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Background: Hydroquinone-containing creams cause false increases in capillary glycemia. However, the magnitude of this false increase, and the means to reverse it have not been investigated. Objective: To evaluate the technical and clinical impact of hydroquinone-containing creams on capillary glycemia and investigate the efficacy of hand washing and other common practices, in reversing cream effects. Methods: We included 91 participants in a quasi-experimental study in Buea, Cameroon. After determining the hydroquinone content of a cream, Caro Light, we used two glucometers with different enzymatic systems (Accu-Chek Active and OneTouch Ultra 2) to measure fasting glycemia after: initial hand washing (reference), application of 1 ml of hydroquinone-containing cream, finger swabbing with wet gauze, sanitizer application and a series of three hand washings following cream application. Reference glycemia was compared to those obtained after various interventions. Statistical significance was assessed by paired sample t-test, clinical significance by total error allowable (TEa), and clinical impact by Parke’s error grid analysis. Results: The mean differences in capillary glycemia (Intervention—reference) measured by Accu-Chek Active in mg/dl were 28, 27, 38, 16, 4, and -2 after cream application, finger swabbing, sanitizer application, one, two, and three hand washings respectively. Corresponding values for OneTouch Ultra2 were 41, 44, 64, 22, 5 and -5. These differences, except after two and three hand washings were both statistically (p < 0.0001) and clinically significant (TEa). After cream application, Accu-Check had 9.9% of values in Parke’s Zones C-E, while OneTouch had 18.7%. Conclusion: Hydroquinone-containing creams cause significant false increase in capillary glycemia irrespective of the enzymatic system of the glucometer used, and can lead to potentially wrong clinical decisions. A minimum of two hand washings is required prior to capillary glucose measurement. [ABSTRACT FROM AUTHOR]

Linear description (LD) of conformation traits was introduced in horse breeding to minimise subjectivity in scoring. However, recent studies have shown that LD traits show essentially the same problems as traditionally scored traits, such as data converging around the mean value with very small standard deviations. To improve the assessment of conformation traits of horses, we investigated the application of the recently described horse shape space model based upon 403 digitised photographs of 243 Franches-Montagnes (FM) stallions and extracted joint angles based on specific landmark triplets. Repeatability, reproducibility and consistency of the resulting shape data and joint angles were assessed with Procrustes ANOVA (Rep) and intra-class correlation coefficients (ICC). Furthermore, we developed a subjective score to classify the posture of the horses on each photograph. We derived relative warp scores (PCs) based upon the digitised photos conducting a principal component analysis (PCA). The PCs of the shapes and joint angles were compared to the posture scores and to the linear description data using linear mixed effect models including significant posture scores as random factors. The digitisation process was highly repeatable and reproducible for the shape (Rep = 0.72–0.99, ICC = 0.99). The consistency of the shape was limited by the age and posture (p < 0.05). The angle measurements were highly repeatable within one digitiser. Between digitisers, we found a higher variability of ICC values (ICC = 0.054–0.92), indicating digitising error in specific landmarks (e.g. shoulder point). The posture scores were highly repeatable (Fleiss’ kappa = 0.713–0.857). We identified significant associations (p(X2) < 0.05) with traits describing the withers height, shoulder length and incline, overall leg conformation, walk and trot step length. The horse shape data and angles provide additional information to explore the morphology of horses and therefore can be applied to improve the knowledge of the genetic architecture of LD traits. [ABSTRACT FROM AUTHOR]

Personal protective equipment (PPE) is an element of biosecurity intended to prevent the access or spread of diseases in farms. Nevertheless, to date no extensive reports exist about the effectiveness of different available PPE on farms. Thus, our aim was to estimate the degree of protection of PPE from viral contamination during farm visits. Two farms, infected with Aleutian mink disease virus and porcine circovirus–2 respectively, were visited by six visitors wearing different combinations of PPE: coveralls with hood and bootcovers, both with a certified barrier to infective agents (certified PPE group) and non-certified bootcover and coverall without hood (non-certified PPE group). Seventy-two swab samples from PPE and both hair and street clothes under PPE were taken after the visit and analysed by qPCR. Our results reveal viral exposure during visits, and the external protections of body and shoes were contaminated in all cases (24/24). In addition, protection from viral contamination varied noticeably according to the biosecurity elements used. A higher number of positives were detected in the non-certified PPE group than in the certified PPE group, both in elements under external protections (14/18 vs 3/18) and also in hair (4/6 vs 0/6). In fact, non-certified bootcovers broke during visits, resulting in viral contamination of the internal elements under them; these are consequently not suitable for using with wrinkled surfaces usually found in farm facilities. Thus, certified coveralls should be used in order to prevent contaminations, and workers and personnel of farms should be trained in their proper use. qPCR is a useful tool in the risk management of biosecurity programmes, and our results may serve as a model to evaluate different biosecurity measures. [ABSTRACT FROM AUTHOR]

Previous research points to two major hypotheses regarding the mechanisms by which touch can be experienced as erotogenic. The first concerns the body part to which touch is applied (erogenous zones) and the second the modality of touch (sensual touch optimal in activating C Tactile afferents). In this study, we explored for the first time the relation between those two mechanisms in actual and imagined social touch. In a first experiment, we randomly assigned “Giver” and “Receiver” roles within 19 romantic couples (20 females, 18 males, age 32.34 ± 8.71SD years) and asked the “Giver” to apply CT-optimal (3 cm/s) vs. CT-suboptimal (18 cm/s) touch on an erogenous (neck) vs. non-erogenous zone (forehead) of their partner. We then obtained ratings of pleasantness and sexual arousal from both “Receivers” and “Givers”. In a second experiment, 32 healthy females (age 25.16 ± 5.91SD years) were asked to imagine CT-optimal vs. CT-suboptimal stimulation (stroking vs. patting) and velocity (3 cm/s vs. 18 cm/s) on different erogenous vs. non-erogenous zones and rate pleasantness. While both erogenous body part and CT-optimal, sensual touch were found to increase pleasant and erotic sensations, the results showed a lack of an interaction. Furthermore, pleasantness was induced by mere imagination of touch without any tactile stimulation, and touch that was sexually arousing for the receiver was rated as more sexually arousing for the giver as well, pointing to top-down, learned expectations of sensory pleasure and erogeneity. Taken together, these studies provide the first direct evidence that while both the body location to which touch is applied and the mode of touch contribute to pleasant and erotic sensations, these two factors appear to mediate subjective pleasantness and erogeneity by, at least partly, independent mechanisms. [ABSTRACT FROM AUTHOR]

Interactive technologies are beneficial to stroke recovery as rehabilitation interventions; however, they lack evidence for use as assessment tools. Mystic Isle is a multi-planar full-body rehabilitation game developed using the Microsoft Kinect® V2. It aims to help stroke patients improve their motor function and daily activity performance and to assess the motions of the players. It is important that the assessment results generated from Mystic Isle are accurate. The Kinect V2 has been validated for tracking lower limbs and calculating gait-specific parameters. However, few studies have validated the accuracy of the Kinect® V2 skeleton model in upper-body movements. In this paper, we evaluated the spatial accuracy and measurement validity of a Kinect-based game Mystic Isle in comparison to a gold-standard optical motion capture system, the Vicon system. Thirty participants completed six trials in sitting and standing. Game data from the Kinect sensor and the Vicon system were recorded simultaneously, then filtered and sample rate synchronized. The spatial accuracy was evaluated using Pearson’s r correlation coefficient, signal to noise ratio (SNR) and 3D distance difference. Each arm-joint signal had an average correlation coefficient above 0.9 and a SNR above 5. The hip joints data had less stability and a large variation in SNR. Also, the mean 3D distance difference of joints were less than 10 centimeters. For measurement validity, the accuracy was evaluated using mean and standard error of the difference, percentage error, Pearson’s r correlation coefficient and intra-class correlation (ICC). Average errors of maximum hand extent of reach were less than 5% and the average errors of mean and maximum velocities were about 10% and less than 5%, respectively. We have demonstrated that Mystic Isle provides accurate measurement and assessment of movement relative to the Vicon system. [ABSTRACT FROM AUTHOR]

The stick insect is a well-established experimental animal to study the neural basis of walking. Here, we introduce a preparation that allows combining calcium imaging in efferent neurons with electrophysiological recordings of motor neuron activity in the stick insect thoracic nerve cord. The intracellular free calcium concentration in middle leg retractor coxae motor neurons and modulatory octopaminergic DUM neurons was monitored after backfilling lateral nerve nl5 that contains the axons of these neurons with the calcium indicator Oregon Green BAPTA-1. Rhythmic spike activity in retractor and protractor motor neurons was evoked by pharmacological activation of central pattern generating neuronal networks and recorded extracellularly from lateral nerves. A primary goal of this study was to investigate whether changes in the intracellular free calcium concentration observed in motor neurons during oscillatory activity depend on action potentials. We show that rhythmic spike activity in leg motor neurons induced either pharmacologically or by tactile stimulation of the animal is accompanied by a synchronous modulation in the intracellular free calcium concentration. Calcium oscillations in motor neurons do not appear to depend on calcium influx through voltage-sensitive calcium channels that are gated by action potentials because Calcium oscillations persist after pharmacologically blocking action potentials in the motor neurons. Calcium oscillations were also apparent in the modulatory DUM neurons innervating the same leg muscle. However, the timing of calcium oscillations varied not only between DUM neurons and motor neurons, but also among different DUM neurons. Therefore, we conclude that the motor neurons and the different DUM neurons receive independent central drive. [ABSTRACT FROM AUTHOR]

We characterized the establishment of an Epidermal Growth Factor Receptor (EGFR) organizing center (EOC) during leg development in Drosophila melanogaster. Initial EGFR activation occurs in the center of leg discs by expression of the EGFR ligand Vn and the EGFR ligand-processing protease Rho, each through single enhancers, vnE and rhoE, that integrate inputs from Wg, Dpp, Dll and Sp1. Deletion of vnE and rhoE eliminates vn and rho expression in the center of the leg imaginal discs, respectively. Animals with deletions of both vnE and rhoE (but not individually) show distal but not medial leg truncations, suggesting that the distal source of EGFR ligands acts at short-range to only specify distal-most fates, and that multiple additional ‘ring’ enhancers are responsible for medial fates. Further, based on the cis-regulatory logic of vnE and rhoE we identified many additional leg enhancers, suggesting that this logic is broadly used by many genes during Drosophila limb development. [ABSTRACT FROM AUTHOR]

Introduction: Dry immersion is a ground-based experiment simulating the effects of weightlessness, and it is a model of acute symmetrical bilateral deafferentation. This exploratory study aimed to investigate the effects of three days of dry immersion (DI) on sensory thresholds and the functioning of lemniscal pathways, assessed by somatosensory evoked potentials (SEPs). Methods: Twelve healthy male volunteers (32+/-4.8 years) participated in the study. Sensory thresholds and SEPs of the tibial nerve of both limbs were recorded before (D-1) and on the third day of dry immersion (D3). Results: Sensory thresholds significantly decreased on D3 (-20.75 +/-21.7%; z = -2.54; p = 0.0109 on the right side and -22.18+/-17.28%; z = -3.059; p = 0.002 on the left side). The amplitude of P40 responses did not differ between D-1 and D3. Latencies of all central responses until P30 were shortened on D3 (N21 right:-0.57+/-0.31; z = -3.06; p = 0.002; N21 left -0.83+/-0.53; z = -2.94; p = 0.003; P30 right: -1.26+/-1.42; z = -3.059; p = 0.002; P30 left: -1.11+/-1.55; z = -2.27; p = 0.02) Conclusion: Three days of dry immersion can induce hyperexcitability of lemniscal pathways. Significance: This may be explained by a change in the expression of membrane channels and/or medullar plasticity and/or hypersensitization of peripheral sensory receptors induced by this acute deafferentation. Additional studies are needed to further elucidate the mechanisms. [ABSTRACT FROM AUTHOR]

The present study aims to clarify the association of vitamin D status with functionality, measured through gait speed and hand grip strength, in a sample of older adults, considering sex-specific characteristics and the potential confounding effect of lifestyle factors, disease, skin phenotype, season of blood collection and vitamin D supplementation. The Nutrition UP 65 cross-sectional study was conducted in a population-based sample of 1,425 older adults ≥ 65 years old. Serum levels of 25-hydroxyvitamin D were quantified through electrochemiluminescence immunoassay. Multinomial logistic regressions were carried out using quartiles of gait speed and of hand grip strength as dependent variables. Participants at risk of vitamin D inadequacy (30.0-49.9 nmol/L) and deficiency (< 30.0 nmol/L) presented higher adjusted odds ratio of the lowest values of gait speed and hand grip strength than those with adequate vitamin D levels (≥ 50.0 nmol/L). These associations were strongest among men at risk of vitamin D deficiency [adjusted odds ratio for the lowest quartile of gait speed = 3.24; 95% CI: 1.56–6.73 and for the lowest quartile of hand grip strength = 3.28; 95% CI: 1.47-7.31] than in women at risk of vitamin D deficiency [adjusted odds ratio for the lowest quartile of gait speed = 2.72; 95% CI: 1.37-5.41 and for the lowest quartile of hand grip strength = 1.56; 95% CI: 0.81–3.00]. In conclusion, in older adults, particularly in men, the risk of vitamin D deficiency was directly associated with the lowest values of gait speed and of hand grip strength. However, randomized controlled trials are needed to overcome the possibility of reverse causation and residual confounding. Present results emphasise the need for strategies to promote the reduction of the high prevalence of low vitamin D status among the Portuguese older adult population. [ABSTRACT FROM AUTHOR]

Introduction: Muscle weakness is linked to a range of adverse health outcomes across the lifespan including mortality, morbidity, and disability. Because lifestyles and body composition are quite different between Western and Asian countries, there is an urgent need to establish normative grip strength values for individuals of Asian descent. This study presents normative data for hand grip strength in a Korean population-representative sample. Methods: A sample of 11,073 individuals (age 10–80 years) was included from the Sixth Korea National Health and Nutrition Examination Survey, 2014–2015. Isometric grip strength was assessed using a handheld dynamometer. Relative grip strength was calculated as the maximum absolute grip strength divided by body mass index. Means, standard error, and quintiles for grip strength and relative grip strength were analyzed per 5-year age group for each sex. To create growth charts for grip strength and relative grip strength, parametric quantile regression was used. Results: In males, absolute grip strength increased quickly starting from 10 years of age until approximately 20 years of age. In females, there was gradual growth until approximately 15 years of age. Grip strength continued to increase until a peak between ages 30 and 39 years, and then declined from midlife onwards in both sexes. Our data showed that the prevalence of weak grip strength increased rapidly in late adult life based on a T-score of -2 standard deviations below the sex-specific peak mean (equivalent to 33 kg in males and 20 kg in females). Approximately 20% of subjects had weak grip strength at age 65–69 years. Conclusion: This was the first study to establish normative reference values for grip strength across the lifespan in a Korean population aged 10–80 years. Percentiles of grip strength will inform clinical assessments and will help identify thresholds for the identification of muscle weakness. [ABSTRACT FROM AUTHOR]

The Colombian paso horse, the most important horse breed in Colombia, performs specific and particular gaits (paso fino, trocha, and Colombian trot), which display different footfall patterns and stride frequencies. The breed has been selected for gait and conformation for more than 50 years and we hypothesize that this selection has led to kinematic differences of the gaits that can be explained by different genetic variants. Hence, the aims of the study were: 1. To identify if there are any differences in the kinematic and genetic variants between the Colombian paso horse’s gaits. 2. To evaluate if and how much the gait differences were explained by the nonsense mutation in the DMRT3 gene and 3. To evaluate these results for selecting and controlling the horses gait performance. To test our hypotheses, kinematic data, microsatellites and DMRT3 genotypes for 187 Colombian paso horses were analyzed. The results indicated that there are significant kinematic and DMRT3 differences between the Colombian paso horse’s gaits, and those parameters can be used partially to select and control the horses gait performance. However, the DMRT3 gene does not play a major role in controlling the trocha and the Colombian trot gaits. Therefore, modifying genes likely influence these gaits. This study may serve as a foundation for implementing a genetic selection program in the Colombian paso horse and future gene discovery studies for locomotion pattern in horses. [ABSTRACT FROM AUTHOR]

Introduction: Mottling score, defined by 5 areas over the knee is developed to evaluate tissue perfusion at bedside. Because of the subjective aspect of the score, we aimed to compare mottling score and skin temperature in septic shock with infrared thermography in ICU and the correlation to survival. Methods: We conducted a prospective and observational study in a teaching hospital in France during 8 months in ICU. All patients with sepsis requiring vasoactive drugs were included. We recorded epidemiologic data, hemodynamic parameters, mottling score and skin temperature with a thermic camera of the 5 mottling areas around the knee (temperatures recorded with FLIR™ software) at bedside. Measures were performed at ICU admission (H0) and six hours after initial resuscitation (H6). Results: 46 patients were included. Median age was 69 (60–78), SOFA score 11 (8–12) mean SAPS II was 57±20 and 28-day mortality rate was 30%. Patients with mottling (score≥1), had a skin temperature of the knee significantly lower (30.7 vs 33,2°C p = 0.01 at H6) than patients without mottling (score = 0). Skin temperatures of the knee in mottling groups 1 to 5 were similar at H0 and H6. Neither mottling score nor skin temperature of the knee were associated with prognostic regarding day-28 mortality. Conclusions: Skin temperature measured with infrared thermography technology around the knee is lower when mottling sign is present and sign microcirculation alterations. This method, compared to standard mottling score is objective and allows data collections. However, this method failed to predict mortality in ICU patients. [ABSTRACT FROM AUTHOR]

The current study aimed to examine the reliability of the conventional and functional ratios derived from peak torques (PTs) and those obtained from the combination of knee flexors torque at the angle of knee extensors PT. Twenty-six male athletes (mean of 24.0±0.7 years) from different sports completed a test-to-test variation in isokinetic strength (Biodex, System 3) within a period of one week. Anthropometry and body composition assessed by Dual Energy X-ray Absorptiometry were also measured. The proposed isokinetic strength ratio measurements appeared to be highly reliable: conventional ratio at PT angle (intra-class correlation, ICC = 0.98; 95% confidence interval; 95%CI: 0.95 to 0.99); functional extension ratio at PT angle (ICC = 0.98; 95%CI: 0.96 to 0.99); and, functional flexion ratio at PT angle (ICC = 0.95; 95%CI: 0.89 to 0.98). Technical error of measurement (TEM) and associated percentage of the coefficient of variation (%CV) were as follows: conventional ratio at PT angle (TEM = 0.02; %CV = 4.1); functional extension ratio at PT angle (TEM = 0.02; %CV = 3.8); and, functional flexion ratio at PT angle (TEM = 0.03; %CV = 3.6). The current study demonstrated that the traditional and new obtained simple and combined isokinetic indicators seem highly reliable to assess muscle strength and function in adult male athletes. A single testing session seems to be sufficiently to obtain these isokinetic strength indicators. [ABSTRACT FROM AUTHOR]

Immersion in chest-deep water may augment explicit memory in healthy adults however, there is limited information on how this environment might affect implicit memory or motor learning. The purpose of this study was to compare the speed and accuracy for learning a motor skill on land and in chest-deep water. Verbal word recall and grip strength were included to gain a more complete understanding of the intervention. Sixty-two younger adults (age = 23.3 ± 3.59 yrs.) were randomly assigned to either a water group immersed to the xiphoid or a land group. Participants in both groups completed the same eight practice trials of a mirror-drawing task on two separate days. Outcome measures for this task included time and error numbers to complete each drawing. The number of words recalled using a 12 word recall test, and peak grip strength using a hand dynamometer were measured each day of testing. The influence of environment and repeated practice on each outcome measure were assessed with an analysis of variance and effect sizes (ES). Time and errors for both groups significantly decreased with practice (p < 0.01, ES = 0.11–0.28), however the drawing time was greater in water than on land for trials 1, 5, and 6 (ES = 0.50–0.55). There was a 7% increase in words recalled (9.24 ± 1.19 vs 8.60 ± 1.19) and a 16% increase in grip strength (405 ± 104 vs 342 ± 83) for water than land groups (ES 0.54–0.64). Healthy adults in chest-deep water and on land display comparable mirror-drawing speed and accuracy after minimal practice. Curiously, water immersion may augment verbal word recall and grip strength abilities. [ABSTRACT FROM AUTHOR]

Background: Physical fitness of patients with a lower limb amputation predicts their walking ability and may be improved by physical exercise and training. A maximal exercise test is recommended prior to training in order to determine cardiovascular risks and design exercise programs. A potentially suitable ergometer for maximal exercise testing in patients with a lower limb amputation is the combined arm-leg (Cruiser) ergometer. The aim of this study was to determine feasibility, safety, and reliability of (sub)maximal exercise testing on the Cruiser ergometer in subjects with a lower limb amputation. Methods and findings: Subjects with a lower limb amputation performed 1 submaximal exercise test and 3 maximal exercise tests on the Cruiser ergometer. Feasibility was determined by examining whether key variables such as power output, heart rate and oxygen uptake were correctly and reliably measured, by determining whether a test was a maximal aerobic performance, by studying reasons for non-completion, and by measuring gross efficiency. Safety was analyzed by recording complications, electrocardiogram results, and blood pressure. Reliability was tested by comparing the results of the second and third maximal exercise test. Seventeen subjects (14 men and 3 women) out of 21 preselected subjects completed the study. In general, the maximal Cruiser exercise test was feasible. Almost 75% of the subjects reached a maximal aerobic performance. The test was also safe because no complications occurred, although electrocardiogram and blood pressure could only be reliably recorded in most subjects just before and after the test. Reliability was good: Intraclass correlation was 0.84 for peak oxygen uptake. Conclusions: The Cruiser ergometer is a feasible, safe, and reliable ergometer for measuring physical fitness of subjects with a lower limb amputation. [ABSTRACT FROM AUTHOR]

Background/Purpose: Ankle sprains are common and potentially disabling musculoskeletal injuries that often lead to chronic ankle instability (CAI). CAI has been linked to impairments in postural and neuromuscular control; however, inconsistent findings have been reported. Individuals who experience a lateral ankle sprain, but do not develop instability, termed copers, may adapt different neuromuscular control strategies after injury. This study aimed to compare postural control and electromyographic (EMG) activity of hip and ankle muscles during the performance of the Star Excursion Balance Test (SEBT) in subjects with and without CAI. Method: 48 participants were classified into three groups (16 control, 16 copers, 16 CAI) based on ankle sprain history and Cumberland Ankle Instability Tool score. Outcome measures included normalized reach distance, center of pressure (COP), and integrated EMG activation of gluteus medius (Gmed), gluteus maximus (Gmax), tibialis anterior (TA), and peroneus longus (PL) during each reach direction of SEBT. Results: Compared to copers and controls, CAI group demonstrated significantly diminished postural control (reach distance and COP measures, p< 0.05) and less EMG activity of TA during the anterior direction (CAI: 33.1% ± 10.1% versus copers: 44.8% ± 12.7% versus controls: 51.7% ± 8.4%, p<0.01) and Gmax in the posterolateral direction (CAI: 25.6% ± 9.4% versus copers: 37.5% ± 13.8% versus controls: 40.2% ± 17.2%, p = 0.011). Conclusion: Alteration in proximal and distal muscle activity appears to negatively affect postural control and quality of movement, which may lead to prolonged functional impairments. Hence, implementing hip and ankle muscle exercises in the rehabilitation of ankle instability might benefit these patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to provide an overview of device-related complications occurring in individuals with an upper or lower extremity amputation treated with a screw, press-fit or other type of bone-anchored implant as well as interventions related to these complications. Method: A systematic literature search was conducted in the MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science databases. The included studies reported on device-related complications and interventions occurring in individuals with bone-anchored prostheses. The outcomes evaluated were death, infection, bone/device breakage, implant loosening, soft tissue complications, systemic events, antibiotic and surgical treatment. Subgroup analyses were performed for the following groups: a) implant type (screw, press-fit and other types of implants) and b) level of amputation (transfemoral, transtibial and upper extremity amputation). Results: Of 309 studies, 12 cohort studies were eligible for inclusion, all of which had methodological shortcomings and 12 studies were excluded due to complete overlap of patient data. Implant infection were rare in certain transfemoral implants (screw: 2–11%, press-fit: 0–3%, Compress: 0%) but common in transtibial implants (29%). The same was observed for implant loosening, in transfemoral (screw: 6%, press-fit: 0–3%, Compress: 0%), transtibial implants (29%) as well as for upper extremity implants (13–23%). Intramedullary device breakage were rare in transfemoral implants (screw: 0%, press-fit: 1%, Compress: unknown) but frequent in individuals with transradial implants (27%) and absent in transtibial implants. Soft tissue infections and complications were common and underreported in most articles. Conclusions: Major complications (e.g. implant infection, implant loosening and intramedullary device breakage) are rare in transfemoral bone-anchored prosthesis and seem to occur less frequently in individuals with press-fit implants. Minor complications, such as soft tissue infections and complications, are common but are substantially influenced by the learning curve, implant design and surgical technique. Data for patients treated with a transtibial, upper extremity or Compress implant are underreported, precluding definitive conclusions. There is a need for either an international database to report on or a standard core set of complications as well as the need to follow classification systems that result in unequivocal data. [ABSTRACT FROM AUTHOR]

Unsaturated omega-3 fatty acids, especially docosahexaenoic acid (DHA), when fed to dogs improves cognitive and neurological development. Supplementation with omega-3 fatty acids such as DHA and eicosapentaenoic acid (EPA) has also been associated with lipid peroxidation, which in turn has been implicated in reduced body weight and altered bone formation. To assess the impact of omega-3 fatty acid supplementation on skeletal growth, diets containing three levels of DHA and EPA (0.01 and 0.01%, 0.14 and 0.12%, and 0.21 and 0.18%, respectively) were fed to bitches during gestation and lactation with puppies also supplemented through weaning. Thus, the subjects studied were the puppies supplemented with DHA and EPA through gestation and early postnatal life. The hip joint conformation of the puppies (n = 676) was recorded at adulthood using two radiographic, non-invasive evaluations. In this population, females had higher hip distraction indices (DI) than males. Males from the lower two levels of DHA and EPA supplementation had significantly smaller hip DI than all females and males from the highest DHA and EPA supplementation. In contrast, there were no diet effects on anatomical indicators of hip joint conformation and no visible arthritic changes. These data suggest that dietary supplementation of DHA and EPA during gestation and the perinatal period to weaning does not adversely influence hip joint formation of dogs. [ABSTRACT FROM AUTHOR]

Background and purpose: Spared fibers after spinal cord injury (SCI) tend to consist predominantly of subcortical circuits that are not under volitional (cortical) control. We aim to improve function after SCI by using targeted physical exercises designed to simultaneously stimulate cortical and spared subcortical neural circuits. Methods: Participants with chronic motor-incomplete SCI enrolled in a single-center, prospective interventional crossover study. Participants underwent 48 sessions each of weight-supported robotic-assisted treadmill training and a novel combination of balance and fine hand exercises, in randomized order, with a 6-week washout period. Change post-intervention was measured for lower extremity motor score, soleus H-reflex facilitation; seated balance function; ambulation; spasticity; and pain. Results: Only 9 of 21 enrolled participants completed both interventions. Thirteen participants completed at least one intervention. Although there were no statistically significant differences, multimodal training tended to increase short-interval H-reflex facilitation, whereas treadmill training tended to improve dynamic seated balance. Discussion: The low number of participants who completed both phases of the crossover intervention limited the power of this study to detect significant effects. Other potential explanations for the lack of significant differences with multimodal training could include insufficient engagement of lower extremity motor cortex using skilled upper extremity exercises; and lack of skill transfer from upright postural stability during multimodal training to seated dynamic balance during testing. To our knowledge, this is the first published study to report seated posturography outcomes after rehabilitation interventions in individuals with SCI. Conclusion: In participants with chronic incomplete SCI, a novel mix of multimodal exercises incorporating balance exercises with skilled upper extremity exercises showed no benefit compared to an active control program of body weight-supported treadmill training. To improve participant retention in long-term rehabilitation studies, subsequent trials would benefit from a parallel group rather than crossover study design. [ABSTRACT FROM AUTHOR]

Mindfulness based stress reduction (MBSR) training has been proposed to improve attentional skills by modulating thalamo-cortical loops that affect the sensitivity of relevant cortical areas like the somatosensory cortex. This modulation may be reflected in the electroencephalographic (EEG) alpha rhythm, and could affect the processing of subsequently applied intracutaneous electrical stimuli. Participants took part in an MBSR training and participated in two EEG sessions. EEG was measured in variants of an endogenous orienting paradigm in which attention had to be directed to the left or right forearm. After the orienting interval, the electrical stimulus was applied, equally likely on the attended or the unattended forearm. One group of participants took part in the EEG session before and after the training, while the other group took part after the training, and another time, eight weeks later. The influence of the MBSR training and spatial attention were examined with behavioral measures, lateralized alpha power within the orienting interval, and with event-related potentials (ERPs) evoked by the electrical stimuli. Self-reported mindfulness was clearly affected by the training, but no influence was found on other behavioral measures. Alpha power was clearly lateralized due to spatial attention and several ERP components (N130, N180, P340) were modulated by spatial attention but no support was found for an influence of the MBSR training. Finally, analyses revealed that individual differences in training time modulated some of the observed effects, but no support was found for an influence on attentional orienting. [ABSTRACT FROM AUTHOR]

Background: The previous studies on basketball landing have not shown a systematic agreement between landing impacts and midsole densities. One plausible reason is that the midsole densities alone used to represent the cushioning capability of a shoe seems over simplified. The aim of this study is to examine the effects of different landing heights and shoes of different cushioning performance on tibial shock, impact loading and knee kinematics of basketball players. Methods: Nineteen university team basketball players performed drop landings from different height conditions (0.45m vs. 0.61m) as well as with different shoe cushioning properties (regular, better vs. best-cushioned). For each condition, tibial acceleration, vertical ground reaction force and knee kinematics were measured with a tri-axial accelerometer, force plate and motion capture system, respectively. Heel comfort perception was indicated on the 150-mm Visual Analogue Scale. A 2 (height) x 3 (footwear) ANOVA with repeated measures was performed to determine the effects of different landing heights and shoe cushioning on the measured parameters. Results: We did not find significant interactions between landing height and shoe conditions on tibial shock, impact peak, mean loading rate, maximum knee flexion angle and total ankle range of motion. However, greater tibial shock, impact peak, mean loading rates and total ankle range of motion were determined at a higher landing height (P < 0.01). Regular-cushioned shoes demonstrated significantly greater tibial shock and mean loading rate compared with better- and best-cushioned shoes (P < 0.05). The correlation analysis indicated that the heel comfort perception was fairly associated with impact peak and mean loading rate regardless of heights (P < 0.05), but not associated with tibial shock. Conclusions: Determination of shoe cushioning performance, regardless of shoe midsole materials and constructions, would be capable in order to identify optimal shoe models for better protection against tibial stress fracture. Subjective comfort rating could estimate the level of impact loading in non-laboratory based situations. [ABSTRACT FROM AUTHOR]

Introduction: Compared to young adults, older adults walk with smaller propulsive forces and a redistribution to more proximal leg muscles for power generation during push-off. Despite this deficit in propulsive function, older adults can increase push-off intensity when encouraged to via real-time biofeedback. However, the specific joint-level modifications used by older adults to enhance propulsive force generation has yet to be elucidated. The purpose of this study was to identify the joint-level modifications used by young and older adults to modulate propulsive forces when walking at their preferred speed. Methods: 9 young and 16 older adults walked at their preferred speed while visual biofeedback prompted them to modulate their propulsive forces using targets prescribed at ±10% and ±20% of their preferred value. Older adults were then divided into groups exhibiting relatively larger or smaller baseline redistribution to more proximal leg muscles for power generation. Results: Neither young nor either older adult cohort modulated propulsive forces by altering their peak ankle power generation. Instead, subjects increased trailing limb extension and attenuated mechanical power demands at the hip during push-off. Older adults that had a larger baseline redistribution exhibited larger responses to enhanced push-off intensity than their peers–for example, walking with 11% less hip flexor power and 10% more trailing limb extension during push-off when exerting larger than preferred propulsive forces. Conclusion: Propulsive force biofeedback that elicits larger than preferred propulsive forces also increases trailing limb extension and attenuates mechanical power demands at the hip in older adults most exhibiting a distal-to-proximal redistribution. Our results suggest that considering baseline redistribution may be important in the personalized prescription of interventions aimed at enhancing walking performance by improving push-off intensity. [ABSTRACT FROM AUTHOR]

Suction experiments have been extensively applied for skin characterization. In these tests the deformation behavior of superficial tissue layers determines the elevation of the skin surface observed when a predefined negative (suction) pressure history is applied. The ability of such measurements to differentiate between skin conditions is limited by the variability of the elevation response observed in repeated experiments. The scatter was shown to be associated with the force exerted by the observer when holding the instrument against the skin. We have developed a novel suction device and a measurement procedure aiming at a tighter control of mechanical boundary conditions during the experiments. The new device weighs only 3.5 g and thus allows to minimize the force applied on the skin during the test. In this way, it is possible to reliably characterize the mechanical response of skin, also in case of low values of suction pressure and deformation. The influence of the contact force is analyzed through experiments on skin and synthetic materials, and rationalized based on corresponding finite element calculations. A comparative study, involving measurements on four body locations in two subjects by three observers, showed the good performance of the new procedure, specific advantages, and limitations with respect to the Cutometer®, i.e. the suction device most widely applied for skin characterization. As a byproduct of the present investigation, a correction procedure is proposed for the Cutometer measurements, which allows to partially compensate for the influence of the contact force. The characteristics of the new suction method are discussed in view of future applications for diagnostic purposes. [ABSTRACT FROM AUTHOR]

Data describing the effect of in vivo B cell depletion on general bone loss in patients with rheumatoid arthritis (RA) are limited. Given the pathogenetic role of B cells in RA, it is tempting to speculate that B cell depletion might have a beneficial effect on bone loss. We prospectively investigated the changes in bone mineral density (BMD), bone turnover, inflammation and disease activity before and after rituximab in 45 RA patients over a 12 month period, 36 patients of whom completed the study and were included in the analysis. There was no significant change in our primary endpoint; lumbar spine BMD after 12 months. However, we found a significant decrease in neck of femur (mean -0.017 g/cm2, 95% CI -0.030, -0.004 p = 0.011) and total femur BMD (mean -0.016 g/cm2, 95% CI -0.025, -0.007 p = 0.001). Additionally, there was a significant increase in procollagen type 1 amino-terminal propeptide (P1NP) and bone specific alkaline phosphatase (BAP); biomarkers of bone formation (median change from baseline to 12 months; P1NP 11.3 μg/L, 95% CI -1.1, 24.8 p = 0.025; BAP 2.5 μg/L, 95% CI 1.2, 3.6 p = 0.002), but no significant change in bone resorption or osteocyte markers. The fall in BMD occurred despite improvement in disease control. Post-menopausal women had the lowest mean lumbar spine, femoral and forearm BMD at baseline and after 12 months, additionally they had a higher level of bone turnover throughout the study. In conclusion, BMD was maintained at the lumbar spine and forearm, but fell at the femur sites. A high prevalence of vitamin D deficiency was observed and these patients had lower BMD and evidence of higher bone turnover. [ABSTRACT FROM AUTHOR]

Humans often learn new things via imitation. Here we draw on studies of imitation in children to characterise the brain system(s) involved in the imitation of different sequence types using functional magnetic resonance imaging. On each trial, healthy adult participants learned one of two rule types governing the sequencing of three pictures: a motor-spatial rule (in the spatial task) or an object-based rule (in the cognitive task). Sequences were learned via one of three demonstration types: a video of a hand selecting items in the sequence using a joystick (Hand condition), a computer display highlighting each item in order (Ghost condition), or a text-based demonstration of the sequence (Text condition). Participants then used a joystick to execute the learned sequence. Patterns of activation during demonstration observation suggest specialisation for object-based imitation in inferior frontal gyrus, specialisation for spatial sequences in anterior intraparietal sulcus (IPS), and a general preference for imitation in middle IPS. Adult behavioural performance contrasted with that of children in previous studies—indicating that they experienced more difficulty with the cognitive task—while neuroimaging results support the engagement of different neural regions when solving these tasks. Further study is needed on whether children’s differential performance is related to delayed IPS maturation. [ABSTRACT FROM AUTHOR]

Human gait analysis provides valuable information regarding the way of walking of a given subject. Low-cost RGB-D cameras, such as the Microsoft Kinect, are able to estimate the 3-D position of several body joints without requiring the use of markers. This 3-D information can be used to perform objective gait analysis in an affordable, portable, and non-intrusive way. In this contribution, we present a system for fully automatic gait analysis using a single RGB-D camera, namely the second version of the Kinect. Our system does not require any manual intervention (except for starting/stopping the data acquisition), since it firstly recognizes whether the subject is walking or not, and identifies the different gait cycles only when walking is detected. For each gait cycle, it then computes several gait parameters, which can provide useful information in various contexts, such as sports, healthcare, and biometric identification. The activity recognition is performed by a predictive model that distinguishes between three activities (walking, standing and marching), and between two postures of the subject (facing the sensor, and facing away from it). The model was built using a multilayer perceptron algorithm and several measures extracted from 3-D joint data, achieving an overall accuracy and F1 score of 98%. For gait cycle detection, we implemented an algorithm that estimates the instants corresponding to left and right heel strikes, relying on the distance between ankles, and the velocity of left and right ankles. The algorithm achieved errors for heel strike instant and stride duration estimation of 15 ± 25 ms and 1 ± 29 ms (walking towards the sensor), and 12 ± 23 ms and 2 ± 24 ms (walking away from the sensor). Our gait cycle detection solution can be used with any other RGB-D camera that provides the 3-D position of the main body joints. [ABSTRACT FROM AUTHOR]

Introduction: Osteoarthritis (OA) is the most common form of arthritis. Medical and surgical treatments have yet to substantially diminish the global health and economic burden of OA. Due to recent advances in clinical imaging, including magnetic resonance imaging (MRI), a correlation has been established between structural joint damage and OA-related pain and disability. Existing preclinical animal models of OA are useful tools but each suffers specific roadblocks when translating structural MRI data to humans. Intraarticular injection of mono-iodoacetate (MIA) is a reliable, well-studied method to induce OA in small animals but joint size discrepancy precludes the use of clinical grade MRI to study structural disease. The porcine knee is suited for clinical MRI and demonstrates homology with humans. We set out to establish the first large animal model of MIA-induced knee OA in swine characterized by structural MRI. Materials and methods: Yucatan swine (n = 27) underwent ultrasound-guided injection of knees with 1.2, 4, 12, or 40 mg MIA. MRI was performed at several time points over 12 weeks (n = 54 knees) and images were assessed according to a modified clinical grading scheme. Knees were harvested and graded up to 35 weeks after injection. Results: MIA-injected knees (n = 25) but not control knees (n = 29) developed gross degeneration. A total of n = 6,000 MRI measurements were recorded by two radiologists. MRI revealed progressive cartilage damage, bone marrow edema, erosions, and effusions in MIA-injected knees. Lesion severity and progression was influenced by time, dose, and inter-individual variability. Conclusions: Intraarticular injection of MIA produced structural knee degradation that was reliably characterized using clinical MRI in swine. Destruction was progressive and, similar to human OA, lesion severity was heterogeneous between and within treatment groups. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the effect of increasing workload on individual thigh muscle activation during a 20 minute incremental cycling test. Intramuscular electromyographic signals were recorded from the knee extensors rectus femoris, vastus lateralis, vastus medialis and vastus intermedius and the knee flexors semimembranosus, semitendinosus, and the short and long heads of the biceps femoris during increasing workloads. Mean activation levels were compared over the whole pedaling cycle and the crank angles at which onset and offset of activation and peak activity occurred were identified for each muscle. These data were compared between three workloads. EMG activation level significantly increased (p<0.05) with increasing workload in the rectus femoris, vastus medialis, vastus lateralis, vastus intermedius, biceps femoris long head, semitendinosus and semimembranosus but not in the biceps femoris short head. A significant change in activation timing was found for the rectus femoris, vastus lateralis, vastus medialis and semitendinosus. Of the knee flexors only the short head of the biceps femoris had its peak activity during the upstroke phase at the two highest workloads indicating a unique contribution to knee flexion. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effect of (new) treatments or analyse prevalence and risk factors of contractures, rating scales are used based on joint range of motion. However, cut-off points for levels of severity vary between scales, and it seems unclear how cut-off points relate to function. The purpose of this study was to compare severity ratings of different rating scales for the shoulder and elbow and relate these with functional range of motion. Methods: Often used contracture severity rating scales in orthopedics, physiotherapy, and burns were included. Functional range of motion angles for the shoulder and elbow were derived from a recent synthesis published by our group. Shoulder flexion and elbow flexion range of motion data of patients three months after a burn injury were rated with each of the scales to illustrate the effects of differences in classifications. Secondly, the shoulder and elbow flexion range of motion angles were related to the required angles to perform over 50 different activities of daily living tasks. Results: Eighteen rating scales were included (shoulder: 6, elbow: 12). Large differences in the number of severity levels and the cut-off points between scales were determined. Rating the measured range of motions with the different scales showed substantial inconsistency in the number of joints without impairment (shoulder: 14–36%, elbow: 26–100%) or with severe impairment (shoulder: < 10%–29%, elbow 0%–17%). Cut-off points of most scales were not related to actual function in daily living. Conclusion: There is an urgent need for rating scales that express the severity of contractures in terms of loss of functionality. This study proposes a direction for a solution. [ABSTRACT FROM AUTHOR]

Scientific production has increased exponentially in recent years. It is necessary to find methodological strategies for understanding holistic or macro views of the major research trends developed in specific fields. Data mining is a useful technique to address this task. In particular, our study presents a global analysis of the information generated during last decades in the Sport Sciences Category (SSC) included in the Web of Science database. An analysis of the frequency of appearance and the dynamics of the Author Keywords (AKs) has been made for the last thirty years. Likewise, the network of co-occurrences established between words and the survival time of new words that have appeared since 2001 has also been analysed. One of the main findings of our research is the identification of six large thematic clusters in the SSC. There are also two major terms that coexist ('REHABILITATION' and 'EXERCISE') and show a high frequency of appearance, as well as a key behaviour in the calculated co-occurrence networks. Another significant finding is that AKs are mostly accepted in the SSC since there has been high percentage of new terms during 2001–2006, although they have a low survival period. These results support a multidisciplinary perspective within the Sport Sciences field of study and a colonization of the field by rehabilitation according to our AK analysis. [ABSTRACT FROM AUTHOR]

Spacecrafts need to maneuver their solar panels towards the sun and antennas towards the ground station for maximum solar power harvesting and communication with the ground station. For tracking purpose, usually magnetorquer rods, reaction wheels and permanent magnets are used, but they are heavier, expensive, and occupy extra space on the spacecraft. Keeping in mind the dimension, budget and mass constraints of small satellites, a system compatible with small satellite is worth consideration. Consequently, this paper focuses on designing and analyzing a solar panel module with embedded Air-Coil. Such an Air-Coil is an innovative idea for the replacement of heavier, bulky and expensive attitude control systems. The proposed Air-Coil is integrated in the internal layers of an eight layers solar panel PCB module. Complete degradation analyses of the solar panel have been done to ensure that it will meet the satellite power requirements at BOL (beginning of life) and EOL (end of life). The proposed embedded Air-Coil has been analyzed for the generated magnetic moment, resultant torque, power consumption and temperature increase of the complete solar panel unit. A steady state thermal model is proposed to measure the thermal resistance between top and bottom layers of the solar panel module, which gives an idea about the heat trapped inside the solar panel module. The designed embedded Air-Coil is fully reconfigurable where coil in each layer can be operated as a separate coil. The four coils in different layers can be attached or detached through switches in different configurations i.e. single coil, four in series, four in parallel, and their hybrid combinations. The analyses of power consumption, heat dissipation, temperature rise, magnetic moment and torque generation by different configurations of the designed Air-Coil have been performed. The generated magnetic moment is very high i.e. around 12Am2, which is enough to rotate a microsatellite by 90° in 200s. The efficacy of the proposed module is significantly higher than the already available systems with respect to mass, price, power dissipation, heat generation, and dimension. [ABSTRACT FROM AUTHOR]

Background: Medical Infrared Imaging (MII) is an investigative method that can be potentially used in emergency care to non-invasively detect thermal signatures associated with change in blood flow. We have developed a protocol for the use of MII in the Emergency Department (ED) and shown that it is feasible. To derive initial data for sample size calculations, we performed an exploratory study in patients with fever and sepsis. Methods: The Leicester MII protocol was used to image the temperature patterns along the arm among three patient groups (control, fever and sepsis) of a total 56 patients. Anatomical markers were used to divide this gradient into upper arm, forearm, hand and finger regions. Variations in measurements within and between these regions were described. Results: The thermal gradient down the arm was successfully extracted in all patients. The distribution of values in each region of the arm was described in control, fever and sepsis patients. There was a significant gradient between upper arm and finger in controls (2.75, p < 0.0001), but no gradient in fever (p = 0.944) or sepsis (p = 0.710). This was reflected in the finger/arm difference, which was of -2.74°C (±3.50) in controls, -0.39C (±2.48) in fever, and -1.80°C (±3.09) in sepsis. Conclusions: This study found different thermal gradients along the arm in control and febrile groups, and defined the degree of individual variation. It is likely that the difference between upper arm temperature and finger temperature (representing the temperature gradient down the arm) may be more useful than absolute measurements in future studies. [ABSTRACT FROM AUTHOR]

Background: Most humans have the ability to activate the auricular muscles. Although (intentional) control suggests an involvement of higher cortical centers underlying posterior auricular muscle (PAM) activation, the cortical representation of the auricular muscles is still unknown. Methods: With the purpose of identifying a possible cortical representation area we performed automated robotic and image-guided transcranial magnetic stimulation (TMS) mapping (n = 8) and functional magnetic resonance imaging (fMRI) (n = 13). For topographical comparison, a similar experimental protocol was applied for the first dorsal interosseus muscle (FDI) of the hand. Results: The calculated centers of gravity (COGs) of both muscles were located on the precentral gyrus with the PAM COGs located more laterally compared to the FDI. The distance between the mean PAM and mean FDI COG was 26.3 mm. The TMS mapping results were confirmed by fMRI, which showed a dominance of cortical activation within the precentral gyrus during the corresponding motor tasks. The correspondence of TMS and fMRI results was high. Conclusion: The involvement of the primary motor cortex in PAM activation might point to an evolved function of the auricular muscles in humans and/or the ability of intentional (and selective) muscle activation. [ABSTRACT FROM AUTHOR]

Cognitive-motor interference, a negative influence on the performance of one or both tasks, is manifested when simultaneously performing a cognitive and a motor task. Motor fatigue reduces the ability of generating a required force level. However, little is known about the effects of motor fatigue on the cognitive-motor dual-tasking performance, an important capability during our daily lives. This study investigated how motor fatigue affects dual-task walking performance. Eighteen healthy younger adults walked on a treadmill under three different conditions: walking only, walking while receiving the Paced Auditory Serial Addition Test (PASAT) or a modified Stroop test before and after a lower-extremity fatiguing exercise. We computed dynamic margins of stability (MOS), step and joint kinematic variability, and short-term local divergence exponent (LDE) of the trunk motion. We found that subjects had similar values of short-term LDE during all conditions, indicating that local stability was not affected by the motor fatigue or dual-task conditions. Compared to the baseline, subjects had significantly greater mean MOS after the fatiguing exercise by walking with greater step length and width while having significantly greater gait variability. In contrast, subjects walked with similar mean MOS but significantly less gait variability during the dual-task conditions, indicating that subjects used different adaptive strategies when walking with motor fatigue and during dual-task conditions. There were no significant differences in the number of errors for the two cognitive tests before and after the fatiguing exercise. The current findings demonstrate that motor fatigue does not affect cognitive but motor performance in younger adults. [ABSTRACT FROM AUTHOR]

Background: Accelerated bone loss occurs rapidly following renal transplantation due to intensive immunosuppression and persistent hyperparathyroidism. In renal transplant recipients (RTRs) due to the hyperparathyroidism the non-dominant forearm is often utilized as a peripheral measurement site for dual-energy x-ray absorptiometry (DXA) measurements. The forearm is also the site of previous created distal arteriovenous fistulas (AVF). Although AVF remain patent long after successful transplantation, there are no data available concerning their impact on radial bone DXA measurements. Methods: In this cross-sectional study we performed DXA in 40 RTRs with preexisting distal AVF (RTRs-AVF) to assess areal bone mineral density (aBMD) differences between both forearms (three areas) and compared our findings to patients with chronic kidney disease (CKD, n = 40), pre-emptive RTRs (RTRs-pre, n = 15) and healthy volunteers (n = 20). In addition, we assessed relevant demographic, biochemical and clinical aspects. Results: We found a marked radial asymmetry between the forearms in RTRs with preexisting AVF. The radial aBMD at the distal AVF forearm was lower compared to the contralateral forearm, resulting in significant differences for all three areas analyzed: the Rad-1/3: median (interquartile range) in g/cm2, Rad-1/3: 0.760 (0.641–0.804) vs. 0.742 (0.642, 0.794), p = 0.016; ultradistal radius, Rad-UD: 0.433 (0.392–0.507) vs. 0.420 (0.356, 0.475), p = 0.004; and total radius, Rad-total: 0.603 (0.518, 0.655) vs. 0.599 (0.504, 0.642), p = 0.001). No such asymmetries were observed in any other groups. Lower aBMD in AVF forearm subregions resulted in misclassification of osteoporosis. Conclusions: In renal transplant recipients, a previously created distal fistula may exert a negative impact on the radial bone leading to significant site-to-site aBMD differences, which can result in diagnostic misclassifications. [ABSTRACT FROM AUTHOR]

Objective: To provide a neurophysiological tool for assessing sensorimotor pathways, which may differ for those involving distal muscles in simple tasks from those involving distal muscles in a kinetic chain task, or proximal muscles in both. Methods: We compared latencies and magnitudes of motor responses in a reaction time paradigm in a proximal (biceps brachii, BB) and a distal (first dorsal interosseous, FDI) muscle following electrical stimuli used as imperative signal (IS) delivered to the index finger. These stimuli were applied during different motor tasks: simple tasks involving either one muscle, e.g. flexing the elbow for BB (FLEX), or pinching a pen for FDI (PINCH); combined tasks engaging both muscles by pinching and flexing simultaneously (PINCH-FLEX). Stimuli were of varying intensity and occasionally elicited a startle response, and a StartReact effect. Results: In BB, response latencies decreased gradually and response amplitudes increased progressively with increasing IS intensities for non-startling trials, while for trials containing startle responses, latencies were uniformly shortened and response amplitudes similarly augmented across all IS intensities in both FLEX and PINCH-FLEX. In FDI, response latencies decreased gradually and response amplitudes increased progressively with increasing IS intensities in both PINCH and PINCH-FLEX for non-startling trials, but, unlike in BB for the simple task, in PINCH for trials containing startle responses as well. In PINCH-FLEX, FDI latencies were uniformly shortened and amplitudes similarly increased across all stimulus intensities whenever startle signs were present. Conclusions: Our results suggest the presence of different sensorimotor pathways supporting a dissociation between simple tasks that involve distal upper limb muscles (FDI in PINCH) from simple tasks involving proximal muscles (BB in FLEX), and combined tasks that engage both muscles (FDI and BB in PINCH-FLEX), all in accordance with differential importance in the control of movements by cortical and subcortical structures. Significance: Simple assessment tools may provide useful information regarding the differential involvement of sensorimotor pathways in the control of both simple and combined tasks that engage proximal and distal muscles. [ABSTRACT FROM AUTHOR]

Spinal muscular atrophy (SMA) is a monogenic disorder caused by loss of function mutations in the survival motor neuron 1 gene, which results in a broad range of disease severity, from neonatal to adult onset. There is currently a concerted effort to define the natural history of the disease and develop outcome measures that accurately capture its complexity. As several therapeutic strategies are currently under investigation and both the FDA and EMA have recently approved the first medical treatment for SMA, there is a critical need to identify the right association of responsive outcome measures and biomarkers for individual patient follow-up. As an approved treatment becomes available, untreated patients will soon become rare, further intensifying the need for a rapid, prospective and longitudinal study of the natural history of SMA Type 2 and 3. Here we present the baseline assessments of 81 patients aged 2 to 30 years of which 19 are non-sitter SMA Type 2, 34 are sitter SMA Type 2, 9 non-ambulant SMA Type 3 and 19 ambulant SMA Type 3. Collecting these data at nine sites in France, Germany and Belgium established the feasibility of gathering consistent data from numerous and demanding assessments in a multicenter SMA study. Most assessments discriminated between the four groups well. This included the Motor Function Measure (MFM), pulmonary function testing, strength, electroneuromyography, muscle imaging and workspace volume. Additionally, all of the assessments showed good correlation with the MFM score. As the untreated patient population decreases, having reliable and valid multi-site data will be imperative for recruitment in clinical trials. The pending two-year study results will evaluate the sensitivity of the studied outcomes and biomarkers to disease progression. Trial Registration: ClinicalTrials.gov (). [ABSTRACT FROM AUTHOR]

The natural world is filled with substrates of varying properties that challenge locomotor abilities. Birds appear to transition smoothly from aerial to terrestrial environments during take-offs and landings using substrates that are incredibly variable. It may be challenging to control movement on and off compliant (flexible) substrates such as twigs, yet birds routinely accomplish such tasks. Previous research suggests that birds do not use their legs to harness elastic recoil from perches. Given avian mastery of take-off and landing, we hypothesized that birds instead modulate wing, body and tail movements to effectively use compliant perches. We measured take-off and landing performance of diamond doves (Geopelia cuneata (N = 5) in the laboratory and perch selection in this species in the field (N = 25). Contrary to our hypothesis, doves do not control take-off and landing on compliant perches as effectively as they do on stiff perches. They do not recover elastic energy from the perch, and take-off velocities are thus negatively impacted. Landing velocities remain unchanged, which suggests they may not anticipate the need to compensate for compliance. Legs and wings function as independent units: legs produce lower initial velocities when taking off from a compliant substrate, which negatively impacts later flight velocities. During landing, significant stability problems arise with compliance that are ameliorated by the wings and tail. Collectively, we suggest that the diamond dove maintains a generalized take-off and landing behavior regardless of perch compliance, leading us to conclude that perch compliance represents a challenge for flying birds. Free-living diamond doves avoid the negative impacts of compliance by preferentially selecting perches of larger diameter, which tend to be stiffer. [ABSTRACT FROM AUTHOR]

Background: Total knee replacement (TKR) is increasingly performed in short term hospital stay, making same day mobilization an important issue is after surgery. This implies little joint effusion by reducing intra-articular blood loss, which will enhance knee range of motion. The application of a topical fibrin sealant on the intraoperative bare bone and synovial tissue may contribute to better early full mobilization and thus improved functional outcomes. Since ambulation with a fully extended knee is less strenuous, we hypothesized that patients who received fibrin sealant would demonstrate improved early knee extension after six weeks compared to patients who received standard care. Methods: A multicenter randomized controlled trial in a consecutive series of osteoarthritis patients scheduled for TKR surgery. Participants were randomized to receive fibrin sealant or not before closing the knee joint capsule. Primary outcome was change in knee extension angle(°) at short term (2 weeks) follow-up (cExt). Secondary outcomes were 6-week extension angle, knee flexion angle, hemoglobin loss, blood transfusion rates, complication rates, the Knee Society Score, and the KOOS and EQ5D questionnaires. Results: When data on primary outcome became available from 250 patients, an interim analysis was performed by an independent Data Safety Monitoring Board for safety and effectivity assessment. This analysis showed that sufficient patients were included to detect a cExt of 10° between both groups. Inclusion was stopped however, all in the meantime included patients were treated according to their randomization. A total of 466 were available for analysis. Both groups were comparable in terms of baseline characteristics. The estimated mean cExt difference was 0.2° (95%CI -0.5 to 0.9). No differences in secondary outcomes were found. Conclusions: No beneficial effects or side effects were found of a topically applied fibrin sealant during TKR surgery. These results discourage the clinical use of a fibrin sealant in TKR. Trial registration: Dutch Trial Register, . [ABSTRACT FROM AUTHOR]

Background: This study deals with management of a group of elderly patients with a history of leprosy and hand deformities by a multidisciplinary team of dentists and occupational therapists. Assistive technology devices have been developed to allow such patients to obtain independence in oral self-care and can be a cost-effective approach to improving oral care in this population. The objective of this study was to describe the development of assistive devices to facilitate daily oral hygiene in older people with enduring leprosy-related impairments. Methodology: Case study realized among elders with a history of leprosy residents in a former isolation colony in Betim, Minas Gerais, Brazil. The elders were evaluated for dependence on others for denture hygiene and mouthwash using the Daily Oral Hygiene Activity Index (ADOH). Those deemed partially or completely dependent on others were eligible for an intervention based on assistive technology. We adopted a personalized approach to each case, taking into account medical history, physical impairment and living environment. Six months after the intervention, the participants were assessed again using the ADOH and an unstructured interview about use of the devices. Principal findings: Assistive devices for denture hygiene and mouthwash were developed for 16 elders. These devices facilitated oral hygiene in most patients and there was no worsening in any of the cases. Patients’ report suggested they were satisfied with the devices provided. Conclusions: This study demonstrated that assistive devices can facilitate oral hygiene activities in leprosy patients. It also reinforces the importance of using a multidisciplinary team for the rehabilitation of these patients. [ABSTRACT FROM AUTHOR]

Movement is fundamental to human and animal life, emerging through interaction of complex neural, muscular, and skeletal systems. Study of movement draws from and contributes to diverse fields, including biology, neuroscience, mechanics, and robotics. OpenSim unites methods from these fields to create fast and accurate simulations of movement, enabling two fundamental tasks. First, the software can calculate variables that are difficult to measure experimentally, such as the forces generated by muscles and the stretch and recoil of tendons during movement. Second, OpenSim can predict novel movements from models of motor control, such as kinematic adaptations of human gait during loaded or inclined walking. Changes in musculoskeletal dynamics following surgery or due to human–device interaction can also be simulated; these simulations have played a vital role in several applications, including the design of implantable mechanical devices to improve human grasping in individuals with paralysis. OpenSim is an extensible and user-friendly software package built on decades of knowledge about computational modeling and simulation of biomechanical systems. OpenSim’s design enables computational scientists to create new state-of-the-art software tools and empowers others to use these tools in research and clinical applications. OpenSim supports a large and growing community of biomechanics and rehabilitation researchers, facilitating exchange of models and simulations for reproducing and extending discoveries. Examples, tutorials, documentation, and an active user forum support this community. The OpenSim software is covered by the Apache License 2.0, which permits its use for any purpose including both nonprofit and commercial applications. The source code is freely and anonymously accessible on GitHub, where the community is welcomed to make contributions. Platform-specific installers of OpenSim include a GUI and are available on simtk.org. [ABSTRACT FROM AUTHOR]

Physical rehabilitation aims people with physical impairments to enhance and restore their functional ability. The Microsoft Kinect v1 and v2 technologies apply depth information and machine vision techniques to generate 3D coordinates of a set of anatomical landmarks on the human body regarded as Kinect joints. Trigonometry relationship between Kinect joints can be used to extract body Range of Motion (ROM). The purpose of this study was to evaluate stability of Kinect for ROM measurement during static stretching exercises. According to the literature, the stability of Kinect in static exercises has been reported to a limited extent. 13 healthy men participated in this study and performed 5 exercises in 2 different distances from the cameras. Exercises were recorded by Kinect v1 and Kinect v2, concurrently. The stability of Kinect was also evaluated for 5 ROMs including: elbow flexion, shoulder abduction, wrist pronation, wrist flexion, and wrist ulnar deviation. Maximum and average joint displacement errors were used for stability analysis. Results showed that Kinect v2 is more stable compared to Kinect v1. Kinect v2 joints showed displacement error of more than 15 mm for wrist. For the other joints, Kinect showed an average displacement error of less than 10 mm. [ABSTRACT FROM AUTHOR]

Work spaces for assembly or maintenance operations are considered in the design stage of products. Maintenance space is a key factor in determining how well a product can be maintained. If the work space is sufficiently considered in the design stage, it will benefit both the user and the maintainer. From a maintenance perspective, this paper proposes a quantitative method to evaluate the maintenance space by virtual simulation and consideration of ergonomics. In this method, maintenance operations are concisely classified into three types. Based on the virtual simulation of the maintenance process and maintainer data, the swept volume of a hand is built using envelope theory. The operation range of the maintainer is derived by establishing a mathematical model for the upper limb. Combining the swept volume and operation range, the maintenance space can be quantitatively evaluated. A concise validation demonstrates that the proposed method is effective for evaluating the maintenance space to improve the space design. The proposed method could be applied to the space design of a complex product. [ABSTRACT FROM AUTHOR]

This study sought to assess the reliability and comparability of two custom-built isokinetic dynamometers (Model A and Model B) with the gold-standard (Humac Norm). The two custom-built dynamometers consisted of commercially available leg extension machines attached to a robotically controlled resistance device (1080 Quantum), able to measure power, force and velocity outputs. Twenty subjects (14m/6f, 26±4.8yr, 176±7cm, 74.4±12.4kg) performed concentric leg extensions on the custom-built dynamometers and the Humac Norm. Fifteen maximal leg extensions were performed with each leg at 180° s-1, or the linear equivalent (~0.5m s-1). Peak power (W), mean power (W), and fatigue indexes (%) achieved on all three devices were compared. Both custom-built dynamometers revealed high reliability for peak and mean power on repeated tests (ICC>0.88). Coefficient of variation (CV) and standard error of measurement (SEM) were small when comparing power outputs obtained using Model A and the Humac Norm ( CV = 9.0%, SEM = 49W; peak CV = 8.4%, peak SEM = 49W). Whereas, Model B had greater variance ( CV = 13.3% SEM = 120W; peak CV = 14.7%, peak SEM = 146W). The custom-built dynamometers are capable of highly reliable measures, but absolute power outputs varied depending on the leg extension model. Consistent use of a single model offers reliable results for tracking muscular performance over time or testing an intervention. [ABSTRACT FROM AUTHOR]

An ongoing study of the genus Merodon Meigen, 1803 in the Republic of South Africa (RSA) has revealed the existence of new species related to M. melanocerus Bezzi, 1915. The M. melanocerus subgroup belongs to the Afrotropical lineage of the M. desuturinus group. Revision of all available material from museums and detailed analyses of newly -collected specimens from our own expeditions to RSA resulted in delimitation of five species: M. capensis Hurkmans sp. n., M. commutabilis Radenković et Vujić sp. n., M. drakonis Vujić et Radenković sp. n., M. flavocerus Hurkmans sp. n. and M. melanocerus. In addition to classical morphological characters, sequences of the mitochondrial COI gene are provided for four related taxa. Results of molecular phylogenetic analyses supports monophyly of the M. desuturinus group and confirmed delimitation between species. Links between Palaearctic and Afrotropical faunas of this group, as well as possible evolutionary paths, are discussed. Based on phylogenetic analyses, four lineages (putative subgenera) have been recognized within the genus Merodon; besides the three previously established ones, albifrons+desuturinus, aureus (sensu lato) and avidus-nigritarsis, one new lineage named natans is distinguished. [ABSTRACT FROM AUTHOR]

Iterative prototyping is costly and time-consuming. Particularly when designing medical instruments, human factors related design choices significantly impact performance and safety. A tool is presented that allows for the evaluation of steerable instrument controls before the onset of the prototyping stage. The design tool couples gestural input to virtually simulated instrument motions using hand motion tracking. We performed a human-subject evaluation of two manual control strategies that differed in their degrees of freedom (DOF). 2DOF thumb control was compared to 4DOF thumb-index finger control. Results identified regions within the instrument workspace that are difficult to reach and showed participants to favor using the thumb for gross and fine-tuning motions at both control strategies. Index finger ab/adduction was found to be least functional. A strong learning effect was observed at 4DOF control. Based on the results, gesture-based instrument design is a viable design tool. [ABSTRACT FROM AUTHOR]

Behavioral and neurophysiological findings in vision suggest that perceptual grouping is not a unitary process and that different grouping principles have different processing requirements and neural correlates. The present study aims to examine whether the same occurs in the haptic modality using two grouping principles widely studied in vision, spatial proximity and texture similarity. We analyzed behavioral responses (accuracy and response times) and conducted an independent component analysis of brain oscillations in alpha and beta bands for haptic stimuli grouped by spatial proximity and texture similarity, using a speeded orientation detection task performed on a novel haptic device (MonHap). Behavioral results showed faster response times for patterns grouped by spatial proximity relative to texture similarity. Independent component clustering analysis revealed the activation of a bilateral network of sensorimotor and parietal areas while performing the task. We conclude that, as occurs in visual perception, grouping the elements of the haptic scene by means of their spatial proximity is faster than forming the same objects by means of texture similarity. In addition, haptic grouping seems to involve the activation of a network of widely distributed bilateral sensorimotor and parietal areas as reflected by the consistent event-related desynchronization found in alpha and beta bands. [ABSTRACT FROM AUTHOR]

Embodied cognition research suggests that bodily experiences might ground mental representations of emotional valence in the vertical dimension of space (i.e., positive is up and negative is down). Accordingly, recent studies show that upward and downward arm movements may also influence the evaluation of valence-laden stimuli, suggesting that upward (downwards) movements lead to more positive (negative) evaluations. Interestingly, these studies typically did not investigate paradigms that require a direct hand interaction with the stimuli. With the advent of touchscreen devices and their use for experimental environments, however, a direct and more natural hand interaction with the stimuli has come to the fore. In this regard, the goal of the present study is to examine how direct hand interaction with valence-laden stimuli on a touchscreen monitor affects their perceived valence. To do so, participants evaluated emotional pictures after touching and moving them either upwards or downwards across a vertically mounted touchscreen. In contrast to previous findings, the results suggest that positive pictures were evaluated as more positive after downward movements while negative pictures were evaluated as less negative following upward movements. This finding may indicate that a matching between the pictures’ valence and the valence associated with their vertical touch location leads to more positive evaluations. Thus, the present study extends earlier results by an important point: Touching the emotional pictures during movement may influence their valence processing. [ABSTRACT FROM AUTHOR]

Stroke effects millions of people each year and can have a significant impact on the ability to use the impaired arm and hand. One of the results of stroke is the development of an abnormal shoulder-elbow flexion synergy, where lifting the arm can cause the elbow, wrist, and finger flexors to involuntarily contract, reducing the ability to reach with the arm and hand opening. This study explored the effect of using support at the upper arm to improve hand and arm reaching performance. Nine participants were studied while performing a virtual reaching task under three conditions: while the weight of their impaired arm was supported by a robot arm, while unsupported, and while using their non-impaired arm. Most subjects exhibited faster and more accurate reaching while supported compared to unsupported. For the subjects who could voluntarily open their hand, most were able to more swiftly open their hand when using upper arm support. In many cases, performance with support was not statistically different than the unaffected arm and hand. Muscle activity of the impaired limb with upper arm support showed decreased effort to lift the arm and reduced biceps activity in most subjects, pointing to a reduction in the abnormal flexion synergy while using upper arm support. While arm support can help to reduce the activation of abnormal synergies, weakness resulting from hemiparesis remains an issue impacting performance. Future systems will need to address both of these causes of disability to more fully restore function after stroke. [ABSTRACT FROM AUTHOR]

Adapting reaches to altered visual feedback not only leads to motor changes, but also to shifts in perceived hand location; “proprioceptive recalibration”. These changes are robust to many task variations and can occur quite rapidly. For instance, our previous study found both motor and sensory shifts arise in as few as 6 rotated-cursor training trials. The aim of this study is to investigate one of the training signals that contribute to these rapid sensory and motor changes. We do this by removing the visuomotor error signals associated with classic visuomotor rotation training; and provide only experience with a visual-proprioceptive discrepancy for training. While a force channel constrains reach direction 30o away from the target, the cursor representing the hand unerringly moves straight to the target. The resulting visual-proprioceptive discrepancy drives significant and rapid changes in no-cursor reaches and felt hand position, again within only 6 training trials. The extent of the sensory change is unexpectedly larger following the visual-proprioceptive discrepancy training. Not surprisingly the size of the reach aftereffects is substantially smaller than following classic visuomotor rotation training. However, the time course by which both changes emerge is similar in the two training types. These results suggest that even the mere exposure to a discrepancy between felt and seen hand location is a sufficient training signal to drive robust motor and sensory plasticity. [ABSTRACT FROM AUTHOR]