A sensor fusion approach for inertial sensors based 3D kinematics and pathological gait assessments: toward an adaptive control of stimulation in post-stroke subjects.

Pathological gait assessment and assistive control based on functional electrical stimulation (FES) in post-stroke individuals, brings out a common need to robustly quantify kinematics facing multiple constraints. This study proposes a novel approach using inertial sensors to compute dorsiflexion angles and spatio-temporal parameters, in order to be later used as inputs for online close-loop control of FES. 26 post-stroke subjects were asked to walk on a pressure mat equipped with inertial measurement units (IMU) and passive reflective markers. A total of 930 strides were individually analyzed and results between IMU-based algorithms and reference systems compared. Mean absolute (MA) errors of dorsiflexion angles were found to be less than 4°, while stride lengths were robustly segmented and estimated with a MA error less than 10 cm. These results open new doors to rehabilitation using adaptive FES closed-loop control strategies in "foot drop" syndrome correction.

Toward an affordable and user-friendly visual motion capture system.

The present study aims at designing and evaluating a low-cost, simple and portable system for arm joint angle estimation during grasping-like motions. The system is based on a single RGB-D camera and three customized markers. The automatically detected and tracked marker positions were used as inputs to an offline inverse kinematic process based on bio-mechanical constraints to reduce noise effect and handle marker occlusion. The method was validated on 4 subjects with different motions. The joint angles were estimated both with the proposed low-cost system and, a stereophotogrammetric system. Comparative analysis shows good accuracy with high correlation coefficient (r= 0.92) and low average RMS error (3.8 deg).

Evaluation of surgical treatment for ruptured Achilles tendon in 31 athletes.

INTRODUCTION: In the past few decades, the incidence of Achilles tendon rupture has increased in parallel with increased sports participation. Although the optimal treatment remains controversial, there is a trend towards surgical treatment in athletes. HYPOTHESIS: Surgical repair of ruptured Achilles tendon in athlete results in good functional and objective recovery, irrespective of the type of surgery performed. Subsidiarily, are the results different between percutaneous surgery (PS) and standard open surgery (OS)? MATERIALS AND METHODS: This was a cross-sectional study of 31 patients who presented with a ruptured Achilles tendon that occurred during sports participation. Percutaneous surgery was performed in 16 patients and open surgery in 15 patients between 2005 and 2009. The objective recovery status was evaluated by open chain goniometry, measurement of leg muscle atrophy and assessment of isokinetic strength. The functional analysis was based on the delay, level of sports upon return, AOFAS and VAS for pain. RESULTS: Our series of Achilles tendon rupture patients consisted of 88% men and 12% women, with an average age of 38 years. In 71% of cases, the rupture occurred during eccentric loading. After a follow-up of 15 months, the muscle atrophy was 13 mm after PS and 24 mm after OS (P=0.01). A strength deficit of 19% in the plantar flexors was found in the two groups. No patient experienced a rerupture. The return to sports occurred at 130 days after PS and 178 days after OS (P=0.005). The average AOFAS score was 94 and the VAS was 0.5. There were no differences in ankle range of motion between the two groups. The majority (77%) of patients had returned to their preinjury level of sports activity. DISCUSSION: The return to activities of daily living was slower in our study than in studies based in Anglo-Saxon countries; this can be explained by the different sick leave coverage systems. Percutaneous surgery resulted in a faster return to sports (about 130 days) and less muscle atrophy than open surgery. Our results for return to sports and return to preinjury levels were similar to published results for athletes and were independent of the type of surgery performed. The AOFAS score was comparable to published studies. We found no difference in muscle strength between the two surgery groups 15 months after the procedure. Apart from venous thrombosis typically described after lower-limb immobilization, secondary postoperative complications mostly consisted of sural paresthesia, which had resolved at the 15-month postoperative follow-up evaluation. CONCLUSION: The results of surgical treatment for ruptured Achilles tendon are good overall. By combining the simplicity of conservative treatment and the reliability of standard surgical treatment, percutaneous surgery is the treatment of choice to achieve excellent results. The return to sports occurred earlier, the muscle atrophy was less and the functional score was better in our patients treated by percutaneous surgery. LEVEL OF EVIDENCE: Level IV.

Percutaneous iliosacral screw fixation in unstable pelvic ring lesions: the interest of O-ARM CT-guided navigation.

INTRODUCTION: The reference surgical treatment for unstable posterior pelvic fracture is percutaneous iliosacral screw fixation, isolated or in association with other techniques. As there is a risk of passage outside the bone when performing screw fixation under fluoroscopy, new image-guidance techniques have been developed: fluoronavigation, peroperative 3D navigation, CT-linked navigation, etc. Since September 2011, our department has performed iliosacral screw fixation under CT control linked to navigation so as to optimize screw positioning. This innovative technology has been used in neurosurgery in our center since 2007, for disc implants, spinal fracture, vertebral arthrodesis and intracerebral localization. MATERIAL AND METHODS: Six patients were treated by iliosacral screw fixation for posterior pelvic ring fracture lesion. The O-ARM (Medtronic(®)) computer-assisted surgical navigation system was used, combining surgical navigation and peroperative 3D imaging. This kind of osteosynthesis is suitable for non-displaced or prereduced fracture. A radiation dose report is drawn up at end of surgery. DISCUSSION: Postoperative course does not differ from other percutaneous osteosynthesis techniques, combing the advantages of a percutaneous approach (reduced infection and blood-loss rates, etc.) while optimizing iliosacral screw positioning. To date, no radiation overexposure has been found. CONCLUSION: The precision and safety of iliosacral screw fixation are now unequalled, meeting the basic computer-assisted surgery principles of reduced morbidity without overexposure to ionizing radiation. Indications for computer-assisted surgery should therefore be extended to iliosacral pathologies (arthritic, tumoral and inflammatory), non-displaced acetabular fracture, etc.

A paradigm for the control of upright standing in paraplegic patients.

The objective of this paper is to present a new paradigm in control strategy for unsupported paraplegic standing, based on closed-loop control of paraplegics' lower extremities. The main advantage of our approach is taking into account voluntary motions of the upper-part of the body by controlling Center of Mass (CoM) position. The validity of our approach is tested, in computer simulations, using human CoM trajectories estimated from experimental data and by applying perturbations in simulation during quiet standing in order to simulate voluntary upper body movements. From the results presented in this study it can be seen that controller is able to track desired CoM position with sufficient precision and to maintain stability even in the presence of simulated movements of the upper body.

A computational model of the primary auditory neuron activity.

Sound translation into neural message at the first auditory synapse is of prime importance for providing organism with sound environment. Here, we compiled experimental features of the primary auditory neurons into a computational model, composed of two distinct compartments (i.e., afferent bouton and axon). Simulation of the model closely reproduces the whole biophysical properties of both excitatory post-synaptic currents and action potentials firing. This simple model provides a powerful tool to understand the synaptic disorders on the sound neural coding at the first auditory synapse.

Single-file diffusion of macroscopic charged particles.

In this paper, we study a macroscopic system of electrically interacting metallic beads organized as a sequence along an annulus. A random mechanical shaking mimics the thermal excitation. We exhibit non-Fickian diffusion (single-file diffusion) at large time. We measure the mobility of the particles and compare it to theoretical expectations. We show that our system cannot be accurately described by theories assuming only hard-sphere interactions. Its behavior is qualitatively described by a theory extended to more realistic potentials [M. Kollmann, Phys. Rev. Lett. 90, 180602 (2003)]. A correct quantitative agreement is shown and we interpret the discrepancies by the violation of the assumption of overdamped dynamics, which is a key point in the theory. We recast previous results on colloids with known interaction potentials and compare them quantitatively to the theory. Focusing on the transition between ordinary and single-file diffusions, we exhibit a dimensionless crossover time that is of order 1 both for colloids and our system, although the time and length scales differ by several orders of magnitude.

Single-file diffusion of interacting particles in a finite-sized channel.

We study the dynamics of charged macroscopic particles (millimetric steel balls) confined in a linear channel of finite length, sufficiently narrow to avoid particles crossing. We show that their individual response to thermal fluctuations strongly depends either on their position in the channel or the local potential they experience. Three different dynamical regimes are identified. At small times, a "free regime" takes place, with the outermost particles exhibiting the highest diffusion coefficient. This effect results from an "echo" of the thermal fluctuations reflected by the channel wall. Then, forbidden crossing induces a correlated regime similar to single file diffusion. Surprisingly, the corresponding mobility increases with the local potential. Lastly, the finite length of the channel induces the saturation of fluctuations. We show that those behaviors may be described heuristically with the help of models for N hard-core interacting particles diffusing in a finite channel of length L, provided that we replace the uniform interparticle distance L/N by a characteristic distance (k(B)T/K)(1/2) built upon the temperature T and the stiffness K of the local potential. It provides a very satisfactory estimate for the fluctuations sizes, whereas they are greatly overestimated assuming hard-core interactions.

[Ochronosis or black cartilage disease]. / L'ochronose ou la maladie du cartilage noir.

We report two cases of ochronosis. This rare disease (1/1,000,000) transmitted by recessive autosomic inheritance results from an enzyme disorder. Clinically, the disease begins by black deposits in connective tissue followed by a group of symptoms, particularly involving the joints, and then destructive joint disease affecting the larger joints. Diagnosis is often established late. Early detection is important, preoperatively if possible, in order to avoid the serious complication of infectious endocarditis. These patients require adapted multidisciplinary care associating social support and symptomatic treatment. Drug therapy is currently under study and appears to provide effective symptom relief.

Safety of Oxygreen, an ozone treatment on wheat grains. Part 2. Is there a substantial equivalence between Oxygreen-treated wheat grains and untreated wheat grains?

The Oxygreen process is a new process based on wheat grain treatment by ozone (produced in situ), in a closed sequential batch reactor. The Oxygreen process offers a close, homogeneous, and controlled contact between the gas and the grain. It is proposed for use for wheat grain decontamination (insects, fungi, bacteria, mycotoxins, pesticides). It takes place in classical milling diagram, and occurs after grain cleaning and before milling. The aim of the study reported here was to determine if Oxygreen treatment could induce in the grain the formation of processing-related compounds, and if these compounds are specific or could be recognized as classical modifications already used in the cereal industry (milling, baking). Studies were performed in order to evaluate any effect of Oxygreen treatment on vitamins, ferulic acid, phytates, proteins, carbohydrates, and lipids. It was concluded that there was no detectable substantial difference between ozone-treated grains and the untreated ones, although some quantitative differences can occur. The more detectable differences concern concentration of free sugars, and inhibition of some oxidative enzymes. These quantitative differences are very slight compared to the modifications that occur in dough, after addition of oxidative products directly in flour, or during kneading and dough fermentation.

Safety of Oxygreen, an ozone treatment on wheat grains. Part 1. A four-week toxicity study in rats by dietary administration of treated wheat.

The Oxygreen process is a new treatment approved by The French Food Safety Authority (AFSSA) as a processing aid for flour quality improvement, based on treatment by ozone, in a closed sequential batch reactor. This treatment takes place in the classical milling sequence, after the grain-cleaning step and before milling. The Oxygreen process could also be used for its properties in wheat grain decontamination (insects, fungi, bacteria, mycotoxins, storage insecticides residues). The aim of this study was to determine if Oxygreen treatment could induce in the grain the formation of processing-related substances, able to provoke adverse effects, after ingestion of the wheat and/or derived products, and to establish the safety of the Oxygreen process for animals and consumers. A four-week toxicity study, according to OECD guideline No. 407, was performed on Dark agouti rats fed exclusively with wheat grains, treated or untreated with Oxygreen. Clinical, haematological, blood biochemical, urinary and histopathological parameters were investigated during the study. The few modifications observed in animals given treated wheat were an increase of rectal temperature in females, a slight decrease of calcium concentration in males and slight decrease of certain blood cell number without clinical significances. This work shows that wheat treated by Oxygreen does not induce adverse effects in Dark agouti rats after oral administration. Therefore wheat and derived products from wheat, after Oxygreen treatment on grain, could be considered as safe for the consumer.

Shearing of a confined granular layer: tangential stress and dilatancy.

We study the behavior of a confined granular layer under shearing, in an annular cell, at low velocity. We give evidence that the response of the granular layer under shearing is described by characteristic length scales. The tangential stress reaches its steady state on the same length scale as the dilatancy. Stop-and-go experiments performed at several driving velocities show a logarithmic increase of the static friction coefficient with waiting time, followed by rejuvenation on a characteristic length of the order of the magnitude of a Hertz contact between adjacent grains. The dilatancy does not evolve during the stop, neither during the elastic reloading when the driving is resumed. There is a small variation when sliding sets anew, which corresponds to the rejuvenation of the layer, and this variation is independent of the waiting time. We argue that aging is due to the behavior of individual contacts between grains, not global evolution of the piling. Under an instantaneous increase of the velocity, the tangential stress reaches a new steady state, exhibiting velocity strengthening behavior. An increase of dilatancy is also observed. It is much larger than fluctuations in the steady state, variations in a stop and-go-experiment, but much less than for shearing of freshly poured grains. The dilatancy variation during a velocity jump is not due to structural rearrangements of the piling. The evolutions of tangential stress and dilatancy are logarithmic in the ratio of upper and lower velocities.

[Delayed discovery of congenital diaphragmatic hernia: diagnostic difficulties. A report of two cases]. / Les hernies diaphragmatiques congénitales de révélation tardive: difficultés diagnostiques. A propos de deux cas.

Delayed revelation of congenital diaphragmatic hernias (CDH) is not uncommon and can represent 5-30% of total CDHs. Time before diagnosis may be prolonged, sometimes to the adult period. Respiratory and gastrointestinal symptoms are frequent but not specific. The clinical presentation of delayed CDH may thus mislead the practitioner. Diagnosis can be approached and/or confirmed by plain radiography. Outcome is usually favorable after surgery. We report two cases of delayed CDH and we discuss the difficulty of diagnosis.

Using a partial-wave method for sound-mean-flow scattering problems.

We present a semianalytical method, based on a partial-wave expansion and valid in the short wavelength limit for small Mach number flows, to analyze sound-vortical-flow interactions. It is more powerful than ray-tracing methods because it gives both amplitude and phase of the sound wave, and because it is less restrictive on the smallness of the wavelength. In contrast with the Born approximation approach, this method allows the computation of the sound field in the whole interaction domain (including the near field), and preserves energy conservation. Vortical flows with finite circulation are amenable to our analysis, which gives a satisfactory description of wave front dislocation by vorticity, in good agreement with direct numerical simulations. We extend previous versions of this method to the case of smooth vorticity profiles which are observed in aeroacoustics experiments.

Effect of covering pig slurry stores on the ammonia emission processes.

The aim of this study was to evaluate the effects of different covers (oil, plastic film, perforated polystyrene float, peat and zeolites) on slurry settling characteristics and ammonia emission during storage and following surface application in the field. Laboratory trials were carried out for 15 days using a pilot scale device. Samples of 5 kg slurry were used. At the end of the storage period, distributions of dry matter, pH, total ammoniacal nitrogen and total Kjeldahl nitrogen in slurry were characterized. In the field, ammonia volatilisation was measured for three days using a wind tunnel system. Oil and plastic film retained all ammoniacal nitrogen forms in the slurry, whereas the others reduced ammonia volatilisation by reducing the emitting surface or by adsorbing/absorbing ammonia. Over the whole process studied (storage plus application) ammonia emissions were reduced by 40% by oil up to 65-71% by zeolites with different particle sizes.

Genetic analysis of multicase families of visceral leishmaniasis in northeastern Brazil: no major role for class II or class III regions of HLA.

Familial aggregation, high relative risk to siblings, and segregation analysis, suggest genetic control of visceral leishmaniasis in Brazil. Class II gene effects in mice, and high circulating tumour necrosis factor alpha in humans, provide reasons to target HLA. Fifteen polymorphic markers across 1.03 Mb (DQB1 to TNFa) were genotyped (87 multicase families; 638 individuals). Model-based parametric analyses using single-point combined segregation and linkage in COMDS, or multi-point linkage in ALLEGRO, failed to detect linkage. Model-free nonparametric affected sibling pair (SPLINK) or NPL(all) score (ALLEGRO) analyses also failed to detect linkage. Information content mapping confirmed sufficient marker information to detect linkage. Analysis of simulated data sets demonstrated that these families had 100% power to detect NPL(all) scores of 5 to 6 (>LOD4; P < 0.00001) over the range (7% to 61%) of age-related penetrances for a disease susceptibility gene. The extended transmission disequilibrium test (TDT) showed no consistent allelic associations between disease and the 15 loci. TDT also failed to detect significant associations between extended haplotypes and disease, consistent with failure to detect significant linkage disequilibrium across the region. Linkage disequilibrium between adjacent groups of markers (HLADQ/DR; 82-1/82-3/-238bpTNFA; LTA/62/TNFa) was not accompanied by significant global haplotype TDT associations with disease. The data suggest that class II/III regions of HLA do not contain major disease gene(s) for visceral leishmaniasis in Brazil.

Normal-mode-vortex interactions.

Standing surface waves that interact with a confined, vertical, vorticity field with zero net circulation are studied both analytically and experimentally. The surface waves are generated by vertical vibration, and constant vorticity injection is achieved by a rotating disk flush mounted in the cell. Experimental results are indicative of a local wave-vortex interaction (no dislocation), and a simple theoretical model is able to explain them in quantitative detail.

Efficacy of macrolides vs. metronidazole against Entamoeba histolytica clinical isolates.

Current treatment of Entamoeba histolytica infection requires the use of several agents that are effective at different sites of the body. Commonly administered agents such as nitroimidazoles have a high rate of gastrointestinal side effects and their use is restricted during pregnancy. In order to offer new choices, four macrolide antibiotics (erythromycin, clarithromycin, azithromycin, josamycin) and metronidazole were tested for their in vitro activity against E. histolytica. Ten clinically isolated strains from an endemic area (Santo Domingo, Dominican Republic) were tested after polyxenical culture. Protozoan viability was significantly reduced by josamycin after 24 and 48 hours of incubation at a concentration of > or = 50 mg/l, which was slightly higher than that of metronidazole (25 mg/l). No resistance to metronidazole was found. The antiamebic activity of azithromycin, clarithromycin and erythromycin was significant at drug concentrations > or = 100 mg/l. High doses of josamycin, which is a very well tolerated drug, may serve as a useful therapeutic agent in the presence of E. histolytica infection.

Kinetics of chemical degradation of isoxaflutole: influence of the nature of aqueous buffers (alkanoic acid/sodium salt vs phosphate).

A kinetic study of the chemical degradation of isoxaflutole (5-cyclopropyl-1,2-oxazol-4-yl alpha alpha alpha-trifluoro-2-mesyl-p-tolyl ketone) into its diketonitrile derivative (DKN), which is its active herbicide principle, in organic buffers at different pH values was carried out using a HPLC/UV detection method. The values of the pseudo-first-order rate constants Kobs for the reaction were calculated and compared with those previously obtained in inorganic buffers. In both cases, Kobs was found to be dependent on pH and temperature, but at pH 5.2 the degradation of isoxaflutole in CH3COOH/CH3COONa buffers was considerably faster than in KH2PO4/Na2HPO4 buffers, indicating that the compound was sensitive to the nature of the reagents used to prepare buffered solutions. The influence of phosphate and acetate concentrations and the influence of the R-substituent in RCOOH/RCOONa buffers were investigated. For the HA/A- buffers studied, the values of Kobs were linearly dependent on HA and A- concentrations, which meant that the degradation of isoxaflutole was subject to general catalysis. The values of Kobs were also found to be dependent on the number and the position of the CH3 groups of the R-substituent. The known degradation product of DKN (a benzoic acid derivative) was not detected throughout this study.