Development of a Mobile Phone App for Measuring Striking Response Time in Combat Sports: Cross-Sectional Validation Study.

BACKGROUND: TReaction is a mobile app developed to determine strike response time at low cost and with easy application in combat sports. However, the validity and accuracy of the response time obtained by the TReaction app has not yet been evaluated. OBJECTIVE: This study aimed to test the validity and reliability of the TReaction app in measuring motor response time in combat sports. METHODS: A total of two athletes performed 59 strikes to assess the response time upon visual stimulus using the TReaction app simultaneously with a high-speed camera. Accuracy of the measure was verified using a computer simulator programmed to discharge visual stimuli and obtain the response time. Pearson correlation, Student t test for dependent samples, and the Bland-Altman analysis were performed. Accuracy was verified using the intraclass correlation coefficient. Effect size (g) and the typical error of measurement (TEM) were calculated. The significance level was set at P<.05. RESULTS: No significant difference (P=.56) was found between both systems. The methods presented a very strong correlation (r=0.993). The magnitude of differences was trivial (g<0.25), and TEM was 1.4%. These findings indicate a high accuracy between the computer screen and the mobile app measures to determine the beginning of the task and the response time. CONCLUSIONS: Our findings suggest that the TReaction app is a valid tool to evaluate the response time in combat sports athletes.

A study of reproducibility of kinesiology tape applications: review, reliability and validity.

BACKGROUND: Literature addressing the mechanical properties of kinesiology tape is quite scarce. There are no studies which focus on the mechanical characteristics of kinesiology tape, its mechanical properties, nor its adherence following the ISO international standard test methods for tape elongation. METHODS: This study quantified the mechanical characteristics of 380 samples of kinesiology tape from 19 different brands and in 4 different colors using a dynamometer. Mechanical testing was controlled by UNE EN ISO 13934-1. RESULTS: Significant differences were found between tape brands in terms of grammage, maximum force tenacity, work, pre-elongation and percentage elongation (P < .001). Regarding kinesiology tape color, statistically significant differences were found between tape brands in terms of grammage, maximum force and tenacity (P < .001), work and pre-elongation (P < .05). When adherence was studied, statistically significant differences were found between tape brands in terms of maximum force and work (P < .001). CONCLUSIONS: The different kinesiology tapes presented different behaviors with regard to rupture and removal when applied to skin in dry state, wet state and after being submerged in artificial acidic sweat solution. Therefore, different kinesiology tape brands will produce different levels of strain even though the same elongation is used. Depending on the characteristics (body dimensions) and properties (skin elongation) of each subject in the sample, bandages with different elongations must be applied to achieve the same strain in all of the tapes and therefore produce the same effect. The absence of these data at this time limits the reliability of previous clinical studies, makes comparing their findings impossible and presents new challenges for research in this field.

Comparison of the performance of battery-operated fluid warmers.

OBJECTIVES: Warming intravenous fluids is essential to prevent hypothermia in patients with trauma, especially when large volumes are administered. Prehospital and transport settings require fluid warmers to be small, energy efficient and independent of external power supply. We compared the warming properties and resistance to flow of currently available battery-operated fluid warmers. METHODS: Fluid warming was evaluated at 50, 100 and 200 mL/min at a constant input temperature of 20°C and 10°C using a cardiopulmonary bypass roller pump and cooler. Output temperature was continuously recorded. RESULTS: Performance of fluid warmers varied with flows and input temperatures. At an input temperature of 20°C and flow of 50 mL/min, the Buddy Lite, enFlow, Thermal Angel and Warrior warmed 3.4, 2.4, 1 and 3.6 L to over 35°C, respectively. However, at an input temperature of 10°C and flow of 200 mL/min, the Buddy Lite failed to warm, the enFlow warmed 3.3 L to 25.7°C, the Thermal Angel warmed 1.5 L to 20.9°C and the Warrior warmed 3.4 L to 34.4°C (p<0.0001). CONCLUSION: We found significant differences between the fluid warmers: the use of the Buddy Lite should be limited to moderate input temperature and low flow rates. The use of the Thermal Angel is limited to low volumes due to battery capacity and low output temperature at extreme conditions. The Warrior provides the best warming performance at high infusion rates, as well as low input temperatures, and was able to warm the largest volumes in these conditions.

Development of new hard hat dimensions using user-centered design approach among oil palm harvesters.

BACKGROUND: Hard hats are among the personal protective equipment (PPE) used in many industries to reduce the impact of any falling object on the skull and also to prevent head and brain injuries. However, the practice of wearing a safety helmet during working hours is still low. This is due to the physical discomfort perceived by safety helmet users. OBJECTIVE: Given the unpopularity of the current hard hat, the general perception of workers concerning its use and its measurements are the determining factors in the development of a new hard hat. METHOD: A cross-sectional study was conducted in which 132 male oil palm harvesters between 19 and 60 years of age were selected from among the employees of the same oil palm harvesting company. A set of questionnaires was developed to collect their socio-demographic information as well as their perceptions of comfort and the prevalence of head injury. In addition, a set of measuring instruments, including Martin's anthropometry set, was used for head measurement and data collection in respect of the current hard hat. In this research, six respondents were randomly selected to attend an interview session for qualitative assessment.RESULTSBased on the questionnaires, the unpopularity in the use of the hard hat was largely influenced by factors related to poor design, in general, and, specifically, poor ventilation (64%), load (67% ), and physical discomfort (42% ). The measurements of the anthropometric parameters and the dimensions of the hard hat also showed a significant mismatch. CONCLUSION: The unpopularity of the current hard hat among oil palm harvesters stemmed from the discomfort from wearing, which showed that the development of a new hard hat could lead to better usage and the greater likelihood of wearing a hard hat throughout the working day.

A review of machines and devices to potentize homeopathic medicines.

BACKGROUND: Potentization, consisting of serial dilution and succussion, is a key step in the manufacture of homeopathic medicines. Originally prescribed as a manual process, several attempts at mechanization have been published, patented and even commercialised in order to remove the human element and introduce reproducibility without drudgery. Various machines have been used over the years to prepare homeopathic medicines. Although these machines follow the same principles, i.e. energetically mixing the medicines and diluting them significantly, their mode of operation is different from each other. METHODS: This review paper surveys the main methods of preparation of homeopathic medicines. The main machines discussed are: Boericke's potentizer, Tyler Kent's instrument, John Alphonse's machine and the fluxion potentizer, which were used in the past, as well as more recent potentizers like arm-and-weight instruments, the K-Tronic potentizer and Quinn's machine. We review the construction and operating principle of each of these machines, along with their advantages and limitations. A scheme for relative performance assessment of these machines is proposed based on the parameters mechanical efficiency, physico-chemical efficiency, turbulence generation, energy dissipation, and accuracy of dilution. RESULTS: Quinn's machine and the arm-and-weight potentizer perform well for generating turbulence due to high impaction forces, while John Alphonse's machine is much more accurate in diluting the homeopathic medicines at every step. CONCLUSIONS: Both the commercial potentizers, Quinn's machine and the K-Tronic potentizer, are completely automated and therefore reduce the manual labour and variation in succussive forces during each step, which may produce uniformity in physico-chemical changes within the resulting homeopathic medicines.

Analysis of Al2O3-parylene C bilayer coatings and impact of microelectrode topography on long term stability of implantable neural arrays.

OBJECTIVE: Performance of many dielectric coatings for neural electrodes degrades over time, contributing to loss of neural signals and evoked percepts. Studies using planar test substrates have found that a novel bilayer coating of atomic-layer deposited (ALD) Al2O3 and parylene C is a promising candidate for neural electrode applications, exhibiting superior stability to parylene C alone. However, initial results from bilayer encapsulation testing on non-planar devices have been less positive. Our aim was to evaluate ALD Al2O3-parylene C coatings using novel test paradigms, to rigorously evaluate dielectric coatings for neural electrode applications by incorporating neural electrode topography into test structure design. APPROACH: Five test devices incorporated three distinct topographical features common to neural electrodes, derived from the utah electrode array (UEA). Devices with bilayer (52 nm Al2O3 + 6 µm parylene C) were evaluated against parylene C controls (N ⩾ 6 per device type). Devices were aged in phosphate buffered saline at 67 °C for up to 311 d, and monitored through: (1) leakage current to evaluate encapsulation lifetimes (>1 nA during 5VDC bias indicated failure), and (2) wideband (1-105 Hz) impedance. MAIN RESULTS: Mean-times-to-failure (MTTFs) ranged from 12 to 506 d for bilayer-coated devices, versus 10 to >2310 d for controls. Statistical testing (log-rank test, α = 0.05) of failure rates gave mixed results but favored the control condition. After failure, impedance loss for bilayer devices continued for months and manifested across the entire spectrum, whereas the effect was self-limiting after several days, and restricted to frequencies <100 Hz for controls. These results correlated well with observations of UEAs encapsulated with bilayer and control films. SIGNIFICANCE: We observed encapsulation failure modes and behaviors comparable to neural electrode performance which were undetected in studies with planar test devices. We found the impact of parylene C defects to be exacerbated by ALD Al2O3, and conclude that inferior bilayer performance arises from degradation of ALD Al2O3 when directly exposed to saline. This is an important consideration, given that neural electrodes with bilayer coatings are expected to have ALD Al2O3 exposed at dielectric boundaries that delineate electrode sites. Process improvements and use of different inorganic coatings to decrease dissolution in physiological fluids may improve performance. Testing frameworks which take neural electrode complexities into account will be well suited to reliably evaluate such encapsulation schemes.

A multiport MR-compatible neuroendoscope: spanning the gap between rigid and flexible scopes.

OBJECTIVE Rigid endoscopes enable minimally invasive access to the ventricular system; however, the operative field is limited to the instrument tip, necessitating rotation of the entire instrument and causing consequent tissue compression while reaching around corners. Although flexible endoscopes offer tip steerability to address this limitation, they are more difficult to control and provide fewer and smaller working channels. A middle ground between these instruments-a rigid endoscope that possesses multiple instrument ports (for example, one at the tip and one on the side)-is proposed in this article, and a prototype device is evaluated in the context of a third ventricular colloid cyst resection combined with septostomy. METHODS A prototype neuroendoscope was designed and fabricated to include 2 optical ports, one located at the instrument tip and one located laterally. Each optical port includes its own complementary metal-oxide semiconductor (CMOS) chip camera, light-emitting diode (LED) illumination, and working channels. The tip port incorporates a clear silicone optical window that provides 2 additional features. First, for enhanced safety during tool insertion, instruments can be initially seen inside the window before they extend from the scope tip. Second, the compliant tip can be pressed against tissue to enable visualization even in a blood-filled field. These capabilities were tested in fresh porcine brains. The image quality of the multiport endoscope was evaluated using test targets positioned at clinically relevant distances from each imaging port, comparing it with those of clinical rigid and flexible neuroendoscopes. Human cadaver testing was used to demonstrate third ventricular colloid cyst phantom resection through the tip port and a septostomy performed through the lateral port. To extend its utility in the treatment of periventricular tumors using MR-guided laser therapy, the device was designed to be MR compatible. Its functionality and compatibility inside a 3-T clinical scanner were also tested in a brain from a freshly euthanized female pig. RESULTS Testing in porcine brains confirmed the multiport endoscope's ability to visualize tissue in a blood-filled field and to operate inside a 3-T MRI scanner. Cadaver testing confirmed the device's utility in operating through both of its ports and performing combined third ventricular colloid cyst resection and septostomy with an endoscope rotation of less than 5°. CONCLUSIONS The proposed design provides freedom in selecting both the number and orientation of imaging and instrument ports, which can be customized for each ventricular pathological entity. The lightweight, easily manipulated device can provide added steerability while reducing the potential for the serious brain distortion that happens with rigid endoscope navigation. This capability would be particularly valuable in treating hydrocephalus, both primary and secondary (due to tumors, cysts, and so forth). Magnetic resonance compatibility can aid in endoscope-assisted ventricular aqueductal plasty and stenting, the management of multiloculated complex hydrocephalus, and postinflammatory hydrocephalus in which scarring obscures the ventricular anatomy.

Construction and Evaluation of Rodent-Specific rTMS Coils.

Rodent models of transcranial magnetic stimulation (TMS) play a crucial role in aiding the understanding of the cellular and molecular mechanisms underlying TMS induced plasticity. Rodent-specific TMS have previously been used to deliver focal stimulation at the cost of stimulus intensity (12 mT). Here we describe two novel TMS coils designed to deliver repetitive TMS (rTMS) at greater stimulation intensities whilst maintaining spatial resolution. Two circular coils (8 mm outer diameter) were constructed with either an air or pure iron-core. Peak magnetic field strength for the air and iron-cores were 90 and 120 mT, respectively, with the iron-core coil exhibiting less focality. Coil temperature and magnetic field stability for the two coils undergoing rTMS, were similar at 1 Hz but varied at 10 Hz. Finite element modeling of 10 Hz rTMS with the iron-core in a simplified rat brain model suggests a peak electric field of 85 and 12.7 V/m, within the skull and the brain, respectively. Delivering 10 Hz rTMS to the motor cortex of anaesthetized rats with the iron-core coil significantly increased motor evoked potential amplitudes immediately after stimulation (n = 4). Our results suggest these novel coils generate modest magnetic and electric fields, capable of altering cortical excitability and provide an alternative method to investigate the mechanisms underlying rTMS-induced plasticity in an experimental setting.

Scanning electron microscopy of chronically implanted intracortical microelectrode arrays in non-human primates.

OBJECTIVE: Signal attenuation is a major problem facing intracortical sensors for chronic neuroprosthetic applications. Many studies suggest that failure is due to gliosis around the electrode tips, however, mechanical and material causes of failure are often overlooked. The purpose of this study was to investigate the factors contributing to progressive signal decline by using scanning electron microscopy (SEM) to visualize structural changes in chronically implanted arrays and histology to examine the tissue response at corresponding implant sites. APPROACH: We examined eight chronically implanted intracortical microelectrode arrays (MEAs) explanted from non-human primates at times ranging from 37 to 1051 days post-implant. We used SEM, in vivo neural recordings, and histology (GFAP, Iba-1, NeuN). Three MEAs that were never implanted were also imaged as controls. MAIN RESULTS: SEM revealed progressive corrosion of the platinum electrode tips and changes to the underlying silicon. The parylene insulation was prone to cracking and delamination, and in some instances the silicone elastomer also delaminated from the edges of the MEA. Substantial tissue encapsulation was observed and was often seen growing into defects in the platinum and parylene. These material defects became more common as the time in vivo increased. Histology at 37 and 1051 days post-implant showed gliosis, disruption of normal cortical architecture with minimal neuronal loss, and high Iba-1 reactivity, especially within the arachnoid and dura. Electrode tracts were either absent or barely visible in the cortex at 1051 days, but were seen in the fibrotic encapsulation material suggesting that the MEAs were lifted out of the brain. Neural recordings showed a progressive drop in impedance, signal amplitude, and viable channels over time. SIGNIFICANCE: These results provide evidence that signal loss in MEAs is truly multifactorial. Gliosis occurs in the first few months after implantation but does not prevent useful recordings for several years. Progressive meningeal fibrosis encapsulates and lifts MEAs out of the cortex while ongoing foreign body reactions lead to progressive degradation of the materials. Long-term impedance drops are due to the corrosion of platinum, cracking and delamination of parylene, and delamination of silicone elastomer. Oxygen radicals released by cells of the immune system likely mediate the degradation of these materials. Future MEA designs must address these problems through more durable insulation materials, more inert electrode alloys, and pharmacologic suppression of fibroblasts and leukocytes.

Reliability of transcutaneous bilirubin devices in preterm infants: a systematic review.

BACKGROUND AND OBJECTIVE: Transcutaneous bilirubin (TcB) devices are widely used for the estimation of serum bilirubin levels in term and near-term infants. Our objective was to review the diagnostic accuracy of TcB devices in preterm infants. METHODS: Medline, Embase, Cochrane library, Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched (from database inception date until December 2012). Additional citations were identified by using the bibliographies of selected articles and from conference proceedings. The studies were included if they compared TcB with total serum bilirubin in preterm infants before phototherapy and presented data as correlation coefficients or as Bland-Altman difference plots. Data were extracted by 1 reviewer and checked for accuracy by the second reviewer. An assessment tool (quality assessment of diagnostic accuracy studies) was used for risk of bias assessments. RESULTS: Twenty-two studies met the inclusion criteria; 21 studies reported results as correlation coefficients, with pooled estimates of r = 0.83 for each site of measurement. Pooled estimates in infants <32 weeks' gestation were similar to the overall preterm population (r = 0.89 [95% confidence interval: 0.82-0.93]). For the 2 commonly used TcB devices (ie, JM103 and BiliCheck), the results were comparable at the forehead site, although the JM103 device exhibited better correlation at the sternum. Analysis of the Bland-Altman plots (13 studies) revealed negligible bias in measurement at the forehead or sternum site by using either the JM-103 or BiliCheck device; however, the JM-103 device exhibited better precision than the BiliCheck (SD for TcB - total serum bilirubin differences: 24.3 and 31.98 µmol/L, respectively). CONCLUSIONS: The TcB devices reliably estimated bilirubin levels in preterm infants and could be used in clinical practice to reduce blood sampling.

[Path to the execution of explorative clinical researches in National Cerebral and Cardiovascular Center (NCVC)].

In the Ministry of Health, Labour and Welfare's (MHLW) "5-year plan for activating clinical trials", we have put in place the infrastructure including human resources for supporting not only commercial clinical trials but also those initiated by academic researchers, including clinical research coordinator (CRC) support and consultation for planning clinical trial with biostatistician. We also prepared a data management unit and trained data managers for academic clinical trials. In 2011, the National Cerebral and Cardiovascular Center (NCVC) was selected one of the sites of the MHLW project of structure improvement to execute early phase clinical trials. To clinically develop medical devices invented by the NCVC researchers involved in the project, animal experiments which meet the GLP standards must be finished before the first-in-human clinical trial. We are planning to create the units containing human resources for developing medical devices such as professionals in regulatory affairs, safety tests, and Good Laboratory Practice (GLP) systems. Creation of a smooth pathway from the preclinical to the clinical phases will be key to the efficient development of new medical devices.

Paralympic sports medicine--current evidence in winter sport: considerations in the development of equipment standards for paralympic athletes.

OBJECTIVE: To highlight and discuss the considerations for the future development of equipment standards for Winter Paralympic sports. DATA SOURCES: Literature searches were performed (in English) during May 2011 using the key words "technology, winter sport, Olympic, and Paralympic" in the computerized databases PubMed, PsycINFO, Science Direct, and Google Scholar. In addition, personal scientific observations were made at several Winter Paralympic Games. The retrieved articles were screened and assessed for relevance to the biological, biomechanical, and sport medicine aspects of equipment. MAIN RESULTS: There are 3 key areas in which technology has influenced sports performance in Paralympic winter sports, namely, specialized prostheses, crutch skis or outriggers (in lieu of poles), and sport-specific wheelchairs (such as the sit-ski). From a sport medicine perspective, a crucial factor not considered in the standard laboratory test of mechanical efficiency is the influence of the human-equipment connection, such as the stump-to-prosthesis interface or the required human-to-wheelchair control. This connectivity is critical to the effective operation of the assistive device. When assessing the efficiency of this equipment, the not-so-obvious, holistic, compensatory factors need to be considered. CONCLUSIONS: Assistive equipment is fundamental for a person with a disability to participate and compete in winter sport activities. Although there have been improvements in the mechanical function of some assistive devices, the key issue is matching the residual function of the person with the assistive equipment. Equitable access to this technology will also ensure that the fundamental spirit of fair play that underpins the Paralympic Games is maintained.

A hyperbaric oxygen chamber for animal experimental purposes.

Facilities for hyperbaric oxygen therapy that are suitable for animal experimental research are scarce. In this paper, the authors introduce a hyperbaric oxygen chamber that was developed specifically for animal experimental purposes. The hyperbaric oxygen chamber was designed to meet a number of criteria regarding safety and ease of use. The hyperbaric oxygen chamber conforms to 97/23/EC (Pressure Equipment Directive), Conformity Assessment Module G Product Group 1. It provides easy access, and can be run in manual mode, semi-automatic mode and full-automatic mode. Sensors for pressure level, oxygen level, temperature, humidity and carbon dioxide level allow full control. This state-of-the-art hyperbaric oxygen chamber for animal experimental purposes permits the investigation of the biological mechanisms through which hyperbaric oxygen therapy acts at a fundamental level.

Why do pedometers work?: a reflection upon the factors related to successfully increasing physical activity.

The results of two recent independent meta-analyses focused on pedometer-based programmes conclude that they work; that is, they are effective. Specifically, physical activity increases while blood pressure and weight decrease as a result of participating in a pedometer-based intervention. An improved understanding of the unique measurement and motivational properties of pedometers as behaviour-change tools will assist researchers and practitioners to maximize benefits. In an effort to begin to outline why pedometers work, for whom, and under what conditions, the purpose of this current opinion article is to explore the published literature (drawing heavily from those studies previously identified in published meta-analyses and our own work in this area) to identify factors related to using pedometers to increase physical activity. In particular it is important to: (i) gain a better understanding of the activity-promoting characteristics of pedometers; (ii) determine effective elements of pedometer-based programming; and (iii) identify participants who engage in, and benefit most from, such programming. Pedometers are most sensitive to walking behaviours, which is consistent with public health and clinical approaches to increasing physical activity. Specifically, they offer an affordable and accessible technology that is simplistic in output, low-literacy friendly, and immediately understandable to end-users. Support materials are becoming readily available for researchers and practitioners in terms of expected (normative or benchmark) values, patterns of change, indices to aid screening and interpretation, and measurement protocols. Pedometer-based programme theory is now being articulated and tested, and the critical elements necessary to shape a successful programme are becoming more clearly defined. More research is needed, however, to compare the effectiveness of self-selected individualized goals with tailored goals (based on a specified baseline characteristic, for example), standardized goals (e.g. percentage-based increments) and pre-set uniformly administered goals (i.e. a volume total of 10 000 steps/day or an incremental total of 2000 extra steps/day for everyone). Since most studies of pedometer-based programmes have been of relatively short duration, it is unknown to what extent observed changes are sustainable or whether it is possible to continue to accrue benefits over long-term adherence. Peer delivery of treatment has the potential for enabling wider and less costly dissemination, although this has not been directly evaluated. In addition, the majority of pedometer-based programme participants to date have been women, suggesting that more research is needed on men and how they react to this form of physical activity intervention. Increases in steps/day have been negatively correlated with baseline values, indicating that those with lower baseline steps/day stand to make the greatest relative incremental increases in physical activity behaviour. A clearly articulated programme theory is lacking in most interventions. A clearer understanding is needed of what programme features, including the nature of goal-setting, are necessary for optimal participant success. Additionally, we need a better profile of the participant who benefits most, and/or requires additional or alternative strategies to succeed in their personal behaviour-change attempts. Continued efforts to refine answers regarding what works well for whom under what conditions will foster evidence-based applications of pedometer-based programmes.

Decision process to assess medical equipment for hyperbaric use.

There are very few items of medical equipment specifically designed for hyperbaric use; and little information is available about medical equipment already tested for hyperbaric use. Hyperbaricists are usually left to their own devices in making a determination about the safe and effective use of standard medical equipment in the hyperbaric setting. This article proposes a logical and systematic process to arrive at this determination. The process involves seven steps beginning with a need assessment and ending with endorsement by appropriate individuals. The discussion of decision steps includes identifying risk elements, compliance with safety standards, testing, and documentation.

Performance evaluation of cylindrical fiber optic light diffusers for biomedical applications.

BACKGROUND AND OBJECTIVES: Dosimetry for intracavity and interstitial light delivery requires next to the knowledge of tissue optical properties and models describing light propagation in tissue also exact knowledge of the spatial light source emission characteristics. However, the emission characteristics of cylindrical diffusers are often ill defined by the manufacturer, and not regularly determined by the end user, thus limiting the attainable dosimetry accuracy. STUDY DESIGN/MATERIALS AND METHODS: Commercial cylindrical diffusers, with active diffusive lengths of 1-2 cm and outer diameters of