A novel approach in development of dynamic muscle model for paraplegic with functional electrical stimulation

This paper presents the development of paraplegic muscle model with Adaptive Neuro-Fuzzy Inference System (ANFIS). A series of experiments using Functional Electrical Stimulation (FES) with different stimulation frequencies, pulse width and pulse duration to investigate the impact on muscle output torque are conducted. The data that is obtained is used to develop the paraplegic muscle model. 500 training data and 300 testing data set are used in the development of muscle model. The muscle model thus developed is validated with clinical data from one paraplegic subject and in comparison with two other muscle models from previous researchers. The ANFIS muscle model is found to be the most accurate muscle model representing paraplegic muscle model. The established model is then used to predict the behaviour of the underlying system and will be used in the future for the design and evaluation of various control strategies

Necessity of Education for Environmental Literacy in the Architecture

Abstract: Environmental literacy is the main field of activities which its knowledge is necessary for consumers, producers as well as observers. The objective of environmental education is improving applied literacy of stakeholders. The concept of environmental literacy consists of science (facts, concepts and skill) and practice (vision and awareness) which makes personal behavior. In this framework, awareness has two sciencebased (knowing) and emotional-based understanding. In general, scientific education and environmental science have two-way relationship in which scientific education is a prerequisite of environmental literacy and environmental literacy functions as a base for scientific education. Furthermore, scientific literacy and environmental literacy are overlapping in many cases and it is difficult to differentiate them because of their internal linkages. Studies have shown that environmental education can improve environmental literacy as high as three folds which will be ended in responsible action with the environment. Academic education of architecture in Iran exceeds six decades; however, there is no any satisfactory paradigm for environmental literacy and education in this discipline. In the present essay, we evaluated the relationship between architecture education and environmental literacy and the necessity of environmental literacy as a neglected element in architecture faculties

Modeling and control of a novel FES driven assisted cycling mechanism

Functional Electrical Stimulation (FES) driven cycling using single muscle group, the quadriceps, is achieved using PID controller with a novel assisting mechanism represented by a flywheel with an electrical clutch. This mechanism is useful for disabled individuals whose muscles are weak and unable to push a fix-geared flywheel. The flywheel is engaged and disengaged by the clutch when necessary to assist or retard the cycling without imposing additional load on the person's leg muscle. A comparison between this new mechanism and a previously proposed method show positive results of the new mechanism towards reducing the number of muscle stimulation which leads to delay muscle fatigue and consequently promoting prolonged FES driven cycling for paralyzed people

Echocardiographic findings and joint hypermobility: Patients with mitral valve prolapse vs. healthy controls

Background: Mitral valve prolapse is a relatively common valvular abnormality in most communities and joint hypermobility (JHM) is also seen in many healthy people as well as in certain clinical disorders, such as Marfan syndrome. The present study was designed to investigate the association between joint hypermobility and mitral valve prolapse (MVP) in an Iranian population sample. Methods: Fifty-seven patients with nonrheumatic and isolated mitral anterior leaflet prolapse (24 men and 33 women, mean age 23.5 +/-2.3) and 51 healthy subjects (20 men and 31 women, mean age 22.9+/-2.3) were studied. The presence of JHM was evaluated according to the Carter-Wilkinson & Beighton criteria. Echocardiographic examination was performed in all subjects and the correlation between the echocardiographic features of the mitral valve and the hypermobility score were investigated. Results: The frequency of JHM in patients with MVP was found to be significantly higher than that of controls (26.3 vs. 7.8), with mean JHM scores of 3.1+/-2.2 and 1.9+/-1.7, respectively. The patients in the MVP group had significantly increased the anterior mitral leaflet thickness (AMLT, 3.4+/-0.4 mm vs. 3.0+/-0.3 mm; p<0.0005) and maximal leaflet displacement (MLD, 2.4+/-0.3 mm vs. 1.5+/-0.2 mm; p<0.0005) compared to the controls. Conclusions: We detect a statistically significant relationship between isolated MVP and joint hypermobility as well as between the severity of JHM and echocardiographic features of the mitral leaflets. These results suggest a common etiology for MVP and JHM, which should be investigated in future well-conducted studies. © 2008, Tehran University of Medical Sciences. All rights reserved

Exotendons for assistance of human locomotion

BACKGROUND: Powered robotic exoskeletons for assistance of human locomotion are currently under development for military and medical applications. The energy requirements for such devices are excessive, and this has become a major obstacle for practical applications. Legged locomotion in many animals, however, is very energy efficient. We propose that poly-articular elastic mechanisms are a major contributor to the economy of locomotion in such specialized animals. Consequently, it should be possible to design unpowered assistive devices that make effective use of similar mechanisms. METHODS: A passive assistive technology is presented, based on long elastic cords attached to an exoskeleton and guided by pulleys placed at the joints. A general optimization procedure is described for finding the best geometrical arrangement of such "exotendons" for assisting a specific movement. Optimality is defined either as minimal residual joint moment or as minimal residual joint power. Four specific exotendon systems with increasing complexity are considered. Representative human gait data were used to optimize each of these four systems to achieve maximal assistance for normal walking. RESULTS: The most complex exotendon system, with twelve pulleys per limb, was able to reduce the joint moments required for normal walking by 71% and joint power by 74%. A simpler system, with only three pulleys per limb, could reduce joint moments by 46% and joint power by 47%. CONCLUSION: It is concluded that unpowered passive elastic devices can substantially reduce the muscle forces and the metabolic energy needed for walking, without requiring a change in movement. When optimally designed, such devices may allow independent locomotion in patients with large deficits in muscle function

The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review.

OBJECTIVES: To assess the reporting of study design and characteristics in multi-level degenerative cervical myelopathy (DCM) treated by posterior surgical approaches, and perform a comparison of clinical and radiographic outcomes between different approaches. METHODS: A literature search was performed in Embase and MEDLINE between 1995-2019 using a sensitive search string combination. Studies were selected by predefined selection criteria: Full text articles in English, with >10 patients (prospective) or >50 patients (retrospective), reporting outcomes of multi-level DCM treated by posterior surgical approach. RESULTS: A total of 75 studies involving 19,510 patients, conducted worldwide, were identified. Laminoplasty was described in 56 studies (75%), followed by laminectomy with (36%) and without fusion (16%). The majority of studies were conducted in Asia (84%), in the period of 2016-2019 (51%), of which laminoplasty was studied predominantly. Twelve (16%) prospective studies and 63 (84%) retrospective studies were identified. The vast majority of studies were conducted in a single centre (95%) with clear inclusion/exclusion criteria and explicit cause of DCM. Eleven studies (15%) included patients with ossification of the posterior longitudinal ligament exclusively with cohorts of 57 to 252. The clinical and radiographic outcomes were reported with heterogeneity when comparing laminoplasty, laminectomy with and without fusion. CONCLUSIONS: Heterogeneity in the reporting of study and sample characteristics exists, as well as in clinical and radiographic outcomes, with a paucity of studies with a higher level of evidence. Future studies are needed to elucidate the clinical effectiveness of posterior surgical treatments

A New Framework for Investigating the Biological Basis of Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 5]: Mechanical Stress, Vulnerability and Time

Study design: Literature Review (Narrative). Objective: To propose a new framework, to support the investigation and understanding of the pathobiology of DCM, AO Spine RECODE-DCM research priority number 5. Methods: Degenerative cervical myelopathy is a common and disabling spinal cord disorder. In this perspective, we review key knowledge gaps between the clinical phenotype and our biological models. We then propose a reappraisal of the key driving forces behind DCM and an individual\u27s susceptibility, including the proposal of a new framework. Results: Present pathobiological and mechanistic knowledge does not adequately explain the disease phenotype; why only a subset of patients with visualized cord compression show clinical myelopathy, and the amount of cord compression only weakly correlates with disability. We propose that DCM is better represented as a function of several interacting mechanical forces, such as shear, tension and compression, alongside an individual\u27s vulnerability to spinal cord injury, influenced by factors such as age, genetics, their cardiovascular, gastrointestinal and nervous system status, and time. Conclusion: Understanding the disease pathobiology is a fundamental research priority. We believe a framework of mechanical stress, vulnerability, and time may better represent the disease as a whole. Whilst this remains theoretical, we hope that at the very least it will inspire new avenues of research that better encapsulate the full spectrum of disease