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1.
Front Bioeng Biotechnol ; 12: 1389031, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827035

RESUMO

Introduction: Surgical planning and custom prosthesis design for pelvic cancer patients are challenging due to the unique clinical characteristics of each patient and the significant amount of pelvic bone and hip musculature often removed. Limb-sparing internal hemipelvectomy surgery with custom prosthesis reconstruction has become a viable option for this patient population. However, little is known about how post-surgery walking function and neural control change from pre-surgery conditions. Methods: This case study combined comprehensive walking data (video motion capture, ground reaction, and electromyography) with personalized neuromusculoskeletal computer models to provide a thorough assessment of pre- to post-surgery changes in walking function (ground reactions, joint motions, and joint moments) and neural control (muscle synergies) for a single pelvic sarcoma patient who received internal hemipelvectomy surgery with custom prosthesis reconstruction. Pre- and post-surgery walking function and neural control were quantified using pre- and post-surgery neuromusculoskeletal models, respectively, whose pelvic anatomy, joint functional axes, muscle-tendon properties, and muscle synergy controls were personalized using the participant's pre-and post-surgery walking and imaging data. For the post-surgery model, virtual surgery was performed to emulate the implemented surgical decisions, including removal of hip muscles and implantation of a custom prosthesis with total hip replacement. Results: The participant's post-surgery walking function was marked by a slower self-selected walking speed coupled with several compensatory mechanisms necessitated by lost or impaired hip muscle function, while the participant's post-surgery neural control demonstrated a dramatic change in coordination strategy (as evidenced by modified time-invariant synergy vectors) with little change in recruitment timing (as evidenced by conserved time-varying synergy activations). Furthermore, the participant's post-surgery muscle activations were fitted accurately using his pre-surgery synergy activations but fitted poorly using his pre-surgery synergy vectors. Discussion: These results provide valuable information about which aspects of post-surgery walking function could potentially be improved through modifications to surgical decisions, custom prosthesis design, or rehabilitation protocol, as well as how computational simulations could be formulated to predict post-surgery walking function reliably given a patient's pre-surgery walking data and the planned surgical decisions and custom prosthesis design.

2.
Front Neurosci ; 18: 1249783, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562307

RESUMO

Introduction: Plantar cutaneous augmentation is a promising approach in balance rehabilitation by enhancing motion-dependent sensory feedback. The effect of plantar cutaneous augmentation on balance has been mainly investigated in its passive form (e.g., textured insole) or on lower-limb amputees. In this study, we tested the effect of plantar cutaneous augmentation on balance in its active form (i.e., electrical stimulation) for individuals with intact limbs. Methods: Ten healthy subjects participated in the study and were instructed to maintain their balance as long as possible on the balance board, with or without electrotactile feedback evoked on the medial side of the heel, synched with the lateral board sway. Electrotactile feedback was given in two different modes: 1) Discrete-mode E-stim as the stimulation on/off by a predefined threshold of lateral board sway and 2) Proportional-mode E-stim as the stimulation frequency proportional to the amount of lateral board sway. All subjects were distracted from the balancing task by the n-back counting task, to test subjects' balancing capability with minimal cognitive involvement. Results: Proportional-mode E-stim, along with the n-back counting task, increased the balance time from 1.86 ± 0.03 s to 1.98 ± 0.04 s (p = 0.010). However, discrete-mode E-stim did not change the balance time (p = 0.669). Proportional-mode E-stim also increased the time duration per each swayed state (p = 0.035) while discrete-mode E-stim did not (p = 0.053). Discussion: These results suggest that proportional-mode E-stim is more effective than discrete-mode E-stim on improving standing balance. It is perhaps because the proportional electrotactile feedback better mimics the natural tactile sensation of foot pressure than its discrete counterpart.

3.
Front Neurol ; 15: 1286856, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38450075

RESUMO

Purpose: Evidence suggests that transcranial direct current stimulation (tDCS) can enhance motor performance and learning of hand tasks in persons with chronic stroke (PCS). However, the effects of tDCS on the locomotor tasks in PCS are unclear. This pilot study aimed to: (1) determine aggregate effects of anodal tDCS combined with step training on improvements of the neural and biomechanical attributes of stepping initiation in a small cohort of persons with chronic stroke (PCS) over a 4-week training program; and (2) assess the feasibility and efficacy of this novel approach for improving voluntary stepping initiation in PCS. Methods: A total of 10 PCS were randomly assigned to one of two training groups, consisting of either 12 sessions of VST paired with a-tDCS (n = 6) or sham tDCS (s-tDCS, n = 4) over 4 weeks, with step initiation (SI) tests at pre-training, post-training, 1-week and 1-month follow-ups. Primary outcomes were: baseline vertical ground reaction force (B-vGRF), response time (RT) to initiate anticipatory postural adjustment (APA), and the retention of B-VGRF and RT. Results: a-tDCS paired with a 4-week VST program results in a significant increase in paretic weight loading at 1-week follow up. Furthermore, a-tDCS in combination with VST led to significantly greater retention of paretic BWB compared with the sham group at 1 week post-training. Clinical implications: The preliminary findings suggest a 4-week VST results in improved paretic limb weight bearing (WB) during SI in PCS. Furthermore, VST combined with a-tDCS may lead to better retention of gait improvements (NCT04437251) (https://classic.clinicaltrials.gov/ct2/show/NCT04437251).

4.
Horm Metab Res ; 55(11): 771-780, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37402380

RESUMO

The influence of acute glycemic variability (GV) on early outcomes of patients after cardiac surgery remains not fully determined. We performed a systematic review and meta-analysis to evaluate the association between acute GV and in-hospital outcomes of patients after cardiac surgery. Relevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library, and Web of Science. A randomized-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. Nine cohort studies involving 16 411 patients after cardiac surgery were included in this meta-analysis. Pooled results showed that a high acute GV was associated with an increased risk of major adverse events (MAE) during hospitalization for patients after cardiac surgery [odds ratio [OR]: 1.29, 95% CI: 1.15 to 1.45, p<0.001, I22=38%]. Sensitivity analysis limited to studies of on-pump surgery and GV evaluated by coefficient of variation of blood glucose showed similar results. Subgroup analysis suggested that a high acute GV was related to an increased incidence of MAE in patients after coronary artery bypass graft, but not for those after isolated valvular surgery (p=0.04), and the association was weakened after adjustment of glycosylated hemoglobin (p=0.01). Moreover, a high acute GV was also related to an increased risk of in-hospital mortality (OR: 1.55, 95% CI: 1.15 to 2.09, p=0.004; I22=0%). A high acute GV may be associated with poor in-hospital outcomes in patients after cardiac surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Hiperglicemia , Humanos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Glicemia , Hemoglobinas Glicadas , Hospitalização , Hiperglicemia/etiologia
5.
Mol Med Rep ; 28(2)2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37417365

RESUMO

The present study aimed to screen for potential biomarkers in the urine of immunoglobulin A vasculitis with nephritis (IgAVN) using parallel accumulation­serial fragmentation combined with data­independent acquisition (diaPASEF) proteomic approach. Urine proteomes of eight children with IgAVN and eight healthy children were identified by diaPASEF and all differential proteins were analyzed by Gene Ontology and Kyoto Encyclopedia of Gene and Genome. Then, the specific biomarkers of urine samples from 10 children with IgAVN, 10 children with IgAV and 10 healthy children were verified by ELISA. The present study screened 254 differential proteins from the experiment, including 190 upregulated proteins and 64 downregulated proteins. The results of the ELISA showed that the concentration of urinary zinc­alpha­2­glycoprotein (AZGP1) in children with IgAVN was significantly higher compared with that in children with IgAV and healthy children. The present study provided the potential clinical application of AZGP1 as a helpful biomarker and a potential indicator for early diagnosis of the occurrence of IgAVN.


Assuntos
Vasculite por IgA , Nefrite , Sistema Urinário , Humanos , Criança , Vasculite por IgA/diagnóstico , Proteômica , Nefrite/diagnóstico , Biomarcadores , Imunoglobulina A , Adipocinas
6.
Sensors (Basel) ; 23(5)2023 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-36904680

RESUMO

Specific emitter identification (SEI) and automatic modulation classification (AMC) are generally two separate tasks in the field of radio monitoring. Both tasks have similarities in terms of their application scenarios, signal modeling, feature engineering, and classifier design. It is feasible and promising to integrate these two tasks, with the benefit of reducing the overall computational complexity and improving the classification accuracy of each task. In this paper, we propose a dual-task neural network named AMSCN that simultaneously classifies the modulation and the transmitter of the received signal. In the AMSCN, we first use a combination of DenseNet and Transformer as the backbone network to extract the distinguishable features; then, we design a mask-based dual-head classifier (MDHC) to reinforce the joint learning of the two tasks. To train the AMSCN, a multitask cross-entropy loss is proposed, which is the sum of the cross-entropy loss of the AMC and the cross-entropy loss of the SEI. Experimental results show that our method achieves performance gains for the SEI task with the aid of additional information from the AMC task. Compared with the traditional single-task model, our classification accuracy of the AMC is generally consistent with the state-of-the-art performance, while the classification accuracy of the SEI is improved from 52.2% to 54.7%, which demonstrates the effectiveness of the AMSCN.

7.
J Neuroeng Rehabil ; 20(1): 10, 2023 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-36681852

RESUMO

BACKGROUND: Few, if any estimates of cost-effectiveness for locomotor training strategies following spinal cord injury (SCI) are available. The purpose of this study was to estimate the cost-effectiveness of locomotor training strategies following spinal cord injury (overground robotic locomotor training versus conventional locomotor training) by injury status (complete versus incomplete) using a practice-based cohort. METHODS: A probabilistic cost-effectiveness analysis was conducted using a prospective, practice-based cohort from four participating Spinal Cord Injury Model System sites. Conventional locomotor training strategies (conventional training) were compared to overground robotic locomotor training (overground robotic training). Conventional locomotor training included treadmill-based training with body weight support, overground training, and stationary robotic systems. The outcome measures included the calculation of quality adjusted life years (QALYs) using the EQ-5D and therapy costs. We estimate cost-effectiveness using the incremental cost utility ratio and present results on the cost-effectiveness plane and on cost-effectiveness acceptability curves. RESULTS: Participants in the prospective, practice-based cohort with complete EQ-5D data (n = 99) qualified for the analysis. Both conventional training and overground robotic training experienced an improvement in QALYs. Only people with incomplete SCI improved with conventional locomotor training, 0.045 (SD 0.28), and only people with complete SCI improved with overground robotic training, 0.097 (SD 0.20). Costs were lower for conventional training, $1758 (SD $1697) versus overground robotic training $3952 (SD $3989), and lower for those with incomplete versus complete injury. Conventional overground training was more effective and cost less than robotic therapy for people with incomplete SCI. Overground robotic training was more effective and cost more than conventional training for people with complete SCI. The incremental cost utility ratio for overground robotic training for people with complete spinal cord injury was $12,353/QALY. CONCLUSIONS: The most cost-effective locomotor training strategy for people with SCI differed based on injury completeness. Conventional training was more cost-effective than overground robotic training for people with incomplete SCI. Overground robotic training was more cost-effective than conventional training for people with complete SCI. The effect estimates may be subject to limitations associated with small sample sizes and practice-based evidence methodology. These estimates provide a baseline for future research.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Traumatismos da Medula Espinal , Humanos , Análise de Custo-Efetividade , Estudos Prospectivos , Caminhada
8.
Int J Cardiol ; 371: 211-220, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36243183

RESUMO

BACKGROUND: Atrial high-rate episode (AHRE) and stroke are related; however, the magnitude of the correlations between different AHRE burdens and stroke remains unknown. We analysed studies that evaluated this relationship. METHODS: We searched for observational controlled studies that reported the associations of different AHRE burdens with stroke in populations with cardiac implantable electronic devices (CIEDs). The primary endpoint was stroke or thrombosis during follow-up. We performed subgroup analyses according to the classification criteria and research design of the included studies. RESULTS: Of the 5985 studies identified, 9 met the eligibility criteria and included 42,958 patients. Patients with low and high AHRE burdens had a 1.2-fold risk of stroke (no heterogeneity) and a 2.52-fold risk of stroke (moderate heterogeneity), respectively. After excluding studies analysing the atrial fibrillation history, no significant difference in progressive stroke risk was observed for patients with a low AHRE burden (without significant heterogeneity). An increased likelihood of stroke was observed for patients with a high AHRE burden (decreased heterogeneity). Four of the nine studies classified high and low AHRE burdens using the longest AHRE time. Five studies classified high and low AHRE burdens based on the median of the total AHRE time as the cutoff value. Low and high AHRE burdens were more closely related to stroke when classified by the total AHRE duration than when classified by the single longest AHRE duration. CONCLUSIONS: For populations with CIEDs without an atrial fibrillation history, a high AHRE burden was significantly associated with stroke.


Assuntos
Fibrilação Atrial , Desfibriladores Implantáveis , Acidente Vascular Cerebral , Humanos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/complicações , Átrios do Coração/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Fatores de Risco , Desfibriladores Implantáveis/efeitos adversos
9.
ACS Appl Mater Interfaces ; 14(51): 56735-56742, 2022 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-36515640

RESUMO

Perovskite anodes with in situ exsolved nanocatalysts have been proven to overcome carbon deposition and increase anode catalytic activity as an alternative to conventional Ni/YSZ anodes for direct hydrocarbon solid oxide fuel cells (SOFCs). This study, for the first time, demonstrates the state-of-the-art exsolution over cathode-supported SOFCs, which achieve the highest cell performance compared to conventional electrolyte-supported SOFCs with perovskite anodes using CH4 as a fuel. The dendritic channel structure of cathode supports retains a high active surface during high-temperature electrolyte sintering. Sr2Ti0.8Co0.2FeO6-δ perovskite ceramic is employed as anodes, and Co-Fe alloy nanoparticles are exsolved after reduction, which increases the cell power output by about 40%. The peak power densities of the cells are 0.82, 0.59, 0.43, and 0.33 W cm-2 at 800 °C using hydrogen, methane, methanol, and ethanol, respectively. The SOFCs with the exsolved nanocatalysts demonstrate stable power generation up to 110 h using methane, methanol, and ethanol fuels. Interestingly, the perovskite anodes show high methane fuel utilization by the complete oxidation of methane, which is in contrast to the partial oxidation over Ni catalysts. Robust hydrocarbon SOFCs have been developed by coupling anode catalyst exsolution with dendritically channeled cathode supports.

10.
Front Bioeng Biotechnol ; 10: 964359, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36582837

RESUMO

One of the surgical treatments for pelvic sarcoma is the restoration of hip function with a custom pelvic prosthesis after cancerous tumor removal. The orthopedic oncologist and orthopedic implant company must make numerous often subjective decisions regarding the design of the pelvic surgery and custom pelvic prosthesis. Using personalized musculoskeletal computer models to predict post-surgery walking function and custom pelvic prosthesis loading is an emerging method for making surgical and custom prosthesis design decisions in a more objective manner. Such predictions would necessitate the estimation of forces generated by muscles spanning the lower trunk and all joints of the lower extremities. However, estimating trunk and leg muscle forces simultaneously during walking based on electromyography (EMG) data remains challenging due to the limited number of EMG channels typically used for measurement of leg muscle activity. This study developed a computational method for estimating unmeasured trunk muscle activations during walking using lower extremity muscle synergies. To facilitate the calibration of an EMG-driven model and the estimation of leg muscle activations, EMG data were collected from each leg. Using non-negative matrix factorization, muscle synergies were extracted from activations of leg muscles. On the basis of previous studies, it was hypothesized that the time-varying synergy activations were shared between the trunk and leg muscles. The synergy weights required to reconstruct the trunk muscle activations were determined through optimization. The accuracy of the synergy-based method was dependent on the number of synergies and optimization formulation. With seven synergies and an increased level of activation minimization, the estimated activations of the erector spinae were strongly correlated with their measured activity. This study created a custom full-body model by combining two existing musculoskeletal models. The model was further modified and heavily personalized to represent various aspects of the pelvic sarcoma patient, all of which contributed to the estimation of trunk muscle activations. This proposed method can facilitate the prediction of post-surgery walking function and pelvic prosthesis loading, as well as provide objective evaluations for surgical and prosthesis design decisions.

11.
J Opt Soc Am A Opt Image Sci Vis ; 39(8): 1498-1504, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36215595

RESUMO

This research explores the focusing characteristics of a polarization mixing quadratic space-variant phase-modulated sinh-Gaussian vortex beam. Various intriguing evolutionary trends of the focal pattern are demonstrated by the modulation of each parameter. The results show that the adjustable parameter C makes the focusing spot form an optical chain structure. The length of the structure and the number of dark optical traps in the structure can be altered by adjusting C. Simultaneously, the variation of beam order m will cause focal spot deformation. Moreover, the variation of the focal pattern indicates that polarization parameter B has the ability to adjust the position of the spot. In addition, the influence of topological charge l on the component field is also discussed. With the introduction of a polarization mixing quadratic space-variant phase, the focal pattern obtains a series of unique characteristics. These results have potential value for cutting-edge optical applications such as optical shaping, optical transmission, and multiple optical capture.

13.
Sensors (Basel) ; 22(7)2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35408157

RESUMO

With autonomous driving developing in a booming stage, accurate object detection in complex scenarios attract wide attention to ensure the safety of autonomous driving. Millimeter wave (mmWave) radar and vision fusion is a mainstream solution for accurate obstacle detection. This article presents a detailed survey on mmWave radar and vision fusion based obstacle detection methods. First, we introduce the tasks, evaluation criteria, and datasets of object detection for autonomous driving. The process of mmWave radar and vision fusion is then divided into three parts: sensor deployment, sensor calibration, and sensor fusion, which are reviewed comprehensively. Specifically, we classify the fusion methods into data level, decision level, and feature level fusion methods. In addition, we introduce three-dimensional(3D) object detection, the fusion of lidar and vision in autonomous driving and multimodal information fusion, which are promising for the future. Finally, we summarize this article.


Assuntos
Condução de Veículo , Radar , Algoritmos , Calibragem , Visão Ocular
14.
IEEE Trans Biomed Eng ; 69(10): 3265-3274, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35412969

RESUMO

OBJECTIVE: Gait deficit after multiple sclerosis (MS) can be characterized by altered muscle activation patterns. There is preliminary evidence of improved walking with a lower limb exoskeleton in persons with MS. However, the effects of exoskeleton-assisted walking on neuromuscular modifications are relatively unclear. The objective of this study was to investigate the muscle synergies, their activation patterns and the differences in neural strategies during walking with (EXO) and without (No-EXO) an exoskeleton. METHODS: Ten subjects with MS performed walking during EXO and No-EXO conditions. Electromyography signals from seven leg muscles were recorded. Muscle synergies and the activation profiles were extracted using non-negative matrix factorization. RESULTS: The stance phase duration was significantly shorter during EXO compared to the No-EXO condition (p<0.05). Moreover, typically 3-5 modules were extracted in each condition. The module-1 (comprising Vastus Medialis and Rectus Femoris muscles), module-2 (comprising Soleus and Medial Gastrocnemius muscles), module-3 (Tibialis Anterior muscle) and module-4 (comprising Biceps Femoris and Semitendinosus muscles) were comparable between conditions. During EXO condition, Semitendinosus and Vastus Medialis emerged in module-5 in 7/10 subjects. Compared to No-EXO, average activation amplitude was significantly reduced corresponding to module-2 during the stance phase and module-3 during the swing phase during EXO. CONCLUSION: Exoskeleton-assistance does not alter the existing synergy modules, but could induce a new module to emerge, and alters the control of these modules, i.e., modifies the neural commands indicated by the reduced amplitude of the activation profiles. SIGNIFICANCE: The work provides insights on the potential underlying mechanism of improving gait functions after exoskeleton-assisted locomotor training.


Assuntos
Exoesqueleto Energizado , Esclerose Múltipla , Eletromiografia , Marcha/fisiologia , Humanos , Músculo Esquelético/fisiologia , Caminhada/fisiologia
15.
PLoS One ; 17(2): e0264171, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35213577

RESUMO

We investigated whether time-of-day dependent changes in the rat soleus (SOL) muscle size, after eccentric exercises, operate via the mechanistic target of rapamycin (mTOR) signaling pathway. For our first experiment, we assigned 9-week-old male Wistar rats randomly into four groups: light phase (zeitgeber time; ZT6) non-trained control, dark phase (ZT18) non-trained control, light phase-trained, and dark phase-trained. Trained animals performed 90 min of downhill running once every 3 d for 8 weeks. The second experiment involved dividing 9-week-old male Wistar rats to control and exercise groups. The latter were subjected to 15 min of downhill running at ZT6 and ZT18. The absolute (+12.8%) and relative (+9.4%) SOL muscle weights were higher in the light phase-trained group. p70S6K phosphorylation ratio was 42.6% higher in the SOL muscle of rats that had exercised only in light (non-trained ZT6). Collectively, the degree of muscle hypertrophy in SOL is time-of-day dependent, perhaps via the mTOR/p70S6K signaling.


Assuntos
Ritmo Circadiano , Músculo Esquelético/metabolismo , Condicionamento Físico Animal , Corrida , Transdução de Sinais , Animais , Masculino , Ratos , Ratos Wistar , Proteínas Quinases S6 Ribossômicas 70-kDa/metabolismo , Serina-Treonina Quinases TOR/metabolismo
16.
Spinal Cord ; 60(6): 522-532, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35094007

RESUMO

STUDY DESIGN: Clinical trial. OBJECTIVE: To demonstrate that a 12-week exoskeleton-based robotic gait training regimen can lead to a clinically meaningful improvement in independent gait speed, in community-dwelling participants with chronic incomplete spinal cord injury (iSCI). SETTING: Outpatient rehabilitation or research institute. METHODS: Multi-site (United States), randomized, controlled trial, comparing exoskeleton gait training (12 weeks, 36 sessions) with standard gait training or no gait training (2:2:1 randomization) in chronic iSCI (>1 year post injury, AIS-C, and D), with residual stepping ability. The primary outcome measure was change in robot-independent gait speed (10-meter walk test, 10MWT) post 12-week intervention. Secondary outcomes included: Timed-Up-and-Go (TUG), 6-min walk test (6MWT), Walking Index for Spinal Cord Injury (WISCI-II) (assistance and devices), and treating therapist NASA-Task Load Index. RESULTS: Twenty-five participants completed the assessments and training as assigned (9 Ekso, 10 Active Control, 6 Passive Control). Mean change in gait speed at the primary endpoint was not statistically significant. The proportion of participants with improvement in clinical ambulation category from home to community speed post-intervention was greatest in the Ekso group (>1/2 Ekso, 1/3 Active Control, 0 Passive Control, p < 0.05). Improvements in secondary outcome measures were not significant. CONCLUSIONS: Twelve weeks of exoskeleton robotic training in chronic SCI participants with independent stepping ability at baseline can improve clinical ambulatory status. Improvements in raw gait speed were not statistically significant at the group level, which may guide future trials for participant inclusion criteria. While generally safe and tolerable, larger gains in ambulation might be associated with higher risk for non-serious adverse events.


Assuntos
Exoesqueleto Energizado , Procedimentos Cirúrgicos Robóticos , Robótica , Traumatismos da Medula Espinal , Terapia por Exercício , Marcha , Humanos , Traumatismos da Medula Espinal/complicações , Caminhada
17.
Arch Phys Med Rehabil ; 103(4): 665-675, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34648804

RESUMO

OBJECTIVE: To characterize individuals with spinal cord injuries (SCI) who use outpatient physical therapy or community wellness services for locomotor training and predict the duration of services, controlling for demographic, injury, quality of life, and service and financial characteristics. We explore how the duration of services is related to locomotor strategy. DESIGN: Observational study of participants at 4 SCI Model Systems centers with survival. Weibull regression model to predict the duration of services. SETTING: Rehabilitation and community wellness facilities at 4 SCI Model Systems centers. PARTICIPANTS: Eligibility criteria were SCI or dysfunction resulting in motor impairment and the use of physical therapy or community wellness programs for locomotor/gait training. We excluded those who did not complete training or who experienced a disruption in training greater than 45 days. Our sample included 62 participants in conventional therapy and 37 participants in robotic exoskeleton training. INTERVENTIONS: Outpatient physical therapy or community wellness services for locomotor/gait training. MAIN OUTCOME MEASURES: SCI characteristics (level and completeness of injury) and the duration of services from medical records. Self-reported perceptions of SCI consequences using the SCI-Functional Index for basic mobility and SCI-Quality of Life measurement system for bowel difficulties, bladder difficulties, and pain interference. RESULTS: After controlling for predictors, the duration of services for the conventional therapy group was an average of 63% longer than for the robotic exoskeleton group, however each visit was 50% shorter in total time. Men had an 11% longer duration of services than women had. Participants with complete injuries had a duration of services that was approximately 1.72 times longer than participants with incomplete injuries. Perceived improvement was larger in the conventional group. CONCLUSIONS: Locomotor/gait training strategies are distinctive for individuals with SCI using a robotic exoskeleton in a community wellness facility as episodes are shorter but individual sessions are longer. Participants' preferences and the ability to pay for ongoing services may be critical factors associated with the duration of outpatient services.


Assuntos
Exoesqueleto Energizado , Traumatismos da Medula Espinal , Feminino , Marcha , Humanos , Masculino , Pacientes Ambulatoriais , Modalidades de Fisioterapia , Qualidade de Vida , Traumatismos da Medula Espinal/reabilitação
18.
Opt Lett ; 46(22): 5695-5698, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34780439

RESUMO

In this Letter, we have demonstrated the generation of dissipative solitons (DSs) or multi-wavelength noise-like pulses (NLPs) directly from a common linear Yb-doped fiber laser in the presence of stimulated Raman scattering (SRS). For the DSs, the pulse energy of the solitons with a pulse width of 74.2 ps reaches 21.2 nJ. For the NLPs, the generation of the main NLP (1032 nm) together with the first-order Raman NLP (1080 nm) is realized. The narrow peak of the double-scale autocorrelation trace is characterized by quasi-periodic beat pulses with a pulse beating of 40.6 fs and a pulse separation of 79 fs, indicating that the generated solitons at dual wavelengths are mutually coherent. Furthermore, a three-color stable NLP complex with a broader spectrum is also obtained. The results contribute to an in-depth understanding of nonlinear dynamics and ultrafast physics.

19.
Appl Opt ; 60(21): 6128-6134, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34613276

RESUMO

Based on the vector diffraction theory, this paper investigates the focusing properties of linearly polarized Lorentz-Gaussian vortex beams with sinusoidal phase modulation and discusses the focused light intensity under different parameters in detail. Results show that the focus pattern in the horizontal direction at the focal region can be compressed by increasing the relative Gaussian parameter wx. As the relative Lorentz parameter γy increases, the focus pattern will separate in the vertical direction of the optical field. With the topological charge number m increases, a special tunable optical dark trap focusing mode can be obtained. Through changing the sinusoidal modulation parameter n, the regular trilateral, quadrangle, pentagon, and hexagon shapes of the focusing mode can be correspondingly constructed. Besides, on increasing propagation distance z, the focusing mode in the near focusing region gradually extends outside and always exhibits hexagon-shaped patterns, which reflects that this special focusing mode has a good stability. In addition, the optical gradient force distributions and the field intensity distributions in the longitudinal plane are also investigated to illuminate the applications of these alterable focal patterns. Those novel, to the best of our knowledge, findings may be helpful in applications such as optical manipulation, optical focusing, and imaging.

20.
Opt Express ; 29(10): 14336-14344, 2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-33985156

RESUMO

We have demonstrated the generation of multicolor noise-like pulse complex in a passively Yb-doped mode-locked fiber laser based on a single mode-graded index multimode-single mode fiber (SMF-GIMF-SMF) device as the saturable absorber (SA). The stimulated Raman scattering (SRS) effect leads to the cascaded generation of the main noise-like pulse (NLP) at 1028.8 nm together with the noise like Raman pulse (RP) at 1076.1 nm. The generated dual wavelength pulses demonstrate the unique properties of mutually synchronization and coherence. The autocorrelation traces show that each of the synchronously mode-locked pulses exhibits a double-scale structure with a narrow peak which consists of a train of quasi-periodic beat pulses with a 35.7 fs pulse width and a pulse separation of about 77.2 fs. The total output power reaches 102.5 mW with 34% of it belonging to the RP. And furthermore, by separating the two pulses with spectral filters, the modulation fringes cannot be observed anymore. These results indicate that the Raman component participates in the mode-locking operation as a 'signal' instead of 'noise'. Such a coherent Raman pulse source provides a novel platform for numerous applications, such as frequency comb spectroscopy and so on.

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