Leg Sympathetic Response to Noxious Skin Stimuli is Similar in High and Low Level Human Spinal Cord Injury

Objective To determine if sympathetically mediated vasoconstriction in the lower extremities is injury level dependent. Although sympathetic responses have been measured in the limbs of people with high and low level SCI using blood flow measurements, including Doppler ultrasound and venous plethysmography, a direct comparison between injury levels has not been made. Methods Volunteers with chronic SCI were grouped according to injury level. Above T6: high level (HL, n = 7), and T6 and below: low level (LL, n = 6). All subjects had complete motor and sensory loss. Leg arterial flows were recorded by venous occlusion plethysmography, and continuous heart rate and mean arterial pressure (MAP) were measured. The conditioning stimulus consisted of transcutaneous stimulation to the arch of the contralateral foot. Results HL and LL subjects demonstrated a significant decrease in arterial conductance during stimulation with no significant difference found between groups. As expected, only group HL demonstrated a significant increase in MAP. Conclusions These results support our hypothesis that local (leg) sympathetic responses are similar for both high and low level SCI. Significance While low level SCI does not typically present with autonomic dysreflexia, bouts of increased reflex sympathetic activity could have ramifications for metabolism as well as renal and motor system functio

Leg Sympathetic Response to Noxious Skin Stimuli is Similar in High and Low Level Human Spinal Cord Injury

Objective To determine if sympathetically mediated vasoconstriction in the lower extremities is injury level dependent. Although sympathetic responses have been measured in the limbs of people with high and low level SCI using blood flow measurements, including Doppler ultrasound and venous plethysmography, a direct comparison between injury levels has not been made. Methods Volunteers with chronic SCI were grouped according to injury level. Above T6: high level (HL, n = 7), and T6 and below: low level (LL, n = 6). All subjects had complete motor and sensory loss. Leg arterial flows were recorded by venous occlusion plethysmography, and continuous heart rate and mean arterial pressure (MAP) were measured. The conditioning stimulus consisted of transcutaneous stimulation to the arch of the contralateral foot. Results HL and LL subjects demonstrated a significant decrease in arterial conductance during stimulation with no significant difference found between groups. As expected, only group HL demonstrated a significant increase in MAP. Conclusions These results support our hypothesis that local (leg) sympathetic responses are similar for both high and low level SCI. Significance While low level SCI does not typically present with autonomic dysreflexia, bouts of increased reflex sympathetic activity could have ramifications for metabolism as well as renal and motor system functio

An efficient shooting algorithm for Evans function calculations in large systems

In Evans function computations of the spectra of asymptotically constant-coefficient linear operators, a basic issue is the efficient and numerically stable computation of subspaces evolving according to the associated eigenvalue ODE. For small systems, a fast, shooting algorithm may be obtained by representing subspaces as single exterior products \cite{AS,Br.1,Br.2,BrZ,BDG}. For large systems, however, the dimension of the exterior-product space quickly becomes prohibitive, growing as $\binom{n}{k}$, where $n$ is the dimension of the system written as a first-order ODE and $k$ (typically $\sim n/2$) is the dimension of the subspace. We resolve this difficulty by the introduction of a simple polar coordinate algorithm representing ``pure'' (monomial) products as scalar multiples of orthonormal bases, for which the angular equation is a numerically optimized version of the continuous orthogonalization method of Drury--Davey \cite{Da,Dr} and the radial equation is evaluable by quadrature. Notably, the polar-coordinate method preserves the important property of analyticity with respect to parameters.Comment: 21 pp., two figure

Pilot Study: Assistive Technology as a Vocational Support for Individuals with Autism Spectrum Disorder

The purpose of this pilot study was to determine the effectiveness of video-based instruction (VBI) to support completion of vocational tasks. A mixed-method approach was utilized to explore the use of VBI on a personal digital assistant with individuals with autism spectrum disorder (ASD). Using two assembling cooking tasks, researchers investigated the level of independence with task completion through written instruction versus VBI. The results indicated a small non-significant increase in the level of independence with task completion during the VBI task independent of intelligence quotient (IQ) levels. Participant’s feedback of VBI was also noted as positive to help learn other tasks. This study presents evidence for the use of assistive technology to support task completion in the area of vocation for individuals with ASD

Pilot Study: Assistive Technology as a Vocational Support for Individuals with Autism Spectrum Disorder

The purpose of this pilot study was to determine the effectiveness of video-based instruction (VBI) to support completion of vocational tasks. A mixed-method approach was utilized to explore the use of VBI on a personal digital assistant with adults with autism spectrum disorder. Using two assembling cooking tasks, researchers investigated the level of independence with task completion through written instruction versus VBI. The results indicated a small non-significant increase in the level of independence with task completion during the intervention task independent of intelligence quotient (IQ) levels. Participant’s feedback of VBI was also noted as positive to help learn other tasks. This study presents evidence for the use of assistive technology to support task completion in the area of vocation.https://scholar.dominican.edu/ug-student-posters/1067/thumbnail.jp

Encoding tactile frequency and intensity information in the temporal pattern of afferent nerve impulses

Using our hands to interact with the world around us produces complex vibrations travelling across the skin. These complex waves are transduced by tactile afferent neurons whose impulse patterns convey information about the external world. A major question in this field is how important the timing of these afferent impulses is in shaping perception. We have the means to investigate this question by artificially inducing impulse patterns using brief mechanical and electrical stimuli, allowing us to study the neural coding of vibrotactile sensory information. Our lab has used this to show that when mechanical pulses evoked impulse trains grouped into periodic bursts, perceived frequency corresponded to the duration of the silent inter-burst gap interval, rather than the periodicity or the mean impulse rate. In this thesis, we induced controlled impulse trains, while measuring the perceptual responses of human subjects using psychophysical methods to assess the dimensions of frequency and intensity. As electrical stimulation has broad utility in prosthetic applications, we first verified that the same perceived frequency as predicted by the burst gap was elicited with electrical pulses in subjects within the low frequency flutter range. We then tested whether this same coding mechanism also applied outside the flutter frequency range by conducting further experiments with higher pulse rates. We found that burst gap coding correctly predicted perceived frequencies above flutter, suggesting a generalised temporal processing strategy that operates on tactile afferent inputs spanning a broad range of frequencies. Next, we investigated perceived intensity where stimulus pulse rate was varied without changes in afferent population recruitment or in perceived frequency by using bursts of pulsatile stimuli. Increasing the number of pulses within a burst caused a significant increase in perceived intensity when electrical stimulation was used. Mechanical pulses with the same burst groupings did not produce a comparable intensity increase, possibly due to minimal variations in the population firing rate. These new insights into the encoding of tactile information through temporal patterning in peripheral impulse patterns may allow the multiplexing of frequency and intensity sensations with a fixed stimulation amplitude for use in neural interfaces to deliver sensory feedback information

Primary prevention implantable cardiac defibrillators: a Townsville district perspective

Background: Despite major advances in treating patients with severe heart failure, deciding who should receive an implantable cardiac defibrillator (ICD) remains challenging. Objective: To study the risk factors and mortality in patients after receiving an ICD (January 2008–December 2015) in a regional hospital in Australia. Methods: Eighty-two primary prevention patients received an ICD for ischemic cardiomyopathy (ICM, n = 41) and non-ischemic cardiomyopathy (NICM, n = 40) with 4.8-yrs follow-up. One patient had mixed ICM/NICM indications. Ventricular arrhythmias were assessed using intracardiac electrograms. Statistical analysis compared the total population and ICM and NICM groups using Kaplan-Meier for survival, Cox regression for mortality predictors, and binary logistic regression for predictors of ventricular arrhythmias (p < 0.05). Results: Major risk factors were hypercholesterolemia (70.7%), hypertension (47.6%), and obesity (41.5%). Severe obstructive sleep apnea (OSA) was found exclusively in NICM patients (23.7%, p = 0.001). Mortality was 30.5% after 4.8-yrs. The majority of patients (n=67) had no sustained ventricular arrhythmias yet 28% received therapy (n = 23), 18.51% were appropriate (n = 15), and 13.9% inappropriate (n = 11). Patients receiving ≥2 incidences of inappropriate shocks were 18-times more likely to die (p =0.013). Three sudden cardiac deaths (SCD) (3.7%) were prevented by the ICD. Conclusion: Patients implanted with an ICD in Townsville had 30.5% all-cause mortality after 4.8-yrs. Only 28% of patients received ICD therapy and 13.9% were inappropriate. OSA may have contributed to the fourfold increase in inappropriate therapy in NICM patients. Our study raises important efficacy, ethical and healthcare cost questions about who should receive an ICD, and possible regional and urban center disparities