A Feasibility Study of a Novel Delayed Cord Clamping Cart.

Delaying umbilical cord clamping (DCC) for 1 min or longer following a neonate's birth has now been recommended for preterm and term newborns by multiple professional organizations. DCC has been shown to decrease rates of iron deficiency anemia, intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and blood transfusion. Despite these benefits, clinicians typically cut the umbilical cord without delay in neonates requiring resuscitation and move them to a radiant warmer for further care; this effectively prevents these patients from receiving any benefits from DCC. This study evaluated the feasibility of a delayed cord clamping cart (DCCC) in low-risk neonates born via Cesarean section (CS). The DCCC is a small, sterile cart designed to facilitate neonatal resuscitation while the umbilical cord remains intact. The cart is cantilevered over the operating room (OR) table during a CS, allowing the patient to be placed onto it immediately after birth. For this study, a sample of 20 low-risk CS cases were chosen from the non-emergency Labor and Delivery surgical case list. The DCCC was utilized for 1 min of DCC in all neonates. The data collected included direct observation by research team members, recorded debriefings and surveys of clinicians as well as surveys of patients. Forty-four care team members participated in written surveys; of these, 16 (36%) were very satisfied, 12 (27%) satisfied, 13 (30%) neutral, and 3 (7%) were somewhat dissatisfied with use of the DCCC in the OR. Feedback was collected from all 20 patients, with 18 (90%) reporting that they felt safe with the device in use. This study provides support that utilizing a DCCC can facilitate DCC with an intact umbilical cord.

A split-crank bicycle ergometer uses servomotors to provide programmable pedal forces for studies in human biomechanics.

This paper presents a novel computer-controlled bicycle ergometer, the TiltCycle, for use in human biomechanics studies of locomotion. The TiltCycle has a tilting (reclining) seat and backboard, a split pedal crankshaft to isolate the left and right loads to the feet of the pedaler, and two belt-driven, computer-controlled motors to provide assistance or resistance loads independently to each crank. Sensors measure the kinematics and force production of the legs to calculate work performed, and the system allows for goniometric and electromyography signals to be recorded. The technical description presented includes the mechanical design, low-level software and control algorithms, system identification and validation test results.

Automated Constraint-Induced Therapy Extension (AutoCITE) for movement deficits after stroke.

We report progress in the development of AutoCITE, a workstation that delivers the task practice component of upper-limb Constraint-Induced Movement therapy and that can potentially be used in the clinic or the home without the need for one-on-one supervision from a therapist. AutoCITE incorporates a computer and eight task devices arranged on a modified cabinet. Task performance is automatically recorded, and several types of feedback are provided. In preliminary testing, nine chronic stroke subjects with mild to moderate motor deficits practiced with AutoCITE for 3 h each weekday for 2 weeks. Subjects wore a padded mitt on the less-affected hand for a target of 90% of their waking hours. In terms of effect sizes, gains were large and significant on the Motor Activity Log, and moderate to large on the Wolf Motor Function Test. These gains were comparable to the gains of a matched group of 12 subjects who received standard Constraint-Induced Movement therapy.

Dynamic exercise imaging with an MR-compatible stationary cycle within the general electric open magnet.

Many cases of muscular ischemia do not manifest without increased metabolic demand. Hence, diagnosis of intermittent claudication often requires inducing physiologic challenge, such as by exercise. Cine phase-contrast MRI can concurrently acquire cross-sectional vascular anatomy and through-plane blood velocities, enabling blood flow rate quantification. An MR-compatible stationary cycle was designed, constructed, and tested for flow quantification in large arteries during lower-limb exercise in a General Electric Signa SP 0.5 T open magnet. The cycle demonstrated smooth cycling during image acquisition, has freewheeling capability, is adjustable for subject size and strength, and can quantify workload. A healthy 59-year-old male was imaged at the supraceliac and infrarenal levels of the abdominal aorta at rest and during exercise. An exercise workload of 47.9 W was achieved. His heart rate increased from 52 to 78 bpm, supraceliac flow increased from 1.7 to 3.7 L/min, and infrarenal flow increased from 0.4 to 3.2 L/min from rest to exercise.