Non-intrusive real-time breathing pattern detection and classification for automatic abdominal functional electrical stimulation

Abdominal Functional Electrical Stimulation (AFES) has been shown to improve the respiratory function of people with tetraplegia. The effectiveness of AFES can be enhanced by using different stimulation parameters for quiet breathing and coughing. The signal from a spirometer, coupled with a facemask, has previously been used to differentiate between these breath types. In this study, the suitability of less intrusive sensors was investigated with able-bodied volunteers. Signals from two respiratory effort belts, positioned around the chest and the abdomen, were used with a Support Vector Machine (SVM) algorithm, trained on a participant by participant basis, to classify, in real-time, respiratory activity as either quiet breathing or coughing. This was compared with the classification accuracy achieved using a spirometer signal and an SVM. The signal from the belt positioned around the chest provided an acceptable classification performance compared to the signal from a spirometer (mean cough (<i>c</i>) and quiet breath (<i>q</i>) sensitivity (<i>Se</i>) of <i>Se<sup>c</sup></i> = 92.9% and <i>Se<sup>q</sup></i> = 96.1% vs. <i>Se<sup>c</sup></i> = 90.7% and <i>Se<sup>q</sup></i> = 98.9%). The abdominal belt and a combination of both belt signals resulted in lower classification accuracy. We suggest that this novel SVM classification algorithm, combined with a respiratory effort belt, could be incorporated into an automatic AFES device, designed to improve the respiratory function of the tetraplegic population

Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis

Objectives: Abdominal functional electrical stimulation (abdominal FES) is the application of a train of electrical pulses to the abdominal muscles, causing them to contract. Abdominal FES has been used as a neuroprosthesis to acutely augment respiratory function and as a rehabilitation tool to achieve a chronic increase in respiratory function after abdominal FES training, primarily focusing on patients with spinal cord injury (SCI). This study aimed to review the evidence surrounding the use of abdominal FES to improve respiratory function in both an acute and chronic manner after SCI. Settings: A systematic search was performed on PubMed, with studies included if they applied abdominal FES to improve respiratory function in patients with SCI. Methods: Fourteen studies met the inclusion criteria (10 acute and 4 chronic). Low participant numbers and heterogeneity across studies reduced the power of the meta-analysis. Despite this, abdominal FES was found to cause a significant acute improvement in cough peak flow, whereas forced exhaled volume in 1 s approached significance. A significant chronic increase in unassisted vital capacity, forced vital capacity and peak expiratory flow was found after abdominal FES training compared with baseline. Conclusions: This systematic review suggests that abdominal FES is an effective technique for improving respiratory function in both an acute and chronic manner after SCI. However, further randomised controlled trials, with larger participant numbers and standardised protocols, are needed to fully establish the clinical efficacy of this technique

P2X7 Receptor Primes IL-1β and the NLRP3 Inflammasome in Astrocytes Subjected to Mechanical Strain

Inflammatory responses play a key role in many neural pathologies, with localized signaling from non-immune cells making critical contributions. The NLRP3 inflammasome is an important component of innate immune signaling and can link neural insult to chronic inflammation. Stimulation of the NLRP3 inflammasome is a two-stage process. The priming stage involves upregulation of the biosynthesis of the structural components while activation results in their assembly into the actual inflammasome complex and subsequent activation. The priming step can be rate limiting and can connect insult to chronic inflammation but our knowledge of the signals that regulate NLRP3 inflammasome priming in sterile inflammatory conditions is limited. This study examined the link between mechanical strain and inflammasome priming in neural systems. Transient non-ischemic elevation of intraocular pressure (IOP) increased mRNA for inflammasome components IL-1β, NLRP3, ASC, CASP1 and IL-6 in rat and mouse retinas. The P2X7 receptor was implicated in the in vivo mechanosensitive priming of IL-1β and IL-6 transcription and translation. In vitro experiments with optic nerve head astrocytes demonstrated enhanced expression of the IL-1β and IL-6 genes following stretching or swelling. The increase in IL-1β expression was inhibited by degradation of extracellular ATP with apyrase, blocking pannexin hemichannels with carbenoxolone, probenecid or 10Panx1 peptide, P2X7 receptor antagonists (BBG, A839977 or A740003) as well inhibition of the NFκB transcription factor with Bay 11-7082. The swelling-dependent fall in expression of the NFκB inhibitor IκB-α was reduced by treatment of cells with A839977 and in P2X7 knockout mice. In summary, our data suggest that mechanical trauma to the retina results in priming of the NLRP3 inflammasome components and upregulated IL-6 expression and release. This was dependent upon ATP release through pannexin hemichannels and autostimulation of the P2X7 receptor. Since the P2X7 receptor can also trigger inflammasome activation it appears to have a central role in linking mechanical strain to neuroinflammation

T1R3: A human calcium taste receptor

Many animals can detect the taste of calcium but it is unclear how or whether humans have this ability. We show here that calcium activates hTAS1R3-transfected HEK293 cells and that this response is attenuated by lactisole, an inhibitor of hT1R3. Moreover, trained volunteers report that lactisole reduces the calcium intensity of calcium lactate. Thus, humans can detect calcium by taste, T1R3 is a receptor responsible for this, and lactisole can reduce the taste perception of calcium by acting on T1R3

Knowing your place and commanding space:de/constructions of gendered embodiment in mixed-sex karate

Feminists have long acknowledged that gendered divisions in access to spaces of leisure, and how women and men physically take up that space, reproduces gender inequality. This article will explore how karate practitioners participate in the space of mixed-sex karate practice and how such uses of space de/construct gendered embodiments and a gender hierarchy. Data presented is drawn from nine months of ethnographic emersion within three karate clubs and fifteen photo-elicitation interviews with karate participants from the three clubs. The findings of this paper suggest that whilst women often occupied spaces of expertise within the karate hall, gendered distinctions in uses of space emerged in the more subtle ways in which women and men used their voice, responded to the tacit and smelt dilemmas of sweat, and moved their bodies across physical space. This research highlights both the potential of physical leisure practice to ‘undo’ conventional gendered embodiments that particularly restrict women’s intentionality in the world (Young, 1980), and the power of spatially-attuned research to illuminate the minute ways in which unequal gender relations are naturalised, legitimised and done

Gender, media, and mixed martial arts in Poland: the case of Joanna Jędrzejczyk

Recent growth in the media visibility of female combat sport athletes has offered a compelling site for research on gender and sport media, as women in deeply masculinized sports have been increasingly placed in the public spotlight. While scholars in the Anglophone West have offered analyses of the media framing of this phenomenon, little work has been done outside these cultural contexts. Thus, in this paper we offer a qualitative exploration of how Joanna Jędrzejczyk, a Polish champion of the Ultimate Fighting Championship, has been represented in Polish media. Our findings reveal a relatively de-gendered, widely celebratory account, primarily framed by nationalistic discourse–findings we ascribe to both the particularities of the sport of mixed martial arts as well as the historic nature of Jędrzejczyk’s success

The P2Y12 Receptor Antagonist Ticagrelor Reduces Lysosomal pH and Autofluorescence in Retinal Pigmented Epithelial Cells From the ABCA4-/- Mouse Model of Retinal Degeneration

The accumulation of partially degraded lipid waste in lysosomal-related organelles may contribute to pathology in many aging diseases. The presence of these lipofuscin granules is particularly evident in the autofluorescent lysosome-associated organelles of the retinal pigmented epithelial (RPE) cells, and may be related to early stages of age-related macular degeneration. While lysosomal enzymes degrade material optimally at acidic pH levels, lysosomal pH is elevated in RPE cells from the ABCA4-/- mouse model of Stargardt\u27s disease, an early onset retinal degeneration. Lowering lysosomal pH through cAMP-dependent pathways decreases accumulation of autofluorescent material in RPE cells in vitro, but identification of an appropriate receptor is crucial for manipulating this pathway in vivo. As the P2Y12 receptor for ADP is coupled to the inhibitory Gi protein, we asked whether blocking the P2Y12 receptor with ticagrelor could restore lysosomal acidity and reduce autofluorescence in compromised RPE cells from ABCA4-/- mice. Oral delivery of ticagrelor giving rise to clinically relevant exposure lowered lysosomal pH in these RPE cells. Ticagrelor also partially reduced autofluorescence in the RPE cells of ABCA4-/- mice. In vitro studies in ARPE-19 cells using more specific antagonists AR-C69931 and AR-C66096 confirmed the importance of the P2Y12 receptor for lowering lysosomal pH and reducing autofluorescence. These observations identify P2Y12 receptor blockade as a potential target to lower lysosomal pH and clear lysosomal waste in RPE cells. © 2018 Lu, Gómez, Lim, Guha, O\u27Brien-Jenkins, Coffey, Campagno, McCaughey, Laties, Carlsson and Mitchell

The impact of venepuncture training on the reduction of pre?analytical blood sample haemolysis rates: A systematic review

BackgroundVenepuncture involves the introduction of a needle into a vein to collect a representative blood sample for laboratory testing. In the pre‐analytical phase, haemolysis (the rupturing of erythrocytes and release of their contents into the extracellular compartment) has safety, quality and cost implications. Training in correct venepuncture practice has the potential to reduce in vitro haemolysis rates, but the evidence for this notion has yet to be synthesised.DesignSystematic review (PRISMA Checklist).MethodsPublished studies on the effectiveness of venepuncture training on haemolysis rates were searched in relevant databases. The McMaster critical appraisal tool was used to assess methodological quality. The GRADE tool was used to evaluate the body of evidence in relation to the research questions. Implementation fidelity was also scrutinised in each study.ResultsEight out of 437 retrieved studies met the inclusion criteria. None were randomised controlled trials (RCT). Between‐study heterogeneity in design, intervention characteristics and the biochemical threshold for haemolysis precluded a meta‐analysis. Post‐training reductions in haemolysis rates of between 0.4%–19.8% were reported in four of the studies, which developed their intervention according to a clear evidence base and included mentoring in the intervention. Rises in haemolysis rates of between 1.3%–1.9% were reported in two studies, while the intervention effect was inconsistent within two other studies.ConclusionThere are no RCTS on the effectiveness of venepuncture training for reducing haemolysis rates, and findings from the existing uncontrolled studies are unclear. For a more robust evidence base, we recommend more RCTs with standardisation of haemolysis thresholds and training‐related factors.Relevance to clinical practiceWhile venepuncture training is an important factor influencing quality of blood sample in clinical practice, more robust evidence is needed to make specific recommendations about training content for reduction of haemolysis rates. Standardisation of haemolysis thresholds would also enable future meta‐analyses