Parallel Facilitatory Reflex Pathways from the Foot and Hip to Flexors and Extensors in the Injured Human Spinal Cord

Spinal integration of sensory signals associated with hip position, muscle loading, and cutaneous sensation of the foot contributes to movement regulation. The exact interactive effects of these sensory signals under controlled dynamic conditions are unknown. The purpose of the present study was to establish the effects of combined plantar cutaneous afferent excitation and hip movement on the Hoffmann (H) and flexion reflexes in people with a spinal cord injury (SCI). The flexion and H-reflexes were elicited through stimulation of the right sural (at non-nociceptive levels) and posterior tibial nerves respectively. Reflex responses were recorded from the ipsilateral tibialis anterior (TA) (flexion reflex) and soleus (H-reflex) muscles. The plantar cutaneous afferents were stimulated at three times the perceptual threshold (200 Hz, 24-ms pulse train) at conditioning–test intervals that ranged from 3 to 90 ms. Sinusoidal movements were imposed to the right hip joint at 0.2 Hz with subjects supine. Control and conditioned reflexes were recorded as the hip moved in flexion and extension. Leg muscle activity and sagittal-plane joint torques were recorded. We found that excitation of plantar cutaneous afferents facilitated the soleus H-reflex and the long latency flexion reflex during hip extension. In contrast, the short latency flexion reflex was depressed by plantar cutaneous stimulation during hip flexion. Oscillatory joint forces were present during the transition phase of the hip movement from flexion to extension when stimuli were delivered during hip flexion. Hip-mediated input interacts with feedback from the foot sole to facilitate extensor and flexor reflex activity during the extension phase of movement. The interactive effects of these sensory signals may be a feature of impaired gait, but when they are appropriately excited, they may contribute to locomotion recovery in these patients

Predicting Factors of Re-Hospitalization After Medically Managed Intensive Inpatient Services in Opioid Use Disorder

IntroductionOpioid use disorder has continued to rise in prevalence across the United States, with an estimated 2.5 million Americans ailing from the condition (NIDA, 2020). Medically managed detoxification incurs substantial costs and, when used independently, may not be effective in preventing relapse (Kosten & Baxter, 2019). While numerous studies have focused on predicting the factors of developing opioid use disorder, few have identified predictors of readmission to medically managed withdrawal at an inpatient level of care. Utilizing a high-fidelity dataset from a large multi-site behavioral health hospital, these predictors are explored. MethodsPatients diagnosed with Opioid Use Disorder and hospitalized in the inpatient level of care were analyzed to identify readmission predictors. Factors including patient demographics, patient-reported outcome measures, and post-discharge treatment interventions were included. Patients re-hospitalized to the inpatient level of care were binary labeled in the dataset, and various machine learning algorithms were tested, including machine learning techniques. Methods include random forest, gradient boosting, and deep learning techniques. Evaluation statistics include specificity, accuracy, precision, and Matthew\u27s Coefficient. ResultsOverall, there was a wide variation if correctly predicting the class of patients that would readmit to a medically managed level of inpatient detoxification. Out of the six models evaluated, three of the six did not converge, thus not producing a viable feature ranking. However, of the other three models that did converge, the deep learning model produced almost perfect classification, producing an accuracy of .98. AdaBoost and the logistic regression model produced an accuracy of .97 and .61, respectively. Each of these models produced a similar set of features that were important to predicting which patient profile would readmit to medically managed inpatient detoxification. ConclusionsThe results indicate that overall reduction in the Quick Inventory of Depressive Symptomology, discharge disposition, age, length of stay, and a patient\u27s total number of diagnoses were important features at predicting readmission. Additionally, deep learning algorithms vastly outperformed other machine learning algorithms

Applying Kansei Engineering, the Kano model and QFD to services

This paper aims to present an integrative framework of Kansei Engineering (KE), the Kano model and quality function deployment (QFD) applied to services. An empirical study involving Indonesian and Singaporean tourists was conducted to showcase the framework’s applicability. The study utilises a sample of 100 Indonesian and 125 Singaporean tourists who stayed in luxury hotels and covers only services in luxury hotels. Interviews and face-to-face questionnaire surveys were carried out. Using stepwise linear regression analysis, this research models the effect of perceived hotel service performance on customer emotional needs (Kansei). House of quality (HOQ) is then used to formulate managerial strategies. We present the fruitfulness of integrating the Kano model, KE and QFD. Perceived attractive qualities have a direct significant impact on Kansei response. There is no analysis of the impact of cultural differences on Kansei. We provide insight on which service attributes deserve more attention with regard to their significant impact on customer emotions. It may guide service managers to provide and implement improvement strategies in satisfying customer emotional needs. The study proposes a unique methodology of integrative three concepts commonly used in manufacturing and service quality research to measure and model customer emotional needs

Cultural differences in applying Kansei Engineering to services

It is imperative for companies to provide competitive products and services at a competitive price. Products and services need to offer features and properties which can makethem distinguishable and attractive to customers. Emotions and feelings are prominent during product interaction and service encounter. Kansei Engineering (KE) enables interpretation and translation of customer emotions into design parameters. The application of KE covers both products and services design. Besides dealing with attractive exterior appearances, KE has an ability to optimize properties that are not directly detectable or visible, such as the comfort of hospital and concert hall. There are few empirical studies. Kansei management should recognize cultural differences in Kansei. However, for analysis of cultural values we need to understand the different needs of different customers. A study of luxury hotel services for Indonesian, Japanese and Singaporean tourists, was conducted using interviews and a tri-lingual face-to-face questionnaire. 425 responses were collected. Japanese tourists were found to be the most Kansei-oriented. They tended to value luxury hotels as “clean” and “quiet” places to stay. Indonesian and Singaporean tourists shared a common response to the Kansei word “elegant” which correlates with their common cultural dimension of “power distance”. Incorporation of cultural issues into Kansei studies can provide marketing strategies for customers of different cultural backgrounds

Pre- and Post-alpha Motoneuronal Control of the Soleus H-reflex during Sinusoidal Hip Movements in Human Spinal Cord Injury

The aim of this study was to establish the contribution of hip-mediated sensory feedback to spinal interneuronal circuits during dynamic conditions in people with incomplete spinal cord injury (SCI). Specifically, we investigated the effects of synergistic and antagonistic group I afferents on the soleus H-reflex during imposed sinusoidal hip movements. The soleus H-reflex was conditioned by stimulating the common peroneal nerve (CPN) at short (2, 3, and 4 ms) and long (80, 100, and 120 ms) conditioning test (C-T) intervals to assess the reciprocal and pre-synaptic inhibition of the soleus H-reflex, respectively. The soleus H-reflex was also conditioned by medial gastrocnemius (MG) nerve stimulation at C-T intervals ranging from 4 to 7 ms to assess changes in autogenic Ib inhibition during hip movement. Sinusoidal hip movements were imposed to the right hip joint at 0.2 Hz by the Biodex system while subjects were supine. The effects of sinusoidal hip movement on five leg muscles along with hip, knee, and ankle joint torques were also established during sensorimotor conditioning of the reflex. Phase-dependent modulation of antagonistic and synergistic muscle afferents was present during hip movement, with the reciprocal, pre-synaptic, and Ib inhibition to be significantly reduced during hip extension and reinforced during hip flexion. Reflexive muscle and joint torque responses – induced by the hip movement – were entrained to specific phases of hip movement. This study provides evidence that hip-mediated input acts as a controlling signal of pre- and post-alpha motoneuronal control of the soleus H-reflex. The expression of these spinal interneuronal circuits during imposed sinusoidal hip movements is discussed with respect to motor recovery in humans after SCI

Impendance Probe Payload Development for Space-based Joint Service Collaboration

Collaborations utilizing small spacecraft in near earth orbit between the U. S. Coast Guard Academy (CGA), Naval Research Lab (NRL), the U. S. Naval Academy (USNA), and the Air Force Institute of Technology (AFIT) have initiated scientific and engineering space-based experiments. Sourced opportunities like the VaSpace ThinSat missions have provided a platform for payload, sensor, and experiment development that would have otherwise been resource prohibitive. We have constructed an impedance probe payload derived from the existing ‘Space PlasmA Diagnostic suitE’ (SPADE) mission operating from NASA’s International Space Station. Currently both space and laboratory plasmas are investigated with AC impedance measurements using a radio frequency antenna. Plasma electron density data collected from the ThinSat will however use an innovative surface-mounted dipole antenna to gather the required sheath-plasma and plasma resonance information. Results from this experiment will provide the framework for a CGA CubeSat with an impedance probe payload set to launch in late 2021. Impedance probe optimization, data collection obstacles, solutions, and procedures will be reported

Alcohol Biomarkers as Predictive Factors of Rearrest in High Risk Repeat Offense Drunk Drivers

Alcohol biomarkers, or naturally occurring molecules which occur in response to one\u27s alcohol consumption, are proving to be a value tool in objectively monitoring one\u27s alcohol consumption. Coupling this assessment tool, with advances in computing power, new and powerful predictions are becoming evermore possible. In this retrospective study, data was first collected that consisted of a sample of 249 drivers convicted of driving under the influence charge and who monitored over the course of a year by biomarker blood tests. This data was then analyzed using machine learning methods. TwoStep cluster analysis showed distinct drinking groups within the drivers who were monitored. In addition to this, a cost sensitive learning classifier was utilized in order to predict if a driver would relapse, having a subsequent driving under the influence arrest. The algorithm was able to predict 64% of the cases within the training set. Additionally, learning curves indicated that correctly classified cases increased with the increase of training data, indicating that predictions may become more accurate with the availability of more training data

Soleus H-reflex Excitability Changes in Response to Sinusoidal Hip Stretches in the Injured Human Spinal Cord

Imposed static hip stretches substantially modulate the soleus H-reflex in people with an intact or injured spinal cord while stretch of the hip flexors affect the walking pattern in lower vertebrates and humans. The aim of this study was to assess the effects of dynamic hip stretches on the soleus H-reflex in supine spinal cord injured (SCI) subjects. Sinusoidal movements were imposed on the right hip joint at 0.2 Hz by a Biodex system. H-reflexes from the soleus muscle were recorded as the leg moved in flexion or extension. Stimuli were sent only once in every hip movement cycle that each lasted 5 s. Torque responses were recorded at the hip, knee, and ankle joints. A hip phase-dependent soleus H-reflex modulation was present in all subjects. The reflex was facilitated during hip extension and suppressed during hip flexion. There were no significant differences in pre- or post-stimulus soleus background activity between the two conditions. Oscillatory responses were present as the hip was maximally flexed. Sinusoidal hip stretches modulated the soleus H-reflex in a manner similar to that previously observed following static hip stretches. The amount of reflex facilitation depended on the angle of hip extension. Further research is needed on the afferent control of spinal reflex pathways in health and disease in order to better understand the neural control of movement in humans. This will aid in the development of rehabilitation strategies to restore motor function in these patients

Tactile Aids for Teaching Statistics to the Visually Impaired

This case study explored the use of haptic tools to teach concepts in introductory statistics to a blind student. Statistics education typically relies heavily on the visual modality, which limits accessibility for the visually impaired. Our study made use of tactile aids such as LEGO building blocks, push pin diagrams, and 3D printed models to demonstrate typical statistical concepts such as histograms, normal distributions, skewed distributions, central tendency, and scatterplots. We argue that such models are beneficial for elucidating course material which is typically taught visually. For example, 3D printed models were able to highlight all the same components of the standard normal distribution as visual drawings do, making a complex topic easily understandable. The aim of this project is to establish an easily-accessible, replicable model for utilizing these tools and methods to teach statistical concepts. This work has implications for teaching statistical content to those with visual impairment, and may also serve as a valuable supplement for any student of statistics