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Background High frequency alternating current (HFAC) stimulation have been shown to produce a peripheral nerve conduction block. Currently, all the studies applying HFAC stimulation in clinical studies, have employed frequencies below 10 kHz. The main aim of this work was to investigate the neuromodulatory effect of transcutaneous 20 kHz stimulation on somatosensory and pain thresholds, and maximal handgrip strength. Methods A randomized, crossover, single-blinded, placebo-controlled trial was conducted following recruitment of fourteen healthy volunteers. Transcutaneous stimulation at 20 kHz and sham stimulation were applied over the ulnar and median nerves of fourteen healthy volunteers for 20 min. Maximal handgrip strength (MHS), mechanical detection threshold (MDT) and pressure pain threshold (PPT) were registered prior to, during (15 min), immediately after the end (20 min), and 10 min following stimulation. Results The 20 kHz stimulation showed a lower MHS during the stimulation at the 15 min (30.1 kgs SE 2.8) and at 20 min (31.8 kgs, SE 2.8) when compared to sham stimulation (35.1 kgs, SE 3.4; p p = 0.03, respectively). The 20 kHz stimulation resulted in a slight increase in MDT at 15 min (0.25 mN; 0.25–2.00) when compared to the sham stimulation (0.25 mN; 0.25–0.25; p = 0.02), and no effects were showed for PPT. Conclusions High-frequency stimulation at 20 kHz suggests a partial block of nerve activity. Studies in subjects with neurological disorders characterized by nerve hyperactivity are needed to confirm the clinical impact of this non-invasive electrical stimulation technique. Trial registration NCT, NCT02837458. Registered on 12 April 2017.

High frequency alternating current (HFAC) stimulation has been shown to produce a peripheral nerve conduction block. Currently, all the studies applying HFAC stimulation in clinical studies have employed frequencies below 20 kHz. The main aim of this study was to investigate the neuromodulatory effect of transcutaneous HFAC applied at higher than 20 kHz on maximal handgrip strength (MHS). A randomized, crossover, double-blinded, placebo-controlled trial was conducted in eight healthy volunteers. Transcutaneous stimulation at 30–40–50 kHz and sham stimulation were applied over the ulnar and median nerves for 20 min. MHS was registered prior to, during, immediately after, and 10 min following stimulation. The 30 and 40 kHz HFAC stimulation reduced MHS during the stimulation when compared to baseline, suggesting a partial block of nerve activity. These results open potential development of this non-invasive stimulation technique as a therapy in subjects with motor nerve hyperactivity.

The aim of this study was to analyze the feasibility and safety of transcutaneous spinal cord stimulation (tSCS), applied over T11–T12 vertebral level combined with robotic-assisted gait training in a volunteer with incomplete spinal cord injury (SCI). We performed 20 sessions, with 30 min in Lokomat, which first 20 min tSCS was applied. The outcomes measured were the lower extremity motor score (LEMS), modified Ashworth scale (MAS), the lower limbs strength by a hand dynamometer, functional outcomes using 10 m walk test (10MWT), timed up and go test (TUG), Walking index of spinal cord injury (WISCI-II), the spinal cord independence measure (SCIM-III) and pain perceived during treatment. The assessment was done at baseline, after and follow-up at 4 weeks post-treatment. The preliminary results support that the tSCS combined with Lokomat seems to be a safety therapy and there was not a relationship between the level of stimulation intensity and pain perceived.

Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method able to modulate neuronal activity after stroke. The aim of this systematic review was to determine if tDCS combined with robotic therapy (RT) improves limb function after stroke when compared to RT alone. Methods: A search for randomized controlled trials (RCTs) published prior to July 15, 2021 was performed. The main outcome was function assessed with the Fugl-Meyer motor assessment for upper extremities (FM/ue) and 10-m walking test (10MWT) for the lower limbs. As secondary outcomes, strength was assessed with the Motricity Index (MI) or Medical Research Council scale (MRC), spasticity with the modified Ashworth scale (MAS), functional independence with the Barthel Index (BI), and kinematic parameters. Results: Ten studies were included for analysis (n = 368 enrolled participants). The results showed a non-significant effect for tDCS combined with RT to improve upper limb function [standardized mean difference (SMD) = − 0.12; 95% confidence interval (CI): − 0.35–0.11)]. However, a positive effect of the combined therapy was observed in the lower limb function (SMD = 0.48; 95% CI: − 0.15–1.12). Significant results favouring tDCS combined with RT were not found in strength (SMD = − 0.15; 95% CI: − 0.4–0.1), spasticity [mean difference (MD) = − 0.15; 95% CI: − 0.8–0.5)], functional independence (MD = 2.5; 95% CI: − 1.9–6.9) or velocity of movement (SMD = 0.06; 95% CI: − 0.3–0.5) with a “moderate” or “low” recommendation level according to the GRADE guidelines. Conclusions: Current findings suggest that tDCS combined with RT does not improve upper limb function, strength, spasticity, functional independence or velocity of movement after stroke. However, tDCS may enhance the effects of RT alone for lower limb function. tDCS parameters and the stage or type of stroke injury could be crucial factors that determine the effectiveness of this therapy., This was supported by the Ministerio de Economía, Industria y Competitividad. RECODE project [Grant number: DPI2017‑91117‑EXP]; and by Junta de Comunidades de Castilla la Mancha and Fondo Europeo de Desarrollo Regional (Fondos FEDER). EXO‑STIM Project [Grant number: SBPLY/19/180501/000316].

Background. Epidural spinal electrical stimulation at the lumbar spinal level evokes rhythmic muscle activation of lower-limb antagonists, attributed to the central pattern generator. However, the efficacy of noninvasive spinal stimulation for the activation of lower-limb muscles is not yet clear. This review aimed to analyze the feasibility and efficacy of noninvasive transcutaneous spinal cord stimulation (tSCS) on motor function in individuals with spinal cord injury. Methods. A search for tSCS studies was made of the following databases: PubMed; Cochrane Registry; and Physiotherapy Evidence Database (PEDro). In addition, an inverse manual search of the references cited by the identified articles was carried out. The keywords transcutaneous, non-invasive, electrical stimulation, spinal cord stimulation [Mesh term], and spinal cord injury were used. Results. A total of 352 articles were initially screened, of which 13 studies met the inclusion criteria for systematic review. The total participant sample comprised 55 persons with spinal cord injury. All studies with tSCS provided evidence of induced muscle activation in the lower and upper limbs, and applied stimulation at the level of the T11-T12 and C4-C7 interspinous space, respectively. All studies reported an increase in motor response measured by recording surface electromyography, voluntary movement, muscle strength, or function. Conclusions. Although this review highlights tSCS as a feasible therapeutic neuromodulatory strategy to enhance voluntary movement, muscle strength, and function in patients with chronic spinal cord injury, the clinical impact and efficacy of electrode location and current intensity need to be characterized in statistically powered and controlled clinical trials.

Resumen: Objetivo: Determinar si la estimulación eléctrica nerviosa transcutánea (TENS) tiene un efecto analgésico superior al placebo o a otros tratamientos en pacientes con fibromialgia. Además, se pretendía analizar los parámetros de aplicación óptimos para conseguir una mayor reducción del dolor. Diseño: Revisión sistemática. Fuentes de datos: Ensayos clínicos aleatorizados sobre el efecto del TENS en la fibromialgia en las bases de datos Pubmed, Cochrane y PEDro hasta noviembre de 2016. Selección de estudios: Se seleccionaron 8 estudios de un total de 62. Se incluyeron ensayos clínicos controlados en los que se aplicase TENS a personas con fibromialgia. Extracción de datos: Se analizó el dolor como variable principal, aunque también se incluyeron otras variables como fatiga, calidad de vida e impacto de la enfermedad, recorrido articular y depresión. Resultados: Seis de 8 trabajos obtuvieron una disminución significativa del dolor. En 2 estudios se aplicó el TENS como tratamiento complementario al ejercicio terapéutico con resultados evidenciando una disminución del dolor. El resto de variables estudiadas presentaron gran variabilidad y no se pudieron establecer resultados concluyentes. Conclusiones: El tratamiento con TENS resulta efectivo para la disminución del dolor en personas con fibromialgia. Además, la inclusión del TENS en programas de ejercicio terapéutico parece tener un efecto superior a la realización del ejercicio terapéutico de forma aislada. Sin embargo, no se ha demostrado eficacia en otras variables diferentes al dolor. Son necesarios más estudios que indaguen en la optimización de los parámetros del TENS y un mayor consenso entre las variables utilizadas. Abstract: Objective: To determine whether transcutaneous electrical nerve stimulation (TENS) has an analgesic effect greater than placebo or other treatments in patients with fibromyalgia. Furthermore, it was intended to analyze the optimal application parameters to achieve a greater reduction of pain. Design: A systematic review. Data source: Randomized clinical trials on the effect of TENS on fibromyalgia in the databases Pubmed, Cochrane and PEDro until November 2016. Selection of studies: 8 studies out of a total of 62 were selected. Controlled clinical trials in which TENS was applied in patients with fibromyalgia were included. Data extraction: Pain was analyzed as the main variable, although other variables such as fatigue, quality of life and impact, range of motion and depression were also included. Results: 6 out of 8 studies obtained a significant decrease of pain. In 2 studies, TENS was applied as complementary treatment to therapeutic exercise with results evidencing a decrease in pain. The rest of the variables studied presented a great variability and conclusive results could not be established. Conclusions: Treatment with TENS is effective for reducing pain in people with fibromyalgia. In addition, the inclusion of TENS in therapeutic exercise programs seems to have a greater effect than practicing therapeutic exercise in isolation. However, no efficacy has been demonstrated in other variables different to pain. Further studies are needed to investigate the optimization of the parameters of the TENS and a greater consensus among the variables used. Palabras clave: Fibromialgia, Estimulación eléctrica nerviosa transcutánea, Sensibilización central, Dolor crónico, Keywords: Fibromyalgia, Transcutaneous electric nerve stimulation, Central sensitization, Chronic pain

The main aim of this work was to investigate the difference in the excitability of the soleus H-reflex in healthy volunteers following spinal transcutaneous electrical nerve stimulation (TENS) and high-frequency alternating current (HFAC) at a frequency of 10 kHz applied at the lower thoracic spinal level (T10-T12). A double-blind, randomized, crossover, controlled clinical trial was designed. Participants received three randomized interventions (TENS, 10 kHz, and sham stimulation) during 40 min. The amplitude and latency of the soleus H-reflex were registered prior to, during, and 10 min following stimulation. Twenty-four participants completed the study. A significant inhibition of H-reflex amplitude was observed following transcutaneous spinal TENS (12.7%; 95% CI 1.5-22.2%) when compared with sham stimulation (5.5%; 95% CI 3.6-14.5%; p = 0.03). An increase in H-reflex latency was also observed following transcutaneous spinal stimulation at 10 kHz (2%; 95% CI 1.4-2.5%) as compared with sham stimulation (0.7%; 95% CI 0.07-1.3%; p 0.01). No differences were found between TENS and 10 kHz for H-reflex modulation. Transcutaneous spinal TENS and HFAC at a frequency of 10 kHz had a modulatory effect on the soleus H-reflex when compared to sham stimulation; however, no differences were found between these two interventions.

Objective The purpose of this study was to develop and validate a Spanish version of the Whiplash Disability Questionnaire (WDQ) for the Spanish population with acute whiplash-associated disorder (WAD). Methods This was a cross-sectional questionnaire validation study. Adults with acute WAD (grade I to III) were enrolled within 3 weeks of their injury. A blinded forward and back translation of the WDQ was made from English to Spanish, and the resulting back-translation version was compared with the original. Patients with WAD completed the Spanish version of the 13-item WDQ. The developed questionnaire was assessed using psychometric statistical analysis including correlation with the numerical rating score for pain, Northwick Park Neck Pain Questionnaire, Neck Disability Index, and 36-item Short Form Health Survey. Results Fifty-six patients completed the questionnaire, the mean age was 33.9 years (standard deviation [SD] = 10.5), and 76.8% were women. Participants were enrolled 13.9 days (SD 4.9) after the injury, with 14.3% presenting with WAD grade I and 85.7% with WAD grade II. The mean WDQ score was 62 (SD = 31). Two factors were detected, and the factor structure remained stable after translation. Positive correlations were identified between the total WDQ score and the numerical rating score, Neck Pain Questionnaire, and Neck Disability Index results, with a strong negative correlation with the 36-item Short Form Health Survey. Conclusion The Spanish version of WDQ is psychometrically reliable and a valid instrument to measure the disability status in patients with acute WAD within the clinic.

The number of Web APIs for accessing information and services is continuously increasing, and yet, no tools exist to automate the time-consuming and error-prone process of invoking those APIs and composing their responses. The recent emergence of widely-adopted, standardized, Web-API description formats and the development of Linked Data technologies for data integration have motivated our work on the LRA (Linked REST APIs) methodology [1, 2]. LRA relies on RDF service specifications to automate the development process around the usage of Web APIs. This automation represents a great opportunity to systematize and improve the quality of service-oriented application development. However, LRA’s reliance on SPARQL as the user-interaction model may hinder its adoption, because it requires developers to learn the intricacies of the unconventional graph data model and its associated datasets. In this paper we have developed the LRA Workbench ($$LRA_{Wbench}$$ L R A Wbench ), which takes advantage of the emergent schema of Web-API specifications, in order to simplify the formulation of LRA-compliant SPARQL queries. Our empirical evaluation of the $$LRA_{Wbench}$$ L R A Wbench usability demonstrates that our tool significantly improves the performance of developers formulating SPARQL queries for LRA. A subsequent study on the effectiveness of the $$LRA_{Wbench}$$ L R A Wbench demonstrated that developers using LRA tend to produce code with considerable better structural complexity, in less time, than developers manually composing APIs.

Sunitinib and pazopanib are standard first-line treatments for patients with metastatic renal cell carcinoma (mRCC). Nonetheless, as the number of treatment options increases, there is a need to identify biomarkers that can predict drug efficacy and toxicity. In this prospective study we evaluated a set of biomarkers that had been previously identified within a secretory signature in mRCC patients. This set includes tumor expression of c-Met and serum levels of HGF, IL-6, IL-8, CXCL9, CXCL10 and CXCL11. Our cohort included 60 patients with mRCC from 10 different Spanish hospitals who received sunitinib (n = 51), pazopanib (n = 4) or both (n = 5). Levels of biomarkers were studied in relation to response rate, progression-free survival (PFS) and overall survival (OS). High tumor expression of c-Met and high basal serum levels of HGF, IL-6, CXCL11 and CXCL10 were significantly associated with reduced PFS and/or OS. In multivariable Cox regression analysis, CXCL11 was identified as an independent biomarker predictive of shorter PFS and OS, and HGF was an independent predictor of reduced PFS. Correlation analyses using our cohort of patients and patients from TCGA showed that HGF levels were significantly correlated with those of IL-6, CXCL11 and CXCL10. Bioinformatic protein–protein network analysis revealed a significant interaction between these proteins, all this suggesting a coordinated expression and secretion. We also developed a prognostic index that considers this group of biomarkers, where high values in mRCC patients can predict higher risk of relapse (HR 5.28 [2.32–12.0], p &lt, 0.0001). In conclusion, high plasma HGF, CXCL11, CXCL10 and IL-6 levels are associated with worse outcome in mRCC patients treated with sunitinib or pazopanib. Our findings also suggest that these factors may constitute a secretory cluster that acts coordinately to promote tumor growth and resistance to antiangiogenic therapy.

Objective The aim of this study was to assess whether anodal DCS applied to the suboccipital (SO) target area could potentiate antinociception assessed primarily with conditioned pain modulation of tonic thermal test stimuli. Design Randomized double-blinded control trial. Setting Rehabilitation hospital. Subjects Healthy participants. Methods Forty healthy participants were randomized to receive either SO-DCS or M1-DCS. The 20-minute 1.5 mA anodal or sham DCS intervention were applied to each participant in randomized order during two test sessions. The primary outcome measure included heterotopic cold-pressor conditioned pain modulation (CPM) of tonic heat pain. Secondary measures included pressure pain threshold and tonic thermal pain intensity. Results Heterotopic CPM of tonic heat pain intensity was unaffected by either SO-DCS or active M1, including the secondary measures of pressure pain threshold and tonic thermal pain intensity. Although low-power non-significant interactions were identified for DCS intervention (active versus sham) and time (before and after), a significant within-group inhibition of tonic cold pain was identified following SO-DCS (P = .011, mean [SD]: −0.76 ± 0.88 points) and M1-DCS (P Conclusions Although heterotopic CPM was not facilitated with either SO-DCS or M1-DCS, a general significant inhibition of tonic cold pain intensity was demonstrated following both interventions. The general effects of active DCS compared to sham on tonic cold pain—irrespective of the M1 or SO target—need to be confirmed using standard quantitative sensory testing.

This work has been funded by the Foundation for Applied Medical Research, ISCIII-Fondo de Investigación Sanitaria-Fondo Europeo de Desarrollo Regional 'Una manera de hacer Europa' (PI19/00230 to AC, PI19/00098 to LMM, PI17/00411 to RP and DA, PI19/00560 to JMGP; CIBERONC CB16/12/00443 to LMM and CB16/12/00390 to JMGP), AECC and Ramón Areces Foundations (both to LMM), 'Instituto de Investigación Sanitaria del Principado de Asturias to JMGP and BMS (to JA and LMM)., Redin, E., Garmendia, I., Lozano, T., Serrano, D., Senent, Y., Redrado, M., Villalba, M., De Andrea, C.E., Exposito, F., Ajona, D., Ortiz-Espinosa, S., Remirez, A., Bertolo, C., Sainz, C., Garcia-Pedrero, J., Pio, R., Lasarte, J., Agorreta, J., Montuenga, L.M., Calvo, A.

The posterior root muscle response (PRM) is a monosynaptic reflex that is evoked by single pulse transcutaneous spinal cord stimulation (tSCS). The main aim of this work was to analyse how body weight loading influences PRM reflex threshold measured from several lower limb muscles in healthy participants. PRM reflex responses were evoked with 1-ms rectangular monophasic pulses applied at an interval of 6 s via a self-adhesive electrode (9 × 5 cm) at the T11–T12 vertebral level. Surface electromyographic activity of lower limb muscles was recorded during four different conditions, one in decubitus supine (DS) and the other three involving standing at 100%, 50%, and 0% body weight loading (BW). PRM threshold intensity, peak-to-peak amplitude, and latency for each muscle were analysed in different conditions study. PRM reflex threshold increased with body weight unloading compared with DS, and the largest change was observed between DS and 0% BW for the proximal muscles and between DS and 50% BW for distal muscles. Peak-to-peak amplitude analysis showed only a significant mean decrease of 34.6% (SD 10.4, p = 0.028) in TA and 53.6% (SD 15.1, p = 0.019) in GM muscles between DS and 50% BW. No significant differences were observed for PRM latency. This study has shown that sensorimotor networks can be activated with tSCS in various conditions of body weight unloading. Higher stimulus intensities are necessary to evoke reflex response during standing at 50% body weight loading. These results have practical implications for gait rehabilitation training programmes that include body weight support., This research was funded by the“Junta de Comunidadesde Castilla-La Mancha”and“Fondos FEDER”(EXO-STIM project, grant number SBPLY/19/180501/000316)and by the EXPLORA 2017 program (Recode project,grant number: DPI2017-91117-EXP). DSM has receivedfunding by the European Regional Development Fund(2019/7375).

If we are to sustainably provide food to a rapidly growing human population, biological pest control (BPC) should integrate food web theory and evolution. This will account for the impacts of climate warming on the complex community settings of agroecosystems. We review recent studies looking for top-down augmentative pest control being hampered/promoted by biotic (community contexts) and/or abiotic (climate) drivers. Most studies found either positive or neutral effects on BPC. However, most ignored potential evolutionary responses occurring in the environments under study. We propose engineering food webs by engaging in a continuous feedback between ecological and evolutionary data, and individual-based modelling of agroecosystems. This should speed up the procurement of strains of efficient natural enemies better adapted to warming.

Simple Summary Apart from genetic changes, cancer is characterized by epigenetic alterations, which indicate modifications in the DNA (such as DNA methylation) and histones (such as methylation and acetylation), as well as gene expression regulation by non-coding (nc)RNAs. These changes can be used in biological fluids (liquid biopsies) for diagnosis, prognosis and prediction of cancer drug response. Although these alterations are not widely used as biomarkers in the clinical practice yet, increasing number of commercial kits and clinical trials are expected to prove that epigenetic changes are able to offer valuable information for cancer patients. Abstract Early alterations in cancer include the deregulation of epigenetic events such as changes in DNA methylation and abnormal levels of non-coding (nc)RNAs. Although these changes can be identified in tumors, alternative sources of samples may offer advantages over tissue biopsies. Because tumors shed DNA, RNA, and proteins, biological fluids containing these molecules can accurately reflect alterations found in cancer cells, not only coming from the primary tumor, but also from metastasis and from the tumor microenvironment (TME). Depending on the type of cancer, biological fluids encompass blood, urine, cerebrospinal fluid, and saliva, among others. Such samples are named with the general term “liquid biopsy” (LB). With the advent of ultrasensitive technologies during the last decade, the identification of actionable genetic alterations (i.e., mutations) in LB is a common practice to decide whether or not targeted therapy should be applied. Likewise, the analysis of global or specific epigenetic alterations may also be important as biomarkers for diagnosis, prognosis, and even for cancer drug response. Several commercial kits that assess the DNA promoter methylation of single genes or gene sets are available, with some of them being tested as biomarkers for diagnosis in clinical trials. From the tumors with highest incidence, we can stress the relevance of DNA methylation changes in the following genes found in LB: SHOX2 (for lung cancer); RASSF1A, RARB2, and GSTP1 (for lung, breast, genitourinary and colon cancers); and SEPT9 (for colon cancer). Moreover, multi-cancer high-throughput methylation-based tests are now commercially available. Increased levels of the microRNA miR21 and several miRNA- and long ncRNA-signatures can also be indicative biomarkers in LB. Therefore, epigenetic biomarkers are attractive and may have a clinical value in cancer. Nonetheless, validation, standardization, and demonstration of an added value over the common clinical practice are issues needed to be addressed in the transfer of this knowledge from “bench to bedside”.

A hybrid 48V-12V fixed ratio converter (DCX) is analyzed in this paper. It is composed of soft charging switched capacitors and an autotransformer with DC winding current, aiming at high output current applications. Its non-resonant operation and the self-balance between the capacitor and the autotransformer make the converter robust to parasitics and component tolerances. The transformer structure is simple and easy to be built since no interleaving is required. Operation of the circuit is explained, and the switching transition taking account of parasitics is analyzed, revealing a method to achieve ZVS on all switches by the stray inductance in the switched capacitor loop. The resonant problem at the switching nodes during the switching transition is discussed, a lossless snubber is proposed to clamp this voltage spike for the two low side switches. A proof-of-concept prototype of 250W (22A output current) is tested to verify the operation of this topology, achieving 97.1% peak efficiency.

Transcutaneous electrical spinal cord stimulation (tSCS) is a non-invasive technique for neuromodulation and has therapeutic potential for motor rehabilitation following spinal cord injury. The main aim of the present study is to quantify the effect of a single session of tSCS on lower limb motor evoked potentials (MEPs) in healthy participants. A double-blind, sham-controlled, randomized, crossover, clinical trial was carried out in 15 participants. Two 10-min sessions of tSCS (active-tSCS and sham-tSCS) were applied at the T11-T12 vertebral level. Quadriceps (Q) and tibialis anterior (TA) muscle MEPs were recorded at baseline, during and after tSCS. Q and TA isometric maximal voluntary contraction was also recorded. A significant increase of the Q-MEP amplitude was observed during active-tSCS (1.96 &plusmn, 0.3 mV) when compared from baseline (1.40 &plusmn, 0.2 mV, p = 0.01) and when compared to sham-tSCS at the same time-point (1.13 &plusmn, 0.3 mV, p = 0.03). No significant modulation was identified for TA-MEP amplitude or for Q and TA isometric maximal voluntary isometric strength. In conclusion, tSCS applied over the T11-T12 vertebral level increased Q-MEP but not TA-MEP compared to sham stimulation. The specific neuromodulatory effect of tSCS on Q-MEP may reflect optimal excitation of this motor response at the interneuronal or motoneuronal level.

This work presents a non-isolated hybrid topology targeting at 4:1 fixed ratio and high output current applications. This topology can be regarded as a compact integration of switched capacitor and autotransformer. The switched capacitors are soft charged and the two winding currents in the autotransformer are auto balanced. The transformer has quasi-DC current with negligible AC winding losses. To further study the performance of the transformer in the proposed circuit, the transformer is simulated with different current waveforms, and the results show that with quasi-DC current the winding losses do not increase with switching frequency, and they are at least two times lower than the losses generated from sinusoidal or square current. The proposed circuit is measured at 24V-6V step-down and up to 25A output current, achieving 96.7% peak efficiency. The same transformer is also tested in a full bridge testbench to compare winding losses with square current by measuring its temperature.

Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This systematic review aimed at compiling and summarizing the currently available scientific evidence about the effect of tDCS on functionality in older adults over 60 years of age. A search of databases was conducted to find randomized clinical trials that applied tDCS versus sham stimulation in the above-mentioned population. No limits were established in terms of date of publication. A total of 237 trials were found, of which 24 met the inclusion criteria. Finally, nine studies were analyzed, including 260 healthy subjects with average age between 61.0 and 85.8 years. Seven of the nine included studies reported superior improvements in functionality variables following the application of tDCS compared to sham stimulation. Anodal tDCS applied over the motor cortex may be an effective technique for improving balance and posture control in healthy older adults. However, further high-quality randomized controlled trials are required to determine the most effective protocols and to clarify potential benefits for older adults.

Introducción: La Fibrosis Quística (FQ) es una enfermedad hereditaria recesiva que afecta a varios órganos, fundamentalmente de los aparatos respiratorio y digestivo. La Diabetes Relacionada con la Fibrosis Quística (DRFQ) es una de sus principales complicaciones.Objetivos: Estudiar las complicaciones específicas de los pacientes pediátricos que padecen DRFQ y cómo afectan a su calidad de vida. Comparar las tasas de mortalidad de los pacientes pediátricos con FQ y con DRFQ. Poner de manifiesto la importancia del personal de enfermería en el manejo de los pacientes pediátricos con DRFQ.Metodología: Se llevó a cabo una revisión bibliográfica sistemática. Se incluyeron estudios publicados, en inglés y castellano, durante los últimos 10 años, y que analizaban una muestra de población de entre 0 y 9 años con FQ y/o DRFQ.Resultados: Se utilizaron 4 bases de datos para la búsqueda sistemática. Se analizaron 10 artículos para la resolución de los objetivos.Conclusiones: Las complicaciones que provocan la DRFQ, y los cuidados que requieren afectan a la calidad de vida de los pacientes. La progresión del diagnóstico y los tratamientos ha hecho que mejore su calidad de vida y que la diferencia de mortalidad entre los pacientes con FQ y con DRFQ se reduzca. El personal enfermero que atiende a los niños con DRFQ es un recurso de información esencial para los pacientes y sus familias. Las enfermeras deben transmitir la importancia de la adhesión a los tratamientos para conseguir una mejor calidad de vida. Introduction: Cystic Fibrosis (CF) is a hereditary recessive disease that affects several organs, mainly within the respiratory and digestive systems. Cystic Fibrosis Related Diabetes (CFRD) is one of its main complications.Objectives: To study the specific complications of pediatric patients suffering from CFRD and how they affect a patient’s quality of life. To compare the mortality rates of pediatric patients with CF and with CFRD. To highlight the importance of nurses in the management of pediatric patients with CFRD.Methodology: A systematic bibliographic review was conducted. We included studies, in English and Spanish, published over the last 10 years, which analysed a population aged between 0 and 9 years old with CF and/or CFRD.Results: Four databases were used for the systematic search. We analysed 10 articles to address the objectives.Conclusions: The complications caused by CFRD and the care that patients require affect the patient’s quality of life. Progress both with diagnosis and with treatment has improved the quality of life of patients, and has contributed to reductions in the difference between the mortality rates of patients with CF and without CFRD. Nurses who care for children with CFRD are essential as an information resource for patients and their families. Nurses must convey the importance of therapeutic adherence to achieve a better quality of life.

Objective The purpose of the present study was to examine the effect of dry needling (DN) on the biomechanical properties of a latent medial myofascial trigger point (MTrP) of the soleus muscle compared with an adjacent point within the taut band (TB) measured by myotonometry. Methods Fifty asymptomatic volunteers were randomly assigned to an intervention group (n = 26) or control group (n = 24). One session of DN was performed in every group as follows: 10 needle insertions into the MTrP area (intervention group) or TB area (control group). Myotonometric measurements (frequency, decrement, and stiffness) were performed at baseline (pre-intervention) and after the intervention (post-intervention) in both locations (MTrP and TB areas). Results The results showed that stiffness outcome significantly decreased with a large effect size after DN in the MTrP when measured in the MTrP location (P = .002; d = 0.928) but not when measured in the TB location. In contrast, no significant changes were observed in any location when the TB was needled (P > .05). Conclusions The findings suggest that only DN into the MTrP area was effective in decreasing stiffness outcome, therefore a specific puncture was needed to modify myofascial muscle stiffness.

Background Transcranial direct-current stimulation (tDCS) is an easy-to-apply, cheap, and safe technique capable of affecting cortical brain activity. However, its effectiveness has not been proven for many clinical applications. Objective The aim of this systematic review was to determine whether the effect of different strategies for gait training in patients with neurological disorders can be enhanced by the combined application of tDCS compared to sham stimulation. Additionally, we attempted to record and analyze tDCS parameters to optimize its efficacy. Methods A search in Pubmed, PEDro, and Cochrane databases was performed to find randomized clinical trials that combined tDCS with gait training. A chronological filter from 2010 to 2018 was applied and only studies with variables that quantified the gait function were included. Results A total of 274 studies were found, of which 25 met the inclusion criteria. Of them, 17 were rejected based on exclusion criteria. Finally, 8 trials were evaluated that included 91 subjects with stroke, 57 suffering from Parkinson’s disease, and 39 with spinal cord injury. Four of the eight assessed studies did not report improved outcomes for any of its variables compared to the placebo treatment. Conclusions There are no conclusive results that confirm that tDCS can enhance the effect of the different strategies for gait training. Further research for specific pathologies, with larger sample sizes and adequate follow-up periods, are required to optimize the existing protocols for applying tDCS.

OBJECTIVES This study examined predictive correlations between periaqueductal gray (PAG) and anterior cingulate cortex (ACC) metabolite levels with deficient inhibitory endogenous pain modulation (EPM), including sensory and affective measures of pain during chronic whiplash injury (WHI). MATERIALS AND METHODS Healthy patients, and participants with chronic WHI, without (WHI-noP) or with pain (WHI-P), were screened with the Douleur Neuropathique 4 tool (DN4). EPM was assessed with C6 tonic heat pain stimuli with a Conditioned Pain Modulation (CPM) protocol. Magnetic resonance spectroscopy quantified ACC and PAG metabolite levels. RESULTS WHI-P participants were characterized with high pain intensity and interference, and lower quality of life scores, compared with WHI-noP. Inhibitory CPM at 30 seconds was identified in the healthy noninjured (-45±16%; P

In modern aircraft designs, following the More Electrical Aircraft (MEA) philosophy, there is a growing need for new high-power converters. In this context, innovative solutions to provide high efficiency and power density are required. This paper proposes an unregulated LLC full-bridge operating at resonant frequency to obtain a constant gain at all loads. The first harmonic approximation (FHA) model is not accurate enough to estimate the voltage gain in converters with high parasitic resistance. A modified FHA model is proposed for voltage gain analysis, and time-based models are used to calculate the instantaneous current required for the ZVS transition analysis. A method using charge instead of current is proposed and used for this ZVS analysis. Using this method, an auxiliary circuit is proposed to achieve complete ZVS within the whole load range, avoiding a gapped transformer design and increasing the efficiency and power density. A 28 Vdc output voltage prototype, with 10 kW peak output power, has been developed to validate the theoretical analysis and the proposed auxiliary circuit. The maximum efficiency (96.3%) is achieved at the nominal power of 5 kW.

Objectives: To evaluate the effectiveness of high-intensity laser therapy on shoulder pain and function in subacromial impingement syndrome. Design: Clinical controlled trial with alternate allocation. Setting: Hospital Department of Rehabilitation. Subjects: A total of 46 participants with subacromial impingement syndrome. Intervention: Participants were sequence allocated to an intervention group (high-intensity laser therapy + exercise therapy) and control group (sham-laser + exercise therapy) and received 15 sessions (five days a week during three weeks). Main measures: Patiens were evaluated at baseline, after 15 sessions, and at one month and at three months after completing the intervention. The main outcome variables were pain and functionality as measured by visual analogue scale; pressure pain threshold; Shoulder Pain and Disability Index; Constant-Murley Score; and QuickDASH. Secondary outcomes were number of sessions at discharge and drug use. Results: A total of 21 patients in high-intensity laser therapy group (56.7 ± 8.9 years) and 22 patients in sham-laser group (61.3 ± 8.9 years) concluded the study. Visual analogue scale (cm) at baseline, one-month, and three-months were 6.2 ± 0.5, 3 ± 2.6, and 2.6 ± 2.4 for the control group and 5.4 ± 1.5, 3.6 ± 1.3, and 1.8 ± 1.7 for experimental group, respectively. Shoulder Pain and Disability Index (points) at baseline, one-month, and three-monts were 51.8 ± 16.1, 16.3 ± 16.1, and 13.6 ± 17.1 in the control group and 41.8 ± 20.6, 20.5 ± 19.7, 11 ± 14.5 in experimental group, respectively. No differences were found between groups ( P > 0.05). Conclusion: The effect of high-intensity laser therapy plus exercise is not higher than exercise alone to reduce pain and improve functionality in patients with subacromial syndrome.

In this paper, we present a highly efficient and compact voltage doubler based on a resonant switched-capacitor converter implemented with GaN FETs. Two possible approaches for its implementation are analyzed and compared. In the first approach, the resonant inductor is placed in series with a resonant capacitor, conducting a sinusoidal current, while in the second, it is placed in series with the input source, conducting rectified sinusoidal current. Both resonant converters have the same voltage gain, and although the change in the position of the resonant inductor is, at the first glance, of minor importance, the analysis and results show that it has huge impact on the capability to achieve zero-voltage switching (ZVS) transitions at low output power. The experimental results clearly show that at low loads when the resonant inductor is in series with the resonant capacitor, the switching frequency can be significantly higher than the resonant frequency and that it is, practically, impossible to achieve ZVS transitions, forcing the implementation of cycle skipping. The prototype implemented for the experiments can provide up to 4.5-kW losing between 20 and 22 W. In the case of light load (500 W), the power losses were only 2–3 W. Its power density is higher than 65 kW/dm3. The same resonant converter was tested with Si CoolMOS devices as well and the impact of the semiconductor technology on the overall power losses was verified. Due to higher $C_{\mathrm {oss}}$ capacitance, the Si-based converter has 40% higher power losses at full power than its GaN-based counterpart. The components of the GaN-based converter occupy only 65 cm3, which opens a possibility to obtain a design with extremely high power density

Service-science research has long been studying T-shapedness, arguing that service scientists should be T-shaped individuals, deeply knowledgeable in one field and able to collaborate and communicate across disciplines. The value of multidisciplinarity has also been recognized in academic environments, as funding agencies are committing substantial support to large-scale research initiatives that span across disciplines, organizations, academia and industry, even across national borders, and aim to address the major challenges of our time, from climate change, to energy shortage, to pandemics. New incentives and performance indicators are needed to encourage and reward multidisciplinary collaborative work. In this paper, we introduce a metric for multidisciplinarity, based on the notion of T-shapedness and we report on the application of this measure on data collected over four years from the GRAND Network of Centres of Excellence, a large-scale, Canadian, multidisciplinary research network conducting research on digital media with numerous academic and industrial partners. We describe our findings on how the community evolved over time in terms of its T-shaped multidisciplinarity and compare the multidisciplinarity of GRAND researchers to their non-GRAND peers.

BACKGROUND: High-frequency alternating currents of greater than 1 kHz applied on peripheral nerves has been used in animal studies to produce a motor nerve block. It has been evidenced that frequencies higher than 5 kHz are necessary to produce a complete peripheral nerve block in primates, whose nerve thickness is more similar to humans. The aim of the study was to determine the effect on muscle strength after the application of a high-frequency stimulation at 5 and 10 kHz compared to sham stimulation in healthy volunteers. FINDINGS: Transcutaneous stimulation at 5 kHz, 10 kHz and sham stimulation were applied to eleven healthy volunteers over the ulnar and median nerves for 20 min. Maximal handgrip strength was measured before, during, immediately after the intervention, and 10 min after the end of intervention. The 10 kHz stimulation showed a lower handgrip strength during the intervention (28.1 N, SEM 3.9) when compared to 5 kHz (31.1 N, SEM 3.6; p

The constantly increasing importance of cloud computing and Internet of Things (IoT) has led to solutions able to integrate heterogenous and diverse systems as well manage big data. This is especially true in Smart City environments with respect to traffic monitoring. Furthermore, cloud computing, and the various technologies around it are quickly becoming a must in the education domain. Unlike traditional education, it promotes the use of computing infrastructures anywhere and at any time, without restrictions. In this paper, we present our experience in using cloud computing technologies for a computing science course on Software Quality, with fourth-year undergraduate students at the University of Alberta, Canada. In particular, the paper illustrates how students have been actively involved in carrying out a real project and coordinated their project work among the class groups thanks to cloud technologies. Project work consisted in building a scalable system for an urban IoT environment of traffic monitoring and routing based on open source technologies and publicly available data from the city of Edmonton, Alberta in Canada.

This paper describes a simple methodology to generate “continuous power models” (CPM), based on VA area interpretation of the power flowing through the ports of multiport converters. These models enable the calculation of the minimum indirect power to be processed by power converters based on their electrical specifications. It is especially useful to compare power architectures with multiple building blocks or multiple ports, such as stacked sources (PV cells) or loads (digital cores) and energy buffered converters such as single-phase inverters, power factor correction circuits and three phase rectifiers and inverters. The synthesis of circuits that minimize the figure of merit $P_{ind}/P_{diff}$ is also illustrated in the paper.

BACKGROUND Tibialis Anterior (TA) cutaneous reflex (CR) activity evoked following cutaneous stimulation of the plantar (Pl) surface (Pl-TA CR) has demonstrated hyperreflexia and damage of inhibitory mechanisms in subjects with spinal cord injury (SCI) and spasticity. OBJECTIVES To modulate Pl-TA CR and Soleus H-reflex activity with transcutaneous electrical nerve stimulation (TENS) and vibratory stimulation of the plantar pad during rest and controlled isometric plantarflexion. METHODS Non-injured subjects (n = 11) and individuals with incomplete SCI with (n = 14) and without spasticity (n = 14) were recruited. The effect of TENS and vibratory stimuli on Pl-TA CR and soleus H-reflex activity were assessed during rest and controlled ramp-and-hold plantarflexion. RESULTS Vibration failed to inhibit H-reflex activity during rest or plantarflexoin following SCI compared to healthy subjects. In contrast, vibration-induced inhibition of Pl-TA CR was specifically detected in SCI spastic subjects during both rest and the hold phase of plantarflexion. TENS inhibited Pl-TA CR activity in the SCI spasticity group only during hold plantarflexion. CONCLUSIONS Plantar vibratory stimuli inhibited the pl-TA CR, but not the H reflex, during rest and controlled movement in SCI spastic subjects. Assessment of Pl-TA CR modulation should contribute to the development of modality-specific sensory stimuli programmes for the neurorehabilitation of SCI spasticity.

The number of Web APIs for accessing information and services is continuously increasing, and yet, no tools exist to automate the process of invoking these APIs and composing their responses, which can be time consuming and error prone. In our previous work, we described LRA (Linked REST APIs) [1], a middleware that enables the automatic composition of REST APIs. Although this automation represents a great opportunity to systematize and improve the quality of the process of using Web APIs, LRA's reliance on SPARQL as the user-interaction model may hinder its adoption. Hence, based upon previous work on Linked Data query systems, in this paper we present a tool that takes advantage of the emergent schema of Web API descriptions, in order to simplify the formulation of LRA-compliant queries.

In this paper we compare two resonant switched capacitor converters in which the resonant inductor can be placed in series with a resonant capacitor (AC side), conducting a sinusoidal current, or it can be placed in series with the input source (DC side), conducting rectified sinusoidal current. Both resonant converters have the same voltage gain, and although the change in the position of the resonant inductor is, at first glance, of minor importance, the analysis and results show that it has huge impact on the capability to achieve ZVS transitions at low output power and on the inductor design and power losses. The experimental results show that for circuit with the resonant inductor in the AC side, the ZVS transitions produce an effective switching frequency significantly higher than the resonant frequency which forces the implementation of cycle skipping at light loads. The difference between the power losses in these two approaches is between 3W and 5W. The prototype implemented for the experiments provides up to 4.5kW with 33.3W power loss (99.3% efficiency). In the case of light load (1.5kW) power losses are only 8.25W (η=99.45%). Its power density is higher than 65kW/dm3.

This paper presents the development of a questionnaire to measure consumer wellness associated with food. The paper describes the selection of the questionnaire items, the validation of the questionnaire content, and the stability of the results. This new questionnaire, consisting of 5 dimensions (emotional, intellectual, physical, social and spiritual), and a total of 45 items, measures expected or perceived wellness response to food names or consumed food. The questionnaire was tested using internet surveys (names of aromatics, peppermint and lavender), and central location tests (different recipes of meatloaf and vegetables). The construct of this questionnaire and data analyses provide not only an overall (calculated) wellness score, but also insights into the dimensions that drive the wellness response and specific foods or ingredient characteristics that drive the wellness response.

In this paper we propose the mode selection strategy of a multi-mode single-stage single-phase inverter and the associated mode selection scheme for double-line-frequency power pulsation decoupling between the input an the output port for PV (photovoltaic) panel applications. Multiple modulation strategies are used along the line cycle to optimize the overall efficiency of the converter. The proposed topology uses several modulations for the inductor current waveform, such that the power handled internally by the elements in the converter is minimized at any time, while performing the output voltage control and power decoupling. The evaluation and selection of the most appropriate modulation in real-time represents a challenge for the control. This work allows to reduce the computational cost of evaluating the decision metric. A mode selection scheme is proposed and validated in a hardware prototype.

This work proposes a control linearization technique for a single phase 3 level-flying capacitor multi-level (FCML) inverter with multiple modulation strategies along the line period, based on the plant inversion. Multiple modulation strategies are used along the line cycle so that the overall size and efficiency of the converter are optimized. This benefit from the point of view of the energy processing generates a design challenge for the control. The proposed technique allows decoupling the control of the input current and the output current, which simplifies the control of the output voltage and the storage capacitor voltage in two ways: first, the control of both variables is independent and second, the controller parameters will be independent on the modulation strategy due to the plant inversion. These advantages are critical for the successful control of this highly non-linear time-varying system.

OBJECTIVE Appropriate afferent feedback delivery during the execution of motor tasks is important for rehabilitation after incomplete spinal cord injury (iSCI). However, during leg-cycling therapy, the plantar afferent feedback is minimal. We hypothesize that the augmentation of sensory input by combining cycling with a locomotor-like stimulation of plantar cutaneous innervations (ES-cycling), might help to restore proper spinal processing of sensorimotor function. METHODS Thirteen non-injured subjects and 10 subjects with iSCI performed 10 minutes of cycling and, on another session, of ES-cycling. To assess spinal processing of sensorimotor function, soleus H-reflex response was tested following a conditioning plantar electrical stimulation applied at 25-100 ms inter-stimulus intervals (ISI's), measured before and after the execution of the tasks. RESULTS Before tasks execution, the conditioned H-reflex response was modulated in non-injured subjects, and absent in subjects with iSCI; after cycling, modulation profiles were unchanged. However, after ES-cycling a significant increase in H-reflex excitability was observed in the non-injured group at 100 ms ISI (p

In this paper we review some of the fundamental limits of dc-dc power converters described in 1966 and 1969 and generate an averaged power model that is useful to perform high-level comparison of power converters and architectures. The model is extended to 3 port power converters, which is used to calculate the minimum possible internal power to be processed by the components of the power stage of energy buffered converters. Finally, a single stage inverter/rectifier with energy storage capability that meets the fundamental limit is synthesized.

Several studies have examined spinal reflex modulation during leg cycling in healthy and spinal cord injury (SCI) subjects. However, the effect of cutaneous plantar afferent input on spinal excitability during leg cycling after SCI has not been characterised. The aim of the study was to test the feasibility of using controlled leg cycling in combination with plantar cutaneous electrical stimulation (ES) cycling to assess lower limb spinal sensorimotor excitability in subjects with motor complete or incomplete SCI. Spinal sensorimotor excitability was estimated by measuring cutaneomuscular-conditioned soleus H-reflex activity. Reflex excitability was tested before and after a 10-min ES cycling session in 13 non-injured subjects, 6 subjects with motor incomplete SCI (iSCI) who had moderately impaired gait function, 4 subjects with motor iSCI who had severely impaired gait function, and 5 subjects with motor complete SCI (cSCI). No modulation of soleus H-reflex with plantar cutaneous stimuli was observed after either iSCI or cSCI when compared to non-injured subjects. However, after ES cycling, reflex excitability significantly increased in subjects with iSCI and moderately impaired gait function. ES cycling facilitated spinal sensorimotor excitability only in subjects with motor iSCI with residual gait function. Increased spinal excitability induced with a combination of exercise and afferent stimulation could be adopted with diagnostic and prognostic purposes to reveal the activity-based neurorehabilitation profile of individual subjects with motor iSCI. Trial registration: ISRCTN 26172500 ; retrospectively registered on 15 July 2016

The emergence of cloud computing and the Internet of Things (IoT) have given rise to a wealth of new opportunities for integrating heterogeneous systems and collecting massive data sets, whose analysis may lead to new information, insight, and knowledge. Building a scalable architecture for urban IoT environments is a complex task, primarily because of the massive amounts of data generated by sensor devices, and the variety of data sources. And yet it is a compelling application area, given the number of potential municipal services that can be improved using these technologies. In this paper, we describe our study of how cloud-computing and big-data management technologies can assist decision making for transportation systems in smart cities. More specifically, this paper presents and discusses a proof-of-concept prototype, based on open-source technologies and publicly available data for the city of Edmonton.

Nowadays, exoskeletons have been introduced for empowering walking in military, industrial and rehabilitation settings. Several companies are commercializing these devices, but there is a lack of understanding of their effects on muscle activations and coordination. The objective of this article is to investigate the impact on muscle activation and user effort during ambulatory, robotic-assisted walking. Compared with free walking, our results suggest that robotic assistance with the Exo-H2 lower limb exoskeleton may result in increased muscle activation. Muscular timing experienced unspecific changes with respect to unassisted walking. Further research is needed to unveil the mechanical interaction between the robot and the lower limbs and the underlying motor adaptations in response to robot-assisted walking.

Gait rehabilitation robots are of increasing importance in neurorehabilitation. The aim of this study is to assess the effects of Exo-H2 on metabolic cost in patients with incomplete SCI while walking with two control modes, compared with unassisted walking. Three patients with incomplete SCI participated in the study and three walking tests were conducted in randomized order with two control modes and unassisted gait while recording the oxygen consumption and prior and after blood pressure, heart rate, VAS of pain and fatigue was obtained. As conclusion, our results suggest that the gait robotic assistance with Exo-H2 is more physiological when is selected compliant mode.

The aim of this study was to investigate the effects of a rehabilitation exercise for people with incomplete Spinal Cord Injury (iSCI), based on cycling and combined afferent electrical stimulation (ES-cycling), to normalize spinal activity in response to a plantar cutaneous stimulation. We studied Soleus H-reflex excitability following ipsilateral plantar electrical stimulation applied at 25–100 ms inter-stimulus intervals (ISI’s), on 13 non-injured subjects and 10 subjects with iSCI. Reflexes were tested before and after a 10 min session of ES-cycling to evaluate the effects of the exercise. Plantar-conditioned H-reflex modulation increased in the iSCI group after ES-cycling, compared to the limited modulation observed before the exercise. Conversely, the non-injured group presented pronounced modulation both before and after the exercise. We conclude that ES-cycling improved plantar-conditioned spinal neuronal excitability in subjects with iSCI. Results could be used in the design of more effective leg-cycling therapies, to promote central neuroplasticity and rehabilitation in lower limb muscle activity following iSCI.

Cutaneomuscular afferent information is essential for voluntary motor tasks such as gait and balance. After spinal cord injury (SCI) changes in sensorimotor activity are involved in recovery of limited motor function. Here we present a review of clinical neurophysiological measures that quantify sensorimotor dysfunction and which have the potential to benchmark the therapeutic effect of cutaneous stimulation during SCI neurorehabilitation. Specifically we will show that long-latency cutaneous reflex and cutaneomuscular conditioned H-reflex techniques can quantify spinal neuronal activity and the presence of either adaptive or maladaptive motor control mechanisms after incomplete SCI. In conclusion, the development of neurorehabilitation programs in combination with cutaneomuscular stimulation protocols is a viable strategy not only to promote motor recovery but to prevent maladaptive neuroplasticity such as spasticity after SCI.

Mobile video streaming becomes increasingly useful in a variety of contexts (social interaction, education, and entertainment) and increasingly feasible with the rapid advancement of wireless networks and mobile technologies. In this paper, we present, Kaleidoscope, a cloud platform for multimedia streaming on mobile devices, enhanced with textual and touch-display interactions for a rich user experience. We evaluate the Kaleidoscope system on two different clouds at different locations, testing the streaming quality, and CPU and memory usage, using different numbers of clients.

Radiotherapy (RT) is a common treatment for localised prostate cancer, but can cause important side effects. The therapeutic efficacy of RT can be enhanced by pharmacological compounds that target specific pathways involved in cell survival. This would elicit a similar therapeutic response using lower doses of RT and, in turn, reducing side effects. This study describes the antitumour activity of the novel Akt inhibitor 8-(1-Hydroxy-ethyl)-2-methoxy-3-(4-methoxy-benzyloxy)-benzo[c]chromen-6-one (Palomid 529 or P529) as well as its ability to decrease radiation-activated phospho-Akt (p-Akt) signalling in a prostate cancer model. P529 showed a potent antiproliferative activity in the NCI-60 cell lines panel, with growth inhibitory 50 (GI50)

The intensity used during transcutaneous electrical nerve stimulation (TENS) in both, clinical practice and research studies, is often based on subjective commands such as "strong but comfortable sensation". There is no consensus regarding the effectiveness dose of TENS. The objective was to determine the difference in the effect of spinal TENS on soleus H-reflex modulation when applied by two therapists instructed to apply the stimulation at a "strong but comfortable" intensity. Twenty healthy volunteers divided into two groups: Therapist 1 (n = 10) and Therapist 2 (n = 10). Both therapist applied spinal TENS and sham stimulation at the T10-12 spinal level for 40min in random order to each subject, at an intensity designed to produce a "strong but comfortable" sensation. To avoid habituation, the intensity was adjusted every 2min. Soleus H-reflex was recorded before, during, and 10min after TENS by an observer blinded to the stimulus applied. Despite the instruction to apply TENS at a "strong comfortable" level, a significant difference in current density was identified: Therapist 1 (0.67mA/cm2, SD 0.54) applied more than Therapist 2 (0.53mA/cm2, SD 0.57; p