194 research outputs found

    Scattering, loss, and gain of surface plasmons

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    A surface plasmon is light that is bound to a metal surface. The main merit of a surface plasmon is that is provides confinement below the diffraction limit. In this thesis, we first study the excitation and scattering of surface plasmons by subwavelength holes in the metal. Thereafter we show that an array of these hole acts as a surface plasmon laser when the surface plasmons are sufficiently amplified using a semiconductor gain mediumQuantum Matter and Optic

    A Feasibility Study in Measuring Soft Tissue Artifacts on the Upper Leg Using Inertial and Magnetic Sensors

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    Soft-tissue artifacts cause inaccurate estimates of body segment orientations. The inertial sensor (or optical marker) is orientating (or displacing) with respect to the bone it has to measure, due to muscle and skin movement [1]. In this pilot study 11 inertial and magnetic sensors (MTw, Xsens Technologies) were placed on the rectus femoris, vastus medialis and vastus lateralis (upper leg). One sensor was positioned on the tendon plate behind the quadriceps (iliotibial tract, as used in Xsens MVN [1]) and used as reference sensor. Walking, active and passive knee extensions and muscle contractions without flexion/extension were recorded using one subject. The orientation of each sensor with respect to the reference sensor was calculated. During walking, relative orientations of up to 28.6Âș were measured (22.4±3.6Âș). During muscle contractions without flexion/extension the largest relative orientations were measured on the rectus femoris (up to 11.1Âș) [2]. This pilot showed that the ambulatory measurement of deformation of the upper leg is feasible; however, improving the measurement technology is required. We therefore have designed a new inertial and magnetic sensor system containing smaller sensors, based on the design of an instrumented glove for the assessment of hand kinematics [3]. This new sensor system will then be used to investigate soft-tissue artifacts more accurately; in particular we will focus on in-use estimation and elimination of these artifacts

    Glucose regulation beyond hba<sub>1c</sub> in type 2 diabetes treated with insulin:Real-world evidence from the dialect-2 cohort

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    OBJECTIVE: To investigate glucose variations associated with glycated hemoglobin (HbA(1c)) in insulin-treated patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Patients included in Diabetes and Lifestyle Cohort Twente (DIALECT)-2 (n = 79) were grouped into three HbA(1c) categories: low, intermediate, and high (≀53, 54–62, and ≄63 mmol/mol or ≀7, 7.1–7.8, and ≄7.9%, respectively). Blood glucose time in range (TIR), time below range (TBR), time above range (TAR), glucose variability parameters, day and night duration, and frequency of TBR and TAR episodes were determined by continuous glucose monitoring (CGM) using the FreeStyle Libre sensor and compared between HbA(1c) categories. RESULTS: CGM was performed for a median (interquartile range) of 10 (7–12) days/patient. TIR was not different for low and intermediate HbA(1c) categories (76.8% [68.3–88.2] vs. 76.0% [72.5.0–80.1]), whereas in the low category, TBR was higher and TAR lower (7.7% [2.4–19.1] vs. 0.7% [0.3–6.1] and 8.2% [5.7–17.6] vs. 20.4% [11.6–27.0], respectively; P < 0.05). Patients in the highest HbA(1c) category had lower TIR (52.7% [40.9–67.3]) and higher TAR (44.1% [27.8–57.0]) than the other HbA(1c) categories (P < 0.05), but did not have less TBR during the night. All patients had more (0.06 ± 0.06/h vs. 0.03 ± 0.03/h; P = 0.002) and longer (88.0 [45.0–195.5] vs. 53.4 [34.4–82.8] minutes; P < 0.001) TBR episodes during the night than during the day. CONCLUSIONS: In this study, a high HbA(1c) did not reduce the occurrence of nocturnal hypoglycemia, and low HbA(1c) was not associated with the highest TIR. Optimal personalization of glycemic control requires the use of newer tools, including CGM-derived parameters

    A Sensor-Based Feedback Device Stimulating Daily Life Upper Extremity Activity in Stroke Patients:A Feasibility Study

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    This study aims to evaluate the feasibility and explore the efficacy of the Arm Activity Tracker (AAT). The AAT is a device based on wrist-worn accelerometers that provides visual and tactile feedback to stimulate daily life upper extremity (UE) activity in stroke patients. Methods: A randomised, crossover within-subject study was conducted in sub-acute stroke patients admitted to a rehabilitation centre. Feasibility encompassed (1) adherence: the dropout rate and the number of participants with insufficient AAT data collection; (2) acceptance: the technology acceptance model (range: 7–112) and (3) usability: the system usability scale (range: 0–100). A two-way ANOVA was used to estimate the difference between the baseline, intervention and control conditions for (1) paretic UE activity and (2) UE activity ratio. Results: Seventeen stroke patients were included. A 29% dropout rate was observed, and two participants had insufficient data collection. Participants who adhered to the study reported good acceptance (median (IQR): 94 (77–111)) and usability (median (IQR): 77.5 (75–78.5)-). We found small to medium effect sizes favouring the intervention condition for paretic UE activity (η2G = 0.07, p = 0.04) and ratio (η2G = 0.11, p = 0.22). Conclusion: Participants who adhered to the study showed good acceptance and usability of the AAT and increased paretic UE activity. Dropouts should be further evaluated, and a sufficiently powered trial should be performed to analyse efficacy.</p

    Smoothness metrics for reaching performance after stroke:Part 1: which one to choose?

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    BACKGROUND: Smoothness is commonly used for measuring movement quality of the upper paretic limb during reaching tasks after stroke. Many different smoothness metrics have been used in stroke research, but a ‘valid’ metric has not been identified. A systematic review and subsequent rigorous analysis of smoothness metrics used in stroke research, in terms of their mathematical definitions and response to simulated perturbations, is needed to conclude whether they are valid for measuring smoothness. Our objective was to provide a recommendation for metrics that reflect smoothness after stroke based on: (1) a systematic review of smoothness metrics for reaching used in stroke research, (2) the mathematical description of the metrics, and (3) the response of metrics to simulated changes associated with smoothness deficits in the reaching profile. METHODS: The systematic review was performed by screening electronic databases using combined keyword groups Stroke, Reaching and Smoothness. Subsequently, each metric identified was assessed with mathematical criteria regarding smoothness: (a) being dimensionless, (b) being reproducible, (c) being based on rate of change of position, and (d) not being a linear transform of other smoothness metrics. The resulting metrics were tested for their response to simulated changes in reaching using models of velocity profiles with varying reaching distances and durations, harmonic disturbances, noise, and sub-movements. Two reaching tasks were simulated; reach-to-point and reach-to-grasp. The metrics that responded as expected in all simulation analyses were considered to be valid. RESULTS: The systematic review identified 32 different smoothness metrics, 17 of which were excluded based on mathematical criteria, and 13 more as they did not respond as expected in all simulation analyses. Eventually, we found that, for reach-to-point and reach-to-grasp movements, only Spectral Arc Length (SPARC) was found to be a valid metric. CONCLUSIONS: Based on this systematic review and simulation analyses, we recommend the use of SPARC as a valid smoothness metric in both reach-to-point and reach-to-grasp tasks of the upper limb after stroke. However, further research is needed to understand the time course of smoothness measured with SPARC for the upper limb early post stroke, preferably in longitudinal studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12984-021-00949-6

    Low Physical Activity in Patients with Complicated Type 2 Diabetes Mellitus Is Associated with Low Muscle Mass and Low Protein Intake

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    Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary protein intake, and PA. Methods: We performed cross-sectional analyses in all patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT) between November 2016 and November 2018. Patients were divided into four groups: = 10,000 steps/day. We studied the association between muscle mass (24 h urinary creatinine excretion rate, CER) and protein intake (by Maroni formula), and the main outcome variable PA (steps/day, Fitbit Flex device) using multivariate linear regression analyses. Results: In the 217 included patients, the median steps/day were 6118 (4115-8638). Of these patients, 48 patients (22%) took 7000-9999 steps/day, 37 patients (17%) took >= 10,000 steps/day, and 78 patients (36%) took = 10,000 steps/day, a higher body mass index (BMI) (33 +/- 6 vs. 30 +/- 5 kg/m(2), p = 0.009), lower CER (11.7 +/- 4.8 vs. 14.8 +/- 3.8 mmol/24 h, p = 0.001), and lower protein intake (0.84 +/- 0.29 vs. 1.08 +/- 0.22 g/kg/day, p < 0.001). Both creatinine excretion (beta = 0.26, p < 0.001) and dietary protein intake (beta = 0.31, p < 0.001) were strongly associated with PA, which remained unchanged after adjustment for potential confounders. Conclusions: Prevalent insufficient protein intake and low muscle mass co-exist in obese patients with low physical activity. Dedicated intervention studies are needed to study the role of sufficient protein intake and physical activity in increasing or maintaining muscle mass in patients with type 2 diabetes
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