The effectiveness of upper-limb wearable technology for improving activity and participation in adult stroke survivors : a systematic review

Background: With advances in technology, the adoption of wearable devices has become a viable adjunct in poststroke rehabilitation. Upper limb (UL) impairment affects up to 77% of stroke survivors impacting on their ability to carry out everyday activities. However, despite an increase in research exploring these devices for UL rehabilitation, little is known of their effectiveness. Objective: This review aimed to assess the effectiveness of UL wearable technology for improving activity and participation in adult stroke survivors. Methods: Randomized controlled trials (RCTs) and randomized comparable trials of UL wearable technology for poststroke rehabilitation were included. Primary outcome measures were validated measures of activity and participation as defined by the International Classification of Functioning, Disability, and Health. Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the RCTs and the Downs and Black Instrument for the quality of non RCTs. Results: In the review, we included 11 studies with collectively 354 participants at baseline and 323 participants at final follow-up including control groups and participants poststroke. Participants’ stroke type and severity varied. Only 1 study found significant between-group differences for systems functioning and activity (P≤.02). The 11 included studies in this review had small sample sizes ranging from 5 to 99 participants at an average (mean) age of 57 years. Conclusions: This review has highlighted a number of reasons for insignificant findings in this area including low sample sizes and the appropriateness of the methodology for complex interventions. However, technology has the potential to measure outcomes, provide feedback, and engage users outside of clinical sessions. This could provide a platform for motivating stroke survivors to carry out more rehabilitation in the absence of a therapist, which could maximize recovery

The Effects of Dissolved Oxygen Concentration and Biological Solids Retention Time on Activated Sludge Treatment Performance

A bench scale treatment system with dissolved oxygen (DO) control was used to determine the effects of DO concentration and biological solids retention time (BSRT) on treatment performance using the activated sludge process. The four reactors, operating at BSRTs of 20, 10, 5, and 2 days, were fed settled municipal wastewater collected from the Kuwahee wastewater treatment plant in Knoxville, TN. The DO was maintained at different set points in each reactor ranging from 4.0 to 0.2 mg/L. Experimental results indicate that carbon treatment performance improved, on average, with increasing BSRT but DO had little effect on carbon oxidation. Sludge volume index (SVI) and effluent suspended solids (ESS) values also indicated that BSRT not DO concentration, affected sludge settling. Complete nitrification occurred in the 20, 10, and 5 day BSRT reactors under excess DO conditions ( ³2.0 mg/L). Nitrification was unaffected at a DO as low as 0.5 mg/L for the two longest BSRTs; however, nitrite buildup occurred in the 5 day BSRT during operation at 0.5 mg/L DO suggesting that nitrite oxidation can limit nitrification when insufficient DO is present. A 2 day BSRT was found to be insufficient for complete nitrification at all DO levels. Kinetic coefficients for the nitrifiers were determined for Knoxville’s municipal wastewater. The yield, decay coefficient, maximum substrate utilization rate, maximum growth rate, substrate half saturation coefficient, and oxygen half saturation coefficient were found to be 0.33 mg VSS/mg N, 0.17 day-1, 2.2 mg N/mg VSS-day, 0.75 day-1, 0.25 mg/L NH4+, and 0.92 mg/L O2 respectively. These values are within a published range identified in the literature

Double Ionisation in R-Matrix Theory Using a 2-electron Outer Region

We have developed a two-electron outer region for use within R-matrix theory to describe double ionisation processes. The capability of this method is demonstrated for single-photon double ionisation of He in the photon energy region between 80 eV to 180 eV. The cross sections are in agreement with established data. The extended RMT method also provides information on higher-order processes, as demonstrated by the identification of signatures for sequential double ionisation processes involving an intermediate He$^{+}$ state with $n=2$.Comment: 5 pages, 4 figure

Geographical and Temporal Changes of Reef Fish (Labridae) Assemblages: A Case Study of South Western Australia

Changes in Labridae assemblages and distributions along South Western Australia’s (SWA) coastline were investigated over 10 years of climate change. This study found district assemblage composition changes, with an inundation of warm water associated species and functional groups and a corresponding decline in large bodied cool water species. This thesis identified unprecedented marine assemblage changes in SWA and forms a platform for future research to further manage the unique SWA ecosystem

An Upscaled Approach for Transport in Media with Extended Tailing Due to Back-Diffusion Using Analytical and Numerical Solutions of the Advection Dispersion Equation

The mono-continuum advection-dispersion equation (mADE) is commonly regarded as unsuitable for application to media that exhibit rapid breakthrough and extended tailing associated with diffusion between high and low permeability regions. This paper demonstrates that the mADE can be successfully used to model such conditions if certain issues are addressed. First, since hydrodynamic dispersion, unlike molecular diffusion, cannot occur upstream of the contaminant source, models must be formulated to prevent “back-dispersion.” Second, large variations in aquifer permeability will result in differences between volume-weighted average concentration (resident concentration) and flow-weighted average concentration (flux concentration). Water samples taken from wells may be regarded as flux concentrations, while soil samples may be analyzed to determine resident concentrations. While the mADE is usually derived in terms of resident concentration, it is known that a mADE of the same mathematical form may be written in terms of flux concentration. However, when solving the latter, the mathematical transformation of a flux boundary condition applied to the resident mADE becomes a concentration type boundary condition for the flux mADE. Initial conditions must also be consistent with the form of the mADE that is to be solved. Thus, careful attention must be given to the type of concentration data that is available, whether resident or flux concentrations are to be simulated, and to boundary and initial conditions. We present 3-D analytical solutions for resident and flux concentrations, discuss methods of solving numerical models to obtain resident and flux concentrations, and compare results for hypothetical problems. We also present an upscaling method for computing “effective” dispersivities and other mADE model parameters in terms of physically meaningful parameters in a diffusion-limited mobile–immobile model. Application of the latter to previously published studies of systems that exhibit early breakthrough and extended tailing shows that the upscaled mADE model is able to describe the observed behavior with reasonable accuracy given only known physical parameters for the systems without any model calibration

An Upscaled Approach for Transport in Media with Extended Tailing Due to Back-Diffusion Using Analytical and Numerical Solutions of the Advection Dispersion Equation

The mono-continuum advection-dispersion equation (mADE) is commonly regarded as unsuitable for application to media that exhibit rapid breakthrough and extended tailing associated with diffusion between high and low permeability regions. This paper demonstrates that the mADE can be successfully used to model such conditions if certain issues are addressed. First, since hydrodynamic dispersion, unlike molecular diffusion, cannot occur upstream of the contaminant source, models must be formulated to prevent “back-dispersion.” Second, large variations in aquifer permeability will result in differences between volume-weighted average concentration (resident concentration) and flow-weighted average concentration (flux concentration). Water samples taken from wells may be regarded as flux concentrations, while soil samples may be analyzed to determine resident concentrations. While the mADE is usually derived in terms of resident concentration, it is known that a mADE of the same mathematical form may be written in terms of flux concentration. However, when solving the latter, the mathematical transformation of a flux boundary condition applied to the resident mADE becomes a concentration type boundary condition for the flux mADE. Initial conditions must also be consistent with the form of the mADE that is to be solved. Thus, careful attention must be given to the type of concentration data that is available, whether resident or flux concentrations are to be simulated, and to boundary and initial conditions. We present 3-D analytical solutions for resident and flux concentrations, discuss methods of solving numerical models to obtain resident and flux concentrations, and compare results for hypothetical problems. We also present an upscaling method for computing “effective” dispersivities and other mADE model parameters in terms of physically meaningful parameters in a diffusion-limited mobile–immobile model. Application of the latter to previously published studies of systems that exhibit early breakthrough and extended tailing shows that the upscaled mADE model is able to describe the observed behavior with reasonable accuracy given only known physical parameters for the systems without any model calibration