Neurophysiological methods for the assessment of spasticity: the Hoffmann reflex, the tendon reflex, and the stretch reflex

Purpose: To review the literature concerning neurophysiological methods to assess spasticity with respect to mechanisms and methodology, and to describe the three most commonly used methods: the Hoffmann reflex (H-reflex), the Tendon reflex (T-reflex), and the Stretch Reflex (SR).\ud Method: A systematic internet database search was performed to identify neurophysiological measurement methods of spasticity. A systematic exclusion procedure resulted in 185 included references, completed by additional informal search. For this paper, information about the H-, T- and stretch reflexes was extracted from these references. \ud Results: Although the reflexes are basically monosynaptic, there are many supraspinal pathways which modulate the responses in terms of their amplitude and latency. As a consequence the methods are sensitive to a considerable number of experimental conditions and are characterized by a moderate reliability and sensitivity. Correlations with other (i.e. biomechanical, neurophysiological or clinical) spasticity assessment parameters are moderate to poor. Standardised and broadly accepted protocols are still largely lacking preventing an effective exchange of knowledge. \ud Conclusions: The clinical and experimental use of the three methods is restricted due to moderate reliability and sensitivity. It is recommended to perform combined neurophysiological – biomechanical assessment of spasticity during active, functional movement

A 19-channel d.c. SQUID magnetometer system for brain research

A 19-channel d.c. SQUID magnetometer system for neuromagnetic investigations is under constuction. The first-order gradiometers for sensing the signal are placed in a hexagonal configuration. D.c. SQUIDs based on niobium/aluminium technology have been developed, leading to a field sensitivity of about 5 fT/ Hz. SQUID read-out is realized with a resonant transformer circuit at 100 kHz. The multichannel control and detection electronics are compactly built

A Context-Aware Adaptive Feedback System for Activity Monitoring

An active lifestyle is an important factor in the prevention of deconditioning and many negative secondary effects in chronic diseases (e.g. COPD). A number of studies have been conducted with the aim of gaining insight into the daily activity patterns of these patients. Current research is focussing on motivating patients to stay physically active and balancing their activity patterns by using an activity sensor combined with remote monitoring and smart, personalised feedback

Requirements for a Nutrition Education Demonstrator

[Context and Motivation] Development of innovative ICT-based applications is a complex process involving collaboration of all relevant disciplines. This complexity arises due to differences in terminology, knowledge and often also the ways of working between developers in the disciplines involved. [Question/problem] Advances in each discipline bring a rich design environment of theories, models, methods and techniques. Making a selection from these makes the development of distributed applications very challenging, often requiring a holistic approach to address the needs of the disciplines involved. This paper describes early stage requirements acquisition of a mobile nutrition education demonstrator which supports overweight persons in adopting healthier dietary behaviour. [Principal idea/results] We present a novel way to combine and use known requirements acquisition methods involving a two stage user needs analysis based on scenarios which apply a theory-based model of behavioural change and are onstructed in two phases. The first phase scenarios specify an indicative description reflecting the use of the transtheoretical model of behavioural change. In the second phase, a handshake protocol adds elements of optative system-oriented descriptions to the scenarios such that the intended system can support the indicative description. [Contribution] The holistic and phased approach separates design concerns to which each of the disciplines contributes with their own expertise and domain principles. It preserves the applied domain principles in the design and it bridges gaps in terminology, knowledge and ways of working

Model-Based Predictive Control Scheme for Cost Optimization and Balancing Services for Supermarket Refrigeration Systems

A new formulation of model predictive control for supermarket refrigeration systems is proposed to facilitate the regulatory power services as well as energy cost optimization of such systems in the smart grid. Nonlinear dynamics existed in large-scale refrigeration plants challenges the predictive control design. It is however shown that taking into account the knowledge of different time scales in the dynamical subsystems makes possible a linear formulation of a centralized predictive controller. A realistic scenario of regulatory power services in the smart grid is considered and formulated in the same objective as of cost optimization one. A simulation benchmark validated against real data and including significant dynamics of the system are employed to show the effectiveness of the proposed control scheme

Cardiovascular Responses Induced by Obstructive Apnea Are Enhanced in Hypertensive Rats Due to Enhanced Chemoreceptor Responsivity

Spontaneously hypertensive rats (SHR), like patients with sleep apnea, have hypertension, increased sympathetic activity, and increased chemoreceptor drive. We investigated the role of carotid chemoreceptors in cardiovascular responses induced by obstructive apnea in awake SHR. A tracheal balloon and vascular cannulas were implanted, and a week later, apneas of 15 s each were induced. the effects of apnea were more pronounced in SHR than in control rats (Wistar Kyoto; WKY). Blood pressure increased by 57 +/- 3 mmHg during apnea in SHR and by 28 +/- 3 mmHg in WKY (p < 0.05, n = 14/13). the respiratory effort increased by 53 +/- 6 mmHg in SHR and by 34 +/- 5 mmHg in WKY. the heart rate fell by 209 +/- 19 bpm in SHR and by 155 +/- 16 bpm in WKY. the carotid chemoreceptors were then inactivated by the ligation of the carotid body artery, and apneas were induced two days later. the inactivation of chemoreceptors reduced the responses to apnea and abolished the difference between SHR and controls. the apnea-induced hypertension was 11 +/- 4 mmHg in SHR and 8 +/- 4 mmHg in WKY. the respiratory effort was 15 +/- 2 mmHg in SHR and 15 +/- 2 mmHg in WKY. the heart rate fell 63 +/- 18 bpm in SHR and 52 +/- 14 bpm in WKY. Similarly, when the chemoreceptors were unloaded by the administration of 100% oxygen, the responses to apnea were reduced. in conclusion, arterial chemoreceptors contribute to the responses induced by apnea in both strains, but they are more important in SHR and account for the exaggerated responses of this strain to apnea.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Escola Paulista Med, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Physiol, São Paulo, BrazilFAPESP: 2010/19705-6CNPq: 472187/2010-4Web of Scienc

Morphology of the female reproductive organs of the African lion (Panthera leo)

The topography and splanchnology of the reproductive organs of the African lioness were studied and described in situ and after removal. The kidneys were located far caudally in relation to the thirteenth ribs. The suspensory ligament was very well developed, originated in a fan-like manner from the dorsolateral abdominal wall lateral to the kidney and extended up to a few centimetres cranial to the kidney. The proper ligament of the ovary as well as the round ligament was well developed. The round ligament inserted on the medial femoral fascia. The left ovary was bigger than the right. The ovarian bursa had a short mesosalpinx that did not cover any part of the ovary and the fimbriae extended along the entire length. The urethral tuberculum as well as the urethral crest were well developed. The left uterine horn was longer than the right. The uterine tube was found to open directly into the tip of the uterine horn and not onto a papilla. The reproductive organs of the lioness resembled those of the domestic cat and dog but with some major differences.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1463-6395hb201

Moderate-to-deep sedation technique, using propofol and ketamine, allowing synchronised breathing for magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids: a pilot study

BACKGROUND: Magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids is rapidly gaining popularity as a treatment modality. This procedure is generally uncomfortable, painful, and requires minimal or absence of movement and an MR-HIFU synchronised breathing pattern of the patient. Procedural sedation and analgesia protocols have become the standard practice in interventional radiology departments worldwide. The aim of this study was to explore if a sedation regimen with low-dose propofol and ketamine performed by trained non-medical sedation practitioners could result in relief of discomfort for the patient and in adequate working conditions for MR-HIFU treatment for uterine fibroids. METHODS: In this study, conducted from August 2013 until November 2014, 20 patients were subjected to MR-HIFU treatment of uterine fibroids. Patients were deeply sedated using intravenous propofol and esketamine according to a standardised hospital protocol to allow synchronisation of the breathing pattern to the MR-HIFU. The quality of sedation for MR-HIFU and complications were recorded and analysed. The side effects of the sedation technique, the propofol and esketamine consumption rate, the duration of recovery, and patient satisfaction after 24 h were examined. RESULTS: A total of 20 female patients (mean age 42.4 [range 32-53] years) were enrolled. Mean propofol/esketamine dose was 1309 mg/39.5 mg (range 692-1970 mg/ 23.6-87.9 mg). Mean procedure time was 269 min (range 140-295 min). Application of the sedation protocol resulted in a regular breathing pattern, which could be synchronised with the MR-HIFU procedures without delay. The required treatment was completed in all cases. There were no major adverse events. Hypoxemia (oxygen desaturation <92%) and hallucinations were not observed. CONCLUSIONS: The use of a specific combination of IV propofol and esketamine for procedural sedation and analgesia reduced the discomfort and pain during MR-guided HIFU treatments of uterine fibroids. The resulting regular breathing pattern allowed for easy synchronisation of the MR-HIFU procedure. Based on our results, esketamine and propofol sedation performed by trained non-medical sedation practitioners is feasible and safe, has a low risk of major adverse events, and has a short recovery time, avoiding a session of general anaesthesia