57 research outputs found
Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis
Objectives: Abdominal functional electrical stimulation (abdominal FES) is the application of a train of electrical pulses to the abdominal muscles, causing them to contract. Abdominal FES has been used as a neuroprosthesis to acutely augment respiratory function and as a rehabilitation tool to achieve a chronic increase in respiratory function after abdominal FES training, primarily focusing on patients with spinal cord injury (SCI). This study aimed to review the evidence surrounding the use of abdominal FES to improve respiratory function in both an acute and chronic manner after SCI.
Settings: A systematic search was performed on PubMed, with studies included if they applied abdominal FES to improve respiratory function in patients with SCI.
Methods: Fourteen studies met the inclusion criteria (10 acute and 4 chronic). Low participant numbers and heterogeneity across studies reduced the power of the meta-analysis. Despite this, abdominal FES was found to cause a significant acute improvement in cough peak flow, whereas forced exhaled volume in 1 s approached significance. A significant chronic increase in unassisted vital capacity, forced vital capacity and peak expiratory flow was found after abdominal FES training compared with baseline.
Conclusions: This systematic review suggests that abdominal FES is an effective technique for improving respiratory function in both an acute and chronic manner after SCI. However, further randomised controlled trials, with larger participant numbers and standardised protocols, are needed to fully establish the clinical efficacy of this technique
Jury Systems Around the World
Lay citizens participate as decision makers in the legal systems of many countries. This review describes the different approaches that countries employ to integrate lay decision makers, contrasting in particular the use of juries composed of all citizens with mixed decision-making bodies of lay and law-trained judges. The review discusses research on the benefits and drawbacks of lay legal decision making as well as international support for the use of ordinary citizens as legal decision makers, with an eye to explaining a recent increase in new jury systems around the world. The review calls for more comparative work on diverse approaches to lay participation, examining how different methods of including lay participation promote or detract from fact finding, legal consciousness, civic engagement, and citizen power
Relativistic Dynamics and Extreme Mass Ratio Inspirals
It is now well-established that a dark, compact object (DCO), very likely a
massive black hole (MBH) of around four million solar masses is lurking at the
centre of the Milky Way. While a consensus is emerging about the origin and
growth of supermassive black holes (with masses larger than a billion solar
masses), MBHs with smaller masses, such as the one in our galactic centre,
remain understudied and enigmatic. The key to understanding these holes - how
some of them grow by orders of magnitude in mass - lies in understanding the
dynamics of the stars in the galactic neighbourhood. Stars interact with the
central MBH primarily through their gradual inspiral due to the emission of
gravitational radiation. Also stars produce gases which will subsequently be
accreted by the MBH through collisions and disruptions brought about by the
strong central tidal field. Such processes can contribute significantly to the
mass of the MBH and progress in understanding them requires theoretical work in
preparation for future gravitational radiation millihertz missions and X-ray
observatories. In particular, a unique probe of these regions is the
gravitational radiation that is emitted by some compact stars very close to the
black holes and which could be surveyed by a millihertz gravitational wave
interferometer scrutinizing the range of masses fundamental to understanding
the origin and growth of supermassive black holes. By extracting the
information carried by the gravitational radiation, we can determine the mass
and spin of the central MBH with unprecedented precision and we can determine
how the holes "eat" stars that happen to be near them.Comment: Update from the first version, 151 pages, accepted for publication @
Living Reviews in Relativit
What scans we will read: imaging instrumentation trends in clinical oncology
Oncological diseases account for a significant portion of the burden on public healthcare systems with associated
costs driven primarily by complex and long-lasting therapies. Through the visualization of patient-specific
morphology and functional-molecular pathways, cancerous tissue can be detected and characterized non-
invasively, so as to provide referring oncologists with essential information to support therapy management
decisions. Following the onset of stand-alone anatomical and functional imaging, we witness a push towards
integrating molecular image information through various methods, including anato-metabolic imaging (e.g., PET/
CT), advanced MRI, optical or ultrasound imaging.
This perspective paper highlights a number of key technological and methodological advances in imaging
instrumentation related to anatomical, functional, molecular medicine and hybrid imaging, that is understood as
the hardware-based combination of complementary anatomical and molecular imaging. These include novel
detector technologies for ionizing radiation used in CT and nuclear medicine imaging, and novel system
developments in MRI and optical as well as opto-acoustic imaging. We will also highlight new data processing
methods for improved non-invasive tissue characterization. Following a general introduction to the role of imaging
in oncology patient management we introduce imaging methods with well-defined clinical applications and
potential for clinical translation. For each modality, we report first on the status quo and point to perceived
technological and methodological advances in a subsequent status go section. Considering the breadth and
dynamics of these developments, this perspective ends with a critical reflection on where the authors, with the
majority of them being imaging experts with a background in physics and engineering, believe imaging methods
will be in a few years from now.
Overall, methodological and technological medical imaging advances are geared towards increased image contrast,
the derivation of reproducible quantitative parameters, an increase in volume sensitivity and a reduction in overall
examination time. To ensure full translation to the clinic, this progress in technologies and instrumentation is
complemented by progress in relevant acquisition and image-processing protocols and improved data analysis. To
this end, we should accept diagnostic images as “data”, and – through the wider adoption of advanced analysis,
including machine learning approaches and a “big data” concept – move to the next stage of non-invasive tumor
phenotyping. The scans we will be reading in 10 years from now will likely be composed of highly diverse multi-
dimensional data from multiple sources, which mandate the use of advanced and interactive visualization and
analysis platforms powered by Artificial Intelligence (AI) for real-time data handling by cross-specialty clinical experts
with a domain knowledge that will need to go beyond that of plain imaging
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