Adaptable videogame platform for interactive upper extremity rehabilitation

The primary objective of this work is to design a recreational rehabilitation videogame platform for customizing motivating games that interactively encourage purposeful upper extremity gross motor movements. Virtual reality (VR) technology is a popular application for rehabilitation therapies but there is a constant need for more accessible and affordable systems. We have developed a recreational VR game platform can be used as an independent therapy supplement without laboratory equipment and is inexpensive, motivating, and adaptable. The behaviors and interactive features can be easily modified and customized based on players\u27 limitations or progress. A real-time method of capturing hand movements using programmed color detection mechanisms to create the simulated virtual environments (VEs) is implemented. Color markers are tracked and simultaneously given coordinates in the VE where the player sees representations of their hands and other interacting objects whose behaviors can be customized and adapted to fit therapeutic objectives and players\u27 interests. After gross motor task repetition and involvement in the adaptable games, mobility of the upper extremities may improve. The videogame platform is expanded and optimized to allow modifications to base inputs and algorithms for object interactions through graphical user interfaces, thus providing the adaptable need in VR rehabilitation

The Effect of Respirator Wear on Blood Lactate During Maximal Exertion

The impact of a filtering half-face respirator and a half-face supplied air respirator use on blood lactate production was assessed during maximal exertion to determine if anaerobic strain increased compared to no respirator use. Twenty-eight participants performed a 30 second cycling Wingate anaerobic test (WAnT) wearing a half-face respirator. Blood lactate production was measured to evaluate if there was an increase in anaerobic strain from wearing a tight fitting half-face respirator compared to wearing no respirator. A supplied air respirator WAnT was then performed using 18 participants from the first experiment to evaluate if supplied air decreased anaerobic strain. Data from both experiments were compared to evaluate differences in the physiological effects due to respirator use during maximal exertion. A survey was administered following the second WAnT experiment to measure the participants\u27 perception of acceptability and impact of supplied air respirator use in workplace. The blood lactate levels measured directly after the WAnT yielded lower overall mean values during the half-mask respirator trial (12.1 mmollL) and supplied air respirator trial (12.2 mmollL) than the no respirator trial (13.1 mmoI/L). However, differences in blood lactate levels were not statistically significant (p =0.597). Participants reported an average acceptability of 92.3% to wearing the supplied air respirator while performing light work. However, the average acceptability decreased as the exertion increased to moderate (78.8%) and heavy (46.6%) workloads. The supplied air respirator used provided no significant reduction in anaerobic strain within this study group compared to either the filtering half-face respirator or the no respirator condition. However, there were differences in physiological effects of respirators on each gender identified in this study. Further assessment of the anaerobic impact of respirators on each gender should be conducted

The nature of imagination in Education for Sustainability

 This research investigated the nature and role of imagination in Education for Sustainability. Through participation, observation and interview, the research examined the ways in which understanding sustainability requires imagination. From a New Materialist standpoint, imagination is re-conceptualised and re-positioned as central and constitutive to learning and knowing

Computational Simulations of a Mach 0.745 Transonic Truss-Braced Wing Design

A joint effort between the NASA Ames and Langley Research Centers was undertaken to analyze the Mach 0.745 variant of the Boeing Transonic Truss-Braced Wing (TTBW) Design. Two different flow solvers, LAVA and USM3D, were used to predict the TTBW flight performance. Sensitivity studies related to mesh resolution and numerical schemes were conducted to define best practices for this type of geometry and flow regime. Validation efforts compared the numerical simulation results of various modeling methods against experimental data taken from the NASA Ames 11-foot Unitary Wind Tunnel experimental data. The fidelity of the computational representation of the wind tunnel experiment, such as utilizing a porous wall boundary condition to model the ventilated test section, was varied to examine how different tunnel effects influence CFD predictions. LAVA and USM3D results both show an approximate 0.5 angle of attack shift from experimental lift curve data. This drove an investigation that revealed that the trailing edge of the experimental model was rounded in comparison to the CAD model, due to manufacturing tolerances, which had not been accounted for in the initial simulations of the experiment. Simulating the TTBW with an approximation of this rounded trailing-edge reduces error by approximately 60%. An accurate representation of the tested TTBW geometry, ideally including any wing twists and deflections experienced during the test under various loading conditions, will be necessary for proper validation of the CFD

Investigating the Dose-Response Relationship between Deep Breathing and Heart Rate Variability in Healthy Participants and Across-Days Reliability in Patients with Rheumatoid Arthritis and Systemic Lupus Erythematosus

Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) are associated with autonomic dysfunction, potentially through reduced vagus nerve tone. Vagus nerve stimulation has been proposed as an anti-inflammatory treatment, and it can be performed through deep breathing (DB) exercises. In this study, the dose-response relationship between DB exercises and heart rate variability (HRV) was investigated in healthy participants and reliability across days in patients with RA and SLE. On three separate days, 41 healthy participants performed DB for: 5, 15, or 30 min. On two separate days, 52 RA or SLE patients performed DB with the dose associated with the highest HRV increase in healthy participants. The HRV was estimated from ECG-recordings recorded prior and post the DB exercises. Increases in dose led to larger HRV-responses. Thirty minutes led to the largest HRV-response. In the RA and SLE patients, this dose increased the HRV-parameters consistently across the two days, indicating reliability. DB increases HRV in healthy participants and RA or SLE patients, which indicates stimulation of the vagus nerve. Of the tested durations, 30 min of DB was the optimal period of stimulation. A potential anti-inflammatory effect of DB exercises should be investigated in future studies

Modulating Heart Rate Variability through Deep Breathing Exercises and Transcutaneous Auricular Vagus Nerve Stimulation:A Study in Healthy Participants and in Patients with Rheumatoid Arthritis or Systemic Lupus Erythematosus

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are associated with an impaired autonomic nervous system and vagus nerve function. Electrical or physiological (deep breathing—DB) vagus nerve stimulation (VNS) could be a potential treatment approach, but no direct comparison has been made. In this study, the effect of transcutaneous auricular VNS (taVNS) and DB on vagal tone was compared in healthy participants and RA or SLE patients. The vagal tone was estimated using time-domain heart-rate variability (HRV) parameters. Forty-two healthy participants and 52 patients performed 30 min of DB and 30 min of taVNS on separate days. HRV was recorded before and immediately after each intervention. For the healthy participants, all HRV parameters increased after DB (SDNN + RMSSD: 21–46%), while one HRV parameter increased after taVNS (SDNN: 16%). For the patients, all HRV parameters increased after both DB (17–31%) and taVNS (18–25%), with no differences between the two types of VNS. DB was associated with the largest elevation of the HRV parameters in healthy participants, while both types of VNS led to elevated HRV parameters in the patients. The findings support a potential use of VNS as a new treatment approach, but the clinical effects need to be investigated in future studies

Patient-reported outcomes in performance measurement

Patient-reported outcomes (PROs) are measures of how patients feel or what they are able to do in the context of their health status; PROs are reports, usually on questionnaires, about a patient's health conditions, health behaviors, or experiences with health care that individuals report directly, without modification of responses by clinicians or others; thus, they directly reflect the voice of the patient. PROs cover domains such as physical health, mental and emotional health, functioning, symptoms and symptom burden, and health behaviors. They are relevant for many activities: helping patients and their clinicians make informed decisions about health care, monitoring the progress of care, setting policies for coverage and reimbursement of health services, improving the quality of health care services, and tracking or reporting on the performance of health care delivery organizations. We address the major methodological issues related to choosing, administering, and using PROs for these purposes, particularly in clinical practice settings. We include a framework for best practices in selecting PROs, focusing on choosing appropriate methods and modes for administering PRO measures to accommodate patients with diverse linguistic, cultural, educational, and functional skills, understanding measures developed through both classic and modern test theory, and addressing complex issues relating to scoring and analyzing PRO data.Publishe

Role for DNA Methylation in the Regulation of miR-200c and miR-141 Expression in Normal and Cancer Cells

The microRNA-200 family participates in the maintenance of an epithelial phenotype and loss of its expression can result in epithelial to mesenchymal transition (EMT). Furthermore, the loss of expression of miR-200 family members is linked to an aggressive cancer phenotype. Regulation of the miR-200 family expression in normal and cancer cells is not fully understood.Epigenetic mechanisms participate in the control of miR-200c and miR-141 expression in both normal and cancer cells. A CpG island near the predicted mir-200c/mir-141 transcription start site shows a striking correlation between miR-200c and miR-141 expression and DNA methylation in both normal and cancer cells, as determined by MassARRAY technology. The CpG island is unmethylated in human miR-200/miR-141 expressing epithelial cells and in miR-200c/miR-141 positive tumor cells. The CpG island is heavily methylated in human miR-200c/miR-141 negative fibroblasts and miR-200c/miR-141 negative tumor cells. Mouse cells show a similar inverse correlation between DNA methylation and miR-200c expression. Enrichment of permissive histone modifications, H3 acetylation and H3K4 trimethylation, is seen in normal miR-200c/miR-141-positive epithelial cells, as determined by chromatin immunoprecipitation coupled to real-time PCR. In contrast, repressive H3K9 dimethylation marks are present in normal miR-200c/miR-141-negative fibroblasts and miR-200c/miR-141 negative cancer cells and the permissive histone modifications are absent. The epigenetic modifier drug, 5-aza-2′-deoxycytidine, reactivates miR-200c/miR-141 expression showing that epigenetic mechanisms play a functional role in their transcriptional control.We report that DNA methylation plays a role in the normal cell type-specific expression of miR-200c and miR-141 and this role appears evolutionarily conserved, since similar results were obtained in mouse. Aberrant DNA methylation of the miR-200c/141 CpG island is closely linked to their inappropriate silencing in cancer cells. Since the miR-200c cluster plays a significant role in EMT, our results suggest an important role for DNA methylation in the control of phenotypic conversions in normal cells

Computational Simulations of a Mach 0.745 Transonic Truss-Braced Wing Design

A joint effort between the NASA Ames and Langley Research Centers was undertaken to analyze the Mach 0.745 variant of the Boeing Transonic Truss-Braced Wing (TTBW) Design. Two different flow solvers, LAVA and USM3D, were used to predict the TTBW flight performance. Sensitivity studies related to mesh resolution and numerical schemes were conducted to define best practices for this type of geometry and flow regime. Validation efforts compared the numerical simulation results of various modeling methods against experimental data taken from the NASA Ames 11-foot Unitary Wind Tunnel experimental data. The fidelity of the computational representation of the wind tunnel experiment, such as utilizing a porous wall boundary condition to model the ventilated test section, was varied to examine how different tunnel effects influence CFD predictions. LAVA and USM3D results both show an approximate 0.5o angle of attack shift from experimental lift curve data. This drove an investigation that revealed that the trailing edge of the experimental model was rounded in comparison to the CAD model, due to manufacturing tolerances, which had not been accounted for in the initial simulations of the experiment. Simulating the TTBW with an approximation of this rounded trailing-edge reduces error by approximately 60%. An accurate representation of the tested TTBW geometry, ideally including any wing twists and deflections experienced during the test under various loading conditions, will be necessary for more thorough validation of the CFD