Autonomic Dysreflexia during a Bowel Program in Patients with Cervical Spinal Cord Injury.

The purpose of the present study was to investigate the relationship between bowel maneuvers and autonomic dysreflexia (AD) in patients with cervical spinal cord injuries (CSCI). Fifteen consecutive, clinically stable patients with CSCI participated. We evaluated changes in blood pressure (BP), pulse rate (PR) and classic symptoms of AD before, during and after a bowel program involving the manual removal of stool in lateral recumbency. The insertion of rectal medication induced a significant increase in systolic BP, which persisted during additional digital rectal stimulation. Furthermore, the manual removal of stool induced AD, with maximal increases of systolic BP (169.1(+-)19.5 mmHg, mean(+-)SD). However, the insertion of a finger into the anus after the end of stool flow did not cause a further increase in systolic BP. Systolic BP recovered to pre-program values within 5 min after defecation. Our study demonstrated that the combined effects of rectal and/or anal sphincter distension and uninhibited rectal contraction in response to the manual removal of stool might induce AD. We recommend avoiding, if at all possible, the manual removal of stool in order to prevent AD in patients with CSCI

The effect of service dogs on the improvement of health-related quality of life

To assess the effects of service dogs on health-related quality of life (HRQOL), we conducted a survey of 10 service dog owners using SF-36v2 (Medical Outcomes Study 36 Item Short-Form Health Survey Version 2.0) and compared it with a matched control group of people with physical disabilities who did not have service dogs but were eligible for one. The scores for mental health and role emotional of service dog owners were relatively high, and their mental component summary was higher than the general population norm. These results indicate that service dogs affect the mentality of their owners. The comparison with the control group indicated that service dogs alleviate the mental burden of daily activities, and subjectively improved the physical functioning of their owners. This study showed that service dogs have positive functional and mental effects on their disabled owners.</p

Effects of mechanical insufflation-exsufflation on compartmental chest wall volume in patients with chronic cervical spinal cord injuries

　The purpose of this study was to evaluate the effects of mechanical insufflationexsufflation (MI-E) on volume change of the chest wall and each compartment of the chest wall in patients with cervical spinal cord injury using optoelectronic plethysmography (OEP).　Fourteen male patients with chronic cervical spinal cord injuries were included with the following characteristics: age, 56.2 ± 13.6 years; height, 168.4 ± 5.5 cm; body weight, 62.3 ± 12.7 kg; median number of days after injury, 387 days (range, 200-3575 days). The change of chest wall volume was significantly greater during MI-E of ≥ ±30 cmH2O than when taking a deep breath. The volume change in the upper and lower thorax compartment was significantly greater during MI-E of ≥ ±30 cmH2O than when taking a deep breath. However, MI-E made no significant difference to the volume of the upper and lower thorax compartment between pressures of ±30 cmH2O and ±50 cmH2O. The volume change in the abdomen compartment was slightly greater during MI-E than when taking a deep breath, but this was not statistically significant.　The findings of this study indicate the possibility of maintenance or improvement of the compliance of the chest wall, especially the rib cage in patients with spinal cord injuries, using MI-E. In turn, these findings could lead to the prevention of pulmonary complications

Assessment of chest movements in tetraplegic patients using a three-dimensional motion analysis system

We used optoelectronic plethysmography (OEP) to evaluate the effects of posture on chest and abdominal movements during respiration in patients with chronic-stage complete spinal cord injuries. The subjects were five cervical injury patients (male, C4-C8 injury, American Spinal Injury Association Impairment Scale grade A) and five healthy people matched to each of the cervical injury patients for age, height, and weight. The chest wall movement each of the subjects was recorded using OEP during six quiet breathing and three deep breathing periods in each of the following positions: supine, with the trunk elevated to 30°, and with the trunk elevated to 60°. Data on the chest wall volume and compartment volumes (upper thorax, lower thorax, abdomen) were then compared among the postures. During quiet breathing in the tetraplegic patients, the change in upper thorax volume was smaller at the end of inhalation than at the end of exhalation, presenting as a paradoxical breathing pattern. During deep breathing in the tetraplegic patients, abdominal volume accounted for a large portion of the change in total chest wall volume. Posture affected the recorded abdominal volume; volume was greatest in the supine position and decreased as the posture became more upright

Time-series analysis of satellite imagery for detecting vegetation cover changes in Indonesia

Abstract Indonesia has one of the world’s largest tropical forests; thus, its deforestation and environmental degradation are a global concern. This study is the first to perform comprehensive big data analyses with coherent vegetation criteria to measure the vegetation change at a high temporal resolution (every 16-day period) for 20 years and the high administrative resolution (regency or city) all over Indonesia. The normalized difference vegetation index (NDVI) of the Moderate Resolution Imaging Spectroradiometer is analyzed through state space modeling. The findings reveal that the NDVI increases in almost all regencies, except in urban areas. A high correlation between the NDVI change and the time is observed in Sumatra, Papua, and Kalimantan. The gain of the NDVI values is obvious in the Central and Eastern Java Island. Human activities, such as the expansion of agriculture and forestry and forest conservation policies, are the key factors for the observed pattern