveness were evaluated in the experiments. The results indicated that the exoskeleton could be controlled by the user's motion intention in real time and that it was useful for augmenting arm performance with neurological signal control, which could be applied to assist in elbow rehabilitation after neurological injury. PMID:24727501

  20. An upper-limb power-assist exoskeleton using proportional myoelectric control.

    Science.gov (United States)

    Tang, Zhichuan; Zhang, Kejun; Sun, Shouqian; Gao, Zenggui; Zhang, Lekai; Yang, Zhongliang

    2014-04-10

    We developed an upper-limb power-assist exoskeleton actuated by pneumatic muscles. The exoskeleton included two metal links: a nylon joint, four size-adjustable carbon fiber bracers, a potentiometer and two pneumatic muscles. The proportional myoelectric control method was proposed to control the exoskeleton according to the user's motion intention in real time. With the feature extraction procedure and the classification (back-propagation neural network), an electromyogram (EMG)-angle model was constructed to be used for pattern recognition. Six healthy subjects performed elbow flexion-extension movements under four experimental conditions: (1) holding a 1-kg load, wearing the exoskeleton, but with no actuation and for different periods (2-s, 4-s and 8-s periods); (2) holding a 1-kg load, without wearing the exoskeleton, for a fixed period; (3) holding a 1-kg load, wearing the exoskeleton, but with no actuation, for a fixed period; (4) holding a 1-kg load, wearing the exoskeleton under proportional myoelectric control, for a fixed period. The EMG signals of the biceps brachii, the brachioradialis, the triceps brachii and the anconeus and the angle of the elbow were collected. The control scheme's reliability and power-assist effectiveness were evaluated in the experiments. The results indicated that the exoskeleton could be controlled by the user's motion intention in real time and that it was useful for augmenting arm performance with neurological signal control, which could be applied to assist in elbow rehabilitation after neurological injury.

  1. Intuitive adaptive orientation control of assistive robots for people living with upper limb disabilities.

    Science.gov (United States)

    Vu, Dinh-Son; Allard, Ulysse Cote; Gosselin, Clement; Routhier, Francois; Gosselin, Benoit; Campeau-Lecours, Alexandre

    2017-07-01

    Robotic assistive devices enhance the autonomy of individuals living with physical disabilities in their day-to-day life. Although the first priority for such devices is safety, they must also be intuitive and efficient from an engineering point of view in order to be adopted by a broad range of users. This is especially true for assistive robotic arms, as they are used for the complex control tasks of daily living. One challenge in the control of such assistive robots is the management of the end-effector orientation which is not always intuitive for the human operator, especially for neophytes. This paper presents a novel orientation control algorithm designed for robotic arms in the context of human-robot interaction. This work aims at making the control of the robot's orientation easier and more intuitive for the user, in particular, individuals living with upper limb disabilities. The performance and intuitiveness of the proposed orientation control algorithm is assessed through two experiments with 25 able-bodied subjects and shown to significantly improve on both aspects.

  2. Admittance-Based Upper Limb Robotic Active and Active-Assistive Movements

    Directory of Open Access Journals (Sweden)

    Cristóbal Ochoa Luna

    2015-09-01

    Full Text Available This paper presents two rehabilitation schemes for patients with upper limb impairments. The first is an active-assistive scheme based on the trajectory tracking of predefined paths in Cartesian space. In it, the system allows for an adjustable degree of variation with respect to ideal tracking. The amount of variation is determined through an admittance function that depends on the opposition forces exerted on the system by the user, due to possible impairments. The coefficients of the function allow the adjustment of the degree of assistance the robot will provide in order to complete the target trajectory. The second scheme corresponds to active movements in a constrained space. Here, the same admittance function is applied; however, in this case, it is unattached to a predefined trajectory and instead connected to one generated in real time, according to the user's intended movements. This allows the user to move freely with the robot in order to track a given path. The free movement is bounded through the use of virtual walls that do not allow users to exceed certain limits. A human-machine interface was developed to guide the robot's user.

  3. Discharge destination following lower limb fracture: development of a prediction model to assist with decision making.

    Science.gov (United States)

    Kimmel, Lara A; Holland, Anne E; Edwards, Elton R; Cameron, Peter A; De Steiger, Richard; Page, Richard S; Gabbe, Belinda

    2012-06-01

    Accurate prediction of the likelihood of discharge to inpatient rehabilitation following lower limb fracture made on admission to hospital may assist patient discharge planning and decrease the burden on the hospital system caused by delays in decision making. To develop a prognostic model for discharge to inpatient rehabilitation. Isolated lower extremity fracture cases (excluding fractured neck of femur), captured by the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), were extracted for analysis. A training data set was created for model development and validation data set for evaluation. A multivariable logistic regression model was developed based on patient and injury characteristics. Models were assessed using measures of discrimination (C-statistic) and calibration (Hosmer-Lemeshow (H-L) statistic). A total of 1429 patients met the inclusion criteria and were randomly split into training and test data sets. Increasing age, more proximal fracture type, compensation or private fund source for the admission, metropolitan location of residence, not working prior to injury and having a self-reported pre-injury disability were included in the final prediction model. The C-statistic for the model was 0.92 (95% confidence interval (CI) 0.88, 0.95) with an H-L statistic of χ(2)=11.62, p=0.17. For the test data set, the C-statistic was 0.86 (95% CI 0.83, 0.90) with an H-L statistic of χ(2)=37.98, plower limb fracture was developed with excellent discrimination although the calibration was reduced in the test data set. This model requires prospective testing but could form an integral part of decision making in regards to discharge disposition to facilitate timely and accurate referral to rehabilitation and optimise resource allocation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. An Upper-Limb Power-Assist Exoskeleton Using Proportional Myoelectric Control

    Directory of Open Access Journals (Sweden)

    Zhichuan Tang

    2014-04-01

    Full Text Available We developed an upper-limb power-assist exoskeleton actuated by pneumatic muscles. The exoskeleton included two metal links: a nylon joint, four size-adjustable carbon fiber bracers, a potentiometer and two pneumatic muscles. The proportional myoelectric control method was proposed to control the exoskeleton according to the user’s motion intention in real time. With the feature extraction procedure and the classification (back-propagation neural network, an electromyogram (EMG-angle model was constructed to be used for pattern recognition. Six healthy subjects performed elbow flexion-extension movements under four experimental conditions: (1 holding a 1-kg load, wearing the exoskeleton, but with no actuation and for different periods (2-s, 4-s and 8-s periods; (2 holding a 1-kg load, without wearing the exoskeleton, for a fixed period; (3 holding a 1-kg load, wearing the exoskeleton, but with no actuation, for a fixed period; (4 holding a 1-kg load, wearing the exoskeleton under proportional myoelectric control, for a fixed period. The EMG signals of the biceps brachii, the brachioradialis, the triceps brachii and the anconeus and the angle of the elbow were collected. The control scheme’s reliability and power-assist effectiveness were evaluated in the experiments. The results indicated that the exoskeleton could be controlled by the user’s motion intention in real time and that it was useful for augmenting arm performance with neurological signal control, which could be applied to assist in elbow rehabilitation after neurological injury.

  5. An assistive controller for a lower-limb exoskeleton for rehabilitation after stroke, and preliminary assessment thereof.

    Science.gov (United States)

    Murray, Spencer A; Ha, Kevin H; Goldfarb, Michael

    2014-01-01

    This paper describes a novel controller, intended for use in a lower-limb exoskeleton, to aid gait rehabilitation in patients with hemiparesis after stroke. The controller makes use of gravity compensation, feedforward movement assistance, and reinforcement of isometric joint torques to achieve assistance without dictating the spatiotemporal nature of joint movement. The patient is allowed to self-select walking speed and is able to make trajectory adaptations to maintain balance without interference from the controller. The governing equations and the finite state machine which comprise the system are described herein. The control architecture was implemented in a lower-limb exoskeleton and a preliminary experimental assessment was conducted in which a patient with hemiparesis resulting from stroke walked with assistance from the exoskeleton. The patient exhibited improvements in fast gait speed, step length asymmetry, and stride length in each session, as measured before and after exoskeleton training, presumably as a result of using the exoskeleton.

  6. An assistive control approach for a lower-limb exoskeleton to facilitate recovery of walking following stroke.

    Science.gov (United States)

    Murray, Spencer A; Ha, Kevin H; Hartigan, Clare; Goldfarb, Michael

    2015-05-01

    This paper presents a control approach for a lower-limb exoskeleton intended to facilitate recovery of walking in individuals with lower-extremity hemiparesis after stroke. The authors hypothesize that such recovery is facilitated by allowing the patient rather than the exoskeleton to provide movement coordination. As such, an assistive controller that provides walking assistance without dictating the spatiotemporal nature of joint movement is described here. Following a description of the control laws and finite state structure of the controller, the authors present the results of an experimental implementation and preliminary validation of the control approach, in which the control architecture was implemented on a lower limb exoskeleton, and the exoskeleton implemented in an experimental protocol on three subjects with hemiparesis following stroke. In a series of sessions in which each patient used the exoskeleton, all patients showed substantial single-session improvements in all measured gait outcomes, presumably as a result of using the assistive controller and exoskeleton.

  7. Analysis of a Hybrid Solar-Assisted Trigeneration System

    Directory of Open Access Journals (Sweden)

    Elisa Marrasso

    2016-09-01

    Full Text Available A hybrid solar-assisted trigeneration system is analyzed in this paper. The system is composed of a 20 m2 solar field of evacuated tube collectors, a natural gas fired micro combined heat and power system delivering 12.5 kW of thermal power, an absorption heat pump (AHP with a nominal cooling power of 17.6 kW, two storage tanks (hot and cold and an electric auxiliary heater (AH. The plant satisfies the energy demand of an office building located in Naples (Southern Italy. The electric energy of the cogenerator is used to meet the load and auxiliaries electric demand; the interactions with the grid are considered in cases of excess or over requests. This hybrid solution is interesting for buildings located in cities or historical centers with limited usable roof surface to install a conventional solar heating and cooling (SHC system able to achieve high solar fraction (SF. The results of dynamic simulation show that a tilt angle of 30° maximizes the SF of the system on annual basis achieving about 53.5%. The influence on the performance of proposed system of the hot water storage tank (HST characteristics (volume, insulation is also studied. It is highlighted that the SF improves when better insulated and bigger HSTs are considered. A maximum SF of about 58.2% is obtained with a 2000 L storage, whereas the lower thermal losses take place with a better insulated 1000 L tank.

  8. Reducing Circumduction and Hip Hiking During Hemiparetic Walking Through Targeted Assistance of the Paretic Limb Using a Soft Robotic Exosuit.

    Science.gov (United States)

    Awad, Louis N; Bae, Jaehyun; Kudzia, Pawel; Long, Andrew; Hendron, Kathryn; Holt, Kenneth G; OʼDonnell, Kathleen; Ellis, Terry D; Walsh, Conor J

    2017-10-01

    The aim of the study was to evaluate the effects on common poststroke gait compensations of a soft wearable robot (exosuit) designed to assist the paretic limb during hemiparetic walking. A single-session study of eight individuals in the chronic phase of stroke recovery was conducted. Two testing conditions were compared: walking with the exosuit powered versus walking with the exosuit unpowered. Each condition was 8 minutes in duration. Compared with walking with the exosuit unpowered, walking with the exosuit powered resulted in reductions in hip hiking (27 [6%], P = 0.004) and circumduction (20 [5%], P = 0.004). A relationship between changes in knee flexion and changes in hip hiking was observed (Pearson r = -0.913, P Exosuit assistance of the paretic limb during walking produces immediate changes in the kinematic strategy used to advance the paretic limb. Future work is necessary to determine how exosuit-induced reductions in paretic hip hiking and circumduction during gait training could be leveraged to facilitate more normal walking behavior during unassisted walking.

  9. Feasibility and safety of early lower limb robot-assisted training in sub-acute stroke patients: a pilot study.

    Science.gov (United States)

    Gandolfi, Marialuisa; Geroin, Christian; Tomelleri, Christopher; Maddalena, Isacco; Kirilova Dimitrova, Eleonora; Picelli, Alessandro; Smania, Nicola; Waldner, Andreas

    2017-12-01

    So far, the development of robotic devices for the early lower limb mobilization in the sub-acute phase after stroke has received limited attention. To explore the feasibility of a newly robotic-stationary gait training in sub-acute stroke patients. To report the training effects on lower limb function and muscle activation. A pilot study. Rehabilitation ward. Two sub-acute stroke inpatients and ten age-matched healthy controls were enrolled. Healthy controls served as normative data. Patients underwent 10 robot-assisted training sessions (20 minutes, 5 days/week) in alternating stepping movements (500 repetitions/session) on a hospital bed in addition to conventional rehabilitation. Feasibility outcome measures were compliance, physiotherapist time, and responses to self-report questionnaires. Efficacy outcomes were bilateral lower limb muscle activation pattern as measured by surface electromyography (sEMG), Motricity Index (MI), Medical Research Council (MRC) grade, and Ashworth Scale (AS) scores before and after training. No adverse events occurred. No significant differences in sEMG activity between patients and healthy controls were observed. Post-training improvement in MI and MRC scores, but no significant changes in AS scores, were recorded. Post-treatment sEMG analysis of muscle activation patterns showed a significant delay in rectus femoris offset (P=0.02) and prolonged duration of biceps femoris (P=0.04) compared to pretreatment. The robot-assisted training with our device was feasible and safe. It induced physiological muscle activations pattern in both stroke patients and healthy controls. Full-scale studies are needed to explore its potential role in post-stroke recovery. This robotic device may enrich early rehabilitation in subacute stroke patients by inducing physiological muscle activation patterns. Future studies are warranted to evaluate its effects on promoting restorative mechanisms involved in lower limb recovery after stroke.

  10. An easy two-step microwave assisted synthesis of SnO2/CNT hybrids

    CSIR Research Space (South Africa)

    Motshekga, SC

    2011-11-01

    Full Text Available Tin oxide (SnO2) - decorated carbon nanotube (CNT) heterostructures were synthesized by microwave assisted wet impregnation method. CNTs of three different aspect ratios were compared. The hybrid samples were characterized by powder X...

  11. Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: A review.

    Science.gov (United States)

    Tran, Vi Do; Dario, Paolo; Mazzoleni, Stefano

    2018-03-01

    This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains. The correlations between these parameters and the clinical scales were summarized. Forty-nine kinematic parameters were identified from 67 articles involving 1750 patients. The most frequently used parameters were: movement speed, movement accuracy, peak speed, number of speed peaks, and movement distance and duration. According to the ICF domains, 44 kinematic parameters were categorized into Body Functions and Structure, 5 into Activities and no parameters were categorized into Participation and Personal and Environmental Factors. Thirteen articles investigated the correlations between kinematic parameters and clinical outcome measures. Some kinematic measures showed a significant correlation coefficient with clinical scores, but most were weak or moderate. The proposed classification of kinematic measures into ICF domains and their correlations with clinical scales could contribute to identifying the most relevant ones for an integrated assessment of upper limb robot-assisted rehabilitation treatments following stroke. Increasing the assessment frequency by means of kinematic parameters could optimize clinical assessment procedures and enhance the effectiveness of rehabilitation treatments. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. Hand Passive Mobilization Performed with Robotic Assistance: Acute Effects on Upper Limb Perfusion and Spasticity in Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Massimiliano Gobbo

    2017-01-01

    Full Text Available This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS. Symptoms concerning UL heaviness, joint stiffness, and pain were evaluated as secondary outcomes by self-reporting. Significant (p=0.014 improvements were found in forearm perfusion when all fingers were mobilized simultaneously. After the intervention, MAS scores decreased globally, being the changes statistically significant for the wrist (from 1.6±1.0 to 1.1±1.0; p=0.001 and fingers (from 1.2±1.1 to 0.7±0.9; p=0.004. Subjects reported decreased UL heaviness and stiffness after treatment, especially for the hand, as well as diminished pain when present. This study supports novel evidence that hand robotic assistance promotes local UL circulation changes, may help in the management of spasticity, and acutely alleviates reported symptoms of heaviness, stiffness, and pain in subjects with poststroke hemiparesis. This opens new scenarios for the implications in everyday clinical practice. Clinical Trial Registration Number is NCT03243123.

  13. Hand Passive Mobilization Performed with Robotic Assistance: Acute Effects on Upper Limb Perfusion and Spasticity in Stroke Survivors.

    Science.gov (United States)

    Gobbo, Massimiliano; Gaffurini, Paolo; Vacchi, Laura; Lazzarini, Sara; Villafane, Jorge; Orizio, Claudio; Negrini, Stefano; Bissolotti, Luciano

    2017-01-01

    This single arm pre-post study aimed at evaluating the acute effects induced by a single session of robot-assisted passive hand mobilization on local perfusion and upper limb (UL) function in poststroke hemiparetic participants. Twenty-three patients with subacute or chronic stroke received 20 min passive mobilization of the paretic hand with robotic assistance. Near-infrared spectroscopy (NIRS) was used to detect changes in forearm tissue perfusion. Muscle tone of the paretic UL was assessed by the Modified Ashworth Scale (MAS). Symptoms concerning UL heaviness, joint stiffness, and pain were evaluated as secondary outcomes by self-reporting. Significant ( p = 0.014) improvements were found in forearm perfusion when all fingers were mobilized simultaneously. After the intervention, MAS scores decreased globally, being the changes statistically significant for the wrist (from 1.6 ± 1.0 to 1.1 ± 1.0; p = 0.001) and fingers (from 1.2 ± 1.1 to 0.7 ± 0.9; p = 0.004). Subjects reported decreased UL heaviness and stiffness after treatment, especially for the hand, as well as diminished pain when present. This study supports novel evidence that hand robotic assistance promotes local UL circulation changes, may help in the management of spasticity, and acutely alleviates reported symptoms of heaviness, stiffness, and pain in subjects with poststroke hemiparesis. This opens new scenarios for the implications in everyday clinical practice. Clinical Trial Registration Number is NCT03243123.

  14. Hybrid video-assisted and limited open (VALO) resection of superior sulcus tumors.

    Science.gov (United States)

    Nun, Alon Ben; Simansky, David; Rokah, Merav; Zeitlin, Nona; Avi, Roni Ben; Soudack, Michalle; Golan, Nir; Apel, Sarit; Bar, Jair; Yelin, Alon

    2016-06-01

    To compare the postoperative recovery of patients with superior sulcus tumors (Pancoast tumors) following conventional open surgery vs. a hybrid video-assisted and limited open approach (VALO). The subjects of this retrospective study were 20 patients we operated on to resect a Pancoast tumor. All patients received induction chemo-radiation followed by surgery, performed via either a conventional thoracotomy approach (n = 10) or the hybrid VALO approach (n = 10). In the hybrid VALO group, lobectomy and internal chest wall preparation were performed using a video technique, with rib resection and specimen removal through a limited incision. There was no mortality in either group. Two patients from the thoracotomy group required mechanical ventilation, but there was no major morbidity in the hybrid VALO group. The operative times were similar for the two procedures. The average length of hospital stay was shorter and the average pain scores were significantly lower in the hybrid VALO group. The incidence of chronic pain was 10 % in the hybrid VALO group vs. 50 % in the thoracotomy group. Hybrid VALO resection of Pancoast tumors is feasible and safe, resulting in faster patient recovery and a significantly lower incidence of severe chronic pain than open thoracotomy. We conclude that centers experienced with video-assisted lobectomy should consider hybrid VALO surgery as the procedure of choice for Pancoast tumors.

  15. The yeast two hybrid system in a screen for proteins interacting with axolotl (Ambystoma mexicanum) Msx1 during early limb regeneration.

    Science.gov (United States)

    Abuqarn, Mehtap; Allmeling, Christina; Amshoff, Inga; Menger, Bjoern; Nasser, Inas; Vogt, Peter M; Reimers, Kerstin

    2011-07-01

    Urodele amphibians are exceptional in their ability to regenerate complex body structures such as limbs. Limb regeneration depends on a process called dedifferentiation. Under an inductive wound epidermis terminally differentiated cells transform to pluripotent progenitor cells that coordinately proliferate and eventually redifferentiate to form the new appendage. Recent studies have developed molecular models integrating a set of genes that might have important functions in the control of regenerative cellular plasticity. Among them is Msx1, which induced dedifferentiation in mammalian myotubes in vitro. Herein, we screened for interaction partners of axolotl Msx1 using a yeast two hybrid system. A two hybrid cDNA library of 5-day-old wound epidermis and underlying tissue containing more than 2×10⁶ cDNAs was constructed and used in the screen. 34 resulting cDNA clones were isolated and sequenced. We then compared sequences of the isolated clones to annotated EST contigs of the Salamander EST database (BLASTn) to identify presumptive orthologs. We subsequently searched all no-hit clone sequences against non redundant NCBI sequence databases using BLASTx. It is the first time, that the yeast two hybrid system was adapted to the axolotl animal model and successfully used in a screen for proteins interacting with Msx1 in the context of amphibian limb regeneration. 2011 Elsevier B.V. All rights reserved.

  16. IKO: A Five Actuated DoF Upper Limb Exoskeleton Oriented to Workplace Assistance

    Directory of Open Access Journals (Sweden)

    Felix Martinez

    2009-01-01

    Full Text Available IKerlan’s Orthosis (IKO is an upper limb exoskeleton oriented to increasing human force during routine activity at the workplace. Therefore, it can be considered as a force-amplification device conceived to work in collaboration with the human arm and implementing biomimetic principles. The aim of the proposed design is to find the best compromise between maximum reachable workspace and minimum moving mass, which are the key factors for obtaining an ergonomic, wearable exoskeleton. It consists of five actuated degree of freedom (DoF to move the human arm and three non-actuated DoF between the back and shoulder to allow relative displacement of the sterno-clavicular joint. Conventional electrical motors are used for most of the DoF and pneumatic muscles for one of them (forearm rotation. Power transmission is based on Bowden cables. This paper presents the IKO design, the mechanical structure of a first prototype and the redesign process from an aesthetic point of view. Controller set-up and control strategies are also shown, together with dynamic performance from experimental results.

  17. The hybrid assistive limb (HAL) for Care Support successfully reduced lumbar load in repetitive lifting movements.

    Science.gov (United States)

    Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Kumagai, Hiroshi; Nagashima, Katsuya; Mataki, Kentaro; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

    2018-05-03

    Work-related low back pain is a serious socioeconomic problem. This study examined whether HAL for Care Support, which is a newly developed wearable robot, would decrease lumbar fatigue and improve lifting performance during repetitive lifting movements. Eighteen healthy volunteers (11 men, 7 women) performed repetitive stoop lifting movements of a cardboard box weighing 12 kg as many times as possible. The first lifting trial was executed without HAL for Care Support, and the second was with it. We evaluated the VAS of lumbar fatigue as the lumbar load and the number of lifts and the lifting time as lifting performance. Without HAL for Care Support, the mean VAS of lumbar fatigue, the number of lifts and lifting time were 68 mm, 60 and 230 s; with HAL for Care Support, they were 51 mm, 87 and 332 s, respectively. Both lifting performance measures were significantly improved by using HAL for Care Support (Fig. 2). A power analysis showed that there was sufficient statistical power for the VAS of lumbar fatigue (0.99), the number of lifts (0.92), and lifting time (0.93). All participants performed their repetitive lifting trials safely. There were no adverse events caused by using HAL for Care Support. In conclusion, the HAL for Care Support can decrease lumbar load and improve the lifting performance during repetitive stoop lifting movements in healthy adults. Copyright © 2018. Published by Elsevier Ltd.

  18. Lower Limb Voluntary Movement Improvement Following a Robot-Assisted Locomotor Training in Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Mirbagheri Mehdi

    2011-12-01

    Full Text Available Individuals with spinal cord injury (SCI suffer from severe impairments in voluntary movements. Literature reports a reduction in major kinematic and kinetic parameters of lower limbs’ joints. A body weight support treadmill training with robotic assistance has been widely used to improve lower-extremity function and locomotion in persons with SCI. Our objective was to explore the effects of 4-weeks robot-assisted locomotor training on voluntary movement of the ankle musculature in patients with incomplete SCI. In particular, we aimed to characterize the therapeutic effects of Lokomat training on kinematic measures (range of motion, velocity, smoothness during a dorsiflexion movement. We hypothesized that training would improve these measures. Preliminary results show an improvement of kinematic parameters during ankle dorsiflexion voluntary movement after a 4-weeks training in the major part of our participants. Complementary investigations are in progress to confirm these results and understand underlying mechanisms associated with the recovery.

  19. Navigation system for robot-assisted intra-articular lower-limb fracture surgery.

    Science.gov (United States)

    Dagnino, Giulio; Georgilas, Ioannis; Köhler, Paul; Morad, Samir; Atkins, Roger; Dogramadzi, Sanja

    2016-10-01

    In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

  20. Laser assisted hybrid additive manufacturing of thermoelectric modules

    Science.gov (United States)

    Zhang, Tao; Tewolde, Mahder; Longtin, Jon P.; Hwang, David J.

    2017-02-01

    Thermoelectric generators (TEGs) are an attractive means to produce electricity, particular from waste heat applications. However, TEGs are almost exclusively manufactured as flat, rigid modules of limited size and shape, and therefore an appropriate mounting for intimate contact of TEGs modules onto arbitrary surfaces represents a significant challenge. In this study, we introduce laser assisted additive manufacturing method to produce multi-layered thermoelectric generator device directly on flat and non-flat surfaces for waste heat recovery. The laser assisted processing spans from laser scribing of thermal sprayed thin films, curing of dispensed thermoelectric inks and selective laser sintering to functionalize thermoelectric materials.

  1. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Amy R. Wu

    2017-06-01

    Full Text Available Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI, where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection, can be decomposed into relevant control modules (e.g., only knee or hip control, and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects (N = 7, four with complete paraplegia, two incomplete, one healthy to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects—from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined

  2. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury.

    Science.gov (United States)

    Wu, Amy R; Dzeladini, Florin; Brug, Tycho J H; Tamburella, Federica; Tagliamonte, Nevio L; van Asseldonk, Edwin H F; van der Kooij, Herman; Ijspeert, Auke J

    2017-01-01

    Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI), where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC) which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection), can be decomposed into relevant control modules (e.g., only knee or hip control), and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects ( N = 7, four with complete paraplegia, two incomplete, one healthy) to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects-from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined settings for

  3. An Adaptive Neuromuscular Controller for Assistive Lower-Limb Exoskeletons: A Preliminary Study on Subjects with Spinal Cord Injury

    Science.gov (United States)

    Wu, Amy R.; Dzeladini, Florin; Brug, Tycho J. H.; Tamburella, Federica; Tagliamonte, Nevio L.; van Asseldonk, Edwin H. F.; van der Kooij, Herman; Ijspeert, Auke J.

    2017-01-01

    Versatility is important for a wearable exoskeleton controller to be responsive to both the user and the environment. These characteristics are especially important for subjects with spinal cord injury (SCI), where active recruitment of their own neuromuscular system could promote motor recovery. Here we demonstrate the capability of a novel, biologically-inspired neuromuscular controller (NMC) which uses dynamical models of lower limb muscles to assist the gait of SCI subjects. Advantages of this controller include robustness, modularity, and adaptability. The controller requires very few inputs (i.e., joint angles, stance, and swing detection), can be decomposed into relevant control modules (e.g., only knee or hip control), and can generate walking at different speeds and terrains in simulation. We performed a preliminary evaluation of this controller on a lower-limb knee and hip robotic gait trainer with seven subjects (N = 7, four with complete paraplegia, two incomplete, one healthy) to determine if the NMC could enable normal-like walking. During the experiment, SCI subjects walked with body weight support on a treadmill and could use the handrails. With controller assistance, subjects were able to walk at fast walking speeds for ambulatory SCI subjects—from 0.6 to 1.4 m/s. Measured joint angles and NMC-provided joint torques agreed reasonably well with kinematics and biological joint torques of a healthy subject in shod walking. Some differences were found between the torques, such as the lack of knee flexion near mid-stance, but joint angle trajectories did not seem greatly affected. The NMC also adjusted its torque output to provide more joint work at faster speeds and thus greater joint angles and step length. We also found that the optimal speed-step length curve observed in healthy humans emerged for most of the subjects, albeit with relatively longer step length at faster speeds. Therefore, with very few sensors and no predefined settings for

  4. Hybrid entanglement concentration assisted with single coherent state

    International Nuclear Information System (INIS)

    Guo Rui; Zhou Lan; Sheng Yu-Bo; Gu Shi-Pu; Wang Xing-Fu

    2016-01-01

    Hybrid entangled state (HES) is a new type of entanglement, which combines the advantages of an entangled polarization state and an entangled coherent state. HES is widely discussed in the applications of quantum communication and computation. In this paper, we propose three entanglement concentration protocols (ECPs) for Bell-type HES, W-type HES, and cluster-type HES, respectively. After performing these ECPs, we can obtain the maximally entangled HES with some success probability. All the ECPs exploit the single coherent state to complete the concentration. These protocols are based on the linear optics, which are feasible in future experiments. (paper)

  5. Early Stroke Rehabilitation of the Upper Limb Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation-Robotic Arm

    Directory of Open Access Journals (Sweden)

    Qiuyang Qian

    2017-09-01

    Full Text Available BackgroundEffective poststroke motor rehabilitation depends on repeated limb practice with voluntary efforts. An electromyography (EMG-driven neuromuscular electrical stimulation (NMES-robot arm was designed for the multi-joint physical training on the elbow, the wrist, and the fingers.ObjectivesTo investigate the training effects of the device-assisted approach on subacute stroke patients and to compare the effects with those achieved by the traditional physical treatments.MethodThis study was a pilot randomized controlled trial with a 3-month follow-up. Subacute stroke participants were randomly assigned into two groups, and then received 20-session upper limb training with the EMG-driven NMES-robotic arm (NMES-robot group, n = 14 or the time-matched traditional therapy (the control, n = 10. For the evaluation of the training effects, clinical assessments including Fugl-Meyer Assessment (FMA, Modified Ashworth Score (MAS, Action Research Arm Test (ARAT, and Function Independence Measurement (FIM were conducted before, after the rehabilitation training, and 3 months later. Session-by-session EMG parameters in the NMES-robot group, including normalized co-contraction Indexes (CI and EMG activation level of target muscles, were used to monitor the progress in muscular coordination patterns.ResultsSignificant improvements were obtained in FMA (full score and shoulder/elbow, ARAT, and FIM [P < 0.001, effect sizes (EFs > 0.279] for both groups. Significant improvement in FMA wrist/hand was only observed in the NMES-robot group (P < 0.001, EFs = 0.435 after the treatments. Significant reduction in MAS wrist was observed in the NMES-robot group after the training (P < 0.05, EFs = 0.145 and the effects were maintained for 3 months. MAS scores in the control group were elevated following training (P < 0.05, EFs > 0.24, and remained at an elevated level when assessed 3 months later. The EMG parameters

  6. Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy.

    Science.gov (United States)

    Preston, Nick; Weightman, Andrew; Gallagher, Justin; Holt, Raymond; Clarke, Michael; Mon-Williams, Mark; Levesley, Martin; Bhakta, Bipinchandra

    2016-01-01

    We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Nine boys and two girls with cerebral palsy (6-12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB-BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2 min, p = 0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p = 0.424; COPM, p = 0.484) but we found significant improvements in hand speed (p = 0.028), smoothness (p = 0.005) and accuracy (p = 0.007). School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity. Implications for Rehabilitation School premises and teaching staff present no obstacles to the installation of rehabilitation gaming technology. Twelve minutes per day is the average amount of time that the school time table permits children to use rehabilitation gaming equipment (without disruption to academic attendance). The use of rehabilitation gaming technology for an average of 12 minutes daily does not appear to benefit children's functional performance, but there are improvements in the kinematics of children's upper limb.

  7. The effect of vacuum assisted socket suspension on prospective, community-based falls by users of lower limb prostheses.

    Science.gov (United States)

    Rosenblatt, Noah J; Ehrhardt, Tess

    2017-06-01

    Individuals with lower limb amputation are at increased risk of falling compared to age-matched peers. The purpose of this study was to quantify the effect of socket suspension on the risk of falling, by comparing prospectively tracked falls between a group of participants that used vacuum assisted socket suspension (VASS) and a group that did not use this system. Fifteen current users of VASS and 12 non-VASS users received an email every two weeks for one year, with a link to an online survey that asked whether they fell (i.e., "unintentionally came to rest on a lower surface") or stumbled (i.e., lost balance but did not fall) in the prior two weeks. A Chi-squared test was used to compare fall and stumble risk between groups, after stratifying by level of amputation, and the phi coefficient (φ) was used to quantify effect size. While the use of VASS did not affect the rate of falling (i.e., falls per person year) for either persons with transtibial amputation (TTA) or those with transfemoral amputation (TFA), the absolute risk of having multiple falls was reduced by nearly 75% in the former (φ=0.83), which is particularly important given that recurrent falls are associated with more severe injuries. There was no effect of VASS on the risk of falls in TFA. Further work is warranted to demonstrate the persistence of these effects in larger, more controlled samples. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Pattern of improvement in upper limb pointing task kinematics after a 3-month training program with robotic assistance in stroke.

    Science.gov (United States)

    Pila, Ophélie; Duret, Christophe; Laborne, François-Xavier; Gracies, Jean-Michel; Bayle, Nicolas; Hutin, Emilie

    2017-10-13

    When exploring changes in upper limb kinematics and motor impairment associated with motor recovery in subacute post stroke during intensive therapies involving robot-assisted training, it is not known whether trained joints improve before non-trained joints and whether target reaching capacity improves before movement accuracy. Twenty-two subacute stroke patients (mean delay post-stroke at program onset 63 ± 29 days, M2) underwent 50 ± 17 (mean ± SD) 45-min sessions of robot-assisted (InMotion™) shoulder/elbow training over 3 months, in addition to conventional occupational therapy. Monthly evaluations (M2 to M5) included Fugl-Meyer Assessment (FM), with subscores per joint, and four robot-based kinematic measures: mean target distance covered, mean velocity, direction accuracy (inverse of root mean square error from straight line) and movement smoothness (inverse of mean number of zero-crossings in the velocity profile). We assessed delays to reach statistically significant improvement for each outcome measure. At M5, all clinical and kinematic parameters had markedly improved: Fugl-Meyer, +65% (median); distance covered, +87%; mean velocity, +101%; accuracy, +134%; and smoothness, +96%. Delays to reach statistical significance were M3 for the shoulder/elbow Fugl-Meyer subscore (+43%), M4 for the hand (+80%) and M5 for the wrist (+133%) subscores. For kinematic parameters, delays to significant improvements were M3 for distance (+68%), velocity (+65%) and smoothness (+50%), and M5 for accuracy (+134%). An intensive rehabilitation program combining robot-assisted shoulder/elbow training and conventional occupational therapy was associated with improvement in shoulder and elbow movements first, which suggests focal behavior-related brain plasticity. Findings also suggested that recovery of movement quantity related parameters (range of motion, velocity and smoothness) might precede that of movement quality (accuracy). EudraCT 2016-005121-36 . Date of

  9. Hand-assisted hybrid laparoscopic-robotic total proctocolectomy with ileal pouch--anal anastomosis.

    Science.gov (United States)

    Morelli, Luca; Guadagni, Simone; Mariniello, Maria Donatella; Furbetta, Niccolò; Pisano, Roberta; D'Isidoro, Cristiano; Caprili, Giovanni; Marciano, Emanuele; Di Candio, Giulio; Boggi, Ugo; Mosca, Franco

    2015-08-01

    Few studies have reported minimally invasive total proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP). We herein report a novel hand-assisted hybrid laparoscopic-robotic technique for patients with FAP and UC. Between February 2010 and March 2014, six patients underwent hand-assisted hybrid laparoscopic-robotic total proctocolectomy with IPAA. The abdominal colectomy was performed laparoscopically with hand assistance through a transverse suprapubic incision, also used to fashion the ileal pouch. The proctectomy was carried out with the da Vinci Surgical System. The IPAA was hand-sewn through a trans-anal approach. The procedure was complemented by a temporary diverting loop ileostomy. The mean hand-assisted laparoscopic surgery (HALS) time was 154.6 (±12.8) min whereas the mean robotic time was 93.6 (±8.1) min. In all cases, a nerve-sparing proctectomy was performed, and no conversion to traditional laparotomy was required. The mean postoperative hospital stay was 13.2 (±7.4) days. No anastomotic leakage was observed. To date, no autonomic neurological disorders have been observed with a mean of 5.8 (±1.3) bowel movements per day. The hand-assisted hybrid laparoscopic-robotic approach to total proctocolectomy with IPAA has not been previously described. Our report shows the feasibility of this hybrid approach, which surpasses most of the limitations of pure laparoscopic and robotic techniques. Further experience is necessary to refine the technique and fully assess its potential advantages.

  10. Wheeled mobility: factors influencing mobility and assistive technology in veterans and servicemembers with major traumatic limb loss from Vietnam war and OIF/OEF conflicts.

    Science.gov (United States)

    Laferrier, Justin Z; McFarland, Lynne V; Boninger, Michael L; Cooper, Rory A; Reiber, Gayle E

    2010-01-01

    Returning wounded veterans and servicemembers to their highest level of function following traumatic injury is a priority of the Departments of Defense and Veterans Affairs. We surveyed 245 veterans from the Vietnam war and 226 servicemembers and veterans from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) conflicts with at least one major traumatic lower-limb loss to determine their use of mobility assistive technology (AT) and patterns of limb abandonment. Prosthetic device use without wheelchair use is found in 50.5% of Vietnam and 42.8% of OIF/OEF groups. Prostheses and supplementary wheelchairs are used by Vietnam (32%) and OIF/OEF (53%) groups (p Vietnam group (18%) than in the OIF/OEF group (4.0%, p Vietnam participants, multivariate analysis found that multiple-limb loss (adjusted odds ratio [AOR] = 14.5; 95% confidence interval [CI] 5.5-38.5), bilateral lower-limb loss (AOR = 12.7; 95% CI 6.2-26.1), and number of comorbidities (AOR = 1.3; 95% CI 1.2-1.5) are associated with increased likelihood of wheelchair use. In OIF/OEF participants, bilateral lower-limb loss (AOR = 29.8; 95% CI 11.0-80.7), multiple-limb loss (AOR = 16.3; 95% CI 3.1-85.3), cumulative trauma disorder (AOR = 2.4; 95% CI 1.2-4.9), and number of combat injuries (AOR = 1.4; 95% CI 1.2-1.7) are associated with wheelchair use. Combined use of different types of mobility ATs promotes improved rehabilitation and ability to function.

  11. Development of hybrid solar-assisted cooling/heating system

    KAUST Repository

    Huang, B.J.; Wu, J.H.; Hsu, H.Y.; Wang, J.H.

    2010-01-01

    A solar-assisted ejector cooling/heating system (SACH) was developed in this study. The SACH combines a pump-less ejector cooling system (ECS) with an inverter-type heat pump (R22) and is able to provide a stable capacity for space cooling. The ECS is driven by solar heat and is used to cool the condenser of the R22 heat pump to increase its COP and reduce the energy consumption of the compressor by regulating the rotational speed of the compressor through a control system. In a complete SACH system test run at outdoor temperature 35 °C, indoor temperature 25 °C and compressor speed 20-80 Hz, and the ECS operating at generator temperature 90 °C and condensing temperature 37 °C, the corresponding condensing temperature of the heat pump in the SACH is 24.5-42 °C, cooling capacity 1.02-2.44 kW, input power 0.20-0.98 kW, and cooling COPc 5.11-2.50. This indicates that the use of ECS in SACH can effectively reduce the condensing temperature of the heat pump by 12.6-7.3 °C and reduce the power consumption by 81.2-34.5%. The SACH can also supply heat from the heat pump. At ambient temperature from 5 °C to 35 °C, the heating COPh is in the range 2.0-3.3. © 2010 Elsevier Ltd. All rights reserved.

  12. Development of hybrid solar-assisted cooling/heating system

    KAUST Repository

    Huang, B.J.

    2010-08-01

    A solar-assisted ejector cooling/heating system (SACH) was developed in this study. The SACH combines a pump-less ejector cooling system (ECS) with an inverter-type heat pump (R22) and is able to provide a stable capacity for space cooling. The ECS is driven by solar heat and is used to cool the condenser of the R22 heat pump to increase its COP and reduce the energy consumption of the compressor by regulating the rotational speed of the compressor through a control system. In a complete SACH system test run at outdoor temperature 35 °C, indoor temperature 25 °C and compressor speed 20-80 Hz, and the ECS operating at generator temperature 90 °C and condensing temperature 37 °C, the corresponding condensing temperature of the heat pump in the SACH is 24.5-42 °C, cooling capacity 1.02-2.44 kW, input power 0.20-0.98 kW, and cooling COPc 5.11-2.50. This indicates that the use of ECS in SACH can effectively reduce the condensing temperature of the heat pump by 12.6-7.3 °C and reduce the power consumption by 81.2-34.5%. The SACH can also supply heat from the heat pump. At ambient temperature from 5 °C to 35 °C, the heating COPh is in the range 2.0-3.3. © 2010 Elsevier Ltd. All rights reserved.

  13. Water-assisted growth of graphene-carbon nanotube hybrids in plasma

    Science.gov (United States)

    Tewari, Aarti; Ghosh, Santanu; Srivastava, Pankaj

    2018-04-01

    The enhanced growth of graphene-carbon nanotube (CNT) hybrids in a hydrocarbon and hydrogen plasma assisted by water is numerically formulated. The catalyst activity and agglomeration of catalyst particles are the rate determining factors in the growth of hybrids and their constituents, i.e., the CNT and graphene. The water vapor concentration is varied to investigate its effect on the growth process. The enhanced catalyst activity on account of oxidation by hydroxyl ions of water to impede the agglomeration of catalyst particles and the removal of amorphous carbon through etching by hydrogen ions of water are seen to be the main driving forces behind the many fold increase in the dimensions of constituent nanostructures and the hybrids with water vapor concentration. Importantly, beyond a certain specific water vapor concentration, the growth rates dropped due to active oxidation of the catalyst particle.

  14. Single Balloon Enteroscopy-Assisted ERCP Using Rendezvous Technique for Sharp Angulation of Roux-en-Y Limb in a Patient with Bile Duct Stones

    Science.gov (United States)

    Itoi, Takao; Ishii, Kentaro; Sofuni, Atsushi; Itokawa, Fumihide; Kurihara, Toshio; Tsuchiya, Takayoshi; Tsuji, Shujiro; Umeda, Junko; Moriyasu, Fuminori

    2009-01-01

    The acute angulation of Roux-en-Y (R-Y) limb precludes endoscopic access for endoscopic retrograde cholangiopancreatography (ERCP) even using a balloon enteroscopy. Here, we describe a case of successful single balloon enteroscopy (SBE)-assisted ERCP using a rendezvous technique in a patient with sharply angulated R-Y limb in a 79-year-old woman who had bile duct stones. Method. At first, a guidewire was passed antegradely through the major papilla after the needle puncture using percutaneous transhepatic biliary drainage technique. A hydrophilic guidewire with an ERCP catheter was antegradely advanced beyond the Roux limb. After a guidewire was firmly grasped by a snare forceps, it was pulled out of the body, resulting that the enteroscope could advance to the papilla. After papillary dilation, complete removal of bile duct stones was achieved without any procedure-related complication. In conclusion, although further study is needed, SBE-assisted ERCP using a rendezvous technique may have a potential for selected patients. PMID:20169091

  15. Single Balloon Enteroscopy-Assisted ERCP Using Rendezvous Technique for Sharp Angulation of Roux-en-Y Limb in a Patient with Bile Duct Stones

    Directory of Open Access Journals (Sweden)

    Takao Itoi

    2009-01-01

    Full Text Available The acute angulation of Roux-en-Y (R-Y limb precludes endoscopic access for endoscopic retrograde cholangiopancreatography (ERCP even using a balloon enteroscopy. Here, we describe a case of successful single balloon enteroscopy (SBE-assisted ERCP using a rendezvous technique in a patient with sharply angulated R-Y limb in a 79-year-old woman who had bile duct stones. Method. At first, a guidewire was passed antegradely through the major papilla after the needle puncture using percutaneous transhepatic biliary drainage technique. A hydrophilic guidewire with an ERCP catheter was antegradely advanced beyond the Roux limb. After a guidewire was firmly grasped by a snare forceps, it was pulled out of the body, resulting that the enteroscope could advance to the papilla. After papillary dilation, complete removal of bile duct stones was achieved without any procedure-related complication. In conclusion, although further study is needed, SBE-assisted ERCP using a rendezvous technique may have a potential for selected patients.

  16. Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

    KAUST Repository

    Liu, Guozheng

    2016-07-06

    Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

  17. Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat.

    Directory of Open Access Journals (Sweden)

    Guozheng Liu

    Full Text Available Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1 examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2 explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3 investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L. and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs, but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

  18. Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

    KAUST Repository

    Liu, Guozheng; Zhao, Yusheng; Gowda, Manje; Longin, C. Friedrich H.; Reif, Jochen C.; Mette, Michael F.

    2016-01-01

    Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population.

  19. Predicting Hybrid Performances for Quality Traits through Genomic-Assisted Approaches in Central European Wheat

    Science.gov (United States)

    Liu, Guozheng; Zhao, Yusheng; Gowda, Manje; Longin, C. Friedrich H.; Reif, Jochen C.; Mette, Michael F.

    2016-01-01

    Bread-making quality traits are central targets for wheat breeding. The objectives of our study were to (1) examine the presence of major effect QTLs for quality traits in a Central European elite wheat population, (2) explore the optimal strategy for predicting the hybrid performance for wheat quality traits, and (3) investigate the effects of marker density and the composition and size of the training population on the accuracy of prediction of hybrid performance. In total 135 inbred lines of Central European bread wheat (Triticum aestivum L.) and 1,604 hybrids derived from them were evaluated for seven quality traits in up to six environments. The 135 parental lines were genotyped using a 90k single-nucleotide polymorphism array. Genome-wide association mapping initially suggested presence of several quantitative trait loci (QTLs), but cross-validation rather indicated the absence of major effect QTLs for all quality traits except of 1000-kernel weight. Genomic selection substantially outperformed marker-assisted selection in predicting hybrid performance. A resampling study revealed that increasing the effective population size in the estimation set of hybrids is relevant to boost the accuracy of prediction for an unrelated test population. PMID:27383841

  20. Hybrid procedure for total laryngectomy with a flexible robot-assisted surgical system.

    Science.gov (United States)

    Schuler, Patrick J; Hoffmann, Thomas K; Veit, Johannes A; Rotter, Nicole; Friedrich, Daniel T; Greve, Jens; Scheithauer, Marc O

    2017-06-01

    Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented. TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure. The transoral approach was performed with a robotic flexible robot-assisted surgical system (Flex®) and compatible flexible instruments. Transoral access and visualization of anatomical landmarks were studied in detail. Total laryngectomy is feasible with a combined transoral-transcervical approach using the flexible robot-assisted surgical system. Transoral visualization of all anatomical structures is sufficient. The flexible design of the robot is advantageous for transoral surgery of the laryngeal structures. Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. The Effects of Upper-Limb Training Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation Robotic Hand on Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Chingyi Nam

    2017-12-01

    Full Text Available BackgroundImpaired hand dexterity is a major disability of the upper limb after stroke. An electromyography (EMG-driven neuromuscular electrical stimulation (NMES robotic hand was designed previously, whereas its rehabilitation effects were not investigated.ObjectivesThis study aims to investigate the rehabilitation effectiveness of the EMG-driven NMES-robotic hand-assisted upper-limb training on persons with chronic stroke.MethodA clinical trial with single-group design was conducted on chronic stroke participants (n = 15 who received 20 sessions of EMG-driven NMES-robotic hand-assisted upper-limb training. The training effects were evaluated by pretraining, posttraining, and 3-month follow-up assessments with the clinical scores of the Fugl-Meyer Assessment (FMA, the Action Research Arm Test (ARAT, the Wolf Motor Function Test, the Motor Functional Independence Measure, and the Modified Ashworth Scale (MAS. Improvements in the muscle coordination across the sessions were investigated by EMG parameters, including EMG activation level and Co-contraction Indexes (CIs of the target muscles in the upper limb.ResultsSignificant improvements in the FMA shoulder/elbow and wrist/hand scores (P < 0.05, the ARAT (P < 0.05, and in the MAS (P < 0.05 were observed after the training and sustained 3 months later. The EMG parameters indicated a significant decrease of the muscle activation level in flexor digitorum (FD and biceps brachii (P < 0.05, as well as a significant reduction of CIs in the muscle pairs of FD and triceps brachii and biceps brachii and triceps brachii (P < 0.05.ConclusionThe upper-limb training integrated with the assistance from the EMG-driven NMES-robotic hand is effective for the improvements of the voluntary motor functions and the muscle coordination in the proximal and distal joints. Furthermore, the motor improvement after the training could be maintained till 3 months later.Trial registration

  2. The Effects of Upper-Limb Training Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation Robotic Hand on Chronic Stroke.

    Science.gov (United States)

    Nam, Chingyi; Rong, Wei; Li, Waiming; Xie, Yunong; Hu, Xiaoling; Zheng, Yongping

    2017-01-01

    Impaired hand dexterity is a major disability of the upper limb after stroke. An electromyography (EMG)-driven neuromuscular electrical stimulation (NMES) robotic hand was designed previously, whereas its rehabilitation effects were not investigated. This study aims to investigate the rehabilitation effectiveness of the EMG-driven NMES-robotic hand-assisted upper-limb training on persons with chronic stroke. A clinical trial with single-group design was conducted on chronic stroke participants ( n  = 15) who received 20 sessions of EMG-driven NMES-robotic hand-assisted upper-limb training. The training effects were evaluated by pretraining, posttraining, and 3-month follow-up assessments with the clinical scores of the Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the Wolf Motor Function Test, the Motor Functional Independence Measure, and the Modified Ashworth Scale (MAS). Improvements in the muscle coordination across the sessions were investigated by EMG parameters, including EMG activation level and Co-contraction Indexes (CIs) of the target muscles in the upper limb. Significant improvements in the FMA shoulder/elbow and wrist/hand scores ( P  < 0.05), the ARAT ( P  < 0.05), and in the MAS ( P  < 0.05) were observed after the training and sustained 3 months later. The EMG parameters indicated a significant decrease of the muscle activation level in flexor digitorum (FD) and biceps brachii ( P  < 0.05), as well as a significant reduction of CIs in the muscle pairs of FD and triceps brachii and biceps brachii and triceps brachii ( P  < 0.05). The upper-limb training integrated with the assistance from the EMG-driven NMES-robotic hand is effective for the improvements of the voluntary motor functions and the muscle coordination in the proximal and distal joints. Furthermore, the motor improvement after the training could be maintained till 3 months later. ClinicalTrials.gov. NCT02117089; date of registration: April

  3. Single axis controlled hybrid magnetic bearing for left ventricular assist device: hybrid core and closed magnetic circuit.

    Science.gov (United States)

    da Silva, Isaias; Horikawa, Oswaldo; Cardoso, Jose R; Camargo, Fernando A; Andrade, Aron J P; Bock, Eduardo G P

    2011-05-01

    In previous studies, we presented main strategies for suspending the rotor of a mixed-flow type (centrifugal and axial) ventricular assist device (VAD), originally presented by the Institute Dante Pazzanese of Cardiology (IDPC), Brazil. Magnetic suspension is achieved by the use of a magnetic bearing architecture in which the active control is executed in only one degree of freedom, in the axial direction of the rotor. Remaining degrees of freedom, excepting the rotation, are restricted only by the attraction force between pairs of permanent magnets. This study is part of a joint project in development by IDPC and Escola Politecnica of São Paulo University, Brazil. This article shows advances in that project, presenting two promising solutions for magnetic bearings. One solution uses hybrid cores as electromagnetic actuators, that is, cores that combine iron and permanent magnets. The other solution uses actuators, also of hybrid type, but with the magnetic circuit closed by an iron core. After preliminary analysis, a pump prototype has been developed for each solution and has been tested. For each prototype, a brushless DC motor has been developed as the rotor driver. Each solution was evaluated by in vitro experiments and guidelines are extracted for future improvements. Tests have shown good results and demonstrated that one solution is not isolated from the other. One complements the other for the development of a single-axis-controlled, hybrid-type magnetic bearing for a mixed-flow type VAD. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Organic/hybrid thin films deposited by matrix-assisted pulsed laser evaporation (MAPLE)

    Science.gov (United States)

    Stiff-Roberts, Adrienne D.; Ge, Wangyao

    2017-12-01

    Some of the most exciting materials research in the 21st century attempts to resolve the challenge of simulating, synthesizing, and characterizing new materials with unique properties designed from first principles. Achievements in such development for organic and organic-inorganic hybrid materials make them important options for electronic and/or photonic devices because they can impart multi-functionality, flexibility, transparency, and sustainability to emerging systems, such as wearable electronics. Functional organic materials include small molecules, oligomers, and polymers, while hybrid materials include inorganic nanomaterials (such as zero-dimensional quantum dots, one-dimensional carbon nanotubes, or two-dimensional nanosheets) combined with organic matrices. A critically important step to implementing new electronic and photonic devices using such materials is the processing of thin films. While solution-based processing is the most common laboratory technique for organic and hybrid materials, vacuum-based deposition has been critical to the commercialization of organic light emitting diodes based on small molecules, for example. Therefore, it is desirable to explore vacuum-based deposition of organic and hybrid materials that include larger macromolecules, such as polymers. This review article motivates the need for physical vapor deposition of polymeric and hybrid thin films using matrix-assisted pulsed laser evaporation (MAPLE), which is a type of pulsed laser deposition. This review describes the development of variations in the MAPLE technique, discusses the current understanding of laser-target interactions and growth mechanisms for different MAPLE variations, surveys demonstrations of MAPLE-deposited organic and hybrid materials for electronic and photonic devices, and provides a future outlook for the technique.

  5. Direct deposition of inorganic–organic hybrid semiconductors and their template-assisted microstructures

    International Nuclear Information System (INIS)

    Dwivedi, V.K.; Baumberg, J.J.; Prakash, G. Vijaya

    2013-01-01

    A straight-forward method is developed to deposit a new class of self-organized inorganic–organic (IO) hybrid, (C 12 H 25 NH 3 ) 2 PbI 4 . These IO hybrid structures are stacked-up as natural multiple quantum well structures and exhibit strong room-temperature exciton emission and other multifunctional features. Here it is successfully demonstrated that these materials can be directly carved into 2D photonic structures from the inexpensive template-assisted electrochemical deposition followed by solution processing. The applicability of this method for many such varieties of IO-hybrids is also explored. By appropriately controlling the deposition conditions and the self-assembly templates, target structures are developed for new-generation low-cost photonic devices. -- Highlights: ► New fabrication methodology for self-organized inorganic–organic hybrids. ► Strongly confined exciton emission and photoconductive properties. ► Simple bottom-up fabrication for device applications.

  6. Tailoring double Fano profiles with plasmon-assisted quantum interference in hybrid exciton-plasmon system

    International Nuclear Information System (INIS)

    Zhao, Dongxing; Wu, Jiarui; Gu, Ying; Gong, Qihuang

    2014-01-01

    We propose tailoring of the double Fano profiles via plasmon-assisted quantum interference in a hybrid exciton-plasmon system. Tailoring is performed by the interference between two exciton channels interacting with a common localized surface plasmon. Using an applied field of low intensity, the absorption spectrum of the hybrid system reveals a double Fano lineshape with four peaks. For relatively large field intensity, a broad flat window in the absorption spectrum appears which results from the destructive interference between excitons. Because of strong constructive interference, this window vanishes as intensity is further increased. We have designed a nanometer bandpass optical filter for visible light based on tailoring of the optical spectrum. This study provides a platform for quantum interference that may have potential applications in ultracompact tunable quantum devices.

  7. Universal quantum gates for photon-atom hybrid systems assisted by bad cavities

    Science.gov (United States)

    Wang, Guan-Yu; Liu, Qian; Wei, Hai-Rui; Li, Tao; Ai, Qing; Deng, Fu-Guo

    2016-01-01

    We present two deterministic schemes for constructing a CNOT gate and a Toffoli gate on photon-atom and photon-atom-atom hybrid quantum systems assisted by bad cavities, respectively. They are achieved by cavity-assisted photon scattering and work in the intermediate coupling region with bad cavities, which relaxes the difficulty of their implementation in experiment. Also, bad cavities are feasible for fast quantum operations and reading out information. Compared with previous works, our schemes do not need any auxiliary qubits and measurements. Moreover, the schematic setups for these gates are simple, especially that for our Toffoli gate as only a quarter wave packet is used to interact the photon with each of the atoms every time. These atom-cavity systems can be used as the quantum nodes in long-distance quantum communication as their relatively long coherence time is suitable for multi-time operations between the photon and the system. Our calculations show that the average fidelities and efficiencies of our two universal hybrid quantum gates are high with current experimental technology. PMID:27067992

  8. Potential Evaluation of Solar Heat Assisted Desiccant Hybrid Air Conditioning System

    Science.gov (United States)

    Tran, Thien Nha; Hamamoto, Yoshinori; Akisawa, Atsushi; Kashiwagi, Takao

    The solar thermal driven desiccant dehumidification-absorption cooling hybrid system has superior advantage in hot-humid climate regions. The reasonable air processing of desiccant hybrid air conditioning system and the utility of clean and free energy make the system environment friendly and energy efficient. The study investigates the performance of the desiccant dehumidification air conditioning systems with solar thermal assistant. The investigation is performed for three cases which are combinations of solar thermal and absorption cooling systems with different heat supply temperature levels. Two solar thermal systems are used in the study: the flat plate collector (FPC) and the vacuum tube with compound parabolic concentrator (CPC). The single-effect and high energy efficient double-, triple-effect LiBr-water absorption cooling cycles are considered for cooling systems. COP of desiccant hybrid air conditioning systems are determined. The evaluation of these systems is subsequently performed. The single effect absorption cooling cycle combined with the flat plate collector solar system is found to be the most energy efficient air conditioning system.

  9. Simulation of Hybrid Photovoltaic Solar Assisted Loop Heat Pipe/Heat Pump System

    Directory of Open Access Journals (Sweden)

    Nannan Dai

    2017-02-01

    Full Text Available A hybrid photovoltaic solar assisted loop heat pipe/heat pump (PV-SALHP/HP water heater system has been developed and numerically studied. The system is the combination of loop heat pipe (LHP mode and heat pump (HP mode, and the two modes can be run separately or compositely according to the weather conditions. The performances of independent heat pump (HP mode and hybrid loop heat pipe/heat pump (LHP/HP mode were simulated and compared. Simulation results showed that on typical sunny days in spring or autumn, using LHP/HP mode could save 40.6% power consumption than HP mode. In addition, the optimal switchover from LHP mode to HP mode was analyzed in different weather conditions for energy saving and the all-year round operating performances of the system were also simulated. The simulation results showed that hybrid LHP/HP mode should be utilized to save electricity on sunny days from March to November and the system can rely on LHP mode alone without any power consumption in July and August. When solar radiation and ambient temperature are low in winter, HP mode should be used

  10. Hybrid plasma system for magnetron deposition of coatings with ion assistance

    International Nuclear Information System (INIS)

    Vavilin, K V; Kralkina, E A; Nekludova, P A; Petrov, A. K; Nikonov, A M; Pavlov, V B; Airapetov, A A; Odinokov, V V; Pavlov, G Ya; Sologub, V A

    2016-01-01

    The results of the study of the plasma hybrid system based on the combined magnetron discharge and high-frequency inductive discharge located in the external magnetic field is presented. Magnetron discharge provides the generation of atoms and ions of the target materials while the flow of accelerated ions used for the ion assistance is provided by the RF inductive discharge. An external magnetic field is used to optimize the power input to the discharge, to increase the ion current density in the realm of substrate and to enhance the area of uniform plasma. The joint operation of magnetron and RF inductive discharge leads to a substantial increase (not equal to the sum of the parameters obtained under separate operation of two hybrid system channels) of the ion current density and intensity of sputtered material spectral lines radiation. Optimal mode of the hybrid plasma system operation provides uniform ion current density on the diameter of at least 150mm at 0.7PA argon pressure. The optimal values of the magnetic fields in the region of the substrate location lie in the range 2-8 mTl, while in the region of the RF input power unit lie in the range 0.5-25 mTl. (paper)

  11. Practical requirements for software tools to assist in the validation and verification of hybrid expert systems

    International Nuclear Information System (INIS)

    Singh, G.P.; Cadena, D.; Burgess, J.

    1992-01-01

    Any practical software development effort must remain focused on verification and validation of user requirements. Knowledge-based system development is no different in this regard. In industry today, most expert systems being produced are, in reality, hybrid software systems which, in addition to those components that provide the knowledge base and expert reasoning over the problem domain using various rule-based and object-oriented paradigms, incorporate significant bodies of code based on more traditional software techniques such as database management, graphical user interfaces, hypermedia, spreadsheets, as well as specially developed sequential code. Validation and verification of such hybrid systems must perforce integrate suitable methodologies from all such fields. This paper attempts to provide a broad overview of the practical requirements for methodologies and the concomitant groupware tools which would assist in such an enterprise. These methodologies and groupware tools would facilitate the teamwork efforts necessary to validate and verify all components of such hybrid systems by emphasizing cooperative recording of requirements and negotiated resolutions of any conflicts grounded in a solid understanding of the semantics of such a system

  12. Development of an Upper Limb Power Assist System Using Pneumatic Actuators for Farming Lift-up Motion

    Science.gov (United States)

    Yagi, Eiichi; Harada, Daisuke; Kobayashi, Masaaki

    A power assist system has lately attracted considerable attention to lifting-up an object without low back pain. We have been developing power assist systems with pneumatic actuators for the elbow and shoulder to farming support of lifting-up a bag of rice weighing 30kg. This paper describes the mechanism and control method of this power assist system. The pneumatic rotary actuator supports shoulder motion, and the air cylinder supports elbow motion. In this control method, the surface electromyogram(EMG) signals are used as input information of the controller. The joint support torques of human are calculated based on the antigravity term of necessary joint torques, which are estimated on the dynamics of a human approximated link model. The experimental results show the effectiveness of the proposed mechanism and control method of the power assist system.

  13. Hybrid quantum gates between flying photon and diamond nitrogen-vacancy centers assisted by optical microcavities

    Science.gov (United States)

    Wei, Hai-Rui; Lu Long, Gui

    2015-01-01

    Hybrid quantum gates hold great promise for quantum information processing since they preserve the advantages of different quantum systems. Here we present compact quantum circuits to deterministically implement controlled-NOT, Toffoli, and Fredkin gates between a flying photon qubit and diamond nitrogen-vacancy (NV) centers assisted by microcavities. The target qubits of these universal quantum gates are encoded on the spins of the electrons associated with the diamond NV centers and they have long coherence time for storing information, and the control qubit is encoded on the polarizations of the flying photon and can be easily manipulated. Our quantum circuits are compact, economic, and simple. Moreover, they do not require additional qubits. The complexity of our schemes for universal three-qubit gates is much reduced, compared to the synthesis with two-qubit entangling gates. These schemes have high fidelities and efficiencies, and they are feasible in experiment. PMID:26271899

  14. Studies of lower-hybrid-assisted current rampup in NET/ITER

    International Nuclear Information System (INIS)

    Litaudon, X.; Moreau, D.; Bizarro, J.P.; Hoang, G.T.; Kupfer, K.; Peysson, Y.; Bonoli, P.

    1992-01-01

    Plasma current rampup, from 3.5 MA to the full operating value of 22 MA, is examined in NET/ITER at a density n = 6x10 19 m -3 and a rampup rate 0.35 MA/s. At these conditions, purely ohmic rampup requires about 250 Vs of transformer flux. With 30 MW of lower hybrid (LH) assist, we find that about 20-30 Vs can be saved depending on details of the incident power spectrum, fast electron trapping, etc. The principal constraint is to maintain monotonic (and thus stable) q profiles. The results indicate that a good overall strategy is to add the LH power slowly. Results are then quite insensitive to the incident power spectrum and deposition profiles

  15. ANN based optimization of a solar assisted hybrid cooling system in Turkey

    Energy Technology Data Exchange (ETDEWEB)

    Ozgur, Arif; Yetik, Ozge; Arslan, Oguz [Mechanical Eng. Dept., Engineering Faculty, Dumlupinar University (Turkey)], email: maozgur@dpu.edu.tr, email: ozgeyetik@dpu.edu.tr, email: oarslan@dpu.edu.tr

    2011-07-01

    This study achieved optimization of a solar assisted hybrid cooling system with refrigerants such as R717, R141b, R134a and R123 using an artificial neural network (ANN) model based on average total solar radiation, ambient temperature, generator temperature, condenser temperature, intercooler temperature and fluid types. ANN is a new tool; it works rapidly and can thus be a solution for design and optimization of complex power cycles. A unique flexible ANN algorithm was introduced to evaluate the solar ejector cooling systems because of the nonlinearity of neural networks. The conclusion was that the best COPs value obtained with the ANN is 1.35 and COPc is 3.03 when the average total solar radiation, ambient temperature, generator temperature, condenser temperature, intercooler temperature and algorithm are respectively 674.72 W/m2, 17.9, 80, 15 and 13 degree celsius and LM with 14 neurons in single hidden layer, for R717.

  16. Hybrid chemical vapour and nanoceramic aerosol assisted deposition for multifunctional nanocomposite thin films

    Energy Technology Data Exchange (ETDEWEB)

    Warwick, Michael E.A.; Dunnill, Charles W.; Goodall, Josie; Darr, Jawwad A.; Binions, Russell, E-mail: uccarbi@ucl.ac.uk

    2011-07-01

    Hybrid atmospheric pressure chemical vapour and aerosol assisted deposition via the reaction of vanadium acetylacetonate and a suspension of preformed titanium dioxide or cerium dioxide nanoparticles, led to the production of vanadium dioxide nanocomposite thin films on glass substrates. The preformed nanoparticle oxides used for the aerosol were synthesised using a continuous hydrothermal flow synthesis route involving the rapid reaction of a metal salt solution with a flow of supercritical water in a flow reactor. Multifunctional nanocomposite thin films from the hybrid deposition process were characterised using scanning electron microscopy, X-ray diffraction and X-ray photoelectron spectroscopy. The functional properties of the films were evaluated using variable temperature optical measurements to assess thermochromic behaviour and methylene blue photodecolourisation experiments to assess photocatalytic activity. The tests show that the films are multifunctional in that they are thermochromic (having a large change in infra-red reflectivity upon exceeding the thermochromic transition temperature) and have significant photocatalytic activity under irradiation with 254 nm light.

  17. An exonuclease-assisted amplification electrochemical aptasensor for Hg(2+) detection based on hybridization chain reaction.

    Science.gov (United States)

    Bao, Ting; Wen, Wei; Zhang, Xiuhua; Xia, Qinghua; Wang, Shengfu

    2015-08-15

    In this work, a novel electrochemical aptasensor was developed for Hg(2+) detection based on exonuclease-assisted target recycling and hybridization chain reaction (HCR) dual signal amplification strategy. The presence of Hg(2+) induced the T-rich DNA partly folded into duplex-like structure via the Hg(2+) mediated T-Hg(2+)-T base pairs, which triggered the activity of exonuclease III (Exo III). Exo III selectively digested the double-strand DNA containing multiple T-Hg(2+)-T base pairs from its 3'-end, the released Hg(2+) participated analyte recycle. With each digestion cycle, a digestion product named as help DNA was obtained, which acted as a linkage between the capture DNA and auxiliary DNA. The presence of help DNA and two auxiliary DNA collectively facilitated successful HCR process and formed long double-stranded DNA. [Ru(NH3)6](3+) was used as redox indicator, which electrostatically bound to the double strands and produced an electrochemical signal. Exo III-assisted target recycling and HCR dual amplification significantly improved the sensitivity for Hg(2+) with a detection limit of 0.12 pM (S/N=3). Furthermore, the proposed aptasensor had a promising potential for the application of Hg(2+) detection in real aquatic sample analysis. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Hybrid brain-computer interfaces and hybrid neuroprostheses for restoration of upper limb functions in individuals with high-level spinal cord injury.

    Science.gov (United States)

    Rohm, Martin; Schneiders, Matthias; Müller, Constantin; Kreilinger, Alex; Kaiser, Vera; Müller-Putz, Gernot R; Rupp, Rüdiger

    2013-10-01

    The bilateral loss of the grasp function associated with a lesion of the cervical spinal cord severely limits the affected individuals' ability to live independently and return to gainful employment after sustaining a spinal cord injury (SCI). Any improvement in lost or limited grasp function is highly desirable. With current neuroprostheses, relevant improvements can be achieved in end users with preserved shoulder and elbow, but missing hand function. The aim of this single case study is to show that (1) with the support of hybrid neuroprostheses combining functional electrical stimulation (FES) with orthoses, restoration of hand, finger and elbow function is possible in users with high-level SCI and (2) shared control principles can be effectively used to allow for a brain-computer interface (BCI) control, even if only moderate BCI performance is achieved after extensive training. The individual in this study is a right-handed 41-year-old man who sustained a traumatic SCI in 2009 and has a complete motor and sensory lesion at the level of C4. He is unable to generate functionally relevant movements of the elbow, hand and fingers on either side. He underwent extensive FES training (30-45min, 2-3 times per week for 6 months) and motor imagery (MI) BCI training (415 runs in 43 sessions over 12 months). To meet individual needs, the system was designed in a modular fashion including an intelligent control approach encompassing two input modalities, namely an MI-BCI and shoulder movements. After one year of training, the end user's MI-BCI performance ranged from 50% to 93% (average: 70.5%). The performance of the hybrid system was evaluated with different functional assessments. The user was able to transfer objects of the grasp-and-release-test and he succeeded in eating a pretzel stick, signing a document and eating an ice cream cone, which he was unable to do without the system. This proof-of-concept study has demonstrated that with the support of hybrid FES

  19. Homogenization-assisted cavitation hybrid rotation extraction and macroporous resin enrichment of dihydroquercetin from Larix gmelinii.

    Science.gov (United States)

    Xia, Yu; Wang, Yinhang; Li, Wei; Ma, Chunhui; Liu, Shouxin

    2017-12-01

    Cavitation hybrid rotation, which was and is still looked upon as an unavoidable nuisance in the flow systems, for extraction processing intensification of active chemical compounds from natural products. In this study, a homogenization-assisted cavitation hybrid rotation extraction method was applied to extract dihydroquercetin (DHQ) from larch (Larix gmelinii) wood root. The extraction parameters were optimized in single factor experiments with the DHQ extraction yields as the response values. The optimum conditions were as follows: number of extractions, three; ethanol volume fraction for the extraction, 60%; liquid-solid ratio for homogenization, 10mL/g; homogenization time, 8min; liquid-solid ratio for cavitation extraction, 9mL/g, and cavitation extraction time, 35min. Under these conditions, the DHQ content in extract was 4.50±0.02mg/g, and the extraction efficiency was higher than those of traditional techniques. Cavitation can be effectively used to improve the extraction rate by increasing the mass transfer rates and possible rupture of cell wall due to formation of microcavities leading to higher product yields with reduced processing time and solvent consumption. After the extraction process, macroporous resin column chromatography was used to concentrate and purify the DHQ. Three resins were selected from fifteen macroporous resins for further investigation of their performance. Among these resins, AB-8 resin exhibited relatively better adsorption capacities and desorption ratios for DHQ. The ethanol volume fraction of the solutions for sample loading and desorption, and flow rates for loading and desorption were optimized for the macroporous resin column chromatography. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. sEMG-based joint force control for an upper-limb power-assist exoskeleton robot.

    Science.gov (United States)

    Li, Zhijun; Wang, Baocheng; Sun, Fuchun; Yang, Chenguang; Xie, Qing; Zhang, Weidong

    2014-05-01

    This paper investigates two surface electromyogram (sEMG)-based control strategies developed for a power-assist exoskeleton arm. Different from most of the existing position control approaches, this paper develops force control methods to make the exoskeleton robot behave like humans in order to provide better assistance. The exoskeleton robot is directly attached to a user's body and activated by the sEMG signals of the user's muscles, which reflect the user's motion intention. In the first proposed control method, the forces of agonist and antagonist muscles pair are estimated, and their difference is used to produce the torque of the corresponding joints. In the second method, linear discriminant analysis-based classifiers are introduced as the indicator of the motion type of the joints. Then, the classifier's outputs together with the estimated force of corresponding active muscle determine the torque control signals. Different from the conventional approaches, one classifier is assigned to each joint, which decreases the training time and largely simplifies the recognition process. Finally, the extensive experiments are conducted to illustrate the effectiveness of the proposed approaches.

  1. Effects of robot-assisted training on upper limb functional recovery during the rehabilitation of poststroke patients.

    Science.gov (United States)

    Daunoraviciene, Kristina; Adomaviciene, Ausra; Grigonyte, Agne; Griškevičius, Julius; Juocevicius, Alvydas

    2018-05-18

    The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring. To identify the effect of robot training on functional recovery of the arm. A total of 34 stroke patients were divided into either an experimental group (EG; n= 17) or a control group (n= 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment. Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy. Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (Peffect in the EG and CG was meaningful for shoulder and elbow kinematic parameters. The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients.

  2. Role of exact exchange in thermally-assisted-occupation density functional theory: A proposal of new hybrid schemes.

    Science.gov (United States)

    Chai, Jeng-Da

    2017-01-28

    We propose hybrid schemes incorporating exact exchange into thermally assisted-occupation-density functional theory (TAO-DFT) [J.-D. Chai, J. Chem. Phys. 136, 154104 (2012)] for an improved description of nonlocal exchange effects. With a few simple modifications, global and range-separated hybrid functionals in Kohn-Sham density functional theory (KS-DFT) can be combined seamlessly with TAO-DFT. In comparison with global hybrid functionals in KS-DFT, the resulting global hybrid functionals in TAO-DFT yield promising performance for systems with strong static correlation effects (e.g., the dissociation of H 2 and N 2 , twisted ethylene, and electronic properties of linear acenes), while maintaining similar performance for systems without strong static correlation effects. Besides, a reasonably accurate description of noncovalent interactions can be efficiently achieved through the inclusion of dispersion corrections in hybrid TAO-DFT. Relative to semilocal density functionals in TAO-DFT, global hybrid functionals in TAO-DFT are generally superior in performance for a wide range of applications, such as thermochemistry, kinetics, reaction energies, and optimized geometries.

  3. Evaluation of a Prototype Hybrid Vacuum Pump to Provide Vacuum-Assisted Suspension for Above-Knee Prostheses.

    Science.gov (United States)

    Major, Matthew J; Caldwell, Ryan; Fatone, Stefania

    2015-12-01

    Vacuum-assisted suspension (VAS) of prosthetic sockets utilizes a pump to evacuate air from between the prosthetic liner and socket, and are available as mechanical or electric systems. This technical note describes a hybrid pump that benefits from the advantages of mechanical and electric systems, and evaluates a prototype as proof-of-concept. Cyclical bench testing of the hybrid pump mechanical system was performed using a materials testing system to assess the relationship between compression cycles and vacuum pressure. Phase 1 in vivo testing of the hybrid pump was performed by an able-bodied individual using prosthesis simulator boots walking on a treadmill, and phase 2 involved an above-knee prosthesis user walking with the hybrid pump and a commercial electric pump for comparison. Bench testing of 300 compression cycles produced a maximum vacuum of 24 in-Hg. In vivo testing demonstrated that the hybrid pump continued to pull vacuum during walking, and as opposed to the commercial electric pump, did not require reactivation of the electric system during phase 2 testing. The novelty of the hybrid pump is that while the electric system provides rapid, initial vacuum suspension, the mechanical system provides continuous air evacuation while walking to maintain suspension without reactivation of the electric system, thereby allowing battery power to be reserved for monitoring vacuum levels.

  4. Adaptive hybrid brain-computer interaction: ask a trainer for assistance!

    Science.gov (United States)

    Müller-Putz, Gernot R; Steyrl, David; Faller, Josef

    2014-01-01

    In applying mental imagery brain-computer interfaces (BCIs) to end users, training is a key part for novice users to get control. In general learning situations, it is an established concept that a trainer assists a trainee to improve his/her aptitude in certain skills. In this work, we want to evaluate whether we can apply this concept in the context of event-related desynchronization (ERD) based, adaptive, hybrid BCIs. Hence, in a first session we merged the features of a high aptitude BCI user, a trainer, and a novice user, the trainee, in a closed-loop BCI feedback task and automatically adapted the classifier over time. In a second session the trainees operated the system unassisted. Twelve healthy participants ran through this protocol. Along with the trainer, the trainees achieved a very high overall peak accuracy of 95.3 %. In the second session, where users operated the BCI unassisted, they still achieved a high overall peak accuracy of 83.6%. Ten of twelve first time BCI users successfully achieved significantly better than chance accuracy. Concluding, we can say that this trainer-trainee approach is very promising. Future research should investigate, whether this approach is superior to conventional training approaches. This trainer-trainee concept could have potential for future application of BCIs to end users.

  5. Throttleable GOX/ABS launch assist hybrid rocket motor for small scale air launch platform

    Science.gov (United States)

    Spurrier, Zachary S.

    Aircraft-based space-launch platforms allow operational flexibility and offer the potential for significant propellant savings for small-to-medium orbital payloads. The NASA Armstrong Flight Research Center's Towed Glider Air-Launch System (TGALS) is a small-scale flight research project investigating the feasibility for a remotely-piloted, towed, glider system to act as a versatile air launch platform for nano-scale satellites. Removing the crew from the launch vehicle means that the system does not have to be human rated, and offers a potential for considerable cost savings. Utah State University is developing a small throttled launch-assist system for the TGALS platform. This "stage zero" design allows the TGALS platform to achieve the required flight path angle for the launch point, a condition that the TGALS cannot achieve without external propulsion. Throttling is required in order to achieve and sustain the proper launch attitude without structurally overloading the airframe. The hybrid rocket system employs gaseous-oxygen and acrylonitrile butadiene styrene (ABS) as propellants. This thesis summarizes the development and testing campaign, and presents results from the clean-sheet design through ground-based static fire testing. Development of the closed-loop throttle control system is presented.

  6. An economic analysis of robot-assisted therapy for long-term upper-limb impairment after stroke.

    Science.gov (United States)

    Wagner, Todd H; Lo, Albert C; Peduzzi, Peter; Bravata, Dawn M; Huang, Grant D; Krebs, Hermano I; Ringer, Robert J; Federman, Daniel G; Richards, Lorie G; Haselkorn, Jodie K; Wittenberg, George F; Volpe, Bruce T; Bever, Christopher T; Duncan, Pamela W; Siroka, Andrew; Guarino, Peter D

    2011-09-01

    Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness. We estimated the intervention costs and tracked participants' healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization. A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (Prehabilitation compared with traditional rehabilitation. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00372411.

  7. Assistive-as-needed strategy for upper-limb robotic systems: A preliminary evaluation of the impedance control architecture

    Science.gov (United States)

    Khairuddin, I. M.; Sidek, S. N.; Yusof, H. Md; Majeed, A. P. P. Abdul; Puzi, A. Ahmad; Mat Rosly, H.

    2018-04-01

    Rehabilitation is a necessary restoration process of recovering impaired joint motion and muscle strength. Recent trends of rehabilitation have also moved towards providing more participation of the patient in therapy rather than simple passive treatments as it has been demonstrated to be non-trivial in promoting neural plasticity meant to promote motor recovery process. This paper presents an assistive control strategy based on impedance control technique. Dynamic modelling of upper arm is obtained by utilising the Euler-Lagrange formulation. The proportional-derivative (PD), computed torque control (CTC) impedance based framework is applied to examine its effectiveness in performing joint-space control with objectives specified in rehabilitating the elbow joint along the sagittal plane. A feasibility study through simulation was carried out to investigate the efficacy of the proposed controller on acceleration-based impedance model. The results show that impedance controller is more suitable as it allows the cooperative effort of the patient.

  8. Limb anomalies

    DEFF Research Database (Denmark)

    Gurrieri, Fiorella; Kjær, Klaus Wilbrandt; Sangiorgi, Eugenio

    2002-01-01

    of limb development has been conserved for more than 300 millions years, with all the necessary adaptive modifications occurring throughout evolution, we also take into consideration the evolutionary aspects of limb development in terms of genetic repertoire, molecular pathways, and morphogenetic events....

  9. Mild hybrids with CVT: comparison of electrical and mechanical torque assist

    NARCIS (Netherlands)

    Druten, van R.M.; Serrarens, A.F.A.; Vroemen, B.G.; Tillaart, van den E.L.; de Haas, J.

    2001-01-01

    This paper evaluates two mild hybrid drive trains for a mid-class passenger car with a gasoline engine by means of comptuer simulation. The term mild hybrid is used for vehicles with sustained electric propulsion. The mild hybrid drive trains both have a Continuously Variable Transmission (CVT) with

  10. Cool excimer laser-assisted angioplasty (CELA) and tibial balloon angioplasty (TBA) in management of infragenicular arterial occlusion in critical lower limb ischemia (CLI).

    Science.gov (United States)

    Sultan, Sherif; Tawfick, Wael; Hynes, Niamh

    2013-04-01

    We aim to compare cool excimer laser-assisted angioplasty (CELA) versus tibial balloon angioplasty (TBA) in patients with critical limb ischemia (CLI) with tibial artery occlusive disease. The primary end point is sustained clinical improvement (SCI) and amputation-free survival (AFS). The secondary end points are binary restenosis, target extremity revascularization (TER), and cost-effectiveness. From June 2005 to October 2010, 1506 patients were referred with peripheral vascular disease and 572 with CLI. A total of 80 patients underwent 89 endovascular revascularizations (EVRs) for tibial occlusions, 47 using TBA and 42 using CELA. All patients were Rutherford category 4 to 6. Three-year SCI was enhanced with CELA (81%) compared to TBA (63.8%; P = .013). Three-year AFS significantly improved with CELA (95.2%) versus TBA (89.4%; P = .0165). Three-year freedom from TER was significantly improved with CELA (92.9%) versus 78.7% TBA (P = .026). Three-year freedom from MACE was comparable in both the groups (P = .455). Patients with CELA had significantly improved quality time without symptoms of disease or toxicity of treatment (Q-TWiST) at 3 years (10.5 months; P = .048) with incremental cost of €2073.19 per quality-adjusted life year gained. Tibial EVR provides exceptional outcome in CLI. The CELA has superior SCI, AFS, and freedom from TER, with improved Q-TWiST and cost-effectiveness.

  11. Enhancing prospective chemistry teachers cognitive structures in the topics of bonding and hybridization by internet-assisted chemistry applications

    OpenAIRE

    Özge Özyalçın Oskay, Sinem Dinçol

    2011-01-01

    The purpose of this study is to determine the effects of internet-assisted chemistry applications on prospective chemistry teachers’ cognitive structures in the topics of bonding and hybridization. The sample of the study consisted of 36 prospective chemistry teachers attending Hacettepe University, Faculty of Education, the Department of Chemistry Education in 2010-2011 academic year and taking Basic Chemistry I lesson. In the study, students were separated into experimental and control gr...

  12. Performance evaluation of a solar energy assisted hybrid desiccant air conditioner integrated with HDH desalination system

    International Nuclear Information System (INIS)

    Kabeel, A.E.; Abdelgaied, Mohamed; Zakaria, Yehya

    2017-01-01

    Highlights: • The performance of a solar hybrid air conditioner integrated with HDH desalination system is numerically investigated. • For increase the regeneration air from 70 to 130 m 3 /h, the distillate water productivity increases from 2.988 to 4.78 L/h. • For increase the regeneration air from 70 to 130 m 3 /h, COP overall daily decreases from 4.66 to 3.386. • For increases the regeneration air temperature from 75 to 95 °C, the distillate water increases from 3.1752 to 5.011 L/h. • For increases the regeneration air temperature from 75 to 95 °C, COP overall daily decreases from 4.392 to 3.636. - Abstract: In this study, the performances of a solar energy assisted hybrid desiccant air conditioning system integrated with humidification–dehumidification (HDH) desalination system are numerically investigated. The aim of this study is to benefit from the temperature rise of the regeneration air outside of the desiccant conditioning system as well as the water vapor content in this regeneration air by feeding it to the humidification-dehumidification water desalination unit to produce distillate water. The distillate water productivity, human thermal comfort issues, and energy saving represent the main objective of the present numerical study. The simulated results developed for subsystems are validated with the published experimental results. The effects of regeneration air temperature and flow rate on supply cooled air temperature, distillate water productivity, the cooling coefficient of performance and overall daily coefficient of performance of the proposed system are investigated. The results show that (i) the distillate water productivity increases from 3.175 to 5.011 L/h and overall daily coefficient of performance decreases from 4.392 to 3.636 with increasing the regeneration air temperature from 75 to 95 as (ii) the increase in the regeneration air flow rate from 70 to 130 m 3 /h, increases the distillate water productivity from 2.988 to 4

  13. Limb Loss

    Science.gov (United States)

    ... in amputation. Injuries, including from traffic accidents and military combat Cancer Birth defects Some amputees have phantom pain, which is the feeling of pain in the missing limb. Other physical problems include surgical complications and skin problems, if you ...

  14. Assisting People with Attention Deficit Hyperactivity Disorder by Actively Reducing Limb Hyperactive Behavior with a Gyration Air Mouse through a Controlled Environmental Stimulation

    Science.gov (United States)

    Shih, Ching-Hsiang

    2011-01-01

    The latest researches have adopted software technology turning the gyration air mouse into a high performance limb movement detector, and have assessed whether two persons with multiple disabilities would be able to control an environmental stimulation using limb movement. This study extends gyration air mouse functionality by actively reducing…

  15. Assisting Children with Attention Deficit Hyperactivity Disorder Actively Reduces Limb Hyperactive Behavior with a Nintendo Wii Remote Controller through Controlling Environmental Stimulation

    Science.gov (United States)

    Shih, Ching-Hsiang; Yeh, Jui-Chi; Shih, Ching-Tien; Chang, Man-Ling

    2011-01-01

    The latest studies have adopted software technology which turns the Wii Remote Controller into a high-performance limb action detector, we assessed whether two persons with multiple disabilities would be able to control an environmental stimulus through limb action. This study extends the functionality of the Wii Remote Controller to the…

  16. Enhancing prospective chemistry teachers cognitive structures in the topics of bonding and hybridization by internet-assisted chemistry applications

    Directory of Open Access Journals (Sweden)

    Özge Özyalçın Oskay, Sinem Dinçol

    2011-08-01

    Full Text Available The purpose of this study is to determine the effects of internet-assisted chemistry applications on prospective chemistry teachers’ cognitive structures in the topics of bonding and hybridization. The sample of the study consisted of 36 prospective chemistry teachers attending Hacettepe University, Faculty of Education, the Department of Chemistry Education in 2010-2011 academic year and taking Basic Chemistry I lesson. In the study, students were separated into experimental and control groups according to their pre-cognitive structures. Students were requested to answer two open ended questions. Answers by each student were gathered and evaluated by flow map method. “Bonding and hybridization” topics were taught to control group with traditional teaching method and to experimental group besides traditional method internet-assisted applications were conducted. The same open-ended questions were given to both groups and their cognitive structures were examined once more. The differences between control and experimental groups’ cognitive structures were examined. A significant difference was identified in favour of experimental group (p<0, 05. The mean score of the Experimental group was X=19.94, and the mean score of the Control group was X=13.88. In addition, subsequent to internet assisted chemistry applications differences in terms of concepts and descriptions in prospective chemistry teachers’ in experimental and control group cognitive structure have been determined. When post flow maps of prospective chemistry teachers in experimental group, on whom internet assisted chemistry applications were made, are formed, it has been determined that there are more statements about hybridization, hybridization types, molecule geometry and bond angles compared to control grou

  17. Feedback error learning controller for functional electrical stimulation assistance in a hybrid robotic system for reaching rehabilitation

    Directory of Open Access Journals (Sweden)

    Francisco Resquín

    2016-07-01

    Full Text Available Hybrid robotic systems represent a novel research field, where functional electrical stimulation (FES is combined with a robotic device for rehabilitation of motor impairment. Under this approach, the design of robust FES controllers still remains an open challenge. In this work, we aimed at developing a learning FES controller to assist in the performance of reaching movements in a simple hybrid robotic system setting. We implemented a Feedback Error Learning (FEL control strategy consisting of a feedback PID controller and a feedforward controller based on a neural network. A passive exoskeleton complemented the FES controller by compensating the effects of gravity. We carried out experiments with healthy subjects to validate the performance of the system. Results show that the FEL control strategy is able to adjust the FES intensity to track the desired trajectory accurately without the need of a previous mathematical model.

  18. The hybrid assisted limb (HAL) for Care Support, a motion assisting robot providing exoskeletal lumbar support, can potentially reduce lumbar load in repetitive snow-shoveling movements.

    Science.gov (United States)

    Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Endo, Hirooki; Murakami, Hideki; Doita, Minoru; Kumagai, Hiroshi; Nagashima, Katsuya; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi

    2018-03-01

    An excessive lumbar load with snow-shoveling is a serious problem in snowfall areas. Various exoskeletal robots have been developed to reduce lumbar load in lifting work. However, few studies have reported the attempt of snow-shoveling work using exoskeletal robots. The purpose of the present study was to test the hypothesis that the HAL for Care Support robot would reduce lumbar load in repetitive snow-shoveling movements. Nine healthy male volunteers performed repetitive snow-shoveling movements outdoors in a snowfall area for as long as possible until they were fatigued. The snow-shoveling trial was performed under two conditions: with and without HAL for Care Support. Outcome measures were defined as the lumbar load assessed by the VAS of lumbar fatigue after the snow-shoveling trial and the snow-shoveling performance, including the number of scoops, and snow shoveling time and distance. The mean of VAS of lumbar fatigue, the number of scoops, and snow-shoveling time and distance without HAL for Care Support were 75.4 mm, 50.3, 145 s, and 9.6 m, while with HAL for Care Support were 39.8 mm, 144, 366 s, and 35.4 m. The reduction of lumbar fatigue and improvement of snow-shoveling performance using HAL for Care Support were statistically significant. There was no adverse event during snow-shoveling with HAL for Care Support. In conclusion, the HAL for Care Support can reduce lumbar load in repetitive snow-shoveling movements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Limb myokymia

    International Nuclear Information System (INIS)

    Albers, J.W.; Allen, A.A.; Bastron, J.A.; Daube, J.R.

    1981-01-01

    Thirty-eight patients with myokymic discharges localized to limb muscles on needle electromyography had various neurologic lesions, both acute and chronic. Of the 38 patients, 27 had had previous radiation therapy and the clinical diagnosis of radiation-induced plexopathy, myelopathy, or both. For the remaining 11 patients, the diagnoses included multiple sclerosis, inflammatory polyradiculoneuropathy, ischemic neuropathy, inflammatory myopathy, and chronic disorders of the spinal cord and peripheral nerves. The clinical presentations and results of local ischemia, peripheral nerve block, and percutaneous stimulation suggest that most limb myokymic discharges arise focally at the site of a chronic peripheral nerve lesion

  20. Excellent electrochemical performance of graphene-silver nanoparticle hybrids prepared using a microwave spark assistance process

    International Nuclear Information System (INIS)

    Shanmugharaj, A.M.; Ryu, Sung Hun

    2012-01-01

    Highlights: ► A simple synthesis route is explored in preparing graphene-metal nanoparticle hybrids using cost effective microwave radiation process. ► Electrochemical performance of the synthesized graphene-silver nanoparticle hybrids have been compared with graphite and silver nanoparticle based anode materials. ► Graphene-silver nanoparticle hybrid exhibits stable charge/discharge characteristics of 714 mAh g −1 and it is significantly higher compared to natural graphite and silver based electrodes. - Abstract: A simple method is described for the synthesis of graphene-silver nanoparticle hybrids from graphite and silver precursors using microwave spark ignition process. Adding ecofriendly free radical initiators, in the presence of hydrogen peroxide solution leads to the expansion of graphite to graphene nanosheets. Simultaneously, silver ions intercalated between the graphene layers are reduced to silver nanocrystals leading to the development of graphene-silver nanoparticle hybrids. Transmission electron microscopic (TEM) studies reveal the successful formation of graphene-silver nanoparticle hybrids. X-ray diffraction (XRD) shows that the silver nanoparticles formed on the graphene surfaces are face centered cubic crystals. The surface composition and functional groups present on the graphene-silver nanoparticle hybrids are corroborated using X-ray photoelectron spectroscopy (XPS) and Fourier Transform Infrared Spectroscopy (FT-IR). The lithium storage capacity of the synthesized material, when used as an anode material for rechargeable lithium secondary batteries is investigated. Its first specific discharge capacity is observed to be 580 mAh g −1 and this has been increased to 827 mAh g −1 , by incorporating the silver nanoparticles between the graphene platelets. The reversible capacity of the graphene-silver nanoparticle hybrids is observed to be 714 mAh g −1 , which is significantly higher compared to that of graphene (420 mAh g −1

  1. Development of an assist controller with robot suit HAL for hemiplegic patients using motion data on the unaffected side.

    Science.gov (United States)

    Kawamoto, Hiroaki; Kandone, Hideki; Sakurai, Takeru; Ariyasu, Ryohei; Ueno, Yukiko; Eguchi, Kiyoshi; Sankai, Yoshiyuki

    2014-01-01

    Among several characteristics seen in gait of hemiplegic patients after stroke, symmetry is known to be an indicator of the degree of impairment of walking ability. This paper proposes a control method for a wearable type lower limb motion assist robot to realize spontaneous symmetric gait for these individuals. This control method stores the motion of the unaffected limb during swing and then provides motion support on the affected limb during the subsequent swing using the stored pattern to realize symmetric gait based on spontaneous limb swing. This method is implemented on the robot suit HAL (Hybrid Assistive Limbs). Clinical tests were conducted in order to assess the feasibility of the control method. Our case study involved participation of one chronic stroke patient who was not able to flex his right knee. As a result, the walking support for hemiplegic leg provided by the HAL improved the subject's gait symmetry. The feasibility study showed promising basis for the future clinical study.

  2. Hybrid video-assisted thoracic surgery with segmental-main bronchial sleeve resection for non-small cell lung cancer.

    Science.gov (United States)

    Li, Shuben; Chai, Huiping; Huang, Jun; Zeng, Guangqiao; Shao, Wenlong; He, Jianxing

    2014-04-01

    The purpose of the current study is to present the clinical and surgical results in patients who underwent hybrid video-assisted thoracic surgery with segmental-main bronchial sleeve resection. Thirty-one patients, 27 men and 4 women, underwent segmental-main bronchial sleeve anastomoses for non-small cell lung cancer between May 2004 and May 2011. Twenty-six (83.9%) patients had squamous cell carcinoma, and 5 patients had adenocarcinoma. Six patients were at stage IIB, 24 patients at stage IIIA, and 1 patient at stage IIIB. Secondary sleeve anastomosis was performed in 18 patients, and Y-shaped multiple sleeve anastomosis was performed in 8 patients. Single segmental bronchiole anastomosis was performed in 5 cases. The average time for chest tube removal was 5.6 days. The average length of hospital stay was 11.8 days. No anastomosis fistula developed in any of the patients. The 1-, 2-, and 3-year survival rates were 83.9%, 71.0%, and 41.9%, respectively. Hybrid video-assisted thoracic surgery with segmental-main bronchial sleeve resection is a complex technique that requires training and experience, but it is an effective and safe operation for selected patients.

  3. Management of the multiple limb amputee.

    Science.gov (United States)

    Davidson, J H; Jones, L E; Cornet, J; Cittarelli, T

    2002-09-10

    Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual. Loss of an arm and leg results in difficulty donning the prostheses and difficulty using crutches and parallel bars during mobilization. A review is given of 16 multiple limb amputees seen in our rehabilitation centre in the last 15 years. Return to work was seen in one third and was not related to the number of the amputations. A higher proportion of these multiple limb amputations occur through alcoholism or attempted suicide behaviour than occurs with either single upper limb amputations or lower limb amputations. This existing behaviour can create a management problem for the rehabilitation team during rehabilitation. Guidelines as to appropriate prosthetic and preprosthetic care are provided to assist the practitioner who has the acute and long term care of these patients. All multiple limb amputees should be referred to a specialized rehabilitation centre to discuss prosthetic options and long term rehabilitation requirements. This paper does not discuss bilateral lower limb amputations when not combined with an upper limb amputation.

  4. Effect of oven cooking method on formation of heterocyclic amines and quality characteristics of chicken patties: steam-assisted hybrid oven versus convection ovens.

    Science.gov (United States)

    Isleroglu, Hilal; Kemerli, Tansel; Özdestan, Özgül; Uren, Ali; Kaymak-Ertekin, Figen

    2014-09-01

    The aim of this study was to evaluate effect of steam-assisted hybrid oven cooking method in comparison with convection ovens (natural and forced) on quality characteristics (color, hardness, cooking loss, soluble protein content, fat retention, and formation of heterocyclic aromatic amines) of chicken patties. The cooking experiments of chicken patties (n = 648) were conducted at oven temperatures of 180, 210, and 240°C until 3 different end point temperatures (75, 90, and 100°C) were reached. Steam-assisted hybrid oven cooking enabled faster cooking than convection ovens and resulted in chicken patties having lower a* and higher L* value, lower hardness, lower fat, and soluble protein content (P cooking loss than convection ovens. Steam-assisted hybrid oven could reduce the formation of heterocyclic aromatic amines that have mutagenic and carcinogenic effects on humans. © 2014 Poultry Science Association Inc.

  5. Hybrid helical magnetic microrobots obtained by 3D template-assisted electrodeposition.

    Science.gov (United States)

    Zeeshan, Muhammad A; Grisch, Roman; Pellicer, Eva; Sivaraman, Kartik M; Peyer, Kathrin E; Sort, Jordi; Özkale, Berna; Sakar, Mahmut S; Nelson, Bradley J; Pané, Salvador

    2014-04-09

    Hybrid helical magnetic microrobots are achieved by sequential electrodeposition of a CoNi alloy and PPy inside a photoresist template patterned by 3D laser lithography. A controlled actuation of the microrobots by a rotating magnetic field is demonstrated in a fluidic environment. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Treatment with vacuum-assisted closure and cryo-preserved homologous de-epidermalised dermis of complex traumas to the lower limbs with loss of substance, and bones and tendons exposure.

    Science.gov (United States)

    Brandi, C; Grimaldi, L; Nisi, G; Silvestri, A; Brafa, A; Calabrò, M; D'Aniello, C

    2008-12-01

    Lower-limb injuries with loss of tissue and exposure of bones and tendons are an increasing problem. The condition of the wound locally and the patient in general does not always allow immediate and adequate coverage of the structures exposed by the trauma. Therefore, new therapeutic solutions are needed. A reduction in the time that bones and tendons are exposed is essential to achieve complete healing of bone fractures, with reduced risks of infection and less disabling outcomes. The effectiveness of vacuum-assisted closure (VAC) therapy in supporting wound healing and of cryopreserved homologous de-epidermalised dermis (DED) in providing an effective template for re-epithelialisation has been previously reported. We carried out a study to evaluate the effectiveness of the synergistic and combined use of the two methodologies. Eighteen patients with traumatic loss of tissue in the lower limbs, involving exposure of bone and tendon structures, were enrolled in the study. All participants had local, general contraindications to first-instance reconstructions, or both. All patients received a combination of VAC therapy and DED implants. Granulation tissue was obtained in all wounds, with complete coverage of exposed structures. No infections were detected in the cohort, and all patients were prepared for further necessary reconstructive treatments. In our experience, the combination of VAC therapy and DED could, in selected cases, constitute an effective treatment for complex lower limb traumatic injuries with bone and tendon exposure.

  7. Microwave-assisted synthesis and characterization of poly(acrylic)/SiO2-TiO2 core-shell nanoparticle hybrid thin films

    International Nuclear Information System (INIS)

    Chien, Wen-Chen; Yu, Yang-Yen; Chen, Po-Kan; Yu, Hui-Huan

    2011-01-01

    In this study, poly(acrylic)/SiO 2 -TiO 2 core-shell nanoparticle hybrid thin films were successfully synthesized by microwave-assisted polymerization. The coupling agent 3-(trimethoxysilyl) propyl methacrylate (MSMA) was hydrolyzed with colloidal SiO 2 -TiO 2 core-shell nanoparticles, and then polymerized with two acrylic monomers and initiator to form a precursor solution. The results of this study showed that the spin-coated hybrid films had relatively good surface planarity, high thermal stability, a tunable refractive index (1.525 2 -TiO 2 core-shell nanoparticle hybrid thin films, for potential use in optical applications.

  8. Resonant Infrared Matrix-Assisted Pulsed Laser Evaporation Of Inorganic Nanoparticles And Organic/Inorganic Hybrid Nanocomposites

    Science.gov (United States)

    Pate, Ryan; Lantz, Kevin R.; Dhawan, Anuj; Vo-Dinh, Tuan; Stiff-Roberts, Adrienne D.

    2010-10-01

    In this research, resonant infrared matrix-assisted pulsed laser evaporation (RIR-MAPLE) has been used to deposit different classes of inorganic nanoparticles, including bare, un-encapsulated ZnO and Au nanoparticles, as well as ligand-encapsulated CdSe colloidal quantum dots (CQDs). RIR-MAPLE has been used for thin-film deposition of different organic/inorganic hybrid nanocomposites using some of these inorganic nanoparticles, including CdSe CQD-poly[2-methoxy-5-(2'-ethylhexyloxy)-1,4-(1-cyanovinylene)phenylene] (MEH-CN-PPV) nanocomposites and Au nanoparticle-poly(methyl methacrylate) (PMMA) nanocomposites. The unique contribution of this research is that a technique is demonstrated for the deposition of organic-based thin-films requiring solvents with bond energies that do not have to be resonant with the laser energy. By creating an emulsion of solvent and ice in the target, RIR-MAPLE using a 2.94 μm laser can deposit most material systems because the hydroxyl bonds in the ice component of the emulsion matrix are strongly resonant with the 2.94 μm laser. In this way, the types of materials that can be deposited using RIR-MAPLE has been significantly expanded. Furthermore, materials with different solvent bond energies can be co-deposited without concern for material degradation and without the need to specifically tune the laser energy to each material solvent bond energy, thereby facilitating the realization of organic/inorganic hybrid nanocomposite thin-films. In addition to the structural characterization of the inorganic nanoparticle and hybrid nanocomposite thin-films deposited using this RIR-MAPLE technique, optical characterization is presented to demonstrate the potential of such films for optoelectronic device applications.

  9. Resonant Infrared Matrix-Assisted Pulsed Laser Evaporation Of Inorganic Nanoparticles And Organic/Inorganic Hybrid Nanocomposites

    International Nuclear Information System (INIS)

    Pate, Ryan; Lantz, Kevin R.; Stiff-Roberts, Adrienne D.; Dhawan, Anuj; Vo-Dinh, Tuan

    2010-01-01

    In this research, resonant infrared matrix-assisted pulsed laser evaporation (RIR-MAPLE) has been used to deposit different classes of inorganic nanoparticles, including bare, un-encapsulated ZnO and Au nanoparticles, as well as ligand-encapsulated CdSe colloidal quantum dots (CQDs). RIR-MAPLE has been used for thin-film deposition of different organic/inorganic hybrid nanocomposites using some of these inorganic nanoparticles, including CdSe CQD-poly[2-methoxy-5-(2'-ethylhexyloxy )-1,4-(1-cyanovinylene)phenylene](MEH-CN-PPV) nanocomposites and Au nanoparticle-poly(methyl methacrylate)(PMMA) nanocomposites. The unique contribution of this research is that a technique is demonstrated for the deposition of organic-based thin-films requiring solvents with bond energies that do not have to be resonant with the laser energy. By creating an emulsion of solvent and ice in the target, RIR-MAPLE using a 2.94 μm laser can deposit most material systems because the hydroxyl bonds in the ice component of the emulsion matrix are strongly resonant with the 2.94 μm laser. In this way, the types of materials that can be deposited using RIR-MAPLE has been significantly expanded. Furthermore, materials with different solvent bond energies can be co-deposited without concern for material degradation and without the need to specifically tune the laser energy to each material solvent bond energy, thereby facilitating the realization of organic/inorganic hybrid nanocomposite thin-films. In addition to the structural characterization of the inorganic nanoparticle and hybrid nanocomposite thin-films deposited using this RIR-MAPLE technique, optical characterization is presented to demonstrate the potential of such films for optoelectronic device applications.

  10. [Hybrid (femtosecond laser-assisted) phaco surgery and the state of the macula].

    Science.gov (United States)

    Avetisov, K S; Bol'shunov, A V; Avetisov, S E; Yusef, Y N; Ivanov, M N; Sobol, E N; Sakalova, E D

    The review covers different aspects of the impact of femtosecond laser-assisted cataract surgery on the state of the macular zone of the retina. Literature search has revealed inconsistency of the published data and indicated the need for a more detailed study of this problem.

  11. Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: focused review and results of new randomized controlled trial.

    Science.gov (United States)

    Masiero, Stefano; Armani, Mario; Rosati, Giulio

    2011-01-01

    The successful motor rehabilitation of stroke patients requires early intensive and task-specific therapy. A recent Cochrane Review, although based on a limited number of randomized controlled trials (RCTs), showed that early robotic training of the upper limb (i.e., during acute or subacute phase) can enhance motor learning and improve functional abilities more than chronic-phase training. In this article, a new subacute-phase RCT with the Neuro-Rehabilitation-roBot (NeReBot) is presented. While in our first study we used the NeReBot in addition to conventional therapy, in this new trial we used the same device in substitution of standard proximal upper-limb rehabilitation. With this protocol, robot patients achieved similar reductions in motor impairment and enhancements in paretic upper-limb function to those gained by patients in a control group. By analyzing these results and those of previous studies, we hypothesize a new robotic protocol for acute and subacute stroke patients based on both treatment modalities (in addition and in substitution).

  12. Sb(III)-Imprinted Organic-Inorganic Hybrid Sorbent Prepared by Hydrothermal-Assisted Surface Imprinting Technique for Selective Adsorption of Sb(III)

    Science.gov (United States)

    Zhang, Dan; Zhao, Yue; Xu, Hong-Bo

    2018-03-01

    Sb(III)-imprinted organic-inorganic hybrid sorbent was prepared by hydrothermal-assisted surface imprinting technique and was characterized by Fourier transform infrared spectroscopy, scanning electron microscopy coupled to an energy dispersive spectrometer and N2 adsorption/desorption isotherms. Hydrothermal-assisted process can improve the selectivity of the Sb(III)-imprinted hybrid sorbent for Sb(III) due to stable control of temperature and pressure. The Sb(III)-imprinted hybrid sorbent IIS indicated higher selectivity for Sb(III), had high static adsorption capacity of 37.3 mg g-1 for Sb(III), displayed stable adsorption capacity in pH range from 4 to 8, reached an rapid adsorption equilibrium within 30 min. According to the correlation coefficient ( r 2 > 0.99), the experimental data fitted better the pseudo-second-order kinetic model and Langmuir equilibrium isotherm.

  13. Modeling plasma-assisted growth of graphene-carbon nanotube hybrid

    Energy Technology Data Exchange (ETDEWEB)

    Tewari, Aarti [Department of Applied Physics, Delhi Technological University, Shahbad Daulatpur, Bawana Road, Delhi 110 042 (India)

    2016-08-15

    A theoretical model describing the growth of graphene-CNT hybrid in a plasma medium is presented. Using the model, the growth of carbon nanotube (CNT) on a catalyst particle and thereafter the growth of the graphene on the CNT is studied under the purview of plasma sheath and number density kinetics of different plasma species. It is found that the plasma parameter such as ion density; gas ratios and process parameter such as source power affect the CNT and graphene dimensions. The variation in growth rates of graphene and CNT under different plasma power, gas ratios, and ion densities is analyzed. Based on the results obtained, it can be concluded that higher hydrocarbon ion densities and gas ratios of hydrocarbon to hydrogen favor the growth of taller CNTs and graphene, respectively. In addition, the CNT tip radius reduces with hydrogen ion density and higher plasma power favors graphene with lesser thickness. The present study can help in better understanding of the graphene-CNT hybrid growth in a plasma medium.

  14. Modeling plasma-assisted growth of graphene-carbon nanotube hybrid

    International Nuclear Information System (INIS)

    Tewari, Aarti

    2016-01-01

    A theoretical model describing the growth of graphene-CNT hybrid in a plasma medium is presented. Using the model, the growth of carbon nanotube (CNT) on a catalyst particle and thereafter the growth of the graphene on the CNT is studied under the purview of plasma sheath and number density kinetics of different plasma species. It is found that the plasma parameter such as ion density; gas ratios and process parameter such as source power affect the CNT and graphene dimensions. The variation in growth rates of graphene and CNT under different plasma power, gas ratios, and ion densities is analyzed. Based on the results obtained, it can be concluded that higher hydrocarbon ion densities and gas ratios of hydrocarbon to hydrogen favor the growth of taller CNTs and graphene, respectively. In addition, the CNT tip radius reduces with hydrogen ion density and higher plasma power favors graphene with lesser thickness. The present study can help in better understanding of the graphene-CNT hybrid growth in a plasma medium.

  15. Improvement of laser keyhole formation with the assistance of arc plasma in the hybrid welding process of magnesium alloy

    Science.gov (United States)

    Liu, Liming; Hao, Xinfeng

    2009-11-01

    In the previous work, low-power laser/arc hybrid welding technique is used to weld magnesium alloy and high-quality weld joints are obtained. In order to make clear the interactions between low-power laser pulse and arc plasma, the effect of arc plasma on laser pulse is studied in this article. The result shows that the penetration of low-power laser welding with the assistance of TIG arc is more than two times deeper than that of laser welding alone and laser welding transforms from thermal-conduction mode to keyhole mode. The plasma behaviors and spectra during the welding process are studied, and the transition mechanism of laser-welding mode is analyzed in detail. It is also found that with the assistance of arc plasma, the threshold value of average power density to form keyhole welding for YAG laser is only 3.3×10 4 W/cm 2, and the average peak power density is 2.6×10 5 W/cm 2 in the present experiment. Moreover, the distribution of energy density during laser pulse is modulated to improve the formation and stability of laser keyholes.

  16. Hybrid plasmonic waveguide-assisted Metal–Insulator–Metal ring resonator for refractive index sensing

    Science.gov (United States)

    Butt, M. A.; Khonina, S. N.; Kazanskiy, N. L.

    2018-05-01

    A highly sensitive refractive index sensor based on an integrated hybrid plasmonic waveguide (HPWG) and a Metal-Insulator-Metal (M-I-M) micro-ring resonator is presented. In our design, there are two slot-waveguide-based micro-rings that encircle a gold disc. The outer slot WG is formed by the combination of Silicon-Air-Gold ring and the inner slot-waveguide is formed by Gold ring-Air-Gold disc. The slot-waveguide rings provide an interaction length sufficient to accumulate a detectable wavelength shift. The transmission spectrum and electric field distribution of this sensor structure are simulated using Finite Element Method (FEM). The sensitivity of this micro-ring resonator is achieved at 800 nm/RIU which is about six times higher than that of the conventional Si ring with the same geometry. Our proposed sensor design has a potential to find further applications in biomedical science and nano-photonic circuits.

  17. CO_2-assisted compression-adsorption hybrid for cooling and desalination

    International Nuclear Information System (INIS)

    Ali, Syed Muztuza; Chakraborty, Anutosh; Leong, Kai Choong

    2017-01-01

    Highlights: • Amalgamation of vapour compression and adsorption. • Thermodynamic frameworks of compression-adsorption hybrid. • 60% improvement in COP as compared with conventional CO_2 cooling system. • Energy recovery from CO_2 is used for cooling and desalination. • Energy from gas cooler accelerates the desalination process. - Abstract: This paper presents a novel compression-adsorption hybrid that symbiotically combines adsorption and CO_2 compression cooling devices. The seemingly low efficiency of each cycle individually is overcome by an amalgamation with the other. Hence, both heat and water vapour refrigerant mass are recovered for continuous cooling and desalination. Two different configurations are presented. The first configuration deals with a two-stage heat recovery system. At the first stage, heat is recovered from the compressed carbon dioxide to drive the adsorption device. The second stage heat recovery system internally exchanges heat between the low pressure and high pressure refrigerants of the CO_2 cycle. The second configuration is proposed with an additional third-stage heat recovery from the gas cooler to the high pressure evaporator of the adsorption cycle. The water vapour mass is recovered from bed-to-bed adsorption at relatively higher pressure. A detailed thermodynamic framework is presented to simulate the performances in terms of COP (coefficient of performance), SCP (specific cooling power), SDWP (specific daily water production), PR (performance ratio) and OCR (overall conversion ratio). It is found that the overall COP is improved by more than 60% as compared to the conventional CO_2 cycle, and in addition, the system generates 12.7 m"3 of desalinated water per tonne of silica gel per day as extra benefits. Furthermore, both the heat and mass recoveries improve the overall conversion ratio, which is almost double as compared to the conventional CO_2 cycle.

  18. Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

    Science.gov (United States)

    Ram Prabhakar, J.; Ragavan, K.

    2013-07-01

    This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

  19. Analysis of environmental effect of hybrid solar-assisted desalination cycle in Sirdarya Thermal Power Plant, Uzbekistan

    International Nuclear Information System (INIS)

    Alikulov, Khusniddin; Xuan, Tran Dang; Higashi, Osamu; Nakagoshi, Nobukazu; Aminov, Zarif

    2017-01-01

    Highlights: • A hybrid solar-assisted desalination cycle was designed and stimulated. • Maximum of 21,064.00 kW effective solar heat can be achieved. • The use of parabolic-trough collectors in the Multi Effect Distillation is potential. • The cycle can be applied in other regions with high Direct Normal Irradiation. - Abstract: This study was to investigate possible reduction of fossil fuel consumption and carbon dioxide emission in one of energy sectors of Sirdarya Thermal Power Plant (TPP), Uzbekistan. A hybrid solar-assisted desalination cycle has been designed and simulated for partially supplying saturated steam with 200 °C, 8 bar, and 32 t/h parameters to a Multi Effect Distillation (MED) process in the Sirdarya Thermal Power Plant. The outcome of the parental design model stated that maximum, 21,064.00 kW effective solar heat can be achieved, which is equivalent to 31.76 t/h of saturated steam with 200 °C and 8 bar parameters. Total saved fossil fuel in each month proved that it is possible to reduce fossil fuel (heavy oil and natural gas) consumption with 59.64, 95.24, 389.96, and 298.26 tons during available Direct Normal Irradiation (DNI) by using parabolic-trough collectors. Moreover, the above-mentioned fossil fuel savings accounted for CO_2 reduction with amounts of 182.50, 255.46, 1045.87 & 799.96 tons per each consistent month. Findings proved that integration of parabolic-trough collectors into the MED process is feasible in terms of high DNI availability and demand for retrofitting old existing heat-consuming facilities in Sirdarya Thermal Power Plant. Besides, the cycle also can be applied in other regions of Uzbekistan with high DNI for generating solar heat. Therefore, conducted study is eligible to be applied on the research site by taking into account of sufficient meteorological data and required steam parameters.

  20. A novel 3D-printed hybrid simulation model for robotic-assisted kidney transplantation (RAKT).

    Science.gov (United States)

    Uwechue, Raphael; Gogalniceanu, Petrut; Kessaris, Nicos; Byrne, Nick; Chandak, Pankaj; Olsburgh, Jonathon; Ahmed, Kamran; Mamode, Nizam; Loukopoulos, Ioannis

    2018-01-27

    Robotic-assisted kidney transplantation (RAKT) offers key benefits for patients that have been demonstrated in several studies. A barrier to the wider uptake of RAKT is surgical skill acquisition. This is exacerbated by the challenges of modern surgery with reduced surgical training time, patient safety concerns and financial pressures. Simulation is a well-established method of developing surgical skill in a safe and controlled environment away from the patient. We have developed a 3D printed simulation model for the key step of the kidney transplant operation which is the vascular anastomosis. The model is anatomically accurate, based on the CT scans of patients and it incorporates deceased donor vascular tissue. Crucially, it was developed to be used in the robotic operating theatre with the operating robot to enhance its fidelity. It is portable and relatively inexpensive when compared with other forms of simulation such as virtual reality or animal lab training. It thus has the potential of being more accessible as a training tool for the safe acquisition of RAKT specific skills. We demonstrate this model here.

  1. Hybrid approach of ventricular assist device and autologous bone marrow stem cells implantation in end-stage ischemic heart failure enhances myocardial reperfusion

    Directory of Open Access Journals (Sweden)

    Khayat Andre

    2011-01-01

    Full Text Available Abstract We challenge the hypothesis of enhanced myocardial reperfusion after implanting a left ventricular assist device together with bone marrow mononuclear stem cells in patients with end-stage ischemic cardiomyopathy. Irreversible myocardial loss observed in ischemic cardiomyopathy leads to progressive cardiac remodelling and dysfunction through a complex neurohormonal cascade. New generation assist devices promote myocardial recovery only in patients with dilated or peripartum cardiomyopathy. In the setting of diffuse myocardial ischemia not amenable to revascularization, native myocardial recovery has not been observed after implantation of an assist device as destination therapy. The hybrid approach of implanting autologous bone marrow stem cells during assist device implantation may eventually improve native cardiac function, which may be associated with a better prognosis eventually ameliorating the need for subsequent heart transplantation. The aforementioned hypothesis has to be tested with well-designed prospective multicentre studies.

  2. A hybrid BMI-based exoskeleton for paresis: EMG control for assisting arm movements.

    Science.gov (United States)

    Kawase, Toshihiro; Sakurada, Takeshi; Koike, Yasuharu; Kansaku, Kenji

    2017-02-01

    Brain-machine interface (BMI) technologies have succeeded in controlling robotic exoskeletons, enabling some paralyzed people to control their own arms and hands. We have developed an exoskeleton asynchronously controlled by EEG signals. In this study, to enable real-time control of the exoskeleton for paresis, we developed a hybrid system with EEG and EMG signals, and the EMG signals were used to estimate its joint angles. Eleven able-bodied subjects and two patients with upper cervical spinal cord injuries (SCIs) performed hand and arm movements, and the angles of the metacarpophalangeal (MP) joint of the index finger, wrist, and elbow were estimated from EMG signals using a formula that we derived to calculate joint angles from EMG signals, based on a musculoskeletal model. The formula was exploited to control the elbow of the exoskeleton after automatic adjustments. Four able-bodied subjects and a patient with upper cervical SCI wore an exoskeleton controlled using EMG signals and were required to perform hand and arm movements to carry and release a ball. Estimated angles of the MP joints of index fingers, wrists, and elbows were correlated well with the measured angles in 11 able-bodied subjects (correlation coefficients were 0.81  ±  0.09, 0.85  ±  0.09, and 0.76  ±  0.13, respectively) and the patients (e.g. 0.91  ±  0.01 in the elbow of a patient). Four able-bodied subjects successfully positioned their arms to adequate angles by extending their elbows and a joint of the exoskeleton, with root-mean-square errors  exoskeleton, successfully carried a ball to a goal in all 10 trials. A BMI-based exoskeleton for paralyzed arms and hands using real-time control was realized by designing a new method to estimate joint angles based on EMG signals, and these may be useful for practical rehabilitation and the support of daily actions.

  3. A hybrid BMI-based exoskeleton for paresis: EMG control for assisting arm movements

    Science.gov (United States)

    Kawase, Toshihiro; Sakurada, Takeshi; Koike, Yasuharu; Kansaku, Kenji

    2017-02-01

    Objective. Brain-machine interface (BMI) technologies have succeeded in controlling robotic exoskeletons, enabling some paralyzed people to control their own arms and hands. We have developed an exoskeleton asynchronously controlled by EEG signals. In this study, to enable real-time control of the exoskeleton for paresis, we developed a hybrid system with EEG and EMG signals, and the EMG signals were used to estimate its joint angles. Approach. Eleven able-bodied subjects and two patients with upper cervical spinal cord injuries (SCIs) performed hand and arm movements, and the angles of the metacarpophalangeal (MP) joint of the index finger, wrist, and elbow were estimated from EMG signals using a formula that we derived to calculate joint angles from EMG signals, based on a musculoskeletal model. The formula was exploited to control the elbow of the exoskeleton after automatic adjustments. Four able-bodied subjects and a patient with upper cervical SCI wore an exoskeleton controlled using EMG signals and were required to perform hand and arm movements to carry and release a ball. Main results. Estimated angles of the MP joints of index fingers, wrists, and elbows were correlated well with the measured angles in 11 able-bodied subjects (correlation coefficients were 0.81  ±  0.09, 0.85  ±  0.09, and 0.76  ±  0.13, respectively) and the patients (e.g. 0.91  ±  0.01 in the elbow of a patient). Four able-bodied subjects successfully positioned their arms to adequate angles by extending their elbows and a joint of the exoskeleton, with root-mean-square errors  exoskeleton, successfully carried a ball to a goal in all 10 trials. Significance. A BMI-based exoskeleton for paralyzed arms and hands using real-time control was realized by designing a new method to estimate joint angles based on EMG signals, and these may be useful for practical rehabilitation and the support of daily actions.

  4. Characteristic analysis of a less-rare-earth hybrid PM-assisted synchronous reluctance motor for EVs application

    Directory of Open Access Journals (Sweden)

    Wenye Wu

    2017-05-01

    Full Text Available Low-energy permanent magnet (PM such as ferrite is usually adopted in a PM-assisted reluctance (PMAREL motor to enhance the output torque and reduce costs. However, the relatively low magnetic energy product and remanence in such PMs may lead to the risk of demagnetization. By using two types of materials of rare-earth NdFeB and non-rare-earth ferrite PM, a new less-rare-earth hybrid PMAREL motor is proposed in this paper, where the output torque and the power factor can be improved obviously, and meanwhile the risk of irreversible demagnetization in ferrite PMs can be reduced significantly due to the existence of NdFeB PMs. To verify the validity of the proposed motor, the operating principles of the motor and the positive interaction influences between the two involved types of PMs are analyzed. Moreover, by using the finite element method, the torque characteristics and anti-demagnetization capabilities are also investigated in details. Both the theoretical analysis and simulated results confirm the advantages of the proposed motor.

  5. Characteristic analysis of a less-rare-earth hybrid PM-assisted synchronous reluctance motor for EVs application

    Science.gov (United States)

    Wu, Wenye; Zhu, Xiaoyong; Quan, Li; Fan, Deyang; Xiang, Zixuan

    2017-05-01

    Low-energy permanent magnet (PM) such as ferrite is usually adopted in a PM-assisted reluctance (PMAREL) motor to enhance the output torque and reduce costs. However, the relatively low magnetic energy product and remanence in such PMs may lead to the risk of demagnetization. By using two types of materials of rare-earth NdFeB and non-rare-earth ferrite PM, a new less-rare-earth hybrid PMAREL motor is proposed in this paper, where the output torque and the power factor can be improved obviously, and meanwhile the risk of irreversible demagnetization in ferrite PMs can be reduced significantly due to the existence of NdFeB PMs. To verify the validity of the proposed motor, the operating principles of the motor and the positive interaction influences between the two involved types of PMs are analyzed. Moreover, by using the finite element method, the torque characteristics and anti-demagnetization capabilities are also investigated in details. Both the theoretical analysis and simulated results confirm the advantages of the proposed motor.

  6. Analysis of a Hybrid PV/Thermal Solar-Assisted Heat Pump System for Sports Center Water Heating Application

    Directory of Open Access Journals (Sweden)

    Y. Bai

    2012-01-01

    Full Text Available The application of solar energy provides an alternative way to replace the primary source of energy, especially for large-scale installations. Heat pump technology is also an effective means to reduce the consumption of fossil fuels. This paper presents a practical case study of combined hybrid PV/T solar assisted heat pump (SAHP system for sports center hot water production. The initial design procedure was first presented. The entire system was then modeled with the TRNSYS 16 computation environment and the energy performance was evaluated based on year round simulation results. The results show that the system COP can reach 4.1 under the subtropical climate of Hong Kong, and as compared to the conventional heating system, a high fractional factor of energy saving at 67% can be obtained. The energy performances of the same system under different climatic conditions, that include three other cities in France, were analyzed and compared. Economic implications were also considered in this study.

  7. Solvent-Assisted Gel Printing for Micropatterning Thin Organic-Inorganic Hybrid Perovskite Films.

    Science.gov (United States)

    Jeong, Beomjin; Hwang, Ihn; Cho, Sung Hwan; Kim, Eui Hyuk; Cha, Soonyoung; Lee, Jinseong; Kang, Han Sol; Cho, Suk Man; Choi, Hyunyong; Park, Cheolmin

    2016-09-27

    While tremendous efforts have been made for developing thin perovskite films suitable for a variety of potential photoelectric applications such as solar cells, field-effect transistors, and photodetectors, only a few works focus on the micropatterning of a perovskite film which is one of the most critical issues for large area and uniform microarrays of perovskite-based devices. Here we demonstrate a simple but robust method of micropatterning a thin perovskite film with controlled crystalline structure which guarantees to preserve its intrinsic photoelectric properties. A variety of micropatterns of a perovskite film are fabricated by either microimprinting or transfer-printing a thin spin-coated precursor film in soft-gel state with a topographically prepatterned elastomeric poly(dimethylsiloxane) (PDMS) mold, followed by thermal treatment for complete conversion of the precursor film to a perovskite one. The key materials development of our solvent-assisted gel printing is to prepare a thin precursor film with a high-boiling temperature solvent, dimethyl sulfoxide. The residual solvent in the precursor gel film makes the film moldable upon microprinting with a patterned PDMS mold, leading to various perovskite micropatterns in resolution of a few micrometers over a large area. Our nondestructive micropatterning process does not harm the intrinsic photoelectric properties of a perovskite film, which allows for realizing arrays of parallel-type photodetectors containing micropatterns of a perovskite film with reliable photoconduction performance. The facile transfer of a micropatterned soft-gel precursor film on other substrates including mechanically flexible plastics can further broaden its applications to flexible photoelectric systems.

  8. Customizable Rehabilitation Lower Limb Exoskeleton System

    Directory of Open Access Journals (Sweden)

    Riaan Stopforth

    2012-10-01

    Full Text Available Disabled people require assistance with the motion of their lower limbs to improve rehabilitation. Exoskeletons used for lower limb rehabilitation are highly priced and are not affordable to the lowerincome sector of the population. This paper describes an exoskeleton lower limb system that was designed keeping in mind that the cost must be as low as possible. The forward kinematic system that is used must be a simplified model to decrease computational time, yet allow the exoskeleton to be adjustable according to the patient's leg dimensions.

  9. Highly Efficient 2D/3D Hybrid Perovskite Solar Cells via Low-Pressure Vapor-Assisted Solution Process.

    Science.gov (United States)

    Li, Ming-Hsien; Yeh, Hung-Hsiang; Chiang, Yu-Hsien; Jeng, U-Ser; Su, Chun-Jen; Shiu, Hung-Wei; Hsu, Yao-Jane; Kosugi, Nobuhiro; Ohigashi, Takuji; Chen, Yu-An; Shen, Po-Shen; Chen, Peter; Guo, Tzung-Fang

    2018-06-08

    The fabrication of multidimensional organometallic halide perovskite via a low-pressure vapor-assisted solution process is demonstrated for the first time. Phenyl ethyl-ammonium iodide (PEAI)-doped lead iodide (PbI 2 ) is first spin-coated onto the substrate and subsequently reacts with methyl-ammonium iodide (MAI) vapor in a low-pressure heating oven. The doping ratio of PEAI in MAI-vapor-treated perovskite has significant impact on the crystalline structure, surface morphology, grain size, UV-vis absorption and photoluminescence spectra, and the resultant device performance. Multiple photoluminescence spectra are observed in the perovskite film starting with high PEAI/PbI 2 ratio, which suggests the coexistence of low-dimensional perovskite (PEA 2 MA n -1 Pb n I 3 n +1 ) with various values of n after vapor reaction. The dimensionality of the as-fabricated perovskite film reveals an evolution from 2D, hybrid 2D/3D to 3D structure when the doping level of PEAI/PbI 2 ratio varies from 2 to 0. Scanning electron microscopy images and Kelvin probe force microscopy mapping show that the PEAI-containing perovskite grain is presumably formed around the MAPbI 3 perovskite grain to benefit MAPbI 3 grain growth. The device employing perovskite with PEAI/PbI 2 = 0.05 achieves a champion power conversion efficiency of 19.10% with an open-circuit voltage of 1.08 V, a current density of 21.91 mA cm -2 , and a remarkable fill factor of 80.36%. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Simulation of the thermal performance of a hybrid solar-assisted ground-source heat pump system in a school building

    Science.gov (United States)

    Androulakis, N. D.; Armen, K. G.; Bozis, D. A.; Papakostas, K. T.

    2018-04-01

    A hybrid solar-assisted ground-source heat pump (SAGSHP) system was designed, in the frame of an energy upgrade study, to serve as a heating system in a school building in Greece. The main scope of this study was to examine techniques to reduce the capacity of the heating equipment and to keep the primary energy consumption low. Simulations of the thermal performance of both the building and of five different heating system configurations were performed by using the TRNSYS software. The results are presented in this work and show that the hybrid SAGSHP system displays the lower primary energy consumption among the systems examined. A conventional ground-source heat pump system has the same primary energy consumption, while the heat pump's capacity is double and the ground heat exchanger 2.5 times longer. This work also highlights the contribution of simulation tools to the design of complex heating systems with renewable energy sources.

  11. Effect of inter-cooling on the performance and economics of a solar energy assisted hybrid air conditioning system with six stages one-rotor desiccant wheel

    International Nuclear Information System (INIS)

    Elzahzby, Ali M.; Kabeel, A.E.; Bassuoni, M.M.; Abdelgaied, Mohamed

    2014-01-01

    Highlights: • Development of a mathematical model for predicting the performance of solar energy assisted hybrid air conditioning system. • The model uses a one-rotor six-stage rotary silica gel desiccant wheel. • Theoretical model results are in good agreement with experimental data. • The influences of main operating parameters on optimal rotational speed are discussed. • A life cycle cost analysis of the proposed system has been investigated. - Abstract: In this study, a mathematical model for predicting the performance of solar energy assisted hybrid air conditioning system (SEAHACS) was considered. The desiccant wheels used honeycombed silica gel–haloids composite material. This one-rotor desiccant wheel is divided into six stages, in which two-stage dehumidification process, two-stage pre-cooling process and two-stage regeneration process are realized. Three air streams are involved in the present system. The mathematical model has been validated with the experimental data. As the key operating and design parameter, the range of process air inlet temperature from 27.5 to 45 °C, range of humidity ratio of the inlet process air from 9 to 21 g/kg, process air inlet velocity from 1.5 to 5.5 m/s have been examined for a range of rotation speed from 6 to 20 rev/h. the optimization of this parameters is conducted based on the moisture removal capacity D, relative moisture removal capacity, dehumidification coefficient of performance, thermal coefficient of performance, and supply air temperature and humidity ratio. At last, the influences of these main parameters on optimal rotational speed are discussed. Eventually, the life cycle cost analysis of the solar energy assisted hybrid air conditioning system has been investigated

  12. Robot-Assisted Hybrid Esophagectomy Is Associated with a Shorter Length of Stay Compared to Conventional Transthoracic Esophagectomy

    DEFF Research Database (Denmark)

    Rolff, Hans C; Ambrus, Rikard B; Belmouhand, Mohammed

    2017-01-01

    Aim: To compare the peri- and postoperative data between a hybrid minimally invasive esophagectomy (HMIE) and the conventional Ivor Lewis esophagectomy. Methods: Retrospective comparison of perioperative characteristics, postoperative complications, and survival between HMIE and Ivor Lewis esopha...

  13. Traditional and Hybrid Dental Assisting Program: An Exploration of Design and Optimal Outcomes for Community College Students

    Science.gov (United States)

    Sell, Janet A.

    2016-01-01

    This study was designed to investigate an accredited dental assisting educational program at a Midwest community college. The Bureau of Labor of Statistics (2015) claimed the profession of dental assisting is one of the fastest growing occupation, along with ongoing research that good oral health is linked to overall general health, thereby…

  14. Ultrasensitive Faraday cage-type electrochemiluminescence assay for femtomolar miRNA-141 via graphene oxide and hybridization chain reaction-assisted cascade amplification.

    Science.gov (United States)

    Lu, Jing; Wu, Lin; Hu, Yufang; Wang, Sui; Guo, Zhiyong

    2018-06-30

    In this study, a novel electrochemiluminescence (ECL) biosensor for sensitive detection of femtomolar miRNA-141 was constructed on the basis of Faraday cage-type strategy via graphene oxide (GO) and hybridization chain reaction (HCR)-assisted cascade amplification. A capture probe (CP) was immobilized on Fe 3 O 4 @SiO 2 @Au nanoparticles as capture unit, which could catch the miRNA-141, and the immobilization of the signal unit (Ru(phen) 3 2+ -HCR/GO) was allowed via nucleic acid hybridization. The prepared biosensor exhibited two advantages for signal amplification: firstly, GO could lap on the electrode surface directly, extending Outer Helmholtz Plane (OHP) of the sensor due to the large surface area and good electronic transport property; secondly, HCR-assisted cascade amplification was designed by anchoring all HCR products on the GO surface, then embedding Ru(phen) 3 2+ as a signal readout pathway. All these signal molecules could take part in electrochemical reactions, thus further enhancing the ECL signal drastically. Therefore, the proposed sensor constructed by integrating HCR with Faraday cage-type strategy displayed an ultrasensitive detection platform for the miRNA-141 with a low detection limit of 0.03 fM. In addition, this proposed biosensor provides a universal platform for analysis of other microRNAs. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Gas tungsten arc welding assisted hybrid friction stir welding of dissimilar materials Al6061-T6 aluminum alloy and STS304 stainless steel

    International Nuclear Information System (INIS)

    Bang, HanSur; Bang, HeeSeon; Jeon, GeunHong; Oh, IkHyun; Ro, ChanSeung

    2012-01-01

    Highlights: ► GTAW assisted hybrid friction stir welding (HFSW) has been carried out for dissimilar butt joint. ► Mechanical strength of dissimilar butt joint by HFSW and FSW has been investigated and compared. ► Microstructure of dissimilar butt joint by HFSW and FSW has been investigated and compared. -- Abstract: The aim of this research is to evaluate the potential for using the gas tungsten arc welding (GTAW) assisted hybrid friction stir welding (HFSW) process to join a stainless steel alloy (STS304) to an aluminum alloy (Al6061) in order to improve the weld strength. The difference in mechanical and microstructural characteristics of dissimilar joint by friction stir welding (FSW) and HFSW has been investigated and compared. Transverse tensile strength of approximately 93% of the aluminum alloy (Al6061) base metal tensile strength is obtained with HFSW, which is higher than the tensile strength of FSW welds. This may be due to the enhanced material plastic flow and partial annealing effect in dissimilar materials due to preheating of stainless steel surface by GTAW, resulting in significantly increased elongation of welds. The results indicate that HFSW that integrates GTAW preheating to FSW is advantageous in joining dissimilar combinations compared to conventional FSW.

  16. Robotic Transnasal Endoscopic Skull Base Surgery: Systematic Review of the Literature and Report of a Novel Prototype for a Hybrid System (Brescia Endoscope Assistant Robotic Holder).

    Science.gov (United States)

    Bolzoni Villaret, Andrea; Doglietto, Francesco; Carobbio, Andrea; Schreiber, Alberto; Panni, Camilla; Piantoni, Enrico; Guida, Giovanni; Fontanella, Marco Maria; Nicolai, Piero; Cassinis, Riccardo

    2017-09-01

    Although robotics has already been applied to several surgical fields, available systems are not designed for endoscopic skull base surgery (ESBS). New conception prototypes have been recently described for ESBS. The aim of this study was to provide a systematic literature review of robotics for ESBS and describe a novel prototype developed at the University of Brescia. PubMed and Scopus databases were searched using a combination of terms, including Robotics OR Robot and Surgery OR Otolaryngology OR Skull Base OR Holder. The retrieved papers were analyzed, recording the following features: interface, tools under robotic control, force feedback, safety systems, setup time, and operative time. A novel hybrid robotic system has been developed and tested in a preclinical setting at the University of Brescia, using an industrial manipulator and readily available off-the-shelf components. A total of 11 robotic prototypes for ESBS were identified. Almost all prototypes present a difficult emergency management as one of the main limits. The Brescia Endoscope Assistant Robotic holder has proven the feasibility of an intuitive robotic movement, using the surgeon's head position: a 6 degree of freedom sensor was used and 2 light sources were added to glasses that were therefore recognized by a commercially available sensor. Robotic system prototypes designed for ESBS and reported in the literature still present significant technical limitations. Hybrid robot assistance has a huge potential and might soon be feasible in ESBS. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Microwave-assisted synthesis of C-doped TiO2 and ZnO hybrid nanostructured materials as quantum-dots sensitized solar cells

    Science.gov (United States)

    Rangel-Mendez, Jose R.; Matos, Juan; Cházaro-Ruiz, Luis F.; González-Castillo, Ana C.; Barrios-Yáñez, Guillermo

    2018-03-01

    The microwave-assisted solvothermal synthesis of C-doped TiO2 and ZnO hybrid materials was performed. Saccharose, titanium isopropoxide and zinc acetate were used as organic and inorganic sources for the synthesis. The influence of temperature and reaction time on the textural and optoelectronic properties of the hybrid materials was verified. Carbon quantum-dots of TiO2 and ZnO nanostructured spheres were obtained in a second pot by controlled calcination steps of the precursor hybrid materials. A carefully characterization by adsorption-desorption N2 isotherms, XRD, XPS, SEM, UV-vis/DR and electro- and photo-electrochemistry properties of the carbon quantum-dots TiO2 and ZnO spheres was performed. The photoelectrochemical activity of TiO2-C and ZnO-C films proved to be dependent on the conditions of synthesis. It was found a red-shift in the energy band gap of the semiconductors with values of 3.02 eV and 3.13 eV for the TiO2-C and ZnO-C, respectively, clearly lower than those on bare semiconductors, which is associated with the C-doping effect. From the photo-electrochemistry characterization of C-doped TiO2 and ZnO films can be concluded that the present materials have potential applications as photoelectrodes for quantum-dots sensitized solar cells.

  18. Joint properties of dissimilar Al6061-T6 aluminum alloy/Ti–6%Al–4%V titanium alloy by gas tungsten arc welding assisted hybrid friction stir welding

    International Nuclear Information System (INIS)

    Bang, HanSur; Bang, HeeSeon; Song, HyunJong; Joo, SungMin

    2013-01-01

    Highlights: • Hybrid friction stir welding for Al alloy and Ti alloy joint has been carried out. • Mechanical strength of dissimilar joint by HFSW and FSW has been compared. • Microstructure of dissimilar joint by HFSW and FSW has been compared. - Abstract: Hybrid friction stir butt welding of Al6061-T6 aluminum alloy plate to Ti–6%Al–4%V titanium alloy plate with satisfactory acceptable joint strength was successfully achieved using preceding gas tungsten arc welding (GTAW) preheating heat source of the Ti alloy plate surface. Hybrid friction stir welding (HFSW) joints were welded completely without any unwelded zone resulting from smooth material flow by equally distributed temperature both in Al alloy side and Ti alloy side using GTAW assistance for preheating the Ti alloy plate unlike friction stir welding (FSW) joints. The ultimate tensile strength was approximately 91% in HFSW welds by that of the Al alloy base metal, which was 24% higher than that of FSW welds without GTAW under same welding condition. Notably, it was found that elongation in HFSW welds increased significantly compared with that of FSW welds, which resulted in improved joint strength. The ductile fracture was the main fracture mode in tensile test of HFSW welds

  19. Synthesis and characterization of ultrasound assisted “graphene oxide–magnetite” hybrid, and investigation of its adsorption properties for Sr(II) and Co(II) ions

    Energy Technology Data Exchange (ETDEWEB)

    Tayyebi, Ahmad; Outokesh, Mohammad, E-mail: Outokesh@sharif.edu; Moradi, Shahab; Doram, Amir

    2015-10-30

    Graphical abstract: - Highlights: • Narrow size magnetite NPs were synthesized by ultrasound assisted coprecipitaion method. • A formation mechanism for deposition of magnetite NPs on graphene oxide is proposed. • The formation mechanism supported using X-ray photoelectron spectroscopy analysis. • The modified Langevin equation was used for size estimation of magnetite NPs on M–GO. • Adsorption properties of M–GO for Co(II) and Sr(II) were investigated. - Abstract: Magnetite nanoparticles with a size distribution of 15–21 nm were synthesized and decorated onto surface of graphene oxide by ultrasound assisted precipitation. Size and size distribution of the obtained M–GO hybrid were appreciably finer than the hybrids prepared by stirring method. M–GO is a superparamagnetic material with saturation magnetization of 31 emu g{sup −1}. The Langevin equation was successfully applied for estimation of size of Fe{sub 3}O{sub 4} nanoparticles in M–GO hybrid, with maximum error of 17.5%. The study put forward a formation mechanism for M–GO, based on instrumental analyses. Adsorption isotherms of Sr{sup 2+} and Co{sup 2+} ions, which were fitted by Langmuir monolayer model, displayed two-fold higher capacity for Co{sup 2+} ions, presumably due to its similarity to Fe{sup 2+} (of Fe{sub 3}O{sub 4} component). Uptake of both Co{sup 2+} and Sr{sup 2+} ions were endothermic, and spontaneous, however the former proceeded through inner-shell complex formation, while the latter took place via ion exchange mechanism. Rate of adsorption of Co{sup 2+} was faster, but for both ions, chemical reaction was the rate determining step. Sorption of Sr{sup 2+} and Co{sup 2+} ions greatly increased at pHs above 5, where (1) surface zeta potential changed its sign, and (2) deprotonating reactions at the surface became complete.

  20. Interdiffusion Reaction-Assisted Hybridization of Two-Dimensional Metal-Organic Frameworks and Ti3C2Tx Nanosheets for Electrocatalytic Oxygen Evolution.

    Science.gov (United States)

    Zhao, Li; Dong, Biliang; Li, Shaozhou; Zhou, Lijun; Lai, Linfei; Wang, Zhiwei; Zhao, Shulin; Han, Min; Gao, Kai; Lu, Min; Xie, Xiaoji; Chen, Bo; Liu, Zhengdong; Wang, Xiangjing; Zhang, Hao; Li, Hai; Liu, Juqing; Zhang, Hua; Huang, Xiao; Huang, Wei

    2017-06-27

    Two-dimensional (2D) metal-organic framework (MOF) nanosheets have been recently regarded as the model electrocatalysts due to their porous structure, fast mass and ion transfer through the thickness, and large portion of exposed active metal centers. Combining them with electrically conductive 2D nanosheets is anticipated to achieve further improved performance in electrocatalysis. In this work, we in situ hybridized 2D cobalt 1,4-benzenedicarboxylate (CoBDC) with Ti 3 C 2 T x (the MXene phase) nanosheets via an interdiffusion reaction-assisted process. The resulting hybrid material was applied in the oxygen evolution reaction and achieved a current density of 10 mA cm -2 at a potential of 1.64 V vs reversible hydrogen electrode and a Tafel slope of 48.2 mV dec -1 in 0.1 M KOH. These results outperform those obtained by the standard IrO 2 -based catalyst and are comparable with or even better than those achieved by the previously reported state-of-the-art transition-metal-based catalysts. While the CoBDC layer provided the highly porous structure and large active surface area, the electrically conductive and hydrophilic Ti 3 C 2 T x nanosheets enabled the rapid charge and ion transfer across the well-defined Ti 3 C 2 T x -CoBDC interface and facilitated the access of aqueous electrolyte to the catalytically active CoBDC surfaces. The hybrid nanosheets were further fabricated into an air cathode for a rechargeable zinc-air battery, which was successfully used to power a light-emitting diode. We believe that the in situ hybridization of MXenes and 2D MOFs with interface control will provide more opportunities for their use in energy-based applications.

  1. An optimal control strategy for hybrid actuator systems: Application to an artificial muscle with electric motor assist.

    Science.gov (United States)

    Ishihara, Koji; Morimoto, Jun

    2018-03-01

    Humans use multiple muscles to generate such joint movements as an elbow motion. With multiple lightweight and compliant actuators, joint movements can also be efficiently generated. Similarly, robots can use multiple actuators to efficiently generate a one degree of freedom movement. For this movement, the desired joint torque must be properly distributed to each actuator. One approach to cope with this torque distribution problem is an optimal control method. However, solving the optimal control problem at each control time step has not been deemed a practical approach due to its large computational burden. In this paper, we propose a computationally efficient method to derive an optimal control strategy for a hybrid actuation system composed of multiple actuators, where each actuator has different dynamical properties. We investigated a singularly perturbed system of the hybrid actuator model that subdivided the original large-scale control problem into smaller subproblems so that the optimal control outputs for each actuator can be derived at each control time step and applied our proposed method to our pneumatic-electric hybrid actuator system. Our method derived a torque distribution strategy for the hybrid actuator by dealing with the difficulty of solving real-time optimal control problems. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  2. Hybridization between multi-objective genetic algorithm and support vector machine for feature selection in walker-assisted gait.

    Science.gov (United States)

    Martins, Maria; Costa, Lino; Frizera, Anselmo; Ceres, Ramón; Santos, Cristina

    2014-03-01

    Walker devices are often prescribed incorrectly to patients, leading to the increase of dissatisfaction and occurrence of several problems, such as, discomfort and pain. Thus, it is necessary to objectively evaluate the effects that assisted gait can have on the gait patterns of walker users, comparatively to a non-assisted gait. A gait analysis, focusing on spatiotemporal and kinematics parameters, will be issued for this purpose. However, gait analysis yields redundant information that often is difficult to interpret. This study addresses the problem of selecting the most relevant gait features required to differentiate between assisted and non-assisted gait. For that purpose, it is presented an efficient approach that combines evolutionary techniques, based on genetic algorithms, and support vector machine algorithms, to discriminate differences between assisted and non-assisted gait with a walker with forearm supports. For comparison purposes, other classification algorithms are verified. Results with healthy subjects show that the main differences are characterized by balance and joints excursion in the sagittal plane. These results, confirmed by clinical evidence, allow concluding that this technique is an efficient feature selection approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Integration of computer-assisted fracture reduction system and a hybrid 3-DOF-RPS mechanism for assisting the orthopedic surgery

    Science.gov (United States)

    Irwansyah; Sinh, N. P.; Lai, J. Y.; Essomba, T.; Asbar, R.; Lee, P. Y.

    2018-02-01

    In this paper, we present study to integrate virtual fracture bone reduction simulation tool with a novel hybrid 3-DOF-RPS external fixator to relocate back bone fragments into their anatomically original position. A 3D model of fractured bone was reconstructed and manipulated using 3D design and modeling software, PhysiGuide. The virtual reduction system was applied to reduce a bilateral femoral shaft fracture type 32-A3. Measurement data from fracture reduction and fixation stages were implemented to manipulate the manipulator pose in patient’s clinical case. The experimental result presents that by merging both of those techniques will give more possibilities to reduce virtual bone reduction time, improve facial and shortest healing treatment.

  4. Microwave assisted synthesis and characterisation of a zinc oxide/tobacco mosaic virus hybrid material. An active hybrid semiconductor in a field-effect transistor device

    Directory of Open Access Journals (Sweden)

    Shawn Sanctis

    2015-03-01

    Full Text Available Tobacco mosaic virus (TMV has been employed as a robust functional template for the fabrication of a TMV/zinc oxide field effect transistor (FET. A microwave based approach, under mild conditions was employed to synthesize stable zinc oxide (ZnO nanoparticles, employing a molecular precursor. Insightful studies of the decomposition of the precursor were done using NMR spectroscopy and material characterization of the hybrid material derived from the decomposition was achieved using dynamic light scattering (DLS, transmission electron microscopy (TEM, grazing incidence X-ray diffractometry (GI-XRD and atomic force microscopy (AFM. TEM and DLS data confirm the formation of crystalline ZnO nanoparticles tethered on top of the virus template. GI-XRD investigations exhibit an orientated nature of the deposited ZnO film along the c-axis. FET devices fabricated using the zinc oxide mineralized virus template material demonstrates an operational transistor performance which was achieved without any high-temperature post-processing steps. Moreover, a further improvement in FET performance was observed by adjusting an optimal layer thickness of the deposited ZnO on top of the TMV. Such a bio-inorganic nanocomposite semiconductor material accessible using a mild and straightforward microwave processing technique could open up new future avenues within the field of bio-electronics.

  5. Limb anomalies in DiGeorge and CHARGE syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Prasad, C.; Quackenbush, E.J.; Whiteman, D.; Korf, B. [Harvard Medical School, Boston, MA (United States)

    1997-01-20

    Limb anomalies are not common in the DiGeorge or CHARGE syndromes. We describe limb anomalies in two children, one with DiGeorge and the other with CHARGE syndrome. Our first patient had a bifid left thumb, Tetralogy of Fallot, absent thymus, right facial palsy, and a reduced number of T-cells. A deletion of 22q11 was detected by fluorescence in situ hybridization (FISH). The second patient, with CHARGE syndrome, had asymmetric findings that included right fifth finger clinodactyly, camptodactyly, tibial hemimelia and dimpling, and severe club-foot. The expanded spectrum of the DiGeorge and CHARGE syndromes includes limb anomalies. 14 refs., 4 figs.

  6. Selenium-assisted controlled growth of graphene–Bi_2Se_3 nanoplates hybrid Dirac materials by chemical vapor deposition

    International Nuclear Information System (INIS)

    Sun, Zhencui; Man, Baoyuan; Yang, Cheng; Liu, Mei; Jiang, Shouzhen; Zhang, Chao; Zhang, Jiaxin; Liu, Fuyan; Xu, Yuanyuan

    2016-01-01

    Graphical abstract: - Highlights: • We synthesize the graphene–Bi_2Se_3 nanoplates hybrid Dirac materials via CVD. • The Se seed layer impels the Bi_2Se_3 plates growing along the lateral direction. • The Se seed layer can supply enough Se atoms to fill the Se vacancies. • The Se seed layer can effectively avoid the interaction of Bi_2Se_3 and the graphene. • The Se seed layer can be used to control the density of the Bi_2Se_3 nanoplates. - Abstract: Se seed layers were used to synthesize the high-quality graphene–Bi_2Se_3 nanoplates hybrid Dirac materials via chemical vapor deposition (CVD) method. The morphology, crystallization and structural properties of the hybrid Dirac materials were characterized by SEM, EDS, Raman, XRD, AFM and HRTEM. The measurement results verify that the Se seed layer on the graphene surface can effectively saturate the surface dangling bonds of the graphene, which not only impel the uniform Bi_2Se_3 nanoplates growing along the horizontal direction but also can supply enough Se atoms to fill the Se vacancies. We also demonstrate the Se seed layer can effectively avoid the interaction of Bi_2Se_3 and the graphene. Further experiments testify the different Se seed layer on the graphene surface can be used to control the density of the Bi_2Se_3 nanoplates.

  7. Plasma assisted fabrication of multi-layer graphene/nickel hybrid film as enhanced micro-supercapacitor electrodes

    Science.gov (United States)

    Ding, Q.; Li, W. L.; Zhao, W. L.; Wang, J. Y.; Xing, Y. P.; Li, X.; Xue, T.; Qi, W.; Zhang, K. L.; Yang, Z. C.; Zhao, J. S.

    2017-03-01

    A facile synthesis strategy has been developed for fabricating multi-layer graphene/nickel hybrid film as micro-supercapacitor electrodes by using plasma enhanced chemical vapor deposition. The as-presented method is advantageous for rapid graphene growth at relatively low temperature of 650 °C. In addition, after pre-treating for the as-deposited nickel film by using argon plasma bombardment, the surface-to-volume ratio of graphene film on the treated nickel substrate is effectively increased by the increasing of surface roughness. This is demonstrated by the characterization results from transmission electron microscopy, scanning electron microscope and atomic force microscopy. Moreover, the electrochemical performance of the resultant graphene/nickel hybrid film as micro-supercapacitor working electrode was investigated by cyclic voltammetry and galvanostatic charge/discharge measurements. It was found that the increase of the surface-to-volume ratio of graphene/nickel hybrid film improved the specific capacitance of 10 times as the working electrode of micro-supercapacitor. Finally, by using comb columnar shadow mask pattern, the micro-supercapacitor full cell device was fabricated. The electrochemical performance measurements of the micro-supercapacitor devices indicate that the method presented in this study provides an effective way to fabricate micro-supercapacitor device with enhanced energy storage property.

  8. Upper limb treatment technigues for stroke survivors

    Directory of Open Access Journals (Sweden)

    Martyna Kornet

    2017-03-01

    It was considered that the most important elements of the treatment used in the rehabilitation of the paretic upper limb are: exercise matching the anti-spasm pattern, maintaining appropriate position for exercise that provide an approximation of the shoulder joint and the use of cross-facilitation. The study indicates that the treatment of a post stroke upper limb should be based on the: physiotherapy, kinesiotherapy and specific positioning - all of them corresponding to a given stage of the disease. The work also presents the most frequently used methods, especially highlighting: the Prorioceptive Neuromuscular Facilitation (PNF, Bobath, Brunnstrom, CIMT and OIT. It was also shown that in order to enhance the effects of a post-stroke upper limb rehabilitation, it should be extended by modern methods such as Mirror Therapy, Virtual Reality or Robot-assisted Therapy.

  9. Enhanced Etching, Surface Damage Recovery, and Submicron Patterning of Hybrid Perovskites using a Chemically Gas-Assisted Focused-Ion Beam for Subwavelength Grating Photonic Applications

    KAUST Repository

    Alias, Mohd Sharizal

    2015-12-22

    The high optical gain and absorption of organic–inorganic hybrid perovskites have attracted attention for photonic device applications. However, owing to the sensitivity of organic moieties to solvents and temperature, device processing is challenging, particularly for patterning. Here, we report the direct patterning of perovskites using chemically gas-assisted focused-ion beam (GAFIB) etching with XeF2 and I2 precursors. We demonstrate etching enhancement in addition to controllability and marginal surface damage compared to focused-ion beam (FIB) etching without precursors. Utilizing the GAFIB etching, we fabricated a uniform and periodic submicron perovskite subwavelength grating (SWG) absorber with broadband absorption and nanoscale precision. Our results demonstrate the use of FIB as a submicron patterning tool and a means of providing surface treatment (after FIB patterning to minimize optical loss) for perovskite photonic nanostructures. The SWG absorber can be patterned on perovskite solar cells to enhance the device efficiency through increasing light trapping and absorption.

  10. Antisolvent-assisted powder engineering for controlled growth of hybrid CH3NH3PbI3 perovskite thin films

    Directory of Open Access Journals (Sweden)

    Yong Chan Choi

    2017-02-01

    Full Text Available We develop antisolvent-assisted powder engineering for the controlled growth of hybrid inorganic-organic CH3NH3PbI3 (MAPbI3 perovskite thin films. The powders, which are used as the precursors for solution processing, are synthesized by pouring a MAPbI3 precursor solution into various antisolvents, such as dichloromethane, chloroform, diethyl ether, and toluene. Two types of powders having different colors are obtained, depending on the antisolvent used. The choice of the antisolvent used for synthesizing the powders strongly influences not only the phases of the powders but also the morphology and structure of the thin films subsequently fabricated by solution processing. This, in turn, affects the photovoltaic performance.

  11. Ultrasonically assisted hydrothermal synthesis of activated carbon-HKUST-1-MOF hybrid for efficient simultaneous ultrasound-assisted removal of ternary organic dyes and antibacterial investigation: Taguchi optimization.

    Science.gov (United States)

    Azad, F Nasiri; Ghaedi, M; Dashtian, K; Hajati, S; Pezeshkpour, V

    2016-07-01

    Activated carbon (AC) composite with HKUST-1 metal organic framework (AC-HKUST-1 MOF) was prepared by ultrasonically assisted hydrothermal method and characterized by FTIR, SEM and XRD analysis and laterally was applied for the simultaneous ultrasound-assisted removal of crystal violet (CV), disulfine blue (DSB) and quinoline yellow (QY) dyes in their ternary solution. In addition, this material, was screened in vitro for their antibacterial actively against Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAO1) bacteria. In dyes removal process, the effects of important variables such as initial concentration of dyes, adsorbent mass, pH and sonication time on adsorption process optimized by Taguchi approach. Optimum values of 4, 0.02 g, 4 min, 10 mg L(-1) were obtained for pH, AC-HKUST-1 MOF mass, sonication time and the concentration of each dye, respectively. At the optimized condition, the removal percentages of CV, DSB and QY were found to be 99.76%, 91.10%, and 90.75%, respectively, with desirability of 0.989. Kinetics of adsorption processes follow pseudo-second-order model. The Langmuir model as best method with high applicability for representation of experimental data, while maximum mono layer adsorption capacity for CV, DSB and QY on AC-HKUST-1 estimated to be 133.33, 129.87 and 65.37 mg g(-1) which significantly were higher than HKUST-1 as sole material with Qm to equate 59.45, 57.14 and 38.80 mg g(-1), respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. The transvaginal hybrid NOTES versus conventionally assisted laparoscopic sigmoid resection for diverticular disease (TRANSVERSAL) trial: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Senft, Jonas D; Warschkow, Rene; Diener, Markus K; Tarantino, Ignazio; Steinemann, Daniel C; Lamm, Sebastian; Simon, Thomas; Zerz, Andreas; Müller-Stich, Beat P; Linke, Georg R

    2014-11-20

    Natural orifice transluminal endoscopic surgery (NOTES) is the consequence of further development of minimally invasive surgery to reduce abdominal incisions and surgical trauma. The potential benefits are expected to be less postoperative pain, faster convalescence, and reduced risk for incisional hernias and wound infections compared to conventional methods. Recent clinical studies have demonstrated the feasibility and safety of transvaginal NOTES, and transvaginal access is currently the most frequent clinically applied route for NOTES procedures. However, despite increasing clinical application, no firm clinical evidence is available for objective assessment of the potential benefits and risks of transvaginal NOTES compared to the current surgical standard. The TRANSVERSAL trial is designed as a randomized controlled trial to compare transvaginal hybrid NOTES and laparoscopic-assisted sigmoid resection. Female patients referred to elective sigmoid resection due to complicated or reoccurring diverticulitis of the sigmoid colon are considered eligible. The primary endpoint will be pain intensity during mobilization 24 hours postoperatively as measured by the blinded patient and blinded assessor on a visual analogue scale (VAS). Secondary outcomes include daily pain intensity and analgesic use, patient mobility, intraoperative complications, morbidity, length of stay, quality of life, and sexual function. Follow-up visits are scheduled 3, 12, and 36 months after surgery. A total sample size of 58 patients was determined for the analysis of the primary endpoint. The confirmatory analysis will be performed based on the intention-to-treat (ITT) principle. The TRANSVERSAL trial is the first study to compare transvaginal hybrid NOTES and conventionally assisted laparoscopic surgery for colonic resection in a randomized controlled setting. The results of the TRANSVERSAL trial will allow objective assessment of the potential benefits and risks of NOTES compared to the

  13. Ultrasensitive electrochemical detection of DNA based on Zn²⁺ assistant DNA recycling followed with hybridization chain reaction dual amplification.

    Science.gov (United States)

    Qian, Yong; Wang, Chunyan; Gao, Fenglei

    2015-01-15

    A new strategy to combine Zn(2+) assistant DNA recycling followed with hybridization chain reaction dual amplification was designed for highly sensitive electrochemical detection of target DNA. A gold electrode was used to immobilize molecular beacon (MB) as the recognition probe and perform the amplification procedure. In the presence of the target DNA, the hairpin probe 1 was opened, and the DNAzyme was liberated from the caged structure. The activated DNAzyme hybridized with the MB and catalyzed its cleavage in the presence of Zn(2+) cofactor and resulting in a free DNAzyme strand. Finally, each target-induced activated DNAzyme underwent many cycles triggering the cleavage of MB, thus forming numerous MB fragments. The MB fragments triggered the HCR and formed a long double-helix DNA structure. Because both H1 and H2 were labeled by biotin, a lot of SA-ALP was captured on the electrode surface, thus catalyzing a silver deposition process for electrochemical stripping analysis. This novel cascade signal amplification strategy can detect target DNA down to the attomolar level with a dynamic range spanning 6 orders of magnitude. This highly sensitive and specific assay has a great potential to become a promising DNA quantification method in biomedical research and clinical diagnosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Technology for Large-Scale Translation of Clinical Practice Guidelines: A Pilot Study of the Performance of a Hybrid Human and Computer-Assisted Approach.

    Science.gov (United States)

    Van de Velde, Stijn; Macken, Lieve; Vanneste, Koen; Goossens, Martine; Vanschoenbeek, Jan; Aertgeerts, Bert; Vanopstal, Klaar; Vander Stichele, Robert; Buysschaert, Joost

    2015-10-09

    The construction of EBMPracticeNet, a national electronic point-of-care information platform in Belgium, began in 2011 to optimize quality of care by promoting evidence-based decision making. The project involved, among other tasks, the translation of 940 EBM Guidelines of Duodecim Medical Publications from English into Dutch and French. Considering the scale of the translation process, it was decided to make use of computer-aided translation performed by certificated translators with limited expertise in medical translation. Our consortium used a hybrid approach, involving a human translator supported by a translation memory (using SDL Trados Studio), terminology recognition (using SDL MultiTerm terminology databases) from medical terminology databases, and support from online machine translation. This resulted in a validated translation memory, which is now in use for the translation of new and updated guidelines. The objective of this experiment was to evaluate the performance of the hybrid human and computer-assisted approach in comparison with translation unsupported by translation memory and terminology recognition. A comparison was also made with the translation efficiency of an expert medical translator. We conducted a pilot study in which two sets of 30 new and 30 updated guidelines were randomized to one of three groups. Comparable guidelines were translated (1) by certificated junior translators without medical specialization using the hybrid method, (2) by an experienced medical translator without this support, and (3) by the same junior translators without the support of the validated translation memory. A medical proofreader who was blinded for the translation procedure, evaluated the translated guidelines for acceptability and adequacy. Translation speed was measured by recording translation and post-editing time. The human translation edit rate was calculated as a metric to evaluate the quality of the translation. A further evaluation was made of

  15. Optimizing an advanced hybrid of solar-assisted supercritical CO2 Brayton cycle: A vital transition for low-carbon power generation industry

    International Nuclear Information System (INIS)

    Milani, Dia; Luu, Minh Tri; McNaughton, Robbie; Abbas, Ali

    2017-01-01

    Highlights: • The layout of 14 demonstrative supercritical CO 2 closed Brayton cycles are analysed. • The key parameters of the “combined” cycle are sensitized and optimized. • The effect of thermal efficiency vs HX area on techno-economic nexus is highlighted. • The design of a matching solar heliostat field in direct configuration is revealed. • The water demand for hybrid vs water-only cooling scenarios are assessed. - Abstract: Current worldwide infrastructure of electrical power generation would mostly continue to rely on fossil-fuel but require a modest transition for the ultimate goal of decarbonizing power generation industry. By relying on those already established and carefully managed centrepiece power plants (PPs), we aim at filling the deficits of the current electrical networks with smaller, cleaner, and also more efficient PPs. In this context, we present a unique model for a small-scale decentralized solar-assisted supercritical CO 2 closed Brayton cycle (sCO 2 -CBC). Our model is based on the optimized values of three key performance indicators (KPIs); thermal efficiency, concentrated solar power (CSP) compatibility, and water demand for cooling. For a case-study of 10 MW e CSP-assisted sCO 2 -CBC power plant, our dynamic model shows a 52.7% thermal efficiency and 25.9% solar penetration and up to 80% of water saving in heat-rejection units. These KPIs show significant promise of the solar-assisted supercritical CO 2 power cycle for an imperative transformation in the power industry towards future sustainable electricity generation.

  16. Enzyme-assisted growth of nacreous CaCO3/polymer hybrid nanolaminates via the formation of mineral bridges

    Science.gov (United States)

    Yeom, Bongjun; Char, Kookheon

    2016-06-01

    Laminated nanostructures in nacre have been adopted as models in the fabrication of strong, tough synthetic nanocomposites. However, the utilization of CaCO3 biominerals in these composites is limited by the complexity of the synthesis method for nanosized biominerals. In this study, we use the enzymatic reaction of urease to generate a nanoscale CaCO3 thin film to prepare CaCO3/polymer hybrid nanolaminates. Additional layers of CaCO3 thin film are consecutively grown over the base CaCO3 layer with the intercalation of organic layers. The morphology and crystallinity of the added CaCO3 layers depend strongly on the thickness of the organic layer coated on the underlying CaCO3 layer. When the organic layer is less than 20 nm thick, the amorphous CaCO3 layer is spontaneously transformed into crystalline calcite layer during the growth process. We also observe crystalline continuity between adjacent CaCO3 layers through interconnecting mineral bridges. The formation of these mineral bridges is crucial to the epitaxial growth of CaCO3 layers, similar to the formation of natural nacre.

  17. Multi-scale theory-assisted nano-engineering of plasmonic-organic hybrid electro-optic device performance

    Science.gov (United States)

    Elder, Delwin L.; Johnson, Lewis E.; Tillack, Andreas F.; Robinson, Bruce H.; Haffner, Christian; Heni, Wolfgang; Hoessbacher, Claudia; Fedoryshyn, Yuriy; Salamin, Yannick; Baeuerle, Benedikt; Josten, Arne; Ayata, Masafumi; Koch, Ueli; Leuthold, Juerg; Dalton, Larry R.

    2018-02-01

    Multi-scale (correlated quantum and statistical mechanics) modeling methods have been advanced and employed to guide the improvement of organic electro-optic (OEO) materials, including by analyzing electric field poling induced electro-optic activity in nanoscopic plasmonic-organic hybrid (POH) waveguide devices. The analysis of in-device electro-optic activity emphasizes the importance of considering both the details of intermolecular interactions within organic electro-optic materials and interactions at interfaces between OEO materials and device architectures. Dramatic improvement in electro-optic device performance-including voltage-length performance, bandwidth, energy efficiency, and lower optical losses have been realized. These improvements are critical to applications in telecommunications, computing, sensor technology, and metrology. Multi-scale modeling methods illustrate the complexity of improving the electro-optic activity of organic materials, including the necessity of considering the trade-off between improving poling-induced acentric order through chromophore modification and the reduction of chromophore number density associated with such modification. Computational simulations also emphasize the importance of developing chromophore modifications that serve multiple purposes including matrix hardening for enhanced thermal and photochemical stability, control of matrix dimensionality, influence on material viscoelasticity, improvement of chromophore molecular hyperpolarizability, control of material dielectric permittivity and index of refraction properties, and control of material conductance. Consideration of new device architectures is critical to the implementation of chipscale integration of electronics and photonics and achieving the high bandwidths for applications such as next generation (e.g., 5G) telecommunications.

  18. Limb salvage surgery.

    Science.gov (United States)

    Kadam, Dinesh

    2013-05-01

    The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

  19. Limb salvage surgery

    Directory of Open Access Journals (Sweden)

    Dinesh Kadam

    2013-01-01

    Full Text Available The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

  20. Running With an Elastic Lower Limb Exoskeleton.

    Science.gov (United States)

    Cherry, Michael S; Kota, Sridhar; Young, Aaron; Ferris, Daniel P

    2016-06-01

    Although there have been many lower limb robotic exoskeletons that have been tested for human walking, few devices have been tested for assisting running. It is possible that a pseudo-passive elastic exoskeleton could benefit human running without the addition of electrical motors due to the spring-like behavior of the human leg. We developed an elastic lower limb exoskeleton that added stiffness in parallel with the entire lower limb. Six healthy, young subjects ran on a treadmill at 2.3 m/s with and without the exoskeleton. Although the exoskeleton was designed to provide ~50% of normal leg stiffness during running, it only provided 24% of leg stiffness during testing. The difference in added leg stiffness was primarily due to soft tissue compression and harness compliance decreasing exoskeleton displacement during stance. As a result, the exoskeleton only supported about 7% of the peak vertical ground reaction force. There was a significant increase in metabolic cost when running with the exoskeleton compared with running without the exoskeleton (ANOVA, P exoskeletons for human running are human-machine interface compliance and the extra lower limb inertia from the exoskeleton.

  1. One-step microwave-assisted colloidal synthesis of hybrid silver oxide/silver nanoparticles: characterization and catalytic study

    Science.gov (United States)

    Prakoso, S. P.; Taufik, A.; Saleh, R.

    2017-04-01

    This study reports the characterization and catalytic activities of silver-oxide/silver nanoparticles (Ag2O/Ag NPs) synthesized by microwave-assisted colloidal method in the presence of anionic sodium dodecyl sulfate (SDS) surfactant. To promote different contents of silver in silver oxide, the volume ratio (VR) of ethylene glycol (EG) was varied (VR: 10% to 14%) in relation to the total volume of distilled water solvent. The plasmonic resonance of Ag2O/Ag NPs could be detected around a wavelength of 350 nm, and it is suggested that Ag2O/Ag NPs were successfully formed in the colloid solution following exposure to microwaves. Additionally, the growth rate for each crystal phase within Ag2O and Ag was influenced by an increase of EG as revealed by x-ray diffraction patterns. The morphology, average diameter, and uniformity of Ag2O/Ag NPs were studied simultaneously by transmission electron microscopy. Infrared absorption measurement of Ag2O/Ag NPs confirmed the existence of SDS surfactant as a protective agent. Based on the characterization data, Ag2O/Ag NPs synthesized using this technique exhibited good properties, with high-yield production of NPs. The photocatalytic experiments demonstrate the key role of the crystal phase of Ag2O/Ag NPs in photocatalytic efficiency.

  2. Isolated limb perfusion.

    Science.gov (United States)

    Gillespie, Rosalyn; Chantier, Nariane

    1994-12-08

    Growing concern over the rising incidence of malignant melanoma has brought about a need for information on this disorder and the treatment available. Isolated limb perfusion is a relatively new technique used in only a few hospitals. An increased knowledge base will lead to a better understanding of the nursing care required and to a more in-depth care plan.

  3. Life-cycle assessment of a Solar Assist Plug-in Hybrid electric Tractor (SAPHT) in comparison with a conventional tractor

    International Nuclear Information System (INIS)

    Mousazadeh, Hossein; Keyhani, Alireza; Javadi, Arzhang; Mobli, Hossein; Abrinia, Karen; Sharifi, Ahmad

    2011-01-01

    The most well-known reason of global warming is equivalent carbon dioxide (CO 2equ ) emitted from fossil fuels combustion in on-road and off-road vehicles. An appreciable portion of off-road pollution is allocated to farm implements. All cited studies have shown that renewable based electric vehicles (EVs) decrease petroleum consumption and consequently reduce criteria emissions under nearly all circumstances. Considering this, a Solar Assist Plug-in Hybrid electric Tractor (SAPHT) was designed, constructed and evaluated. This research evaluated the life cycle analysis of SAPHT project and compared the results with that of an internal combustion engine tractor (ICET). The life cycle was analyzed based on economical cost and environmental emissions. The externality of environmental pollutions was calculated to derive the life-cycle costs (LCC). The results showed that substituting each ICET by SAPHT can prevent 14 ton CO 2equ emission to atmosphere annually. Also it prevents a high volume of other emissions such as CO, NO x and PM 10 entering the atmosphere. LCC assessment emphasizes on economical effectiveness of SAPHT rather than ICET at any diesel fuel price, therefore, increasing fuel unit prices leads to more effectiveness. It is concluded that levelized cost of energy (LCE) in Euro /kW h for ICET is almost twice as that of SAPHT. Some of these advantages for SAPHT are offset in part by high purchase costs, heavy and massive batteries and low operating range.

  4. Ultrasound-assisted dispersive solid phase extraction of cadmium(II) and lead(II) using a hybrid nanoadsorbent composed of graphene and the zeolite clinoptilolite

    International Nuclear Information System (INIS)

    Ghazaghi, Mehri; Mousavi, Hassan Zavvar; Shirkhanloo, Hamid; Rashidi, Ali Morad

    2015-01-01

    We describe a hybrid nanoadsorbent prepared by depositing graphene on the zeolite clinoptilolite by chemical vapor deposition. The resulting sorbent is well suited for the preconcentration of lead(II) and cadmium(II) by ultrasound-assisted dispersive micro solid–phase extraction. An extraction unit has been designed and manufactured that facilitates handling of small sample volumes. The effects of sample pH, amount of sorbent, concentration and volume of elution and time of ultrasonic bath were investigated. The nanoadsorbent was characterized by scanning electron microscopy, X-ray diffraction and energy dispersive X-ray microanalysis, all of which revealed the high surface area of the graphene sheets on the clinoptilolite. The extraction recoveries when using the new nanoadsorbent are 97 % (as opposed to a mere 10 % in case of clinoptilolite only). It is assumed that the graphene sheets located around the porous structure of clinoptilolite are acting as a barrier against macromolecules potentially existing in the sample matrices. The method was applied to the determination of lead and cadmium in water and human serum samples by electrothermal atomic absorption spectrometry. The detection limits were as low as 70 and 4 ng L −1 for Pb(II) and Cd(II), respectively. The accuracy of the method was underpinned by correct analysis of a standard reference material (SRM: 203105 Seronorm Trace Elements Serum L-2). (author)

  5. Multimodal hybrid imaging agents for sentinel node mapping as a means to (re)connect nuclear medicine to advances made in robot-assisted surgery.

    Science.gov (United States)

    KleinJan, Gijs H; van den Berg, Nynke S; de Jong, Jeroen; Wit, Esther M; Thygessen, Helene; Vegt, Erik; van der Poel, Henk G; van Leeuwen, Fijs W B

    2016-07-01

    Radical prostatectomy and complementary extended pelvic lymph node dissection (ePLND) of sentinel lymph nodes (SNs) and non-sentinel lymph nodes (LNs) at risk of containing metastases are increasingly being performed using high-tech robot-assisted approaches. Although this technological evolution has clear advantages, the physical nature of robotic systems limits the integrated use of routine radioguided surgery technologies. Hence, engineering effort in robotics are focused on the integration of fluorescence guidance technologies. Using the hybrid SN tracer indocyanine green-(99m)Tc-nanocolloid (radioactive and fluorescent), for the first time in combination with a robot-integrated laparoscope, we investigated whether the robot-assisted approach affects the accuracy of fluorescence detection of SNs identified preoperatively using nuclear medicine. The study included 55 patients (Briganti nomogram-based risk >5 % on LN metastases) scheduled for robot-assisted radical prostatectomy, SN biopsy and ePLND. Following indocyanine green-(99m)Tc-nanocolloid injection, preoperative nuclear imaging (lymphoscintigraphy and SPECT/CT) was used to locate the SN(s). The fluorescence laparoscope was used intraoperatively to identify the SN(s) with standard fluorescence settings (in 50 patients) and with customized settings (in 5 patients). The number and location of the SNs, the radioactive, fluorescence (both in vivo and ex vivo) and tumour status of the resected SNs/LNs, and postoperative complications were recorded and analysed. Combined, preoperative lymphoscintigraphy and SPECT/CT imaging identified 212 SNs (median 4 per patient). Intraoperative fluorescence imaging using standard fluorescence settings visualized 80.4 % (148/184 SNs; 50 patients; ex vivo 97.8 %). This increased to 85.7 % (12/14 SNs; 5 patients; ex vivo 100 %) with customized fluorescence settings. SPECT/CT images provided guidance towards the residual SNs. Ex vivo all removed SNs were radioactive. SNs

  6. Multimodal hybrid imaging agents for sentinel node mapping as a means to (re)connect nuclear medicine to advances made in robot-assisted surgery

    Energy Technology Data Exchange (ETDEWEB)

    KleinJan, Gijs H. [Leiden University Medical Hospital, Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Berg, Nynke S. van den [Leiden University Medical Hospital, Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Jong, Jeroen de [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Pathology, Amsterdam (Netherlands); Wit, Esther M.; Poel, Henk G. van der [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Thygessen, Helene [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Biostatistics, Amsterdam (Netherlands); Vegt, Erik [The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Leeuwen, Fijs W.B. van [Leiden University Medical Hospital, Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Head and Neck Surgery and Oncology, Amsterdam (Netherlands)

    2016-07-15

    Radical prostatectomy and complementary extended pelvic lymph node dissection (ePLND) of sentinel lymph nodes (SNs) and non-sentinel lymph nodes (LNs) at risk of containing metastases are increasingly being performed using high-tech robot-assisted approaches. Although this technological evolution has clear advantages, the physical nature of robotic systems limits the integrated use of routine radioguided surgery technologies. Hence, engineering effort in robotics are focused on the integration of fluorescence guidance technologies. Using the hybrid SN tracer indocyanine green-{sup 99m}Tc-nanocolloid (radioactive and fluorescent), for the first time in combination with a robot-integrated laparoscope, we investigated whether the robot-assisted approach affects the accuracy of fluorescence detection of SNs identified preoperatively using nuclear medicine. The study included 55 patients (Briganti nomogram-based risk >5 % on LN metastases) scheduled for robot-assisted radical prostatectomy, SN biopsy and ePLND. Following indocyanine green-{sup 99m}Tc-nanocolloid injection, preoperative nuclear imaging (lymphoscintigraphy and SPECT/CT) was used to locate the SN(s). The fluorescence laparoscope was used intraoperatively to identify the SN(s) with standard fluorescence settings (in 50 patients) and with customized settings (in 5 patients). The number and location of the SNs, the radioactive, fluorescence (both in vivo and ex vivo) and tumour status of the resected SNs/LNs, and postoperative complications were recorded and analysed. Combined, preoperative lymphoscintigraphy and SPECT/CT imaging identified 212 SNs (median 4 per patient). Intraoperative fluorescence imaging using standard fluorescence settings visualized 80.4 % (148/184 SNs; 50 patients; ex vivo 97.8 %). This increased to 85.7 % (12/14 SNs; 5 patients; ex vivo 100 %) with customized fluorescence settings. SPECT/CT images provided guidance towards the residual SNs. Ex vivo all removed SNs were radioactive. SNs

  7. Multimodal hybrid imaging agents for sentinel node mapping as a means to (re)connect nuclear medicine to advances made in robot-assisted surgery

    International Nuclear Information System (INIS)

    KleinJan, Gijs H.; Berg, Nynke S. van den; Jong, Jeroen de; Wit, Esther M.; Poel, Henk G. van der; Thygessen, Helene; Vegt, Erik; Leeuwen, Fijs W.B. van

    2016-01-01

    Radical prostatectomy and complementary extended pelvic lymph node dissection (ePLND) of sentinel lymph nodes (SNs) and non-sentinel lymph nodes (LNs) at risk of containing metastases are increasingly being performed using high-tech robot-assisted approaches. Although this technological evolution has clear advantages, the physical nature of robotic systems limits the integrated use of routine radioguided surgery technologies. Hence, engineering effort in robotics are focused on the integration of fluorescence guidance technologies. Using the hybrid SN tracer indocyanine green- 99m Tc-nanocolloid (radioactive and fluorescent), for the first time in combination with a robot-integrated laparoscope, we investigated whether the robot-assisted approach affects the accuracy of fluorescence detection of SNs identified preoperatively using nuclear medicine. The study included 55 patients (Briganti nomogram-based risk >5 % on LN metastases) scheduled for robot-assisted radical prostatectomy, SN biopsy and ePLND. Following indocyanine green- 99m Tc-nanocolloid injection, preoperative nuclear imaging (lymphoscintigraphy and SPECT/CT) was used to locate the SN(s). The fluorescence laparoscope was used intraoperatively to identify the SN(s) with standard fluorescence settings (in 50 patients) and with customized settings (in 5 patients). The number and location of the SNs, the radioactive, fluorescence (both in vivo and ex vivo) and tumour status of the resected SNs/LNs, and postoperative complications were recorded and analysed. Combined, preoperative lymphoscintigraphy and SPECT/CT imaging identified 212 SNs (median 4 per patient). Intraoperative fluorescence imaging using standard fluorescence settings visualized 80.4 % (148/184 SNs; 50 patients; ex vivo 97.8 %). This increased to 85.7 % (12/14 SNs; 5 patients; ex vivo 100 %) with customized fluorescence settings. SPECT/CT images provided guidance towards the residual SNs. Ex vivo all removed SNs were radioactive. SNs were

  8. Artificial limb representation in amputees.

    Science.gov (United States)

    van den Heiligenberg, Fiona M Z; Orlov, Tanya; Macdonald, Scott N; Duff, Eugene P; Henderson Slater, David; Beckmann, Christian F; Johansen-Berg, Heidi; Culham, Jody C; Makin, Tamar R

    2018-05-01

    The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images. This was found even when one-handers were presented with images of active prostheses that share the functionality of the hand but not necessarily its visual features (e.g. a 'hook' prosthesis). Further, we show that daily prosthesis usage determines large-scale inter-network communication across hand-selective areas. This was demonstrated by increased resting state functional connectivity between visual and sensorimotor hand-selective areas, proportional to the intensiveness of everyday prosthesis usage. Further analysis revealed a 3-fold coupling between prosthesis activity, visuomotor connectivity and usage, suggesting a possible role for the motor system in shaping use-dependent representation in visual hand-selective areas, and/or vice versa. Moreover, able-bodied control participants who routinely observe prosthesis usage (albeit less intensively than the prosthesis users) showed significantly weaker associations between degree of prosthesis observation and visual cortex activity or connectivity. Together, our findings suggest that altered daily motor behaviour facilitates prosthesis-related visual processing and shapes communication across hand-selective areas. This neurophysiological substrate for prosthesis embodiment may inspire rehabilitation approaches to improve usage of existing substitutionary devices and aid implementation of future assistive and augmentative technologies.

  9. A Brief History of Limb Lengthening.

    Science.gov (United States)

    Birch, John G

    2017-09-01

    In the last 35 years, orthopaedic surgeons have witnessed 3 major advances in the technique of limb lengthening: "distraction osteogenesis" facilitated by Gavriil Ilizarov method and infinitely-adaptable circular fixator with fine-wire bone fragment fixation; the introduction of the "6-strut" computer program-assisted circular fixators to effect complex deformity correction simultaneously; and the development of motorized intramedullary lengthening nails. However, the principles and associated complications of these techniques are on the basis of observations by Codivilla, Putti, and Abbott from as much as 110 years ago. This review notes the contribution of these pioneers in limb lengthening, and the contribution of Thor Heyerdahl principles of tolerance and diversity to the dissemination of Ilizarov principles to the Western world.

  10. Tharsis Limb Cloud

    Science.gov (United States)

    2005-01-01

    [figure removed for brevity, see original site] Annotated image of Tharsis Limb Cloud 7 September 2005 This composite of red and blue Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) daily global images acquired on 6 July 2005 shows an isolated water ice cloud extending more than 30 kilometers (more than 18 miles) above the martian surface. Clouds such as this are common in late spring over the terrain located southwest of the Arsia Mons volcano. Arsia Mons is the dark, oval feature near the limb, just to the left of the 'T' in the 'Tharsis Montes' label. The dark, nearly circular feature above the 'S' in 'Tharsis' is the volcano, Pavonis Mons, and the other dark circular feature, above and to the right of 's' in 'Montes,' is Ascraeus Mons. Illumination is from the left/lower left. Season: Northern Autumn/Southern Spring

  11. [Limb lengthening in dwarfism].

    Science.gov (United States)

    Correll, J; Held, P

    2000-09-01

    Limb lengthening in dwarfism has become a standardised procedure with a good prognosis. In most cases external fixation is used. Gain of leg length up to 15 cm and more is possible in the lower leg and the femur and 8.5 cm in the humerus. Limb lengthening is useful in many cases of dwarfism due to skeletal dysplasia. There are a number of risks and possible complications involved and the procedure also requires considerable time. We report the results of 48 patients with dwarfism operated on in the Orthopädische Kinderklinik Aschau (Orthopaedic Hospital for Children). It must not be recommended as a normal tool in handling the problems of dwarfism, but it makes sense in some cases of dwarfism. We describe and discuss the prerequisites for the operative treatment.

  12. Coping and posttraumatic growth in women with limb amputations.

    Science.gov (United States)

    Stutts, Lauren A; Bills, Sarah E; Erwin, Savannah R; Good, Jessica J

    2015-01-01

    While ample research has examined the psychological experiences of men with limb amputations, minimal research has examined the psychological experiences of women with limb amputations. The present study utilizes a qualitative design to examine coping and posttraumatic growth in women with limb amputations. Thirty women completed the posttraumatic growth inventory (PTGI) and provided open-ended responses about coping, social support, discrimination, support groups, and acceptance. Interpretative phenomenological analysis was used to discern emergent and superordinate themes in qualitative responses. Superordinate themes included social support (friendships/family and community), self-beliefs, resources, physical complications, spirituality, specific strategies, and acceptance. Concerns related specifically to participants' gender identity included appearance and motherhood. Overall, women reported moderate-to-high PTGI scores. The current findings address a void in the literature by illuminating the unique perspective of women with amputations. Future research should use quantitative methodology to expand on our research findings, as well as assess interventions to assist women adjusting to limb loss.

  13. Microwave solar limb brightening

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad, I A; Kundu, M R [Maryland Univ., College Park (USA)

    1981-02-01

    Previous models of microwave limb brightening have omitted the alignment of spicules along supergranule boundaries, have neglected the high temperature sheath around spicules, and have assumed an interspicular medium which was averaged over chromospheric network and non-network regions. We present a model which includes these factors. By constraining the model to conform to results from earlier UV and optical studies we are effectively left with two free parameters: the temperature at the core of the spicules, Tsub(c)sub(o)sub(r)sub(e), and (at solar minimum), the interspicular chromospheric network density model of the lower transition zone. The absence of limb brightening at the short millimeter wavelengths implies Tsub(c)sub(o)sub(r)sub(e) approx. < 6000 k. Differences between the model and certain deconvolved observations near 9 mm are expected as a consequence of an extension of emission beyond the optical limb, predicted by the model, which affects the accuracy of the deconvolution technique. Unlike models which assume homogeous spicules in a random distribution, ours does not require an abnormally high spicule area.

  14. Microwave-assisted rapid synthesis of Fe{sub 2}O{sub 3}/ACF hybrid for high efficient As(V) removal

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Huiyun; Lv, Kangle; Du, Ying; Ye, Hengpeng; Du, Dongyun, E-mail: dydu666@mail.scuec.edu.cn

    2016-07-25

    In this paper, an efficient adsorbent, iron-modified activated carbon fiber (Fe{sub 2}O{sub 3}/ACF), was rapidly fabricated by microwave-assisted heating treatment strategy, which is used to remove As(V) from simulated wastewater. The adsorbent was characterized by scanning electron microscopy (SEM), TEM, N{sub 2} sorption, X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). The characterization results showed that rod-like Fe{sub 2}O{sub 3} particles in sizes of about 20 nm × 50 nm were homogeneously anchored on the surface of ACF. The goal of high As(V) removal efficiency was achieved with maximum adsorption capacity of 20.33 mg g{sup −1}. The effects of temperature on thermodynamics and kinetics of As(V) adsorption were systematically studied. It was found that the adsorption of As(V) on the surface of Fe{sub 2}O{sub 3}/ACF is an endothermic process with a standard enthalpy change (ΔH{sup 0}) of 24.79 kJ mol{sup −1}. Batch experimental result showed that almost all of the As(V) with initial concentration of 3.0 mg L{sup −1} can be removed in the presence of Fe{sub 2}O{sub 3}/ACF, where the residual As(V) in filtrate was less than 0.01 mg L{sup −1}, below the tolerance level of drinking water suggested by World Health Organization (WHO). The presence of salt such as NaCl, Na{sub 2}SO{sub 4}, and MgSO{sub 4} showed little effects on the adsorption of As(V), indicating the promising application of Fe{sub 2}O{sub 3}/ACF in industrial wastewater. - Highlights: • Fe{sub 2}O{sub 3}/ACF hybrid was rapidly fabricated using a microwave-assisted heating strategy. • Fe{sub 2}O{sub 3} nanorods in sizes of 20 × 50 nm were homogeneously anchored on the surface of ACF. • The maximum adsorption capacity of 20.33 mg g{sup −1} As (V) on Fe{sub 2}O{sub 3}/ACF was achieved. • The adsorption of As (V) is an endothermic process (ΔH{sup 0} = 24.79 kJ mol{sup −1}). • The presence of salt shows little effect on the adsorption of As (V).

  15. Healing of severe polystructural limb wounds using vacuum therapy

    OpenAIRE

    Naumenko, Leonid; Horehliad, Olexii; Mametyev, Andriy; Kostrytsya, Konstantyn; Domansky, Andriy

    2017-01-01

    Vacuum-assisted wound closure has been known for the last two decades as an economically viable and effective treatment method, but the variety of patient injuries caused by severe polystructural (including combat) injuries requires further re­search into the effect of negative pressure on wound healing.Objective: to study the possibilities of vacuum-assisted wound closure therapy for the early management of patients with se­vere open polystructural injuries of limbs with fragmentation or gun...

  16. Intraobserver and intermethod reliability for using two different computer programs in preoperative lower limb alignment analysis

    Directory of Open Access Journals (Sweden)

    Mohamed Kenawey

    2016-12-01

    Conclusion: Computer assisted lower limb alignment analysis is reliable whether using graphics editing program or specialized planning software. However slight higher variability for angles away from the knee joint can be expected.

  17. Limb immobilization and corticobasal syndrome.

    Science.gov (United States)

    Graff-Radford, Jonathan; Boeve, Bradley F; Drubach, Daniel A; Knopman, David S; Ahlskog, J Eric; Golden, Erin C; Drubach, Dina I; Petersen, Ronald C; Josephs, Keith A

    2012-12-01

    Recently, we evaluated two patients with corticobasal syndrome (CBS) who reported symptom onset after limb immobilization. Our objective was to investigate the association between trauma, immobilization and CBS. The charts of forty-four consecutive CBS patients seen in the Mayo Clinic Alzheimer Disease Research Center were reviewed with attention to trauma and limb immobilization. 10 CBS patients (23%) had immobilization or trauma on the most affected limb preceding the onset or acceleration of symptoms. The median age at onset was 61. Six patients manifested their first symptoms after immobilization from surgery or fracture with one after leg trauma. Four patients had pre-existing symptoms of limb dysfunction but significantly worsened after immobilization or surgery. 23 percent of patients had immobilization or trauma of the affected limb. This might have implications for management of CBS, for avoiding injury, limiting immobilization and increasing movement in the affected limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Limb lengthening in achondroplasia

    Directory of Open Access Journals (Sweden)

    Sanjay K Chilbule

    2016-01-01

    Full Text Available Background: Stature lengthening in skeletal dysplasia is a contentious issue. Specific guidelines regarding the age and sequence of surgery, methods and extent of lengthening at each stage are not uniform around the world. Despite the need for multiple surgeries, with their attendant complications, parents demanding stature lengthening are not rare, due to the social bias and psychological effects experienced by these patients. This study describes the outcome and complications of extensive stature lengthening performed at our center. Materials and Methods: Eight achondroplasic and one hypochondroplasic patient underwent bilateral transverse lengthening for tibiae, humeri and femora. Tibia lengthening was carried out using a ring fixator and bifocal corticotomy, while a monolateral pediatric limb reconstruction system with unifocal corticotomy was used for the femur and humerus. Lengthening of each bone segment, height gain, healing index and complications were assessed. Subgroup analysis was carried out to assess the effect of age and bone segment on the healing index. Results: Nine patients aged five to 25 years (mean age 10.2 years underwent limb lengthening procedures for 18 tibiae, 10 femora and 8 humeri. Four patients underwent bilateral lengthening of all three segments. The mean length gain for the tibia, femur and humerus was 15.4 cm (100.7%, 9.9 cm (52.8% and 9.6 cm (77.9%, respectively. Healing index was 25.7, 25.6 and 20.6 days/cm, respectively, for the tibia, femur and humerus. An average of 33.3% height gain was attained. Lengthening of both tibia and femur added to projected height achieved as the 3 rd percentile of standard height in three out of four patients. In all, 33 complications were encountered (0.9 complications per segment. Healing index was not affected by age or bone segment. Conclusion: Extensive limb lengthening (more than 50% over initial length carries significant risk and should be undertaken only after due

  19. Limb lengthening in achondroplasia.

    Science.gov (United States)

    Chilbule, Sanjay K; Dutt, Vivek; Madhuri, Vrisha

    2016-01-01

    Stature lengthening in skeletal dysplasia is a contentious issue. Specific guidelines regarding the age and sequence of surgery, methods and extent of lengthening at each stage are not uniform around the world. Despite the need for multiple surgeries, with their attendant complications, parents demanding stature lengthening are not rare, due to the social bias and psychological effects experienced by these patients. This study describes the outcome and complications of extensive stature lengthening performed at our center. Eight achondroplasic and one hypochondroplasic patient underwent bilateral transverse lengthening for tibiae, humeri and femora. Tibia lengthening was carried out using a ring fixator and bifocal corticotomy, while a monolateral pediatric limb reconstruction system with unifocal corticotomy was used for the femur and humerus. Lengthening of each bone segment, height gain, healing index and complications were assessed. Subgroup analysis was carried out to assess the effect of age and bone segment on the healing index. Nine patients aged five to 25 years (mean age 10.2 years) underwent limb lengthening procedures for 18 tibiae, 10 femora and 8 humeri. Four patients underwent bilateral lengthening of all three segments. The mean length gain for the tibia, femur and humerus was 15.4 cm (100.7%), 9.9 cm (52.8%) and 9.6 cm (77.9%), respectively. Healing index was 25.7, 25.6 and 20.6 days/cm, respectively, for the tibia, femur and humerus. An average of 33.3% height gain was attained. Lengthening of both tibia and femur added to projected height achieved as the 3(rd) percentile of standard height in three out of four patients. In all, 33 complications were encountered (0.9 complications per segment). Healing index was not affected by age or bone segment. Extensive limb lengthening (more than 50% over initial length) carries significant risk and should be undertaken only after due consideration.

  20. Expression of Msx genes in regenerating and developing limbs of axolotl.

    Science.gov (United States)

    Koshiba, K; Kuroiwa, A; Yamamoto, H; Tamura, K; Ide, H

    1998-12-15

    Msx genes, homeobox-containing genes, have been isolated as homologues of the Drosophila msh gene and are thought to play important roles in the development of chick or mouse limb buds. We isolated two Msx genes, Msx1 and Msx2, from regenerating blastemas of axolotl limbs and examined their expression patterns using Northern blot and whole mount in situ hybridization during regeneration and development. Northern blot analysis revealed that the expression level of both Msx genes increased during limb regeneration. The Msx2 expression level increased in the blastema at the early bud stage, and Msx1 expression level increased at the late bud stage. Whole mount in situ hybridization revealed that Msx2 was expressed in the distal mesenchyme and Msx1 in the entire mesenchyme of the blastema at the late bud stage. In the developing limb bud, Msx1 was expressed in the entire mesenchyme, while Msx2 was expressed in the distal and peripheral mesenchyme. The expression patterns of Msx genes in the blastemas and limb buds of the axolotl were different from those reported for chick or mouse limb buds. These expression patterns of axolotl Msx genes are discussed in relation to the blastema or limb bud morphology and their possible roles in limb patterning.

  1. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Suzuki, Kenji; Abe, Tetsuya; Ueno, Tomoyuki; Soma, Yuichiro; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2017-01-01

    Patients with complete paraplegia after spinal cord injury (SCI) are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL) in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman) were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20-67) years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS) grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60-90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG) was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad) in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs) score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention. These findings

  2. Voluntary Ambulation by Upper Limb-Triggered HAL® in Patients with Complete Quadri/Paraplegia Due to Chronic Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Yukiyo Shimizu

    2017-11-01

    Full Text Available Patients with complete paraplegia after spinal cord injury (SCI are unable to stand or walk on their own. Standing exercise decreases the risk of decubitus ulcers, osteoporosis, and joint deformities in patients with SCI. Conventional gait training for complete paraplegia requires excessive upper limb usage for weight bearing and is difficult in cases of complete quadriplegia. The purpose of this study was to describe voluntary ambulation triggered by upper limb activity using the Hybrid Assistive Limb® (HAL in patients with complete quadri/paraplegia after chronic SCI. Four patients (3 men, 1 woman were enrolled in this study. The mean patient age ± standard deviation was 37.2 ± 17.8 (range, 20–67 years. Clinical evaluation before intervention revealed the following findings: case 1, neurological level C6, American Spinal Cord Injury Association impairment scale (AIS grade B; case 2, T6, AIS A; case 3, T10 AIS A; and case 4, T11, AIS A. The HAL intervention consisted of 10 sessions. Each HAL session lasted 60–90 min. The HAL electrodes for hip and knee flexion-extension were placed on the anterior and posterior sides of the upper limbs contralaterally corresponding to each of the lower limbs. Surface electromyography (EMG was used to evaluate muscle activity of the tensor fascia lata and quadriceps femoris (Quad in synchronization with a Vicon motion capture system. The modified Ashworth scale (mAs score was also evaluated before and after each session. All participants completed all 10 sessions. Cases 1, 2, and 3 demonstrated significant decreases in mAs score after the sessions compared to pre-session measurements. In all cases, EMG before the intervention showed no apparent activation in either Quad. However, gait phase dependent activity of the lower limb muscles was seen during voluntarily triggered ambulation driven by upper limb muscle activities. In cases 3 and 4, active contraction in both Quads was observed after intervention

  3. Kinematics and Dynamics Analysis of a 3-DOF Upper-Limb Exoskeleton with an Internally Rotated Elbow Joint

    OpenAIRE

    Xin Wang; Qiuzhi Song; Xiaoguang Wang; Pengzhan Liu

    2018-01-01

    The contradiction between self-weight and load capacity of a power-assisted upper-limb exoskeleton for material hanging is unresolved. In this paper, a non-anthropomorphic 3-degree of freedom (DOF) upper-limb exoskeleton with an internally rotated elbow joint is proposed based on an anthropomorphic 5-DOF upper-limb exoskeleton for power-assisted activity. The proposed 3-DOF upper-limb exoskeleton contains a 2-DOF shoulder joint and a 1-DOF internally rotated elbow joint. The structural parame...

  4. Arterial mapping of lower limbs

    International Nuclear Information System (INIS)

    Acuna Allen, Rafael

    2011-01-01

    A bibliographic review is realized in the arterial mapping of lower limbs by ultrasonographic. The physical properties of the Doppler effect applied to diagnostic ultrasound are described. The anatomical characteristics of the general arterial system and specifically of the lower limbs arterial system are mentioned. Pathologies of the ischemic arterial disease of lower limbs are explained. The study characteristics of lower limbs arterial mapping are documented to determine its importance as appropriate method for the assessment of lower limb ischemia. An adequate arterial mapping of lower limbs is recognized in atherosclerotic ischemic disease as a reliable initial method alternative to arteriography. Arteriography is considered as reference pattern for therapeutic decision making in patients with critical ischemia of the lower limbs. Non-invasive methods to assess the arterial system of lower limbs has evidenced the advantages of the arterial mapping with Doppler, according to the consulted literature. The combination morphological and hemodynamic information has been possible and a map of the explored zone is made. The arterial mapping by ultrasonography has offered similar reliability to angiography [es

  5. Evaluation of Limb-Girdle Muscular Dystrophy

    Science.gov (United States)

    2014-03-06

    Becker Muscular Dystrophy; Limb-Girdle Muscular Dystrophy, Type 2A (Calpain-3 Deficiency); Limb-Girdle Muscular Dystrophy, Type 2B (Miyoshi Myopathy, Dysferlin Deficiency); Limb-Girdle Muscular Dystrophy, Type 2I (FKRP-deficiency)

  6. Limb girdle muscular dystrophies

    DEFF Research Database (Denmark)

    Vissing, John

    2016-01-01

    PURPOSE OF REVIEW: The aim of the study was to describe the clinical spectrum of limb girdle muscular dystrophies (LGMDs), the pitfalls of the current classification system for LGMDs, and emerging therapies for these conditions. RECENT FINDINGS: Close to half of all LGMD subtypes have been...... or are registered in other classification systems for muscle disease. On the contrary, diseases that fulfill classical criteria for LGMD have found no place in the LGMD classification system. These shortcomings call for revision/creation of a new classification system for LGMD. The rapidly expanding gene sequencing...... capabilities have helped to speed up new LGMD discoveries, and unveiled pheno-/genotype relations. Parallel to this progress in identifying new LGMD subtypes, emerging therapies for LGMDs are under way, but no disease-specific treatment is yet available for nonexperimental use. SUMMARY: The field of LGMD...

  7. Ultrasound assisted synthesis of morphology tunable rGO:ZnO hybrid nanostructures and their optical and UV-A light driven photocatalysis

    Energy Technology Data Exchange (ETDEWEB)

    Thangaraj, Pandiyarajan, E-mail: rtpandiyarajan@gmail.com [Advanced Ceramics and Nanotechnology Laboratory, Department of Materials Engineering, University of Concepcion (Chile); Ramalinga Viswanathan, Mangalaraja, E-mail: mangal@udec.cl [Advanced Ceramics and Nanotechnology Laboratory, Department of Materials Engineering, University of Concepcion (Chile); Balasubramanian, Karthikeyan [Department of Physics, National Institute of Technology, Tiruchirappalli 620015 (India); Mansilla, Héctor D. [Departament of Organic Chemistry, Faculty of Chemical Sciences, University of Concepcion (Chile); Contreras, David [Departament of Analytical and Inorganic Chemistry, Faculty of Chemical Sciences, Center for Biotechnology, University of Concepcion (Chile); Sepulveda-Guzman, Selene [Universidad Autónoma de Nuevo León, UANL, Facultad de Ingeniería Mecánica y Eléctrica, FIME, Ave. Pedro de Alba s/n, Ciudad Universitaria, C.P.66455 San Nicolás de los Garza, N.L. (Mexico); Gracia-Pinilla, M.A. [Universidad Autónoma de Nuevo León, Facultad de Ciencias Físico-Matemáticas, Av. Universidad, Cd. Universitaria, San Nicolás de los Garza, NL (Mexico); Centro de Investigación en Innovación y Desarrollo en Ingeniería y Tecnología, Universidad Autónoma de Nuevo León, PIIT, Apodaca, Nuevo León 66600 (Mexico)

    2017-06-15

    Controlling size and shape of hybrid nanostructures is technologically important because of the strong effect of nanostructure dimension and morphology on optoelectronic, biosensors and catalytic properties. Here, we have demonstrated a simple strategy for simultaneous control of morphology, defect engineering and photocatalytic activities of reduced graphene oxide:zinc oxide (rGO:ZnO) hybrid nanostructures which were prepared by using low frequency (42 kHz) ultrasound. By varying the solvents, the morphology of ZnO gradually evolved from spherical shape to a star like nature and the ZnO nanoparticles decorated on reduced graphene oxide were clearly observed in the TEM analysis. Absorption, photoluminescence, Raman and FTIR spectra clearly indicated the formation of rGO:ZnO hybrid nanostructures. Thermal analysis revealed that the hybrid nanostructures exhibited a good thermal stability. The synergistic integration of the unique morphology and size imparts the rGO:ZnO hybrid nanostructures with remarkably enhanced photocatalytic efficiency when compared with bare ZnO. The enhanced photocatalytic behaviour of the rGO:ZnO composite has been discussed in details herein. Simple and facile synthesis route demonstrated the potential for the utilization of rGO:ZnO hybrid nanostructures with unique properties for environmental engineering applications.

  8. Facile synthesis of aluminium doped zinc oxide-polyaniline hybrids for photoluminescence and enhanced visible-light assisted photo-degradation of organic contaminants

    Energy Technology Data Exchange (ETDEWEB)

    Mitra, Mousumi [Department of Physics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah 711103, West Bengal (India); Ghosh, Amrita; Mondal, Anup [Department of Chemistry, Indian Institute of Engineering Science and Technology, Shibpur, Howrah 711103, West Bengal (India); Kargupta, Kajari [Department of Chemical Engineering, Jadavpur University, Kolkata 700032, West Bengal (India); Ganguly, Saibal [Department of Chemical Engineering, BITS Pilani, K K Birla Goa Campus, NH 17 B Bypass Road, Zuarinagar, Sancoale, Goa 403726 (India); Banerjee, Dipali, E-mail: dipalibanerjeebesu@gmail.com [Department of Physics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah 711103, West Bengal (India)

    2017-04-30

    Graphical abstract: The present work focuses on the synergistic effect of a novel hybrid hetero structure (n-type aluminum doped zinc oxide and p-type polyaniline), combining both sol-gel and in-situ oxidative polymerization method and studying its photoluminescence (PL), photocatalytic, electrochemical impedance spectroscopy (EIS), linear scan voltammetry (LSV) and photocurrent properties. - Highlights: • Aluminium doped zinc oxide-polyaniline (PAZ) hybrids were prepared by polymerization of aniline using aluminium doped zinc oxide nanorod templates. • The hybrids were used as visible light photocatalysts for methyl orange (MO) and rose bengal (RB) dye degradation. • First order rate constants of the photocatalytic process were evaluated as 1.77 × 10{sup −2} min{sup −1} and 2.61 × 10{sup −2} min{sup −1} for MO and RB dyes respectively. • Photoluminescence and electrochemical properties were in accord with the photocatalytic performance of the hybrid. - Abstract: The emergence of organic-inorganic photoactive materials has led to marked progress in the field of heterogeneous visible-light photocatalysis. Visible-light active aluminium doped zinc oxide-polyaniline (PAZ) hybrid was prepared employing in-situ oxidative polymerization of polyaniline (PANI) in the presence of aluminium doped zinc oxide (AlZnO) nanorods, synthesized via sol-gel route. The compositions, structural and optical properties of the synthesized hybrids were characterized. Among various samples, the 22 wt% aluminium doped zinc oxide-polyaniline (PAZ 3) hybrid show the best photocatalytic action for the degradation of methyl orange (MO) and rose bengal (RB) dyes under visible-light illumination, even after repeated use. The performance of the photocatalytic process was determined by the first order rate constant, 1.77 × 10{sup −2} min{sup −1} and 2.61 × 10{sup −2} min{sup −1} for MO and RB dyes, respectively. Scavenger test was used to determine the role of active

  9. Short-limb dwarfism and hypertrophic cardiomyopathy in a patient with paternal isodisomy 14: 45,XYidic(14)(p11)

    Energy Technology Data Exchange (ETDEWEB)

    Walter, C.A.; Moore, C.M.; Kaye, C.I. [Univ. of Texas Health Science Center, San Antonio, TX (United States)] [and others

    1996-11-11

    Uniparental disomy (UPD) has been shown to result in specific disorders either due to imprinting and/or homozygosity of mutant alleles. Here we present the findings in a child with paternal UPD14. Ultrasound evaluation was performed at 30 weeks of gestation because of abnormally large uterine size. Pertinent ultrasound findings included polyhydramnios, short limbs, abnormal position of hands, small thorax, and nonvisualization of the fetal stomach. Postnatally the infant was found to have a low birth weight, short birth length, contractures, short limbs, and a small thorax with upslanting ribs. Assisted ventilation and gastrostomy were required. At age 6 months, the infant required hospitalization for hypertrophic cardiomyopathy which responded to Atenolol{reg_sign}. Initial cytogenetic studies demonstrated an apparently balanced de novo Robertsonian translocation involving chromosomes 14 and a karyotype designation of 45,XY,t(14q14q). No indication of mosaicism for trisomy 14 was observed in metaphase spreads prepared from peripheral blood lymphocytes or skin-derived fibroblasts. C-band and fluorescence in situ hybridization results demonstrated that the chromosome was dicentric. DNA analyses showed paternal uniparental isodisomy for chromosome 14. Based on the cytogenetic and DNA results a final karyotype designation of 45,XY,idic(14)(p11) was assigned to this infant with paternal isodisomy of chromosome 14. 41 refs., 5 figs., 2 tabs.

  10. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  11. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  12. Synthesis of ZnO nanorods-Au nanoparticles hybrids via in-situ plasma sputtering-assisted method for simultaneous electrochemical sensing of ascorbic acid and uric acid

    Energy Technology Data Exchange (ETDEWEB)

    Hou, Chao [College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou 310018 (China); Liu, Hongying, E-mail: liuhongying@hdu.edu.cn [College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou 310018 (China); State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210093 (China); Zhang, Dan; Yang, Chi [Department of Pharmacy, Nantong University, Nantong 226001 (China); Zhang, Mingzhen [College of Life Information Science & Instrument Engineering, Hangzhou Dianzi University, Hangzhou 310018 (China)

    2016-05-05

    In this study, ZnO nanorods-Au nanoparticles (ZnO NRs-Au NPs) hybrids were prepared using an in-situ plasma sputtering-assisted method without any template. Characterization results from scanning electron microscopy, high-resolution transmission electron microscopy, and energy dispersive X-ray spectroscopy showed that Au NPs are highly dispersed and tightly anchored on the surface of ZnO NRs. The size and surface coverage of Au NPs were well controlled by plasma sputtering time. Moreover, the hybrids exhibited excellent electrocatalytic properties towards oxidation of ascorbic acid (AA) and uric acid (UA) due to large surface area of Au NPs and ZnO NRs, and thus can be used as electrochemical sensors. Differential pulse voltammetry results showed that AA and UA could be detected simultaneously by ZnO NRs-Au NPs hybrids modified glassy carbon electrode. The linear ranges for AA and UA are 0.1 to 4 mM and 0.01 to 0.4 mM, respectively. The results suggest promising future applications in clinical diagnosis. - Highlights: • ZnO nanorods-Au nanoparticles were synthesized by in-situ plasma sputtering method. • Influence of sputtering time on the formation of Au nanoparticles was studied. • It exhibited a strong electrocatalytic activity toward the oxidation of ascorbic acid and uric acid. • A portable and cheap approach for simultaneous detection of ascorbic acid and uric acid was developed.

  13. Synthesis of ZnO nanorods-Au nanoparticles hybrids via in-situ plasma sputtering-assisted method for simultaneous electrochemical sensing of ascorbic acid and uric acid

    International Nuclear Information System (INIS)

    Hou, Chao; Liu, Hongying; Zhang, Dan; Yang, Chi; Zhang, Mingzhen

    2016-01-01

    In this study, ZnO nanorods-Au nanoparticles (ZnO NRs-Au NPs) hybrids were prepared using an in-situ plasma sputtering-assisted method without any template. Characterization results from scanning electron microscopy, high-resolution transmission electron microscopy, and energy dispersive X-ray spectroscopy showed that Au NPs are highly dispersed and tightly anchored on the surface of ZnO NRs. The size and surface coverage of Au NPs were well controlled by plasma sputtering time. Moreover, the hybrids exhibited excellent electrocatalytic properties towards oxidation of ascorbic acid (AA) and uric acid (UA) due to large surface area of Au NPs and ZnO NRs, and thus can be used as electrochemical sensors. Differential pulse voltammetry results showed that AA and UA could be detected simultaneously by ZnO NRs-Au NPs hybrids modified glassy carbon electrode. The linear ranges for AA and UA are 0.1 to 4 mM and 0.01 to 0.4 mM, respectively. The results suggest promising future applications in clinical diagnosis. - Highlights: • ZnO nanorods-Au nanoparticles were synthesized by in-situ plasma sputtering method. • Influence of sputtering time on the formation of Au nanoparticles was studied. • It exhibited a strong electrocatalytic activity toward the oxidation of ascorbic acid and uric acid. • A portable and cheap approach for simultaneous detection of ascorbic acid and uric acid was developed.

  14. Muscle and Limb Mechanics.

    Science.gov (United States)

    Tsianos, George A; Loeb, Gerald E

    2017-03-16

    Understanding of the musculoskeletal system has evolved from the collection of individual phenomena in highly selected experimental preparations under highly controlled and often unphysiological conditions. At the systems level, it is now possible to construct complete and reasonably accurate models of the kinetics and energetics of realistic muscles and to combine them to understand the dynamics of complete musculoskeletal systems performing natural behaviors. At the reductionist level, it is possible to relate most of the individual phenomena to the anatomical structures and biochemical processes that account for them. Two large challenges remain. At a systems level, neuroscience must now account for how the nervous system learns to exploit the many complex features that evolution has incorporated into muscle and limb mechanics. At a reductionist level, medicine must now account for the many forms of pathology and disability that arise from the many diseases and injuries to which this highly evolved system is inevitably prone. © 2017 American Physiological Society. Compr Physiol 7:429-462, 2017. Copyright © 2017 John Wiley & Sons, Inc.

  15. Kinematics and Dynamics Analysis of a 3-DOF Upper-Limb Exoskeleton with an Internally Rotated Elbow Joint

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2018-03-01

    Full Text Available The contradiction between self-weight and load capacity of a power-assisted upper-limb exoskeleton for material hanging is unresolved. In this paper, a non-anthropomorphic 3-degree of freedom (DOF upper-limb exoskeleton with an internally rotated elbow joint is proposed based on an anthropomorphic 5-DOF upper-limb exoskeleton for power-assisted activity. The proposed 3-DOF upper-limb exoskeleton contains a 2-DOF shoulder joint and a 1-DOF internally rotated elbow joint. The structural parameters of the 3-DOF upper-limb exoskeleton were determined, and the differences and singularities of the two exoskeletons were analyzed. The workspace, the joint torques and the power consumption of two exoskeletons were analyzed by kinematics and dynamics, and an exoskeleton prototype experiment was performed. The results showed that, compared with a typical anthropomorphic upper-limb exoskeleton, the non-anthropomorphic 3-DOF upper-limb exoskeleton had the same actual workspace; eliminated singularities within the workspace; improved the elbow joint force situation; and the maximum elbow joint torque, elbow external-flexion/internal-extension and shoulder flexion/extension power consumption were significantly reduced. The proposed non-anthropomorphic 3-DOF upper-limb exoskeleton can be applied to a power-assisted upper-limb exoskeleton in industrial settings.

  16. Lower-Limb Wearable Exoskeleton

    OpenAIRE

    Pons, J.L.; Moreno, J.C.; Brunetti, F.J.; Rocon, E.

    2007-01-01

    The differences found in the patients' kinematic gait patterns during the application of functional compensation on the lower limb showed significant differences regarding the subjects' usual gait. In both patients rapid adaptations were observed and new motor commands were learnt necessary for managing the exoskeleton with the constraints imposed on the limb. The benefits of the correct release of the knee in both instances is clear evidence of approximating their gait patterns to the normal...

  17. Artificial limb representation in amputees

    OpenAIRE

    van den Heiligenberg, FMZ; Orlov, T; Macdonald, SN; Duff, EP; Henderson Slater, JDE; Beckmann, CF; Johansen-Berg, H; Culham, JC; Makin, TR

    2018-01-01

    The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral o...

  18. A short overview of upper limb rehabilitation devices

    Science.gov (United States)

    Macovei, S.; Doroftei, I.

    2016-08-01

    As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

  19. Physiotherapy after amputation of the limb

    OpenAIRE

    Pospíšil, Daniel

    2010-01-01

    In this bachelor thesis the author considers physiotherapy after amputation of the lower limb. The theoretical section describes the anatomy of the lower limb, a procedure for amputation of the lower limb, occupational theraoy and prosthesis. The author then goes on to discuss physiotherapy in relation to two case studies of patients who have had their lower limbs removed.

  20. Microwave-Assisted Rapid Synthesis of Self-Assembled T-Nb2 O5 Nanowires for High-Energy Hybrid Supercapacitors.

    Science.gov (United States)

    Yang, Huiling; Xu, Henghui; Wang, Libin; Zhang, Lei; Huang, Yunhui; Hu, Xianluo

    2017-03-23

    Recently ion-intercalation hybrid supercapacitors, with high energy density at high power density, have been widely investigated to meet ever-increasing practical demands. Here, a unique hybrid supercapacitor has been designed and fabricated using self-assembled orthorhombic-phase niobium oxide@carbon (T-Nb 2 O 5 @C) nanowires as an anode and commercially available activated carbon as a cathode. The 3D-interconnected T-Nb 2 O 5 @C nanowires have been synthesized through a highly efficient microwave-solvothermal method, combined with subsequent thermal treatment. The experimental parameters (e.g., time and temperature) can be easily programmed, and the synthesis time can be significantly shortened, thus enabling the buildup of abundant recipes for the engineering of scaled-up production. The Li-ion intercalation pseudocapacitance electrode, made from the as-formed self-assembled T-Nb 2 O 5 @C nanowires, shows excellent charge storage and transfer capability. When assembled into a hybrid supercapacitor with a cathode of activated carbon, a high energy density of 60.6 Wh kg -1 and a high power density of 8.5 kW kg -1 with outstanding stability are achieved. In virtue of easy optimization and programmability of the synthetic strategy, and the remarkable electrochemical performance, the self-assembled T-Nb 2 O 5 @C nanowires offer a promising anode for asymmetric hybrid supercapacitors. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. The origin of vertebrate limbs.

    Science.gov (United States)

    Coates, M I

    1994-01-01

    The earliest tetrapod limbs are polydactylous, morphologically varied and do not conform to an archetypal pattern. These discoveries, combined with the unravelling of limb developmental morphogenetic and regulatory mechanisms, have prompted a re-examination of vertebrate limb evolution. The rich fossil record of vertebrate fins/limbs, although restricted to skeletal tissues, exceeds the morphological diversity of the extant biota, and a systematic approach to limb evolution produces an informative picture of evolutionary change. A composite framework of several phylogenetic hypotheses is presented incorporating living and fossil taxa, including the first report of an acanthodian metapterygium and a new reconstruction of the axial skeleton and caudal fin of Acanthostega gunnari. Although significant nodes in vertebrate phylogeny remain poorly resolved, clear patterns of morphogenetic evolution emerge: median fin origination and elaboration initially precedes that of paired fins; pectoral fins initially precede pelvic fin development; evolving patterns of fin distribution, skeletal tissue diversity and structural complexity become decoupled with increased taxonomic divergence. Transformational sequences apparent from the fish-tetrapod transition are reiterated among extant lungfishes, indicating further directions for comparative experimental research. The evolutionary diversification of vertebrate fin and limb patterns challenges a simple linkage between Hox gene conservation, expression and morphology. A phylogenetic framework is necessary in order to distinguish shared from derived characters in experimental model regulatory systems. Hox and related genomic evolution may include convergent patterns underlying functional and morphological diversification. Brachydanio is suggested as an example where tail-drive patterning demands may have converged with the regulation of highly differentiated limbs in tetrapods.

  2. Dimers of coumarin-1,2,3-triazole hybrids bearing alkyl spacer: Design, microwave-assisted synthesis, molecular docking and evaluation as antimycobacterial and antimicrobial agents

    Science.gov (United States)

    Ashok, Dongamanti; Gundu, Srinivas; Aamate, Vikas Kumar; Devulapally, Mohan Gandhi; Bathini, Raju; Manga, Vijjulatha

    2018-04-01

    The present study demonstrated the synthesis of new series of coumarin-1,2,3-triazole hybrids under microwave irradiation method. Several dimers of coumarin based 1,2,3-triazole derivatives were synthesized and their antimycobacterial and antimicrobial activities were investigated. The antimycobacterial activity screening results revealed that compounds 6i and 6j were the most active against Mycobacterium tuberculosis H37Rv strain. The active compounds were further evaluated for cytotoxicity with HEK cell lines and exhibited less % of inhibition. The same synthetic hybrids were evaluated for their antimicrobial activity against various bacterial strains and fungal strains and compounds 6e, 6h, 6i and 6j were found to be the most promising antimicrobial potent molecules. Furthermore, the active compounds against Mycobacterium tuberculosis were evaluated for their molecular docking studies against pantothenate synthetase (PS) enzyme of MTB and the docking results are in well agreement with the antitubercular evaluation results.

  3. [Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

    Science.gov (United States)

    Qin, S H; Guo, B F; Zheng, X J; Jiao, S F; Xia, H T; Peng, A M; Pan, Q; Zang, J C; Wang, Z J

    2017-09-01

    Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical

  4. Quelles aides les formations hybrides en langues proposent-elles à l'apprenant pour favoriser son autonomie ? What kind of assistance do blended language learning courses provide to learners in order to foster their autonomy?

    Directory of Open Access Journals (Sweden)

    Elke Nissen

    2007-11-01

    Full Text Available L'apprenant qui suit une formation hybride en langues travaille partiellement à distance, ce qui lui demande une certaine autonomie. La question alors est de savoir si ces formations soutiennent l'apprenant dans le développement de son autonomie et si oui, comment. Les réponses des concepteurs de huit formations hybrides à un questionnaire auto-administré montrent que les nécessaires développement et soutien de l'autonomie sont toujours respectés ; ainsi, ces huit formations proposent des aides pour favoriser l'autonomie dans les domaines technique, méthodologique, social et, bien sûr, langagier. Développer ces autonomies semble donc être devenu un standard dans le cadre des formations observées. En revanche, les autonomies de type psycho-affectif, informationnel, cognitif et métacognitif ne sont pas prises en considération dans toutes les formations.When taking a blended learning course, a learner works partially at a distance, which requires some autonomy. The aim of this study is to find out whether blended learning courses sustain the development of learner autonomy and if they do so, how they do it. The statements that 8 course designers made in a questionnaire show that their courses always help the learners to become or to be autonomous. All 8 courses provide assistance (advice, information and activities in order to foster technical, methodological, social and, of course, language autonomy. Consequently, sustaining these four types of autonomy seems to have become a standard in blended learning courses. But, on the contrary, assistance for other types of autonomy is not systematically provided: only several of these courses help the learners to develop psycho affective, informational, cognitive and metacognive autonomy.

  5. The accuracy of prediction of genomic selection in elite hybrid rye populations surpasses the accuracy of marker-assisted selection and is equally augmented by multiple field evaluation locations and test years.

    Science.gov (United States)

    Wang, Yu; Mette, Michael Florian; Miedaner, Thomas; Gottwald, Marlen; Wilde, Peer; Reif, Jochen C; Zhao, Yusheng

    2014-07-04

    Marker-assisted selection (MAS) and genomic selection (GS) based on genome-wide marker data provide powerful tools to predict the genotypic value of selection material in plant breeding. However, case-to-case optimization of these approaches is required to achieve maximum accuracy of prediction with reasonable input. Based on extended field evaluation data for grain yield, plant height, starch content and total pentosan content of elite hybrid rye derived from testcrosses involving two bi-parental populations that were genotyped with 1048 molecular markers, we compared the accuracy of prediction of MAS and GS in a cross-validation approach. MAS delivered generally lower and in addition potentially over-estimated accuracies of prediction than GS by ridge regression best linear unbiased prediction (RR-BLUP). The grade of relatedness of the plant material included in the estimation and test sets clearly affected the accuracy of prediction of GS. Within each of the two bi-parental populations, accuracies differed depending on the relatedness of the respective parental lines. Across populations, accuracy increased when both populations contributed to estimation and test set. In contrast, accuracy of prediction based on an estimation set from one population to a test set from the other population was low despite that the two bi-parental segregating populations under scrutiny shared one parental line. Limiting the number of locations or years in field testing reduced the accuracy of prediction of GS equally, supporting the view that to establish robust GS calibration models a sufficient number of test locations is of similar importance as extended testing for more than one year. In hybrid rye, genomic selection is superior to marker-assisted selection. However, it achieves high accuracies of prediction only for selection candidates closely related to the plant material evaluated in field trials, resulting in a rather pessimistic prognosis for distantly related material

  6. Optimizing Hybrid Occlusion in Face-Jaw-Teeth Transplantation: A Preliminary Assessment of Real-Time Cephalometry as Part of the Computer-Assisted Planning and Execution Workstation for Craniomaxillofacial Surgery.

    Science.gov (United States)

    Murphy, Ryan J; Basafa, Ehsan; Hashemi, Sepehr; Grant, Gerald T; Liacouras, Peter; Susarla, Srinivas M; Otake, Yoshito; Santiago, Gabriel; Armand, Mehran; Gordon, Chad R

    2015-08-01

    The aesthetic and functional outcomes surrounding Le Fort-based, face-jaw-teeth transplantation have been suboptimal, often leading to posttransplant class II/III skeletal profiles, palatal defects, and "hybrid malocclusion." Therefore, a novel technology-real-time cephalometry-was developed to provide the surgical team instantaneous, intraoperative knowledge of three-dimensional dentoskeletal parameters. Mock face-jaw-teeth transplantation operations were performed on plastic and cadaveric human donor/recipient pairs (n = 2). Preoperatively, cephalometric landmarks were identified on donor/recipient skeletons using segmented computed tomographic scans. The computer-assisted planning and execution workstation tracked the position of the donor face-jaw-teeth segment in real time during the placement/inset onto recipient, reporting pertinent hybrid cephalometric parameters from any movement of donor tissue. The intraoperative data measured through real-time cephalometry were compared to posttransplant measurements for accuracy assessment. In addition, posttransplant cephalometric relationships were compared to planned outcomes to determine face-jaw-teeth transplantation success. Compared with postoperative data, the real-time cephalometry-calculated intraoperative measurement errors were 1.37 ± 1.11 mm and 0.45 ± 0.28 degrees for the plastic skull and 2.99 ± 2.24 mm and 2.63 ± 1.33 degrees for the human cadaver experiments. These results were comparable to the posttransplant relations to planned outcome (human cadaver experiment, 1.39 ± 1.81 mm and 2.18 ± 1.88 degrees; plastic skull experiment, 1.06 ± 0.63 mm and 0.53 ± 0.39 degrees). Based on this preliminary testing, real-time cephalometry may be a valuable adjunct for adjusting and measuring "hybrid occlusion" in face-jaw-teeth transplantation and other orthognathic surgical procedures.

  7. Enhanced Etching, Surface Damage Recovery, and Submicron Patterning of Hybrid Perovskites using a Chemically Gas-Assisted Focused-Ion Beam for Subwavelength Grating Photonic Applications

    KAUST Repository

    Alias, Mohd Sharizal; Yang, Yang; Ng, Tien Khee; Dursun, Ibrahim; Shi, Dong; Saidaminov, Makhsud I.; Priante, Davide; Bakr, Osman; Ooi, Boon S.

    2015-01-01

    is challenging, particularly for patterning. Here, we report the direct patterning of perovskites using chemically gas-assisted focused-ion beam (GAFIB) etching with XeF2 and I2 precursors. We demonstrate etching enhancement in addition to controllability

  8. NREL technical assistance to Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Lilienthal, P. [National Renewable Energy Lab., Golden, CO (United States)

    1997-12-01

    This paper describes assistance to Argentina from the National Renewable Energy Laboratory which has touched on four programs: tariff analysis for rural concessions programs; wind/diesel hybrid retrofits in Patagonia; small hybrid systems designs for rural schools; an assessment of wind resources. The paper expands briefly on the first two points.

  9. Robust Sliding Mode Control Based on GA Optimization and CMAC Compensation for Lower Limb Exoskeleton

    Directory of Open Access Journals (Sweden)

    Yi Long

    2016-01-01

    Full Text Available A lower limb assistive exoskeleton is designed to help operators walk or carry payloads. The exoskeleton is required to shadow human motion intent accurately and compliantly to prevent incoordination. If the user’s intention is estimated accurately, a precise position control strategy will improve collaboration between the user and the exoskeleton. In this paper, a hybrid position control scheme, combining sliding mode control (SMC with a cerebellar model articulation controller (CMAC neural network, is proposed to control the exoskeleton to react appropriately to human motion intent. A genetic algorithm (GA is utilized to determine the optimal sliding surface and the sliding control law to improve performance of SMC. The proposed control strategy (SMC_GA_CMAC is compared with three other types of approaches, that is, conventional SMC without optimization, optimal SMC with GA (SMC_GA, and SMC with CMAC compensation (SMC_CMAC, all of which are employed to track the desired joint angular position which is deduced from Clinical Gait Analysis (CGA data. Position tracking performance is investigated with cosimulation using ADAMS and MATLAB/SIMULINK in two cases, of which the first case is without disturbances while the second case is with a bounded disturbance. The cosimulation results show the effectiveness of the proposed control strategy which can be employed in similar exoskeleton systems.

  10. Robust Sliding Mode Control Based on GA Optimization and CMAC Compensation for Lower Limb Exoskeleton

    Science.gov (United States)

    Long, Yi; Du, Zhi-jiang; Wang, Wei-dong; Dong, Wei

    2016-01-01

    A lower limb assistive exoskeleton is designed to help operators walk or carry payloads. The exoskeleton is required to shadow human motion intent accurately and compliantly to prevent incoordination. If the user's intention is estimated accurately, a precise position control strategy will improve collaboration between the user and the exoskeleton. In this paper, a hybrid position control scheme, combining sliding mode control (SMC) with a cerebellar model articulation controller (CMAC) neural network, is proposed to control the exoskeleton to react appropriately to human motion intent. A genetic algorithm (GA) is utilized to determine the optimal sliding surface and the sliding control law to improve performance of SMC. The proposed control strategy (SMC_GA_CMAC) is compared with three other types of approaches, that is, conventional SMC without optimization, optimal SMC with GA (SMC_GA), and SMC with CMAC compensation (SMC_CMAC), all of which are employed to track the desired joint angular position which is deduced from Clinical Gait Analysis (CGA) data. Position tracking performance is investigated with cosimulation using ADAMS and MATLAB/SIMULINK in two cases, of which the first case is without disturbances while the second case is with a bounded disturbance. The cosimulation results show the effectiveness of the proposed control strategy which can be employed in similar exoskeleton systems. PMID:27069353

  11. An electrochemical impedance biosensor for Hg2+ detection based on DNA hydrogel by coupling with DNAzyme-assisted target recycling and hybridization chain reaction.

    Science.gov (United States)

    Cai, Wei; Xie, Shunbi; Zhang, Jin; Tang, Dianyong; Tang, Ying

    2017-12-15

    In this work, an electrochemical impedance biosensor for high sensitive detection of Hg 2+ was presented by coupling with Hg 2+ -induced activation of Mg 2+ -specific DNAzyme (Mg 2+ -DNAzyme) for target cycling and hybridization chain reaction (HCR) assembled DNA hydrogel for signal amplification. Firstly, we synthesized two different copolymer chains P1 and P2 by modifying hairpin DNA H3 and H4 with acrylamide polymer, respectively. Subsequently, Hg 2+ was served as trigger to activate the Mg 2+ -DNAzyme for selectively cleavage ribonucleobase-modified substrate in the presence of Mg 2+ . The partial substrate strand could dissociate from DNAzyme structure, and hybridize with capture probe H1 to expose its concealed sequence for further hybridization. With the help of the exposed sequence, the HCR between hairpin DNA H3 and H4 in P1 and P2 was initiated, and assembled a layer of DNA cross-linked hydrogel on the electrode surface. The formed non-conductive DNA hydrogel film could greatly hinder the interfacial electronic transfer which provided a possibility for us to construct a high sensitive impedance biosensor for Hg 2+ detection. Under the optimal conditions, the impedance biosensor showed an excellent sensitivity and selectivity toward Hg 2+ in a concentration range of 0.1pM - 10nM with a detection limit of 0.042pM Moreover, the real sample analysis reveal that the proposed biosensor is capable of discriminating Hg 2+ ions in reliable and quantitative manners, indicating this method has a promising potential for preliminary application in routine tests. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Chicken homeobox gene Msx-1: structure, expression in limb buds and effect of retinoic acid.

    Science.gov (United States)

    Yokouchi, Y; Ohsugi, K; Sasaki, H; Kuroiwa, A

    1991-10-01

    A chicken gene carrying a homeobox highly homologous to the Drosophila muscle segment homeobox (msh) gene was isolated and designated as Msx-1. Conceptual translation from the longest ORF gave a protein of 259 amino acids lacking the conserved hexapeptide. Northern analysis detected a single 2.6 kb transcript. As early as day 2 of incubation, the transcript was detected but was not found in adult tissue. In situ hybridization analysis revealed that Msx-1 expression is closely related to a particular mesenchymal cell lineage during limb bud formation. In early stage embryos, Msx-1 was expressed in the somatopleure. When primordial mesenchyme cells for limb bud were generated from the Wolffian ridge of the somatopleure, Msx-1 expression began to diminish in the posterior half of the limb bud then in the presumptive cartilage-forming mesenchyme. In developing limb buds, remarkable expression was seen in the apical ectodermal ridge (AER), which is responsible for the sustained outgrowth and development of the limb. The Msx-1 transcripts were found in the limb mesenchymal cells in the region covering the necrotic zone and ectodermal cells overlying such mesenchymal cells. Both ectodermal and mesenchymal expression in limb bud were rapidly suppressed by local treatment of retinoic acid which can generate mirror-image duplication of digits. This indicates that retinoic acid alters the marginal presumptive non-cartilage forming mesenchyme cell lineage through suppression of Msx-1 expression.

  13. Neuregulin-1 signaling is essential for nerve-dependent axolotl limb regeneration.

    Science.gov (United States)

    Farkas, Johanna E; Freitas, Polina D; Bryant, Donald M; Whited, Jessica L; Monaghan, James R

    2016-08-01

    The Mexican axolotl (Ambystoma mexicanum) is capable of fully regenerating amputated limbs, but denervation of the limb inhibits the formation of the post-injury proliferative mass called the blastema. The molecular basis behind this phenomenon remains poorly understood, but previous studies have suggested that nerves support regeneration via the secretion of essential growth-promoting factors. An essential nerve-derived factor must be found in the blastema, capable of rescuing regeneration in denervated limbs, and its inhibition must prevent regeneration. Here, we show that the neuronally secreted protein Neuregulin-1 (NRG1) fulfills all these criteria in the axolotl. Immunohistochemistry and in situ hybridization of NRG1 and its active receptor ErbB2 revealed that they are expressed in regenerating blastemas but lost upon denervation. NRG1 was localized to the wound epithelium prior to blastema formation and was later strongly expressed in proliferating blastemal cells. Supplementation by implantation of NRG1-soaked beads rescued regeneration to digits in denervated limbs, and pharmacological inhibition of NRG1 signaling reduced cell proliferation, blocked blastema formation and induced aberrant collagen deposition in fully innervated limbs. Taken together, our results show that nerve-dependent NRG1/ErbB2 signaling promotes blastemal proliferation in the regenerating limb and may play an essential role in blastema formation, thus providing insight into the longstanding question of why nerves are required for axolotl limb regeneration. © 2016. Published by The Company of Biologists Ltd.

  14. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to --image-guided video-assisted thoracoscopic surgery.

    Science.gov (United States)

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. RESUMO O conceito de sala híbrida traduz a união de um aparato cirúrgico de alta complexidade com recursos radiológicos de última geração (ultrassom, TC, radioscopia e/ou ressonância magnética), visando a realização de procedimentos minimamente invasivos e altamente eficazes. Apesar de bem estabelecido em outras especialidades, como neurocirurgia e cirurgia cardiovascular, o uso da sala hibrida ainda é pouco explorado na cirurgia torácica. Nosso objetivo foi discutir as aplicações e as possibilidades abertas por essa tecnologia na cirurgia torácica através do relato de três casos.

  15. Hybrid piezoresistive-optical tactile sensor for simultaneous measurement of tissue stiffness and detection of tissue discontinuity in robot-assisted minimally invasive surgery

    Science.gov (United States)

    Bandari, Naghmeh M.; Ahmadi, Roozbeh; Hooshiar, Amir; Dargahi, Javad; Packirisamy, Muthukumaran

    2017-07-01

    To compensate for the lack of touch during minimally invasive and robotic surgeries, tactile sensors are integrated with surgical instruments. Surgical tools with tactile sensors have been used mainly for distinguishing among different tissues and detecting malignant tissues or tumors. Studies have revealed that malignant tissue is most likely stiffer than normal. This would lead to the formation of a sharp discontinuity in tissue mechanical properties. A hybrid piezoresistive-optical-fiber sensor is proposed. This sensor is investigated for its capabilities in tissue distinction and detection of a sharp discontinuity. The dynamic interaction of the sensor and tissue is studied using finite element method. The tissue is modeled as a two-term Mooney-Rivlin hyperelastic material. For experimental verification, the sensor was microfabricated and tested under the same conditions as of the simulations. The simulation and experimental results are in a fair agreement. The sensor exhibits an acceptable linearity, repeatability, and sensitivity in characterizing the stiffness of different tissue phantoms. Also, it is capable of locating the position of a sharp discontinuity in the tissue. Due to the simplicity of its sensing principle, the proposed hybrid sensor could also be used for industrial applications.

  16. Focal skin defect, limb anomalies and microphthalmia.

    NARCIS (Netherlands)

    Jackson, K.E.; Andersson, H.C.

    2004-01-01

    We describe two unrelated female patients with congenital single focal skin defects, unilateral microphthalmia and limb anomalies. Growth and psychomotor development were normal and no brain malformation was detected. Although eye and limb anomalies are commonly associated, clinical anophthalmia and

  17. An approach to the painful upper limb

    African Journals Online (AJOL)

    Pain in the upper limb is a common presenting complaint in the primary health care setting and the ... disruptions or pathological fracture, as opposed to ... and a neurological assessment of the lower limbs. This is in addition to a thorough.

  18. Fingernails Yield Clues to Limb Regeneration

    Science.gov (United States)

    ... it is involved in limb formation in mammalian embryonic development, as well as limb regeneration in amphibians. ... of the nail stem cells and the underlying layer of cells called the nail epithelium are left ...

  19. Premier's imaging IR limb sounder

    Science.gov (United States)

    Kraft, Stefan; Bézy, Jean-Loup; Meynart, Roland; Langen, Jörg; Carnicero Dominguez, Bernardo; Bensi, Paolo; Silvestrin, Pierluigi

    2017-11-01

    The Imaging IR Limb Sounder (IRLS) is one of the two instruments planned on board of the candidate Earth Explorer Core Mission PREMIER. PREMIER stands for PRocess Exploration through Measurements of Infrared and Millimetre-wave Emitted Radiation. PREMIER went recently through the process of a feasibility study (Phase A) within the Earth Observation Envelope Program. Emerging from recent advanced instrument technologies IRLS shall, next to a millimetre-wave limb sounder (called STEAMR), explore the benefits of three-dimensional limb sounding with embedded cloud imaging capability. Such 3D imaging technology is expected to open a new era of limb sounding that will allow detailed studies of the link between atmospheric composition and climate, since it will map simultaneously fields of temperature and many trace gases in the mid/upper troposphere and stratosphere across a large vertical and horizontal field of view and with high vertical and horizontal resolution. PREMIER shall fly in a tandem formation looking backwards to METOP's swath and thereby improve meteorological and environmental analyses.

  20. Adolescent Neuroblastoma of Lower Limb

    Directory of Open Access Journals (Sweden)

    Rajeshwari K

    2013-04-01

    Full Text Available Neuroblastoma is an embryonic tumour of neural crest origin, commonly seen in children with upper abdomen involvement. Rarely neuroblastomas present in adolescents and adults involving lower limb. Histopathologically neuroblastoma of lower limb can be confused with other small round cell tumour especially with Ewing's sarcoma and rhabdomyosarcoma. A 16 year old male presented with 15x11cm swelling, pain and multiple discharging sinuses of right leg since 4 months. Routine haematological and biochemical analysis were within normal limits. Radiology of right leg showed large soft tissue swelling encompassing the pathological fracture of tibia and bowing of fibula. Fine needle aspiration of the swelling revealed malignant small round cell tumour. Histopathology revealed poorly differentiated neuroblastoma of lower limb. The immunohistochemistry of Synaptophysin and Chromogranin were positive and CD 99 was negative. Neuroblastoma diagnosed at unusual site with uncommon age has poor prognosis. Hence, one must keep in mind the differential diagnosis of neuroblastoma as one of the differential diagnosis in evaluating the soft tissue tumours of lower limb.

  1. Learning about Vertebrate Limb Development

    Science.gov (United States)

    Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

    2014-01-01

    We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

  2. Endograft Limb Occlusion in EVAR

    DEFF Research Database (Denmark)

    Taudorf, M; Jensen, L P; Vogt, K C

    2014-01-01

    % at 3 years. Logistic regression showed that iliac artery tortuosity (DIS) (p = .001) and body mass index (p = .007) had a significant impact on graft patency. CONCLUSION: A tortuous vessel on the preoperative CTA is associated with an increased risk of limb occlusion after EVAR. Adjunctive stenting...

  3. Hyperinnervation improves Xenopus laevis limb regeneration.

    Science.gov (United States)

    Mitogawa, Kazumasa; Makanae, Aki; Satoh, Akira

    2018-01-15

    Xenopus laevis (an anuran amphibian) shows limb regeneration ability between that of urodele amphibians and that of amniotes. Xenopus frogs can initiate limb regeneration but fail to form patterned limbs. Regenerated limbs mainly consist of cone-shaped cartilage without any joints or branches. These pattern defects are thought to be caused by loss of proper expressions of patterning-related genes. This study shows that hyperinnervation surgery resulted in the induction of a branching regenerate. The hyperinnervated blastema allows the identification and functional analysis of the molecules controlling this patterning of limb regeneration. This paper focuses on the nerve affects to improve Xenopus limb patterning ability during regeneration. The nerve molecules, which regulate limb patterning, were also investigated. Blastemas grown in a hyperinnervated forelimb upregulate limb patterning-related genes (shh, lmx1b, and hoxa13). Nerves projecting their axons to limbs express some growth factors (bmp7, fgf2, fgf8, and shh). Inputs of these factors to a blastema upregulated some limb patterning-related genes and resulted in changes in the cartilage patterns in the regenerates. These results indicate that additional nerve factors enhance Xenopus limb patterning-related gene expressions and limb regeneration ability, and that bmp, fgf, and shh are candidate nerve substitute factors. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. From fins to limbs to fins: limb evolution in fossil marine reptiles.

    Science.gov (United States)

    Caldwell, Michael W

    2002-10-15

    Limb osteology and ontogenetic patterns of limb ossification are reviewed for extinct lineages of aquatically adapted diapsid reptiles. Phylogenies including these fossil taxa show that paddle-like limbs were independently derived, and that the varied limb morphologies were produced by evolutionary modifications to different aspects of the limb skeleton. Ancient marine reptiles modify the limb by reducing the relative size of the epipodials, modifying the perichondral and periosteal surface of elements distal to the propodials, and evolving extremes of hyperphalangy and hyperdactyly. Developmental genetic models illuminate gene systems that may have controlled limb evolution in these animals. Copyright 2002 Wiley-Liss, Inc.

  5. Development of a Hybrid Piezo Natural Rubber Piezoelectricity and Piezoresistivity Sensor with Magnetic Clusters Made by Electric and Magnetic Field Assistance and Filling with Magnetic Compound Fluid.

    Science.gov (United States)

    Shimada, Kunio; Saga, Norihiko

    2017-02-10

    Piezoelements used in robotics require large elasticity and extensibility to be installed in an artificial robot skin. However, the piezoelements used until recently are vulnerable to large forces because of the thin solid materials employed. To resolve this issue, we utilized a natural rubber and applied our proposed new method of aiding with magnetic and electric fields as well as filling with magnetic compound fluid (MCF) and doping. We have verified the piezoproperties of the resulting MCF rubber. The effect of the created magnetic clusters is featured in a new two types of multilayered structures of the piezoelement. By measuring the piezoelectricity response to pressure, the synergetic effects of the magnetic clusters, the doping and the electric polymerization on the piezoelectric effect were clarified. In addition, by examining the relation between the piezoelectricity and the piezoresistivity created in the MCF piezo element, we propose a hybrid piezoelement.

  6. Development of a Hybrid Piezo Natural Rubber Piezoelectricity and Piezoresistivity Sensor with Magnetic Clusters Made by Electric and Magnetic Field Assistance and Filling with Magnetic Compound Fluid

    Science.gov (United States)

    Shimada, Kunio; Saga, Norihiko

    2017-01-01

    Piezoelements used in robotics require large elasticity and extensibility to be installed in an artificial robot skin. However, the piezoelements used until recently are vulnerable to large forces because of the thin solid materials employed. To resolve this issue, we utilized a natural rubber and applied our proposed new method of aiding with magnetic and electric fields as well as filling with magnetic compound fluid (MCF) and doping. We have verified the piezoproperties of the resulting MCF rubber. The effect of the created magnetic clusters is featured in a new two types of multilayered structures of the piezoelement. By measuring the piezoelectricity response to pressure, the synergetic effects of the magnetic clusters, the doping and the electric polymerization on the piezoelectric effect were clarified. In addition, by examining the relation between the piezoelectricity and the piezoresistivity created in the MCF piezo element, we propose a hybrid piezoelement. PMID:28208625

  7. Development of a Hybrid Piezo Natural Rubber Piezoelectricity and Piezoresistivity Sensor with Magnetic Clusters Made by Electric and Magnetic Field Assistance and Filling with Magnetic Compound Fluid

    Directory of Open Access Journals (Sweden)

    Kunio Shimada

    2017-02-01

    Full Text Available Piezoelements used in robotics require large elasticity and extensibility to be installed in an artificial robot skin. However, the piezoelements used until recently are vulnerable to large forces because of the thin solid materials employed. To resolve this issue, we utilized a natural rubber and applied our proposed new method of aiding with magnetic and electric fields as well as filling with magnetic compound fluid (MCF and doping. We have verified the piezoproperties of the resulting MCF rubber. The effect of the created magnetic clusters is featured in a new two types of multilayered structures of the piezoelement. By measuring the piezoelectricity response to pressure, the synergetic effects of the magnetic clusters, the doping and the electric polymerization on the piezoelectric effect were clarified. In addition, by examining the relation between the piezoelectricity and the piezoresistivity created in the MCF piezo element, we propose a hybrid piezoelement.

  8. Role of Hoxc genes in the development of the limb integumentary organ (nail, claw, or hoof).

    Science.gov (United States)

    Lasierra, Maria Angeles Ros; Fernández-Guerrero, Marc; Delisle, Lucille; Yakushiji-Kaminatsui, Nayuta; Darbellay, Fabrice; Pérez-Gómez, Rocío; Duboule, Denis

    2018-04-01

    The developing vertebrate limb has long proved as an excellent system for studying the mechanisms involved in pattern formation and morphogenesis and more recently in transcriptional regulation and morphological evolution. To elucidate the stage-specific expression profiles of the components of the developing limb, we have generated the temporal transcriptome of the limb progenitors and of the overlying ectoderm separately. Our study has uncovered a collinear activation of Hoxc genes in the limb ectoderm that we have validated by in situ hybridization. However, while members of the HoxA and HoxD clusters show complex and dynamic patterns of expression during limb development that correlate with the morphology of the different limb segments, no specific function for the HoxC or HoxB clusters has been identified ( 1 - 3 ). To investigate the function of Hoxc genes in the limb ectoderm, we have reexamined the HoxC cluster null mice. Remarkably, and despite exhibiting normal terminal phalanges, these mice didn't form claws (anonychia). Morphological and immunohistochemical analysis identified a failure in the differentiation of the main components of the nail/claw organ. To unravel the transcriptional regulation of Hoxc genes in the limb ectoderm, we used the ATACseq technique. Using this approach, we identified two putative regulatory regions which activity was tested in mouse transgenic enhancer assays. It is currently considered that Hox genes have played a key role in the evolution of morphological traits, probably associated with changes in their regulatory landscapes ( 4 ). Given that the form and size of the distal limb integumentary organ (nail, claw or hoof) correlates with that of the distal phalanx and that the development of hooves was a major innovation in the evolution of a cursorial lifestyle, we are also exploring the possible implication of Hoxc genes in the nail/claw/hoof transition. This abstract is from the Experimental Biology 2018 Meeting. There

  9. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    OpenAIRE

    M. Jaszczak

    2011-01-01

    This study 1) examined the influence of lower limb movement on upper limb movement symmetry, 2) determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3) diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limb...

  10. Salvage versus amputation: Utility of mangled extremity severity score in severely injured lower limbs

    Directory of Open Access Journals (Sweden)

    Kumar M

    2007-01-01

    Full Text Available Background: The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS in severely injured lower limbs. Materials and Methods: Retrospectively 25 and prospectively 36 lower limbs in 58 patients with high-energy injuries were evaluated with the use of MESS, to assist in the decision-making process for the care of patients with such injuries. Difference between the mean MESS scores for amputated and salvaged limbs was analyzed. Results: In the retrospective study 4.65 (4.65 ± 1.32 was the mean score for the salvaged limbs and 8.80 (8.8 ± 1.4 for the amputated limbs. In the prospective study 4.53 (4.53 ± 2.44 was the mean score for the salvaged limbs and 8.83 (8.83 ± 2.34 for the amputated limbs. There was a significant difference in the mean scores for salvaged and amputated limbs. Retrospective 21 (84% and prospective 29 (80.5% limbs remained in the salvage pathway six months after the injury. Conclusion: MESS could predict amputation of severely injured lower limbs, having score of equal or more than 7 with 91% sensitivity and 98% specificity. There was a significant difference in the mean MESS scores in the prospective study (n=36, 4.53 (4.53 ± 2.44 in thirty salvaged limbs (83.33% and 8.83 (8.83 ± 2.34 in six amputated limbs (16.66% with a P -value 0.002 ( P -value < 0.01. Similarly there was a significant difference in the mean MESS score in the retrospective study (n=25, 4.65 (4.65 ± 1.32 in twenty salvaged limbs (80% and 8.80 (8.8 ± 1.4 in five amputated limbs (20% with a P -value 0.00005 ( P -value < 0.01. MESS is a simple and relatively easy and readily available scoring system which can help the surgeon to decide the fate of the lower extremity with a high-energy injury.

  11. Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

    Science.gov (United States)

    Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A.; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

    2017-01-01

    Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies. PMID:28848377

  12. Treadmill Training with HAL Exoskeleton-A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy-Preliminary Study.

    Science.gov (United States)

    Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

    2017-01-01

    Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

  13. Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

    Directory of Open Access Journals (Sweden)

    Matthias Sczesny-Kaiser

    2017-08-01

    Full Text Available Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD.Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT, 6-minute walk test, and timed-up-and-go test (TUG. Parameters were assessed pre and post training and 6 weeks later (follow-up.Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up.Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

  14. Limb development: a paradigm of gene regulation.

    Science.gov (United States)

    Petit, Florence; Sears, Karen E; Ahituv, Nadav

    2017-04-01

    The limb is a commonly used model system for developmental biology. Given the need for precise control of complex signalling pathways to achieve proper patterning, the limb is also becoming a model system for gene regulation studies. Recent developments in genomic technologies have enabled the genome-wide identification of regulatory elements that control limb development, yielding insights into the determination of limb morphology and forelimb versus hindlimb identity. The modulation of regulatory interactions - for example, through the modification of regulatory sequences or chromatin architecture - can lead to morphological evolution, acquired regeneration capacity or limb malformations in diverse species, including humans.

  15. An upper limb robot model of children limb for cerebral palsy neurorehabilitation.

    Science.gov (United States)

    Pathak, Yagna; Johnson, Michelle

    2012-01-01

    Robot therapy has emerged in the last few decades as a tool to help patients with neurological injuries relearn motor tasks and improve their quality of life. The main goal of this study was to develop a simple model of the human arm for children affected with cerebral palsy (CP). The Simulink based model presented here shows a comparison for children with and without disabilities (ages 6-15) with normal and reduced range of motion in the upper limb. The model incorporates kinematic and dynamic considerations required for activities of daily living. The simulation was conducted using Matlab/Simulink and will eventually be integrated with a robotic counterpart to develop a physical robot that will provide assistance in activities of daily life (ADLs) to children with CP while also aiming to improve motor recovery.

  16. Safety Supervisory Strategy for an Upper-Limb Rehabilitation Robot Based on Impedance Control

    Directory of Open Access Journals (Sweden)

    Lizheng Pan

    2013-02-01

    Full Text Available User security is an important consideration for robots that interact with humans, especially for upper-limb rehabilitation robots, during the use of which stroke patients are often more susceptible to injury. In this paper, a novel safety supervisory control method incorporating fuzzy logic is proposed so as to guarantee the impaired limb's safety should an emergency situation occur and the robustness of the upper-limb rehabilitation robot control system. Firstly, a safety supervisory fuzzy controller (SSFC was designed based on the impaired-limb's real-time physical state by extracting and recognizing the impaired-limb's tracking movement features. Then, the proposed SSFC was used to automatically regulate the desired force either to account for reasonable disturbance resulting from pose or position changes or to respond in adequate time to an emergency based on an evaluation of the impaired-limb's physical condition. Finally, a position-based impedance controller was implemented to achieve compliance between the robotic end-effector and the impaired limb during the robot-assisted rehabilitation training. The experimental results show the effectiveness and potential of the proposed method for achieving safety and robustness for the rehabilitation robot.

  17. Development and the evolvability of human limbs.

    Science.gov (United States)

    Young, Nathan M; Wagner, Günter P; Hallgrímsson, Benedikt

    2010-02-23

    The long legs and short arms of humans are distinctive for a primate, the result of selection acting in opposite directions on each limb at different points in our evolutionary history. This mosaic pattern challenges our understanding of the relationship of development and evolvability because limbs are serially homologous and genetic correlations should act as a significant constraint on their independent evolution. Here we test a developmental model of limb covariation in anthropoid primates and demonstrate that both humans and apes exhibit significantly reduced integration between limbs when compared to quadrupedal monkeys. This result indicates that fossil hominins likely escaped constraints on independent limb variation via reductions to genetic pleiotropy in an ape-like last common ancestor (LCA). This critical change in integration among hominoids, which is reflected in macroevolutionary differences in the disparity between limb lengths, facilitated selection for modern human limb proportions and demonstrates how development helps shape evolutionary change.

  18. Continuum limbed robots for locomotion

    Science.gov (United States)

    Mutlu, Alper

    This thesis focuses on continuum robots based on pneumatic muscle technology. We introduce a novel approach to use these muscles as limbs of lightweight legged robots. The flexibility of the continuum legs of these robots offers the potential to perform some duties that are not possible with classical rigid-link robots. Potential applications are as space robots in low gravity, and as cave explorer robots. The thesis covers the fabrication process of continuum pneumatic muscles and limbs. It also provides some new experimental data on this technology. Afterwards, the designs of two different novel continuum robots - one tripod, one quadruped - are introduced. Experimental data from tests using the robots is provided. The experimental results are the first published example of locomotion with tripod and quadruped continuum legged robots. Finally, discussion of the results and how far this technology can go forward is presented.

  19. Using upper limb kinematics to assess cognitive deficits in people living with both HIV and stroke.

    Science.gov (United States)

    Bui, Kevin D; Rai, Roshan; Johnson, Michelle J

    2017-07-01

    In this study, we aim to explore ways to objectively assess cognitive deficits in the stroke and HIV/stroke populations, where cognitive and motor impairments can be hard to separate. Using an upper limb rehabilitation robot called the Haptic TheraDrive, we collect performance error scores and motor learning data on the impaired and unimpaired limb during a trajectory tracking task. We compare these data to clinical cognitive scores. The preliminary results suggest a possible relationship between unimpaired upper limb performance error and visuospatial/executive function cognitive domains, but more work needs to be done to further investigate this. The potential of using robot-assisted technologies to measure unimpaired limb kinematics as a tool to assess cognitive deficits would be useful to inform more effective rehabilitation strategies for HIV, stroke, and HIV/stroke populations.

  20. Comparison between Hybrid III dummy and cadaver knee response in frontal impact

    OpenAIRE

    MASSON, Catherine; CAVALLERO, Claude

    2003-01-01

    Lower limb injuries frequently occur during car accidents. The purpose of this work was to compare the response of the hybrid iii lower limb with the response of cadaver lower limb subjected to similar impacts. These experiments were performed with the objective to evaluate the biofidelity, repeatability and response characteristics of the knee-femur-pelvis HIII dummy. The tests have examined the dynamic response of the knee-femur-pelvis complex to sub injury simple pendulum impacts. The expe...

  1. MgO-hybridized TiO{sub 2} interfacial layers assisting efficiency enhancement of solid-state dye-sensitized solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Nobuya; Ikegami, Masashi; Miyasaka, Tsutomu, E-mail: miyasaka@toin.ac.jp [Graduate School of Engineering, Toin University of Yokohama, 1614 Kurogane-cho, Aoba, Yokohama, Kanagawa 225-8502 (Japan)

    2014-02-10

    Interfacial modification of a thin TiO{sub 2} compact layer (T-CL) by hybridization with MgO enhanced the quantum conversion efficiency of solid-state dye-sensitized solar cells (ssDSSCs) comprising a multilayer structure of transparent electrode/T-CL/dye-sensitized mesoporous TiO{sub 2}/hole conductor/metal counter electrode. The Mg(CH{sub 3}COO){sub 2} treatment was employed to introduce a MgO-TiO{sub 2} CL (T/M-CL), which enhanced the physical connection and conduction between the CL and mesoporous semiconductor layer as a consecutive interface, owing to the dehydration reaction of Mg(CH{sub 3}COO){sub 2}. The photocurrent density of ssDSSC was increased 33% by the T/M-CL compared with the T-CL, using an equivalent amount of adsorbed dye. The ssDSSC with the T/M-CL yielded the highest efficiency of 4.02% under irradiation at 100 mW cm{sup −2}. The electrical impedance spectroscopy showed that the charge-transfer resistance (R{sub ct}) of the photoelectrode with T/M-CL was reduced by 300 Ω from the reference non-treated T-CL electrode. Characterized by the intrinsically low R{sub ct} of the compact layer, the T/M-CL is capable of improving the photovoltaic performance of solid-state sensitized mesoscopic solar cells.

  2. Comparative transcriptional profiling of the axolotl limb identifies a tripartite regeneration-specific gene program.

    Directory of Open Access Journals (Sweden)

    Dunja Knapp

    Full Text Available Understanding how the limb blastema is established after the initial wound healing response is an important aspect of regeneration research. Here we performed parallel expression profile time courses of healing lateral wounds versus amputated limbs in axolotl. This comparison between wound healing and regeneration allowed us to identify amputation-specific genes. By clustering the expression profiles of these samples, we could detect three distinguishable phases of gene expression - early wound healing followed by a transition-phase leading to establishment of the limb development program, which correspond to the three phases of limb regeneration that had been defined by morphological criteria. By focusing on the transition-phase, we identified 93 strictly amputation-associated genes many of which are implicated in oxidative-stress response, chromatin modification, epithelial development or limb development. We further classified the genes based on whether they were or were not significantly expressed in the developing limb bud. The specific localization of 53 selected candidates within the blastema was investigated by in situ hybridization. In summary, we identified a set of genes that are expressed specifically during regeneration and are therefore, likely candidates for the regulation of blastema formation.

  3. Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

    Science.gov (United States)

    Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2017-07-01

    Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

  4. Considerations for designing robotic upper limb rehabilitation devices

    Science.gov (United States)

    Nadas, I.; Vaida, C.; Gherman, B.; Pisla, D.; Carbone, G.

    2017-12-01

    The present study highlights the advantages of robotic systems for post-stroke rehabilitation of the upper limb. The latest demographic studies illustrate a continuous increase of the average life span, which leads to a continuous increase of stroke incidents and patients requiring rehabilitation. Some studies estimate that by 2030 the number of physical therapists will be insufficient for the patients requiring physical rehabilitation, imposing a shift in the current methodologies. A viable option is the implementation of robotic systems that assist the patient in performing rehabilitation exercises, the physical therapist role being to establish the therapeutic program for each patient and monitor their individual progress. Using a set of clinical measurements for the upper limb motions, the analysis of rehabilitation robotic systems provides a comparative study between the motions required by clinicians and the ones that robotic systems perform for different therapeutic exercises. A critical analysis of existing robots is performed using several classifications: mechanical design, assistance type, actuation and power transmission, control systems and human robot interaction (HRI) strategies. This classification will determine a set of pre-requirements for the definition of new concepts and efficient solutions for robotic assisted rehabilitation therapy.

  5. Early regulation of axolotl limb regeneration.

    Science.gov (United States)

    Makanae, Aki; Satoh, Akira

    2012-10-01

    Amphibian limb regeneration has been studied for a long time. In amphibian limb regeneration, an undifferentiated blastema is formed around the region damaged by amputation. The induction process of blastema formation has remained largely unknown because it is difficult to study the induction of limb regeneration. The recently developed accessory limb model (ALM) allows the investigation of limb induction and reveals early events of amphibian limb regeneration. The interaction between nerves and wound epidermis/epithelium is an important aspect of limb regeneration. During early limb regeneration, neurotrophic factors act on wound epithelium, leading to development of a functional epidermis/epithelium called the apical epithelial cap (AEC). AEC and nerves create a specific environment that inhibits wound healing and induces regeneration through blastema formation. It is suggested that FGF-signaling and MMP activities participate in creating a regenerative environment. To understand why urodele amphibians can create such a regenerative environment and humans cannot, it is necessary to identify the similarities and differences between regenerative and nonregenerative animals. Here we focus on ALM to consider limb regeneration from a new perspective and we also reported that focal adhesion kinase (FAK)-Src signaling controlled fibroblasts migration in axolotl limb regeneration. Copyright © 2012 Wiley Periodicals, Inc.

  6. Modulation of shoulder muscle and joint function using a powered upper-limb exoskeleton.

    Science.gov (United States)

    Wu, Wen; Fong, Justin; Crocher, Vincent; Lee, Peter V S; Oetomo, Denny; Tan, Ying; Ackland, David C

    2018-04-27

    Robotic-assistive exoskeletons can enable frequent repetitive movements without the presence of a full-time therapist; however, human-machine interaction and the capacity of powered exoskeletons to attenuate shoulder muscle and joint loading is poorly understood. This study aimed to quantify shoulder muscle and joint force during assisted activities of daily living using a powered robotic upper limb exoskeleton (ArmeoPower, Hocoma). Six healthy male subjects performed abduction, flexion, horizontal flexion, reaching and nose touching activities. These tasks were repeated under two conditions: (i) the exoskeleton compensating only for its own weight, and (ii) the exoskeleton providing full upper limb gravity compensation (i.e., weightlessness). Muscle EMG, joint kinematics and joint torques were simultaneously recorded, and shoulder muscle and joint forces calculated using personalized musculoskeletal models of each subject's upper limb. The exoskeleton reduced peak joint torques, muscle forces and joint loading by up to 74.8% (0.113 Nm/kg), 88.8% (5.8%BW) and 68.4% (75.6%BW), respectively, with the degree of load attenuation strongly task dependent. The peak compressive, anterior and superior glenohumeral joint force during assisted nose touching was 36.4% (24.6%BW), 72.4% (13.1%BW) and 85.0% (17.2%BW) lower than that during unassisted nose touching, respectively. The present study showed that upper limb weight compensation using an assistive exoskeleton may increase glenohumeral joint stability, since deltoid muscle force, which is the primary contributor to superior glenohumeral joint shear, is attenuated; however, prominent exoskeleton interaction moments are required to position and control the upper limb in space, even under full gravity compensation conditions. The modeling framework and results may be useful in planning targeted upper limb robotic rehabilitation tasks. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. ABLE, a Versatile Transparent Upper-Limb Exoskeleton for Teleoperation

    OpenAIRE

    Garrec , P.; Perrot , Y.; Méasson , Y.; Colledani , F.

    2008-01-01

    International audience; This paper presents a new portable exoskeleton design for superior limbs by the CEA-LIST laboratories. The first model described here (4 axis) is designed to apply forces in 3 directions The first application is foreseen as an assistance device to enable a disabled person to carry an object such as a teapot or water bottle. It is designed as a base for more complete systems. A partial realization of it is presented for the first time. The high potential of the actuator...

  8. Hybrid gait training with an overground robot for people with incomplete spinal cord injury: a pilot study

    Directory of Open Access Journals (Sweden)

    Antonio J del-Ama

    2014-05-01

    Full Text Available Locomotor training has proved to provide beneficial effect in terms of mobility in incomplete paraplegic patients. Neuroprosthetic technology can contribute to increase the efficacy of a training paradigm in the promotion of a locomotor pattern. Robotic exoskeletons can be used to manage the unavoidable loss of performance of artificially-driven muscles. Hybrid exoskeletons blend complementary robotic and neuro-prosthetic technologies. The aim of this pilot study was to determine the effects of hybrid gait training in three case studies with persons with incomplete spinal cord injury in terms of locomotion performance during assisted gait, patient-robot adaptations, impact on ambulation and assessment of lower limb muscle strength and spasticity. Participants with incomplete Spinal Cord Injury (SCI received interventions with a hybrid bilateral exoskeleton for 4 days. Assessment of gait function revealed that patients improved the 6 minutes and 10 meters walking tests after the intervention, and further improvements were observed one week after the intervention. Muscle examination revealed improvements in knee and hip sagittal muscle balance scores and decreased score in ankle extensor balance. It is concluded that improvements in biomechanical function of the knee joint after the tested overground hybrid gait trainer are coherent with improvements in gait performance.

  9. Hybrid gait training with an overground robot for people with incomplete spinal cord injury: a pilot study.

    Science.gov (United States)

    Del-Ama, Antonio J; Gil-Agudo, Angel; Pons, José L; Moreno, Juan C

    2014-01-01

    Locomotor training has proved to provide beneficial effect in terms of mobility in incomplete paraplegic patients. Neuroprosthetic technology can contribute to increase the efficacy of a training paradigm in the promotion of a locomotor pattern. Robotic exoskeletons can be used to manage the unavoidable loss of performance of artificially driven muscles. Hybrid exoskeletons blend complementary robotic and neuro-prosthetic technologies. The aim of this pilot study was to determine the effects of hybrid gait training in three case studies with persons with incomplete spinal cord injury (iSCI) in terms of locomotion performance during assisted gait, patient-robot adaptations, impact on ambulation and assessment of lower limb muscle strength and spasticity. Participants with iSCI received interventions with a hybrid bilateral exoskeleton for 4 days. Assessment of gait function revealed that patients improved the 6 min and 10 m walking tests after the intervention, and further improvements were observed 1 week after the intervention. Muscle examination revealed improvements in knee and hip sagittal muscle balance scores and decreased score in ankle extensor balance. It is concluded that improvements in biomechanical function of the knee joint after the tested overground hybrid gait trainer are coherent with improvements in gait performance.

  10. Diagnosis and treatment of upper limb apraxia

    OpenAIRE

    Dovern, A.; Fink, G. R.; Weiss, P. H.

    2012-01-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients’ everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients’ prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed...

  11. Development and the evolvability of human limbs

    OpenAIRE

    Young, Nathan M.; Wagner, Günter P.; Hallgrímsson, Benedikt

    2010-01-01

    The long legs and short arms of humans are distinctive for a primate, the result of selection acting in opposite directions on each limb at different points in our evolutionary history. This mosaic pattern challenges our understanding of the relationship of development and evolvability because limbs are serially homologous and genetic correlations should act as a significant constraint on their independent evolution. Here we test a developmental model of limb covariation in anthropoid primate...

  12. Radiologic analysis of congenital limb anomalies

    International Nuclear Information System (INIS)

    Chung, Hong Jun; Kim, Ok Hwa; Shinn, Kyung Sub; Kim, Nam Ae

    1994-01-01

    Congenital limb anomalies are manifested in various degree of severity and complexity bearing conclusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of the radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications; failure of formation of parts, failure of differentiation of parts, duplications, overgrowth and undergrowth. The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies

  13. Mechanobiology of embryonic limb development.

    Science.gov (United States)

    Nowlan, Niamh C; Murphy, Paula; Prendergast, Patrick J

    2007-04-01

    Considerable evidence exists to support the hypothesis that mechanical forces have an essential role in healthy embryonic skeletal development. Clinical observations and experimental data indicate the importance of muscle contractions for limb development. However, the influence of these forces is seldom referred to in biological descriptions of bone development, and perhaps this is due to the fact that the hypothesis that mechanical forces are essential for normal embryonic skeletal development is difficult to test and elaborate experimentally in vivo, particularly in humans. Computational modeling has the potential to address this issue by simulating embryonic growth under a range of loading conditions but the potential of such models has yet to be fully exploited. In this article, we review the literature on mechanobiology of limb development in three main sections: (a) experimental alteration of the mechanical environment, (b) mechanical properties of embryonic tissues, and (c) the use of computational models. Then we analyze the main issues, and suggest how experimental and computational fields could work closer together to enhance our understanding of mechanobiology of the embryonic skeleton.

  14. Adjustments to amputation and an artificial limb in lower limb amputees

    NARCIS (Netherlands)

    Sinha, Richa; van den Heuvel, Wim J. A.; Arokiasamy, Perianayagam

    Background: Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. Objectives: To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and

  15. Craniomandibular form and body size variation of first generation mouse hybrids: A model for hominin hybridization.

    Science.gov (United States)

    Warren, Kerryn A; Ritzman, Terrence B; Humphreys, Robyn A; Percival, Christopher J; Hallgrímsson, Benedikt; Ackermann, Rebecca Rogers

    2018-03-01

    Hybridization occurs in a number of mammalian lineages, including among primate taxa. Analyses of ancient genomes have shown that hybridization between our lineage and other archaic hominins in Eurasia occurred numerous times in the past. However, we still have limited empirical data on what a hybrid skeleton looks like, or how to spot patterns of hybridization among fossils for which there are no genetic data. Here we use experimental mouse models to supplement previous studies of primates. We characterize size and shape variation in the cranium and mandible of three wild-derived inbred mouse strains and their first generation (F 1 ) hybrids. The three parent taxa in our analysis represent lineages that diverged over approximately the same period as the human/Neanderthal/Denisovan lineages and their hybrids are variably successful in the wild. Comparisons of body size, as quantified by long bone measurements, are also presented to determine whether the identified phenotypic effects of hybridization are localized to the cranium or represent overall body size changes. The results indicate that hybrid cranial and mandibular sizes, as well as limb length, exceed that of the parent taxa in all cases. All three F 1 hybrid crosses display similar patterns of size and form variation. These results are generally consistent with earlier studies on primates and other mammals, suggesting that the effects of hybridization may be similar across very different scenarios of hybridization, including different levels of hybrid fitness. This paper serves to supplement previous studies aimed at identifying F 1 hybrids in the fossil record and to introduce further research that will explore hybrid morphologies using mice as a proxy for better understanding hybridization in the hominin fossil record. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Parallel Hybrid Vehicle Optimal Storage System

    Science.gov (United States)

    Bloomfield, Aaron P.

    2009-01-01

    A paper reports the results of a Hybrid Diesel Vehicle Project focused on a parallel hybrid configuration suitable for diesel-powered, medium-sized, commercial vehicles commonly used for parcel delivery and shuttle buses, as the missions of these types of vehicles require frequent stops. During these stops, electric hybridization can effectively recover the vehicle's kinetic energy during the deceleration, store it onboard, and then use that energy to assist in the subsequent acceleration.

  17. Sliding GAIT Algorithm for the All-Terrain Hex-Limbed Extra-Terrestrial Explorer (ATHLETE)

    Science.gov (United States)

    Townsend, Julie; Biesiadecki, Jeffrey

    2012-01-01

    The design of a surface robotic system typically involves a trade between the traverse speed of a wheeled rover and the terrain-negotiating capabilities of a multi-legged walker. The ATHLETE mobility system, with both articulated limbs and wheels, is uniquely capable of both driving and walking, and has the flexibility to employ additional hybrid mobility modes. This paper introduces the Sliding Gait, an intermediate mobility algorithm faster than walking with better terrain-handling capabilities than wheeled mobility.

  18. Limb-segment selection in drawing behaviour

    NARCIS (Netherlands)

    Meulenbroek, R G; Rosenbaum, D A; Thomassen, A.J.W.M.; Schomaker, L R

    How do we select combinations of limb segments to carry out physical tasks? Three possible determinants of limb-segment selection are hypothesized here: (1) optimal amplitudes and frequencies of motion for the effectors; (2) preferred movement axes for the effectors; and (3) a tendency to continue

  19. LIMB-SEGMENT SELECTION IN DRAWING BEHAVIOR

    NARCIS (Netherlands)

    MEULENBROEK, RGJ; ROSENBAUM, DA; THOMASSEN, AJWM; SCHOMAKER, LRB; Schomaker, Lambertus

    How do we select combinations of limb segments to carry out physical tasks? Three possible determinants of limb-segment selection are hypothesized here: (1) optimal amplitudes and frequencies of motion for the effectors; (2) preferred movement axes for the effectors; and (3) a tendency to continue

  20. Genomic features of human limb specific enhancers.

    Science.gov (United States)

    Ali, Shahid; Amina, Bibi; Anwar, Saneela; Minhas, Rashid; Parveen, Nazia; Nawaz, Uzma; Azam, Syed Sikandar; Abbasi, Amir Ali

    2016-10-01

    To elucidate important cellular and molecular interactions that regulate patterning and skeletal development, vertebrate limbs served as a model organ. A growing body of evidence from detailed studies on a subset of limb regulators like the HOXD cluster or SHH, reveals the importance of enhancers in limb related developmental and disease processes. Exploiting the recent genome-wide availability of functionally confirmed enhancer dataset, this study establishes regulatory interactions for dozens of human limb developmental genes. From these data, it appears that the long-range regulatory interactions are fairly common during limb development. This observation highlights the significance of chromosomal breaks/translocations in human limb deformities. Transcriptional factor (TF) analysis predicts that the differentiation of early nascent limb-bud into future territories entail distinct TF interaction networks. Conclusively, an important motivation for annotating the human limb specific regulatory networks is to pave way for the systematic exploration of their role in disease and evolution. Copyright © 2016. Published by Elsevier Inc.

  1. A Dynamic Model for Limb Selection

    NARCIS (Netherlands)

    Cox, R.F.A; Smitsman, A.W.

    2008-01-01

    Two experiments and a model on limb selection are reported. In Experiment 1 left-handed and right-handed participants (N = 36) repeatedly used one hand for grasping a small cube. After a clear switch in the cube’s location, perseverative limb selection was revealed in both handedness groups. In

  2. The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb.

    Science.gov (United States)

    Manaan, Qazi; Bashir, Adil; Zahoor, Adnan; Mokhdomi, Taseem A; Danish, Qazi

    2016-09-01

    Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.

  3. Effects of the change in cutoff values for human epidermal growth factor receptor 2 status by immunohistochemistry and fluorescence in situ hybridization: a study comparing conventional brightfield microscopy, image analysis-assisted microscopy, and interobserver variation.

    Science.gov (United States)

    Atkinson, Roscoe; Mollerup, Jens; Laenkholm, Anne-Vibeke; Verardo, Mark; Hawes, Debra; Commins, Deborah; Engvad, Birte; Correa, Adrian; Ehlers, Charlotte Cort; Nielsen, Kirsten Vang

    2011-08-01

    New guidelines for HER2 testing have been introduced. To evaluate the difference in HER2 assessment after introduction of new cutoff levels for both immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) and to compare interobserver agreement and time to score between image analysis and conventional microscopy. Samples from 150 patients with breast cancer were scored by 7 pathologists using conventional microscopy, with a cutoff of both 10% and 30% IHC-stained cells, and using automated microscopy with image analysis. The IHC results were compared individually and to HER2 status as determined by FISH, using both the approved cutoff of 2.0 and the recently introduced cutoff of 2.2. High concordance was found in IHC scoring among the 7 pathologists. The 30% cutoff led to slightly fewer positive IHC observations. Introduction of a FISH equivocal zone affected 4% of the FISH scores. If cutoff for FISH is kept at 2.0, no difference in patient selection is found between the 10% and the 30% IHC cutoff. Among the 150 breast cancer samples, the new 30% IHC and 2.2 FISH cutoff levels resulted in one case without a firm diagnosis because both IHC and FISH were equivocal. Automated microscopy and image analysis-assisted IHC led to significantly better interobserver agreement among the 7 pathologists, with an increase in mean scoring time of only about 30 seconds per slide. The change in cutoff levels led to a higher concordance between IHC and FISH, but fewer samples were classified as HER2 positive.

  4. Hybrid reactors

    International Nuclear Information System (INIS)

    Moir, R.W.

    1980-01-01

    The rationale for hybrid fusion-fission reactors is the production of fissile fuel for fission reactors. A new class of reactor, the fission-suppressed hybrid promises unusually good safety features as well as the ability to support 25 light-water reactors of the same nuclear power rating, or even more high-conversion-ratio reactors such as the heavy-water type. One 4000-MW nuclear hybrid can produce 7200 kg of 233 U per year. To obtain good economics, injector efficiency times plasma gain (eta/sub i/Q) should be greater than 2, the wall load should be greater than 1 MW.m -2 , and the hybrid should cost less than 6 times the cost of a light-water reactor. Introduction rates for the fission-suppressed hybrid are usually rapid

  5. Vascularized fibular graft combined with vacuum assisted closure in ...

    African Journals Online (AJOL)

    The flowthrough fibular graft combined with Vacuum Assisted Closure (VAC) controlled the infection, shortened the course of treatment, and effectively restored limb function when applied to the treatment of tibial defects. Keywords: Tibial defect, Flow-through fibular graft, Vacuum Assisted Closure, Chronic Osteomyelitis ...

  6. Cross-limb interference during motor learning.

    Directory of Open Access Journals (Sweden)

    Benedikt Lauber

    Full Text Available It is well known that following skill learning, improvements in motor performance may transfer to the untrained contralateral limb. It is also well known that retention of a newly learned task A can be degraded when learning a competing task B that takes place directly after learning A. Here we investigate if this interference effect can also be observed in the limb contralateral to the trained one. Therefore, five different groups practiced a ballistic finger flexion task followed by an interfering visuomotor accuracy task with the same limb. Performance in the ballistic task was tested before the training, after the training and in an immediate retention test after the practice of the interference task for both the trained and the untrained hand. After training, subjects showed not only significant learning and interference effects for the trained limb but also for the contralateral untrained limb. Importantly, the interference effect in the untrained limb was dependent on the level of skill acquisition in the interfering motor task. These behavioural results of the untrained limb were accompanied by training specific changes in corticospinal excitability, which increased for the hemisphere ipsilateral to the trained hand following ballistic training and decreased during accuracy training of the ipsilateral hand. The results demonstrate that contralateral interference effects may occur, and that interference depends on the level of skill acquisition in the interfering motor task. This finding might be particularly relevant for rehabilitation.

  7. A review of supernumerary and absent limbs and digits of the upper limb.

    Science.gov (United States)

    Klaassen, Zachary; Choi, Monica; Musselman, Ruth; Eapen, Deborah; Tubbs, R Shane; Loukas, Marios

    2012-03-01

    For years people have been enamored by anomalies of the human limbs, particularly supernumerary and absent limbs and digits. Historically, there are a number of examples of such anomalies, including royal families of ancient Chaldea, tribes from Arabia, and examples from across nineteenth century Europe. The development of the upper limbs in a growing embryo is still being elucidated with the recent advent of homeobox genes, but researchers agree that upper limbs develop between stages 12-23 through a complex embryological process. Maternal thalidomide intake during limb development is known to cause limb reduction and subsequent amelia or phocomelia. Additionally, a number of clinical reports have illustrated different limb anomaly cases, with each situation unique in phenotype and developmental abnormality. Supernumerary and absent limbs and digits are not unique to humans, and a number of animal cases have also been reported. This review of the literature illustrates the historical, anatomical, and clinical aspects of supernumerary and absent limbs and digits for the upper limb.

  8. Genetic interactions between Shox2 and Hox genes during the regional growth and development of the mouse limb.

    Science.gov (United States)

    Neufeld, Stanley J; Wang, Fan; Cobb, John

    2014-11-01

    The growth and development of the vertebrate limb relies on homeobox genes of the Hox and Shox families, with their independent mutation often giving dose-dependent effects. Here we investigate whether Shox2 and Hox genes function together during mouse limb development by modulating their relative dosage and examining the limb for nonadditive effects on growth. Using double mRNA fluorescence in situ hybridization (FISH) in single embryos, we first show that Shox2 and Hox genes have associated spatial expression dynamics, with Shox2 expression restricted to the proximal limb along with Hoxd9 and Hoxa11 expression, juxtaposing the distal expression of Hoxa13 and Hoxd13. By generating mice with all possible dosage combinations of mutant Shox2 alleles and HoxA/D cluster deletions, we then show that their coordinated proximal limb expression is critical to generate normally proportioned limb segments. These epistatic interactions tune limb length, where Shox2 underexpression enhances, and Shox2 overexpression suppresses, Hox-mutant phenotypes. Disruption of either Shox2 or Hox genes leads to a similar reduction in Runx2 expression in the developing humerus, suggesting their concerted action drives cartilage maturation during normal development. While we furthermore provide evidence that Hox gene function influences Shox2 expression, this regulation is limited in extent and is unlikely on its own to be a major explanation for their genetic interaction. Given the similar effect of human SHOX mutations on regional limb growth, Shox and Hox genes may generally function as genetic interaction partners during the growth and development of the proximal vertebrate limb. Copyright © 2014 by the Genetics Society of America.

  9. An objective assessment of safety to drive in an upper limb cast.

    Science.gov (United States)

    Stevenson, H L; Peterson, N; Talbot, C; Dalal, S; Watts, A C; Trail, I A

    2013-03-01

    Patients managed with upper limb cast immobilization often seek advice about driving. There is very little published data to assist in decision making, and advice given varies between healthcare professionals. There are no specific guidelines available from the UK Drivers and Vehicles Licensing Agency, police, or insurance companies. Evidence-based guidelines would enable clinicians to standardize the advice given to patients. Six individuals (three male, three female; mean age 36 years, range 27-43 years) were assessed by a mobility occupational therapist and driving standards agency examiner while completing a formal driving test in six different types of upper limb casts (above-elbow, below-elbow neutral, and below-elbow cast incorporating the thumb [Bennett's cast]) on both left and right sides. Of the 36 tests, participants passed 31 tests, suggesting that most people were able to safely drive with upper limb cast immobilization. However, driving in a left above-elbow cast was considered unsafe.

  10. Radiography of syndactylous limbs of cattle

    International Nuclear Information System (INIS)

    Taura, Y.; Takeuchi, A.; Uchino, T.

    1985-01-01

    Fore and hind limbs of 4-month-old Holstein-Friesian cattle ♀ (No.I) and those of 1-month-old Holstein-Friesian×Japanese Black cattle ♀ (No.II) suffering from syndactyly were dissected by means of radiographic examinations. The details were reported as follows. 1. The phalanges of both fore and left hind limbs of No.II cattle were completely fused. But, all the phalanges of left fore limb and proximal phalanges of right fore limb in No.I and the distal phalanges of right hind limb in No.II were normal, the others being of partial synostosis. 2. The distal parforating canal was absent in the metacarpus and the right metatarsus in No.II cattle. Also, in No.II on the distal part of the metacarpal or metatarsal, bone vestiges were noted, not only of the fifth and second metacarpus or metatarsus, but also the mutually jointed phalanges. 3. In No.I cattle, the left fore limb and 4 proximal sesamoid bones and 2 distal sesamoid bones, but the right limb had 4 sesamoid bones and 0 distal one. In No.II cattle, the fore limbs had 2 proximal and 0 distal sesamoid bones, left hind limb had 3 proximal and 0 distal ones, right hind limb had 3 proximal and 1 distal ones. 4. The arteries accommodated the syndactylous deformities. The median and radial arteries were fixed to be descended on to the palmar side of the metacarpus and mutually anastomosed to form a deep palmar arch. arising from the deep palmar arch, two branches (palmar proper digital aa. III and IV) were terminated by the lateral and medial palmar surfaces of the digit, where some anastomosing arches were formed by them. The arteries of the hind limbs were also similar to those of the fore limbs. 5. In radiographic examinations of syndactyly (in No.II) after 7-month feeding, hoof and digital bones were noted to have been developed, but distal phalanges were destructed and left in suspicion of bad prognosis

  11. Smartphone supported upper limb prosthesis

    Directory of Open Access Journals (Sweden)

    Hepp D.

    2015-09-01

    Full Text Available State of the art upper limb prostheses offer up to six active DoFs (degrees of freedom and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be

  12. A Hybrid Neuromechanical Ambulatory Assist System

    Science.gov (United States)

    2014-06-01

    meant to connect to whatever footplate or ankle foot orthoses (AFO) are desired. In the spirit of flexibility, the choice of foot attachment and...locking pressure criteria would not be of any use. The test setup is shown in Figure B2 . An aluminum arm was fabricated to attach to the axle of...Figure B2 . Experimental setup to test locking torque. 32 digital pressure gauges were attached to both chambers, allowing for pressure

  13. A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities.

    Science.gov (United States)

    Eiammanussakul, Trinnachoke; Sangveraphunsiri, Viboon

    2018-01-01

    Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

  14. A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities

    Directory of Open Access Journals (Sweden)

    Trinnachoke Eiammanussakul

    2018-01-01

    Full Text Available Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

  15. Characteristics of the muscle activities of the elderly for various pressures in the pneumatic actuator of lower limb orthosis

    Science.gov (United States)

    Kim, Kyong; Yu, Chang-Ho; Kwon, Tae-Kyu; Hong, Chul-Un; Kim, Nam-Gyun

    2005-12-01

    There developed a lower limb orthosis with a pneumatic rubber actuator, which can assist and improve the muscular activities in the lower limb of the elderly. For this purpose, the characteristics of the lower limbs muscle activities for various pressures in the pneumatic actuator for the lower limb orthosis was investigated. To find out the characteristics of the muscle activities for various pneumatic pressures, it analyzed the flexing and extending movement of the knees, and measured the lower limbs muscular power. The subjects wearing the lower limbs orthosis were instructed to perform flexing and extending movement of the knees. The variation in the air pressure of the pneumatic actuator was varies from one kgf/cm2 to four kgf/cm2. The muscular power was measured by monitoring electromyogram using MP100 (BIOPAC Systems, Inc.) and detailed three-dimensional motions of the lower limbs were collected by APAS 3D Motion Analysis system. Through this study, it expected to find the most suitable air pressure for the improvement of the muscular power of the aged.

  16. The benefit of limb cloud imaging for infrared limb sounding of tropospheric trace gases

    OpenAIRE

    G. Heinemann; P. Preusse; R. Spang; S. Adams

    2009-01-01

    Advances in detector technology enable a new generation of infrared limb sounders to measure 2-D images of the atmosphere. A proposed limb cloud imager (LCI) mode will detect clouds with a spatial resolution unprecedented for limb sounding. For the inference of temperature and trace gas distributions, detector pixels of the LCI have to be combined into super-pixels which provide the required signal-to-noise and information content for the retrievals. This study examines the extent to which tr...

  17. Hybrid composites

    CSIR Research Space (South Africa)

    Jacob John, Maya

    2009-04-01

    Full Text Available mixed short sisal/glass hybrid fibre reinforced low density polyethylene composites was investigated by Kalaprasad et al [25].Chemical surface modifications such as alkali, acetic anhydride, stearic acid, permanganate, maleic anhydride, silane...

  18. γ -phlebography of the upper limbs

    International Nuclear Information System (INIS)

    Jacolot, G.; Legendre, P.; Millour, L.; Barra, J.A.; Perramant, M.; Morin, P.P.

    1981-01-01

    γ-phlebography is an easy and repetitive exploration of deep venous thrombosis. This investigation becomes very useful for the upper limbs on account of the present frequency of iatrogenic thrombosis [fr

  19. A Cognitive Overview of Limb Apraxia.

    Science.gov (United States)

    Bartolo, Angela; Ham, Heidi Stieglitz

    2016-08-01

    Since the first studies on limb apraxia carried out by Hugo Liepmann more than a century ago, research interests focused on the way humans process manual gestures by assessing gesture production after patients suffered neurologic deficits. Recent reviews centered their attention on deficits in gesture imitation or processing object-related gestures, namely pantomimes and transitive gestures, thereby neglecting communicative/intransitive gestures. This review will attempt to reconcile limb apraxia in its entirety. To this end, the existing cognitive models of praxis processing that have been designed to account for the complexity of this disorder will be taken into account, with an attempt to integrate in these models the latest findings in the studies of limb apraxia, in particular on meaningful gestures. Finally, this overview questions the very nature of limb apraxia when other cognitive deficits are observed.

  20. Hybrid intermediaries

    OpenAIRE

    Cetorelli, Nicola

    2014-01-01

    I introduce the concept of hybrid intermediaries: financial conglomerates that control a multiplicity of entity types active in the "assembly line" process of modern financial intermediation, a system that has become known as shadow banking. The complex bank holding companies of today are the best example of hybrid intermediaries, but I argue that financial firms from the "nonbank" space can just as easily evolve into conglomerates with similar organizational structure, thus acquiring the cap...

  1. Goniometry and Limb Girth in Miniature Dachshunds

    OpenAIRE

    Thomovsky, Stephanie A.; Chen, Annie V.; Kiszonas, Alecia M.; Lutskas, Lori A.

    2016-01-01

    Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girt...

  2. THE INFLUENCE OF LOWER LIMB MOVEMENT ON UPPER LIMB MOVEMENT SYMMETRY WHILE SWIMMING THE BREASTSTROKE

    Directory of Open Access Journals (Sweden)

    M. Jaszczak

    2011-09-01

    Full Text Available This study 1 examined the influence of lower limb movement on upper limb movement symmetry, 2 determined the part of the propulsion phase displaying the greatest hand movement asymmetry, 3 diagnosed the range of upper limb propulsion phase which is the most prone to the influence of the lower limbs while swimming the breaststroke. Twenty-four participants took part in two tests. Half of them performed an asymmetrical leg movement. The propulsion in the first test was generated by four limbs while in the second one only by the upper limbs. The pressure differentials exerted by the water on the back and on the palm of the right and left hand were measured. Then, the asymmetry coefficient of the hand movement was determined. No changes in the level of the asymmetry index in participants performing correct (symmetrical lower limb movement were observed. Incorrect (asymmetrical leg motion resulted in an increase of hand asymmetry. It could be concluded that lower limb faults neutralize upper limb performance when swimming on a rectilinear path. However, most asymmetrical arm performance should be identified with the conversion of propulsion into recovery. Nevertheless, its proneness to influence improper leg performance might be expected at the beginning of arm propulsion.

  3. Isolated primary lymphedema tarda of the upper limb.

    Science.gov (United States)

    Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

    2013-03-01

    Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

  4. Gait and Lower Limb Observation of Paediatrics (GALLOP): development of a consensus based paediatric podiatry and physiotherapy standardised recording proforma.

    Science.gov (United States)

    Cranage, Simone; Banwell, Helen; Williams, Cylie M

    2016-01-01

    Paediatric gait and lower limb assessments are frequently undertaken in podiatry and physiotherapy clinical practice and this is a growing area of expertise within Australia. No concise paediatric standardised recording proforma exists to assist clinicians in clinical practice. The aim of this study was to develop a gait and lower limb standardised recording proforma guided by the literature and consensus, for assessment of the paediatric foot and lower limb in children aged 0-18 years. Expert Australian podiatrists and physiotherapists were invited to participate in a three round Delphi survey panel using the online Qualtrics(©) survey platform. The first round of the survey consisted of open-ended questions on paediatric gait and lower limb assessment developed from existing templates and a literature search of standardised lower limb assessment methods. Rounds two and three consisted of statements developed from the first round responses. Questions and statements were included in the final proforma if 70 % or more of the participants indicated consensus or agreement with the assessment method and if there was support within the literature for paediatric age-specific normative data with acceptable reliability of outcome measures. There were 17 of the 21 (81 %) participants who completed three rounds of the survey. Consensus was achieved for 41 statements in Round one, 54 statements achieved agreement in two subsequent rounds. Participants agreed on 95 statements relating to birth history, developmental history, hip measurement, rotation of the lower limb, ankle range of motion, foot posture, balance and gait. Assessments with acceptable validity and reliability were included within the final Gait and Lower Limb Observation of Paediatrics (GALLOP) proforma. The GALLOP proforma is a consensus based, systematic and standardised way to collect information and outcome measures in paediatric lower limb assessment. This standardised recording proforma will assist

  5. Regenerative Engineering and Bionic Limbs.

    Science.gov (United States)

    James, Roshan; Laurencin, Cato T

    2015-03-01

    Amputations of the upper extremity are severely debilitating, current treatments support very basic limb movement, and patients undergo extensive physiotherapy and psychological counselling. There is no prosthesis that allows the amputees near-normal function. With increasing number of amputees due to injuries sustained in accidents, natural calamities and international conflicts, there is a growing requirement for novel strategies and new discoveries. Advances have been made in technological, material and in prosthesis integration where researchers are now exploring artificial prosthesis that integrate with the residual tissues and function based on signal impulses received from the residual nerves. Efforts are focused on challenging experts in different disciplines to integrate ideas and technologies to allow for the regeneration of injured tissues, recording on tissue signals and feed-back to facilitate responsive movements and gradations of muscle force. A fully functional replacement and regenerative or integrated prosthesis will rely on interface of biological process with robotic systems to allow individual control of movement such as at the elbow, forearm, digits and thumb in the upper extremity. Regenerative engineering focused on the regeneration of complex tissue and organ systems will be realized by the cross-fertilization of advances over the past thirty years in the fields of tissue engineering, nanotechnology, stem cell science, and developmental biology. The convergence of toolboxes crated within each discipline will allow interdisciplinary teams from engineering, science, and medicine to realize new strategies, mergers of disparate technologies, such as biophysics, smart bionics, and the healing power of the mind. Tackling the clinical challenges, interfacing the biological process with bionic technologies, engineering biological control of the electronic systems, and feed-back will be the important goals in regenerative engineering over the next

  6. Bounded Control of an Actuated Lower-Limb Exoskeleton

    Directory of Open Access Journals (Sweden)

    Michael Oluwatosin Ajayi

    2017-01-01

    Full Text Available A bounded control strategy is employed for the rehabilitation and assistance of a patient with lower-limb disorder. Complete and partial lower-limb motor function disorders are considered. This application is centered on the knee and the ankle joint level, thereby considering a user in a sitting position. A high gain observer is used in the estimation of the angular position and angular velocities which is then applied to the estimation of the joint torques. The level of human contribution is feedback of a fraction of the estimated joint torque. This is utilised in order to meet the demands for a bounded human torque; that is, τh≤N2,n≤N1,n. The asymptotic stability of the bounded control law without human contribution and the convergence analysis of the high gain observer is verified using Lyapunov-based analysis. Simulations are performed to verify the proposed control law. Results obtained guarantee a fair trajectory tracking of the physiotherapist trajectory.

  7. Assistive Technology

    Science.gov (United States)

    ... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...

  8. Update and validation of the Society for Vascular Surgery wound, ischemia, and foot infection threatened limb classification system.

    Science.gov (United States)

    Mills, Joseph L

    2014-03-01

    The diagnosis of critical limb ischemia, first defined in 1982, was intended to delineate a patient cohort with a threatened limb and at risk for amputation due to severe peripheral arterial disease. The influence of diabetes and its associated neuropathy on the pathogenesis-threatened limb was an excluded comorbidity, despite its known contribution to amputation risk. The Fontaine and Rutherford classifications of limb ischemia severity have also been used to predict amputation risk and the likelihood of tissue healing. The dramatic increase in the prevalence of diabetes mellitus and the expanding techniques of arterial revascularization has prompted modification of peripheral arterial disease classification schemes to improve outcomes analysis for patients with threatened limbs. The diabetic patient with foot ulceration and infection is at risk for limb loss, with abnormal arterial perfusion as only one determinant of outcome. The wound extent and severity of infection also impact the likelihood of limb loss. To better predict amputation risk, the Society for Vascular Surgery Lower Extremity Guidelines Committee developed a classification of the threatened lower extremity that reflects these important clinical considerations. Risk stratification is based on three major factors that impact amputation risk and clinical management: wound, ischemia, and foot infection. This classification scheme is relevant to the patient with critical limb ischemia because many are also diabetic. Implementation of the wound, ischemia, and foot infection classification system in critical limb ischemia patients is recommended and should assist the clinician in more meaningful analysis of outcomes for various forms of wound and arterial revascularizations procedures required in this challenging, patient population. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Assisted Living

    Science.gov (United States)

    ... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

  10. Determinants of limb preference for initiating compensatory stepping poststroke.

    Science.gov (United States)

    Mansfield, Avril; Inness, Elizabeth L; Lakhani, Bimal; McIlroy, William E

    2012-07-01

    To investigate the determinants of limb preference for initiating compensatory stepping poststroke. Retrospective chart review. Inpatient rehabilitation. Convenience sample of individuals admitted to inpatient rehabilitation with poststroke hemiparesis. Not applicable. Compensatory stepping responses were evoked using a lean-and-release postural perturbation. The limb used to initiate compensatory stepping was determined. The relationships between stepping with the paretic limb and premorbid limb dominance, weight bearing on the paretic limb in quiet standing, ability to bear weight on the paretic limb, preperturbation weight bearing on the paretic limb, and lower-limb motor recovery scores were determined. The majority (59.1%) of responses were steps initiated with the nonparetic limb. Increased lower-limb motor recovery scores and preperturbation weight bearing on the nonparetic limb were significantly related to increased frequency of stepping with the paretic limb. When the preferred limb was physically blocked, an inappropriate response was initiated in 21% of trials (ie, nonstep responses or an attempt to step with the blocked limb). This study reveals the challenges that individuals with poststroke hemiparesis face when executing compensatory stepping responses to prevent a fall after a postural perturbation. The inability or challenges to executing a compensatory step with the paretic limb may increase the risk for falls poststroke. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. Upper limb position control in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Bardal Ellen

    2012-09-01

    Full Text Available Abstract Background Motor problems are reported by patients with fibromyalgia (FM. However, the mechanisms leading to alterations in motor performance are not well understood. In this study, upper limb position control during sustained isometric contractions was investigated in patients with FM and in healthy controls (HCs. Methods Fifteen female FM patients and 13 HCs were asked to keep a constant upper limb position during sustained elbow flexion and shoulder abduction, respectively. Subjects received real-time visual feedback on limb position and both tasks were performed unloaded and while supporting loads (1, 2, and 3 kg. Accelerations of the dominant upper limb were recorded, with variance (SD of mean position and power spectrum analysis used to characterize limb position control. Normalized power of the acceleration signal was extracted for three frequency bands: 1–3 Hz, 4–7 Hz, and 8–12 Hz. Results Variance increased with load in both tasks (P 0.001 but did not differ significantly between patients and HCs (P > 0.17. Power spectrum analysis showed that the FM patients had a higher proportion of normalized power in the 1–3 Hz band, and a lower proportion of normalized power in the 8–12 Hz band compared to HCs (P 0.05. The results were consistent for all load conditions and for both elbow flexion and shoulder abduction. Conclusion FM patients exhibit an altered neuromuscular strategy for upper limb position control compared to HCs. The predominance of low-frequency limb oscillations among FM patients may indicate a sensory deficit.

  12. Moving a generalised limb : a simulation with consequences for theories on limb control

    NARCIS (Netherlands)

    Otten, E

    The movement control of articulated limbs in vertebrates has been explained in terms of equilibrium points and moving equilibrium points or virtual trajectories. These hypotheses state that the nervous system makes the control Of multi-segment limbs easier by simply planning in terms of these

  13. Supernumerary and absent limbs and digits of the lower limb: a review of the literature.

    Science.gov (United States)

    Klaassen, Zachary; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios

    2011-07-01

    Anatomical history over centuries includes description of a wide variety of malformations involving the lower limbs. This article offers an organized review of these diverse abnormalities, including new understanding of mechanisms through recent discoveries in genetics and molecular biology. In 19th century Europe, a number of unique anomalies were reported, as well as evidence of foot amputations occurring in ancient Peruvian culture. Embryologically, the limbs develop early, with the lower limb being recognizable for the first time at stage 13 of development. By stage 23, the toes are clearly defined and by birth, although the legs appear bowed, the tibia and fibula are straight. Removal of the apical ectodermal ridge results in cessation of limb development, conversely, a second apical ectodermal ridge results in duplication of distal structures. Supernumerary limbs have been documented to occur as part of a teratoma with unique morphology and accompanying blood supply. Additionally, many examples of polydactyly occur in the foot postulating that deletion of chromosome 22q11 is involved in postaxial polydactyly. Such deletions occur near the middle of the chromosome at a location designated q11.2 (i.e., on the long arm of one of the pair of chromosomes 22) and this syndrome is also referred to as DiGeorge syndrome, which has a prevalence estimated at 1:4,000. Absence of the lower limbs has also been noted, with hypoplasia of the fibula being the most common manifestation of congenital bone absences in the lower limb. In addition to fibular aplasia, cases of tibial aplasia have been reported. This article is important for surgeons attempting correctional repair of lower limb anomalies, as well as providing analysis of the historical, anatomical and clinical aspects of supernumerary and absent limbs and digits for the lower limb. Copyright © 2011 Wiley-Liss, Inc.

  14. How accurate is anatomic limb alignment in predicting mechanical limb alignment after total knee arthroplasty?

    Science.gov (United States)

    Lee, Seung Ah; Choi, Sang-Hee; Chang, Moon Jong

    2015-10-27

    Anatomic limb alignment often differs from mechanical limb alignment after total knee arthroplasty (TKA). We sought to assess the accuracy, specificity, and sensitivity for each of three commonly used ranges for anatomic limb alignment (3-9°, 5-10° and 2-10°) in predicting an acceptable range (neutral ± 3°) for mechanical limb alignment after TKA. We also assessed whether the accuracy of anatomic limb alignment was affected by anatomic variation. This retrospective study included 314 primary TKAs. The alignment of the limb was measured with both anatomic and mechanical methods of measurement. We also measured anatomic variation, including the femoral bowing angle, tibial bowing angle, and neck-shaft angle of the femur. All angles were measured on the same full-length standing anteroposterior radiographs. The accuracy, specificity, and sensitivity for each range of anatomic limb alignment were calculated and compared using mechanical limb alignment as the reference standard. The associations between the accuracy of anatomic limb alignment and anatomic variation were also determined. The range of 2-10° for anatomic limb alignment showed the highest accuracy, but it was only 73 % (3-9°, 65 %; 5-10°, 67 %). The specificity of the 2-10° range was 81 %, which was higher than that of the other ranges (3-9°, 69 %; 5-10°, 67 %). However, the sensitivity of the 2-10° range to predict varus malalignment was only 16 % (3-9°, 35 %; 5-10°, 68 %). In addition, the sensitivity of the 2-10° range to predict valgus malalignment was only 43 % (3-9°, 71 %; 5-10°, 43 %). The accuracy of anatomical limb alignment was lower for knees with greater femoral (odds ratio = 1.2) and tibial (odds ratio = 1.2) bowing. Anatomic limb alignment did not accurately predict mechanical limb alignment after TKA, and its accuracy was affected by anatomic variation. Thus, alignment after TKA should be assessed by measuring mechanical alignment rather than anatomic

  15. Vascular access in critical limb ischemia.

    Science.gov (United States)

    Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Sarkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L

    2016-01-01

    Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Goniometry and Limb Girth in Miniature Dachshunds.

    Science.gov (United States)

    Thomovsky, Stephanie A; Chen, Annie V; Kiszonas, Alecia M; Lutskas, Lori A

    2016-01-01

    Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girth among the three groups (ambulatory paraparetic, nonambulatory paraparetic, or paraplegic) (P > 0.05). When group was disregarded and values for extension, flexion, and girth combined, no differences existed. Conclusions. Goniometry and limb girth measurements can successfully be made in the miniature Dachshund; however, the shape of the Dachshund leg makes obtaining these values challenging. There were no differences in joint angle or girth measurements between dogs with varying neurologic dysfunction at the time of measurement.

  17. Goniometry and Limb Girth in Miniature Dachshunds

    Directory of Open Access Journals (Sweden)

    Stephanie A. Thomovsky

    2016-01-01

    Full Text Available Purpose. To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion. Methods. 15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements. Results. There were no significant differences in joint angles or girth among the three groups (ambulatory paraparetic, nonambulatory paraparetic, or paraplegic (P>0.05. When group was disregarded and values for extension, flexion, and girth combined, no differences existed. Conclusions. Goniometry and limb girth measurements can successfully be made in the miniature Dachshund; however, the shape of the Dachshund leg makes obtaining these values challenging. There were no differences in joint angle or girth measurements between dogs with varying neurologic dysfunction at the time of measurement.

  18. Splenogonadal fusion with limb deficiency and micrognathia.

    Science.gov (United States)

    Moore, P J; Hawkins, E P; Galliani, C A; Guerry-Force, M L

    1997-11-01

    Splenogonadal fusion (SGF) is a rare abnormality with two known types. In the continuous type, the spleen is connected to the gonad, and there are often limb defects, micrognathia, or other congenital malformations such as ventricular septal defect, anal atresia, microgastria, spina bifida, craniosynostosis, thoracopagus, diaphragmatic hernia, hypoplastic lung and abnormal lung fissures, polymicrogyria, deficient coccyx, and bifid spine C6-T3. The discontinuous type is usually not associated with congenital defects, and the gonad that fused with an accessory spleen has no connection with the native spleen. The etiology of SGF is not known. Conceivably, a teratogenic insult occurring between 5 weeks' and 8 weeks' gestation could interfere with the normal development of the spleen, gonads, and limb buds. We describe a case of splenogonadal fusion in a stillborn black boy with associated micrognathia and limb deformities. Also, we review the possible teratogenic etiologies and embryonic basis of SGF.

  19. Hybrid stars

    Indian Academy of Sciences (India)

    Hybrid stars. AsHOK GOYAL. Department of Physics and Astrophysics, University of Delhi, Delhi 110 007, India. Abstract. Recently there have been important developments in the determination of neutron ... number and the electric charge. ... available to the system to rearrange concentration of charges for a given fraction of.

  20. Reliability of lower limb alignment measures using an established landmark-based method with a customized computer software program

    Science.gov (United States)

    Sled, Elizabeth A.; Sheehy, Lisa M.; Felson, David T.; Costigan, Patrick A.; Lam, Miu; Cooke, T. Derek V.

    2010-01-01

    The objective of the study was to evaluate the reliability of frontal plane lower limb alignment measures using a landmark-based method by (1) comparing inter- and intra-reader reliability between measurements of alignment obtained manually with those using a computer program, and (2) determining inter- and intra-reader reliability of computer-assisted alignment measures from full-limb radiographs. An established method for measuring alignment was used, involving selection of 10 femoral and tibial bone landmarks. 1) To compare manual and computer methods, we used digital images and matching paper copies of five alignment patterns simulating healthy and malaligned limbs drawn using AutoCAD. Seven readers were trained in each system. Paper copies were measured manually and repeat measurements were performed daily for 3 days, followed by a similar routine with the digital images using the computer. 2) To examine the reliability of computer-assisted measures from full-limb radiographs, 100 images (200 limbs) were selected as a random sample from 1,500 full-limb digital radiographs which were part of the Multicenter Osteoarthritis (MOST) Study. Three trained readers used the software program to measure alignment twice from the batch of 100 images, with two or more weeks between batch handling. Manual and computer measures of alignment showed excellent agreement (intraclass correlations [ICCs] 0.977 – 0.999 for computer analysis; 0.820 – 0.995 for manual measures). The computer program applied to full-limb radiographs produced alignment measurements with high inter- and intra-reader reliability (ICCs 0.839 – 0.998). In conclusion, alignment measures using a bone landmark-based approach and a computer program were highly reliable between multiple readers. PMID:19882339

  1. [Partial replantation following proximal limb injury].

    Science.gov (United States)

    Dubert, T; Malikov, S A; Dinh, A; Kupatadze, D D; Oberlin, C; Alnot, J Y; Nabokov, B B

    2000-11-01

    Proximal replantation is a technically feasible but life-threatening procedure. Indications must be restricted to patients in good condition with a good functional prognosis. The goal of replantation must be focused not only on reimplanting the amputated limb but also on achieving a good functional outcome. For the lower limb, simple terminalization remains the best choice in many cases. When a proximal amputation is not suitable for replantation, the main aim of the surgical procedure must be to reconstruct a stump long enough to permit fitting a prosthesis preserving the function of the adjacent joint. If the proximal stump beyond the last joint is very short, it may be possible to restore some length by partial replantation of spared tissues from the amputated part. We present here the results we obtained following this policy. This series included 16 cases of partial replantations, 14 involving the lower limb and 2 the upper limb. All were osteocutaneous microsurgical transfers. For the lower limb, all transfers recovered protective sensitivity following tibial nerve repair. The functional calcaeoplantar unit was used in 13 cases. The transfer of this specialized weight bearing tissue provided a stable distal surface making higher support unnecessary. In one case, we raised a 13-cm vascularized tibial segment covered with foot skin for additional length. For the upper limb, the osteocutaneous transfer, based on the radial artery, was not reinnervated, but this lack of sensitivity did not impair prosthesis fitting. One vascular failure was finally amputated. This was the only unsuccessful result. For all other patients, the surgical procedure facilitated prosthesis fitting and preserved the proximal joint function despite an initially very proximal amputation. The advantages of partial replantation are obvious compared with simple terminalization or secondary reconstruction. There is no secondary donor site and, because there is no major muscle mass in the

  2. Cocaine-associated lower limb ischemia.

    LENUS (Irish Health Repository)

    Collins, Chris G

    2011-07-25

    Cocaine-associated thrombosis has been reported in the literature with reports of vascular injuries to cardiac, pulmonary, intestinal, placental, and musculoskeletal vessels; however, injury of the pedal vessels is rare. We report on a 31-year-old man who presented 2 months following a cocaine binge with limb-threatening ischemia without an otherwise identifiable embolic source. Angiography confirmed extensive occlusive disease of the tibioperoneal vessels. The patient improved following therapy with heparin and a prostacyclin analogue. Cocaine-induced thrombosis should be considered in patients presenting with acute arterial insufficiency in the lower limb without any other identifiable cause.

  3. The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

    Science.gov (United States)

    Cole, Grayson Lee; Millis, Darryl

    2017-01-16

    Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.

  4. Classification of different reaching movements from the same limb using EEG

    Science.gov (United States)

    Shiman, Farid; López-Larraz, Eduardo; Sarasola-Sanz, Andrea; Irastorza-Landa, Nerea; Spüler, Martin; Birbaumer, Niels; Ramos-Murguialday, Ander

    2017-08-01

    Objective. Brain-computer-interfaces (BCIs) have been proposed not only as assistive technologies but also as rehabilitation tools for lost functions. However, due to the stochastic nature, poor spatial resolution and signal to noise ratio from electroencephalography (EEG), multidimensional decoding has been the main obstacle to implement non-invasive BCIs in real-live rehabilitation scenarios. This study explores the classification of several functional reaching movements from the same limb using EEG oscillations in order to create a more versatile BCI for rehabilitation. Approach. Nine healthy participants performed four 3D center-out reaching tasks in four different sessions while wearing a passive robotic exoskeleton at their right upper limb. Kinematics data were acquired from the robotic exoskeleton. Multiclass extensions of Filter Bank Common Spatial Patterns (FBCSP) and a linear discriminant analysis (LDA) classifier were used to classify the EEG activity into four forward reaching movements (from a starting position towards four target positions), a backward movement (from any of the targets to the starting position and rest). Recalibrating the classifier using data from previous or the same session was also investigated and compared. Main results. Average EEG decoding accuracy were significantly above chance with 67%, 62.75%, and 50.3% when decoding three, four and six tasks from the same limb, respectively. Furthermore, classification accuracy could be increased when using data from the beginning of each session as training data to recalibrate the classifier. Significance. Our results demonstrate that classification from several functional movements performed by the same limb is possible with acceptable accuracy using EEG oscillations, especially if data from the same session are used to recalibrate the classifier. Therefore, an ecologically valid decoding could be used to control assistive or rehabilitation mutli-degrees of freedom (DoF) robotic devices

  5. The two domain hypothesis of limb prepattern and its relevance to congenital limb anomalies.

    Science.gov (United States)

    Tao, Hirotaka; Kawakami, Yasuhiko; Hui, Chi-Chung; Hopyan, Sevan

    2017-07-01

    Functional annotation of mutations that cause human limb anomalies is enabled by basic developmental studies. In this study, we focus on the prepatterning stage of limb development and discuss a recent model that proposes anterior and posterior domains of the early limb bud generate two halves of the future skeleton. By comparing phenotypes in humans with those in model organisms, we evaluate whether this prepatterning concept helps to annotate human disease alleles. WIREs Dev Biol 2017, 6:e270. doi: 10.1002/wdev.270 For further resources related to this article, please visit the WIREs website. © 2017 Wiley Periodicals, Inc.

  6. Nipbl and mediator cooperatively regulate gene expression to control limb development.

    Directory of Open Access Journals (Sweden)

    Akihiko Muto

    2014-09-01

    Full Text Available Haploinsufficiency for Nipbl, a cohesin loading protein, causes Cornelia de Lange Syndrome (CdLS, the most common "cohesinopathy". It has been proposed that the effects of Nipbl-haploinsufficiency result from disruption of long-range communication between DNA elements. Here we use zebrafish and mouse models of CdLS to examine how transcriptional changes caused by Nipbl deficiency give rise to limb defects, a common condition in individuals with CdLS. In the zebrafish pectoral fin (forelimb, knockdown of Nipbl expression led to size reductions and patterning defects that were preceded by dysregulated expression of key early limb development genes, including fgfs, shha, hand2 and multiple hox genes. In limb buds of Nipbl-haploinsufficient mice, transcriptome analysis revealed many similar gene expression changes, as well as altered expression of additional classes of genes that play roles in limb development. In both species, the pattern of dysregulation of hox-gene expression depended on genomic location within the Hox clusters. In view of studies suggesting that Nipbl colocalizes with the mediator complex, which facilitates enhancer-promoter communication, we also examined zebrafish deficient for the Med12 Mediator subunit, and found they resembled Nipbl-deficient fish in both morphology and gene expression. Moreover, combined partial reduction of both Nipbl and Med12 had a strongly synergistic effect, consistent with both molecules acting in a common pathway. In addition, three-dimensional fluorescent in situ hybridization revealed that Nipbl and Med12 are required to bring regions containing long-range enhancers into close proximity with the zebrafish hoxda cluster. These data demonstrate a crucial role for Nipbl in limb development, and support the view that its actions on multiple gene pathways result from its influence, together with Mediator, on regulation of long-range chromosomal interactions.

  7. Brief biomechanical analysis on the walking of spinal cord injury patients with a lower limb exoskeleton robot.

    Science.gov (United States)

    Jung, Jun-Young; Park, Hyunsub; Yang, Hyun-Dae; Chae, Mingi

    2013-06-01

    This paper presents a brief biomechanical analysis on the walking behavior of spinal cord injury (SCI) patients. It is known that SCI patients who have serious injuries to their spines cannot walk, and hence, several walking assistance lower limb exoskeleton robots have been proposed whose assistance abilities are shown to be well customized. However, these robots are not yet fully helpful to all SCI patients for several reasons. To overcome these problems, an exact analysis and evaluation of the restored walking function while the exoskeleton is worn is important. In this work, walking behavior of SCI patients wearing the rehabilitation of brain injuries (ROBIN) lower-limb walking assistant exoskeleton was analyzed in comparison to that of normal unassisted walking. The analysis method and results presented herein can be used by other researchers to improve their robots.

  8. An integrated neuro-robotic interface for stroke rehabilitation using the NASA X1 powered lower limb exoskeleton.

    Science.gov (United States)

    He, Yongtian; Nathan, Kevin; Venkatakrishnan, Anusha; Rovekamp, Roger; Beck, Christopher; Ozdemir, Recep; Francisco, Gerard E; Contreras-Vidal, Jose L

    2014-01-01

    Stroke remains a leading cause of disability, limiting independent ambulation in survivors, and consequently affecting quality of life (QOL). Recent technological advances in neural interfacing with robotic rehabilitation devices are promising in the context of gait rehabilitation. Here, the X1, NASA's powered robotic lower limb exoskeleton, is introduced as a potential diagnostic, assistive, and therapeutic tool for stroke rehabilitation. Additionally, the feasibility of decoding lower limb joint kinematics and kinetics during walking with the X1 from scalp electroencephalographic (EEG) signals--the first step towards the development of a brain-machine interface (BMI) system to the X1 exoskeleton--is demonstrated.

  9. The evidence-base for elevated vacuum in lower limb prosthetics: Literature review and professional feedback.

    Science.gov (United States)

    Gholizadeh, H; Lemaire, E D; Eshraghi, A

    2016-08-01

    An optimal suspension system can improve comfort and quality of life in people with limb loss. To guide practice on prosthetic vacuum suspension systems, assessment of the current evidence and professional opinion are required. PubMed, Web of Science, and Google Scholar databases were explored to find related articles. Search terms were amputees, artificial limb, prosthetic suspension, prosthetic liner, vacuum, and prosthesis. The results were refined by vacuum socket or vacuum assisted suspension or sub-atmospheric suspension. Study design, research instrument, sample size, and outcome measures were reviewed. An online questionnaire was also designed and distributed worldwide among professionals and prosthetists (www.ispoint.org, OANDP-L, LinkedIn, personal email). 26 articles were published from 2001 to March 2016. The number of participants averaged 7 (SD=4) for transtibial and 6 (SD=6) for transfemoral amputees. Most studies evaluated the short-term effects of vacuum systems by measuring stump volume changes, gait parameters, pistoning, interface pressures, satisfaction, balance, and wound healing. 155 professionals replied to the questionnaire and supported results from the literature. Elevated vacuum systems may have some advantages over the other suspension systems, but may not be appropriate for all people with limb loss. Elevated vacuum suspension could improve comfort and quality of life for people with limb loss. However, future investigations with larger sample sizes are needed to provide strong statistical conclusions and to evaluate long-term effects of these systems. Copyright © 2016. Published by Elsevier Ltd.

  10. Adaptive control based on an on-line parameter estimation of an upper limb exoskeleton.

    Science.gov (United States)

    Riani, Akram; Madani, Tarek; Hadri, Abdelhafid El; Benallegue, Abdelaziz

    2017-07-01

    This paper presents an adaptive control strategy for an upper-limb exoskeleton based on an on-line dynamic parameter estimator. The objective is to improve the control performance of this system that plays a critical role in assisting patients for shoulder, elbow and wrist joint movements. In general, the dynamic parameters of the human limb are unknown and differ from a person to another, which degrade the performances of the exoskeleton-human control system. For this reason, the proposed control scheme contains a supplementary loop based on a new efficient on-line estimator of the dynamic parameters. Indeed, the latter is acting upon the parameter adaptation of the controller to ensure the performances of the system in the presence of parameter uncertainties and perturbations. The exoskeleton used in this work is presented and a physical model of the exoskeleton interacting with a 7 Degree of Freedom (DoF) upper limb model is generated using the SimMechanics library of MatLab/Simulink. To illustrate the effectiveness of the proposed approach, an example of passive rehabilitation movements is performed using multi-body dynamic simulation. The aims is to maneuver the exoskeleton that drive the upper limb to track desired trajectories in the case of the passive arm movements.

  11. Frequency upper limbs injuries in the emergency health service in Paranaiba, MS, Brazil

    Directory of Open Access Journals (Sweden)

    Eliane Cristina Coelho de Oliveira Correia

    2012-09-01

    Full Text Available To assess the frequency of upper limb injuries in the only emergency medical service inParanaiba, State of Mato Grosso do Sul. Methods: Retrospective study with data collection from medical recordsof patients assisted with upper limb injuries in “Santa Casa de Misericordia” Hospital, the only hospital in the cityto provide emergency care, in 2008. Variables of interest such as gender and type of injury were collected basedon the International Code of Diseases (ICD 10. Results: There were 314 cases of upper limb injury in 2008and men were the most affected with 211 cases (67.2%. The wrist was the most affected segment with 64 cases(20.4%, followed by the shoulder with 55 cases (17.5% and the hand with 50 cases (15.9%. Interventions andsurgeries involving bone portion were the most frequent - 225 (71.7%, followed by tendon - 19 (6.1% and neural - 16 (5.1%; 35 patients (11.1% underwent multiple operations. Osteosyntheses - 94 (29.9%, fractures- 48 (15.3%, and reduction - 46 (14.6% were the most frequent interventions, followed by 26 dislocations(8.3% and 14 tenorrhaphies (4.5%. Conclusion: The involvement of the upper limbs, especially bone lesions,is frequent. The segments most affected by injuries are men’s wrists and shoulders.

  12. Differential expression of Meis2, Mab21l2 and Tbx3 during limb development associated with diversification of limb morphology in mammals.

    Science.gov (United States)

    Dai, Mengyao; Wang, Yao; Fang, Lu; Irwin, David M; Zhu, Tengteng; Zhang, Junpeng; Zhang, Shuyi; Wang, Zhe

    2014-01-01

    Bats are the only mammals capable of self-powered flight using wings. Differing from mouse or human limbs, four elongated digits within a broad wing membrane support the bat wing, and the foot of the bat has evolved a long calcar that spread the interfemoral membrane. Our recent mRNA sequencing (mRNA-Seq) study found unique expression patterns for genes at the 5' end of the Hoxd gene cluster and for Tbx3 that are associated with digit elongation and wing membrane growth in bats. In this study, we focused on two additional genes, Meis2 and Mab21l2, identified from the mRNA-Seq data. Using whole-mount in situ hybridization (WISH) we validated the mRNA-Seq results for differences in the expression patterns of Meis2 and Mab21l2 between bat and mouse limbs, and further characterize the timing and location of the expression of these two genes. These analyses suggest that Meis2 may function in wing membrane growth and Mab21l2 may have a role in AP and DV axial patterning. In addition, we found that Tbx3 is uniquely expressed in the unique calcar structure found in the bat hindlimb, suggesting a role for this gene in calcar growth and elongation. Moreover, analysis of the coding sequences for Meis2, Mab21l2 and Tbx3 showed that Meis2 and Mab21l2 have high sequence identity, consistent with the functions of genes being conserved, but that Tbx3 showed accelerated evolution in bats. However, evidence for positive selection in Tbx3 was not found, which would suggest that the function of this gene has not been changed. Together, our findings support the hypothesis that the modulation of the spatiotemporal expression patterns of multiple functional conserved genes control limb morphology and drive morphological change in the diversification of mammalian limbs.

  13. Subacute anterior spinal cord ischemia with lower limb monoplegia: a clinical dilemma and challenging scenario.

    LENUS (Irish Health Repository)

    Waters, Peadar S

    2012-12-01

    A 70-year-old woman presented with crescendo right lower limb monoplegia. Magnetic resonance imaging depicted anterior spinal artery syndrome with an 8.5 cm Crawford type II thoracoabdominal aortic aneurysm (TAAA). A staged hybrid procedure was performed, following which she had total exclusion of her TAAA and full resolution of her monoplegia. Clinical presentations of TAAAs can be diverse and require detailed clinical knowledge and lateral thinking to unearth unorthodox presentations. This erratic presentation of a TAAA with anterior spinal artery syndrome outlines particular challenges with management and portrays the need for tailored utilization of contemporary techniques to deal with the growing complexity of TAAAs.

  14. Io with Loki Plume on Bright Limb

    Science.gov (United States)

    1990-01-01

    Voyager 1 image of Io showing active plume of Loki on limb. Heart-shaped feature southeast of Loki consists of fallout deposits from active plume Pele. The images that make up this mosaic were taken from an average distance of approximately 490,000 kilometers (340,000 miles).

  15. Cross-limb Interference during motor learning

    DEFF Research Database (Denmark)

    Lauber, Benedikt; Jensen, Jesper Lundbye; Keller, Martin

    2013-01-01

    It is well known that following skill learning, improvements in motor performance may transfer to the untrained contralateral limb. It is also well known that retention of a newly learned task A can be degraded when learning a competing task B that takes place directly after learning A. Here we...

  16. Limb reconstruction with the Ilizarov method

    NARCIS (Netherlands)

    Oostenbroek, H.J.

    2014-01-01

    In chapter 1, the background and origins of this study are explained. The aims of the study are defined. In chapter 2, an analysis of the complications rate of limb reconstruction in a cohort of 37 consecutive growing children was done. Several patient and deformity factors were investigated by

  17. Diagnosis and treatment of upper limb apraxia.

    Science.gov (United States)

    Dovern, A; Fink, G R; Weiss, P H

    2012-07-01

    Upper limb apraxia, a disorder of higher motor cognition, is a common consequence of left-hemispheric stroke. Contrary to common assumption, apraxic deficits not only manifest themselves during clinical testing but also have delirious effects on the patients' everyday life and rehabilitation. Thus, a reliable diagnosis and efficient treatment of upper limb apraxia is important to improve the patients' prognosis after stroke. Nevertheless, to date, upper limb apraxia is still an underdiagnosed and ill-treated entity. Based on a systematic literature search, this review summarizes the current tools of diagnosis and treatment strategies for upper limb apraxia. It furthermore provides clinicians with graded recommendations. In particular, a short screening test for apraxia, and a more comprehensive diagnostic apraxia test for clinical use are recommended. Although currently only a few randomized controlled studies investigate the efficacy of different apraxia treatments, the gesture training suggested by Smania and colleagues can be recommended for the therapy of apraxia, the effects of which were shown to extend to activities of daily living and to persist for at least 2 months after completion of the training. This review aims at directing the reader's attention to the ecological relevance of apraxia. Moreover, it provides clinicians with appropriate tools for the reliable diagnosis and effective treatment of apraxia. Nevertheless, this review also highlights the need for further research into how to improve diagnosis of apraxia based on neuropsychological models and to develop new therapeutic strategies.

  18. Risk factors in limb reduction defects.

    Science.gov (United States)

    Stoll, C; Alembik, Y; Dott, B; Roth, M P

    1992-07-01

    Risk factors were studied in 123 children with limb reduction defects (LRD) from 118,265 consecutive births of known outcome during the period from 1979 to 1987 in the area which is covered by our registry of congenital malformations. For each case a control was studied. The LRD was localised and classified according to the EUROCAT guide for the description and classification of limb defects. The prevalence of LRD was 1.04 per thousand: 82.9% of the babies were liveborn, 13.0% were late spontaneous abortion or stillborn and termination was performed in 4.0% of the cases. The proportion of males was 0.55. The most common malformations in the 51.2% of children who had at least one other anomaly than LRD were associated cardiac, digestive and renal anomalies. The pregnancy with limb anomalies was more often complicated by oligohydramnios, polyhydramnios and threatened abortion but there were no differences in parental characteristics. However, 9.7% of marriages were consanguineous (P less than 0.01) and the incidence of LRD in first-degree relatives of the children with LRD was high. First-degree relatives also had more non-limb malformations than did those of controls.

  19. Limb body wall complex: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Panduranga Chikkannaiah

    2013-01-01

    Full Text Available We present autopsy findings of a case of limb body wall complex (LBWC. The fetus had encephalocele, genitourinary agenesis, skeletal anomalies and body wall defects. The rare finding in our case is the occurrence of both cranial and urogenital anomalies. The presence of complex anomalies in this fetus, supports embryonal dysplasia theory of pathogenesis for LBWC.

  20. Inducible limb-shaking transitory ischemic attacks

    DEFF Research Database (Denmark)

    Rosenbaum, Sverre; Ovesen, Christian; Futrell, Nancy

    2016-01-01

    with exercise-induced weakness associated with tremor in his right arm. His left internal carotid artery was occluded at the bifurcation. Administration of statin and antiplatelet did not relieve his symptoms, and his stereotypic, exercise-induced "limb-shaking" episodes persisted. He underwent successful...

  1. Radiographic anatomy of developing canine pectoral limb

    International Nuclear Information System (INIS)

    Charjan, R.Y.; Bhamburkar, V.R.; Dalvi, R.S.; Banubakode, S.B.

    2006-01-01

    Age period for the appearance of the ossification centre that appear after birth in the limb bones of the dog were determined by radiography, at set intervals in 3 German Shepherd, Pomeranian and Non-descript. The ossification centres appeared in the same chronological order, but the ages at which they appear, showed variation

  2. Neurofibromatosis with unilateral lower limb gigantism.

    Science.gov (United States)

    Sabbioni, Giacomo; Rani, Nicola; Devescovi, Valentina

    2010-05-01

    The case of a 3-year-old child diagnosed with Type 1 neurofibromatosis is presented, showing pigmented birthmarks and gigantism of the left lower limb associated with the presence of multiple neurofibromas. Increased bone growth appears to be the direct or indirect consequence of a still undefined paracrine effect of nerve tumor cells.

  3. Infantile lipofibromatosis of the upper limb

    Energy Technology Data Exchange (ETDEWEB)

    Teo, Harvey E.L.; Peh, Wilfred C.G. [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Chan, Mei-Yoke [KK Women' s and Children' s Hospital, Department of Paediatric Medicine, Singapore (Singapore); Walford, Norman [Tan Tock Seng Hospital, Department of Pathology, Singapore (Singapore)

    2005-12-01

    The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. Magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period. (orig.)

  4. Deep brain stimulation for phantom limb pain.

    Science.gov (United States)

    Bittar, Richard G; Otero, Sofia; Carter, Helen; Aziz, Tipu Z

    2005-05-01

    Phantom limb pain is an often severe and debilitating phenomenon that has been reported in up to 85% of amputees. Its pathophysiology is poorly understood. Peripheral and spinal mechanisms are thought to play a role in pain modulation in affected individuals; however central mechanisms are also likely to be of importance. The neuromatrix theory postulates a genetically determined representation of body image, which is modified by sensory input to create a neurosignature. Persistence of the neurosignature may be responsible for painless phantom limb sensations, whereas phantom limb pain may be due to abnormal reorganisation within the neuromatrix. This study assessed the clinical outcome of deep brain stimulation of the periventricular grey matter and somatosensory thalamus for the relief of chronic neuropathic pain associated with phantom limb in three patients. These patients were assessed preoperatively and at 3 month intervals postoperatively. Self-rated visual analogue scale pain scores assessed pain intensity, and the McGill Pain Questionnaire assessed the quality of the pain. Quality of life was assessed using the EUROQOL EQ-5D scale. Periventricular gray stimulation alone was optimal in two patients, whilst a combination of periventricular gray and thalamic stimulation produced the greatest degree of relief in one patient. At follow-up (mean 13.3 months) the intensity of pain was reduced by 62% (range 55-70%). In all three patients, the burning component of the pain was completely alleviated. Opiate intake was reduced in the two patients requiring morphine sulphate pre-operatively. Quality of life measures indicated a statistically significant improvement. This data supports the role for deep brain stimulation in patients with phantom limb pain. The medical literature relating to the epidemiology, pathogenesis, and treatment of this clinical entity is reviewed in detail.

  5. Genetic Regulation of Embryological Limb Development with Relation to Congenital Limb Deformity in Humans

    OpenAIRE

    Barham, Guy; Clarke, Nicholas M. P.

    2008-01-01

    Over the last 15 years, great improvements in genetic engineering and genetic manipulation strategies have led to significant advances in the understanding of the genetics governing embryological limb development. This field of science continues to develop, and the complex genetic interactions and signalling pathways are still not fully understood. In this review we will discuss the roles of the principle genes involved in the three-dimensional patterning of the developing limb and will discu...

  6. Internal models of limb dynamics and the encoding of limb state

    Science.gov (United States)

    Hwang, Eun Jung; Shadmehr, Reza

    2005-09-01

    Studies of reaching suggest that humans adapt to novel arm dynamics by building internal models that transform planned sensory states of the limb, e.g., desired limb position and its derivatives, into motor commands, e.g., joint torques. Earlier work modeled this computation via a population of basis elements and used system identification techniques to estimate the tuning properties of the bases from the patterns of generalization. Here we hypothesized that the neural representation of planned sensory states in the internal model might resemble the signals from the peripheral sensors. These sensors normally encode the limb's actual sensory state in which movement errors occurred. We developed a set of equations based on properties of muscle spindles that estimated spindle discharge as a function of the limb's state during reaching and drawing of circles. We then implemented a simulation of a two-link arm that learned to move in various force fields using these spindle-like bases. The system produced a pattern of adaptation and generalization that accounted for a wide range of previously reported behavioral results. In particular, the bases showed gain-field interactions between encoding of limb position and velocity, very similar to the gain fields inferred from behavioral studies. The poor sensitivity of the bases to limb acceleration predicted behavioral results that were confirmed by experiment. We suggest that the internal model of limb dynamics is computed by the brain with neurons that encode the state of the limb in a manner similar to that expected of muscle spindle afferents.

  7. The benefit of limb cloud imaging for infrared limb sounding of tropospheric trace gases

    Directory of Open Access Journals (Sweden)

    G. Heinemann

    2009-06-01

    Full Text Available Advances in detector technology enable a new generation of infrared limb sounders to measure 2-D images of the atmosphere. A proposed limb cloud imager (LCI mode will detect clouds with a spatial resolution unprecedented for limb sounding. For the inference of temperature and trace gas distributions, detector pixels of the LCI have to be combined into super-pixels which provide the required signal-to-noise and information content for the retrievals. This study examines the extent to which tropospheric coverage can be improved in comparison to limb sounding using a fixed field of view with the size of the super-pixels, as in conventional limb sounders. The study is based on cloud topographies derived from (a IR brightness temperatures (BT of geostationary weather satellites in conjunction with ECMWF temperature profiles and (b ice and liquid water content data of the Consortium for Small-scale Modeling-Europe (COSMO-EU of the German Weather Service. Limb cloud images are simulated by matching the cloud topography with the limb sounding line of sight (LOS. The analysis of the BT data shows that the reduction of the spatial sampling along the track has hardly any effect on the gain in information. The comparison between BT and COSMO-EU data identifies the strength of both data sets, which are the representation of the horizontal cloud extent for the BT data and the reproduction of the cloud amount for the COSMO-EU data. The results of the analysis of both data sets show the great advantage of the cloud imager. However, because both cloud data sets do not present the complete fine structure of the real cloud fields in the atmosphere it is assumed that the results tend to underestimate the increase in information. In conclusion, real measurements by such an instrument may result in an even higher benefit for tropospheric limb retrievals.

  8. Upper limb fractures in rugby in Huddersfield 1986-1990.

    OpenAIRE

    Eyres, K S; Abdel-Salam, A; Cleary, J

    1991-01-01

    Most injuries sustained by rugby players affect the soft tissues, and fracture is relatively uncommon. Whereas the lower limb is most affected in footballers, the upper limb tends to be injured in rugby players. Thirty consecutive fractures and ten dislocations affecting the upper limb, sustained by 35 rugby players, are reported.

  9. The axolotl limb blastema: cellular and molecular mechanisms driving blastema formation and limb regeneration in tetrapods

    Science.gov (United States)

    McCusker, Catherine; Bryant, Susan V.

    2015-01-01

    Abstract The axolotl is one of the few tetrapods that are capable of regenerating complicated biological structures, such as complete limbs, throughout adulthood. Upon injury the axolotl generates a population of regeneration‐competent limb progenitor cells known as the blastema, which will grow, establish pattern, and differentiate into the missing limb structures. In this review we focus on the crucial early events that occur during wound healing, the neural−epithelial interactions that drive the formation of the early blastema, and how these mechanisms differ from those of other species that have restricted regenerative potential, such as humans. We also discuss how the presence of cells from the different axes of the limb is required for the continued growth and establishment of pattern in the blastema as described in the polar coordinate model, and how this positional information is reprogrammed in blastema cells during regeneration. Multiple cell types from the mature limb stump contribute to the blastema at different stages of regeneration, and we discuss the contribution of these types to the regenerate with reference to whether they are “pattern‐forming” or “pattern‐following” cells. Lastly, we explain how an engineering approach will help resolve unanswered questions in limb regeneration, with the goal of translating these concepts to developing better human regenerative therapies. PMID:27499868

  10. Benefit of revascularisation to critical limb ischaemia patients evaluated by a patient-oriented scoring system.

    Science.gov (United States)

    Chisci, E; Perulli, A; Iacoponi, F; Setacci, F; de Donato, G; Palasciano, G; Cappelli, A; Setacci, C

    2012-05-01

    The concept of patency and limb salvage are physician-oriented endpoints in critical limb ischaemia (CLI). These endpoints have failed to enhance function after revascularisation. The aim of this study was to create a scoring system to predict 1-year functional status and to assess the benefit to patients possible by revascularisation. During the period 2007-2009, 480 consecutive patients (mean age ± SD, 83.2 ± 8.7 years) underwent repair for CLI. Preoperative, operative and functional status characteristics and post-operative outcomes were recorded. The following patient-oriented outcomes were investigated pre- and postoperatively: basic and instrumental activities of daily living (BADL and IADL) and ambulatory and living status. Statistical analysis was performed to assess predictors of functional benefit from revascularisation. The variables significant on multivariable analysis were used to generate a scoring system to pre and postoperatively grade individual patient risk of losing baseline functional status at 1 year (CLI functional score). Ninety-three of 480 patients (19.3%) were in Rutherford class IV, 208 (43.3%) in class V and 179 (37.4%) in class VI. Surgical, endovascular and hybrid operations were performed in 108 (22.5%), 319 (66.5%) and 53 (11%) patients, respectively; mean follow-up was 408 ± 363 days. Improved or unchanged functional status was observed in 276 patients (57.5%). Preoperative mean ± SD BADL and IADL (4.26 ± 1.98 and 3.92 ± 2.69, respectively) were modified from mean values at 1-year follow-up (4.19 ± 2.06 and 4.12 ± 3, respectively) (p = 0.401 and p 80% indicates that patients are likely to lose functional abilities and require assistance for ambulation or ADL, as well as risking outcomes such as major amputation, new CLI-related hospitalisation or re-operation (p 2 cm, infection and poor tibial runoff), American Society of Anesthesiologists (ASA) score > II, previous cerebrovascular event and heart

  11. International assistance. Licensing assistance project

    International Nuclear Information System (INIS)

    Aleev, A.

    1999-01-01

    Description of licensing assistance project for VATESI is presented. In licensing of unit No.1 of INPP VATESI is supported by many western countries. Experts from regulatory bodies or scientific organizations of those countries assist VATESI staff in reviewing documentation presented by INPP. Among bilateral cooperation support is provided by European Commission through Phare programme

  12. Sall4-Gli3 system in early limb progenitors is essential for the development of limb skeletal elements

    OpenAIRE

    Akiyama, Ryutaro; Kawakami, Hiroko; Wong, Julia; Oishi, Isao; Nishinakamura, Ryuichi; Kawakami, Yasuhiko

    2015-01-01

    The limb skeletal elements that have unique morphology and distinct locations are developed from limb progenitors, derived from the lateral plate mesoderm. These skeletal elements arise during limb development. In this study, we show genetic evidence that function of Sall4 is essential prior to limb outgrowth for development of the anterior-proximal skeletal elements. Furthermore, genetic interaction between Sall4 and Gli3 is upstream of establishing Shh (Sonic hedgehog) expression, and there...

  13. Comparing pervaporation and vapor permeation hybrid distillation processes

    NARCIS (Netherlands)

    Fontalvo, J.; Cuellar, P.; Timmer, J.M.K.; Vorstman, M.A.G.; Wijers, J.G.; Keurentjes, J.T.F.

    2005-01-01

    Previous studies have shown that hybrid distillation processes using either pervaporation or vapor permeation can be very attractive for the separation of mixtures. In this paper, a comparison between these two hybrid processes has been made. A tool has been presented that can assist designers and

  14. A Force-Feedback Exoskeleton for Upper-Limb Rehabilitation in Virtual Reality

    Directory of Open Access Journals (Sweden)

    Antonio Frisoli

    2009-01-01

    Full Text Available This paper presents the design and the clinical validation of an upper-limb force-feedback exoskeleton, the L-EXOS, for robotic-assisted rehabilitation in virtual reality (VR. The L-EXOS is a five degrees of freedom exoskeleton with a wearable structure and anthropomorphic workspace that can cover the full range of motion of human arm. A specific VR application focused on the reaching task was developed and evaluated on a group of eight post-stroke patients, to assess the efficacy of the system for the rehabilitation of upper limb. The evaluation showed a significant reduction of the performance error in the reaching task (paired t-test, p < 0.02

  15. Hybrid Qualifications

    DEFF Research Database (Denmark)

    Against the background of increasing qualification needs there is a growing awareness of the challenge to widen participation in processes of skill formation and competence development. At the same time, the issue of permeability between vocational education and training (VET) and general education...... has turned out as a major focus of European education and training policies and certainly is a crucial principle underlying the European Qualifications Framework (EQF). In this context, «hybrid qualifications» (HQ) may be seen as an interesting approach to tackle these challenges as they serve «two...

  16. Hybrid Gear

    Science.gov (United States)

    Handschuh, Robert F. (Inventor); Roberts, Gary D. (Inventor)

    2016-01-01

    A hybrid gear consisting of metallic outer rim with gear teeth and metallic hub in combination with a composite lay up between the shaft interface (hub) and gear tooth rim is described. The composite lay-up lightens the gear member while having similar torque carrying capability and it attenuates the impact loading driven noise/vibration that is typical in gear systems. The gear has the same operational capability with respect to shaft speed, torque, and temperature as an all-metallic gear as used in aerospace gear design.

  17. Upper limb therapy in children with cerebral palsy (CP – The Pirate Group

    Directory of Open Access Journals (Sweden)

    Pawlak Marta

    2017-12-01

    Full Text Available Introduction: Children with cerebral palsy (CP in the form of spastic hemiplegia experience numerous difficulties concerning an affected upper limb such as reaching for objects, gripping or manipulating them. These limitations affect their everyday activity. Conducting an effective and simultaneously an interesting therapy aimed at meeting the child’s individual needs and improving upper limb function is a challenge for a physiotherapist. The aim of the study was to assess the effectiveness of upper limb therapy carried out within the project titled “The Pirate Group” based on Constraint-Induced Movement Therapy (CIMT and Bimanual Training (BIT conducted in a specially arranged environment. Material and methods: The research included 16 children with CP in the form of spastic hemiplegia. Mean age of the study participants was 4.23 years. The children underwent a two-week Constraint-Induced Movement Therapy (CIMT combined with Bimanual Training (BIT. In order to evaluate the effects of the therapy, each child underwent the Assisting Hand Assessment (AHA prior to the therapy and after its completion. Results: Statistical analysis revealed a significant difference (p<0.05 between the results of AHA prior to and after the therapy (t(14=9.12, p<0.0001. An improvement in the affected upper limb function was noted in all the children participating in the research. Conclusions: The project titled “The Pirate Group”, based on CIMT and BIT is an effective therapeutic intervention which improves spontaneous activity of the affected upper limb in children with hemiplegia.

  18. Design of a biologically inspired lower limb exoskeleton for human gait rehabilitation.

    Science.gov (United States)

    Lyu, Mingxing; Chen, Weihai; Ding, Xilun; Wang, Jianhua; Bai, Shaoping; Ren, Huichao

    2016-10-01

    This paper proposes a novel bionic model of the human leg according to the theory of physiology. Based on this model, we present a biologically inspired 3-degree of freedom (DOF) lower limb exoskeleton for human gait rehabilitation, showing that the lower limb exoskeleton is fully compatible with the human knee joint. The exoskeleton has a hybrid serial-parallel kinematic structure consisting of a 1-DOF hip joint module and a 2-DOF knee joint module in the sagittal plane. A planar 2-DOF parallel mechanism is introduced in the design to fully accommodate the motion of the human knee joint, which features not only rotation but also relative sliding. Therefore, the design is consistent with the requirements of bionics. The forward and inverse kinematic analysis is studied and the workspace of the exoskeleton is analyzed. The structural parameters are optimized to obtain a larger workspace. The results using MATLAB-ADAMS co-simulation are shown in this paper to demonstrate the feasibility of our design. A prototype of the exoskeleton is also developed and an experiment performed to verify the kinematic analysis. Compared with existing lower limb exoskeletons, the designed mechanism has a large workspace, while allowing knee joint rotation and small amount of sliding.

  19. Design of a biologically inspired lower limb exoskeleton for human gait rehabilitation

    Science.gov (United States)

    Lyu, Mingxing; Chen, Weihai; Ding, Xilun; Wang, Jianhua; Bai, Shaoping; Ren, Huichao

    2016-10-01

    This paper proposes a novel bionic model of the human leg according to the theory of physiology. Based on this model, we present a biologically inspired 3-degree of freedom (DOF) lower limb exoskeleton for human gait rehabilitation, showing that the lower limb exoskeleton is fully compatible with the human knee joint. The exoskeleton has a hybrid serial-parallel kinematic structure consisting of a 1-DOF hip joint module and a 2-DOF knee joint module in the sagittal plane. A planar 2-DOF parallel mechanism is introduced in the design to fully accommodate the motion of the human knee joint, which features not only rotation but also relative sliding. Therefore, the design is consistent with the requirements of bionics. The forward and inverse kinematic analysis is studied and the workspace of the exoskeleton is analyzed. The structural parameters are optimized to obtain a larger workspace. The results using MATLAB-ADAMS co-simulation are shown in this paper to demonstrate the feasibility of our design. A prototype of the exoskeleton is also developed and an experiment performed to verify the kinematic analysis. Compared with existing lower limb exoskeletons, the designed mechanism has a large workspace, while allowing knee joint rotation and small amount of sliding.

  20. Movement patterns of limb coordination in infant rolling.

    Science.gov (United States)

    Kobayashi, Yoshio; Watanabe, Hama; Taga, Gentaro

    2016-12-01

    Infants must perform dynamic whole-body movements to initiate rolling, a key motor skill. However, little is known regarding limb coordination and postural control in infant rolling. To address this lack of knowledge, we examined movement patterns and limb coordination during rolling in younger infants (aged 5-7 months) that had just begun to roll and in older infants (aged 8-10 months) with greater rolling experience. Due to anticipated difficulty in obtaining measurements over the second half of the rolling sequence, we limited our analysis to the first half. Ipsilateral and contralateral limbs were identified on the basis of rolling direction and were classified as either a stationary limb used for postural stability or a moving limb used for controlled movement. We classified the observed movement patterns by identifying the number of stationary limbs and the serial order of combinational limb movement patterns. Notably, older infants performed more movement patterns that involved a lower number of stationary limbs than younger infants. Despite the wide range of possible movement patterns, a small group of basic patterns dominated in both age groups. Our results suggest that the fundamental structure of limb coordination during rolling in the early acquisition stages remains unchanged until at least 8-10 months of age. However, compared to younger infants, older infants exhibited a greater ability to select an effective rotational movement by positioning themselves with fewer stationary limbs and performing faster limb movements.

  1. Lethal neonatal short-limbed dwarfism

    International Nuclear Information System (INIS)

    Kim, Ok Hwa; Yim, Chung Ik; Bahk, Yong Whee

    1986-01-01

    We have detailed our experiences on 6 cases of neonatal lethal short-limbed dwarfism and reviewed the articles. They include, achondrogenesis, thanatophoric dysplasia, asphyxiating thoracic dysplasia, osteogenesis imperfect a congenita, and hypophosphatasia lethals. Five babies were born alive but died soon after birth and one was a stillbirth. The main cause of failure to thrive was respiratory insufficiency. Each case was having quite characteristic radiologic findings, even if the general appearances were similar to the achondroplasts clinically. Precise diagnosis is very important for genetic counselling of the parents and alarm to them the possibility of bone dysplasias to the next offsprings. For this purpose, the radiologists play major role for the correct diagnosis. We stress that when the baby is born with short-limbed dwarfism, whole body radiogram should be taken including lateral view and postmortem radiogram is also very precious.

  2. Lethal neonatal short-limbed dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Yim, Chung Ik; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

    1986-02-15

    We have detailed our experiences on 6 cases of neonatal lethal short-limbed dwarfism and reviewed the articles. They include, achondrogenesis, thanatophoric dysplasia, asphyxiating thoracic dysplasia, osteogenesis imperfect a congenita, and hypophosphatasia lethals. Five babies were born alive but died soon after birth and one was a stillbirth. The main cause of failure to thrive was respiratory insufficiency. Each case was having quite characteristic radiologic findings, even if the general appearances were similar to the achondroplasts clinically. Precise diagnosis is very important for genetic counselling of the parents and alarm to them the possibility of bone dysplasias to the next offsprings. For this purpose, the radiologists play major role for the correct diagnosis. We stress that when the baby is born with short-limbed dwarfism, whole body radiogram should be taken including lateral view and postmortem radiogram is also very precious.

  3. Emulating Upper Limb Disorder for Therapy Education

    Directory of Open Access Journals (Sweden)

    Noor Ayuni binti Che Zakaria

    2014-11-01

    Full Text Available Robotics not only contributes to the invention of rehabilitation devices, it can also enhance the quality of medical education. In recent years, the use of patient simulators and part-task trainers in the medical education field has brought meaningful improvements in the training of medical practitioners. Nevertheless, in the context of therapy training for upper limb disorders, trainee therapists still have to engage directly with the patients to gain experience of the rehabilitation of physical diseases. In this work, a high-fidelity part-task trainer that is able to reproduce the stiffness of spasticity and rigidity symptoms of the upper limb, such as those observed in post-stroke patients and Parkinson's disease patients, has been developed. Based on the evaluation carried out by two experienced therapists, the developed part-task trainer is able to simulate different patient cases and help trainee therapists gain pre-clinical experience in a safe and intuitive learning environment.

  4. Lower limb vascular dysfunction in cyclists

    Directory of Open Access Journals (Sweden)

    Thiago Ayala Melo Di Alencar

    2013-06-01

    Full Text Available Sports-related vascular insufficiency affecting the lower limbs is uncommon, and early signs and symptoms can be confused with musculoskeletal injuries. This is also the case among professional cyclists, who are always at the threshold between endurance and excess training. The aim of this review was to analyze the occurrence of vascular disorders in the lower limbs of cyclists and to discuss possible etiologies. Eighty-five texts, including papers and books, published from 1950 to 2012, were used. According to the literature reviewed, some cyclists receive a late diagnosis of vascular dysfunction due to a lack of familiarity of the medical team with this type of dysfunction. Data revealed that a reduced blood flow in the external iliac artery, especially on the left, is much more common than in the femoral and popliteal arteries, and that vascular impairment is responsible for the occurrence of early fatigue and reduced performance in cycling.

  5. Right lower limb apraxia in a patient with left supplementary motor area infarction: intactness of the corticospinal tract confirmed by transcranial magnetic stimulation

    Directory of Open Access Journals (Sweden)

    Min Cheol Chang

    2015-01-01

    Full Text Available We reported a 50-year-old female patient with left supplementary motor area infarction who presented right lower limb apraxia and investigated the possible causes using transcranial magnetic stimulation. The patient was able to walk and climb stairs spontaneously without any assistance at 3 weeks after onset. However, she was unable to intentionally move her right lower limb although she understood what she supposed to do. The motor evoked potential evoked by transcranial magnetic stimulation from the right lower limb was within the normal range, indicating that the corticospinal tract innervating the right lower limb was uninjured. Thus, we thought that her motor dysfunction was not induced by motor weakness, and confirmed her symptoms as apraxia. In addition, these results also suggest that transcranial magnetic stimulation is helpful for diagnosing apraxia.

  6. Endovascular Management of Acute Limb Ischemia.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2011-09-14

    Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the contemporary endovascular management of ALI encompassing pharmacologic and percutaneous interventional treatment strategies.

  7. PSYCHIATRIC EVALUATION OF LIMB FRACTURE PATIENTS

    OpenAIRE

    CHAUDHURY, S; JOHN, TR; KUMAR, A; SINGH, HARCHARAN

    2002-01-01

    The study included 70 consecutive patients with fracture of the lower and upper limbs each and an equal number of age and sex matched normal control subjects. All the subjects were screened using the General Health Questionnaire (GHQ), the Michigan Alcoholism Screening Test (MAST), Carroll Rating Scale for Depression (CRSD), State-Trait Anxiety Inventory (STAI), Impact of Events Scale (IES), Fatigue Scale (FS) and the Perceived Stress Questionnaire (PSQ). Probable “Psychiatric cases” identifi...

  8. External Fuel Tank, Clouds and Earth Limb

    Science.gov (United States)

    1991-01-01

    It's fuel consumed, the expendable external fuel tank was jettisoned moments earlier from the Space Shuttle Atlantis and now begins its plunge back to Earth (20.5N, 36.0W). Backdropped against the void of space and the thin blue line of the Earth's airglow above the Earth Limb, the harshness of the blackness of space is softened by the fleeciness of Earth's cloud cover below.

  9. [The esthetics of lower limb prosthesis].

    Science.gov (United States)

    Gardrat, Franck

    2015-01-01

    The amputation, which is upper or lower limb, entails important consequences and often traumatic into subject amputee from a physical, psychological, interpersonal and social point of view. It acts on the body image unleashing different psychological disorders and alterations in the social and professional reality. The aesthetic prosthesis can be considered a good support to help the person regain a new body image of themselves, facilitating the process of physical rehabilitation and social integration.

  10. PTSD in Limb Trauma and Recovery

    Science.gov (United States)

    2012-10-01

    of Biomechanics 2012. ANNUAL REPORT 10/16/2012 VIRTUAL REALITY AND MOTION ANALYSIS TO CHARACTERIZE DISABILITIES IN LOWER LIMB INJURY PI...environments, and involves navigating various objects and agents such as other pedestrians, stairs , and moving cars. This necessitates adaptation of...D’Andrea, Brown University. Computer Navigation as an Investigational Tool for ACL Reconstruction. 36th Annual American Society of Biomechanics Meeting

  11. Intuitionistic hybrid logic

    DEFF Research Database (Denmark)

    Braüner, Torben

    2011-01-01

    Intuitionistic hybrid logic is hybrid modal logic over an intuitionistic logic basis instead of a classical logical basis. In this short paper we introduce intuitionistic hybrid logic and we give a survey of work in the area.......Intuitionistic hybrid logic is hybrid modal logic over an intuitionistic logic basis instead of a classical logical basis. In this short paper we introduce intuitionistic hybrid logic and we give a survey of work in the area....

  12. Limb Lengthening in Patients with Achondroplasia.

    Science.gov (United States)

    Park, Kwang-Won; Garcia, Rey-an Niño; Rejuso, Chastity Amor; Choi, Jung-Woo; Song, Hae-Ryong

    2015-11-01

    Although bilateral lower-limb lengthening has been performed on patients with achondroplasia, the outcomes for the tibia and femur in terms of radiographic parameters, clinical results, and complications have not been compared with each other. We proposed 1) to compare the radiological outcomes of femoral and tibial lengthening and 2) to investigate the differences of complications related to lengthening. We retrospectively reviewed 28 patients (average age, 14 years 4 months) with achondroplasia who underwent bilateral limb lengthening between 2004 and 2012. All patients first underwent bilateral tibial lengthening, and at 9-48 months (average, 17.8 months) after this procedure, bilateral femoral lengthening was performed. We analyzed the pixel value ratio (PVR) and characteristics of the callus of the lengthened area on serial radiographs. The external fixation index (EFI) and healing index (HI) were computed to compare tibial and femoral lengthening. The complications related to lengthening were assessed. The average gain in length was 8.4 cm for the femur and 9.8 cm for the tibia. The PVR, EFI, and HI of the tibia were significantly better than those of the femur. Fewer complications were found during the lengthening of the tibia than during the lengthening of the femur. Tibial lengthening had a significantly lower complication rate and a higher callus formation rate than femoral lengthening. Our findings suggest that bilateral limb lengthening (tibia, followed by femur) remains a reasonable option; however, we should be more cautious when performing femoral lengthening in selected patients.

  13. Sports activities after lower limb osteotomy.

    Science.gov (United States)

    Gougoulias, Nikolaos; Khanna, Anil; Maffulli, Nicola

    2009-01-01

    Active sports participation can be important in some patients with degenerative joint disease in the lower limb. We investigated whether this is possible after an osteotomy for osteoarthritis of the hip, knee and ankle joints. We performed a literature search using Medline, Cochrane, CINAHL and Google Scholar with no restriction to time period or language using the keywords: 'osteotomy and sports'. Eleven studies (all level IV evidence) satisfied our inclusion and exclusion criteria. Nine reported on high tibial osteotomies, one on periacetabular osteotomies and one on distal tibial osteotomies. The Coleman Methodology Score to assess the quality of studies showed much heterogeneity in terms of study design, patient characteristics, management methods and outcome assessment. Participation in recreational sports is possible in most patients who were active in sports before lower limb osteotomy. In no study were patients able to participate in competitive sports. Intensive participation in sports after osteotomy may adversely affect outcome and lead to failures requiring re-operation. Patients may be able to remain active in selected sports activities after a lower limb osteotomy for osteoarthritis. More rapid progression of arthritis is however a possibility. Prospective comparative studies investigating activities and sports participation in age-matched patients undergoing osteotomy or joint replacement could lead to useful conclusions. Increased activity and active sports participation may lead to progression of arthritis and earlier failure requiring additional surgery.

  14. Static stiffness modeling of a novel hybrid redundant robot machine

    International Nuclear Information System (INIS)

    Li Ming; Wu Huapeng; Handroos, Heikki

    2011-01-01

    This paper presents a modeling method to study the stiffness of a hybrid serial-parallel robot IWR (Intersector Welding Robot) for the assembly of ITER vacuum vessel. The stiffness matrix of the basic element in the robot is evaluated using matrix structural analysis (MSA); the stiffness of the parallel mechanism is investigated by taking account of the deformations of both hydraulic limbs and joints; the stiffness of the whole integrated robot is evaluated by employing the virtual joint method and the principle of virtual work. The obtained stiffness model of the hybrid robot is analytical and the deformation results of the robot workspace under certain external load are presented.

  15. Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

    Science.gov (United States)

    Resnik, Linda; Meucci, Marissa R; Lieberman-Klinger, Shana; Fantini, Christopher; Kelty, Debra L; Disla, Roxanne; Sasson, Nicole

    2012-04-01

    The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. Is Atherectomy the Best First-Line Therapy for Limb Salvage in Patients With Critical Limb Ischemia?

    Science.gov (United States)

    Loor, Gabriel; Skelly, Christopher L.; Wahlgren, Carl-Magnus; Bassiouny, Hisham S.; Piano, Giancarlo; Shaalan, Wael

    2010-01-01

    Objective To determine the efficacy of atherectomy for limb salvage compared with open bypass in patients with critical limb ischemia. Methods Ninety-nine consecutive bypass and atherectomy procedures performed for critical limb ischemia between January 2003 and October 2006 were reviewed. Results A total of 99 cases involving TASC C (n = 43, 44%) and D (n = 56, 56%) lesions were treated with surgical bypass in 59 patients and atherectomy in 33 patients. Bypass and atherectomy achieved similar 1-year primary patency (64% vs 63%; P = .2). However, the 1-year limb salvage rate was greater in the bypass group (87% vs 69%; P = .004). In the tissue loss subgroup, there was a greater limb salvage rate for bypass patients versus atherectomy (79% vs 60%; P = .04). Conclusions Patients with critical limb ischemia may do better with open bypass compared with atherectomy as first-line therapy for limb salvage. PMID:19640919

  17. Performance Evaluation Methods for Assistive Robotic Technology

    Science.gov (United States)

    Tsui, Katherine M.; Feil-Seifer, David J.; Matarić, Maja J.; Yanco, Holly A.

    Robots have been developed for several assistive technology domains, including intervention for Autism Spectrum Disorders, eldercare, and post-stroke rehabilitation. Assistive robots have also been used to promote independent living through the use of devices such as intelligent wheelchairs, assistive robotic arms, and external limb prostheses. Work in the broad field of assistive robotic technology can be divided into two major research phases: technology development, in which new devices, software, and interfaces are created; and clinical, in which assistive technology is applied to a given end-user population. Moving from technology development towards clinical applications is a significant challenge. Developing performance metrics for assistive robots poses a related set of challenges. In this paper, we survey several areas of assistive robotic technology in order to derive and demonstrate domain-specific means for evaluating the performance of such systems. We also present two case studies of applied performance measures and a discussion regarding the ubiquity of functional performance measures across the sampled domains. Finally, we present guidelines for incorporating human performance metrics into end-user evaluations of assistive robotic technologies.

  18. De novo transcriptome sequencing of axolotl blastema for identification of differentially expressed genes during limb regeneration

    Science.gov (United States)

    2013-01-01

    Background Salamanders are unique among vertebrates in their ability to completely regenerate amputated limbs through the mediation of blastema cells located at the stump ends. This regeneration is nerve-dependent because blastema formation and regeneration does not occur after limb denervation. To obtain the genomic information of blastema tissues, de novo transcriptomes from both blastema tissues and denervated stump ends of Ambystoma mexicanum (axolotls) 14 days post-amputation were sequenced and compared using Solexa DNA sequencing. Results The sequencing done for this study produced 40,688,892 reads that were assembled into 307,345 transcribed sequences. The N50 of transcribed sequence length was 562 bases. A similarity search with known proteins identified 39,200 different genes to be expressed during limb regeneration with a cut-off E-value exceeding 10-5. We annotated assembled sequences by using gene descriptions, gene ontology, and clusters of orthologous group terms. Targeted searches using these annotations showed that the majority of the genes were in the categories of essential metabolic pathways, transcription factors and conserved signaling pathways, and novel candidate genes for regenerative processes. We discovered and confirmed numerous sequences of the candidate genes by using quantitative polymerase chain reaction and in situ hybridization. Conclusion The results of this study demonstrate that de novo transcriptome sequencing allows gene expression analysis in a species lacking genome information and provides the most comprehensive mRNA sequence resources for axolotls. The characterization of the axolotl transcriptome can help elucidate the molecular mechanisms underlying blastema formation during limb regeneration. PMID:23815514

  19. A prosthesis-specific multi-link segment model of lower-limb amputee sprinting.

    Science.gov (United States)

    Rigney, Stacey M; Simmons, Anne; Kark, Lauren

    2016-10-03

    Lower-limb amputees commonly utilize non-articulating energy storage and return (ESAR) prostheses for high impact activities such as sprinting. Despite these prostheses lacking an articulating ankle joint, amputee gait analysis conventionally features a two-link segment model of the prosthetic foot. This paper investigated the effects of the selected link segment model׳s marker-set and geometry on a unilateral amputee sprinter׳s calculated lower-limb kinematics, kinetics and energetics. A total of five lower-limb models of the Ottobock ® 1E90 Sprinter were developed, including two conventional shank-foot models that each used a different version of the Plug-in-Gait (PiG) marker-set to test the effect of prosthesis ankle marker location. Two Hybrid prosthesis-specific models were then developed, also using the PiG marker-sets, with the anatomical shank and foot replaced by prosthesis-specific geometry separated into two segments. Finally, a Multi-link segment (MLS) model was developed, consisting of six segments for the prosthesis as defined by a custom marker-set. All full-body musculoskeletal models were tested using four trials of experimental marker trajectories within OpenSim 3.2 (Stanford, California, USA) to find the affected and unaffected hip, knee and ankle kinematics, kinetics and energetics. The geometry of the selected lower-limb prosthesis model was found to significantly affect all variables on the affected leg (p prosthesis-specific spatial, inertial and elastic properties from full-body models significantly affects the calculated amputee gait characteristics, and we therefore recommend the implementation of a MLS model. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Hybridized Tetraquarks

    CERN Document Server

    Esposito, A.; Polosa, A.D.

    2016-01-01

    We propose a new interpretation of the neutral and charged X, Z exotic hadron resonances. Hybridized-tetraquarks are neither purely compact tetraquark states nor bound or loosely bound molecules. The latter would require a negative or zero binding energy whose counterpart in h-tetraquarks is a positive quantity. The formation mechanism of this new class of hadrons is inspired by that of Feshbach metastable states in atomic physics. The recent claim of an exotic resonance in the Bs pi+- channel by the D0 collaboration and the negative result presented subsequently by the LHCb collaboration are understood in this scheme, together with a considerable portion of available data on X, Z particles. Considerations on a state with the same quantum numbers as the X(5568) are also made.

  1. Developmental origin of limb size variation in lizards.

    Science.gov (United States)

    Andrews, Robin M; Skewes, Sable A

    2017-05-01

    In many respects, reptile hatchlings are fully functional, albeit miniature, adults. This means that the adult morphology must emerge during embryonic development. This insight emphasizes the connection between the mechanisms that generate phenotypic variation during embryonic development and the action of selection on post-hatching individuals. To determine when species-specific differences in limb and tail lengths emerge during embryonic development, we compared allometric patterns of early limb growth of four distantly related species of lizards. The major questions addressed were whether early embryonic limb and tail growth is characterized by the gradual (continuous allometry) or by the abrupt emergence (transpositional allometry) of size differences among species. Our observations supported transpositional allometry of both limbs and tails. Species-specific differences in limb and tail length were exhibited when limb and tail buds first protruded from the body wall. Genes known to be associated with early limb development of tetrapods are obvious targets for studies on the genetic mechanisms that determine interspecific differences in relative limb length. Broadly comparative studies of gene regulation would facilitate understanding of the mechanisms underlying adaptive variation in limb size, including limb reduction and loss, of squamate reptiles. © 2017 Wiley Periodicals, Inc.

  2. Towards an expansive hybrid psychology

    DEFF Research Database (Denmark)

    Brinkmann, Svend

    2011-01-01

    sources of mediators that are the brain, the body, social practices and technological artefacts. It is argued that the mind is normative in the sense that mental processes do not simply happen, but can be done more or less well, and thus are subject to normative appraisal. The expanded hybrid psychology......This article develops an integrative theory of the mind by examining how the mind, understood as a set of skills and dispositions, depends upon four sources of mediators. Harré’s hybrid psychology is taken as a meta-theoretical starting point, but is expanded significantly by including the four...... is meant to assist in integrating theoretical perspectives and research interests that are often thought of as incompatible, among them neuroscience, phenomenology of the body, social practice theory and technology studies. A main point of the article is that these perspectives each are necessary...

  3. Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform.

    Science.gov (United States)

    Sucar, Luis Enrique; Orihuela-Espina, Felipe; Velazquez, Roger Luis; Reinkensmeyer, David J; Leder, Ronald; Hernández-Franco, Jorge

    2014-05-01

    Virtual reality platforms capable of assisting rehabilitation must provide support for rehabilitation principles: promote repetition, task oriented training, appropriate feedback, and a motivating environment. As such, development of these platforms is a complex process which has not yet reached maturity. This paper presents our efforts to contribute to this field, presenting Gesture Therapy, a virtual reality-based platform for rehabilitation of the upper limb. We describe the system architecture and main features of the platform and provide preliminary evidence of the feasibility of the platform in its current status.

  4. [First treatment of distal loss of tissue on lower limbs. About 15 cases].

    Science.gov (United States)

    Marchaland, J-P; Bey, E; Paranque, A; Ollat, D; Boddaert, G; Versier, G

    2008-02-01

    Distal extremity of lower limb sustains the complications of loss of tissue: problem of coverage (cutaneous and tendon necrosis, osteoarticular infection. The whole point of the surgery is to fight against the infection by repeated debridments, against the deformations or their correction by early osteosynthesis (pins and external fixation). The coverage is very important in this treatment: either with Vacuum-Assisted Closure (VAC) and skin graft or fasciocutaneous flap. In spite of this management, the after-effects are important although the conservative treatment is the determining factor of satisfaction.

  5. Linear-hall sensor based force detecting unit for lower limb exoskeleton

    Science.gov (United States)

    Li, Hongwu; Zhu, Yanhe; Zhao, Jie; Wang, Tianshuo; Zhang, Zongwei

    2018-04-01

    This paper describes a knee-joint human-machine interaction force sensor for lower-limb force-assistance exoskeleton. The structure is designed based on hall sensor and series elastic actuator (SEA) structure. The work we have done includes the structure design, the parameter determination and dynamic simulation. By converting the force signal into macro displacement and output voltage, we completed the measurement of man-machine interaction force. And it is proved by experiments that the design is simple, stable and low-cost.

  6. Continuity controlled Hybrid Automata

    NARCIS (Netherlands)

    Bergstra, J.A.; Middelburg, C.A.

    We investigate the connections between the process algebra for hybrid systems of Bergstra and Middelburg and the formalism of hybrid automata of Henzinger et al. We give interpretations of hybrid automata in the process algebra for hybrid systems and compare them with the standard interpretation

  7. Continuity Controlled Hybrid Automata

    NARCIS (Netherlands)

    Bergstra, J.A.; Middelburg, C.A.

    2004-01-01

    We investigate the connections between the process algebra for hybrid systems of Bergstra and Middelburg and the formalism of hybrid automata of Henzinger et al. We give interpretations of hybrid automata in the process algebra for hybrid systems and compare them with the standard interpretation of

  8. Continuity controlled hybrid automata

    NARCIS (Netherlands)

    Bergstra, J.A.; Middelburg, C.A.

    2004-01-01

    We investigate the connections between the process algebra for hybrid systems of Bergstra and Middelburg and the formalism of hybrid automata of Henzinger et al. We give interpretations of hybrid automata in the process algebra for hybrid systems and compare them with the standard interpretation of

  9. Continuity controlled hybrid automata

    NARCIS (Netherlands)

    Bergstra, J.A.; Middelburg, C.A.

    2006-01-01

    We investigate the connections between the process algebra for hybrid systems of Bergstra and Middelburg and the formalism of hybrid automata of Henzinger et al. We give interpretations of hybrid automata in the process algebra for hybrid systems and compare them with the standard interpretation of

  10. Assisted Living

    Science.gov (United States)

    ... a resident's needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you ...

  11. Assistive Devices

    Science.gov (United States)

    If you have a disability or injury, you may use a number of assistive devices. These are tools, products or types of equipment that help you perform tasks and activities. They may help you move around, see, communicate, eat, or get ...

  12. Limb anomaly and associated conditions: our clinical experience

    Directory of Open Access Journals (Sweden)

    Ragavan M

    2011-03-01

    Full Text Available Munisamy Ragavan1, Uppalu Haripriya1, Janarthanam Sarvavinothini2, Nagaraja Rao3, Ramamoorthy Gokulkrishnan31Department of Pediatric Surgery, 2Department of Anesthesia, 3Department of Pediatrics, Narayana Medical College and Superspeciality Hospital, Nellore, Andhra Pradesh, IndiaAbstract: Limb anomalies are a common clinical problem with a various spectrum of involvement. There are many conditions associated with these anomalies. There is a variable extent of involvement in the form of agenesis, overgrowth, and duplication, and there is no standard classification to describe all these lesions. Studying limb anomalies provides insights into limb development which may be useful for etiologic studies and public health monitoring. We pooled our data for 12 limb anomaly cases presenting from January 2008 to May 2009 and investigated their associated conditions. A descriptive system for the nomenclature and classification of congenital limb malformations suitable for clinical, epidemiological, and experimental use is discussed.Keywords: limb anomaly, phocomelia, amelia 

  13. Phantom Limbs, Neuroprosthetics, and the Developmental Origins of Embodiment.

    Science.gov (United States)

    Blumberg, Mark S; Dooley, James C

    2017-10-01

    Amputees who wish to rid themselves of a phantom limb must weaken the neural representation of the absent limb. Conversely, amputees who wish to replace a lost limb must assimilate a neuroprosthetic with the existing neural representation. Whether we wish to remove a phantom limb or assimilate a synthetic one, we will benefit from knowing more about the developmental process that enables embodiment. A potentially critical contributor to that process is the spontaneous activity - in the form of limb twitches - that occurs exclusively and abundantly during active (REM) sleep, a particularly prominent state in early development. The sensorimotor circuits activated by twitching limbs, and the developmental context in which activation occurs, could provide a roadmap for creating neuroprosthetics that feel as if they are part of the body. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Exploring the fine structure at the limb in coronal holes

    Science.gov (United States)

    Karovska, Magarita; Blundell, Solon F.; Habbal, Shadia Rifai

    1994-01-01

    The fine structure of the solar limb in coronal holes is explored at temperatures ranging from 10(exp 4) to 10(exp 6) K. An image enhancement algorithm orignally developed for solar eclipse observations is applied to a number of simultaneous multiwavelength observations made with the Harvard Extreme Ultraviolet Spectrometer experiment on Skylab. The enhanced images reveal the presence of filamentary structures above the limb with a characteristic separation of approximately 10 to 15 sec . Some of the structures extend from the solar limb into the corona to at least 4 min above the solar limb. The brightness of these structures changes as a function of height above the limb. The brightest emission is associated with spiculelike structures in the proximity of the limb. The emission characteristic of high-temperature plasma is not cospatial with the emission at lower temperatures, indicating the presence of different temperature plasmas in the field of view.

  15. Atmospheric limb sounding with imaging FTS

    Science.gov (United States)

    Friedl-Vallon, Felix; Riese, Martin; Preusse, Peter; Oelhaf, Hermann; Fischer, Herbert

    Imaging Fourier transform spectrometers in the thermal infrared are a promising new class of sensors for atmospheric science. The availability of fast and sensitive large focal plane arrays with appropriate spectral coverage in the infrared region allows the conception and construction of innovative sensors for Nadir and Limb geometry. Instruments in Nadir geometry have already reached prototype status (e.g. Geostationary Imaging Fourier Transform Spectrometer / U. Wisconsin and NASA) or are in Phase A study (infrared sounding mission on Meteosat third generation / ESA and EUMETSAT). The first application of the new technical possibilities to atmospheric limb sounding from space, the Imaging Michelson Interferometer for Passive Atmospheric Sounding (IMIPAS), is currently studied by industry in the context of preparatory work for the next set of ESA earth explorers. The scientific focus of the instrument is on the processes controlling the composition of the mid/upper troposphere and lower stratosphere. The instrument concept of IMIPAS has been conceived at the research centres Karlsruhe and J¨lich. The development of a precursor instrument (GLORIA-AB) at these research institutions u started already in 2005. The instrument will be able to fly on board of various airborne platforms. First scientific missions are planned for the second half of the year 2009 on board the new German research aircraft HALO. This airborne sensor serves its own scientific purpose, but it also provides a test bed to learn about this new instrument class and its peculiarities and to learn to exploit and interpret the wealth of information provided by a limb imaging IR Fourier transform spectrometer. The presentation will discuss design considerations and challenges for GLORIA-AB and put them in the context of the planned satellite application. It will describe the solutions found, present first laboratory figures of merit for the prototype instrument and outline the new scientific

  16. UPPER LIMB FUNCTIONAL ASSESSMENT USING HAPTIC INTERFACE

    Directory of Open Access Journals (Sweden)

    Aleš Bardorfer

    2004-12-01

    Full Text Available A new method for the assessment of the upper limb (UL functional state, using a haptic interface is presented. A haptic interface is used as a measuring device, capable of providing objective, repeatable and quantitative data of the UL motion. A patient is presented with a virtual environment, both graphically via a computer screen and haptically via the Phantom Premium 1.5 haptic interface. The setup allows the patient to explore and feel the virtual environment with three of his/her senses; sight, hearing, and most important, touch. Specially designed virtual environments are used to assess the patient’s UL movement capabilities. The tests range from tracking tasks – to assess the accuracy of movement – tracking tasks with added disturbances in a form of random forces – to assess the patient’s control abilities, a labyrinth test – to assess both speed and accuracy, to the last test for measuring the maximal force capacity of the UL.A new method for the assessment of the upper limb (UL functional state, using a haptic interface is presented. A haptic interface is used as a measuring device, capable of providing objective, repeatable and quantitative data of the UL motion. A patient is presented with a virtual environment, both graphically via a computer screen and haptically via the Phantom Premium 1.5 haptic interface. The setup allows the patient to explore and feel the virtual environment with three of his/her senses; sight, hearing, and most important, touch. Specially designed virtual environments are used to assess the patient’s UL movement capabilities. The tests range from tracking tasks–to assess the accuracy of movement-tracking tasks with added disturbances in a form of random forces-to assess the patient’s control abilities, a labyrinth test-to assess both speed and accuracy, to the last test for measuring the maximal force capacity of the UL.A comprehensive study, using the developed measurement setup within the

  17. [May physicians amputate a healthy limb?].

    Science.gov (United States)

    Denys, Damiaan

    2014-01-01

    A recent article in the Dutch Journal of Medicine describes two cases of patients with body integrity identity disorder (BIID), a disorder in which patients might resort to self-amputation in order to create the body they wish for. The authors wonder if medical professionals should provide elective amputations in BIID patients in order to prevent them from harm and death. The amputation of a healthy limb in BIID in a medical context is currently under discussion. Doctors struggle to proceed to elective amputation of a healthy body part in BIID. An analogy with gender dysphoria or euthanasia might shed a different light on this dilemma.

  18. Corporate Hybrid Bonds

    OpenAIRE

    Ahlberg, Johan; Jansson, Anton

    2016-01-01

    Hybrid securities do not constitute a new phenomenon in the Swedish capital markets. Most commonly, hybrids issued by Swedish real estate companies in recent years are preference shares. Corporate hybrid bonds on the other hand may be considered as somewhat of a new-born child in the family of hybrid instruments. These do, as all other hybrid securities, share some equity-like and some debt-like characteristics. Nevertheless, since 2013 the interest for the instrument has grown rapidly and ha...

  19. Oral creatine supplementation attenuates muscle loss caused by limb immobilization: a systematic review

    Directory of Open Access Journals (Sweden)

    Camila Souza Padilha

    Full Text Available Abstract Introduction: Recent studies have pointing creatine supplementation as a promising therapeutic alterna- tive in several diseases, especially myopathies and neurodegenerative disorder. Objective: elucidate the role of creatine supplementation on deleterious effect caused by limb immobilization in humans and rats. Methods: Analyzed articles were searched by three online databases, PubMed, SportDicus e Scielo. After a review and analysis, the studies were included in this review articles on effect of creatine supplementation on skeletal muscle in humans and rat, before, during and after a period of limb immobilization. Results: Studies analyzed demonstrated positive points in use of creatine supplementation as a therapeutic tool to mitigating the deleterious effects of limb immobilization, in humans and rat. Conclusion: The dataset of this literature review allows us to conclude that creatine supplementation may reduce muscle loss and/or assist in the recovery of muscle atrophy caused by immobilization and disuse in rats and humans. Also, we note that further research with better methodological rigor is needed to clarify the mechanisms by which creatine support the recovery of muscle atrophy. Moreover, these effects are positive and promising in the field of muscle rehabilitation, especially after member’s immobilization.

  20. Origin of directionally tuned responses in lower limb muscles to unpredictable upper limb disturbances.

    Directory of Open Access Journals (Sweden)

    Ali Forghani

    Full Text Available Unpredictable forces which perturb balance are frequently applied to the body through interaction between the upper limb and the environment. Lower limb muscles respond rapidly to these postural disturbances in a highly specific manner. We have shown that the muscle activation patterns of lower limb muscles are organized in a direction specific manner which changes with lower limb stability. Ankle muscles change their activity within 80 ms of the onset of a force perturbation applied to the hand which is earlier than the onset of changes in ground reaction force, ankle angle or head motion. The latency of the response is sensitive to the perturbation direction. However, neither the latency nor the magnitude of the response is affected by stiffening the arm even though this alters the magnitude and timing of motion of the body segments. Based on the short latency, insensitivity of the change in ankle muscle activation to motion of the body segments but sensitivity to perturbation direction we reason that changes in ankle muscle activation are most likely triggered by sensory signals originating from cutaneous receptors in the hand. Furthermore, evidence that the latency of changes in ankle muscle activation depends on the number of perturbation directions suggests that the neural pathway is not confined to the spinal cord.

  1. Hemodynamic study of ischemic limb by velocity measurement in foot

    International Nuclear Information System (INIS)

    Shionoya, S.; Hirai, M.; Kawai, S.; Ohta, T.; Seko, T.

    1981-01-01

    By means of a tracer technique with 99mTc-pertechnetate, provided with seven zonal regions of interest, 6 mm in width, placed at equal spaces of 18 mm, from the toe tip to the midfoot at a right angle to the long axis of the foot, arterial flow velocity in the foot during reactive hyperemia was measured. The mean velocity in the foot was 5.66 +/- 1.78 cm/sec in 14 normal limbs, 1.58 +/- 1.07 cm/sec in 29 limbs with distal thromboangiitis obliterans (TAO), 0.89 +/- 0.61 cm/sec in 13 limbs with proximal TAO, and 0.97 +/- 0.85 cm/sec in 15 limbs with arteriosclerosis obliterans (ASO). The velocity returned to normal in all 12 limbs after successful arterial reconstruction, whereas the foot or toe blood pressure remained pathologic in 9 of the 12 limbs postoperatively; the velocity reverted to normal in 4 of 13 limbs after lumbar sympathectomy. When the velocity was normalized after operation, the ulceration healed favorably, and the ischemic limb was salvaged. The most characteristic feature of peripheral arterial occlusive disease of the lower extremity was a stagnation of arterial circulation in the foot, and the flow velocity in the foot was a sensitive predictive index of limb salvage

  2. Hybrid XRF

    International Nuclear Information System (INIS)

    Heckel, J.

    2002-01-01

    Full text: In the last 10 years significant innovations of EDXRF, e.g. total reflection XRF or polarized beam XRF, were utilized in different industrial applications. The decrease of background within the spectra was the goal of these developments. Excellent detection limits and sensitivities demonstrate the success of these new techniques. Nevertheless, further improvements are possible by using Si drift detectors. These detectors allow the processing of input count rates up to 10 6 cps in comparison to 10 5 of Si(Li) detectors. New excitation optics are necessary to produce such count rates. One possibility is the use of doubly curved crystals between tube and sample. These crystals enable the reflection of the primary beam within the given solid angle (0.4π) of an end window tube to the sample. Using such brightness optics excellent sensitivities mainly for light elements are achievable. The combination of a BRAGG crystal as a wavelength dispersive component and a solid state detector as an energy dispersive component creates a new technique: hybrid XRF. Copyright (2002) Australian X-ray Analytical Association Inc. Copyright (2002) Australian X-ray Analytical Association Inc

  3. Hybrid mimics and hybrid vigor in Arabidopsis

    Science.gov (United States)

    Wang, Li; Greaves, Ian K.; Groszmann, Michael; Wu, Li Min; Dennis, Elizabeth S.; Peacock, W. James

    2015-01-01

    F1 hybrids can outperform their parents in yield and vegetative biomass, features of hybrid vigor that form the basis of the hybrid seed industry. The yield advantage of the F1 is lost in the F2 and subsequent generations. In Arabidopsis, from F2 plants that have a F1-like phenotype, we have by recurrent selection produced pure breeding F5/F6 lines, hybrid mimics, in which the characteristics of the F1 hybrid are stabilized. These hybrid mimic lines, like the F1 hybrid, have larger leaves than the parent plant, and the leaves have increased photosynthetic cell numbers, and in some lines, increased size of cells, suggesting an increased supply of photosynthate. A comparison of the differentially expressed genes in the F1 hybrid with those of eight hybrid mimic lines identified metabolic pathways altered in both; these pathways include down-regulation of defense response pathways and altered abiotic response pathways. F6 hybrid mimic lines are mostly homozygous at each locus in the genome and yet retain the large F1-like phenotype. Many alleles in the F6 plants, when they are homozygous, have expression levels different to the level in the parent. We consider this altered expression to be a consequence of transregulation of genes from one parent by genes from the other parent. Transregulation could also arise from epigenetic modifications in the F1. The pure breeding hybrid mimics have been valuable in probing the mechanisms of hybrid vigor and may also prove to be useful hybrid vigor equivalents in agriculture. PMID:26283378

  4. The α-Amino Group of the Threonine Substrate As The General Base During tRNA Aminoacylation: A New Version of Substrate Assisted Catalysis Predicted by Hybrid DFT

    Science.gov (United States)

    Huang, WenJuan; Bushnell, Eric A. C.; Francklyn, Christopher S.; Gauld, James W.

    2013-01-01

    Density functional theory-based methods in combination with large chemical models have been used to investigate the mechanism of the second half-reaction catalyzed by Thr-tRNA synthetase; aminoacyl transfer from Thr-AMP onto the A763'OH of the cognate tRNA. In particular, we have examined pathways in which an active site His309 residue is either protonated or neutral (i.e., potentially able to act as a base). In the protonated His309-assisted mechanism, the rate-limiting step is formation of the tetrahedral intermediate. The barrier for this step is 155.0 kJ mol−1 and thus, such a pathway is concluded to not be enzymatically feasible. For the neutral His309-assisted mechanism two models were used with the difference being whether Lys465 was included. For either model the barrier of the rate-limiting step is below the upper-thermodynamic enzymatic limit of ∼125 kJ mol−1. Specifically, without Lys465 the rate-limiting barrier is 122.1 kJ mol−1 and corresponds to a rotation about the tetrahedral intermediates Ccarb—OH bond. For the model with Lys465 the rate-limiting barrier is slightly lower and corresponds to the formation of the tetrahedral intermediate. Importantly, for both neutral His309’ models the neutral amino group of the threonyl substrate directly acts as the proton accepter; in the formation of the tetrahedral intermediate the A763'OH proton is directly transferred onto the Thr-NH2. Therefore, the overall mechanism follows a general substrate assisted catalytic mechanism. PMID:21942566

  5. Does motor expertise facilitate amplitude differentiation of lower limb-movements in an asymmetrical bipedal coordination task?

    Science.gov (United States)

    Roelofsen, Eefje G J; Brown, Derrick D; Nijhuis-van der Sanden, Maria W G; Staal, J Bart; Meulenbroek, Ruud G J

    2018-04-30

    The motor system's natural tendency is to move the limbs over equal amplitudes, for example in walking. However, in many situations in which people must perform complex movements, a certain degree of amplitude differentiation of the limbs is required. Visual and haptic feedback have recently been shown to facilitate such independence of limb movements. However, it is unknown whether motor expertise moderates the extent to which individuals are able to differentiate the amplitudes of their limb-movements while being supported with visual and haptic feedback. To answer this question 14 pre-professional dancers were compared to 14 non-dancers on simultaneously generating a small displacement with one foot, and a larger one with the other foot, in four different feedback conditions. In two conditions, haptic guidance was offered, either in a passive or active mode. In the other two conditions, veridical and enhanced visual feedback were provided. Surprisingly, no group differences were found regarding the degree to which the visual or haptic feedback assisted the generation of the different target amplitudes of the feet (mean amplitude difference between the feet). The correlation between the displacements of the feet and the standard deviation of the continuous relative phase between the feet, reflecting the degree of independence of the feet movements, also failed to show between-group differences. Sample entropy measures, indicating the predictability of the foot movements, did show a group difference. In the haptically-assisted conditions, the dancers demonstrated more predictable coordination patterns than the non-dancers as reflected by lower sample entropy values whereas the reverse was true in the visual-feedback conditions. The results demonstrate that motor expertise does not moderate the extent to which haptic tracking facilitates the differentiation of the amplitudes of the lower limb movements in an asymmetrical bipedal coordination task. Copyright © 2018

  6. Foreign assistance

    International Nuclear Information System (INIS)

    1991-07-01

    This paper reports that providing energy assistance to developing countries remains a relatively low priority of the Agency for International Development. AID is helping some developing countries meet their energy needs, but this assistance varies substantially because of the agency's decentralized structure. Most AID energy funding has gone to a handful of countries-primarily Egypt and Pakistan. With limited funding in most other countries, AID concentrates on providing technical expertise and promoting energy policy reforms that will encourage both energy efficiency and leverage investment by the private sector and other donors. Although a 1989 congressional directive to pursue a global warming initiative has had a marginal impact on the agency's energy programming, many AID energy programs, including those directed at energy conservation, help address global warming concerns

  7. A RARE CASE OF ACHONDROPLASIA- SHORT LIMB

    Directory of Open Access Journals (Sweden)

    B. Ravichander

    2017-03-01

    Full Text Available BACKGROUND A 6-year-old boy was presented to the paediatric department with shortening of all the limbs and delay in growth. Clinical examinations revealed height less than third percentile along with other abnormalities like frontal bossing, midfacial hypoplasia, flattened nasal bridge, short neck and rhizomelic type of shortening of all the limbs. These clinical features raised the diagnosis towards achondroplasia, which was further supported by radiologic evidence. Achondroplasia is a disorder involving growth of bone. The conversion of cartilage to bone is hampered. The affection is particularly seen in the long bones of arms and legs. The characterising features of this disorder are dwarfism, limitation in range of motion at the elbows, enlarged size of head, small fingers, but with normal intelligence. Other complications like apnoea, obesity, recurrent ear infections and lordosis of the spine are often associated with achondroplasia. The basic defect in achondroplasia lies in mutations of the FGFR3 gene. It is an autosomal dominant disorder.

  8. Leisure activities following a lower limb amputation.

    Science.gov (United States)

    Couture, Mélanie; Caron, Chantal D; Desrosiers, Johanne

    2010-01-01

    The aim of this study was to describe leisure activities, leisure satisfaction and constraints on participation in leisure following a unilateral lower limb amputation due to vascular disease. This study used a mixed-method approach where 15 individuals with lower limb amputation completed the individual leisure profile 2-3 months post-discharge from rehabilitation. A subsample (n = 8) also participated in semi-structured interviews analysed using the Miles and Huberman analytic method. Results show that participants were involved in 12 different leisure activities on average. Compared to before the amputation, a decrease in participation was observed in all categories of leisure activity, and especially crafts, nature and outdoor activities, mechanics, sports and physical activities. Nonetheless, overall satisfaction was high. The most important constraints on participation in leisure were lack of accessibility, material considerations, functional abilities, affective constraints and social constraints. A decrease in leisure activity participation and the presence of constraints do not automatically translate into low levels of leisure satisfaction.

  9. Radiogrammetric analysis of upper limb long bones

    Directory of Open Access Journals (Sweden)

    Stojanović Zlatan

    2011-01-01

    Full Text Available Radiogrammetry is radiological method of bone mineral density quantification. Besides giving an insight in diagnostics and evolution of metabolic bone disorders (osteoporosis, osteomalacia, osteitis deformans- Paget's disease, it can also explain some specific biomechanical characteristics of bone structures. The aim of this study is to evaluate the significance and perspectives of radiogrammetry as a scientific model for further inquiry of skeletal system. The work demonstrates mathematical parameters (Ca-Cortical area, CI- Cortical index, GI- Garn's index, ESI- Exton Smith's index of upper limb long bones (humerus, radius, ulna. Two standard radiological projections of bones were taken: antero-posterior (AP and latero-lateral (LL. Correlation with metacarpal and lower limb bones was also performed. The value of the cortical area of humerus is significantly higher comparing with the two other examined bones (Xmean 2,2443 cm2, p < 0.01. Radial bone has the highest values of the relational mathematical parameters, which implicates its higher strength by volumetric unit concerning humerus and ulna. Despite the development of contemporary osteometric procedures (ultrasound densitometry, dual X-ray absorptiometry, digital X-ray radiogrammetry, the classical radiogrammetry sustains its important role in diagnostics of metabolic bone disorders and it can be successfully used for biomechanical inquiry of skeletal system.

  10. Limb Regeneration in Axolotl: Is It Superhealing?

    Directory of Open Access Journals (Sweden)

    Stéphane Roy

    2006-01-01

    Full Text Available The ability of axolotls to regenerate their limbs is almost legendary. In fact, urodeles such as the axolotl are the only vertebrates that can regenerate multiple structures like their limbs, jaws, tail, spinal cord, and skin (the list goes on throughout their lives. It is therefore surprising to realize, although we have known of their regenerative potential for over 200 years, how little we understand the mechanisms behind this achievement of adult tissue morphogenesis. Many observations can be drawn between regeneration and other disciplines such as development and wound healing. In this review, we present new developments in functional analysis that will help to address the role of specific genes during the process of regeneration. We also present an analysis of the resemblance between wound healing and regeneration, and discuss whether axolotls are superhealers. A better understanding of these animals' regenerative capacity could lead to major benefits by providing regenerative medicine with directions on how to develop therapeutic approaches leading to regeneration in humans.

  11. Consumer design priorities for upper limb prosthetics.

    Science.gov (United States)

    Biddiss, Elaine; Beaton, Dorcas; Chau, Tom

    2007-11-01

    To measure consumer satisfaction with upper limb prosthetics and provide an enumerated list of design priorities for future developments. A self-administered, anonymous survey collected information on participant demographics, history of and goals for prosthesis use, satisfaction, and design priorities. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer; 242 participants of all ages and levels of upper limb absence completed the survey. Rates of rejection for myoelectric hands, passive hands, and body-powered hooks were 39%, 53%, and 50%, respectively. Prosthesis wearers were generally satisfied with their devices while prosthesis rejecters were dissatisfied. Reduced prosthesis weight emerged as the highest priority design concern of consumers. Lower cost ranked within the top five design priorities for adult wearers of all device types. Life-like appearance is a priority for passive/cosmetic prostheses, while improved harness comfort, wrist movement, grip control and strength are required for body-powered devices. Glove durability, lack of sensory feedback, and poor dexterity were also identified as design priorities for electric devices. Design priorities reflect consumer goals for prosthesis use and vary depending on the type of prosthesis used and age. Future design efforts should focus on the development of more light-weight, comfortable prostheses.

  12. Management of ulcers in lymphoedematous limbs

    Directory of Open Access Journals (Sweden)

    Vishnu M Karnasula

    2012-01-01

    Full Text Available Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care.

  13. Altitude Registration of Limb-Scattered Radiation

    Science.gov (United States)

    Moy, Leslie; Bhartia, Pawan K.; Jaross, Glen; Loughman, Robert; Kramarova, Natalya; Chen, Zhong; Taha, Ghassan; Chen, Grace; Xu, Philippe

    2017-01-01

    One of the largest constraints to the retrieval of accurate ozone profiles from UV backscatter limb sounding sensors is altitude registration. Two methods, the Rayleigh scattering attitude sensing (RSAS) and absolute radiance residual method (ARRM), are able to determine altitude registration to the accuracy necessary for long-term ozone monitoring. The methods compare model calculations of radiances to measured radiances and are independent of onboard tracking devices. RSAS determines absolute altitude errors, but, because the method is susceptible to aerosol interference, it is limited to latitudes and time periods with minimal aerosol contamination. ARRM, a new technique introduced in this paper, can be applied across all seasons and altitudes. However, it is only appropriate for relative altitude error estimates. The application of RSAS to Limb Profiler (LP) measurements from the Ozone Mapping and Profiler Suite (OMPS) on board the Suomi NPP (SNPP) satellite indicates tangent height (TH) errors greater than 1 km with an absolute accuracy of +/-200 m. Results using ARRM indicate a approx. 300 to 400m intra-orbital TH change varying seasonally +/-100 m, likely due to either errors in the spacecraft pointing or in the geopotential height (GPH) data that we use in our analysis. ARRM shows a change of approx. 200m over 5 years with a relative accuracy (a long-term accuracy) of 100m outside the polar regions.

  14. Upper limb lymphedema after breast cancer treatment

    International Nuclear Information System (INIS)

    Ben Salah, H.; Bahri, M.; Jbali, B.; Daoud, J.; Guermazi, M.; Frikha, M.

    2012-01-01

    Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

  15. Relative biocompatibility of micro-hybrid and nano-hybrid light-activated composite resins.

    Science.gov (United States)

    Olabisi Arigbede, Abiodun; Folasade Adeyemi, Bukola; Femi-Akinlosotu, Omowumi

    2017-01-01

    Background. In vitro studies have revealed a direct association between resin content and cytotoxicity of composite resins; however, implantation studies in this regard are sparse. This study investigates the relationship between filler content of composite resins and biocompatibility. Methods. This research employed twelve 180‒200-gr male Wistar rats, 1 nano-hybrid (Prime-Dent Inc.) and 1 micro-hybrid (Medental Inc.) composite resins containing 74% and 80‒90% filler content, respectively. The samples were assessed on the 2nd, 14th and 90th day of implantation. Four rats were allocated to each day in this experimental study. A section of 1.5mm long cured nano-hybrid and micro-hybrid materials were implanted into the right and left upper and lower limbs of the rats, respectively. Eight samples were generated on each day of observation. Inflammation was graded according to the criteria suggested by Orstavik and Major. Pearson's chi-squared test was employed to determine the relationship between the tissue responses of the two materials. Statistical significance was set at P resin had a score of 3.0 for cellular inflammation. On the 14th day, the micro-hybrid resin also exhibited a lower average grade for cellular inflammation. On the 90th day, the micro-hybrid resin had a higher grade of inflammation (0.9) compared to 0.3 recorded for nano-hybrid. The composite resins with higher filler content elicited a significantly lower grade of inflammation irrespective of the duration (χ=20.000, df=8, P=0.010) while the composite resins with lower filler content elicited a significantly lower inflammatory response on the 90th day (χ=4.000, df=1, P=0.046). Conclusion. The composite resins with higher filler content generally elicited significantly lower grades of inflammation, and the composite resins with lower filler content exhibited significantly lower inflammatory response on the 90th day of implantation.

  16. Primary motor cortex changes after amputation correlate with phantom limb pain and the ability to move the phantom limb

    DEFF Research Database (Denmark)

    Raffin, Estelle; Richard, Nathalie; Giraux, Pascal

    2016-01-01

    A substantial body of evidence documents massive reorganization of primary sensory and motor cortices following hand amputation, the extent of which is correlated with phantom limb pain. Many therapies for phantom limb pain are based upon the idea that plastic changes after amputation...... for the maladaptative plasticity model, we demonstrate for the first time that motor capacities of the phantom limb correlate with post-amputation reorganization, and that this reorganization is not limited to the face and hand representations but also includes the proximal upper-limb....

  17. Liminality and decision making for upper limb surgery in tetraplegia: a grounded theory.

    Science.gov (United States)

    Dunn, Jennifer A; Hay-Smith, E Jean C; Whitehead, Lisa C; Keeling, Sally

    2013-07-01

    To explore, from the perspective of the person with tetraplegia, the issues that influenced decision making about upper limb surgery and develop a conceptual framework describing the decision making process. Purposive and theoretical sampling of 22 people with tetraplegia, followed by interviews. Ten people had upper limb surgery and 12 had not. Verbatim transcripts were analyzed with constructivist grounded theory. Participants responded to the offer of surgery in one of three ways: yes, let me have it; no thanks; or possibly. Many influences on the decision about surgery had a temporal element, such as hope for the cure or recovery from SCI, inadequate physical or social supports while rehabilitating, life roles and goals, and the avoidance of re-hospitalization. The conceptual framework illustrated that many participants entered a liminal state within which they required a stimulus to review their decision about upper limb surgery. Decision making is a temporal process, and for some the process was a prolonged and liminal one. Therefore, multiple offers for surgery are required to allow for changing thoughts and circumstances throughout an individual's lifetime. Flexibility with regard to timing for surgery and type of rehabilitation may increase the uptake, especially for women. • Multiple offers for upper limb surgery are required throughout an individual's lifetime to account for changing thoughts and priorities. • Identification of the type of support required (informational, emotional) may assist in decreasing the time taken to make the decision about surgery. • Flexibility in surgical and rehabilitation options, especially for women, may increase the uptake of surgery.

  18. Learning by Demonstration for Motion Planning of Upper-Limb Exoskeletons

    Science.gov (United States)

    Lauretti, Clemente; Cordella, Francesca; Ciancio, Anna Lisa; Trigili, Emilio; Catalan, Jose Maria; Badesa, Francisco Javier; Crea, Simona; Pagliara, Silvio Marcello; Sterzi, Silvia; Vitiello, Nicola; Garcia Aracil, Nicolas; Zollo, Loredana

    2018-01-01

    The reference joint position of upper-limb exoskeletons is typically obtained by means of Cartesian motion planners and inverse kinematics algorithms with the inverse Jacobian; this approach allows exploiting the available Degrees of Freedom (i.e. DoFs) of the robot kinematic chain to achieve the desired end-effector pose; however, if used to operate non-redundant exoskeletons, it does not ensure that anthropomorphic criteria are satisfied in the whole human-robot workspace. This paper proposes a motion planning system, based on Learning by Demonstration, for upper-limb exoskeletons that allow successfully assisting patients during Activities of Daily Living (ADLs) in unstructured environment, while ensuring that anthropomorphic criteria are satisfied in the whole human-robot workspace. The motion planning system combines Learning by Demonstration with the computation of Dynamic Motion Primitives and machine learning techniques to construct task- and patient-specific joint trajectories based on the learnt trajectories. System validation was carried out in simulation and in a real setting with a 4-DoF upper-limb exoskeleton, a 5-DoF wrist-hand exoskeleton and four patients with Limb Girdle Muscular Dystrophy. Validation was addressed to (i) compare the performance of the proposed motion planning with traditional methods; (ii) assess the generalization capabilities of the proposed method with respect to the environment variability. Three ADLs were chosen to validate the system: drinking, pouring and lifting a light sphere. The achieved results showed a 100% success rate in the task fulfillment, with a high level of generalization with respect to the environment variability. Moreover, an anthropomorphic configuration of the exoskeleton is always ensured. PMID:29527161

  19. A New Approach: Regional Nerve Blockade for Angioplasty of the Lower Limb

    International Nuclear Information System (INIS)

    Marcus, A.J.; Lotzof, K.; Kamath, B.S.K.; Shanthakumar, R.E.; Munir, N.; Loh, A.; Bird, R.; Howard, A.

    2006-01-01

    Purpose. An audit study investigated the pilot use of regional nerve block analgesia (as an alternative to sedative/opiate, general or central neuraxial anesthesia) performed by radiologists with the assistance of imaging techniques during complex prolonged angiography. Methods. Radiologists were trained by anesthetic consultants to administer and use lower limb peripheral nerve block for difficult prolonged angioplasty procedures for patients with severe lower limb rest pain who were unable to lie in the supine position. In a pilot study 25 patients with limb-threatening ischemia received sciatic and femoral nerve blockade for angioplasty. The technique was developed and perfected in 12 patients and in a subsequent 13 patients the details of the angiography procedures, peripheral anesthesia, supplementary analgesia, complications, and pain assessment scores were recorded. Pain scores were also recorded in 11 patients prior to epidural/spinal anesthesia for critical ischemic leg angioplasty. Results. All patients with peripheral nerve blockade experienced a reduction in their ischemic rest pain to a level that permitted angioplasty techniques to be performed without spinal, epidural or general analgesia. In patients undergoing complex angioplasty intervention, the mean pain score by visual analogue scale was 3.7, out of a maximum score of 10. Conclusions. The successful use of peripheral nerve blocks was safe and effective as an alternative to sedative/opiate, epidural or general anesthesia in patients undergoing complex angiography and has optimized the use of radiological and anesthetic department resources. This has permitted the frequent radiological treatment of patients with limb-threatening ischemia and reduced delays caused by the difficulty in enlisting the help of anesthetists, often at short notice, from the busy operating lists

  20. Learning by Demonstration for Motion Planning of Upper-Limb Exoskeletons

    Directory of Open Access Journals (Sweden)

    Clemente Lauretti

    2018-02-01

    Full Text Available The reference joint position of upper-limb exoskeletons is typically obtained by means of Cartesian motion planners and inverse kinematics algorithms with the inverse Jacobian; this approach allows exploiting the available Degrees of Freedom (i.e. DoFs of the robot kinematic chain to achieve the desired end-effector pose; however, if used to operate non-redundant exoskeletons, it does not ensure that anthropomorphic criteria are satisfied in the whole human-robot workspace. This paper proposes a motion planning system, based on Learning by Demonstration, for upper-limb exoskeletons that allow successfully assisting patients during Activities of Daily Living (ADLs in unstructured environment, while ensuring that anthropomorphic criteria are satisfied in the whole human-robot workspace. The motion planning system combines Learning by Demonstration with the computation of Dynamic Motion Primitives and machine learning techniques to construct task- and patient-specific joint trajectories based on the learnt trajectories. System validation was carried out in simulation and in a real setting with a 4-DoF upper-limb exoskeleton, a 5-DoF wrist-hand exoskeleton and four patients with Limb Girdle Muscular Dystrophy. Validation was addressed to (i compare the performance of the proposed motion planning with traditional methods; (ii assess the generalization capabilities of the proposed method with respect to the environment variability. Three ADLs were chosen to validate the system: drinking, pouring and lifting a light sphere. The achieved results showed a 100% success rate in the task fulfillment, with a high level of generalization with respect to the environment variability. Moreover, an anthropomorphic configuration of the exoskeleton is always ensured.

  1. Transcriptomics provides mechanistic indicators of fluoride toxicology on endochondral ossification in the hind limb of Bufo gargarizans.

    Science.gov (United States)

    Chao, Wu; Zhang, Yuhui; Chai, Lihong; Wang, Hongyuan

    2018-06-10

    Endochondral ossification, the process by which most of the bone is formed, is regulated by many specific groups of molecules and extracellular matrix components. Hind limb of Bufo gargarizans is a model to study endochondral ossification during metamorphosis. Chinese toad (Bufo gargarizans) were exposed to different fluoride concentrations (0, 1, 5, 10 and 20 mg L -1 ) from G3 to G42. The development of hind limb of B. gargarizans was observed using the double staining methodology. The transcriptome of hind limb of B. gargarizans was conducted using RNA-seq approach, and differentially expressed gene was also validated. In addition, the location of Sox9 and Ihh in the growth cartilage was determined using in situ hybridization. Our results showed that 5 mg L -1 stimulated bone mineralization, while 10 and 20 mg L -1 exposure could inhibit the tibio-fibula, tarsus and metacarpals ossification. Besides, 10 mg F/L treatment could down-regulate Ihh, Sox9, D2, D3, TRα, TRβ, Wnt10, FGF3 and BMP6 expression, while up-regulate ObRb and HHAT mRNA expression in the hind limb of B. gargarizans. Transcript level changes of Ihh, Sox9, D2, D3, TRα, TRβ, Wnt10, FGF3 and BMP6 were consistent with the results of RT-qPCR. In situ hybridization revealed that Ihh was expressed in prehypertrophic chondrocytes, while Sox9 was abundantly expressed in proliferous, prehypertrophic and hypertrophic chondrocytes. However, 10 mg F-/L did not cause any affect in the location of the Ihh and Sox9 mRNA. Therefore, high concentration of fluoride could affect the ossification-related genes mRNA expression and then inhibit the endochondral ossification. The present study thus will greatly contribute to our understanding of the effect of environmental contaminant on ossification in amphibian. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Transcriptomic insights into the genetic basis of mammalian limb diversity.

    Science.gov (United States)

    Maier, Jennifer A; Rivas-Astroza, Marcelo; Deng, Jenny; Dowling, Anna; Oboikovitz, Paige; Cao, Xiaoyi; Behringer, Richard R; Cretekos, Chris J; Rasweiler, John J; Zhong, Sheng; Sears, Karen E

    2017-03-23

    From bat wings to whale flippers, limb diversification has been crucial to the evolutionary success of mammals. We performed the first transcriptome-wide study of limb development in multiple species to explore the hypothesis that mammalian limb diversification has proceeded through the differential expression of conserved shared genes, rather than by major changes to limb patterning. Specifically, we investigated the manner in which the expression of shared genes has evolved within and among mammalian species. We assembled and compared transcriptomes of bat, mouse, opossum, and pig fore- and hind limbs at the ridge, bud, and paddle stages of development. Results suggest that gene expression patterns exhibit larger variation among species during later than earlier stages of limb development, while within species results are more mixed. Consistent with the former, results also suggest that genes expressed at later developmental stages tend to have a younger evolutionary age than genes expressed at earlier stages. A suite of key limb-patterning genes was identified as being differentially expressed among the homologous limbs of all species. However, only a small subset of shared genes is differentially expressed in the fore- and hind limbs of all examined species. Similarly, a small subset of shared genes is differentially expressed within the fore- and hind limb of a single species and among the forelimbs of different species. Taken together, results of this study do not support the existence of a phylotypic period of limb development ending at chondrogenesis, but do support the hypothesis that the hierarchical nature of development translates into increasing variation among species as development progresses.

  3. Design and evaluation of a modular lower limb exoskeleton for rehabilitation.

    Science.gov (United States)

    Dos Santos, Wilian M; Nogueira, Samuel L; de Oliveira, Gustavo C; Pena, Guido G; Siqueira, Adriano A G

    2017-07-01

    This paper deals with the evaluation of an exoskeleton designed for assisting individuals to rehabilitate compromised lower limb movements resulting from stroke or incomplete spinal cord injury. The exoskeleton is composed of lightweight tubular structures and six free joints that provide a modular feature to the system. This feature allows the exoskeleton to be adapted to assist the movement of one or more patient joints. The actuation of the exoskeleton is also modular, and can be performed passively, by means of springs and dampers, or actively through actuators. In addition, its telescopic tubular links, developed to adjust the size of the links in order to align the joints of the exoskeleton with patient joints, allows the exoskeleton to be adjustable to fit different patients. Experiments considering the interaction between a healthy subject and the exoskeleton are performed to evaluate the influence of the exoskeleton structure on kinematic and muscular activity profiles during walking.

  4. Modeling and design of a tendon actuated soft robotic exoskeleton for hemiparetic upper limb rehabilitation.

    Science.gov (United States)

    Nycz, Christopher J; Delph, Michael A; Fischer, Gregory S

    2015-01-01

    Robotic technology has recently been explored as a means to rehabilitate and assist individuals suffering from hemiparesis of their upper limbs. Robotic approaches allow for targeted rehabilitation routines which are more personalized and adaptable while providing quantitative measurements of patient outcomes. Development of these technologies into inherently safe and portable devices has the potential to extend the therapy outside of the clinical setting and into the patient's home with benefits to the cost and accessibility of care. To this end, a soft, cable actuated robotic glove and sleeve was designed, modeled, and constructed to provide assistance of finger and elbow movements in a way that mimics the biological function of the tendons. The resulting design increases safety through greater compliance as well as greater tolerance for misalignment with the user's skeletal frame over traditional rigid exoskeletons. Overall this design provides a platform to expand and study the concepts around soft robotic rehabilitation.

  5. Atherectomy offers no benefits over balloon angioplasty in tibial interventions for critical limb ischemia.

    Science.gov (United States)

    Todd, Kevin E; Ahanchi, Sadaf S; Maurer, Christian A; Kim, Jung H; Chipman, Candice R; Panneton, Jean M

    2013-10-01

    Endovascular adjuncts, like atherectomy, were developed to improve outcomes of endovascular arterial interventions. The true impact of atherectomy on endovascular outcomes remains to be determined, and little data exist on the influence of atherectomy on tibial interventions. Our study compares early and late outcomes of tibial intervention with angioplasty vs atherectomy-assisted interventions. We completed a retrospective review of all tibial interventions between 2008 and 2010. Outcomes were analyzed using single and multivariate analysis, Cox regression, and Kaplan-Meier curves. Primary outcomes were primary, primary assisted, and secondary patency rates, as well as limb salvage and survival rates. Over a 2-year period, 480 tibial interventions were completed for 421 patients. Eighty-seven percent (n = 418) of interventions were performed for critical limb ischemia (CLI) and 13% (n = 62) for claudication. The CLI cohort of 418 interventions was analyzed. These patients had a mean age of 71 years with a mean follow-up time of 16 ± 15 months (range, 0-59 months). Of the 418 interventions, 339 underwent percutaneous transluminal angioplasty (PTA): 333 PTA alone, six PTA + stent. The remaining 79 interventions received atherectomy: 33 laser, 13 directional, and 33 orbital either alone or in conjunction with PTA (11 atherectomy only, 68 atherectomy + PTA). The groups did not differ significantly in terms of demographics, risk factors, or technical success. The atherectomy group had more TASC B lesions (54% vs 38%; P = .013), while the PTA-alone group had more TASC D lesions (25% vs 13%; P = .004). TASC A and C lesions did not differ significantly between the groups. No significant differences existed with respect to the early (30-day) outcomes of loss of patency (11% vs 13%; P = .699), complications (8% vs 13%; P = .292), or major amputation (17% vs 13%; P = .344) in the PTA-alone group vs the atherectomy-assisted group. Kaplan-Meier analysis revealed no difference

  6. 6-REXOS: Upper Limb Exoskeleton Robot with Improved pHRI

    Directory of Open Access Journals (Sweden)

    Malin Gunasekara

    2015-04-01

    Full Text Available Close interaction can be observed between an exoskeleton robot and its wearer. Therefore, appropriate physical human-robot interaction (pHRI should be considered when designing an exoskeleton robot to provide safe and comfortable motion assistance. Different features have been used in recent studies to enhance the pHRI in upper-limb exoskeleton robots. However, less attention has been given to integrating kinematic redundancy into upper-limb exoskeleton robots to improve the pHRI. In this context, this paper proposes a six-degrees-of-freedom (DoF upper-limb exoskeleton robot (6-REXOS for the motion assistance of physically weak individuals. The 6-REXOS uses a kinematically different structure to that of the human lower arm, where the exoskeleton robot is worn. The 6-REXOS has four active DoFs to generate the motion of the human lower arm. Furthermore, two flexible bellow couplings are attached to the wrist and elbow joints to generate two passive DoFs. These couplings not only allow translational motion in wrist and elbow joints but also a redundancy in the robot. Furthermore, the compliance of the flexible coupling contributes to avoiding misalignments between human and robot joint axes. The redundancy in the 6-REXOS is verified based on manipulability index, minimum singular value, condition number and manipulability ellipsoids. The 6-REXOS and a four-DoF exoskeleton robot are compared to verify the manipulation advantage due to the redundancy. The four-DoF exoskeleton robot is designed by excluding the two passive DoFs of the 6-REXOS. In addition, a kinematic model is proposed for the human lower arm to validate the performance of the 6-REXOS. Kinematic analysis and simulations are carried out to validate the 6-REXOS and human-lower-arm model.

  7. E2Rebot: A robotic platform for upper limb rehabilitation in patients with neuromotor disability

    Directory of Open Access Journals (Sweden)

    Juan C Fraile

    2016-08-01

    Full Text Available The use of robotic platforms for neuro-rehabilitation may boost the neural plasticity process and improve motor recovery in patients with upper limb mobility impairment as a consequence of an acquired brain injury. A robotic platform for this aim must provide ergonomic and friendly design, human safety, intensive task-oriented therapy, and assistive forces. Its implementation is a complex process that involves new developments in the mechanical, electronics, and control fields. This article presents the end-effector rehabilitation robot, a 2-degree-of-freedom planar robotic platform for upper limb rehabilitation in patients with neuromotor disability after a stroke. We describe the ergonomic mechanical design, the system control architecture, and the rehabilitation therapies that can be performed. The impedance-based haptic controller implemented in end-effector rehabilitation robot uses the information provided by a JR3 force sensor to achieve an efficient and friendly patient–robot interaction. Two task-oriented therapy modes have been implemented based on the “assist as needed” paradigm. As a result, the amount of support provided by the robot adapts to the patient’s requirements, maintaining the therapy as intensive as possible without compromising the patient’s health and safety and promoting engagement.

  8. Lower limb fractures in adult patients with residua of poliomyelitis ...

    African Journals Online (AJOL)

    Few studies have been published in the literature regarding fractures of limbs in patients with poliomyelitis. We have conducted a retrospective study from 1992 to 2004 in order to present our data on fractures of lower limbs in adult patients with residua of poliomyelitis. During the thirteen-year period under study, only eight ...

  9. Micro-lightguide spectrophotometry for tissue perfusion in ischemic limbs

    DEFF Research Database (Denmark)

    Jørgensen, Lise Pyndt; Schroeder, Torben V

    2012-01-01

    To validate micro-lightguide spectrophotometry (O2C) in patients with lower limb ischemia and to compare results with those obtained from toe blood pressure.......To validate micro-lightguide spectrophotometry (O2C) in patients with lower limb ischemia and to compare results with those obtained from toe blood pressure....

  10. Prenatal MRI evaluation of limb-body wall complex

    Energy Technology Data Exchange (ETDEWEB)

    Aguirre-Pascual, Elisa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Hospital Universitario Doce de Octubre, Department of Radiology, Madrid (Spain); Epelman, Monica [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Johnson, Ann M.; Chauvin, Nancy A.; Coleman, Beverly G.; Victoria, Teresa [Perelman School of Medicine at the University of Pennsylvania, Department of Radiology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

    2014-11-15

    The sonographic (US) features of limb-body wall complex have been well documented; however the literature regarding the findings on MRI in limb-body wall complex is scant. To characterize the prenatal MRI features of limb-body wall complex. We performed a retrospective review of all MRI scans of fetuses diagnosed with limb-body wall complex at our institution from 2001 to 2011. Fetuses without correlating US scans or follow-up information were excluded. Three pediatric radiologists blinded to the specific US findings reviewed the prenatal MRIs. Images were evaluated for the organ location and attachment, the body part affected, characterization of the body wall defect, and spinal, limb and umbilical cord abnormalities. Ten subjects met inclusion criteria. MRI was able to detect and characterize the body part affected and associated abnormalities. All fetuses had ventral wall defects, a small thorax and herniated liver and bowel. The kidneys were extracorporeal in three cases. The extruded organs were attached to the placenta or the uterine wall in all cases. Abnormal spinal curvatures of various degrees of severity were present in all cases. Eight cases had a short, uncoiled cord. Limb anomalies were present in 6 of the 10 cases. We illustrate the common fetal MRI findings of limb-body wall complex. The prenatal diagnosis of limb-body wall complex and the differentiation of this defect from treatable abdominal wall defects are crucial to providing appropriate guidance for patient counseling and management. (orig.)

  11. Upper limb function in adults with Duchenne muscular dystrophy

    NARCIS (Netherlands)

    B. Bartels (Bart); R.F. Pangalila (Robert); M.P. Bergen (Michael); N.A.M. Cobben (Nicolle); H.J. Stam (Henk); M.E. Roebroeck (Marij)

    2011-01-01

    textabstractTo determine upper limb function and associated factors in adults with Duchenne muscular dystrophy. Design: Cross-sectional study. Subjects: A sample of 70 men with Duchenne muscular dystrophy (age range 20-43 years). Methods: General motor function and, in particular, upper limb distal

  12. Congenital constriction ring syndrome of the limbs: A prospective ...

    African Journals Online (AJOL)

    In the upper limb malformations involved 42 digits; in the lower limb malformations involved 33 toes, one foot and fi ve legs. Four main types of lesions were found: constriction rings, intrauterine amputations, acrosyndactyly, and simple syndactyly. Conclusion: Congenital constriction ring syndrome is of uncertain aetiology ...

  13. Abnormal 201Tl limb scan due to unilateral tremor

    International Nuclear Information System (INIS)

    Simons, M.; Schelstraete, K.; Bratzlavsky, M.

    1982-01-01

    A abnormal intra- and interextremity distribution pattern on 201 Tl was observed on the limb scan of a patient with a unilateral tremor. This is ascribed to the increased blood flow in the muscles responsible for the tremor. The suggestion is made that the existence of tremor should be considered as a possible explanation for unexpected abnormalities on 201 Tl limb scintigrams

  14. Malignant bone tumors and limb-salvage surgery in children

    International Nuclear Information System (INIS)

    Meyer, James S.; Mackenzie, William

    2004-01-01

    Limb-salvage surgery plays a major role in the management of children with malignant bone tumors. This article provides background on the clinical presentation and imaging evaluation of children with malignant bone tumors and describes various limb-salvage procedures used in the treatment of these children. (orig.)

  15. Motorcycle limb injuries in a developing Country | Oluwadiya | West ...

    African Journals Online (AJOL)

    42.2% were due to collision with automobiles, 22% pedestrian while 8.7% were collisions between motorcycles. The use of protective/safety devices was practically non-existent. Seventy-six (66.1%) patients had lower limbs injuries, 25 (21.7%) patients had upper limb injuries while the remaining 14 (12.2%) injured both ...

  16. Navicular bone fracture in the pelvic limb in two horses

    International Nuclear Information System (INIS)

    Kaser-Hotz, B.; Ueltschi, G.; Hess, N.

    1991-01-01

    The case history, radiographic and scintigraphic findings of two horses with pelvic limb navicular bone fractures are presented. In both cases the fractures were of traumatic origin. One horse had a bilateral fracture of the navicular bone, distal border, the other horse had a fracture of the proximal articular border in one pelvic limb navicular bone

  17. Cell to cell signalling during vertebrate limb bud development

    NARCIS (Netherlands)

    Panman, Lia

    2004-01-01

    Communication between cells is essential during embryonic development. The vertebrate limb bud provides us a model to study signalling interactions between cells during patterning of embryonic tissues and organogenesis. In chapter 1 I give an introduction about limb bud development that is focussed

  18. The eventual outcome of patients who had lower limb amputations ...

    African Journals Online (AJOL)

    C De Klerk

    Background: Peripheral vascular disease (PVD) presenting with irreversible lower limb pathology has a high morbidity and mortality rate. This study aimed to determine the outcome of patients who underwent lower limb amputations (LLAs) because of PVD at Pelonomi Hospital, Bloemfontein, 2008–2011. Methods: ...

  19. Sex Differences in Limb and Joint Stiffness in Recreational Runners

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-09-01

    Full Text Available Purpose. Female runners are known to be at greater risk from chronic running injuries than age-matched males, although the exact mechanisms are often poorly understood. The aim of the current investigation was to determine if female recreational runners exhibit distinct limb and joint stiffness characteristics in relation to their male counterparts. Methods. Fourteen male and fourteen female runners ran over a force platform at 4.0 m · s-1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system operating at 250 Hz. Measures of limb and joint stiffness were calculated as a function of limb length and joint moments divided by the extent of limb and joint excursion. All stiffness and joint moment parameters were normalized to body mass. Sex differences in normalized limb and knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that normalized limb (male = 0.18 ± 0.07, female = 0.37 ± 0.10 kN · kg · m-1 and knee stiffness (male = 5.59 ± 2.02, female = 7.34 ± 1.78 Nm · kg · rad-1 were significantly greater in female runners. Conclusions. On the basis that normalized knee and limb stiffness were shown to be significantly greater in female runners, the findings from the current investigation may provide further insight into the aetiology of the distinct injury patterns observed between sexes.

  20. Modular control of limb movements during human locomotion

    NARCIS (Netherlands)

    Ivanenko, Yuri P; Cappellini, Germana; Dominici, Nadia; Poppele, Richard E; Lacquaniti, Francesco

    2007-01-01

    The idea that the CNS may control complex interactions by modular decomposition has received considerable attention. We explored this idea for human locomotion by examining limb kinematics. The coordination of limb segments during human locomotion has been shown to follow a planar law for walking at

  1. Development of Device to Evoke Stretch Reflexes by Use of Electromagnetic Force for the Rehabilitation of the Hemiplegic Upper Limb after Stroke

    Science.gov (United States)

    Hayashi, Ryota; Ishimine, Tomoyasu; Kawahira, Kazumi; Yu, Yong; Tsujio, Showzow

    In this research, we focus on the method of rehabilitation with stretch reflexes for the hemiplegic upper limb in stroke patients. We propose a new device which utilizes electromagnetic force to evoke stretch reflexes. The device can exert an assisting force safely, because the electromagnetic force is non contact force. In this paper, we develop a support system applying the proposed device for the functional recovery training of the hemiplegic upper limb. The results obtained from several clinical tests with and without our support system are compared. Then we discuss the validity of our support system.

  2. The hybrid electric vehicle revolution, off road

    Energy Technology Data Exchange (ETDEWEB)

    Wood, B.E. [ePower Technologies (United States)

    2004-07-01

    In this presentation the author presents concepts and details of hybrid vehicles in general, including their benefits, then describes off-road hybrid vehicles. Hybrid vehicles have been experimented with for over a century. Demonstrator vehicles include a diesel-electric tractor, an electric lawn tractor, a hybrid snow thrower, and a hybrid wheel loader. A duty cycle for the loader is shown with battery-assisted acceleration, and regenerative braking. Both of these keep the size of the engine small, the loads on it less variable, thus improving fuel economy. A hybrid excavator and its duty cycle is shown. A fuel cell lift truck that is currently in design is illustrated. The author then describes the possibilities of the hydrogen economy where sourcing and infrastructure are yet to be demonstrated on a commercial scale. The author predicts that off-road hydrogen fuel cell vehicles will be commercially viable five years before on-road applications. The author predicts hydrogen sourced from biogas, photovoltaics, and wind power. tabs, figs.

  3. Robotics in Lower-Limb Rehabilitation after Stroke.

    Science.gov (United States)

    Zhang, Xue; Yue, Zan; Wang, Jing

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

  4. Brain machine interface and limb reanimation technologies: restoring function after spinal cord injury through development of a bypass system.

    Science.gov (United States)

    Lobel, Darlene A; Lee, Kendall H

    2014-05-01

    Functional restoration of limb movement after traumatic spinal cord injury (SCI) remains the ultimate goal in SCI treatment and directs the focus of current research strategies. To date, most investigations in the treatment of SCI focus on repairing the injury site. Although offering some promise, these efforts have met with significant roadblocks because treatment measures that are successful in animal trials do not yield similar results in human trials. In contrast to biologic therapies, there are now emerging neural interface technologies, such as brain machine interface (BMI) and limb reanimation through electrical stimulators, to create a bypass around the site of the SCI. The BMI systems analyze brain signals to allow control of devices that are used to assist SCI patients. Such devices may include a computer, robotic arm, or exoskeleton. Limb reanimation technologies, which include functional electrical stimulation, epidural stimulation, and intraspinal microstimulation systems, activate neuronal pathways below the level of the SCI. We present a concise review of recent advances in the BMI and limb reanimation technologies that provides the foundation for the development of a bypass system to improve functional outcome after traumatic SCI. We also discuss challenges to the practical implementation of such a bypass system in both these developing fields. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  5. Recent Trends in Lower-Limb Robotic Rehabilitation Orthosis: Control Scheme and Strategy for Pneumatic Muscle Actuated Gait Trainers

    Directory of Open Access Journals (Sweden)

    Mohd Azuwan Mat Dzahir

    2014-04-01

    Full Text Available It is a general assumption that pneumatic muscle-type actuators will play an important role in the development of an assistive rehabilitation robotics system. In the last decade, the development of a pneumatic muscle actuated lower-limb leg orthosis has been rather slow compared to other types of actuated leg orthoses that use AC motors, DC motors, pneumatic cylinders, linear actuators, series elastic actuators (SEA and brushless servomotors. However, recent years have shown that the interest in this field has grown exponentially, mainly due to the demand for a more compliant and interactive human-robotics system. This paper presents a survey of existing lower-limb leg orthoses for rehabilitation, which implement pneumatic muscle-type actuators, such as McKibben artificial muscles, rubbertuators, air muscles, pneumatic artificial muscles (PAM or pneumatic muscle actuators (PMA. It reviews all the currently existing lower-limb rehabilitation orthosis systems in terms of comparison and evaluation of the design, as well as the control scheme and strategy, with the aim of clarifying the current and on-going research in the lower-limb robotic rehabilitation field.

  6. Post-transplant distal limb syndrome

    Directory of Open Access Journals (Sweden)

    María Florencia Borghi Torzillo

    2017-02-01

    Full Text Available The post-transplant distal limb syndrome is a not well known entity, with a prevalence of 5% in patients with renal transplant. Its diagnosis is based on clinical symptoms, bone scintigraphy and MRI, it has a benign course and the patient recovers without sequel. We present the case of a 37-year-old male, with medical history of hypertension, Berger's disease in 1999 that required dialysis three times a week for four years (2009-2013 and renal transplant in 2013. The patient consults on January 2014 referring severe pain in both feet, with sudden onset; he remembers the exact date of the beginning of the pain and denies trauma, pain prevents ambulation. The bone scintigraphy shows pathological uptake in both feet with no difference between the two. Although there is no treatment for this disease, it has a benign course

  7. How x rays inhibit amphibian limb regeneration

    International Nuclear Information System (INIS)

    Maden, M.; Wallace, H.

    1976-01-01

    The effects of an inhibiting dose of 2,000 rad of x-rays on the regenerating limbs of axolotl larvae have been examined in a histological and cytological study. Particular attention was paid to the mitotic indices of normal and irradiated epidermal and blastemal cells. Both the characteristic pattern of epidermal mitotic stimulation which normally follows amputation and the later increase in blastemal mitoses are suppressed by irradiation. In most cells the effects are permanent, but in a small proportion a mitotic delay is induced and upon subsequent division chromosome damage in the form of micronuclei is revealed. Thus irradiated cells which do divide almost certainly die. These results are discussed in relation to other theories of x-ray inhibition of regeneration with particular reference to the view that irradiated cells can be reactivated

  8. Sensory feedback in upper limb prosthetics.

    Science.gov (United States)

    Antfolk, Christian; D'Alonzo, Marco; Rosén, Birgitta; Lundborg, Göran; Sebelius, Fredrik; Cipriani, Christian

    2013-01-01

    One of the challenges facing prosthetic designers and engineers is to restore the missing sensory function inherit to hand amputation. Several different techniques can be employed to provide amputees with sensory feedback: sensory substitution methods where the recorded stimulus is not only transferred to the amputee, but also translated to a different modality (modality-matched feedback), which transfers the stimulus without translation and direct neural stimulation, which interacts directly with peripheral afferent nerves. This paper presents an overview of the principal works and devices employed to provide upper limb amputees with sensory feedback. The focus is on sensory substitution and modality matched feedback; the principal features, advantages and disadvantages of the different methods are presented.

  9. Phantom Limb Pain in Pediatric Oncology

    Directory of Open Access Journals (Sweden)

    Patrick DeMoss

    2018-04-01

    Full Text Available Phantom limb pain (PLP is a prevalent problem for children and adolescents undergoing amputation due to cancer treatment. The symptoms are wide ranging from sharp to tingling. PLP in children typically lasts for a few minutes but can be almost constant and can be highly distressing. This focused review describes the characteristics, epidemiology, mechanisms, and evidence-based treatment of PLP in pediatric populations, focusing on pediatric cancer. In pediatric oncology, the administration of chemotherapy is a risk factor that potentially sensitizes the nervous system and predisposes pediatric cancer patients to develop PLP after amputation. Gabapentin, tricyclic antidepressants, opiates, nerve blocks, and epidural catheters have shown mixed success in adults and case reports document potential utility in pediatric patients. Non-pharmacologic treatments, such as mirror therapy, psychotherapy, and acupuncture have also been used in pediatric PLP with success. Prospective controlled trials are necessary to advance care for pediatric patients with PLP.

  10. Technologies Assessing Limb Bradykinesia in Parkinson's Disease.

    Science.gov (United States)

    Hasan, Hasan; Athauda, Dilan S; Foltynie, Thomas; Noyce, Alastair J

    2017-01-01

    The MDS-UPDRS (Movement Disorders Society - Unified Parkinson's Disease Rating Scale) is the most widely used scale for rating impairment in PD. Subscores measuring bradykinesia have low reliability that can be subject to rater variability. Novel technological tools can be used to overcome such issues. To systematically explore and describe the available technologies for measuring limb bradykinesia in PD that were published between 2006 and 2016. A systematic literature search using PubMed (MEDLINE), IEEE Xplore, Web of Science, Scopus and Engineering Village (Compendex and Inspec) databases was performed to identify relevant technologies published until 18 October 2016. 47 technologies assessing bradykinesia in PD were identified, 17 of which offered home and clinic-based assessment whilst 30 provided clinic-based assessment only. Of the eligible studies, 7 were validated in a PD patient population only, whilst 40 were tested in both PD and healthy control groups. 19 of the 47 technologies assessed bradykinesia only, whereas 28 assessed other parkinsonian features as well. 33 technologies have been described in additional PD-related studies, whereas 14 are not known to have been tested beyond the pilot phase. Technology based tools offer advantages including objective motor assessment and home monitoring of symptoms, and can be used to assess response to intervention in clinical trials or routine care. This review provides an up-to-date repository and synthesis of the current literature regarding technology used for assessing limb bradykinesia in PD. The review also discusses the current trends with regards to technology and discusses future directions in development.

  11. Lower limb joint replacement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2012-06-01

    Full Text Available Abstract Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov. We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR and total knee replacement (TKR have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.

  12. MR imaging in congenital lower limb deformities

    International Nuclear Information System (INIS)

    Laor, T.; Jaramillo, D.; Hoffer, F.A.; Kasser, J.R.

    1996-01-01

    Treatment for children with cogenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n=5), tibial hemimelia (n=5), and congenital constriction bands (n=3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tribial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congential constriction bands. Articular abormalities in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but one limb imaged had absent or attenuated muscle groups. Of the nine MR arteriograms performed at the level of the knee, eight were abnormal. The normal popliteal trifurcation was absent or in an abnormal location. We conclude that MR imaging of children with congenital lower extremity deformities shows many osteochondral and extraosseous abnormalities that are not depicted by conventional radiogrpahy. This information can help to plan early surgical intervention and prosthetic rehabilitation. (orig.)

  13. Geographic variation in gorilla limb bones.

    Science.gov (United States)

    Jabbour, Rebecca S; Pearman, Tessa L

    2016-06-01

    Gorilla systematics has received increased attention over recent decades from primatologists, conservationists, and paleontologists. Studies of geographic variation in DNA, skulls, and teeth have led to new taxonomic proposals, such as recognition of two gorilla species, Gorilla gorilla (western gorilla) and Gorilla beringei (eastern gorilla). Postcranial differences between mountain gorillas (G. beringei beringei) and western lowland gorillas (G. g. gorilla) have a long history of study, but differences between the limb bones of the eastern and western species have not yet been examined with an emphasis on geographic variation within each species. In addition, proposals for recognition of the Cross River gorilla as Gorilla gorilla diehli and gorillas from Tshiaberimu and Kahuzi as G. b. rex-pymaeorum have not been evaluated in the context of geographic variation in the forelimb and hindlimb skeletons. Forty-three linear measurements were collected from limb bones of 266 adult gorillas representing populations of G. b. beringei, Gorilla beringei graueri, G. g. gorilla, and G. g. diehli in order to investigate geographic diversity. Skeletal elements included the humerus, radius, third metacarpal, third proximal hand phalanx, femur, tibia, calcaneus, first metatarsal, third metatarsal, and third proximal foot phalanx. Comparisons of means and principal components analyses clearly differentiate eastern and western gorillas, indicating that eastern gorillas have absolutely and relatively smaller hands and feet, among other differences. Gorilla subspecies and populations cluster consistently by species, although G. g. diehli may be similar to the eastern gorillas in having small hands and feet. The subspecies of G. beringei are distinguished less strongly and by different variables than the two gorilla species. Populations of G. b. graueri are variable, and Kahuzi and Tshiaberimu specimens do not cluster together. Results support the possible influence of

  14. [Psychotherapies for the Treatment of Phantom Limb Pain].

    Science.gov (United States)

    Cárdenas, Katherine; Aranda, Mariana

    The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis. The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  15. Structure design of lower limb exoskeletons for gait training

    Science.gov (United States)

    Li, Jianfeng; Zhang, Ziqiang; Tao, Chunjing; Ji, Run

    2015-09-01

    Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.

  16. Hybrid Management in Hospitals

    DEFF Research Database (Denmark)

    Byrkjeflot, Haldor; Jespersen, Peter Kragh

    2010-01-01

    Artiklen indeholder et litteraturbaseret studium af ledelsesformer i sygehuse, hvor sundhedsfaglig ledelse og generel ledelse mikses til hybride ledelsesformer......Artiklen indeholder et litteraturbaseret studium af ledelsesformer i sygehuse, hvor sundhedsfaglig ledelse og generel ledelse mikses til hybride ledelsesformer...

  17. Hydraulic Hybrid Vehicles

    Science.gov (United States)

    EPA and the United Parcel Service (UPS) have developed a hydraulic hybrid delivery vehicle to explore and demonstrate the environmental benefits of the hydraulic hybrid for urban pick-up and delivery fleets.

  18. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and postosteomyelitis pseudarthrosis

    OpenAIRE

    Ibrahima F; Fokam P; Mouafo Tambo FF

    2014-01-01

    Farikou Ibrahima,1,2 Pius Fokam,2 Félicien Faustin Mouafo Tambo11Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, 2Department of Surgery, Douala General Hospital, Douala, CameroonBackground: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device.Objective: The objective was to treat the pseudarthrosis and correc...

  19. Unilateral versus bilateral upper limb training after stroke: The upper limb training after stroke clinical trial

    OpenAIRE

    van Delden, AL; Peper, CE; Nienhuys, KN; Zijp, NI; Beek, PJ; Kwakkel, G

    2013-01-01

    This article is available open access through the publisher’s website at the link below. Copyright © 2013 American Heart Association, Inc. Background and Purpose — Unilateral and bilateral training protocols for upper limb rehabilitation after stroke represent conceptually contrasting approaches with the same ultimate goal. In a randomized controlled trial, we compared the merits of modified constraint-induced movement therapy, modified bilateral arm training with rhythmic auditory cueing,...

  20. Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial.

    Science.gov (United States)

    Rink, Cameron; Wernke, Matthew M; Powell, Heather M; Gynawali, Surya; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2016-01-01

    A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation. ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1.

  1. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and postosteomyelitis pseudarthrosis

    Directory of Open Access Journals (Sweden)

    Ibrahima F

    2014-05-01

    Full Text Available Farikou Ibrahima,1,2 Pius Fokam,2 Félicien Faustin Mouafo Tambo11Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, 2Department of Surgery, Douala General Hospital, Douala, CameroonBackground: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device.Objective: The objective was to treat the pseudarthrosis and correct the consequent limb length discrepancy of 50 mm.Materials and methods: The patient was a 5-year-old boy. Osteotomy of the tibia, excision of fibrosis, and decortications were carried out. After a latency period of 5 days, the lengthening started at a rate of 1 mm per day.Results: The pseudarthrosis healed and the gained correction was 21.73%. The index consolidation was 49 days/cm. Minor complications were reported.Discussion: Osteomyelitis of long bones is a common poverty-related disease in Africa. The disease usually is diagnosed at an advanced stage with complications. In these conditions, treatment is much more difficult. Most surgical procedures treating this condition use the Ilizarov device. The most common reported surgical complications are refractures and recurrence of infection.Conclusion: This technique should be popularized in countries with limited resources because it would be an attractive alternative to the amputations that are sometimes performed.Keywords: Limb length discrepancy (LLD, bone gap, Ilizarov device

  2. Mesoscale hybrid calibration artifact

    Science.gov (United States)

    Tran, Hy D.; Claudet, Andre A.; Oliver, Andrew D.

    2010-09-07

    A mesoscale calibration artifact, also called a hybrid artifact, suitable for hybrid dimensional measurement and the method for make the artifact. The hybrid artifact has structural characteristics that make it suitable for dimensional measurement in both vision-based systems and touch-probe-based systems. The hybrid artifact employs the intersection of bulk-micromachined planes to fabricate edges that are sharp to the nanometer level and intersecting planes with crystal-lattice-defined angles.

  3. Exotendons for assistance of human locomotion

    Directory of Open Access Journals (Sweden)

    van den Bogert Antonie J

    2003-10-01

    Full Text Available Abstract Background Powered robotic exoskeletons for assistance of human locomotion are currently under development for military and medical applications. The energy requirements for such devices are excessive, and this has become a major obstacle for practical applications. Legged locomotion in many animals, however, is very energy efficient. We propose that poly-articular elastic mechanisms are a major contributor to the economy of locomotion in such specialized animals. Consequently, it should be possible to design unpowered assistive devices that make effective use of similar mechanisms. Methods A passive assistive technology is presented, based on long elastic cords attached to an exoskeleton and guided by pulleys placed at the joints. A general optimization procedure is described for finding the best geometrical arrangement of such "exotendons" for assisting a specific movement. Optimality is defined either as minimal residual joint moment or as minimal residual joint power. Four specific exotendon systems with increasing complexity are considered. Representative human gait data were used to optimize each of these four systems to achieve maximal assistance for normal walking. Results The most complex exotendon system, with twelve pulleys per limb, was able to reduce the joint moments required for normal walking by 71% and joint power by 74%. A simpler system, with only three pulleys per limb, could reduce joint moments by 46% and joint power by 47%. Conclusion It is concluded that unpowered passive elastic devices can substantially reduce the muscle forces and the metabolic energy needed for walking, without requiring a change in movement. When optimally designed, such devices may allow independent locomotion in patients with large deficits in muscle function.

  4. A Novel Combined Hybrid Approach to Enable Revascularisation of a Trauma-Induced Subclavian Artery Injury

    Directory of Open Access Journals (Sweden)

    C.N. Sabbagh

    Full Text Available : Introduction: This case highlights the complexity of upper limb revascularization after a subclavian artery traumatic injury and strengthens the role of a hybrid/multi-disciplinary approach to such injuries. Report: A 45-year-old male patient presented with an acute right upper limb following a traumatic injury to the right subclavian artery due to a motor vehicle accident (MVA. Associated injuries included an unstable cervical spine injury, a large open right clavicular injury, and a brain injury, which limited the potential revascularisation options available. The arm was revascularised using a hybrid endovascular/open surgical approach, namely embolization of the proximal subclavian artery (just distal to vertebral artery and a right common femoral artery to distal axillary artery bypass using prosthetic material. Discussion: Blunt injuries to the subclavian artery are often high impact, complex and associated with multiple injuries to surrounding structures, which limit the role of standard procedures used in the elective setting. This case highlights the role of multidisciplinary team involvement, using a hybrid approach and a novel distal inflow site to restore upper limb perfusion. Keywords: Upper limb, Ischemia, Trauma, Revascularization

  5. Limb patterning genes and heterochronic development of the emu wing bud

    Directory of Open Access Journals (Sweden)

    Craig A. Smith

    2016-12-01

    Full Text Available Abstract Background The forelimb of the flightless emu is a vestigial structure, with greatly reduced wing elements and digit loss. To explore the molecular and cellular mechanisms associated with the evolution of vestigial wings and loss of flight in the emu, key limb patterning genes were examined in developing embryos. Methods Limb development was compared in emu versus chicken embryos. Immunostaining for cell proliferation markers was used to analyze growth of the emu forelimb and hindlimb buds. Expression patterns of limb patterning genes were studied, using whole-mount in situ hybridization (for mRNA localization and RNA-seq (for mRNA expression levels. Results The forelimb of the emu embryo showed heterochronic development compared to that in the chicken, with the forelimb bud being retarded in its development. Early outgrowth of the emu forelimb bud is characterized by a lower level of cell proliferation compared the hindlimb bud, as assessed by PH3 immunostaining. In contrast, there were no obvious differences in apoptosis in forelimb versus hindlimb buds (cleaved caspase 3 staining. Most key patterning genes were expressed in emu forelimb buds similarly to that observed in the chicken, but with smaller expression domains. However, expression of Sonic Hedgehog (Shh mRNA, which is central to anterior–posterior axis development, was delayed in the emu forelimb bud relative to other patterning genes. Regulators of Shh expression, Gli3 and HoxD13, also showed altered expression levels in the emu forelimb bud. Conclusions These data reveal heterochronic but otherwise normal expression of most patterning genes in the emu vestigial forelimb. Delayed Shh expression may be related to the small and vestigial structure of the emu forelimb bud. However, the genetic mechanism driving retarded emu wing development is likely to rest within the forelimb field of the lateral plate mesoderm, predating the expression of patterning genes.

  6. Hybrid quantum information processing

    Energy Technology Data Exchange (ETDEWEB)

    Furusawa, Akira [Department of Applied Physics, School of Engineering, The University of Tokyo (Japan)

    2014-12-04

    I will briefly explain the definition and advantage of hybrid quantum information processing, which is hybridization of qubit and continuous-variable technologies. The final goal would be realization of universal gate sets both for qubit and continuous-variable quantum information processing with the hybrid technologies. For that purpose, qubit teleportation with a continuousvariable teleporter is one of the most important ingredients.

  7. Kinematic measures for upper limb motor assessment during robot-mediated training in patients with severe sub-acute stroke.

    Science.gov (United States)

    Duret, Christophe; Courtial, Ophélie; Grosmaire, Anne Gaelle

    2016-01-01

    Kinematic assessments are increasingly used as motor outcome measures during upper limb robot-assisted training, in addition to clinical scales. However, their relevance has not been evaluated much. Thirty-eight patients with severe sub-acute stroke (age 56 ± 17 [19-87] years; time since stroke, 55 ± 22 days) carried out 16 sessions (average 3/week, 35 ± 15 days) of upper limb robot-assisted training combined with standard therapy. Pre/post motor performance was evaluated using the Fugl-Meyer Assessment scale, Motor Status Scale (MSS) and kinematic measures. Motor outcomes were compared and relationships between clinical and kinematic outcomes were analyzed. All clinical and kinematic outcomes improved after training (p kinematic measures were strongly correlated with clinical scores. Correlations between clinical and kinematic changes were moderate (r = -0.65 for change in FM Proximal score and change in accuracy measure). However, smoothness and accuracy indicators were shown to be responsive measures. This study demonstrated that baseline kinematic measures and their pre/post training changes were significantly correlated with clinical motor outcome measures. However, even if kinematic measures are valid for the evaluation of motor impairment we cannot propose to substitute common clinical measures of motor function which also evaluate functional abilities of the upper limb.

  8. Tactile, thermal, and electrical thresholds in patients with and without phantom limb pain after traumatic lower limb amputation

    Directory of Open Access Journals (Sweden)

    Li S

    2015-04-01

    Full Text Available Shengai Li,1,2 Danielle H Melton,1,2 Sheng Li1,2 1Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX, USA; 2Neurorehabilitation Research Laboratory, TIRR Memorial Hermann Research Center, Houston, TX, USA Purpose: To examine whether there is central sensitization in patients with phantom limb pain (PLP after traumatic limb amputation. Methods: Seventeen patients after unilateral lower limb amputation secondary to trauma were enrolled. Ten patients had chronic PLP, while the other seven patients had no PLP. Tactile-sensation threshold, cold- and warm-sensation thresholds, cold- and heat-pain thresholds, electrical-sensation threshold (EST, and electrical-pain threshold on the distal residual limb and the symmetrical site on the sound limb were measured in all tested patients. Their thresholds were compared within the PLP and non-PLP group, and between the groups. Results: The novel findings included: 1 electrical-pain threshold was only decreased in the sound limb in the PLP group and there was no difference between two limbs in the non-PLP group, suggesting central sensitization in patients with PLP; and 2 EST was increased on the affected limb as compared to the sound limb within the PLP group, but there were no significant differences in EST between the PLP and non-PLP group. There were in general no significant differences in other tested thresholds within the groups and between groups. Conclusion: Our results demonstrate central sensitization in the patients with PLP after traumatic limb amputation. Keywords: central sensitization, pain threshold, human

  9. Capturing the Perceived Phantom Limb through Virtual Reality

    Directory of Open Access Journals (Sweden)

    Christian Rogers

    2016-01-01

    Full Text Available Phantom limb is the sensation amputees may feel when the missing limb is still attached to the body and is still moving as it would if it still existed. Despite there being between 50 and 80% of amputees who report neuropathic pain, also known as phantom limb pain (PLP, there is still little understanding of why PLP occurs. There are no fully effective long-term treatments available. One of the struggles with PLP is the difficulty for amputees to describe the sensations of their phantom limbs. The sensations may be of a limb that is in a position that is impossible for a normal limb to attain. The goal of this project was to treat those with PLP by developing a system to communicate the sensations those with PLP were experiencing accurately and easily through various hand positions using a model arm with a user friendly interface. The system was developed with Maya 3D animation software, the Leap Motion input device, and the Unity game engine. The 3D modeled arm was designed to mimic the phantom sensation being able to go beyond normal joint extensions of regular arms. The purpose in doing so was to obtain a true 3D visualization of the phantom limb.

  10. MONITORING OF LOWER LIMB COMFORT AND INJURY IN ELITE FOOTBALL

    Directory of Open Access Journals (Sweden)

    Michael Kinchington

    2010-12-01

    Full Text Available The aim of the study was to examine the relation between lower limb comfort scores and injury and to measure the responsiveness of a lower limb comfort index (LLCI to changes over time, in a cohort of professional footballers. Lower limb comfort was recorded for each individual using a comfort index which assessed the comfort status of five anatomical segments and footwear. Specifically we tested the extent to which comfort zones as measured by the LLCI were related to injury measured as time loss events. The hypothesis for the study was that poor lower limb comfort is related to time loss events (training or match day. A total of 3524 player weeks of data was collected from 182 professional athletes encompassing three codes of football (Australian Rules, Rugby league, Rugby Union. The study was conducted during football competition periods for the respective football leagues and included a period of pre- season training. The results of regression indicated that poor lower limb comfort was highly correlated to injury (R2 =0.77 and accounted for 43.5 time loss events/ 1000hrs football exposure. While poor comfort was predictive of injury 47% of all time loss events it was not statistically relevant (R2 =0.18. The results indicate lower limb comfort can be used to assess the well-being of the lower limb; poor comfort is associated with injury, and the LLCI has good face validity and high criterion-related validity for the relationship between comfort and injury

  11. Limb flexion-induced axial compression and bending in human femoropopliteal artery segments.

    Science.gov (United States)

    Poulson, William; Kamenskiy, Alexey; Seas, Andreas; Deegan, Paul; Lomneth, Carol; MacTaggart, Jason

    2018-02-01

    High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations are poorly characterized. The goal of this study was to quantify axial compression and bending of human FPAs that are placed in positions commonly assumed during the normal course of daily activities. Retrievable nitinol markers were deployed using a custom-made catheter system into 28 in situ FPAs of 14 human cadavers. Contrast-enhanced, thin-section computed tomography images were acquired with each limb in the standing (180 degrees), walking (110 degrees), sitting (90 degrees), and gardening (60 degrees) postures. Image segmentation and analysis allowed relative comparison of spatial locations of each intra-arterial marker to determine axial compression and bending using the arterial centerlines. Axial compression in the popliteal artery (PA) was greater than in the proximal superficial femoral artery (SFA) or the adductor hiatus (AH) segments in all postures (P = .02). Average compression in the SFA, AH, and PA ranged from 9% to 15%, 11% to 19%, and 13% to 25%, respectively. The FPA experienced significantly more acute bending in the AH and PA segments compared with the proximal SFA (P < .05) in all postures. In the walking, sitting, and gardening postures, average sphere radii in the SFA, AH, and PA ranged from 21 to 27 mm, 10 to 18 mm, and 8 to 19 mm, whereas bending angles ranged from 150 to 157 degrees, 136 to 147 degrees, and 137 to 148 degrees, respectively. The FPA experiences significant axial compression and bending during limb flexion that occur at even modest limb angles. Moreover, different segments of the FPA appear to undergo significantly different degrees of deformation. Understanding the effects of limb flexion on axial compression and

  12. Delayed amputation following trauma increases residual lower limb infection.

    Science.gov (United States)

    Jain, Abhilash; Glass, Graeme E; Ahmadi, Hootan; Mackey, Simon; Simmons, Jon; Hettiaratchy, Shehan; Pearse, Michael; Nanchahal, Jagdeep

    2013-04-01

    Residual limb infection following amputation is a devastating complication, resulting in delayed rehabilitation, repeat surgery, prolonged hospitalisation and poor functional outcome. The aim of this study was to identify variables predicting residual limb infection following non-salvageable lower limb trauma. All cases of non-salvageable lower limb trauma presenting to a specialist centre over 5 years were evaluated from a prospective database and clinical and management variables correlated with the development of deep infection. Forty patients requiring 42 amputations were identified with a mean age of 49 years (±19.9, 1SD). Amputations were performed for 21 Gustilo IIIB injuries, 12 multi-planar degloving injuries, seven IIIC injuries and one open Schatzker 6 fracture. One limb was traumatically amputated at the scene and surgically revised. Amputation level was transtibial in 32, through-knee in one and transfemoral in nine. Median time from injury to amputation was 4 days (range 0-30 days). Amputation following only one debridement and within 5 days resulted in significantly fewer stump infections (p = 0.026 and p = 0.03, respectively, Fisher's exact test). The cumulative probability of infection-free residual limb closure declined steadily from day 5. Multivariate analyses revealed that neither the nature of the injury nor pre-injury patient morbidity independently influenced residual limb infection. Avoiding residual limb infection is critically dependent on prompt amputation of non-salvageable limbs. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. A neural tracking and motor control approach to improve rehabilitation of upper limb movements

    Directory of Open Access Journals (Sweden)

    Schmid Maurizio

    2008-02-01

    Full Text Available Abstract Background Restoration of upper limb movements in subjects recovering from stroke is an essential keystone in rehabilitative practices. Rehabilitation of arm movements, in fact, is usually a far more difficult one as compared to that of lower extremities. For these reasons, researchers are developing new methods and technologies so that the rehabilitative process could be more accurate, rapid and easily accepted by the patient. This paper introduces the proof of concept for a new non-invasive FES-assisted rehabilitation system for the upper limb, called smartFES (sFES, where the electrical stimulation is controlled by a biologically inspired neural inverse dynamics model, fed by the kinematic information associated with the execution of a planar goal-oriented movement. More specifically, this work details two steps of the proposed system: an ad hoc markerless motion analysis algorithm for the estimation of kinematics, and a neural controller that drives a synthetic arm. The vision of the entire system is to acquire kinematics from the analysis of video sequences during planar arm movements and to use it together with a neural inverse dynamics model able to provide the patient with the electrical stimulation patterns needed to perform the movement with the assisted limb. Methods The markerless motion tracking system aims at localizing and monitoring the arm movement by tracking its silhouette. It uses a specifically designed motion estimation method, that we named Neural Snakes, which predicts the arm contour deformation as a first step for a silhouette extraction algorithm. The starting and ending points of the arm movement feed an Artificial Neural Controller, enclosing the muscular Hill's model, which solves the inverse dynamics to obtain the FES patterns needed to move a simulated arm from the starting point to the desired point. Both position error with respect to the requested arm trajectory and comparison between curvature factors

  14. Rehabilitation and return to running after lower limb stress fractures.

    Science.gov (United States)

    Liem, Brian C; Truswell, Hallie J; Harrast, Mark A

    2013-01-01

    Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the medical literature has focused primarily on rest and cessation of running, but little has been written about the rehabilitation and functional progression of runners following a lower limb stress fracture. This article reviews the scientific evidence behind common rehabilitation concepts used for runners recovering from these injuries and also discusses sport-specific training modalities such as deep water running and antigravity treadmill training. Overall this article is intended to be a practical resource for clinicians to guide runners in functional rehabilitation and return to running following lower limb stress injury.

  15. A hybrid joint based controller for an upper extremity exoskeleton

    Science.gov (United States)

    Mohd Khairuddin, Ismail; Taha, Zahari; Majeed, Anwar P. P. Abdul; Hakeem Deboucha, Abdel; Azraai Mohd Razman, Mohd; Aziz Jaafar, Abdul; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture.

  16. A hybrid joint based controller for an upper extremity exoskeleton

    International Nuclear Information System (INIS)

    Khairuddin, Ismail Mohd; Taha, Zahari; Majeed, Anwar P.P. Abdul; Deboucha, Abdel Hakeem; Razman, Mohd Azraai Mohd; Jaafar, Abdul Aziz; Mohamed, Zulkifli

    2016-01-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture. (paper)

  17. Marine Fish Hybridization

    KAUST Repository

    He, Song

    2017-04-01

    Natural hybridization is reproduction (without artificial influence) between two or more species/populations which are distinguishable from each other by heritable characters. Natural hybridizations among marine fishes were highly underappreciated due to limited research effort; it seems that this phenomenon occurs more often than is commonly recognized. As hybridization plays an important role in biodiversity processes in the marine environment, detecting hybridization events and investigating hybridization is important to understand and protect biodiversity. The first chapter sets the framework for this disseration study. The Cohesion Species Concept was selected as the working definition of a species for this study as it can handle marine fish hybridization events. The concept does not require restrictive species boundaries. A general history and background of natural hybridization in marine fishes is reviewed during in chapter as well. Four marine fish hybridization cases were examed and documented in Chapters 2 to 5. In each case study, at least one diagnostic nuclear marker, screened from among ~14 candidate markers, was found to discriminate the putative hybridizing parent species. To further investigate genetic evidence to support the hybrid status for each hybrid offspring in each case, haploweb analysis on diagnostic markers (nuclear and/or mitochondrial) and the DAPC/PCA analysis on microsatellite data were used. By combining the genetic evidences, morphological traits, and ecological observations together, the potential reasons that triggered each hybridization events and the potential genetic/ecology effects could be discussed. In the last chapter, sequences from 82 pairs of hybridizing parents species (for which COI barcoding sequences were available either on GenBank or in our lab) were collected. By comparing the COI fragment p-distance between each hybridizing parent species, some general questions about marine fish hybridization were discussed: Is

  18. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series.

    Science.gov (United States)

    Marr, Brendan; Yenumula, Panduranga

    2012-01-01

    Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

  19. Use of vacuum-assisted closure therapy following foot amputation.

    Science.gov (United States)

    Ballard, K; McGregor, F

    2001-08-01

    This case study highlights the use of vacuum-assisted closure (VAC) in a diabetic man following a partial transverse amputation of his foot. In this situation infection-free healing is imperative in order to salvage the limb and prevent further trauma. VAC therapy facilitates rapid granulation of wounds and reduces bacterial colonization rates. This method was adopted as a suitable therapy for treatment of a patient who suffered from a complex wound at high-risk of reinfection.

  20. Generating Electricity during Walking with a Lower Limb-Driven Energy Harvester: Targeting a Minimum User Effort.

    Directory of Open Access Journals (Sweden)

    Michael Shepertycky

    Full Text Available Much research in the field of energy harvesting has sought to develop devices capable of generating electricity during daily activities with minimum user effort. No previous study has considered the metabolic cost of carrying the harvester when determining the energetic effects it has on the user. When considering device carrying costs, no energy harvester to date has demonstrated the ability to generate a substantial amount of electricity (> 5W while maintaining a user effort at the same level or lower than conventional power generation methods (e.g. hand crank generator.We developed a lower limb-driven energy harvester that is able to generate approximately 9W of electricity. To quantify the performance of the harvester, we introduced a new performance measure, total cost of harvesting (TCOH, which evaluates a harvester's overall efficiency in generating electricity including the device carrying cost. The new harvester captured the motion from both lower limbs and operated in the generative braking mode to assist the knee flexor muscles in slowing the lower limbs. From a testing on 10 participants under different walking conditions, the harvester achieved an average TCOH of 6.1, which is comparable to the estimated TCOH for a conventional power generation method of 6.2. When generating 5.2W of electricity, the TCOH of the lower limb-driven energy harvester (4.0 is lower than that of conventional power generation methods.These results demonstrated that the lower limb-driven energy harvester is an energetically effective option for generating electricity during daily activities.

  1. The Armeo Spring as training tool to improve upper limb functionality in multiple sclerosis: a pilot study

    Directory of Open Access Journals (Sweden)

    Kerkhofs Lore

    2011-01-01

    Full Text Available Abstract Background Few research in multiple sclerosis (MS has focused on physical rehabilitation of upper limb dysfunction, though the latter strongly influences independent performance of activities of daily living. Upper limb rehabilitation technology could hold promise for complementing traditional MS therapy. Consequently, this pilot study aimed to examine the feasibility of an 8-week mechanical-assisted training program for improving upper limb muscle strength and functional capacity in MS patients with evident paresis. Methods A case series was applied, with provision of a training program (3×/week, 30 minutes/session, supplementary on the customary maintaining care, by employing a gravity-supporting exoskeleton apparatus (Armeo Spring. Ten high-level disability MS patients (Expanded Disability Status Scale 7.0-8.5 actively performed task-oriented movements in a virtual real-life-like learning environment with the affected upper limb. Tests were administered before and after training, and at 2-month follow-up. Muscle strength was determined through the Motricity Index and Jamar hand-held dynamometer. Functional capacity was assessed using the TEMPA, Action Research Arm Test (ARAT and 9-Hole Peg Test (9HPT. Results Muscle strength did not change significantly. Significant gains were particularly found in functional capacity tests. After training completion, TEMPA scores improved (p = 0.02, while a trend towards significance was found for the 9HPT (p = 0.05. At follow-up, the TEMPA as well as ARAT showed greater improvement relative to baseline than after the 8-week intervention period (p = 0.01, p = 0.02 respectively. Conclusions The results of present pilot study suggest that upper limb functionality of high-level disability MS patients can be positively influenced by means of a technology-enhanced physical rehabilitation program.

  2. Generating Electricity during Walking with a Lower Limb-Driven Energy Harvester: Targeting a Minimum User Effort.

    Science.gov (United States)

    Shepertycky, Michael; Li, Qingguo

    2015-01-01

    Much research in the field of energy harvesting has sought to develop devices capable of generating electricity during daily activities with minimum user effort. No previous study has considered the metabolic cost of carrying the harvester when determining the energetic effects it has on the user. When considering device carrying costs, no energy harvester to date has demonstrated the ability to generate a substantial amount of electricity (> 5W) while maintaining a user effort at the same level or lower than conventional power generation methods (e.g. hand crank generator). We developed a lower limb-driven energy harvester that is able to generate approximately 9W of electricity. To quantify the performance of the harvester, we introduced a new performance measure, total cost of harvesting (TCOH), which evaluates a harvester's overall efficiency in generating electricity including the device carrying cost. The new harvester captured the motion from both lower limbs and operated in the generative braking mode to assist the knee flexor muscles in slowing the lower limbs. From a testing on 10 participants under different walking conditions, the harvester achieved an average TCOH of 6.1, which is comparable to the estimated TCOH for a conventional power generation method of 6.2. When generating 5.2W of electricity, the TCOH of the lower limb-driven energy harvester (4.0) is lower than that of conventional power generation methods. These results demonstrated that the lower limb-driven energy harvester is an energetically effective option for generating electricity during daily activities.

  3. Limb Darkening and Planetary Transits: Testing Center-to-limb Intensity Variations and Limb-darkening Directly from Model Stellar Atmospheres

    Energy Technology Data Exchange (ETDEWEB)

    Neilson, Hilding R.; Lester, John B. [Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H4 (Canada); McNeil, Joseph T.; Ignace, Richard, E-mail: neilson@astro.utoronto.ca [Department of Physics and Astronomy, East Tennessee State University, Box 70652, Johnson City, TN 37614 (United States)

    2017-08-10

    The transit method, employed by Microvariability and Oscillation of Stars ( MOST ), Kepler , and various ground-based surveys has enabled the characterization of extrasolar planets to unprecedented precision. These results are precise enough to begin to measure planet atmosphere composition, planetary oblateness, starspots, and other phenomena at the level of a few hundred parts per million. However, these results depend on our understanding of stellar limb darkening, that is, the intensity distribution across the stellar disk that is sequentially blocked as the planet transits. Typically, stellar limb darkening is assumed to be a simple parameterization with two coefficients that are derived from stellar atmosphere models or fit directly. In this work, we revisit this assumption and compute synthetic planetary-transit light curves directly from model stellar atmosphere center-to-limb intensity variations (CLIVs) using the plane-parallel Atlas and spherically symmetric SAtlas codes. We compare these light curves to those constructed using best-fit limb-darkening parameterizations. We find that adopting parametric stellar limb-darkening laws leads to systematic differences from the more geometrically realistic model stellar atmosphere CLIV of about 50–100 ppm at the transit center and up to 300 ppm at ingress/egress. While these errors are small, they are systematic, and they appear to limit the precision necessary to measure secondary effects. Our results may also have a significant impact on transit spectra.

  4. A hybrid brain-machine interface based on EEG and EMG activity for the motor rehabilitation of stroke patients.

    Science.gov (United States)

    Sarasola-Sanz, Andrea; Irastorza-Landa, Nerea; Lopez-Larraz, Eduardo; Bibian, Carlos; Helmhold, Florian; Broetz, Doris; Birbaumer, Niels; Ramos-Murguialday, Ander

    2017-07-01

    Including supplementary information from the brain or other body parts in the control of brain-machine interfaces (BMIs) has been recently proposed and investigated. Such enriched interfaces are referred to as hybrid BMIs (hBMIs) and have been proven to be more robust and accurate than regular BMIs for assistive and rehabilitative applications. Electromyographic (EMG) activity is one of the most widely utilized biosignals in hBMIs, as it provides a quite direct measurement of the motion intention of the user. Whereas most of the existing non-invasive EEG-EMG-hBMIs have only been subjected to offline testings or are limited to one degree of freedom (DoF), we present an EEG-EMG-hBMI that allows the simultaneous control of 7-DoFs of the upper limb with a robotic exoskeleton. Moreover, it establishes a biologically-inspired hierarchical control flow, requiring the active participation of central and peripheral structures of the nervous system. Contingent visual and proprioceptive feedback about the user's EEG and EMG activity is provided in the form of velocity modulation during functional task training. We believe that training with this closed-loop system may facilitate functional neuroplastic processes and eventually elicit a joint brain and muscle motor rehabilitation. Its usability is validated during a real-time operation session in a healthy participant and a chronic stroke patient, showing encouraging results for its application to a clinical rehabilitation scenario.

  5. Botulinum toxin therapy for limb dystonias.

    Science.gov (United States)

    Yoshimura, D M; Aminoff, M J; Olney, R K

    1992-03-01

    We investigated the effectiveness of botulinum toxin in 17 patients with limb dystonias (10 with occupational cramps, three with idiopathic dystonia unrelated to activity, and two each with post-stroke and parkinsonian dystonia) in a placebo-controlled, blinded study. We identified affected muscles clinically and by recording the EMG from implanted wire electrodes at rest and during performance of tasks that precipitated abnormal postures. There were three injections given with graded doses of toxin (average doses, 5 to 10, 10 to 20, and 20 to 40 units per muscle) and one with placebo, in random order. Subjective improvement occurred after 53% of injections of botulinum toxin, and this was substantial in 24%. Only one patient (7%) improved after placebo injection. Subjective improvement occurred in 82% of patients with at least one dose of toxin, lasting for 1 to 4 months. Response rates were similar between clinical groups. Objective evaluation failed to demonstrate significant improvement following treatment with toxin compared with placebo. The major side effect was transient focal weakness after 53% of injections of toxin.

  6. Limb salvage treatment vs. amputation in sarcoma

    Directory of Open Access Journals (Sweden)

    Motamedi M

    1993-05-01

    Full Text Available Many years ago the treatment of sarcoma was radiotherapy up to 2000-4000 rad. This treatment was very complicated, due to producing neoplasm after radiotherapy. By this method of treatment of osteosarcoma, the rate of survival became about 20% (two years. The second method of treatment was chemotherapy for a period of 2-5 weeks that amputation was performed afterwards. By chemotherapy, the rate of being alive reached up to 25-27% (five years. Right now, the best treatment for sarcoma is limb salvage. In our report, the chance of being alive in chondrosarcoma was about four years. This was nearly the same as that of the other institutes in the world especially in America, Europe, and Japan. The rate of recurrence was also more than that from different parts of the world. The survival rate in osteosarcomatic patients was about two years less for males the females, and it was more in tall people than short ones. The survival rate of the patients with giant cell tumor was more than osteosarcoma up to five years, and it has no recurrence or metastasis

  7. Geophysical validation of SCIAMACHY Limb Ozone Profiles

    Directory of Open Access Journals (Sweden)

    E. J. Brinksma

    2006-01-01

    Full Text Available We discuss the quality of the two available SCIAMACHY limb ozone profile products. They were retrieved with the University of Bremen IFE's algorithm version 1.61 (hereafter IFE, and the official ESA offline algorithm (hereafter OL versions 2.4 and 2.5. The ozone profiles were compared to a suite of correlative measurements from ground-based lidar and microwave, sondes, SAGE II and SAGE III (Stratospheric Aerosol and Gas Experiment. To correct for the expected Envisat pointing errors, which have not been corrected implicitly in either of the algorithms, we applied a constant altitude shift of -1.5 km to the SCIAMACHY ozone profiles. The IFE ozone profile data between 16 and 40 km are biased low by 3-6%. The average difference profiles have a typical standard deviation of 10% between 20 and 35 km. We show that more than 20% of the SCIAMACHY official ESA offline (OL ozone profiles version 2.4 and 2.5 have unrealistic ozone values, most of these are north of 15° S. The remaining OL profiles compare well to correlative instruments above 24 km. Between 20 and 24 km, they underestimate ozone by 15±5%.

  8. Weather forecasting based on hybrid neural model

    Science.gov (United States)

    Saba, Tanzila; Rehman, Amjad; AlGhamdi, Jarallah S.

    2017-11-01

    Making deductions and expectations about climate has been a challenge all through mankind's history. Challenges with exact meteorological directions assist to foresee and handle problems well in time. Different strategies have been investigated using various machine learning techniques in reported forecasting systems. Current research investigates climate as a major challenge for machine information mining and deduction. Accordingly, this paper presents a hybrid neural model (MLP and RBF) to enhance the accuracy of weather forecasting. Proposed hybrid model ensure precise forecasting due to the specialty of climate anticipating frameworks. The study concentrates on the data representing Saudi Arabia weather forecasting. The main input features employed to train individual and hybrid neural networks that include average dew point, minimum temperature, maximum temperature, mean temperature, average relative moistness, precipitation, normal wind speed, high wind speed and average cloudiness. The output layer composed of two neurons to represent rainy and dry weathers. Moreover, trial and error approach is adopted to select an appropriate number of inputs to the hybrid neural network. Correlation coefficient, RMSE and scatter index are the standard yard sticks adopted for forecast accuracy measurement. On individual standing MLP forecasting results are better than RBF, however, the proposed simplified hybrid neural model comes out with better forecasting accuracy as compared to both individual networks. Additionally, results are better than reported in the state of art, using a simple neural structure that reduces training time and complexity.

  9. Myoelectric control of artificial limb inspired by quantum information processing

    International Nuclear Information System (INIS)

    Siomau, Michael; Jiang, Ning

    2015-01-01

    Precise and elegant coordination of a prosthesis across many degrees of freedom represents a significant challenge to efficient rehabilitation of people with limb deficiency. Processing the electrical neural signals collected from the surface of the remnant muscles of the stump is a common way to initiate and control the different movements available to the artificial limb. Based on the assumption that there are distinguishable and repeatable signal patterns among different types of muscular activation, the problem of prosthesis control reduces to one of pattern recognition. Widely accepted classical methods for pattern recognition, however, cannot provide simultaneous and proportional control of the artificial limb. Here we show that, in principle, quantum information processing of the neural signals allows us to overcome the above-mentioned difficulties, suggesting a very simple scheme for myoelectric control of artificial limb with advanced functionalities. (paper)

  10. A new type of lethal short-limbed dwarfism

    International Nuclear Information System (INIS)

    Nairn, E.R.; Chapman, S.

    1989-01-01

    Details are presented of a most unusual osteo-chondrodysplasia which presents with lethal neonatal short-limbed dwarfism, defective ossification and nodular calcification with cartilage. The features resemble one case previously described in the literature. (orig.)

  11. Upper Limb Absence : Predictors of Work Participation and Work Productivity

    NARCIS (Netherlands)

    Postema, Sietke G; Bongers, Raoul M; Brouwers, Michael A; Burger, Helena; Norling-Hermansson, Liselotte M; Reneman, Michiel F; Dijkstra, Pieter U; van der Sluis, Corry K

    OBJECTIVES: To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA). DESIGN: Cross-sectional study: postal survey (response rate, 45%). SETTING: Twelve rehabilitation centers and orthopedic workshops.

  12. Lower Limb Amputation at the 34 Military Hospital in Freetown ...

    African Journals Online (AJOL)

    Lower Limb Amputation at the 34 Military Hospital in Freetown, Sierra Leone: Causes and Indications. Paul F. Nabieu, Thomas A. Massaquoi, S. D. Massaquoi, G Luseni, B. Idris, T. B. Kamara, M. L. Baryoh ...

  13. Claudication of the lower limb: an approach to investigation and ...

    African Journals Online (AJOL)

    events far outweighs the 4% risk of a major amputation over 10 years. Asymptomatic patients ... The remainder of this article focuses on patients with PAD and. IC. IC is defined as an ... lower limb: an approach to investigation and management.

  14. New type of lethal short-limbed dwarfism

    Energy Technology Data Exchange (ETDEWEB)

    Nairn, E.R.; Chapman, S.

    1989-05-01

    Details are presented of a most unusual osteo-chondrodysplasia which presents with lethal neonatal short-limbed dwarfism, defective ossification and nodular calcification with cartilage. The features resemble one case previously described in the literature.

  15. Lower limb amputation for ischaemia with special reference to the ...

    African Journals Online (AJOL)

    risk for infection is a vicious circle. Lower limb amputation for ... diffusion. Infection prevention and control .... should be considered in elderly, bedridden, ... can be offered at this stage and to treat any ... classes and continue with physiotherapy.

  16. Soft Tissue Coverage of the Lower Limb following Oncological Surgery.

    Science.gov (United States)

    Radtke, Christine; Panzica, Martin; Dastagir, Khaled; Krettek, Christian; Vogt, Peter M

    2015-01-01

    The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumor board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncological surgery will be described along with the five clinical cases.

  17. Arterial variations of upper limb: a case report

    Directory of Open Access Journals (Sweden)

    Vollala V

    2005-01-01

    Full Text Available Variations of upper limb arteries are common and there are many reports about this subject. We report multiple variations in arterial pattern of upper extremity, which were encountered in a single cadaver.

  18. Reflections on the present and future of upper limb prostheses.

    Science.gov (United States)

    Farina, Dario; Amsüss, Sebastian

    2016-01-01

    Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients.

  19. Self Managing the Consequences of Major Limb Trauma

    National Research Council Canada - National Science Library

    MacKenzie, Ellen J

    2008-01-01

    .... The intervention will build on widely accepted self-management programs developed for persons with arthritis as well as components of a face-to-face self-management program for civilians with long-standing limb loss...

  20. Soft tissue coverage of the lower limb following oncological surgery

    Directory of Open Access Journals (Sweden)

    Christine eRadtke

    2016-01-01

    Full Text Available The treatment of lower limb tumours has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For development of a comprehensive surgical plan, the identity of the tumour should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumour board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncologic surgery will be described along with five clinical cases.