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OBJECTIVES. To compare intraoperative intracochlear electrocochleography (ECochG) with hearing preservation outcomes in cochlear implant (CI) subjects. DESIGN. Intraoperative electrocochleography was performed in adult CI subjects who were recipients of Advanced Bionics’ Bionics LLC precurved HiFocus(™) MidScala or straight HiFocus(™) SlimJ electrode arrays. ECochG responses were recorded from the most apical electrode contact during insertion. No changes to the insertions were made due to ECochG monitoring. No information about insertion resistance was collected. ECochG drops were estimated as the change in amplitude from peak (defined as maximum amplitude response) to drop (largest drop) point after the peak during insertion was measured following the peak response. .Audiometric thresholds from each subject were obtained before and approximately one month after CI surgery. The change in pure tone average (PTA) for frequencies between 125 Hz and 500 Hz was measured after surgery. No post-operative CT scans were collected as part of this study. RESULTS. A total of 68 subjects from 5 surgical centers participated in the study. The study sample included 30 MidScala and 38 SlimJ electrodes implanted by approximately 20 surgeons who contributed to the study. Although a wide range of results were observed, there was a moderate positive correlation (Pearson Correlation coefficient r = 0.56, p < 0.01) between the size of the ECochG drop and the magnitude of PTA change. This trend was present for both the MidScala and SlimJ arrays. The SlimJ and MidScala arrays produced significantly different hearing loss after surgery. CONCLUSION. Large ECochG amplitude drops observed during electrode insertion indicated poorer hearing preservation. Although the outcomes were variable, this information may be helpful to guide surgical decision-making when contemplating full electrode insertion and the likelihood of hearing preservation.

Wiryawan Permadi, Mulyanusa Amarullah Ritonga, Hartanto Bayuaji, Niswan Helja, Corina Delarosa Khoirunnisa, Tono Djuwantono Department of Obstetrics & Gynecology, Dr. Hasan Sadikin Hospital, Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaCorrespondence: Mulyanusa Amarullah Ritonga Email mulyanusa@unpad.ac.idPurpose: We aimed to analyze the relationship between estradiol level and thromboelastography profile.Patients and Methods: This prospective study with comparative analysis was performed on nineteen samples undergoing an IVF procedure in two fertility clinics in Bandung city. Blood samples taken on the second and twelfth days of the IVF cycle.Results: There were significant differences in the value of estradiol, fibrin formation time (α), and coagulation index (CI) (p< 0.05). Correlation tests showed no relationship and no significant correlation between an increased level of estradiol and coagulation index (CI) (rs=0.054; p=0.827) and between an increased level of estradiol and fibrinolysis time (LY30) (rs=− 0.151; p=0.536). A moderate significant relationship was observed between age and coagulation index (CI) (rs=− 0.430; p=0.033) and between age and maximum amplitude (MA) (rs=− 0.494; p=0.032).Conclusion: Supraphysiological estradiol levels in controlled ovarian stimulation cycles affect the coagulation index and change mainly the fibrin formation time.Keywords: estradiol, hemostasis, thromboelastography, controlled ovarian cycles

Patients with severe coronavirus disease-2019 (COVID-19) frequently have hypercoagulability caused by the immune response to the severe acute respiratory syndrome coronavirus-2 infection. The pathophysiology of COVID-19 associated hypercoagulability is not fully understood, but characteristic changes include: increased fibrinogen concentration, increased Factor VIII activity, increased circulating von Willebrand factor, and exhausted fibrinolysis. Anticoagulant therapy improves outcomes in mechanically ventilated patients with COVID-19 and viscoelastic coagulation testing offers an opportunity to tailor anticoagulant therapy based on an individual patient's coagulation status. In this narrative review, we summarize clinical manifestations of COVID-19, mechanisms, monitoring considerations, and anticoagulant therapy. We also review unique considerations for COVID-19 patients who are on extracorporeal membrane oxygenation.

Objectives (1) To study the reliability of quantifying rear-chain stabilization capacity during deadbug bridging (DBB), (2) to provide reference values for competitive alpine skiers, and (3) to study associations with age, anthropometrics, maturation, skiing performance and back overuse complaints. Design Cross-sectional. Setting Biomechanical field experiment including questionnaires. Participants 12 healthy subjects (reliability experiment); 133 skiers of the U16 category and 38 of the elite category (main experiment). Main outcome measures DBB performance was quantified using 3D motion capture as the maximum amplitude of the relative vertical displacement of two pelvis markers (DBBdisplacement). Additionally, in U16 skiers, age, anthropometrics, maturation, skiing performance, and back overuse complaints were assessed. Results The reliability experiment revealed an ICC(3,1) and 95% CI of 0.81 [0.61, 0.93]. Within-subject SEM was 3.89 mm [3.16 mm, 5.12 mm]. Depending on sex and category, medians of DBBdisplacement in skiers ranged between 29 mm and 45 mm. DBBdisplacement differed between elite and U16 skiers (p Conclusion The proposed approach may be considered an adequate method to quantify athletes’ rear-chain stabilization capacity.

Objectives: This study aimed to assess the association between the corneal biomechanical parameters and visual field (VF) loss in patients with asymmetric primary open-angle glaucoma (POAG). Methods: A total of 89 POAG patients (50 males, 56.2%) with asymmetric VF loss, aged 65.2 ± 13.3 years, were enrolled in this study. Asymmetric VF loss was defined as an interocular difference of the global index mean deviation (MD) >2 dB. Intraocular pressure (IOP), central corneal thickness (CCT), and corneal biomechanical parameters such as maximum amplitude at the apex of highest concavity (def ampl HC) were measured. The worse eye was defined as the eye with a smaller MD. Results: The worse eyes had lower MD (−11.9 ± 6.7 dB vs. −5.3 ± 5.0 dB; p < 0.001) and higher IOP (14.6 ± 3.3 vs.13.9 ± 2.6 mm Hg, p = 0.04) than the better eyes. There was no significant difference between the 2 groups for CCT. The interocular difference of MD (IDMD) was negatively correlated with the interocular difference of IOP (r = −0.22, p = 0.04), while positively correlated with the interocular difference of def ampl HC (r = 0.27, p = 0.01). In patients with moderate asymmetric VF loss (IDMD ≥6 dB), def ampl HC of the worse eyes group (1.07 ± 0.12 mm) was significantly lower than the better eyes group (1.10 ± 0.11 mm, p = 0.02). Conclusion: Asymmetric POAG was associated with asymmetry in IOP and corneal biomechanical parameters but not in CCT. Lower deflection amplitude and higher IOP were found in eyes with more severe VF damage in POAG patients.

In total hip arthroplasty, judgment of the appropriateness of stem hammering is dependent on the experience and feelings of the surgeon and no objective evaluation method has been established. In this study, a frequency analysis of the hammering sounds in total hip arthroplasty was performed to investigate objective judgment criteria capable of preventing problems during surgery. Stem hammering was applied following the surgeon’s feelings as usual in an operating room. A directional microphone was placed at a distance about 2 m from the surgical field and the peak frequency reaching the maximum amplitude was determined by Fourier analysis. It was clarified that the same peak frequency repeats when appropriate fixation is acquired during surgery, suggesting that intraoperative fracture and postoperative loosening can be prevented by stopping hammering at the time the peak frequency converged. Investigation of changes in the hammering sound frequency may serve as objective judgment criteria capable of preventing problems during surgery.

Objective To study clinical significance of augmentation of intraoperative motor evoked potentials (MEPs) during direct open surgery for middle cerebral artery (MCA) aneurysms. Methods Between 2009 and 2017, 134 MCA aneurysm surgeries were performed with intraoperative MEP monitoring. The frequency and cause of augmentation with >50% increase of MEP amplitude from baseline were studied. Factors associated with MEP augmentation were investigated. Results MEP augmentation was demonstrated in 9 patients. All 9 events were observed just after application of the temporary clip to the parent artery. The ratio of the maximum amplitude to baseline was 2.6 ± 1.1 at an mean of 2.4 ± 1.1 minutes after parent artery occlusion. Ten patients who did not show MEP augmentation after parent artery occlusion were compared with the patients showing MEP augmentation. The distance of the temporary clip point from the midline was smaller in patients with MEP augmentation compared with patients without MEP augmentation (P = 0.033). Conclusions MEP augmentation was thought to be an early ischemic sign preceding a significant decrease in MEPs during MCA aneurysm surgery. Transient augmentation of MEPs was more frequently observed in cases with a temporary clip applied to the more proximal part of the MCA.

Objective It is well established that women with a previous vaginal delivery have higher success rates in relation to vaginal birth after cesarean than those without. The aim of this study was to examine the effect of past mode of delivery on contractile parameters of human myometrium in vitro. Study Design Myometrial strips were excised from 64 women at cesarean delivery (CD) and recordings of spontaneous contractile activity analyzed and compared across three clinical groups: (1) women with no previous delivery (Group 1); (2) women with CD only (Group 2); and (3) women with a history of vaginal delivery and CD (Group 3). Results Myometrial samples from women in Group 3, women who had a previous vaginal delivery, had a significantly greater maximum amplitude of contractions (p Conclusion Many of the functional parameters of human uterine contractions are altered, or enhanced, in the women who have had a previous vaginal delivery, when compared with those without. This may partly explain the clinical differences observed in labor.

Objective This study compared an antiaging treatment with two currently marketed cosmetic antiaging products for the treatment of lateral canthal lines ("crow's feet"). Methods Healthy female volunteers (72) aged of 54.6 years (mean) having fine‐to‐moderate wrinkles in the lateral canthal areas were randomized to one of three treatments applied daily over 28 days: Group A (Purgenesis™ Day Cream, Purgenesis™ Eye Cream, and Purgenesis™ Night Cream); Group B (Prevage® Eye Lotion, Prevage® Day Cream, and Prevage® Night Cream); or Group C (La Mer® Eye Balm, Crème de La Mer®, and La Mer® Night Cream). The effects on anti‐wrinkle properties and for sensory attributes and general performance were evaluated on Days 1, 7, and 28. Results Skin hydration improved significantly at all time points in Groups A and B, and at Day 28 in Group C. Group A patients experienced significant improvements in measured skin elasticity parameters at Day 28; extensibility and maximum amplitude were significantly better at Day 28 in Groups B and C. Benefits were also seen in profilometric parameters with statistical significance only in Group A Volunteer tolerance was good with all three treatments, although moderate and high levels of adverse events were numerically higher in Group B than in Groups A or C, and levels of slight discomfort were significantly more prevalent in Group B. Conclusion The Purgenesis™ antiaging treatment significantly improved skin hydration, elasticity, and profilometry parameters during a 28‐day study. This therapy was found to be well tolerated and effective in countering the cutaneous signs of aging.

Transcutaneous electrical stimulation (TES) is a frequently used adjunctive modality in dysphagia rehabilitation. Stimulating deeper swallowing muscles requires higher TES amplitude. However, TES amplitude is limited by maximum amplitude tolerance (MAT). Previous studies have reported high interindividual variability regarding MAT and perceived discomfort. This variability might be one of the potential reasons of conflicting outcomes in TES-based swallowing studies. MAT and perceived discomfort are influenced by a variety of biopsychological factors. The influence of these factors related to swallow applications is poorly understood. This study explored the relation of biopsychological factors with MAT and perceived discomfort related to TES in the submental area. A convenience sample of thirty community-dwelling older adults between 60 and 70 years of age provided data for this study. Gender, submental adipose tissue thickness, perceptual pain sensitivity, and pain-coping strategies were evaluated for each subject. Subsequently, MAT and perceived discomfort level were determined using TES on the submental area. Relation of different biopsychological variables with MAT and discomfort level was examined using Pearson and Spearman correlation, and Mann–Whitney U test. Results indicated that neither gender nor adipose thickness was related to MAT and perceived discomfort. Among studied pain-coping strategies, catastrophizing was significantly related to MAT(r = – 0.552, p

Aim To assess whether amplitude‐integrated electroencephalography (aEEG) alterations in the newborn period are associated with poor precursor skills of literacy at five years of age in children born preterm. Methods Between October 2007 and September 2011 248 preterm infants were eligible for the study at Innsbruck Medical University Hospital. aEEG was analysed for dominating background activity, calculation of the percentage of continuous activity, the Burdjalov scoring system, the minimum, mean and maximum amplitude. At the age of five years, we evaluated preterm born children by the Bielefelder screening (BISC) to assess for early diagnosis of reading problems and weak spelling and classified them as normal performers (n = 64) or poor performers (n = 20). Completion of testing was not possible for one infant. Results The minimum amplitude was significantly lower in the poor BISC performance group as compared to the normal BISC performance group at postnatal week two. The percentage of continuous background activity was significantly higher in infants with normal BISC performance than in infants with poor BISC performance at postnatal week three. Conclusion Children with poor developed precursor skills of literacy showed alterations in aEEG signals. The aEEG could be useful in further diagnosing preterm infants at risk for developmental complications.

Purpose and objectives of the study:evaluate and compare the results of surgical treatment of complex fractures and fractures of the proximal humerus. Materials and methods: an analysis of the results of surgical treatment of 202 patients with 3 and 4 fragmentary fractures and fractures of the proximal humerus was performed. During the period of 2015-2017 in the City Clinical Hospital named after V.P. Demikhov. Results: Based on the analysis of surgical treatment of 202 patients with fractures and complex fractures of proximal metaepiphysis of the humerus within 7 days from the time of injury, we came to the conclusion that the most effective method is endoprosthesis of the shoulder joint by a reversible system. This method allows you to reach the maximum amplitude of movements in the shoulder joint in the early stages of rehabilitation treatment. In the main group, where reversive endoprosthetics were used, excellent and good results on the Constant-Murley and ASES scales were obtained in 46 patients (85.2%). Unsatisfactory outcomes were not encountered. More modest results were obtained in the groups where the osteosynthesis of the fractures with pins and plates was performed, and hemiarthroplasty for the surgical treatment of "fresh" fractures and complex fractures of the proximal metaepiphysis of the humerus was found to be untenable.

RATIONALE: Coronavirus disease 2019 (COVID-19) is associated with high rates of venous thromboembolism despite prophylactic anticoagulation. Thromboelastography (TEG) has been suggested as a tool for identifying patients at increased risk of VTE. This study aims to determine if serial TEG evaluation predicts the development of VTE in patients with COVID-19 and respiratory failure admitted to the intensive care unit (ICU). METHODS: We conducted a prospective cohort study of patients admitted to the ICU with COVID-19 and respiratory failure without a prior diagnosis of acute VTE. Patients underwent TEG on days 1, 4, and 6 of ICU admission. The number of hypercoagulable days, defined as elevated TEG maximum amplitude, were recorded. The outcome was time from ICU admission to VTE during the hospital admission. Patients were censored at death and discharge. A Cox proportional hazards model was fit for time to first VTE controlling for patient age, sex, and exposure to antiplatelet agents. RESULTS: A total of 56 patients were enrolled in the study (11 females/45 males);41.1% had a hypercoagulable TEG (MA above the upper limit of normal) on ICU day 1, 55.4% on day 4, and 48.2% on day 6. The primary outcome of VTE occurred in 17 patients (30.4%). The median time from ICU admission to VTE was 7 days (IQR 3-12). Of the 14 patients with hypercoagulable MA on all 3 measured days, 1 patient (7.1%) developed a VTE compared to 15.4% of those with hypercoagulable MA for 2 days (N=13), 30.8% of those hypercoagulable for 1 day (N=13), and 62.5% of patients not hypercoagulable any of the 3 days (N=16). Multivariable Cox-proportional hazards model found that increasing number of hypercoagulable days by MA was associated with a decreased risk of VTE (OR 0.48, CI 0.27-0.85, p=0.01). A Cox proportional hazards regression curve for the number of hypercoagulable days by MA holding all other covariates at their medians is shown in Figure 1. CONCLUSION: In this study, more hypercoagulable days on TEG MA measurement was counterintuitively associated with a decreased risk of VTE in patients with COVID-19 respiratory failure. The normal response to inflammation and infection is upregulation of pro-coagulant acute phase reactants suggesting that increased TEG MA may be physiologic. TEG MA measures below the upper limit of normal are associated with an increased risk of VTE and may mark the development of a consumptive coagulopathy.

Noise affects the recognition of acoustic signals by masking information. To compensate for increased noise, individuals often increase the minimum frequency of their vocalization to reduce noise interference. Our goal was to analyze the effect of noise on the characteristics of different bird vocalizations, through a comparative study of vocalizations on the same bird species. We analyzed the effects of noise variation on the fine spectrotemporal characteristics of calls, songs, and duets of White-eared Ground-sparrows (Melozone leucotis) across three populations over a three-year period. We recorded vocalizations and noise levels simultaneously from 41 territories between 2012 and 2014. We measured the duration, minimum, maximum, and maximum amplitude frequency, and counted the number of songs elements for each vocalization recorded. As we predicted, noise influences the minimum frequency of song, but did not have an effect on the fine spectrotemporal characteristics for calls and duets. We did, however, find that low and high frequency of calls and duets increased with noisepopulation-year interaction. Our results suggest that differences in noise values at each population were inadequate to observe changes in vocalization characteristics. In conclusion, evaluating responses to different noise levels on different vocalization types for the same species expands our understanding of the flexibility of birds to adjust vocalizations in response to anthropogenic noise. Universidad de Costa Rica/[111-B5-241]/UCR/Costa Rica Ministerio de Ciencia y Tecnología/[]MICIT/Costa Rica Consejo Nacional para Investigaciones y Científicas y Tecnológicas/[]/CONICIT/Costa Rica UCR::Vicerrectoría de Docencia::Ciencias Básicas::Facultad de Ciencias::Escuela de Biología

OBJECTIVE To assess the clinical, urodynamic efficacy, and safety of mirabegron in patients with neurogenic detrusor overactivity (NDO) consequent to traumatic spinal cord injury (SCI). METHODS This prospective cohort study was performed between January 2018 and July 2019 and included adult patients with stable traumatic suprasacral SCI, performing clean intermittent catheterization (CIC), and demonstrating NDO on urodynamic study (UDS). A 3-day bladder diary was made at the baseline after which all patients were started on Mirabegron 50 mg. They were followed up at 6 weeks with a repeat bladder diary and UDS which were compared with those at the baseline. RESULTS A total of 30 patients (4 females, 26 males, mean age: 30.07 years) were included. After 6 weeks of treatment, 5 out of the 29 incontinent patients became completely dry. The mean frequency of CIC decreased from 6.63 at the baseline to 5.37 at 6 weeks (p = .002), the mean CIC volume increased from 275 ml to 341 ml (p = .0002), the mean number of incontinence episodes in between CIC reduced from 3.97 to 2.27 (p

The Soleus (SOL) Hoffmann reflex (H-reflex) is commonly recorded in sitting position. However, the reliability of recording is unknown. We assessed the reliability of SOL H-reflex amplitude measurements across multiple traces and sessions during erect, slumped, and slouched sitting postures using the generalizability theory. Five traces of the SOL H-reflex maximum amplitude (Hmax) were recorded from 10 healthy participants during erect, slumped, and slouched sitting postures in two sessions. A decision study analysis was then conducted to calculate the reliability coefficients of the Hmax for five traces and two sessions and to mathematically calculate the coefficients for seven and ten traces, and one and three sessions in the three sitting postures. For five traces and two sessions, the results showed reliability coefficients between 0.970 and 0.971, 0.980 and 0.979, and equal to 0.943 for erect, slumped, and slouched sitting, respectively. Averaging five traces of the Hmax in a single recording session was sufficient to obtain acceptable reliability in the three sitting postures (reliability range, 0.892&ndash, 0.988). It was concluded that the SOL Hmax can be recorded during erect, slumped, and slouched sitting postures with adequate reliability.

Thromboelastography (TEG) is regularly used for monitoring abnormalities of the coagulation system in patients with sepsis. However, it is unclear whether TEG parameters are associated with sepsis-induced coagulopathy (SIC). Thus, we aimed to assess the diagnostic value of TEG for SIC. The medical records of patients who underwent TEG from January 2016 to December 2016 were analyzed retrospectively. The patients were divided into sepsis group and non-sepsis group. Baseline patient characteristics and coagulation function indexes were compared. Receiver–operating characteristic curve analysis was used to determine predictors of SIC. A total of 167 patients were included, of whom 84 had sepsis. The clot formation speed (K) was significantly higher(P < 0.001), and the maximum amplitude (MA) and angle were significantly lower (both P < 0.001) in the sepsis group than that in non-sepsis group. Patients with SIC had higher Sepsis-related Organ Failure Assessment scores than those patients without SIC (P < 0.001). The area under the curve of K for diagnosing SIC was 0.910. The area under the curve of angle and MA for excluding SIC was 0.895 and 0.882, respectively. Thus, TEG parameters have good diagnostic value for SIC.

BackgroundPregnancy is a period when a woman's body undergoes changes. The purpose of this study was to analyze the mechanisms of gait adaptation in overweight pregnant women regarding spatiotemporal gait parameters, ground reaction forces, and plantar pressure distribution.MethodsThe tests were performed in 29 normal-weight pregnant women and 26 pregnant women who were overweight before pregnancy. The measurements included spatiotemporal gait parameters, in-shoe plantar pressure distribution, and ground reaction forces during gestation.ResultsThe results indicate that both normal-weight and overweight pregnant women make use of the same spatiotemporal gait parameters to increase body stability and safety of movement during pregnancy. The double-step duration in the third trimester of pregnancy was higher in normal-weight and overweight pregnant women compared with in the first trimester (P < .05). A significant change in pressure amplitude was found under all anatomical parts of the foot in the third trimester (P < .05). The results also suggest a higher increase in the maximum amplitude of force in overweight pregnant women in the third trimester compared with the normal-weight group.ConclusionsThis study suggests that both normal-weight and overweight pregnant women use different mechanisms of gait adaptation during pregnancy. In practice, understanding the biomechanical changes in women's gait can protect the musculoskeletal system during gestation.

Purpose We present a unique opportunity to compare standard neck injury criteria (used by the automotive industry to predict injury) with real-life injuries. The injuries sustained during, and the overall kinematics of, a television demonstration of whiplash mechanics were used to inform and validate a vertebral level model of neck mechanics to examine the relevance of current injury criteria used by the automotive industry. Methods Frontal and rear impact pulses, obtained from videos of sled motion, were used to drive a MADYMO human model to generate detailed segmental level biomechanics. The maximum amplitude of the frontal and rear crash pulses was 166 ms−2 and 196 ms−2, respectively, both with a duration of 0.137 s. The MADYMO model was used to predict standard automotive neck injury criteria as well as detailed mechanics of each cervical segment. Results Whilst the subject suffered significant upper neck injuries, these were not predicted by conventional upper neck injury criteria (Nij and Nkm). However, the model did predict anterior accelerations of C1 and C2 of 40 g, which is 5 times higher than the threshold of the acceleration for alar ligament injury. Similarly, excessive anterior shear displacement (15 mm) of the skull relative to C2 was predicted. Predictions of NIC, an injury criterion relevant to the lower neck, as well as maximum flexion angles for the lower cervical segments (C3–T1) exceeded injury thresholds. Conclusion The criteria used by the automotive industry as standard surrogates for upper neck injury (Nij and Nkm) did not predict the significant cranio-cervical junction injury observed clinically.

Objectives The first objective of this study aimed to elucidate the relationship between seizure characteristics and Magnetic Seizure Therapy (MST) treatment outcome. The second objective was to determine the effect of stimulation frequency on seizure characteristics. Methods Using a between-subjects design, we compared the seizures of patients with unipolar depression receiving MST at three separate stimulation frequencies: 25 Hz (n = 34), 50 Hz (n = 16) and 100 Hz (n = 11). Seizures were rated for overall seizure adequacy on a scale of 0–6, with one point given for each measure that was considered to be adequate according to the ECT literature: (1) seizure EEG duration (2) motor duration, (3) post-ictal suppression, (4) ictal EEG maximum amplitude, (5) Global Seizure Strength, and (6) Symmetry. Mixed-effect models were used to evaluate the effect of frequency on seizure characteristics and the relationships between seizure characteristics and clinical outcome. Results (1) 100 Hz induced seizures that were less adequate than seizures induced with 50 Hz and 25 Hz stimulations. Seizures induced by 50 Hz stimulations had longer slow-wave phase durations and total EEG durations than the 100 Hz and 25 Hz groups. Global seizure strength was less robust in seizures induced by 100 Hz MST compared to the other stimulation frequencies. (2) Shorter polyspike durations and smaller slow-wave amplitude predicted reductions in overall symptoms of depression as measured by the 24-item Hamilton Depression Scale. Conclusion Analysis of our first objective revealed stimulation frequency significantly influences measures of overall seizure adequacy. However, our results also revealed these descriptions of seizure adequacy based on ECT literature may not be useful for MST-induced seizures, as the characteristics of MST-induced seizure characteristics may predict clinical response in a different manner. Significance These results may help to distinguish the biological processes impacted by stimulation frequency and may suggest different mechanisms of action between convulsive therapies and challenge the current understanding of seizure adequacy for MST.

Pain is considered a condition that most affect the welfare of animals and its measurement is seen as a difficult task. This research aimed to determine the level of pain in pigs by their vocalization. It was recorded the vocalizations of 20 male piglets under normal circumstances (I), marking by Australian method (II), tail trimming management (III), and castration (IV). A unidirectional microphone and a digital recorder were used to record the sound signals. The results suggested that Pitch frequency (Hz), the maximum amplitude (Pa), and intensity (dB) increased from pain-free pigs to the marking procedure; and from marking to both tail trimming and castration The tail trimming and castration vocal response did not differ.

Tremor is a rhythmic, involuntary, oscillatory movement of a limb produced by alternating contractions of reciprocally innervated muscles. More than 4% of the population over 40 years old suffer from tremor. There is no cure for most tremors, and while psychological therapy is sometimes helpful, tremors are usually treated with either medication or invasive surgery including thalamotomy and deep brain stimulation. Both medications and surgery may have adverse effects, and thus, there is a growing interest in developing non-invasive vibration attenuation devices. This paper presents a passive absorber device for attenuating pronation/supination tremor, dubbed Vib-bracelet. It is based on the principles of dynamic vibration absorption and is tuned to the frequency of the tremor. Prototypes were manufactured and tested on a mechanical model of the human forearm. Simulations and experiments demonstrate the efficiency of the device in attenuating vibrations in the range of 4-6 Hz, which is the range of frequency of observed tremor, with maximum amplitude attenuation of 85%.

Background This study aimed to evaluate the relationship between thromboelastography adenosine diphosphate maximum amplitude (TEG-ADPMA) and recurrent ischemic events in patients with minor ischemic stroke or high-risk transient ischemic attack (TIA). Methods A total of 265 patients received dual antiplatelet therapy were consecutively enrolled. High on-treatment platelet reactivity (HTPR) to ADP was assessed by TEG-ADPMA and detected the CYP2C19 genotype; recurrent ischemic events were followed up for 90 days after onset. The difference of recurrent ischemic events was analyzed with or without HTPR to ADP by the Kaplan–Meier, and further to determine the difference of recurrent ischemic events in each group according to TEG-ADPMA-based tertile distribution. Results A total of 23 (8.6%) patients had recurrent ischemic events. TEG-ADPMA greater than or equal to 48 mm had good predictive value. Whether these patients were divided into 2 groups or 3 groups, the HTPR to ADP group had higher risk of recurrent ischemic events than the normal on-treatment platelet reactivity to ADP group by the Kaplan–Meier (all, P Conclusions In patients with minor ischemic stroke and high-risk TIA, the TEG-ADPMA could predict recurrent ischemic events and has auxiliary effect on clinical decision-making.

The ability of athletes with different training specializations to recover vertical posture after an external pushing impact was studied. Athletes engaged in cyclic exercise sports (jogging, n = 7) and complex coordinate sports (wrestling, n = 10) and nonathletes (control, n = 10) were the subjects of this study. The recovery of vertical position after a small external pushing impact on the arms extended forward was assessed using stabilography. We determined the maximum amplitude (Amp-m) of deviation from the general center of pressure, the reaction time (RT) and the velocity of reaction (V-r), as well as the variance and mean velocity of vertical posture oscillations before and after an impact. It was found that, although no differences were observed in the vertical posture stability before pushing, the Amp-m was lower in the wrestlers than in the control group (by 17.5%, p = 0.018 under the eye-open conditions; by 27.3%, p = 0.002 under the eye-closed conditions). The deprivation of visual information about the pushing moment increases the Amp-m and V-r and had no effect on the RT in all groups. Under the eye-closed conditions, an increase in Amp-m as a result of pushing was significantly lower in the wrestlers (p = 0.033) than in the control group. Under the eye-closed conditions, the accuracy of the recovery of the initial vertical position after pushing was higher in the wrestlers than in the control group (p = 0.027). The indicators of postural stability, displacement of the center of pressure, and vertical posture sway and recovery after pushing did not differ between the runners and other groups. Therefore, compared to cyclic exercises, training in complex coordinating sports more effectively improves the ability to maintain vertical posture in response to its perturbation.

The study aimed to characterize spontaneous electrical activity of the ureter, urinary bladder and urethra as well as their interrelationship. The basic parameters of pacemaker activity (amplitude, frequency, peak rise rate, peak rise time, peak half-width) were comparatively analyzed in each of the active areas. Out of the three areas compared, the ureteral rhythmogenic zone displayed the maximum amplitude and apex formation rate. Under conditions of urine influx from the ureter into the bladder and isolation of these organs from the urethra, the amplitude and peak rise rate in the latter decreased by almost 20%. At the same time, all the parameters of the ureter and bladder remained intact. Complete block of urine influx into the bladder by transecting the ureter at the appropriate area led to a slight decrease in the amplitude of action potentials, peak rise rate and rhythmogenicity frequency in the bladder, respectively, by 14.2, 12.5 and 16% at the constancy of other parameters of its activity. Subsequent isolation of the bladder from the urethra had no appreciable effect on the altered parameters of the former. The similar tendency towards a reduction of the parameters was observed under the same conditions in the urethra. Thus, a relationship was revealed between autonomous activities of the ureter, bladder and urethra. The regulatory role in this process is provided by the urine flow through these organs.

Muscle activity is typically normalized to maximal activation from isometric maximum voluntary exertions (MVE) in posture and direction specific exertions for each muscle. This is challenging for the shoulder complex due to the large number of muscles. The objective of this investigation was to compare maximum shoulder muscle activity elicited from a multi-muscle MVE test protocol versus individual muscle MVE tests and determine their reliability. Ten healthy males had muscle activity recorded from 12 trunk and upper extremity muscles while performing 3 repetitions of 12 individual and 4 multi-muscle MVEs. Peak surface EMG (sEMG) amplitudes were compared using paired sample t-tests between the two protocols for each muscle. Individual muscle test maximum sEMG amplitudes differed significantly from the multi-muscle test protocol in 3 of 12 muscles (p

In this study, EEG beta band examinations were performed in patients with facial lesions and compared with the control group. 10 healthy volunteers and 4 patients with face lesions participated in this study Right-hand sensory and rightlower face sensory EEG recordings were analyzed based on wavelet packet transformation, and lower and upper beta band maximum amplitude values and ratios were compared with control group. Significant differences were found in 2 patients for right hand stimulus and were found in 3 patients for right face stimulus. The mapping of the two senses on the cortex was performed and the differences in the activity areas were discussed.

Thromboelastography (TEG) is used for monitoring abnormal blood coagulation in critically ill patients. However, the correlation between TEG parameters and long-term survival in these patients is unknown. We aimed to quantify the effect of TEG on long-term survival of critically ill patients. Critically ill patients undergoing TEG were retrospectively examined. Baseline patient characteristics and coagulation function indexes were compared. Cox regression, receiver–operating characteristic curve analysis, and Kaplan-Meier survival estimate curve were performed. We included 167 critically ill patients. Clot formation speed (K) and reaction time (R) were higher, whereas maximum amplitude (MA) and angle were lower in the mortality group than in the survival group ( P < .01). All TEG parameters were risk factors for 2-year survival in critically ill patients ( P < .01). The area under the curve of MA for predicting 2-year survival was 0.756 (95% confidence interval: 0.670-0.841). The Kaplan-Meier survival estimate curve analysis showed that MA predicted 2-year survival of critically ill patients( P < .01). Maximum amplitude can effectively predict 2-year survival of critically ill patients, indicating the influence of the coagulation system on these patients.

Patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) exhibit complex hemostatic defects. Thromboelastography (TEG) can be used to reveal global hemostasis in patients with liver disease; however, little is known about the association between TEG and the outcome of patients with HBV-related ACLF. The present study aimed to investigate the value of TEG for predicting 90 day mortality in patients with HBV-related ACLF. A total of 51 patients with HBV-related ACLF, 26 patients with chronic hepatitis B (CHB) and 26 healthy controls (HC) were enrolled in the present study. TEG, standard coagulation tests, routine blood tests, biochemical markers and demographic variables were recorded and assessed for prognostic value. The results indicated that a prolonged reaction and kinetics (K) time, a shortened α angle and a decreased maximum amplitude (MA) and coagulation index (CI) were observed in patients with HBV-related ACLF, compared with CHB and HC subjects. Patients with HBV-related ACLF in the mortality group exhibited a decrease in α angle, MA, lysis at 30 min, CI, fibrinogen and platelet count, and an increase in K time, international normalized ratio (INR) and the model for end-stage liver disease (MELD) score in comparison with the survival group. MA and INR were two independent predictors of 90 day mortality in patients with HBV-related ACLF, with hazard ratios of 0.918 (95% CI, 0.867-0.971; P=0.003) and 3.141 (95% CI, 1.843-5.354; P51.5 mm, as revealed via the Kaplan-Meier analysis. In summary, the findings of the present study suggested that TEG MA was associated with 90 day mortality in patients with HBV-related ACLF, and a combination of MA and INR was superior to MA, INR and MELD score in terms of prognostic value.

In current practice, the status of residual low-frequency acoustic hearing in hearing preservation cochlear implantation (CI) is unknown until activation two to three weeks postoperatively. The intraoperatively measured electrically evoked compound action potential (ECAP), a synchronous response from electrically stimulated auditory nerve fibers, is one of the first markers of auditory nerve function after cochlear implant surgery and such may provide information regarding the status of residual low-frequency acoustic hearing.This study aimed to evaluate the relationship between intraoperative ECAP at the time of CI and presence of preoperative and postoperative low-frequency acoustic hearing.A retrospective case review.Two hundred seventeen adult ears receiving CI (42 Advanced Bionics, 82 Cochlear, and 93 MED-EL implants).Intraoperative ECAP and CI.ECAP measurements were obtained intraoperatively, whereas residual hearing data were obtained from postoperative CI activation audiogram. A linear mixed model test revealed no interaction effects for the following variables: manufacturer, electrode location (basal, middle, and apical), preoperative low-frequency pure-tone average (LFPTA), and postoperative LFPTA. The postoperative residual low-frequency hearing status was defined as preservation of unaided air conduction thresholds ≤90 dB at 250 Hz. Electrode location and hearing preservation data were analyzed individually for both the ECAP threshold and ECAP maximum amplitude using multiple t-tests, without assuming a consistent standard deviation between the groups, and with alpha correction.The maximum amplitude, in microvolts, was significantly higher throughout apical and middle regions of the cochlea in patients who had preserved low-frequency acoustic hearing as compared with those who did not have preserved hearing (p = 0.0001 and p = 0.0088, respectively). ECAP threshold, in microamperes, was significantly lower throughout the apical region of the cochlea in patients with preserved low-frequency acoustic hearing as compared with those without preserved hearing (p = 0.0099). Basal electrode maximum amplitudes and middle and basal electrode thresholds were not significantly correlated with postoperative low-frequency hearing.Apical and middle electrode maximum amplitudes and apical electrode thresholds detected through intraoperative ECAP measurements are significantly correlated with preservation of low-frequency acoustic hearing. This association may represent a potential immediate feedback mechanism for postoperative outcomes that can be applied to all CIs.

To change the lower limb muscle activities while walking, we propose a muscle activity controlling system that dynamically changes shoe insoles. We conducted a preliminary experiment on a prototype system to determine the system's validity. In this experiment, we analyzed how tibialis anterior and gastrocnemius muscle might change their activities depending on each insole condition. The results lead us to conclude that our system may affect changes in the duration percentage of tibialis anterior muscle activation when we change the heel part shape, and that it may change the maximum amplitude of gastrocnemius muscle activation when we change the arch part shape and hardness.

Thromboelastography is increasingly utilized in the management of bleeding and thrombotic complications where heparin management remains a cornerstone. This study assessed the feasibility of the cartridge-based TEG® 6s system (Haemonetics Corp., Braintree, Massachusetts, United States) to monitor and quantify the effect of unfractionated and low-molecular-weight heparin (UFH and LMWH). Blood samples from healthy donors were spiked with UFH (n = 23; 0–1.0 IU/mL) or LMWH (enoxaparin; n = 22; 0–1.5 IU/mL). Functional fibrinogen maximum amplitude (CFF.MA), RapidTEG activated clotting time (CRT.ACT), and kaolin and kaolin with heparinase reaction time (CK.R and CKH.R) were evaluated for their correlation with heparin concentrations, as well as the combination parameters ΔCK.R − CKH.R, ratio CK.R/CKH.R, and ratio CKH.R/CK.R. Nonlinear mixed-effect modelling was used to study the relationship between concentrations and parameters, and Bayesian classification modelling for the prediction of therapeutic ranges. CK.R and CRT.ACT strongly correlated with the activity of LMWH and UFH (p 0.5 IU/mL for UFH and >1.5 IU/mL for LMWH. Combination parameters classified blood samples into subtherapeutic, therapeutic, and supratherapeutic heparin ranges, with an accuracy of >90% for UFH, and >78% for LMWH. This study suggests that TEG 6s can effectively monitor and quantify heparin activity for LMWH and UFH. Additionally, combination parameters can be used to classify blood samples into therapeutic ranges based on heparin activity.

Accurate Blood Pressure (BP) estimation plays a crucial role in providing significant information about the patient’s cardiovascular health. In this paper, performance analysis of the various oscillometric BP estimation algorithms – Maximum Amplitude Algorithm (MAA), Maximum Minimum Slope Algorithm (MMSA), Arterial Lumen Area Algorithm (ALA) and Pulse Transit Time (PTT) algorithm has been performed. The analysis was carried out for a data set comprising 37 patients suffering from cardiac problems. The BP for each cardiac patient, estimated with the four oscillometric BP estimation algorithms, was compared with reference invasive BP measurements. The reference BP was estimated from the arterial pulse wave obtained by placing the pressure sensor inside the femoral or brachial arteries of the patients. The comparisons between the oscillometric BP estimation algorithms and the estimated reference BP are reported in terms of Mean Absolute Error (MAE), Standard Deviation of Error (SDE) and Bland-Altman plots analysis. It was found that the ALA followed by PTT are relatively accurate in estimation of BP with lowest MAE and SDE for cardiac patients, whereas MAA is the least accurate BP estimation technique. The results also emphasize the need to develop improved algorithms to estimate BP in cardiac patients.

Based on this model experiment, a small tip and low volume electrode show lowest intra-cochlear pressure values. Insertional support by a tool minimizes fast pressure changes. Higher electrodes volumes affect slow and fast pressure changes as well.Insertion causing low intra-cochlear pressure is assumed to be important for atraumatic cochlear implant surgery to preserve residual hearing. Cochlear implant electrodes differ in terms of parameters like tip size, length, volume, and technique of insertion. The aim of this study was to observe the effect of different cochlear implant electrodes on insertional intra-cochlear pressure in a cochlear model.Cochlear implant electrode insertions were performed in an artificial cochlear model and intra-cochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlear model to follow the maximum values, temporal changes, maximum amplitude, and frequency of changes in intra-cochlear pressure. Insertions were performed with four different electrodes (Advanced Bionics 1j, Helix, HFMS, and LW23).This study found statistically significant differences in the occurrence of initial maximum pressure values correlating with the electrode tip size. The different electrodes and the technique of insertion significantly affected the occurrence of maximum value, amplitude, and frequency of intra-cochlear pressure occurrence.

Objective To demonstrate changes in clot mechanics during pregnancy, and to determine the effect that delivery has on immediate postpartum thromboelastography parameters. Methods In an observational cross-sectional/longitudinal study, thromboelastography was performed on whole blood aliquots obtained from women carrying singleton pregnancies attending a center in London, UK, between December 2013 and March 2014. Thromboelastography was repeated 6 hours after delivery among patients recruited in the third trimester or labor. Bleeding questionnaires were completed and routine clinical/demographic data obtained. Results Overall, 112 women were included. The thromboelastography parameters were significantly correlated with length of pregnancy. From the third trimester to the postpartum period, there was a significant decrease in time until fibrin formation (R value; 5.8 vs 5.0 minutes, P = 0.036) and in time to reach a certain clot strength (amplitude of 20 mm; K value; 1.3 vs 1.1 minutes, P = 0.007). From established labor to after delivery, there was a significant increase in clot lysis at 60 minutes after the maximum amplitude of clot formation (LY60; 1.8% vs 3.1%, P = 0.001). Conclusion The present study describes a novel finding regarding changes in clot mechanics in late pregnancy/puerperium and supports the concept of using thromboelastography as part of the routine assessments at delivery.

No study has investigated the alterations in the flexibility of beginners using an experimental protocol with basic techniques of Capoeira. To analyze the effects of 8 weeks of Capoeira progressive training program on the flexibility of beginners. Twenty-one individuals divided in two groups (Capoeira: n = 13; 26.1 ± 7.2 years; 22.7 ± 2.7 kg m2(−1) and control: n = 08; 27.1 ± 0.5 years; 24.3 ± 3.3 kg m2(−1)) participated in the study. The Capoeira group performed 8 weeks of Capoeira progressive training program (two sessions per week lasting 60 min each). The experimental protocol used was exclusively based on the basic techniques of a programmed Capoeira training system. Before and after the intervention, measurements were performed aiming to analyze (1) trunk flexion flexibility through a sit-and-reach test using a Wells’ Bench (WBtf), (2) passive tension (PThf), and (3) maximum amplitude of hip flexion (MAhf) through goniometry. A two-way ANOVA revealed a main effect of group by time interaction to PThf (F = 11.797; P = 0.003; η p 2 = 0.383) and MAhf (F = 9.650; P = 0.006; η p 2 = 0.337). No significant main effect of group by time interaction occurred to WBtf (F = 3.320; P = 0.084; η p 2 = 0.149). The relative changes (∆ %) before and after the intervention in both groups showed that the Capoeira group significantly differed to the control group in the PThf (Capoeira: 46.2 ± 29.9 % vs. control: 5.7 ± 27.6 %; P = 0.003) and MAhf (Capoeira: 22.4 ± 24.5 % vs. control: −6.1 ± 13.1 %; P = 0.006). Eight weeks of Capoeira progressive training program resulted in a significant improvement in angular flexibility for beginners.

Rodent pups vocalize when placed in social isolation. We apply a method of “joint calls” for examining discomfort in rodent pup ultrasonic (>20 kHz) calls. Previously, this method has been developed for audible calls of fur farm mammals. Using a repeated measures design to exclude effects of individual identity and age on the analysed variables, we compared the ultrasonic call variables produced by 8–40-day pups of fat-tailed gerbils Pachyuromys duprasi during two subsequent experimental stages, the Isolation Stage and the Handling Stage. We considered that discomfort-related negative emotional arousal increased towards the Handling Stage compared to the Isolation Stage because of cumulative effects of handling and time of pup isolation from the nest. At the Isolation Stage, the call rate (calls/s) was higher from 10 to 18 days of age, whereas both the maximum amplitude frequency and power quartiles of joint calls were lower than at the Handling Stage from 20 to 32 days of age. At the same time, i...

Cochlear neuropathy, i.e. the loss of auditory nerve fibers (ANFs) without loss of hair cells, may cause hearing deficits without affecting threshold sensitivity, particularly if the subset of ANFs with high thresholds and low spontaneous rates (SRs) is preferentially lost, as appears to be the case in both aging and noise-damaged cochleas. Because low-SR fibers may also be important drivers of the medial olivocochlear reflex (MOCR) and middle-ear muscle reflex (MEMR), these reflexes might be sensitive metrics of cochlear neuropathy. To test this hypothesis, we measured reflex strength and reflex threshold in mice with noise-induced neuropathy, as documented by confocal analysis of immunostained cochlear whole-mounts. To assay the MOCR, we measured contra-noise modulation of ipsilateral distortion-product otoacoustic emissions (DPOAEs) before and after the administration of curare to block the MEMR or curare + strychnine to also block the MOCR. The modulation of DPOAEs was 1) dominated by the MEMR in anesthetized mice, with a smaller contribution from the MOCR, and 2) significantly attenuated in neuropathic mice, but only when the MEMR was intact. We then measured MEMR growth functions by monitoring contra-noise induced changes in the wideband reflectance of chirps presented to the ipsilateral ear. We found 1) that the changes in wideband reflectance were mediated by the MEMR alone, and 2) that MEMR threshold was elevated and its maximum amplitude was attenuated in neuropathic mice. These data suggest that the MEMR may be valuable in the early detection of cochlear neuropathy.

To achieve a functional atraumatic insertion, low intracochlear pressure changes during the procedure are assumed to be important. The aim of this study was to observe intracochlear pressure changes due to different insertion techniques in a cochlear model. Cochlear implant electrode insertions were performed in an artificial cochlear model to record intracochlear pressure changes with a micropressure sensor to evaluate the maximum amplitude and frequency of pressure changes under different insertional conditions. We found statistically significant differences in the occurrence of intracochlear pressure peak changes comparing different techniques. Based on our model results, an insertion should be maximally supported to minimize micromovement-related pressure changes.

PURPOSE: To evaluate in a macroscopic, histological and histomorphometric manner the healing process of cutaneous wounds in mice. METHODS: The sample consisted of 40 male mice and was divided in four groups: 1st group (control, n=10), 2nd group (High Frequency Generator - HF, the maximum amplitude range, 120s, n=10), 3rd group (AlGaInP Laser 660 nm, 30mW power, 5 J/cm2, applying scan mode, 120s, n=10) and 4thgroup (AlGaInP Laser 660 nm, 30 mW power, 8 J/cm2, applying scan mode, n=10). The surgical incision was made with an 8 mm diameter punch perpendicularly to the back of the animal. The statistical analysis was achieved by the statistical test One Way Anova post hoc Tukey Test and significance at p

The purpose of this study was to detect mind-wandering experienced by pre-service teachers during a video learning lecture on physics. The lecture was videotaped and consisted of a live lecture in a classroom. The lecture was about Gauss's law on physics. We investigated whether oculomotor data and eye movements could be used as a marker to indicate the learner&rsquo, s mind-wandering. Each data was collected in a study in which 24 pre-service teachers (16 females and 8 males) reported mind-wandering experience through self-caught method while learning physics video lecture during 30 minutes. A Tobii Pro Spectrum (sampling rate: 300 Hz) was used to capture their eye-gaze during learning Gauss's law through a course video. After watching the video lecture, we interviewed pre-service teachers about their mind-wandering experience. We first used the self-caught method to capture the mind-wandering timing of pre-service teachers while learning from video lectures. We detected more accurate mind-wandering segments by comparing fixation duration and saccade count. We investigated two types of oculomotor data (blink count, pupil size) and nine eye movements (average peak velocity of saccades, maximum peak velocity of saccades, standard deviation of peak velocity of saccades, average amplitude of saccades, maximum amplitude of saccades, total amplitude of saccades, saccade count/s, fixation duration, fixation dispersion). The result was that the blink count could not be used as a marker for mind-wandering during learning video lectures among them (oculomotor data and eye movements), unlike previous literatures. Based on the results of this study, we identified elements that can be used as mind-wandering markers while learning from video lectures that are similar to real classes, among the oculomotor data and eye movement mentioned in previous literatures. Additionally, we found that most participants focused on past thoughts and felt unpleasant after experiencing mind-wandering through interview analysis.

The amplitude peak R and the duration of each cycle need to be known to be able to diagnose the condition of the heart. The value of peak R is the highest value of each electrocardiogram cycle as a result of depolarization of the ventricle muscle. Peak R-value is mainly to find out the presence of ventricular hypertrophy while the duration of the cycle is to determine the presence of arrhythmia and heart rate. Limitations of information on the value of amplitude and duration of cycles results of examination of the heart condition caused the manual calculation using ECG paper. This study aims to obtain the amplitude peak value of R following the duration of the cycle in each cycle of lead II using the PQRST algorithm. Determination of the threshold value of the result of discrete electrocardiogram plotting observation will obtain the maximum amplitude value, which is referred to as peak R. The duration between the peak Rn position and the peak Rn + 1 position is the cycle duration to n (dn). The heart rate value can be obtained by multiplying 6 from the total peak R for 10 seconds. The program application results indicate that the value of the peak R and the duration of each cycle can be presented by entering the threshold value. The results showed that a 10-second check for A250-A001 patients had 14 peak R, which means having a heart rate of 84 bpm. The lowest peak R-value is 1,907 mV while the highest value is 2,119 mV.

Fetal T-wave alternans (TWA) is a still littleknown marker for severe fetus-heart instabilities and may be related to some currently unjustified fetal deaths. Automatically detecting TWA on direct fetal electrocardiograms (DFECG) means possibility of providing fetuses the right treatment during delivery. Instead, automatically identifying TWA on indirect fetal electrocardiograms (IFECG) means possibility of providing fetuses the right treatment even during pregnancy, when taking actions for outcome improvement is still possible. Moreover, TWA identification from IFECG is noninvasive, and thus safe for both fetuses and mothers. The aim of this work was testing the heart-rate adaptive match filter (HRAMF) for automatic TWA identification in IFECG and comparing HRAMF performance in IFECG against DFECG. To this aim, simultaneously recorded DFECG and IFECG tracings from 5 healthy fetuses were used ("Abdominal and Direct Fetal Electrocardiogram Database" from Physionet). TWA measurements (frequency, mean amplitude, maximum amplitude, and amplitude standard deviation) in IFECG (1.09±0.04 Hz, 11±5 μV, 21±12 μV and 7±3 μV) were of the same order of magnitude of those in DFECG (1.07±0.02 Hz, 9±2 μV, 30±11 μV and 6±2 μV). Moreover, a direct correlation (ñ) was found between maximum TWA and fetal heart rate (IFECG: ρ=0.999; P=0.022; DEFEG: ρ=0.642; P=0.243). Thus, HRAMF was able to detect TWA from IFECG as well as from DFECG.

Rat pups are reared in a nest with a pile of littermates. When a preweaning pup is placed in isolation for a brief period of time, it displays an increase in activity that includes vocalization with frequencies in the ultrasonic range (~ 40 kHz). The vocalization response to isolation is used to investigate early life communicatory, social, and affective behaviors. The rate of vocalization is influenced by multiple sensory stimuli including thermal, tactile, and olfactory. Measured at room temperature, the rate of isolation-induced ultrasonic vocalizations conforms to an inverted-U shaped pattern, peaking between postnatal days 7–11 when the thermoregulatory and locomotor capabilities of the pup remain poor. Other acoustic variables such as duration, amplitude, frequency range, frequency at maximum amplitude, and waveform are also reported in the literature and described in this chapter. Vocal parameters are often correlated but there is no fixed relationship among them.

Background: The flexibility and strength are the physical connected capabilities of the individual autonomy. When these are in adequate levels a considerable improvement in the quality of life of children, young, adults and older people has been noted. Nevertheless, for the development of these capabilities to be significant there must be an intervention of strength training (ST) and flexibility. However, according to recent evidence, there may be a possible interference between these two capabilities when performed in the same session, and the magnitude of this interference can be closely related to the duration and intensity of stretching. Objective: To assess whether the series of high intensity stretching (Flexing or stretching to its maximum amplitude) lasting ten seconds could negatively influence the strength generation. Method/Design: Were evaluated nine healthy volunteers practitioners of ST. Maximum strength was tested with and without a single stretching series, before the 1RM test (test re-test). Data were presented as mean ± standard deviation and the significance level was 0.05. Results: The results shows that the use of flexibility maneuver (FM) lasting 10 seconds in levels 8-10 visual analogue pain scale (classified as severe) was enough to depress at 3.15% (p = 0.021 95% CI = 0.42 to 4.01) maximum strength of subjects when compared to the method without MF. Conclusions: These data suggests that stretching may negatively interfere with the generation of maximum strength even in little time, leaving questionable practice for events that precede strength generation.

To delineate thromboelastographic profiles of the premature infants with and without intracranial hemorrhage during the first 21 days of life.In this study, 49 premature infants (24 female; 25 male) were consecutively admitted at our neonatal intensive care unit during a 6 months period were subject to thromboelastography and standard coagulation assessments at birth and weekly up to 21 days. Sixteen out of 49 infants developed intracranial hemorrhage at birth.The test results of 127/196 were considered eligible for analysis. Overall significant changes of the main thromboelastographic parameters were observed shortly after birth. Newborns with intracranial hemorrhage showed increased thromboelastogram-defined thrombin generation (shorter R and time to maximum amplitude times) from birth onward, suggesting a hypercoagulable state. No significant differences concerning thromboelastographic and coagulation assays parameters were found at birth between infants with and without intracranial hemorrhage, except for higher plasma D-Dimer concentration (p = 0.002) in the former infants. Finally, a positive correlation between clot lysis time and gestational age (Spearman's rho = 0.502, p = 0.002) was observed.Thromboelastographic profiles of the premature infants suggest an effective hemostatic function during the first post-natal weeks. Further study is needed to determine whether thromboelastography may be more useful than coagulation assays to reflect the bleeding risk of the premature infants.

Due to rising public focus scientific analysis of performance parameters is getting more and more important in paralympic sports.Several studies have been performed to investigate different design parameters of handcycles (e.g. crank length) already;however, most of those were done with able-bodied subjects, widely unfamiliar to handcycling. In this study bilateral surfaceelectromyography (sEMG) of several muscles of the upper body and arms of an elite handcyclist (multiple medal-winner inParalympic Games and World Championships) is performed with different crank lengths, crank positions and backrest positionsat power levels of 130, 160 and 190 W resulting in a total of 22 measurements. sEMG data were recorded bilaterally at arecording frequency of 1000Hz using Ag/AgCl electrodes. Concurrently the crank position was acquired with ten Vicon Bonitainfrared cameras recording at 100 Hz. EMG data were rectified, smoothed and normalized to crank-cycle duration (0-360 deg)for each single crank-cycle. Phases of activity for each muscle (i.e. EMG amplitude exceeds 30% of maximum amplitude) andintegrated EMG (iEMG) as an indicator for net muscular e ort were calculated. Results showed that amplitude and iEMG werehigher for higher power output and shorter cranks, crank and backrest position influenced several muscles but results were alwayssimilar for similar shoulder-crank-distances. It could be shown, that muscular effort is clearly influenced by the handcycleparameters investigated and that these measurements can be used to individually optimize the position in a handcycle with regardto muscular effort.

An increasing number of treatments for spinal cord injury (SCI) out of the laboratories and in clinical trials pass. Many of them are used as soon as possible after the injury with the hope of weakening the secondary damage and maximize the preservation of nerve tissue. The aim of the study was to evaluate the effects metilprednizalonium and motor training at an experimental spinal cord injury in rats. To investigate the status of the peripheral neuromuscular system registered motor response (M-response) muscles. In the early period after spinal cord injury was observed, a decrease of the maximum amplitude of M-response. With that, in the group of animals with the introduction of metilprednizalonium, amplitude of M-response was higher than that without drug therapy. Combined therapy metilprednizalonium and motor training has a positive effect on the recovery of motor function in chronic period after contusion spinal cord injury in rats.

Several characteristics of the ventricular fibrillation (VF) waveform during cardiac arrest are associated with defibrillation success, including peak amplitude in the seconds prior to defibrillation. It is not known if immediate pre-defibrillation amplitude is associated with successful defibrillation, return of spontaneous circulation (ROSC) or survival to hospital discharge (SHD).We analyzed automated external defibrillation recordings of 80 patients with out-of-hospital VF cardiac arrest who received 284 defibrillations. We recorded the maximum amplitude during 3-second ECG tracings prior to each defibrillation attempt and the amplitude immediately prior to defibrillation.Both the amplitude just prior to defibrillation and the highest amplitude within 3 seconds of the defibrillation were significantly higher in successful vs unsuccessful defibrillations (0.21 vs 0.11 mV, P = .0001 and 0.51 vs 0.36 mV, P = .0001). Amplitude immediately prior to defibrillation and maximal amplitude within 3 seconds of defibrillation were also higher in defibrillations with ROSC vs. defibrillations without ROSC (0.23 vs. 0.12 mV, P .0001; and 0.52 vs. 0.38 mV, P .0001). In defibrillations that resulted in SHD, immediate pre-defibrillation amplitude and maximum amplitude were also significantly larger (0.20 vs. 0.11 mV, P .0001; and 0.52 vs. 0.35 mV, P .0001). Binary logistic regression including both measures showed that only immediate pre-defibrillation amplitude remained significantly associated with ROSC while maximal amplitude did not (P = .006 and P = .135).Amplitude of the VF waveform at the moment of defibrillation has a strong association with successful defibrillation, ROSC, and SHD.