Looking and aesthetics: beyond literary representations of voyeurism

This thesis examines looking in literary and filmic representations to discover its aims and capacities beyond the conventional interpretations of the act as voyeurism

Musculoskeletal Diseases 2021-2024

This open access book focuses on imaging of the musculoskeletal diseases. Over the last few years, there have been considerable advances in this area, driven by clinical as well as technological developments. The authors are all internationally renowned experts in their field. They are also excellent teachers, and provide didactically outstanding chapters. The book is disease-oriented and covers all relevant imaging modalities, with particular emphasis on magnetic resonance imaging. Important aspects of pediatric imaging are also included. IDKD books are completely re-written every four years. As a result, they offer a comprehensive review of the state of the art in imaging. The book is clearly structured with learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers easily navigate through the text. As an IDKD book, it is particularly valuable for general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic knowledge, and for clinicians interested in imaging as it relates to their specialty

Rehabilitation Outcome Following Acute Stroke: Considering Ideomotor Apraxia

Stroke is a leading cause of death and the leading cause of adult disability in the United States affecting approximately 795,000 people yearly. Stroke sequelae often span multiple domains, including motor, cognitive, and sensory subsystems. Impairments can contribute to difficulty participating in activities of daily living (ADLs) and translate into disability - a concern for patients and occupational therapists alike. The role of ideomotor apraxia (IMA) in stroke rehabilitation is unclear. Thus, the purpose of these two studies is to investigate stroke rehabilitation outcome while considering the presence of ideomotor apraxia. Stroke causes dysfunctional movement patterns arising from an array of potential etiologies. Agreement exists that understanding the patient's functioning serves as the basis for the rehabilitation process and it is insufficient for clinicians simply to determine functional movement problems without knowing how underlying impairments contribute. Stroke-induced paresis is a prevalent impairment and frequent target of traditional rehabilitation. Stroke rehabilitation often addresses paresis narrowly with little consideration for other stroke consequences. Ideomotor apraxia is one such disorder after stroke that could conceivably limit rehabilitation benefit of otherwise efficacious treatment interventions aimed at remediating paresis. This led us to an initial study of a subject who experienced a single left, ischemic stroke with paresis of his right upper extremity and comorbid ideomotor apraxia. The subject participated in combined physical and mental practice for six consecutive weeks to improve use of his right arm. After intervention, the subject demonstrated clinically significant improvements in functional performance of his more-affected right upper extremity and reported greater self-perception of performance. The subject continued to demonstrate improvements after four weeks with no intervention and despite persistent IMA. This single case report highlights the importance of recognizing that ideomotor apraxia does present after stroke, and traditional stroke rehabilitation efforts directed at paresis can be efficacious for subjects with IMA. Traditional beliefs suggested that ideomotor apraxia does not translate to disability in everyday life and that IMA resolves spontaneously. Despite accumulating evidence of the influence of IMA on functional ability, this topic remains relatively neglected. It is unclear how ideomotor apraxia affects the rehabilitation process. The second study reports rehabilitation outcomes of a group of subjects following acute stroke. The Florida Apraxia Battery gesture-to-verbal command test was used to detect IMA in subjects. Level of independence with a set of ADLs and motor impairment of the more-affected upper extremity was documented at admission and discharge. Study subjects participated in standard of care stroke rehabilitation in the inpatient rehabilitation units. A total of fifteen subjects who sustained a left hemisphere stroke participated in this study - ten with IMA and five without IMA. After rehabilitation, subjects with IMA improved ADL independence and displayed decreased motor impairment of their right upper extremity. Subjects with and without IMA exhibited comparable improvements in ADL independence, but subjects with IMA exhibited less ADL independence upon when compared to subjects without IMA. Additional findings suggested that subjects with IMA were not different with respect to motor impairments and length of stay; however, additional studies with larger sample sizes are needed. In summary, these two studies aid to elucidate the implications of ideomotor apraxia on traditional stroke rehabilitation efforts. Study subjects with ideomotor apraxia after acute stroke still derive benefit from traditional rehabilitation. Because traditional rehabilitation interventions narrowly target motor impairment, these findings support the need for considering IMA as a factor in developing interventions tailored to patients with IMA and possibly as a specific focus for interventions. A step toward addressing this need is to assess whether IMA is present after stroke on a regular basis. This work provides a framework for researchers and clinicians to investigate further how ideomotor apraxia translates into disability. These findings are important since consideration of ideomotor apraxia could influence selection and design of rehabilitation interventions to optimize patient daily functioning after stroke

Musculoskeletal Diseases 2021-2024

This open access book focuses on imaging of the musculoskeletal diseases. Over the last few years, there have been considerable advances in this area, driven by clinical as well as technological developments. The authors are all internationally renowned experts in their field. They are also excellent teachers, and provide didactically outstanding chapters. The book is disease-oriented and covers all relevant imaging modalities, with particular emphasis on magnetic resonance imaging. Important aspects of pediatric imaging are also included. IDKD books are completely re-written every four years. As a result, they offer a comprehensive review of the state of the art in imaging. The book is clearly structured with learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers easily navigate through the text. As an IDKD book, it is particularly valuable for general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic knowledge, and for clinicians interested in imaging as it relates to their specialty

A virtual hand assessment system for efficient outcome measures of hand rehabilitation

Previously held under moratorium from 1st December 2016 until 1st December 2021.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control

Collected papers on microsurgery, traumatology and epidemiology.

Leung Ping-chung.Thesis (D.Sc.)--Chinese University of Hong Kong, 1994.Includes bibliographical references

The neuro-cognitive representation of word meaning resolved in space and time.

One of the core human abilities is that of interpreting symbols. Prompted with a perceptual stimulus devoid of any intrinsic meaning, such as a written word, our brain can access a complex multidimensional representation, called semantic representation, which corresponds to its meaning. Notwithstanding decades of neuropsychological and neuroimaging work on the cognitive and neural substrate of semantic representations, many questions are left unanswered. The research in this dissertation attempts to unravel one of them: are the neural substrates of different components of concrete word meaning dissociated? In the first part, I review the different theoretical positions and empirical findings on the cognitive and neural correlates of semantic representations. I highlight how recent methodological advances, namely the introduction of multivariate methods for the analysis of distributed patterns of brain activity, broaden the set of hypotheses that can be empirically tested. In particular, they allow the exploration of the representational geometries of different brain areas, which is instrumental to the understanding of where and when the various dimensions of the semantic space are activated in the brain. Crucially, I propose an operational distinction between motor-perceptual dimensions (i.e., those attributes of the objects referred to by the words that are perceived through the senses) and conceptual ones (i.e., the information that is built via a complex integration of multiple perceptual features). In the second part, I present the results of the studies I conducted in order to investigate the automaticity of retrieval, topographical organization, and temporal dynamics of motor-perceptual and conceptual dimensions of word meaning. First, I show how the representational spaces retrieved with different behavioral and corpora-based methods (i.e., Semantic Distance Judgment, Semantic Feature Listing, WordNet) appear to be highly correlated and overall consistent within and across subjects. Second, I present the results of four priming experiments suggesting that perceptual dimensions of word meaning (such as implied real world size and sound) are recovered in an automatic but task-dependent way during reading. Third, thanks to a functional magnetic resonance imaging experiment, I show a representational shift along the ventral visual path: from perceptual features, preferentially encoded in primary visual areas, to conceptual ones, preferentially encoded in mid and anterior temporal areas. This result indicates that complementary dimensions of the semantic space are encoded in a distributed yet partially dissociated way across the cortex. Fourth, by means of a study conducted with magnetoencephalography, I present evidence of an early (around 200 ms after stimulus onset) simultaneous access to both motor-perceptual and conceptual dimensions of the semantic space thanks to different aspects of the signal: inter-trial phase coherence appears to be key for the encoding of perceptual while spectral power changes appear to support encoding of conceptual dimensions. These observations suggest that the neural substrates of different components of symbol meaning can be dissociated in terms of localization and of the feature of the signal encoding them, while sharing a similar temporal evolution

Linguistic Competence and New Empiricism in Philosophy and Science

The topic of this dissertation is the nature of linguistic competence, the capacity to understand and produce sentences of natural language. I defend the empiricist account of linguistic competence embedded in the connectionist cognitive science. This strand of cognitive science has been opposed to the traditional symbolic cognitive science, coupled with transformational-generative grammar, which was committed to nativism due to the view that human cognition, including language capacity, should be construed in terms of symbolic representations and hardwired rules. Similarly, linguistic competence in this framework was regarded as being innate, rule-governed, domain-specific, and fundamentally different from performance, i.e., idiosyncrasies and factors governing linguistic behavior. I analyze state-of-the-art connectionist, deep learning models of natural language processing, most notably large language models, to see what they can tell us about linguistic competence. Deep learning is a statistical technique for the classification of patterns through which artificial intelligence researchers train artificial neural networks containing multiple layers that crunch a gargantuan amount of textual and/or visual data. I argue that these models suggest that linguistic competence should be construed as stochastic, pattern-based, and stemming from domain-general mechanisms. Moreover, I distinguish syntactic from semantic competence, and I show for each the ramifications of the endorsement of a connectionist research program as opposed to the traditional symbolic cognitive science and transformational-generative grammar. I provide a unifying front, consisting of usage-based theories, a construction grammar approach, and an embodied approach to cognition to show that the more multimodal and diverse models are in terms of architectural features and training data, the stronger the case is for the connectionist linguistic competence. I also propose to discard the competence vs. performance distinction as theoretically inferior so that a novel and integrative account of linguistic competence originating in connectionism and empiricism that I propose and defend in the dissertation could be put forward in scientific and philosophical literature

The cortical integration of tactile sensation in complex regional pain syndrome

Much is still unknown about sensory and perceptual changes in the cortex associated with complex regional pain syndrome (CRPS). This PhD aimed to investigate cortical integration of tactile sensation of the hand specifically the fingers, and how this might be altered in CRPS. A match-paired cross-sectional design was used in a series of neuroimaging and psychophysical studies on patients with unilateral upper limb CRPS (n=21). Clinical characteristics were described and compared with age, gender and hand dominance matched controls (Chapter 2). Methodological improvements for fine-grained fingertip mapping in the primary somatosensory cortex were piloted (n=1) in two separate experiments (Chapter 3). Single fingertip stimulation versus bilateral simultaneous fingertip stimulation was compared using phase encoded functional magnetic resonance imaging (fMRI). Fine-grained fMRI maps of the fingertips in S1 in CRPS were described. Structural morphometry measures underlying the functional S1 fingertip maps including cortical thickness were analysed with step-wise mixed modelling with a priori hypothesised effects including hand dominance and medication. Patient characteristics including pain- related measures were correlated with morphometry measures (Chapter 4). A new finger illusion experiment was applied for the first time in patients with CRPS (Chapter 5). The pilot found that bilateral tactile stimulus was most suitable for use in CRPS and had superior time efficiency. Disordered S1 functional fingertip maps in CRPS with no distinct pattern were found using this stimulus, when compared to the orderly homogenous map pattern in healthy controls. These functional imaging observations were strengthened by the key finding that increased cortical thickness underlying these maps together with hand dominance predicted group (CRPS versus healthy controls) membership. An abnormal finger illusion response in CRPS compared to controls, also suggests a disruption to normal efficiencies of bimanual hand representation cortically, not previously reported. In conclusion, disruption to cortical integration of tactile sensation in CRPS is suggested from the results. These changes also suggest cortical representation of differences in hand dominance rather than CRPS-sided-differences predicted those with CRPS in this study. Future directions to test these suggested cortically mediated changes in CRPS were explored