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Clinical experience with functional electrical stimulation-assisted gait with Parastep in spinal cord-injured patients.

STUDY DESIGN: Clinical evaluation of the Parastep method, a six-channel transcutaneous functional electrical stimulation device, in spinal cord-injured patients. OBJECTIVES: To investigate the motor performances of this new technique regarding energy expenditure and to evaluate its advantages and limitations, especially in social activities involving ambulation. METHODS: This study was conducted in 15 thoracic spine-injured patients. The lesion was complete except in two patients. The gait ability and the functional use were judged clinically. Energy cost was evaluated from heart rate, peak oxygen uptake, and lactatemia. RESULTS: Thirteen patients completed the training (mean: 20 sessions) and achieved independent ambulation with a walker. The mean walking distance, without rest, was 52.8 +/- 69 m, and the mean speed was 0.15 +/- 0.14 m/sec. One patient with incomplete lesion, who had been nonambulatory for 8 months after the injury, became able to walk without functional electrical stimulation after five sessions. The follow-up was 40 +/- 11 months. Five patients pursued using functional electrical stimulation-assisted gait as a means of physical exercise but not for ambulation in social activities. The patients experienced marked psychological benefits, with positive changes in their way of life. In three subjects, a comparison of physiologic responses to exercise between a progressive arm ergometer test and a walking test with the Parastep (Sigmedics, Inc., Northfield, IL) at a speed of 0.1 m/sec was performed, showing that the heart rate, the peak oxygen uptake, and lactatemia during gait were close to those obtained at the end of the maximal test on the ergometer. CONCLUSIONS: In spite of its ease of operation and good cosmetic acceptance, the Parastep approach has very limited applications for mobility in daily life, because of its modest performance associated with high metabolic cost and cardiovascular strain. However, it can be proposed as a resource to keep physical and psychological fitness in patients with spinal cord injury.

Adolescent↗

Infection of apheresis cells by parvovirus B19.

Parvovirus B19 is the only member of the Parvoviridae family known to cause disease in humans. Owing to the high level of cell tropism the virus can only replicate in proliferating and differentiating erythroid precursor cells, which are present in human bone marrow and foetal liver. As human bone marrow is very difficult to obtain, an alternative in vitro system for the propagation of B19 virus has been developed, based on the application of mobilized haemapoietic progenitor (apheresis) cells. These cells are routinely harvested from cancer patients after treatment with recombinant human granulocyte/macrophage colony-stimulating factor. Replication of parvovirus B19 in vitro is possible in these cells after stimulation with erythropoietin. Therefore, this system is an easily, accessible alternative to the use of human bone marrow in parvovirus B19 infection assays.

Blood Component Removal↗

Rapid biologically-inspired scene classification using features shared with visual attention.

We describe and validate a simple context-based scene recognition algorithm for mobile robotics applications. The system can differentiate outdoor scenes from various sites on a college campus using a multiscale set of early-visual features, which capture the "gist" of the scene into a low-dimensional signature vector. Distinct from previous approaches, the algorithm presents the advantage of being biologically plausible and of having low-computational complexity, sharing its low-level features with a model for visual attention that may operate concurrently on a robot. We compare classification accuracy using scenes filmed at three outdoor sites on campus (13,965 to 34,711 frames per site). Dividing each site into nine segments, we obtain segment classification rates between 84.21 percent and 88.62 percent. Combining scenes from all sites (75,073 frames in total) yields 86.45 percent correct classification, demonstrating the generalization and scalability of the approach.

Algorithms↗

Evaluation of a mobile health system for supporting postoperative patients following day surgery.

A system based on mobile phones with built-in cameras has been developed for the postoperative management of patients sent home after day surgery. The system allows patients to send pictures and pulse oximetry measurements to a hospital server in a few seconds. Health professionals can then see what patients are describing and make a more objective estimate of the patients' status. Over a five-month period, a total of 49 patients used the system. A total of 222 images were sent, the average image delivery time being 29 s (SD 11). In nine cases (18%), the availability of images modified the treatment, and a visit to an emergency unit was avoided in eight of them who had blood-stained dressings and normal haematomas. The patients who had their treatment modified sent more images (an average of 5.4/patient) than those for whom images confirmed the correct treatment (3.1/patient). Each telephone call lasted for a mean duration of 18 min (range 8-34). The patient satisfaction data showed that all the aspects studied were evaluated in a very positive way, with 96% of the patients completely satisfied with the attention received by the mobile health application.

Adult↗

Rapid identification of mitochondrial cytochrome B haplotypes by single strand conformation polymorphism in Lutzomyia longipalpis (Diptera: Psychodidae) populations.

Newly designed primers amplified a 365-bp fragment including the 3' end of mitochondrial cytochromeb (cyt b). Field collected specimens of the sand fly, Lutzomyia longipalpis (Lutz and Neiva), from two Brazil locations provided test DNA. The primers, based on consensus sequences from a taxonomic spectrum of arthropods, have also amplified DNA successfully from Lutzomyia shannoni Dyar, Lutzomyia cruzi (Mangabeira), and the mosquito Aedes albopictus (Skuse). Single strand conformation polymorphism (SSCP) was used to recognize the presence of L. longipalpis haplotypes; these were verified subsequently by sequencing the polymerase chain reaction products. The sensitivity of SSCP was demonstrated by (1) the detection of single nucleotide differences in SSCP variants and (2) no sequence variation in specimens with the same SSCP mobility. The application of new primers and the SSCP technique provided a valuable addition to available population genetic tools: they increased the efficiency of detection of variability in the cyt b gene and decreased the time required for screening large numbers of specimens to detect nucleotide variation.

Animals↗

Polycyclic aromatic hydrocarbon behavior in bioactive soil slurry reactors amended with a nonionic surfactant.

The effects of an ethoxylated sorbitan fatty ester nonionic surfactant (Tween 80) on the bioavailability of polycyclic aromatic hydrocarbons (PAHs) were examined by using soil-free and dense-slurry (67% solids content, by wt) systems containing a creosote-contaminated field soil. The dispersed-micelle-phase PAHs in soil-free systems were not readily bioavailable to the mixed consortium of microbes indigenous to the creosote-contaminated soil. Instead, the microbes partially and preferentially utilized readily available portions of the surfactant as carbon sources (16-18% of the initial surfactant dose). This selective microbial attack resulted in destabilization of dispersed-phase micelles and significant decreases in molar solubilization ratio and micelle-water partition coefficient values. Remarkably high dosages (>20 g/L) of Tween 80 were required to enhance mobilization of the sorbed PAHs via micelle association because of the sorption of Tween 80 to the soil employed. The PAHs released from the destabilized micelles in soil-slurry systems either associated with sorbed-phase surfactants or readsorbed to soil organic matter too rapidly to be biologically accessed, even by the acclimated PAH-degrading microbes present. The work provides important new information and practical insights to surfactant solubilization and mobilization technology applications for the bioremediation of PAH-contaminated soils and sediments.

Biodegradation, Environmental↗

Selected aspects of the development of methods for the analysis of drugs by high performance liquid chromatography.

The successful analysis of drugs in biological fluids and other matrices by reversed phase high performance liquid chromatography (h.p.l.c.) relies upon the optimization of the chromatographic separation, the sample preparation and the post-column detection. Recent advances in the detection and derivatisation of exogenous substances are described elsewhere in this volume (Sternson 1986). This paper deals with selected aspects of the optimization of the chromatographic separation, concentrating on the theoretical basis and practical application of mobile phase selectivity in reversed phase ion-pair systems. In addition, recent advances in sample preparation techniques which permit the direct injection of biological fluids are discussed.

Amines↗

Mobile computing acceptance grows as applications evolve.

Handheld devices are becoming more cost-effective to own, and their use in healthcare environments is increasing. Handheld devices currently are being used for e-prescribing, charge capture, and accessing daily schedules and reference tools. Future applications may include education on medications, dictation, order entry, and test-results reporting. Selecting the right handheld device requires careful analysis of current and future applications, as well as vendor expertise. It is important to recognize the technology will continue to evolve over the next three years.

Clinical Pharmacy Information Systems↗

Trace metal distribution in soluble organic matter from municipal solid waste compost determined by size-exclusion chromatography.

Municipal solid waste (MSW) composts carry high amounts of trace metals and organic complexing agents that may influence metal bioavailability and mobility after application to soils. In order to assess the degree of organic complexation of trace metals in the solution phase of MSW compost and the relevance of organic ligand type, size exclusion chromatography (SEC) was applied to compost-extracted organic ligands. Adjustment of the elution conditions minimized the interaction with the gel matrix for compost humic substances and dissolved organic matter (DOM) fractions. The SEC was then used to separate the aqueous compost extract into samples with distinct differences in chemical constituents. The highest quantities of Cu, Zn, Ni, Mn, and Cd were found to coelute with the main peak of the SEC elution curve, which, as observed by Fourier-transformed infrared (FTIR) spectroscopy, also had the highest density of carboxyl groups. The ratio of aromatic to aliphatic structures was higher for eluates with low retention times, and cations such as Al, Cr, and Fe were preferably associated with these larger organic molecules. All trace metals in the compost solution phase were bound mostly to DOM rather than forming inorganic complexes.

Biological Availability↗

Mobile resonance enhanced multiphoton ionisation-time-of-flight mass spectrometer with a novel hybrid laser desorption/molecular beam ion source for rapid detection of aromatic trace compounds from gas phase and solid samples.

A mobile, field applicable resonance enhanced multiphoton ionisation-time-of-flight mass spectrometer (REMPI-TOFMS) for direct-inlet gas-phase analysis as well as for characterisation of solid samples, has been developed. For solid-sample analysis, laser desorption (LD) with IR-laser pulses is used for volatilisation of the neutral analytes from a target in the ion source prior to REMPI-TOFMS analysis. For direct inlet gas-phase analysis, a needle gas inlet is used and the formed molecular beam is REMPI-ionised directly in the ion source. A special ion source was developed, which can be rapidly interchanged between the REMPI-TOFMS and the LD-REMPI-TOFMS modes. The system is equipped with a tuneable optical parametrical oscillator (OPO)-laser system. The analytical properties are characterised for both modes of operations. In both cases, analytical performance is similar to that achieved with instruments specifically designed for either gas-phase or solid-phase characterisation. Results from field measurements of a wood combustion flue gas of a 174 kW bio mass furnace are given. Gas-phase analysis was applied for time-resolved on-line REMPI-TOFMS of the semi-volatile aromatic flue gas constituents. The low-volatile aromatic compounds, which were precipitated with the particulate matter in the filtering unit of the sampling train, were characterised by direct LD-REMPI-TOFMS of the glass fibre filter material. By combining the gas-phase and particulate results a rather comprehensive characterisation of the aromatic species present in the flue gas (i.e. aerosol--gas phase plus particulate matter) was achieved.

Mass Spectrometry↗

[Discussion of the validation of thin-layer chromatographic procedure in pharmaceutical analysis].

TLC has become a convenient, fast, robust, and cost efficient technique in pharmaceutical analysis because of its coherent features. The important analytical performance parameters are summarized, such as accuracy, precision, reproducibility, specificity, detection limit, quantitation limit, linearity and range, etc. The validation methods and the acceptance criteria are discussed for sample preparation, sample stability in solution and on plate, sample exposure time, robustness and quality of stationary and mobile phases, application of sample to plate, spot dimension and shape, temperature, humidity and chamber saturation, detection, and quantitation, etc. It is recommended that the definition of the validation parameters and the validation procedures for quantitative TLC should be described whenever the results are reported.

Chromatography, Thin Layer↗

Towards a Mobile Intelligent Information System with Application to HIV/AIDS.

The United Nations Security Council reports HIV/AIDS as the fastest growing threat to human development. In addition, the World Health Organization [1] reports that nearly 5 million persons (4.3 million adults and 700,000 children) are newly infected with HIV each year; more than 95% of them found in developing countries. Since STDs as a group are a personal problem which few people feel comfortable discussing, we believe that hand-held PDAs can provide an opportunity for learning about this disease while insuring anonymity. This device will employ the newest technologies including Bluetooth wireless technology, which can transmit and receive data via a short-range radio link using a globally available frequency band (2.4 GHz ISM band), enabling rapid and accurate synchronous and asynchronous data communication. The first generation of Bluetooth permits exchange of data up to a rate of 1 Mbps, even in areas with much electromagnetic disturbance. This emerging technology can facilitate HIV/AIDS outreach around the globe.Recent advances in learning have taken a particularly cognitive perspective and these findings have implications for education in general as well as for the development of intelligent tutoring systems in particular. In the past, effective SmartBookstrade markhave been developed for AIDS education to disseminate the critical knowledge relevant to this epidemic [2].Since 1993, the proliferation of the World Wide Web has created a plethora of new opportunities for the delivery of electronic distance learning systems. However, we feel that it is important that a whatever technology is employed is based on a sound educational theory. A new, comprehensive, web-based learning system called SmartTutor has been developed, at Brooklyn College of The City University of New York [3]. This technology provides a user-friendly, self-paced, easy to modify, software environment intended to serve the user's learning needs and is based on a generic SmartTutor methodology organized around the use of concept mapping. Early assessment of SmartTutor has shown that it is well received by students and helps significantly in their learning processes. It is readily adaptable to the presentation of academic and more general subject matter such as the latest available information on HIV/AIDS. Our new HIV/AIDS SmartTutor will incorporate this SmartTutor paradigm. Our new SmartTutor would provide worldwide access to medical professionals as well as the general public to learn about HIV/AIDS. This new device could also provide a survey tool to facilitate HIV risk assessment. Demonstrations of the SmartTutor learning system will be presented and the continued development of the applications will be discussed.

Acquired Immunodeficiency Syndrome↗

An in vivo study of the intervertebral movements produced by posteroanterior mobilization.

OBJECTIVE: To measure the intervertebral movements of the lumbosacral spine when it was subjected to posteroanterior mobilization. DESIGN: An in vivo radiographic study. BACKGROUND: Posteroanterior mobilization is frequently employed in the examination and treatment of low back pain, but its mechanical and therapeutic effects are uncertain. METHODS: Lateral radiographs were taken of 12 healthy male subjects who were in prone lying. This was repeated while a static mobilization force of 150 N was applied vertically to their L4 spinous processes. The radiographic images of the vertebrae were traced and digitized. The sagittal rotation and translations of the motion segments, and the displacements of the spinous processes were then computed. RESULTS: Under the application of the mobilization loads, the lumbar motion segments were found to extend, whereas the L5/S1 segment tended to flex. It was also shown that the upper lumbar segments (L1/2-L3/4) translated posteriorly and the L5/S1 segment anteriorly. The L4/5 segment did not exhibit translation in a consistent direction. In addition, all the spinous processes were found to be displaced anteriorly. CONCLUSIONS: The movement pattern observed in this study strongly suggests that the spine is subjected to three-point bending under the application of mobilization loads. RELEVANCE: The intervertebral movements produced by posteroanterior mobilization were small in magnitude, and it is unlikely that the therapist can assess these movements manually with reasonable reliability. Mobilization should be interpreted as a passive test of the whole lumbar spine in three-point bending.

Journal Article↗

Ion mobility spectrometry and ion mobility spectrometry/mass spectrometric characterization of dimenhydrinate.

Positive and negative ion mobility spectra of dimenhydrinate are presented, and the calculated reduced mobility (K0) values for the most significant peaks are reported. Mass identification of the ionic species associated with the peaks in the ion mobility spectra was achieved by interfacing the ion mobility spectrometer to a mass spectrometer. The application of ion mobility spectrometry to the detection of dimenhydrinate and other drug residues on the hands of patients admitted to hospital with drug overdose is also discussed.

Dimenhydrinate↗