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Biomedical subjects

B J Andrews

Publications and source records attributed to B J Andrews.

At least 37 records · Page 2Linked to original sources

Machine learning in control of functional electrical stimulation systems for locomotion.

Two machine learning techniques were evaluated for automatic design of a rule-based control of functional electrical stimulation (FES) for locomotion of spinal cord injured humans. The task was to learn the invariant characteristics of the relationship between sensory information and the FES-control signal by using off-line supervised training. Sensory signals were recorded using pressure sensors installed in the insoles of a subject's shoes and goniometers attached across the joints of the affected leg. The FES-control consisted of pulses corresponding to time intervals when the subject pressed on the manual push-button to deliver the stimulation during FES-assisted ambulation. The machine learning techniques used were the adaptive logic network (ALN) [1] and the inductive learning algorithm (IL) [2]. Results to date suggest that, given the same training data, the IL learned faster than the ALN, while both performed the test rapidly. The generalization was estimated by measuring the test errors and it was better with an ALN, especially if past points were used to reflect the time dimension. Both techniques were able to predict future stimulation events. An advantage of the ALN over the IL was that ALN's can be retrained with new data without losing previously collected knowledge. The advantages of the IL over the ALN were that the IL produces small, explicit, comprehensible trees and that the relative importance of each sensory contribution can be quantified.

Adult↗

Chemotherapy for giardiasis: randomized clinical trial of bacitracin, bacitracin zinc, and a combination of bacitracin zinc with neomycin.

This study describes a prospective, randomized, clinical trial in patients infected with the protozoa Giardia lamblia. Patients received a 10-day treatment with twice a day doses of either 120,000 U (USP) of bacitracin zinc, 120,000 U (USP) of bacitracin, 120,000 U (USP) of neomycin, or 60,000 U (USP) of bacitracin zinc and 60,000 U (USP) of neomycin. At the first assessment (day 11), all 21 subjects (100%) treated with bacitracin zinc had ceased to show Giardia parasites in their stools compared with 19 (95%) of 20 receiving bacitracin, 20 (90.9%) of 22 subjects receiving neomycin, and 17 (89.5%) of 19 subjects receiving bacitracin zinc plus neomycin. During the two-week follow up period, one (5.3%) of the 19 subjects examined who received bacitracin zinc experienced a recurrence compared with one (6.7%) of 15 receiving bacitracin, one (5.0%) of 20 receiving neomycin, and 0 (0%) of 14 receiving the combination treatment. Final cure rates of 94.7% for bacitracin zinc, 87.5% for bacitracin, 86.4% for neomycin, and 87.5% for bacitracin zinc plus neomycin were obtained. No synergistic activity was noted between bacitracin zinc and neomycin. Side effects were generally limited to nausea, abdominal discomfort, and diarrhea in a small number of patients.

Adolescent↗

The sensitivity of axenic 200:NIH Entamoeba histolytica to bacitracin and its zinc salt.

This study extends the previous knowledge of the action of bacitracin zinc against xenic cultures of Entamoeba histolytica. Results presented here, using axenic E. histolytica, confirm the enhanced activity of bacitracin zinc as compared to native bacitracin and demonstrate that this enhancement is due to a direct effect upon the trophozoite. In the presence of zinc, amoebastatic concentrations of bacitracin became amoebacidal. The expression of the amoebacidal characteristics of 5 g/l bacitracin zinc following 24-35 h incubation coincided with the return of cell division by amoeba exposed to the same concentration of native bacitracin. The activity of both bacitracin and bacitracin zinc on trophozoites was unaffected by autoclaving, indicating a mode of action different from that exerted on Staphylococcus aureus. In contrast to previous clinical observations, no synergism could be detected between bacitracin and neomycin.

Animals↗

Improved harness crutch to reduce upper limb effort in swing-through gait.

A novel crutch, the harness crutch, is described which reduces loading on the arms during the swing phase of swing-through gait. The device was fabricated by attaching a modified mountaineering harness by two side straps, to modified axillary crutches. The harness crutch was compared with the saddle crutch, described by Taylor in 1883. The saddle crutch produced pressures in excess of 500 mmHg in the perineal area; no pressures were produced in this area with the harness crutch. Ischial pressures produced by both systems were similar. In six out of eight non-impaired subjects, significantly more force was transmitted to the harness crutch (an average 47% of body weight) than to the saddle crutch (an average 40% of body weight). A comparison of the oxygen cost of swing-through gait was made between the harness crutch and unmodified axillary crutches; with the harness crutch oxygen cost was significantly lower (p < 0.01) and there were no significant differences in speed and stride length.

Arm↗

Reconstructing muscle activation during normal walking: a comparison of symbolic and connectionist machine learning techniques.

One symbolic (rule-based inductive learning) and one connectionist (neural network) machine learning technique were used to reconstruct muscle activation patterns from kinematic data measured during normal human walking at several speeds. The activation patterns (or desired outputs) consisted of surface electromyographic (EMG) signals from the semitendinosus and vastus medialis muscles. The inputs consisted of flexion and extension angles measured at the hip and knee of the ipsilateral leg, their first and second derivatives, and bilateral foot contact information. The training set consisted of data from six trials, at two different speeds. The testing set consisted of data from two additional trials (one at each speed), which were not in the training set. It was possible to reconstruct the muscular activation at both speeds using both techniques. Timing of the reconstructed signals was accurate. The integrated value of the activation bursts was less accurate. The neural network gave a continuous output, whereas the rule-based inductive learning rule tree gave a quantised activation level. The advantage of rule-based inductive learning was that the rules used were both explicit and comprehensible, whilst the rules used by the neural network were implicit within its structure and not easily comprehended. The neural network was able to reconstruct the activation patterns of both muscles from one network, whereas two separate rule sets were needed for the rule-based technique. It is concluded that machine learning techniques, in comparison to explicit inverse muscular skeletal models, show good promise in modelling nearly cyclic movements such as locomotion at varying walking speeds.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗

Improving limb flexion in FES gait using the flexion withdrawal response for the spinal cord injured person.

In the restoration of gait for paraplegics using functional electrical stimulation, the method most commonly used to produce hip flexion for the swing phase of gait has been the elicitation of the flexion withdrawal response. Several problems have been noted with the response: there is a decrease in the magnitude of the hip flexion to repeated stimuli (habituation); long latency; and inhibition of the response when stimulated bilaterally. These have been characterized and methods for overcoming the problems tested. Results show that increasing stimulation frequency reduces latency. Habituation can be reduced in some subjects by multiplexing two sites of stimulation. Habituation can further be reduced by applying single high-intensity pulses and this has been used in a one-step-ahead controller for regulating hip flexion angle. Inhibition due to bilateral stimulation had been significantly reduced by altering the timing of the stimulation to the two legs.

Adult↗

The role of functional electrical stimulation in the rehabilitation of patients with incomplete spinal cord injury--observed benefits during gait studies.

The benefits of a functional electrical stimulation (FES) gait programme were assessed in a group of 6 incomplete spinal cord injured subjects. Measurements were made of quadriceps spasticity, lower limb muscle strength, postural stability in standing, spatial and temporal values of gait, physiological cost of gait and independence in activities of daily living. The subjects were assessed before commencement of the programme and after a period of gait training using FES. The benefits derived as a result of the FES gait programme included a reduction in quadriceps tone, an increase in voluntary muscle strength, a decrease in the physiological cost of gait and an increase in stride length.

Activities of Daily Living↗

Report on a conference on motor prostheses for workplace mobility of paraplegic patients in North America.

On May 18, 1992 a symposium at Case Western Reserve University in Cleveland, Ohio, USA had the goal of defining the tasks needed to reach clinical utility of investigational neural prosthetic ambulation devices. The characteristics and stage of development of four systems were detailed: the Louiiana State University reciprocating gait orthosis (LSU-RGO) with muscle stimulation; the modular hybrid functional neuromuscular stimulation (FNS) orthosis; the Cleveland VA-Case Western Reserve University (VA-CWRU) implant system; and the Parastep system. Multicenter clinical trials are underway for the Parastep system and are planned to start within the next 2 years for the LSU-RGO with muscle stimulation, the VA-CWRU 8-channel system, and the floor reaction orthosis component of the modular hybrid FNS system. Current investigational systems provide little advantage over the standing wheelchair in some occupations but they do expand social, recreational, and exercise capabilities. Disabled people and some leading rehabilitation physicians are willing to test basic ambulation devices but the regulatory approvals must first be obtained for multicenter clinical trials. Corporate partners are central to the development of devices, their clinical testing, and their subsequent marketing. A key requirement for developing and disseminating motor prostheses is the education of clinicians so that they will participate in trials and be prepared to prescribe the prostheses when they reach the market.

Electric Stimulation↗

Interaction of the yeast Swi4 and Swi6 cell cycle regulatory proteins in vitro.

In budding yeast, two transcription factors, Swi4 and Swi6, control the expression of important cell cycle regulatory proteins (the G1 cyclins, Cln1 and Cln2, and the cyclin-like Hcs26) as well as the HO gene, whose product initiates mating-type switching. Both Swi4 and Swi6 are components of a protein complex that forms at a repeated sequence element, SCB (SWI4, -6-dependent cell cycle box), found in the upstream regulatory sequences of target genes. We show, by using proteins synthesized in vitro, a direct association between Swi4 and Swi6. The cdc10-Swi6 or ankyrin motifs present in both Swi4 and Swi6 are dispensable for their association, which is mediated instead by a region near the C terminus of each protein. Furthermore, we show that interaction with Swi6 is not necessary for specific recognition of the SCB sequence by the Swi4 protein; we propose that Swi4 is responsible for binding to the SCB sequence while Swi6, through its association with Swi4, regulates activity of the complex.

Cell Cycle↗

Reduction of seating pressure using FES in patients with spinal cord injury. A preliminary report.

The aim of this study was to investigate the use of functional electrical stimulation (FES) as a means of pressure sore prevention in seated spinal cord injured (SCI) subjects. Nine SCI subjects took part in tests in which electrical stimulation was applied to the quadriceps with the lower legs restrained. Ischial pressures were measured during periods of quiet sitting and FES application. A strain gauged lever arm was used to measure the knee moment during quadriceps stimulation. The average pressure drop at the right and left buttocks was 44 mmHg and 27 mmHg respectively. In general the greatest reductions occurred in subjects with larger knee moments; however, there was no direct relationship between the pressure reduction obtained and the quadriceps strength. This form of FES may be useful as a prophylactic aid in the management of pressure sores in SCI subjects.

Adult↗

Dishabituation of the flexion reflex in spinal cord-injured man and its application in the restoration of gait.

The flexion withdrawal reflex, evoked by surface electrical stimulation, has been used to provide hip flexion for the restoration of gait in paraplegics. A major limitation to its use has been the decrease in the magnitude of the response to repeated stimulation (habituation). In this study it was found that by using high intensity stimulation the response could be dishabituated. It was demonstrated that sufficient hip flexion for functional electrical stimulation-assisted gait was maintained using high intensity pulses in a one-step-ahead controller.

Adult↗

Transcriptional activation of CLN1, CLN2, and a putative new G1 cyclin (HCS26) by SWI4, a positive regulator of G1-specific transcription.

SWI4 of budding yeast codes for a component of a transcription factor (cell cycle box factor, or CCBF) necessary for G1-specific expression of HO. We show that SWI4 is essential for haploid cell viability at high temperature and in a/alpha cells at all temperatures: SWI4-deficient cells arrest as large unbudded cells. Eight high copy number plasmids were identified that allow swi4- strains to grow under nonpermissive conditions. Two carry G1 cyclin genes, CLN1 and CLN2; another carries HCS26, coding for a putative cyclin, a/alpha swi4- mutants exhibit 3- to 20-fold reductions in the levels of CLN1, CLN2, and HCS26 transcripts. The requirement of SWI4 for transcription appears to be direct: each gene contains sites similar to the CCBF-binding site; CCBF binds to the upstream region of HCS26. We propose that SWI4 participates in a positive feedback loop by which CLN1, CLN2, and possibly HCS26 promote their own transcription in G1.

Amino Acid Sequence↗