Functional electrical stimulation recumbent bicycle for stroke rehabilitation

Stroke is a severe condition that is one of the leading causes to both disabilities and death in the United States. A stroke occurs when blood stops flowing to the brain. It only takes minutes without blood before the brain cells begin to be damaged and even die. Up to 90 percent of people who survive a stroke suffer from some form of paralysis. It is common among stroke patients to experience hemiparesis which paralyses on one side of the body. Functional remodeling of the brain can improve sensation and motor control. However, muscles and nerves degrade (atrophy) over time with disuse. The more a muscle atrophies the longer it takes to rehabilitate that muscle and the degree of recovery is reduced. Functional Electrical Stimulation (FES) can artificially stimulate these muscles and nerves. FES has been proven to be a viable tool for the rehabilitation of atrophied muscles and nerves. The purpose of this thesis project was to design, build and test a Functional Electrical Stimulation (FES) recumbent bicycle that can be used for stroke rehabilitation. An off the shelf FES device was researched and analyzed to determine its capabilities. A circuit was then designed using a recumbent bicycle as the test bed and a Labview program was written as the control mechanism for the FES device. The data collection was done by an optical encoder mounted onto the recumbent bicycle. The system was programmed using Labview for both control and data collection. After the completion of the recumbent bicycle, the protocol and methods were created to provide guidelines for the testing and data analysis. With these guidelines in place, human subject testing could be conducted. The twelve subjects were tested. Electrodes were attached to their thighs and stimulated using the FES device which was controlled by the Labview program. Each participant performed six trials, three with the FES device operating and three with the FES device switched off. The results showed that there were no statistical difference between the test groups, except for the females only group. The female test group pedalled slower with the FES device switched on then with the FES device off. This research showed that the quality of movement was sufficient to allow cycling assisted by FES on the recumbent bicycle. These results may be encouraging for stroke patients with partial hemiparesis and other forms of paralysis to assist them during rehabilitation. The future for FES systems are continuing to progress in a positive direction. This research in conjunction with other research in the biomedical engineering field are enabling new therapy methods that have the potential to improve the quality of life for stroke patients. The FES research completed for the recumbent bicycle showed that the device was capable of properly controlling the leg and propelling it forward with enough power to push the pedal. The experimental study showed that the quality of movement was sufficient to allow cycling assisted by FES on a Recumbent Bicycle. In fact, no statistical differences were found between normal cycling and FES assisted cycling for most groups studied. Initial testing seems suitable for future studies that assist with stroke patients during rehabilitation

Coexistence in an African pastoral landscape: Evidence that livestock and wildlife temporally partition water resources

Funder: Department of Plant Sciences, University of OxfordFunder: Cincinnati Zoo and Botanical GardensFunder: Department of Zoology, University of OxfordFunder: Rob Walker GrantAbstract: African rangelands support substantial wildlife populations alongside pastoralists and livestock. Recent wildlife declines are often attributed to competition with livestock over water and grazing, in part because livestock are thought to spatially displace wildlife. However, more evidence is needed to understand this interaction and inform rangeland management. Here, we analysed the temporal overlap between wildlife and livestock at water points in a community‐governed area of Kenya's South Rift Valley, which is a dry season refuge where Maasai pastoralists, livestock and wildlife co‐occur. We used camera traps to capture images at water points in two time periods: first, when nearby settlements were unoccupied, and second, as people and their herds moved into the area. We measured wildlife activity (independent detections per hour) and the difference in temporal overlap between livestock and wildlife. We found no evidence that daily wildlife activity declined despite increased human and livestock settlement. However, temporal partitioning between livestock and wildlife at watering points increased with wildlife using water resources more at night. Maasai corral livestock overnight to protect them from predation, allowing wildlife to persist in a livestock‐dominated landscape. Our study demonstrates humans and wildlife co‐adapting to mitigate competition for shared water resources, thereby facilitating spatial coexistence

Motion style acupuncture treatment (MSAT) for acute low back pain with severe disability: a multicenter, randomized, controlled trial protocol

<p>Abstract</p> <p>Background</p> <p>Acupuncture is widely-used to treat patients with low back pain, despite insufficient evidence of the technique's efficacy for acute back pain. Motion style acupuncture treatment (MSAT) is a non-traditional acupuncture treatment requiring a patient to exercise while receiving acupuncture. In Korea, MSAT is used to reduce musculoskeletal pain and improve functional status. The study aims to evaluate the effect of MSAT on acute low back pain with severe disability.</p> <p>Methods/Design</p> <p>This study is a multicenter, randomized, active-controlled trial with two parallel arms. Participants with acute low back pain and severe functional disability, defined as an Oswestry Disability Index (ODI) value > 60%, will be randomly allocated to the acupuncture group and the nonsteroidal anti-inflammatory drug (NSAID) injection group. The acupuncture group will receive MSAT and the NSAID injection group will receive an intramuscular injection of diclofenac. All procedures will be limited to one session and the symptoms before and after treatment will be measured by assessors blinded to treatment allocation. The primary outcome will be measured at 30 minutes after treatment using the numerical rating scale (NRS) of low back pain while the patient is moving. Secondary outcomes will be measured at 30 minutes after treatment using the NRS of leg pain, ODI, patient global impression of change, range of motion (ROM) of the lumbar spine, and degrees of straight leg raising (SLR). Post-treatment follow-up will be performed to measure primary and secondary outcomes with the exception of ROM and SLR at 2, 4, and 24 weeks after treatment.</p> <p>Discussion</p> <p>The results of this trial will be discussed.</p> <p>Trial Registration</p> <p>ClinicalTrial.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01315561">NCT01315561</a></p

Melancholic versus non-melancholic depression: differences on cognitive function. A longitudinal study protocol

<p>Abstract</p> <p>Background</p> <p>Cognitive dysfunction is common among depressed patients. However, the pattern and magnitude of impairment during episodes of major depressive disorder (MDD) through to clinical remission remains unclear. Heterogeneity of depressive patients and the lack of longitudinal studies may account for contradictory results in previous research.</p> <p>Methods/Design</p> <p>This longitudinal study will analyze cognitive differences between CORE-defined melancholic depressed patients (n = 60) and non-melancholic depressed patients (n = 60). A comprehensive clinical and cognitive assessment will be performed at admission and after 6 months. Cognitive dysfunction in both groups will be longitudinally compared, and the persistence of cognitive impairment after clinical remission will be determined.</p> <p>Discussion</p> <p>The study of neuropsychological dysfunction and the cognitive changes through the different phases of depression arise a wide variety of difficulties. Several confounding variables must be controlled to determine if the presence of depression could be considered the only factor accounting for group differences.</p

Landscape dynamics (landDX) an open-access spatial-temporal database for the Kenya-Tanzania borderlands

The savannas of the Kenya-Tanzania borderland cover >100,000 km2 and is one of the most important regions globally for biodiversity conservation, particularly large mammals. The region also supports >1 million pastoralists and their livestock. In these systems, resources for both large mammals and pastoralists are highly variable in space and time and thus require connected landscapes. However, ongoing fragmentation of (semi-)natural vegetation by smallholder fencing and expansion of agriculture threatens this social-ecological system. Spatial data on fences and agricultural expansion are localized and dispersed among data owners and databases. Here, we synthesized data from several research groups and conservation NGOs and present the first release of the Landscape Dynamics (landDX) spatial-temporal database, covering ~30,000 km2 of southern Kenya. The data includes 31,000 livestock enclosures, nearly 40,000 kilometres of fencing, and 1,500 km2 of agricultural land. We provide caveats and interpretation of the different methodologies used. These data are useful to answer fundamental ecological questions, to quantify the rate of change of ecosystem function and wildlife populations, for conservation and livestock management, and for local and governmental spatial planning.The South Rift Association of Land Owners (specifically grants from the European Union and the Lion Recovery Fund), BigLife Foundation, Esri Conservation Program, Mara Elephant Project, Microsoft AI4Earth programme, the Carlsberg Foundation Semper Ardens project MegaPast2Future, and the VILLUM Investigator project “Biodiversity Dynamics in a Changing World” funded by VILLUM FONDEN, the European Research Council (ERC) project ANTHEA.http://www.nature.com/scientificdataam2023Mammal Research InstituteZoology and Entomolog

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Conflict or coexistence: human-lion relationships in Kenyaâs southern Maasailand and beyond

Large carnivore populations across the world continue to decline despite concerted efforts to protect them. The range-wide collapse of African lions (Panthera leo) epitomizes this decline. Lions are now confined to 8% of their former range, much outside of formally protected areas. Coexistence with, and tolerance of lions, by communities living within the remaining lion range is therefore essential to their conservation. I sought to investigate the socio-economic, political, cultural, and ecological factors which create and allow for human-lion coexistence. My results show that desire to see current lion populations maintained or increased was not ubiquitous or prevalent amongst communities living with lions. Instead, it was predominantly influenced by exposure to personal benefits (tangible and non-tangible) from conservation. These benefits did not always create a desire to see current lion populations maintained because this was heavily influenced by socio-political context and historical narratives of conservation present within a community. Lions living within pastoral rangelands in Kenyaâs South Rift Valley maintained home ranges comparable in size to those found in prey abundant protected areas and range size was unaffected by seasonal changes in settlement and livestock. Both were influenced by rainfall, pride biomass, cub age and prey dispersion. Pastoralists living in these same areas willingly grazed in areas of known lion presence to attain better pasture. Their use of traditional ecological knowledge and traditional livestock herding helped them to do so. When lion depredations did occur, guarding of livestock at pasture disrupted attacks resulting in reduced mortality. The collective findings of this thesis demonstrate that coexistence between lions and human can be both desirable and achievable. </p

Conflict or coexistence: human-lion relationships in Kenya’s southern Maasailand and beyond

Large carnivore populations across the world continue to decline despite concerted efforts to protect them. The range-wide collapse of African lions (Panthera leo) epitomizes this decline. Lions are now confined to 8% of their former range, much outside of formally protected areas. Coexistence with, and tolerance of lions, by communities living within the remaining lion range is therefore essential to their conservation. I sought to investigate the socio-economic, political, cultural, and ecological factors which create and allow for human-lion coexistence. My results show that desire to see current lion populations maintained or increased was not ubiquitous or prevalent amongst communities living with lions. Instead, it was predominantly influenced by exposure to personal benefits (tangible and non-tangible) from conservation. These benefits did not always create a desire to see current lion populations maintained because this was heavily influenced by socio-political context and historical narratives of conservation present within a community. Lions living within pastoral rangelands in Kenya’s South Rift Valley maintained home ranges comparable in size to those found in prey abundant protected areas and range size was unaffected by seasonal changes in settlement and livestock. Both were influenced by rainfall, pride biomass, cub age and prey dispersion. Pastoralists living in these same areas willingly grazed in areas of known lion presence to attain better pasture. Their use of traditional ecological knowledge and traditional livestock herding helped them to do so. When lion depredations did occur, guarding of livestock at pasture disrupted attacks resulting in reduced mortality. The collective findings of this thesis demonstrate that coexistence between lions and human can be both desirable and achievable. </p

Creating Landscapes of Coexistence: Do Conservation Interventions Promote Tolerance of Lions in Human-dominated Landscapes?

The range-wide decline of lions has led to their conservation becoming a top priority. Protection of free-ranging lion populations is dependent on securing space for lions but also on the ability and desire of local communities to coexist with lions. Our investigation takes a comparative and case study approach to explore the individual and societal desire to maintain current lion populations alongside communities in, or surrounding, Zimbabwe's Hwange National Park, Tanzania's Ruaha National Park, and Kenya's southern Maasailand. Using data from attitudinal questionnaire surveys, we compare the desire to maintain current lion populations as well as the prevalence and success of conservation interventions aimed at increasing human-lion coexistence. In Maasailand, 88% of the respondents expressed a desire to see current lion populations maintained, while only 42% of the respondents in Ruaha and only 5% of the respondents in Hwange expressed this desire. More respondents reported predation by lions (lion predation) on livestock in Maasailand than in Hwange; personal benefits from conservation were greatest in Maasailand; and exposure to conservation education was highest in Ruaha. The Hwange findings were confounded by Zimbabwe's political and economic climate. In Ruaha and Maasailand, communal and individual conservation benefits influenced desired changes to lion population. Once variation between sites was controlled for, twinning personal benefits and conservation education together was most likely to increase an individual's desire to see current lion populations maintained