Pathological tremor is manifested as an involuntary oscillation of one or more body parts. Tremor greatly decreases the quality of life and often prevents the patient from performing daily ...activities. We hypothesized that sensors-driven multichannel electrical stimulation could stabilize affected joints by activating the antagonistic muscles during involuntary activation of agonist muscles and vice versa (out-of-phase stimulation). Here, we present the new system (hardware and software) and the testing of its operation. The hardware consists of a multichannel stimulator and inertial sensors for feedback. The software implements adaptive sensors-driven control for the out-of-phase stimulation. The system was initially applied to healthy persons at the wrist and elbow joints to test the efficiency of the hardware and software solutions. Predefined rhythmic stimulation resulted in tremulous movement, which subjects could not prevent; yet, they were still able to functionally use their hand. The system was then applied to seven patients with Parkinson’s disease and essential tremor for minimization of the wrist joint tremor. In six patients, the adaptive out-of-phase stimulation resulted in a significant decrease in the amplitude of tremor (67 ± 13%). In one patient, the stimulation did not result in the expected reduction of tremor.
ABSTRACT
Type Ia supernovae (SNe Ia) are explosions of white dwarf stars that facilitate exquisite measurements of cosmological expansion history, but improvements in accuracy and precision are ...hindered by observational biases. Of particular concern is the apparent difference in the corrected brightnesses of SNe Ia in different host galaxy environments. SNe Ia in more massive, passive, older environments appear brighter after having been standardized by their light-curve properties. The luminosity difference commonly takes the form of a step function. Recent works imply that environmental characteristics that trace the age of the stellar population in the vicinity of SNe show the largest steps. Here, we use simulations of SN Ia populations to test the impact of using different tracers and investigate promising new models of the step. We test models with a total-to-selective dust extinction ratio RV that changes between young and old SN Ia host galaxies, as well as an intrinsic luminosity difference between SNe from young and old progenitors. The data are well replicated by a model driven by a galaxy-age varying RV and no intrinsic SN luminosity difference, and we find that specific star formation rate measured locally to the SN is a relatively pure tracer of this galaxy-age difference. We cannot rule out an intrinsic difference causing part of the observed step and show that if luminosity differences are caused by multiple drivers then no single environmental measurement is able to accurately trace them. We encourage the use of multiple tracers in luminosity corrections to negate this issue.
Surface electrogastrography (EGG) is a non-invasive technique that is used to record myoelectrical activity of the stomach using cutaneous electrodes placed on the abdomen. Gastric motility ...assessment by EGG is a candidate for standard clinical procedure based on the quantification of parameters characteristic of gastric motility disorders. Despite its noticeable benefits, EGG is not widely implemented in clinical practice. The main reasons are: (1) lack of standardization of electrode placement, (2) time-consuming diagnostic procedures and (3) a complex multi-channel recording setup. We proposed a methodology in which an easy-to-use single-channel EGG, with a less time-consuming protocol (<1 h), would provide sufficient information for gastric motility assessment. Recordings from the three anatomical landmarks in 20 healthy young subjects were compared under two conditions, fasting and postprandial by evaluating the dominant frequency (DF). Our results showed that there is a statistically significant increase of DF after meal ingestion (p<0.05) in each of the three channels. However, when the study group was divided into two subgroups based on body mass index (BMI), the most appropriate recording location was above the body of the stomach (according to statistical significance p=7.82×10
). We showed that a less time-consuming recording session with light meal intake could be used for the assessment of gastric myoelectrical activity (GMA).
Abstract Implantation failure in assisted reproduction is thought to be mainly due to impaired uterine receptivity. With normal uterine anatomy, changes in endocrine profile during ovarian ...stimulation and medical conditions of the mother (i.e. thrombophilia and abnormal immunological response) could result in a non-receptive endometrium. High oestradiol concentrations during ovarian stimulation lead to premature progesterone elevation, causing endometrial advancement and hampering implantation, which can be overcome by a freeze-all approach and embryo transfer in natural cycles or by milder stimulation protocols. Patients with recurrent implantation failure (RIF) should be tested for inherited and acquired thrombophilias. Each patient should be individually assessed and counselled regarding therapy with low-molecular-weight heparin (LMWH). Empirical treatment with LMWH, aspirin or corticosteroids is not effective for women with RIF who have negative thrombophilic tests. If thrombophilic tests are normal, patients should be tested for immunological causes. If human leukocyte antigen dissimilarity is proven, treatment with intravenous immunoglobulin might be beneficial. Preliminary observational studies using intralipid infusion in the presence of increased natural killer cytotoxic activity are interesting but the proposed rationale is controversial and randomized controlled trials are needed. Hysteroscopy and/or endometrial scratching in the cycle preceding ovarian stimulation should become standard for patients with RIF. Implantation failure in assisted reproduction is thought to be mainly due to impaired uterine receptivity. In the presence of normal uterine anatomy, changes in endocrine profile and the medical conditions of the mother (i.e. thrombophilia and abnormal immunological response) could result in non receptive endometrium. Patients with recurrent implantation failures should be tested for inherited and acquired thrombophilias. Each patient should be individually assessed and counselled regarding therapy with low-molecular-weight heparin (LMWH). Empirical treatment with LMWH, aspirin or corticosteroids is not effective for women with RIF who have negative thrombophilic tests. Hysteroscopy and/or endometrial scratching in the cycle preceding ovarian stimulation should become a standard for patients with recurrent implantation failure.
ABSTRACT
Type Ia supernova (SN Ia) cosmology analyses include a luminosity step function in their distance standardization process to account for an observed yet unexplained difference in the ...post-standardization luminosities of SNe Ia originating from different host galaxy populations e.g. high-mass ($M \gtrsim 10^{10} \, {\rm M}_{\odot }$) versus low-mass galaxies. We present a novel method for including host-mass correlations in the SALT3 (Spectral Adaptive Light curve Template 3) light curve model used for standardizing SN Ia distances. We split the SALT3 training sample according to host-mass, training independent models for the low- and high-host-mass samples. Our models indicate that there are different average Si ii spectral feature strengths between the two populations, and that the average spectral energy distribution of SNe from low-mass galaxies is bluer than the high-mass counterpart. We then use our trained models to perform an SN cosmology analysis on the 3-yr spectroscopically confirmed Dark Energy Survey SN sample, treating SNe from low- and high-mass host galaxies as separate populations throughout. We find that our mass-split models reduce the Hubble residual scatter in the sample, albeit at a low statistical significance. We do find a reduction in the mass-correlated luminosity step but conclude that this arises from the model-dependent re-definition of the fiducial SN absolute magnitude rather than the models themselves. Our results stress the importance of adopting a standard definition of the SN parameters (x0, x1, c) in order to extract the most value out of the light curve modelling tools that are currently available and to correctly interpret results that are fit with different models.
Functional electrical stimulation (FES) applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions. To improve the ...stimulation effectiveness of conventional FES, we introduce multi-pad electrodes and a new stimulation paradigm.
The new FES system comprises an electrode composed of small pads that can be activated individually. This electrode allows the targeting of motoneurons that activate synergistic muscles and produce a functional movement. The new stimulation paradigm allows asynchronous activation of motoneurons and provides controlled spatial distribution of the electrical charge that is delivered to the motoneurons. We developed an automated technique for the determination of the preferred electrode based on a cost function that considers the required movement of the fingers and the stabilization of the wrist joint. The data used within the cost function come from a sensorized garment that is easy to implement and does not require calibration. The design of the system also includes the possibility for fine-tuning and adaptation with a manually controllable interface.
The device was tested on three stroke patients. The results show that the multi-pad electrodes provide the desired level of selectivity and can be used for generating a functional grasp. The results also show that the procedure, when performed on a specific user, results in the preferred electrode configuration characteristics for that patient. The findings from this study are of importance for the application of transcutaneous stimulation in the clinical and home environments.
The zero moment point (ZMP), foot rotation indicator (FRI) and centroidal moment pivot (CMP) are important ground reference points used for motion identification and control in biomechanics and ...legged robotics. In this paper, we study these reference points for normal human walking, and discuss their applicability in legged machine control. Since the FRI was proposed as an indicator of foot rotation, we hypothesize that the FRI will closely track the ZMP in early single support when the foot remains flat on the ground, but will then significantly diverge from the ZMP in late single support as the foot rolls during heel-off. Additionally, since spin angular momentum has been shown to remain small throughout the walking cycle, we hypothesize that the CMP will never leave the ground support base throughout the entire gait cycle, closely tracking the ZMP. We test these hypotheses using a morphologically realistic human model and kinetic and kinematic gait data measured from ten human subjects walking at self-selected speeds. We find that the mean separation distance between the FRI and ZMP during heel-off is within the accuracy of their measurement (0.1% of foot length). Thus, the FRI point is determined not to be an adequate measure of foot rotational acceleration and a modified FRI point is proposed. Finally, we find that the CMP never leaves the ground support base, and the mean separation distance between the CMP and ZMP is small (14% of foot length), highlighting how closely the human body regulates spin angular momentum in level ground walking.
ObjectiveCardiac amyloidosis (CA) is a rapidly progressive disease that portends poor prognosis. Our objective was to evaluate the prognostic impact of relative regional strain ratio (RRSR, a measure ...of the relative apical sparing of longitudinal strain (LS)) in CA.MethodsThis is a retrospective study evaluating 97 patients with CA from 2004 to 2013. Patients were included if they met criteria for CA based on endomyocardial biopsy or advanced imaging criteria coupled with either extracardiac biopsy or genetic analysis. Baseline clinical and imaging data were collected and compared between light-chain amyloidosis (AL) (n=59) and transthyretin amyloidosis (ATTR) (n=38) subtypes. RRSR was defined as the average apical LS divided by the sum of the average mid and basal LS values. A Cox proportional hazards model was used to assess the effects of clinical and echocardiographic characteristics, including RRSR, on the outcome of time to death or heart transplantation.ResultsDespite younger age, the AL subtype had a statistically significant association with the composite outcome as compared with ATTR (p=0.022). Log-transformed RRSR was independently associated with the composite outcome at 5 years (HR 2.45 (1.36 to 4.40), p=0.003). Patients with low ejection fraction and high RRSR had the worst prognosis. In multivariable analysis, RRSR remained predictive of the primary outcome (p=0.018). Addition of covariates related to systolic function (global LS and ejection fraction) to the model attenuated this effect.ConclusionsHigh RRSR is adversely prognostic in patients with cardiac amyloid. This novel tool is both diagnostic and prognostic and may have implications in management and suitability for treatment.
ABSTRACT
Type Ia supernovae (SNe Ia) are powerful tools for measuring the expansion history of the Universe, but the impact of dust around SNe Ia remains unknown and is a critical systematic ...uncertainty. One way to improve our empirical description of dust is to analyse highly reddened SNe Ia E(B − V) > 0.4, roughly equivalent to the fitted SALT2 light-curve parameter c > 0.3. With the recently released Pantheon+ sample, there are 57 SNe Ia that were removed because of their high colour alone (with colours up to c = 1.61), which can provide enormous leverage on understanding line-of-sight RV. Previous studies have claimed that RV decreases with redder colour, though it is unclear if this is due to limited statistics, selection effects, or an alternative explanation. To test this claim, we fit two separate colour–luminosity relationships, one for the main cosmological sample (c < 0.3) and one for highly reddened (c > 0.3) SNe Ia. We find the change in the colour–luminosity coefficient to be consistent with zero. Additionally, we compare the data to simulations with different colour models, and find that the data prefers a model with a flat dependence of RV on colour over a declining dependence. Finally, our results strongly support that line-of-sight RV to SNe Ia is not a single value, but forms a distribution.
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