Towards better assessment and training of kinematics in post-stroke gait therapy

Gait impairment is common following neurological injury such as stroke. Therapists train patients based on restoring healthy motions, or kinematics, but evidence for training proper kinematics is not well-established. Because the dosage of therapy has not been well quantified, it is unclear what aspects of gait therapy are important, but simply that more therapy is likely better. However, cost restrictions prevent such intensive therapy, incentivizing value-based care. Robotic gait trainers that repetitively train a specific kinematic walking motions can potentially ease the burden on therapists and allow greater patient throughput, improving the value of therapy. Still, the cost of these trainers is only affordable to the wealthiest clinics, leaving them unavailable to the vast majority of stroke survivors. The overall goal of my research is twofold: to show the role of kinematics in gait recovery following stroke, and how these kinematics can be trained in an economical manner. My first aim focuses on design of an affordable robotic gait trainer that can adapt to an individual’s healthy gait pattern. Such a device could make robotic gait training more accessible to new markets including resource-limited hospitals and even patients’ homes. My second aim presents development of an online algorithm for producing speed-dependent reference joint trajectories that can be used for general robotic gait training applications. The goals of my third and fourth aims investigate the importance of gait kinematics using a novel longitudinal cohort approach in subacute stroke patients. I quantified the dosage of therapy using a wearable motion capture to find correlates of functional recovery, defined as gait speed. I then questioned whether gait speed was sufficient to define gait recovery, taking an innovative look at how gait quality during this subacute period changes as gait function improves. I expect these aims will justify the importance of kinematics and suggest that wearable sensors can become a valuable tool for monitoring detailed kinematic motion, providing insight for more effective therapy regimens.Mechanical Engineerin

3-D finite element analysis of the effects of post location and loading location on stress distribution in root canals of the mandibular 1st molar

Objective The purpose of this study was to evaluate, by using finite element analysis, the influence of post location and occlusal loading location on the stress distribution pattern inside the root canals of the mandibular 1st molar. Material and Methods Three different 3-D models of the mandibular 1st molar were established: no post (NP) – a model of endodontic and prosthodontic treatments; mesiobuccal post (MP) – a model of endodontic and prosthodontic treatments with a post in the mesiobuccal canal; and distal post (DP) – a model of endodontic and prosthodontic treatments with a post in the distal canal. A vertical force of 300 N, perpendicular to the occlusal plane, was applied to one of five 1 mm2 areas on the occlusal surface; mesial marginal ridge, distal marginal ridge, mesiobuccal cusp, distobuccal cusp, and central fossa. Finite element analysis was used to calculate the equivalent von Mises stresses on each root canal. Results The DP model showed similar maximum stress values to the NP model, while the MP model showed markedly greater maximum stress values. The post procedure increased stress concentration inside the canals, although this was significantly affected by the site of the force. Conclusions In the mandibular 1st molar, the distal canal is the better place to insert the post than the mesiobuccal canal. However, if insertion into the mesiobuccal canal is unavoidable, there should be consideration on the occlusal contact, making central fossa and distal marginal ridge the main functioning areas

Prediction Forecast for Culex tritaeniorhynchus Populations in Korea

AbstractObjectivesJapanese encephalitis is considered as a secondary legal infectious disease in Korea and is transmitted by mosquitoes in the summer season. The purpose of this study was to predict the ratio of Culex tritaeniorhynchus to all the species of mosquitoes present in the study regions.MethodsFrom 1999 to 2012, black light traps were installed in 10 regions in Korea (Busan, Gyeonggi, Gangwon, Chungbuk, Chungnam, Jeonbuk, Jeonnam, Gyeongbuk, Gyeongnam, and Jeju) to capture mosquitoes for identification and classification under a dissecting microscope. The number of mosquitoes captured/week was used to calculate its daily occurrence (mosquitoes/trap/night). To predict the characteristics of the mosquito population, an autoregressive model of order p (AR(p)) was used to execute the out-of-sample prediction and the in-sample estimation after presumption.ResultsCompared with the out-of-sample method, the sample-weighted regression method's case was relatively superior for prediction, and this method predicted a decrease in the frequency of Cx. tritaeniorhynchus for 2013. However, the actual frequency of this species showed an increase in frequency. By contrast, the frequency rate of all the mosquitoes including Cx. tritaeniorhynchus gradually decreased.ConclusionThe number of patients with Japanese encephalitis has been strongly associated with the occurrence and density of vector mosquitoes, and the importance of this infectious disease has been highlighted since 2010. The 2013 prediction indicated an increase after an initial decrease, although the ratio of the two mosquito species decreased. The increase in vector density may be due to changes in temperature and the environment. Thus, continuous prevalence prediction is warranted

Liquid crystal display using combined fringe and in-plane electric fields

A high performance liquid crystal display using combined fringe and in-plane horizontal electric fields is proposed. The strong electric fields cause more liquid crystals to reorient almost in plane above and between the pixel electrodes. As a result, the operation voltage is lower and transmittance is higher than those of fringe field switching and in-plane switching modes, while preserving a wide viewing angle. Such a high performance device is particularly attractive for large panel liquid crystal displays

Naegleria fowleri Lysate Induces Strong Cytopathic Effects and Pro-inflammatory Cytokine Release in Rat Microglial Cells

Naegleria fowleri, a ubiquitous free-living ameba, causes fatal primary amebic meningoencephalitis in humans. N. fowleri trophozoites are known to induce cytopathic changes upon contact with microglial cells, including necrotic and apoptotic cell death and pro-inflammatory cytokine release. In this study, we treated rat microglial cells with amebic lysate to probe contact-independent mechanisms for cytotoxicity, determining through a combination of light microscopy and scanning and transmission electron microscopy whether N. fowleri lysate could effect on both necrosis and apoptosis on microglia in a time- as well as dose-dependent fashion. A 51Cr release assay demonstrated pronounced lysate induction of cytotoxicity (71.5%) toward microglial cells by 24 hr after its addition to cultures. In an assay of pro-inflammatory cytokine release, microglial cells treated with N. fowleri lysate produced TNF-α, IL-6, and IL-1β, though generation of the former 2 cytokines was reduced with time, and that of the last increased throughout the experimental period. In summary, N. fowleri lysate exerted strong cytopathic effects on microglial cells, and elicited pro-inflammatory cytokine release as a primary immune response

Association between Dopamine D4 Receptor Gene Polymorphism and Scores on a Continuous Performance Test in Korean Children with Attention Deficit Hyperactivity Disorder

OBJECTIVE: The aim of this study was to evaluate the association between a variable number of tandem repeats polymorphism at the dopamine D4 receptor gene (DRD4) and the performance of children with attention deficit hyperactivity disorder (ADHD) in a continuous performance test (CPT). METHODS: This study included 72 ADHD children (mean age=9.39+/-2.05 years) who were recruited from one child psychiatric clinic. The omission errors, commission errors, reaction time and reaction standardization in the CPT were computed. The number of 48-base pairs tandem repeats in the exon III of DRD4 was analyzed in a blind manner. RESULTS: The homozygosity of the 4-repeat allele at DRD4 was significantly associated with fewer commission errors (t=2.364, df=28.685, p=0.025) and standard deviation of reaction time (t=2.351, df=24.648, p=0.027) even after adjusting for age. The results of analyses of CPT measured values among three groups showed that the group with higher frequency of the 4-repeat allele showed a lower mean score of commission errors (F=4.268, df=2, p=0.018). CONCLUSION: These results suggest a protective role of 4-repeat allele of the DRD4 polymorphisms on commission errors in the CPT in children with ADHDope