Flexor Reflex Decreases during Sympathetic Stimulation in Chronic Human Spinal Cord Injury

A better understanding of autonomic influence on motor reflex pathways in spinal cord injury is important to the clinical management of autonomic dysreflexia and spasticity in spinal cord injured patients. The purpose of this study was to examine the modulation of flexor reflex windup during episodes of induced sympathetic activity in chronic human spinal cord injury (SCI). We simultaneously measured peripheral vascular conductance and the windup of the flexor reflex in response to conditioning stimuli of electrocutaneous stimulation to the opposite leg and bladder percussion. Flexor reflexes were quantified using torque measurements of the response to a noxious electrical stimulus applied to the skin of the medial arch of the foot. Both bladder percussion and skin conditioning stimuli produced a reduction (43–67%) in the ankle and hip flexor torques (p \u3c 0.05) of the flexor reflex. This reduction was accompanied by a simultaneous reduction in vascular conductance, measured using venous plethysmography, with a time course that matched the flexor reflex depression. While there was an overall attenuation of the flexor reflex, windup of the flexor reflex to repeated stimuli was maintained during periods of increased sympathetic activity. This paradoxical depression of flexor reflexes and minimal effect on windup is consistent with inhibition of afferent feedback within the superficial dorsal horn. The results of this study bring attention to the possible interaction of motor and sympathetic reflexes in SCI above and below the T5 spinal level, and have implications for clinicians in spasticity management and for researchers investigating motor reflexes post SCI

Homophonic Couplets

A series of couplets ending with homophones

Leg Sympathetic Response to Noxious Skin Stimuli is Similar in High and Low Level Human Spinal Cord Injury

Objective To determine if sympathetically mediated vasoconstriction in the lower extremities is injury level dependent. Although sympathetic responses have been measured in the limbs of people with high and low level SCI using blood flow measurements, including Doppler ultrasound and venous plethysmography, a direct comparison between injury levels has not been made. Methods Volunteers with chronic SCI were grouped according to injury level. Above T6: high level (HL, n = 7), and T6 and below: low level (LL, n = 6). All subjects had complete motor and sensory loss. Leg arterial flows were recorded by venous occlusion plethysmography, and continuous heart rate and mean arterial pressure (MAP) were measured. The conditioning stimulus consisted of transcutaneous stimulation to the arch of the contralateral foot. Results HL and LL subjects demonstrated a significant decrease in arterial conductance during stimulation with no significant difference found between groups. As expected, only group HL demonstrated a significant increase in MAP. Conclusions These results support our hypothesis that local (leg) sympathetic responses are similar for both high and low level SCI. Significance While low level SCI does not typically present with autonomic dysreflexia, bouts of increased reflex sympathetic activity could have ramifications for metabolism as well as renal and motor system functio

Leg Sympathetic Response to Noxious Skin Stimuli is Similar in High and Low Level Human Spinal Cord Injury

Objective To determine if sympathetically mediated vasoconstriction in the lower extremities is injury level dependent. Although sympathetic responses have been measured in the limbs of people with high and low level SCI using blood flow measurements, including Doppler ultrasound and venous plethysmography, a direct comparison between injury levels has not been made. Methods Volunteers with chronic SCI were grouped according to injury level. Above T6: high level (HL, n = 7), and T6 and below: low level (LL, n = 6). All subjects had complete motor and sensory loss. Leg arterial flows were recorded by venous occlusion plethysmography, and continuous heart rate and mean arterial pressure (MAP) were measured. The conditioning stimulus consisted of transcutaneous stimulation to the arch of the contralateral foot. Results HL and LL subjects demonstrated a significant decrease in arterial conductance during stimulation with no significant difference found between groups. As expected, only group HL demonstrated a significant increase in MAP. Conclusions These results support our hypothesis that local (leg) sympathetic responses are similar for both high and low level SCI. Significance While low level SCI does not typically present with autonomic dysreflexia, bouts of increased reflex sympathetic activity could have ramifications for metabolism as well as renal and motor system functio

Disconnected Connections: Extending Peripersonal Space with a Virtual Hand

Peripersonal (reachable) and extrapersonal (beyond reach) space is linked to hand perception. Using a tool to reach farther than normal recalibrates previously unreachable space as peripersonal, evidenced by Intraparietal Sulcus (IPS) activity related to hand perception and lateral biases during line bisection. The current study looked at the role of a visual connection between the hand and body in the ability to manipulate objects within the extended area of reach. In an immersive virtual environment, participants bisected lines using a connected hand (via arm), a disconnected hand, or a floating dot. A rightward shift in bisection was seen only for the dot condition for far lines, indicating that it was the only "tool" incapable of extending peripersonal space

Collaboration and Co-Teaching: Librarians Teaching Digital Humanities in the Classroom

Digital Humanities (DH) as an area of engagement with students, staff, and teaching faculty has been rapidly evolving at the University of Kansas Libraries (KU Libraries) over the past several years. As the popularity of DH tools, platforms and methodologies has increased, so has the demand to support and engage teaching faculty with incorporating DH in their courses and with their own research interests. Many academic libraries, including KU Libraries, are both adjusting to and leading this shift, figuring out ways to support digital scholarship for research and teaching, while at the same time gently delineating our roles, responsibilities, and limitations. This chapter will describe three examples of efforts by librarians with subject, instruction, and digital scholarship expertise to provide digital humanities instruction and training to students and faculty, and will look at how these efforts relate to our previous and evolving roles within the library. We will also provide concrete examples of in-class assignments, describe what worked well and what could be improved, and discuss some possible ways that we ourselves might develop the knowledge and skills needed to engage in this kind of work. We hope that these examples and observations can serve as models, starting-points, or inspiration for subject specialists to both learn more about digital humanities and to develop their own course activities

Self-Adjusting Biofeedback with a Dynamic Feedback Signal Set (DyFSS)

Abstract - A lack of control over their autonomic nervous system presents a major challenge for many children with Autism Spectrum Disorder (ASD). Autonomic biofeedback training is a promising treatment for managing anxiety and ASD symptoms more generally. We describe software that tunes four autonomic measurements to the best abilities and needs of each individual patient. Using this dynamic feedback signal set (DyFSS), a strength-based, self-customizing algorithm, we aim to address the autonomic heterogeneity of youth with ASD. The DyFSS may improve autonomic biofeedback training for the user by making it more understandable and easier to accomplish. Because it is self-adjusting, it may also ease the integration of autonomic biofeedback training into clinical work. Initial feasibility testing of this algorithm in youth with ASD with a five-session autonomic biofeedback training protocol showed improved behavior in relation to ASD symptoms Initial reactions show that youth with ASD are readily engaged through technological interventions such as autonomic biofeedback

Building a Peer-Learning Service for Students in an Academic Library

Academic libraries are well lauded for offering supportive spaces for students’ self-directed study, and significant resources are dedicated to librarian instruction in the classroom. What many academic libraries lack, however, is a middle ground, a routine way for students to help one another using best practices in peer-to-peer learning theory. A new, nonauthoritative, supplemental service by students and for students began at Grand Valley State University in Allendale, MI, in fall 2012 with a cohort of “peer research consultants.” Students learn information literacy skills with a well-trained peer, untethered from the hierarchy inherent in formal instruction environments. This paper describes the program design, training, and conclusions after two academic years in operation and argues the value of peer tutoring in libraries