Patterns of motor activity in the isolated nerve cord of the octopus arm.

PubMed

Gutfreund, Yoram; Matzner, Henry; Flash, Tamar; Hochner, Binyamin

2006-12-01

The extremely flexible octopus arm provides a unique opportunity for studying movement control in a highly redundant motor system. We describe a novel preparation that allows analysis of the peripheral nervous system of the octopus arm and its interaction with the muscular and mechanosensory elements of the arm's intrinsic muscular system. First we examined the synaptic responses in muscle fibers to identify the motor pathways from the axial nerve cord of the arm to the surrounding musculature. We show that the motor axons project to the muscles via nerve roots originating laterally from the arm nerve cord. The motor field of each nerve is limited to the region where the nerve enters the arm musculature. The same roots also carry afferent mechanosensory information from the intrinsic muscle to the axial nerve cord. Next, we characterized the pattern of activity generated in the dorsal roots by electrically stimulating the axial nerve cord. The evoked activity, although far reaching and long lasting, cannot alone account for the arm extension movements generated by similar electrical stimulation. The mismatch between patterns of activity in the isolated cord and in an intact arm may stem from the involvement of mechanosensory feedback in natural arm extension.

A common neural element receiving rhythmic arm and leg activity as assessed by reflex modulation in arm muscles.

PubMed

Sasada, Syusaku; Tazoe, Toshiki; Nakajima, Tsuyoshi; Futatsubashi, Genki; Ohtsuka, Hiroyuki; Suzuki, Shinya; Zehr, E Paul; Komiyama, Tomoyoshi

2016-04-01

Neural interactions between regulatory systems for rhythmic arm and leg movements are an intriguing issue in locomotor neuroscience. Amplitudes of early latency cutaneous reflexes (ELCRs) in stationary arm muscles are modulated during rhythmic leg or arm cycling but not during limb positioning or voluntary contraction. This suggests that interneurons mediating ELCRs to arm muscles integrate outputs from neural systems controlling rhythmic limb movements. Alternatively, outputs could be integrated at the motoneuron and/or supraspinal levels. We examined whether a separate effect on the ELCR pathways and cortico-motoneuronal excitability during arm and leg cycling is integrated by neural elements common to the lumbo-sacral and cervical spinal cord. The subjects performed bilateral leg cycling (LEG), contralateral arm cycling (ARM), and simultaneous contralateral arm and bilateral leg cycling (A&L), while ELCRs in the wrist flexor and shoulder flexor muscles were evoked by superficial radial (SR) nerve stimulation. ELCR amplitudes were facilitated by cycling tasks and were larger during A&L than during ARM and LEG. A low stimulus intensity during ARM or LEG generated a larger ELCR during A&L than the sum of ELCRs during ARM and LEG. We confirmed this nonlinear increase in single motor unit firing probability following SR nerve stimulation during A&L. Furthermore, motor-evoked potentials following transcranial magnetic and electrical stimulation did not show nonlinear potentiation during A&L. These findings suggest the existence of a common neural element of the ELCR reflex pathway that is active only during rhythmic arm and leg movement and receives convergent input from contralateral arms and legs. Copyright © 2016 the American Physiological Society.

Hyperbaric oxygen therapy as treatment for bilateral arm compartment syndrome after CrossFit: case report and literature review.

PubMed

Mendes, Adriano Fernando; Neto, José da Mota; Heringer, Erica Maciel; de Simoni, Leandro Furtado; Pires, Diego Demolinari; Labronici, Pedro José

2018-01-01

CrossFit is a physical fitness program characterized by high-intensity workouts that can be associated with serious injury. Acute compartment syndrome in the upper limbs is a rare occurrence. It may occur after intense physical exercise, and its usual treatment is surgical. Hyperbaric oxygen therapy is a treatment described as adjunctive in cases of compartmental syndrome. We describe the case of a CrossFit practitioner who, after intense training, developed progressive symptoms of rhabdomyolysis and acute bilateral arm compartment syndrome, who was successfully treated with hyperbaric oxygen therapy and required no fasciotomy as surgical treatment. Acute compartment syndrome in the arms after intense physical exercise is a rare occurrence that should be suspected by practitioners of physical activity experiencing intense, disproportionate and progressive pain. In the case presented, hyperbaric oxygen therapy was successfully used in the treatment of the disorder, with satisfactory progress, and without the need for a surgical fasciotomy as therapy. Copyright© Undersea and Hyperbaric Medical Society.

Constrained handgrip force decreases upper extremity muscle activation and arm strength.

PubMed

Smets, Martin P H; Potvin, James R; Keir, Peter J

2009-09-01

Many industrial tasks require repetitive shoulder exertions to be performed with concurrent physical and mental demands. The highly mobile nature of the shoulder predisposes it to injury. The purpose of this study was to determine the effects of simultaneous gripping, at a specified magnitude, on muscle activity and maximal arm force in various directions. Ten female subjects performed maximal arm exertions at two different heights and five directions using both specified (30% maximum voluntary grip) and preferred (self-selected) grip forces. Electromyography was recorded from eight muscles of the right upper extremity. The preferred grip condition produced grip forces that were dependent on the combination of arm height and force direction and were significantly greater (arm force down), lower (to left, up and push forward), or similar to the specified grip condition. Regardless of the magnitude of the preferred grip force, specifying the grip resulted in decreased maximal arm strength (by 18-25%) and muscle activity (by 15-30%) in all conditions, indicating an interfering effect when the grip force was specified by visual target force-matching. Task constraints, such as specific gripping demands, may decrease peak force levels attainable and alter muscle activity. Depending on the nature of task, the amount of relative demand may differ, which should be considered when determining safety thresholds.

[Efficiency of rehabilitation methods in the treatment of arm lymphedema after breast cancer surgery].

PubMed

Petruseviciene, Daiva; Krisciūnas, Aleksandras; Sameniene, Jūrate

2002-01-01

In this article we analyze influence of rehabilitation methods in treatment of arm lymphedema. In Kaunas oncological hospital were examined 60 women after surgery for breast cancer. The work objective was to evaluate efficiency of rehabilitation methods in treatment of arm lymphedema and in evaluate movement amplitude of shoulder joint. Two groups of women depending on rehabilitation start were evaluated. The same methods of rehabilitation were applied to both groups: physical therapy, electrostimulation, massage, lymphodrainage with apparate. Our study indicated that women, who were treated at early period of rehabilitation (3 months), showed statistically significantly (p < 0.01) better results in increase of movement amplitude of shoulder joint. However, results of treatment of arm lymphedema, comparing with women who started rehabilitation after 12 months, were equally successful--results were not statistically significantly better (p > 0.05).

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation.

PubMed

Franck, Johan Anton; Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies.

Testing non-inferiority of a new treatment in three-arm clinical trials with binary endpoints.

PubMed

Tang, Nian-Sheng; Yu, Bin; Tang, Man-Lai

2014-12-18

A two-arm non-inferiority trial without a placebo is usually adopted to demonstrate that an experimental treatment is not worse than a reference treatment by a small pre-specified non-inferiority margin due to ethical concerns. Selection of the non-inferiority margin and establishment of assay sensitivity are two major issues in the design, analysis and interpretation for two-arm non-inferiority trials. Alternatively, a three-arm non-inferiority clinical trial including a placebo is usually conducted to assess the assay sensitivity and internal validity of a trial. Recently, some large-sample approaches have been developed to assess the non-inferiority of a new treatment based on the three-arm trial design. However, these methods behave badly with small sample sizes in the three arms. This manuscript aims to develop some reliable small-sample methods to test three-arm non-inferiority. Saddlepoint approximation, exact and approximate unconditional, and bootstrap-resampling methods are developed to calculate p-values of the Wald-type, score and likelihood ratio tests. Simulation studies are conducted to evaluate their performance in terms of type I error rate and power. Our empirical results show that the saddlepoint approximation method generally behaves better than the asymptotic method based on the Wald-type test statistic. For small sample sizes, approximate unconditional and bootstrap-resampling methods based on the score test statistic perform better in the sense that their corresponding type I error rates are generally closer to the prespecified nominal level than those of other test procedures. Both approximate unconditional and bootstrap-resampling test procedures based on the score test statistic are generally recommended for three-arm non-inferiority trials with binary outcomes.

Isometric arm counter-pressure maneuvers to abort impending vasovagal syncope.

PubMed

Brignole, Michele; Croci, Francesco; Menozzi, Carlo; Solano, Alberto; Donateo, Paolo; Oddone, Daniele; Puggioni, Enrico; Lolli, Gino

2002-12-04

We hypothesized that isometric arm exercises were able to increase blood pressure (BP) during the phase of impending vasovagal syncope and allow the patient to avoid losing consciousness. Hypotension is always present during the prodromal phase of vasovagal syncope. We evaluated the effect of handgrip (HG) and arm-tensing in 19 patients affected by tilt-induced vasovagal syncope. The study consisted of an acute single-blind, placebo-controlled, randomized, cross-over tilt-table efficacy study and a clinical follow-up feasibility study. In the acute tilt study, HG was administered for 2 min, starting at the time of onset of symptoms of impending syncope. In the active arm, HG caused an increase in systolic blood pressure (SBP) from 92 +/- 10 mm Hg to 105 +/- 38 mm Hg, whereas in the placebo arm SBP decreased from 91 +/- 11 mm Hg to 73 +/- 21 mm Hg (p = 0.008). Heart rate behavior was similar in the two arms. In the active arm, 63% of patients became asymptomatic, versus 11% in the control arm (p = 0.02); conversely, only 5% of patients developed syncope, versus 47% in the control arm (p = 0.01). The patients were trained to self-administer arm-tensing treatment as soon as symptoms of impending syncope occurred. During 9 +/- 3 months of follow-up, the treatment was actually performed in 95/97 episodes of impending syncope (98%) and was successful in 94/95 (99%). No patients suffered injury or other adverse morbidity related to the relapses. Isometric arm contraction is able to abort impending vasovagal syncope by increasing systemic BP. Arm counter-pressure maneuvers can be proposed as a new, feasible, safe, and well accepted first-line treatment for vasovagal syncope.

A dynamic model for generating actuator specifications for small arms barrel active stabilization

NASA Astrophysics Data System (ADS)

Pathak, Anupam; Brei, Diann; Luntz, Jonathan; Lavigna, Chris

2006-03-01

Due to stresses encountered in combat, it is known that soldier marksmanship noticeably decreases regardless of prior training. Active stabilization systems in small arms have potential to address this problem to increase soldier survivability and mission effectiveness. The key to success is proper actuator design, but this is highly dependent on proper specification which is challenging due to the human/weapon interaction. This paper presents a generic analytical dynamic model which is capable of defining the necessary actuation specifications for a wide range of small arms platforms. The model is unique because it captures the human interface--shoulder and arm--that introduces the jitter disturbance in addition to the geometry, inertial properties and active stabilization stiffness of the small arms platform. Because no data to date is available for actual shooter-induced disturbance in field conditions, a method is given using the model to back-solve from measured shooting range variability data the disturbance amplitude information relative to the input source (arm or shoulder). As examples of the applicability of the model to various small arms systems, two different weapon systems were investigated: the M24 sniper weapon and the M16 assault rifle. In both cases, model based simulations provided valuable insight into impact on the actuation specifications (force, displacement, phase, frequency) due to the interplay of the human-weapon-active stabilization interface including the effect of shooter-disturbance frequency, disturbance location (shoulder vs. arm), and system parameters (stiffness, barrel rotation).

Changes in arm-hand function and arm-hand skill performance in patients after stroke during and after rehabilitation

PubMed Central

Smeets, Rob Johannes Elise Marie; Seelen, Henk Alexander Maria

2017-01-01

Background Arm-hand rehabilitation programs applied in stroke rehabilitation frequently target specific populations and thus are less applicable in heterogeneous patient populations. Besides, changes in arm-hand function (AHF) and arm-hand skill performance (AHSP) during and after a specific and well-described rehabilitation treatment are often not well evaluated. Method This single-armed prospective cohort study featured three subgroups of stroke patients with either a severely, moderately or mildly impaired AHF. Rehabilitation treatment consisted of a Concise_Arm_and_hand_ Rehabilitation_Approach_in_Stroke (CARAS). Measurements at function and activity level were performed at admission, clinical discharge, 3, 6, 9 and 12 months after clinical discharge. Results Eighty-nine stroke patients (M/F:63/23; mean age:57.6yr (+/-10.6); post-stroke time:29.8 days (+/-20.1)) participated. All patients improved on AHF and arm-hand capacity during and after rehabilitation, except on grip strength in the severely affected subgroup. Largest gains occurred in patients with a moderately affected AHF. As to self-perceived AHSP, on average, all subgroups improved over time. A small percentage of patients declined regarding self-perceived AHSP post-rehabilitation. Conclusions A majority of stroke patients across the whole arm-hand impairment severity spectrum significantly improved on AHF, arm-hand capacity and self-perceived AHSP. These were maintained up to one year post-rehabilitation. Results may serve as a control condition in future studies. PMID:28614403

Effects of non-paretic arm exercises using a tubing band on abdominal muscle activity in stroke patients.

PubMed

Lee, Dong-Kyu; Kang, Min-Hyeok; Kim, Ji-Won; Kim, Yang-Gon; Park, Ji-Hyuk; Oh, Jae-Seop

2013-01-01

Abdominal strengthening exercises are important for stroke patients; however, there is a lack of research on therapeutic exercises for increasing abdominal muscle activity in stroke patients. We investigated the effects of non-paretic arm exercises using a tubing band on abdominal muscle activity in stroke patients. In total, 18 hemiplegic subjects (13 males, 5 females) were recruited. All subjects performed non-paretic arm exercises involving three different shoulder movements (extension, flexion, and horizontal abduction) using an elastic tubing band. Surface electromyography (EMG) signals were recorded from the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles bilaterally during non-paretic arm exercises. EMG activities of abdominal muscles during non-paretic arm extension and horizontal abduction were increased significantly versus shoulder flexion when subjects performed the arm exercise in a seated position. Muscle activity of the EO was significantly greater in the paretic than the non-paretic side during non-paretic arm extension and horizontal abduction. We suggest that non-paretic arm extension and horizontal abduction exercises using an elastic tubing band may be effective in increasing abdominal muscle activity.

Design of a multi-arm randomized clinical trial with no control arm.

PubMed

Magaret, Amalia; Angus, Derek C; Adhikari, Neill K J; Banura, Patrick; Kissoon, Niranjan; Lawler, James V; Jacob, Shevin T

2016-01-01

Clinical trial designs that include multiple treatments are currently limited to those that perform pairwise comparisons of each investigational treatment to a single control. However, there are settings, such as the recent Ebola outbreak, in which no treatment has been demonstrated to be effective; and therefore, no standard of care exists which would serve as an appropriate control. For illustrative purposes, we focused on the care of patients presenting in austere settings with critically ill 'sepsis-like' syndromes. Our approach involves a novel algorithm for comparing mortality among arms without requiring a single fixed control. The algorithm allows poorly-performing arms to be dropped during interim analyses. Consequently, the study may be completed earlier than planned. We used simulation to determine operating characteristics for the trial and to estimate the required sample size. We present a potential study design targeting a minimal effect size of a 23% relative reduction in mortality between any pair of arms. Using estimated power and spurious significance rates from the simulated scenarios, we show that such a trial would require 2550 participants. Over a range of scenarios, our study has 80 to 99% power to select the optimal treatment. Using a fixed control design, if the control arm is least efficacious, 640 subjects would be enrolled into the least efficacious arm, while our algorithm would enroll between 170 and 430. This simulation method can be easily extended to other settings or other binary outcomes. Early dropping of arms is efficient and ethical when conducting clinical trials with multiple arms. Copyright © 2015 Elsevier Inc. All rights reserved.

Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

PubMed

Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

2015-01-01

This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

Arm position influences the activation patterns of trunk muscles during trunk range-of-motion movements.

PubMed

Siu, Aaron; Schinkel-Ivy, Alison; Drake, Janessa Dm

2016-10-01

To understand the activation patterns of the trunk musculature, it is also important to consider the implications of adjacent structures such as the upper limbs, and the muscles that act to move the arms. This study investigated the effects of arm positions on the activation patterns and co-activation of the trunk musculature and muscles that move the arm during trunk range-of-motion movements (maximum trunk axial twist, flexion, and lateral bend). Fifteen males and fifteen females, asymptomatic for low back pain, performed maximum trunk range-of-motion movements, with three arm positions for axial twist (loose, crossed, abducted) and two positions for flexion and lateral bend (loose, crossed). Electromyographical data were collected for eight muscles bilaterally, and activation signals were cross-correlated between trunk muscles and the muscles that move the arms (upper trapezius, latissimus dorsi). Results revealed consistently greater muscle co-activation (higher cross-correlation coefficients) between the trunk muscles and upper trapezius for the abducted arm position during maximum trunk axial twist, while results for the latissimus dorsi-trunk pairings were more dependent on the specific trunk muscles (either abdominal or back) and latissimus dorsi muscle (either right or left side), as well as the range-of-motion movement. The findings of this study contribute to the understanding of interactions between the upper limbs and trunk, and highlight the influence of arm positions on the trunk musculature. In addition, the comparison of the present results to those of individuals with back or shoulder conditions may ultimately aid in elucidating underlying mechanisms or contributing factors to those conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

Immobilization of pectinase on silica-based supports: Impacts of particle size and spacer arm on the activity.

PubMed

Alagöz, Dilek; Tükel, S Seyhan; Yildirim, Deniz

2016-06-01

The pectinase was separately immobilized onto Florisil and nano silica supports through both glutaraldehyde and 3-glyoxypropyltrietoxysilane spacer arms. The effects of spacer arm, particle size of support and ionic liquids on the activities of pectinase preparations were investigated. The immobilization of pectinase onto Florisil and nano silica through 3-glyoxypropyltrietoxysilane spacer arm completely led to inactivation of enzyme; however, 10 and 75% pectinase activity were retained when it was immobilized through glutaraldehyde spacer arm onto Florisil and nano silica, respectively. The pectinase immobilized onto nano silica through glutaraldehyde spacer arm showed 6.3-fold higher catalytic efficiency than that of the pectinase immobilized onto Florisil through same spacer arm. A 2.3-fold increase in thermal stability of pectinase was provided upon immobilization onto nano silica at 35°C. The effects of IL/buffer mixture and volume ratio of IL/buffer mixture on the catalytic activities of free and immobilized pectinase preparations were also tested. All the pectinase preparations showed highest activity in 10% (v/v) 1-butyl-3-methylimidazolium hexafluorophosphate containing medium and their activities significantly affected from the concentration of 1-butyl-3-methylimidazolium hexafluorophosphate. Copyright © 2016 Elsevier B.V. All rights reserved.

Maintained physical activity and physiotherapy in the management of distal upper limb pain - a protocol for a randomised controlled trial (the arm pain trial).

PubMed

Jones, Gareth T; Mertens, Kathrin; Macfarlane, Gary J; Palmer, Keith T; Coggon, David; Walker-Bone, Karen; Burton, Kim; Heine, Peter J; McCabe, Candy; McNamee, Paul; McConnachie, Alex

2014-03-10

Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period. Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire.We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis. Results from this trial will contribute to the evidence base underpinning the

Physiological Responses to Arm Activity in Individuals With Chronic Obstructive Pulmonary Disease Compared With Healthy Controls: A SYSTEMATIC REVIEW.

PubMed

Lima, Vanessa Pereira; Iamonti, Vinicius C; Velloso, Marcelo; Janaudis-Ferreira, Tania

The mechanisms underlying physiological limitations during arm activity in individuals with chronic obstructive pulmonary disease (COPD) are unknown. The objective of this systematic review was to describe cardiorespiratory responses, symptoms, chest wall kinematics, muscle activity, and lung volumes during arm activity in individuals with COPD relative to the responses of healthy controls. Original research articles that compared cardiorespiratory responses, symptoms, muscle activity, chest wall kinematics, and lung function during arm activity between individuals with COPD and healthy controls were identified after searches of 5 electronic databases and reference lists of pertinent articles. Two reviewers performed the electronic and manual searches with 1 screening title and abstracts. Two investigators screened the full texts to determine eligibility for inclusion. One reviewer performed the data extraction and tabulation using a standardized form with a second reviewer double-checking the data extracted. Of the 54 full-text articles assessed for eligibility, 6 met the inclusion criteria. Reduced cardiorespiratory responses during peak arm exercise in individuals with COPD compared with healthy controls were evident. Compared with healthy controls, individuals with COPD had increased dyspnea and hyperinflation during peak arm exercise. Increased effort of the trapezius muscle during arm activities was also found in persons with COPD compared with healthy controls. There is limited evidence describing physiological responses during arm activity in individuals with COPD. Findings of this systematic review suggest that individuals with COPD have decreased cardiorespiratory responses during peak arm exercise compared with controls but increased dyspnea, hyperinflation, and arm muscle effort.

Maintained physical activity and physiotherapy in the management of distal upper limb pain – a protocol for a randomised controlled trial (the arm pain trial)

PubMed Central

2014-01-01

Background Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period. Methods/Design Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire. We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis. Discussion Results from this trial will contribute to

Development of the Strength Level on Arm for Indonesian People in Lifting Activity

NASA Astrophysics Data System (ADS)

Soewardi, H.; Prabaswari, A. D.; Muzakiroh, H. A.

2017-12-01

Lifting is one of manual material handling activity that involves the whole part of a body. This activity is significant to contribute musculoskeletal disorder specifically on arms. It is because the arms are a major strength to lift objects. However, many people do not know the capability of their arm so that the task designed does not comply with the limitation of workers. Thus, it is required to determine a level of strength on arms. The objective of this study is to develop the strength level of arms for Indonesian people based on musculoskeletal contraction. An experimental study is conducted in the ergonomics laboratory. 24 males and 24 females was participated in this study which consists of three different ethnics. They are sixteen participants of Ethnic A, sixteen participants of Ethnic B and sixteen participants of Ethnic C. A case study of lifting consists of 4 positions of object. They are 38 cm in height, 50 cm in height, 85 - 115 cm in height for forming 90 degrees of the elbow and 100 cm in height. Back lift technique was implemented. An Electromyography is used to investigate muscle contraction on arms. Statistical analysis is done to test the hypothesis. The result of this study shows that the arm strength level for Indonesian workers has significant differences between males and females among difference Ethnic. For male, Ethnic A has 28.82% - 79.28% of MVC, Ethnic B has 17.74% - 58.67% of MVC, and Ethnic C has 22.13% - 68.67% of MVC. For female, Ethnic A has 28.28% - 84.63% of MVC, Ethnic B has 24.47% - 70.98% of MVC, and Ethnic C has 24.24% - 75.67% of MVC.

A reliability study on brain activation during active and passive arm movements supported by an MRI-compatible robot.

PubMed

Estévez, Natalia; Yu, Ningbo; Brügger, Mike; Villiger, Michael; Hepp-Reymond, Marie-Claude; Riener, Robert; Kollias, Spyros

2014-11-01

In neurorehabilitation, longitudinal assessment of arm movement related brain function in patients with motor disability is challenging due to variability in task performance. MRI-compatible robots monitor and control task performance, yielding more reliable evaluation of brain function over time. The main goals of the present study were first to define the brain network activated while performing active and passive elbow movements with an MRI-compatible arm robot (MaRIA) in healthy subjects, and second to test the reproducibility of this activation over time. For the fMRI analysis two models were compared. In model 1 movement onset and duration were included, whereas in model 2 force and range of motion were added to the analysis. Reliability of brain activation was tested with several statistical approaches applied on individual and group activation maps and on summary statistics. The activated network included mainly the primary motor cortex, primary and secondary somatosensory cortex, superior and inferior parietal cortex, medial and lateral premotor regions, and subcortical structures. Reliability analyses revealed robust activation for active movements with both fMRI models and all the statistical methods used. Imposed passive movements also elicited mainly robust brain activation for individual and group activation maps, and reliability was improved by including additional force and range of motion using model 2. These findings demonstrate that the use of robotic devices, such as MaRIA, can be useful to reliably assess arm movement related brain activation in longitudinal studies and may contribute in studies evaluating therapies and brain plasticity following injury in the nervous system.

Arms Control Fellowship

NASA Astrophysics Data System (ADS)

The U.S. Arms Control and Disarmament Agency (ACDA) has announced that it is accepting applications for visiting scholars under the William C. Foster Fellows Program for 1986-1987. This program is designed to give specialists in the physical sciences and other disciplines relevant to ACDA activities an opportunity to participate actively in the arms control and disarmament activities of this agency and to give ACDA the perspective and expertise that such people can offer.

[Experience in using xeomin in the treatment of arm and hand spasticity in the early rehabilitation phase of stroke].

PubMed

Kostenko, E V; Petrova, L V; Ganzhula, P A; Lisenker, L N; Otcheskaia, O V; Khozova, A A; Boĭko, A N

2012-01-01

To reduce arm and hand spasticity, 28 patients in the early rehabilitation phase of ischemic hemisphere stroke received injections of the botulinum toxin A preparation xeomin in the content of complex rehabilitation programs. The following muscles: m. biceps brachii, m. flexor digitorum profundus, m. flexor digitorum superficialis, m. flexor carpi ulnaris, m. flexor carpi radialis were injected according to standard scheme. The total dose of drug was 200U in moderate (2-3 scores on the Ashworth scale) and 300U in marked (3-4 scores on the Ashworth scale) spasticity. Efficacy and safety of treatment was assessed at baseline and 2, 4, 8, 12, 16 weeks after injections. Xeomin significantly (p<0.05) reduced muscle tonus in patients with post-stroke spasticity of different severity. Clinical effect was seen 2 weeks after injection, it reached maximum at week 4 and then slowly decreased to week 16. The improved functional activity of the paretic arm (due to patient's and caregiver's reports) remained for to 12 weeks. The treatment was most effective in the group of patients with moderate spasticity. The correlation analysis confirmed that the severity of spasticity increased with the disease duration that reduced rehabilitation efficiency. The treatment with xeomin was safe, no serious side-effects were found.

Extravehicular activity translation arm (EVATA) study

NASA Technical Reports Server (NTRS)

Preiswerk, P. R.; Stammreich, J. R.

1978-01-01

The preliminary design of a deployable Extravehicular Activity Translation Arm (EVATA) assembly which will allow an EVA crewman to perform tasks in the vicinity of the External TNK (ET) umbilical doors and to inspect most of the underside of the shuttle spacecraft is reported. The concept chosen for the boom structure was the Astro Extendable Support Structure (ESS) which formed the main structure for the Synthetic Aperture Radar (SAR) Antenna System on the SEASAT A spacecraft. This structure is a deployable triangular truss. A comparison of the EVATA and the SEASAT A ESS is shown. The development of status of the ESS is shown. The satellite configuration, the stowed truss load path, and the envelope deployment sequence for the ESS are also shown.

Comparison of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease with Flat-Panel Detectors on Mobile C-arm versus Fixed Systems.

PubMed

Guillou, Marie; Maurel, Blandine; Necib, Hatem; Vent, Pierre-Alexandre; Costargent, Alain; Chaillou, Philippe; Gouëffic, Yann; Kaladji, Adrien

2018-02-01

Flat-panel detectors on mobile C-arm (MC-arm) systems are currently challenging fixed C-arm (FC-arm) systems used in hybrid operating rooms. MC-arm systems offer an alternative to FC-arm systems in the endovascular treatment of peripheral arterial disease (PAD) but their efficiency has not been evaluated comparatively. Two series of patients undergoing arteriography with intention to treat were included. Each series consisted of 2 nonrandomized groups: an MC-arm group and an FC-arm group. Series 1 evaluated exposure to the patient (MC-arm, n = 113; FC-arm, n = 206) while series 2 evaluated exposure to patients and also health care personnel (MC-arm, n = 24; FC-arm, n = 76). The primary end points for evaluating exposure were air kerma (AK, in mGy) for patients and effective dose for health care personnel (in μSv). After adjustment for the effect of body mass index (analysis of covariance test), AK was found to be lower in the MC-arm group than in the FC-arm group (124.1 ± 142 vs. 173.3 ± 248.7, P = 0.025). There was no difference between the groups with regard to effective dose recorded for senior surgeons or for operating room nurses. However, a higher effective dose was recorded by the MC-arm group external dosimeter for the trainee resident and for nurse anesthetists. In endovascular treatment of lower limb PAD, use of an FC-arm system is associated with more radiation exposure to the patient than an MC-arm system. However, this type of imaging system does not appear to affect exposure to health care personnel. Copyright © 2017 Elsevier Inc. All rights reserved.

Dependence of muscle moment arms on in-vivo three-dimensional kinematics of the knee

PubMed Central

Navacchia, Alessandro; Kefala, Vasiliki; Shelburne, Kevin B.

2016-01-01

Quantification of muscle moment arms is important for clinical evaluation of muscle pathology and treatment, and for estimating muscle and joint forces in musculoskeletal models. Moment arms estimated with musculoskeletal models often assume a default motion of the knee derived from measurements of passive cadaveric flexion. However, knee kinematics are unique to each person and activity. The objective of this study was to estimate moment arms of the knee muscles with in vivo subject- and activity-specific kinematics from seven healthy subjects performing seated knee extension and single-leg lunge to show changes between subjects and activities. 3D knee motion was measured with a high-speed stereo-radiography system. Moment arms of ten muscles were estimated in OpenSim by replacing the default knee motion with in vivo measurements. Estimated inter-subject moment arm variability was similar to previously reported in vitro measurements. RMS deviations up to 9.0 mm (35.2% of peak value) were observed between moment arms estimated with subject-specific knee extension and passive cadaveric motion. The degrees of freedom that most impacted inter-activity differences were superior/inferior and anterior/posterior translations. Musculoskeletal simulations used to estimate in vivo muscle forces and joint loads may provide significantly different results when subject- and activity-specific kinematics are implemented. PMID:27620064

Dependence of Muscle Moment Arms on In Vivo Three-Dimensional Kinematics of the Knee.

PubMed

Navacchia, Alessandro; Kefala, Vasiliki; Shelburne, Kevin B

2017-03-01

Quantification of muscle moment arms is important for clinical evaluation of muscle pathology and treatment, and for estimating muscle and joint forces in musculoskeletal models. Moment arms estimated with musculoskeletal models often assume a default motion of the knee derived from measurements of passive cadaveric flexion. However, knee kinematics are unique to each person and activity. The objective of this study was to estimate moment arms of the knee muscles with in vivo subject- and activity-specific kinematics from seven healthy subjects performing seated knee extension and single-leg lunge to show changes between subjects and activities. 3D knee motion was measured with a high-speed stereo-radiography system. Moment arms of ten muscles were estimated in OpenSim by replacing the default knee motion with in vivo measurements. Estimated inter-subject moment arm variability was similar to previously reported in vitro measurements. RMS deviations up to 9.0 mm (35.2% of peak value) were observed between moment arms estimated with subject-specific knee extension and passive cadaveric motion. The degrees of freedom that most impacted inter-activity differences were superior/inferior and anterior/posterior translations. Musculoskeletal simulations used to estimate in vivo muscle forces and joint loads may provide significantly different results when subject- and activity-specific kinematics are implemented.

Treatment of Glioma Using neuroArm Surgical System

PubMed Central

2016-01-01

The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases. neuroArm is equipped with force sensors at the end-effector allowing quantification of tool-tissue interaction forces and transmits force of dissection to the surgeon sited at a remote workstation that includes a haptic interface. Interaction forces between the tool tips and the brain tissue were measured for each procedure, and the peak forces were quantified. Results showed maximum and minimum peak force values of 2.89 N (anaplastic astrocytoma, WHO grade III) and 0.50 N (anaplastic oligodendroglioma, WHO grade III), respectively, with the mean of peak forces varying from case to case, depending on type of the glioma. Mean values of the peak forces varied in range of 1.27 N (anaplastic astrocytoma, WHO grade III) to 1.89 N (glioblastoma with oligodendroglial component, WHO grade IV). In some cases, ANOVA test failed to reject the null hypothesis of equality in means of the peak forces measured. However, we could not find a relationship between forces exerted to the pathological tissue and its size, type, or location. PMID:27314044

Factorial versus multi-arm multi-stage designs for clinical trials with multiple treatments.

PubMed

Jaki, Thomas; Vasileiou, Despina

2017-02-20

When several treatments are available for evaluation in a clinical trial, different design options are available. We compare multi-arm multi-stage with factorial designs, and in particular, we will consider a 2 × 2 factorial design, where groups of patients will either take treatments A, B, both or neither. We investigate the performance and characteristics of both types of designs under different scenarios and compare them using both theory and simulations. For the factorial designs, we construct appropriate test statistics to test the hypothesis of no treatment effect against the control group with overall control of the type I error. We study the effect of the choice of the allocation ratios on the critical value and sample size requirements for a target power. We also study how the possibility of an interaction between the two treatments A and B affects type I and type II errors when testing for significance of each of the treatment effects. We present both simulation results and a case study on an osteoarthritis clinical trial. We discover that in an optimal factorial design in terms of minimising the associated critical value, the corresponding allocation ratios differ substantially to those of a balanced design. We also find evidence of potentially big losses in power in factorial designs for moderate deviations from the study design assumptions and little gain compared with multi-arm multi-stage designs when the assumptions hold. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Cortical Spiking Network Interfaced with Virtual Musculoskeletal Arm and Robotic Arm

PubMed Central

Dura-Bernal, Salvador; Zhou, Xianlian; Neymotin, Samuel A.; Przekwas, Andrzej; Francis, Joseph T.; Lytton, William W.

2015-01-01

Embedding computational models in the physical world is a critical step towards constraining their behavior and building practical applications. Here we aim to drive a realistic musculoskeletal arm model using a biomimetic cortical spiking model, and make a robot arm reproduce the same trajectories in real time. Our cortical model consisted of a 3-layered cortex, composed of several hundred spiking model-neurons, which display physiologically realistic dynamics. We interconnected the cortical model to a two-joint musculoskeletal model of a human arm, with realistic anatomical and biomechanical properties. The virtual arm received muscle excitations from the neuronal model, and fed back proprioceptive information, forming a closed-loop system. The cortical model was trained using spike timing-dependent reinforcement learning to drive the virtual arm in a 2D reaching task. Limb position was used to simultaneously control a robot arm using an improved network interface. Virtual arm muscle activations responded to motoneuron firing rates, with virtual arm muscles lengths encoded via population coding in the proprioceptive population. After training, the virtual arm performed reaching movements which were smoother and more realistic than those obtained using a simplistic arm model. This system provided access to both spiking network properties and to arm biophysical properties, including muscle forces. The use of a musculoskeletal virtual arm and the improved control system allowed the robot arm to perform movements which were smoother than those reported in our previous paper using a simplistic arm. This work provides a novel approach consisting of bidirectionally connecting a cortical model to a realistic virtual arm, and using the system output to drive a robotic arm in real time. Our techniques are applicable to the future development of brain neuroprosthetic control systems, and may enable enhanced brain-machine interfaces with the possibility for finer control of

Cortical Spiking Network Interfaced with Virtual Musculoskeletal Arm and Robotic Arm.

PubMed

Dura-Bernal, Salvador; Zhou, Xianlian; Neymotin, Samuel A; Przekwas, Andrzej; Francis, Joseph T; Lytton, William W

2015-01-01

Embedding computational models in the physical world is a critical step towards constraining their behavior and building practical applications. Here we aim to drive a realistic musculoskeletal arm model using a biomimetic cortical spiking model, and make a robot arm reproduce the same trajectories in real time. Our cortical model consisted of a 3-layered cortex, composed of several hundred spiking model-neurons, which display physiologically realistic dynamics. We interconnected the cortical model to a two-joint musculoskeletal model of a human arm, with realistic anatomical and biomechanical properties. The virtual arm received muscle excitations from the neuronal model, and fed back proprioceptive information, forming a closed-loop system. The cortical model was trained using spike timing-dependent reinforcement learning to drive the virtual arm in a 2D reaching task. Limb position was used to simultaneously control a robot arm using an improved network interface. Virtual arm muscle activations responded to motoneuron firing rates, with virtual arm muscles lengths encoded via population coding in the proprioceptive population. After training, the virtual arm performed reaching movements which were smoother and more realistic than those obtained using a simplistic arm model. This system provided access to both spiking network properties and to arm biophysical properties, including muscle forces. The use of a musculoskeletal virtual arm and the improved control system allowed the robot arm to perform movements which were smoother than those reported in our previous paper using a simplistic arm. This work provides a novel approach consisting of bidirectionally connecting a cortical model to a realistic virtual arm, and using the system output to drive a robotic arm in real time. Our techniques are applicable to the future development of brain neuroprosthetic control systems, and may enable enhanced brain-machine interfaces with the possibility for finer control of

Selecting promising treatments in randomized Phase II cancer trials with an active control.

PubMed

Cheung, Ying Kuen

2009-01-01

The primary objective of Phase II cancer trials is to evaluate the potential efficacy of a new regimen in terms of its antitumor activity in a given type of cancer. Due to advances in oncology therapeutics and heterogeneity in the patient population, such evaluation can be interpreted objectively only in the presence of a prospective control group of an active standard treatment. This paper deals with the design problem of Phase II selection trials in which several experimental regimens are compared to an active control, with an objective to identify an experimental arm that is more effective than the control or to declare futility if no such treatment exists. Conducting a multi-arm randomized selection trial is a useful strategy to prioritize experimental treatments for further testing when many candidates are available, but the sample size required in such a trial with an active control could raise feasibility concerns. In this study, we extend the sequential probability ratio test for normal observations to the multi-arm selection setting. The proposed methods, allowing frequent interim monitoring, offer high likelihood of early trial termination, and as such enhance enrollment feasibility. The termination and selection criteria have closed form solutions and are easy to compute with respect to any given set of error constraints. The proposed methods are applied to design a selection trial in which combinations of sorafenib and erlotinib are compared to a control group in patients with non-small-cell lung cancer using a continuous endpoint of change in tumor size. The operating characteristics of the proposed methods are compared to that of a single-stage design via simulations: The sample size requirement is reduced substantially and is feasible at an early stage of drug development.

Nonparetic arm force does not overinhibit the paretic arm in chronic poststroke hemiparesis.

PubMed

Dimyan, Michael A; Perez, Monica A; Auh, Sungyoung; Tarula, Erick; Wilson, Matthew; Cohen, Leonardo G

2014-05-01

To determine whether nonparetic arm force overinhibits the paretic arm in patients with chronic unilateral poststroke hemiparesis. Case-control neurophysiological and behavioral study of patients with chronic stroke. Research institution. Eighty-six referred patients were screened to enroll 9 participants (N=9) with a >6 month history of 1 unilateral ischemic infarct that resulted in arm hemiparesis with residual ability to produce 1Nm of wrist flexion torque and without contraindication to transcranial magnetic stimulation. Eight age- and handedness-matched healthy volunteers without neurologic diagnosis were studied for comparison. Not applicable. Change in interhemispheric inhibition targeting the ipsilesional primary motor cortex (M1) during nonparetic arm force. We hypothesized that interhemispheric inhibition would increase more in healthy controls than in patients with hemiparesis. Healthy age-matched controls had significantly greater increases in inhibition from their active to resting M1 than patients with stroke from their active contralesional to resting ipsilesional M1 in the same scenario (20%±7% vs -1%±4%, F1,12=6.61, P=.025). Patients with greater increases in contralesional to ipsilesional inhibition were better performers on the 9-hole peg test of paretic arm function. Our findings reveal that producing force with the nonparetic arm does not necessarily overinhibit the paretic arm. Though our study is limited in generalizability by the small sample size, we found that greater active contralesional to resting ipsilesional M1 inhibition was related with better recovery in this subset of patients with chronic poststroke. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: a randomized controlled trial.

PubMed

Timmermans, Annick A A; Lemmens, Ryanne J M; Monfrance, Maurice; Geers, Richard P J; Bakx, Wilbert; Smeets, Rob J E M; Seelen, Henk A M

2014-03-31

Over fifty percent of stroke patients experience chronic arm hand performance problems, compromising independence in daily life activities and quality of life. Task-oriented training may improve arm hand performance after stroke, whereby augmented therapy may lead to a better treatment outcome. Technology-supported training holds opportunities for increasing training intensity. However, the effects of robot-supported task-oriented training with real life objects in stroke patients are not known to date. The aim of the present study was to investigate the effectiveness and added value of the Haptic Master robot combined with task-oriented arm hand training in chronic stroke patients. In a single-blind randomized controlled trial, 22 chronic stroke patients were randomly allocated to receive either task-oriented robot-assisted arm-hand training (experimental group) or task-oriented non-robotic arm-hand training (control group). For training, the T-TOAT (Technology-supported Task-Oriented Arm Training) method was applied. Training was provided during 8 weeks, 4 times/week, 2 × 30 min/day. A significant improvement after training on the Action Research Arm Test (ARAT) was demonstrated in the experimental group (p = 0.008). Results were maintained until 6 months after cessation of the training. On the perceived performance measure (Motor Activity Log (MAL)), both, the experimental and control group improved significantly after training (control group p = 0.008; experimental group p = 0.013). The improvements on MAL in both groups were maintained until 6 months after cessation of the training. With regard to quality of life, only in the control group a significant improvement after training was found (EuroQol-5D p = 0.015, SF-36 physical p = 0.01). However, the improvement on SF-36 in the control group was not maintained (p = 0.012). No between-group differences could be demonstrated on any of the outcome measures. Arm hand performance improved in chronic stroke

A pilot study of activity-based therapy in the arm motor recovery post stroke: a randomized controlled trial.

PubMed

Rabadi, Mh; Galgano, M; Lynch, D; Akerman, M; Lesser, M; Volpe, Bt

2008-12-01

To determine the efficacy of activity-based therapies using arm ergometer or robotic or group occupational therapy for motor recovery of the paretic arm in patients with an acute stroke (< or =4 weeks) admitted to an inpatient rehabilitation facility, and to obtain information to plan a large randomized controlled trial. Prospective, randomized controlled study. Stroke unit in a rehabilitation hospital. Thirty patients with an acute stroke (< or =4 weeks) who had arm weakness (Medical Research Council grade 2 or less at the shoulder joint). Occupational therapy (OT) group (control) (n = 10), arm ergometer (n = 10) or robotic (n = 10) therapy group. All patients received standard, inpatient, post-stroke rehabilitation training for 3 hours a day, plus 12 additional 40-minute sessions of the activity-based therapy. The primary outcome measures were discharge scores in the Fugl-Meyer Assessment Scale for upper limb impairment, Motor Status Scale, total Functional Independence Measure (FIM) and FIM-motor and FIM-cognition subscores. The three groups (OT group versus arm ergometer versus robotic) were comparable on clinical demographic measures except the robotic group was significantly older and there were more haemorrhagic stroke patients in the arm ergometer group. After adjusting for age, stroke type and outcome measures at baseline, a similar degree of improvement in the discharge scores was found in all of the primary outcome measures. This study suggests that activity-based therapies using an arm ergometer or robot when used over shortened training periods have the same effect as OT group therapy in decreasing impairment and improving disability in the paretic arm of severely affected stroke patients in the subacute phase.

Participation in Armed Forces, National, and International Sports Activities

DTIC Science & Technology

1987-03-09

American Games , Olympic Games , and other authorized national and international sports competitions (to include qualifying and preparatory events) as long...concerning the participation of Armed Forces personnel in Armed Forces, national, and international sports competitions ; establishes a Senior Military Sports ...program is to ensure that the U.S. Armed Forces are appropriately represented in national and international sports competitions . 3. The purpose of this

Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice.

PubMed

de Jong, Lex D; van Wijck, Frederike; Stewart, Roy E; Geurts, Alexander C H; Dijkstra, Pieter U

2018-01-01

Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions. Design: This is a retrospective analysis of randomized trial data. 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands. PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories. PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on "moving around using transportation," "self care," and "household tasks" categories. Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries. Copyright © 2017 John Wiley & Sons, Ltd.

A studentized permutation test for three-arm trials in the 'gold standard' design.

PubMed

Mütze, Tobias; Konietschke, Frank; Munk, Axel; Friede, Tim

2017-03-15

The 'gold standard' design for three-arm trials refers to trials with an active control and a placebo control in addition to the experimental treatment group. This trial design is recommended when being ethically justifiable and it allows the simultaneous comparison of experimental treatment, active control, and placebo. Parametric testing methods have been studied plentifully over the past years. However, these methods often tend to be liberal or conservative when distributional assumptions are not met particularly with small sample sizes. In this article, we introduce a studentized permutation test for testing non-inferiority and superiority of the experimental treatment compared with the active control in three-arm trials in the 'gold standard' design. The performance of the studentized permutation test for finite sample sizes is assessed in a Monte Carlo simulation study under various parameter constellations. Emphasis is put on whether the studentized permutation test meets the target significance level. For comparison purposes, commonly used Wald-type tests, which do not make any distributional assumptions, are included in the simulation study. The simulation study shows that the presented studentized permutation test for assessing non-inferiority in three-arm trials in the 'gold standard' design outperforms its competitors, for instance the test based on a quasi-Poisson model, for count data. The methods discussed in this paper are implemented in the R package ThreeArmedTrials which is available on the comprehensive R archive network (CRAN). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Effects of robot-assisted upper limb rehabilitation on daily function and real-world arm activity in patients with chronic stroke: a randomized controlled trial.

PubMed

Liao, Wan-Wen; Wu, Ching-Yi; Hsieh, Yu-Wei; Lin, Keh-Chung; Chang, Wan-Ying

2012-02-01

To compare the outcome of robot-assisted therapy with dose-matched active control therapy by using accelerometers to study functional recovery in chronic stroke patients. Prospective, randomized, controlled trial. Stroke units in three medical centres. Twenty patients post stroke for a mean of 22 months. Robot-assisted therapy (n = 10) or dose-matched active control therapy (n = 10). All patients received either of these two therapies for 90-105 minutes each day, 5 days per week, for four weeks. Outcome measures included arm activity ratio (the ratio of mean activity between the impaired and unimpaired arm) and scores on the Fugl-Meyer Assessment Scale, Functional Independence Measure, Motor Activity Log and ABILHAND questionnaire. The robot-assisted therapy group significantly increased motor function, hemiplegic arm activity and bilateral arm coordination (Fugl-Meyer Assessment Scale: 51.20 ± 8.82, P = 0.002; mean arm activity ratio: 0.76 ± 0.10, P = 0.026; ABILHAND questionnaire: 1.24 ± 0.28, P = 0.043) compared with the dose-matched active control group (Fugl-Meyer Assessment Scale: 40.90 ± 13.14; mean arm movement ratio: 0.69 ± 0.11; ABILHAND questionnaire: 0.95 ± 0.43). Symmetrical and bilateral robotic practice, combined with functional task training, can significantly improve motor function, arm activity, and self-perceived bilateral arm ability in patients late after stroke.

A comparison of ARMS-Plus and droplet digital PCR for detecting EGFR activating mutations in plasma

PubMed Central

Zhang, Xinxin; Chang, Ning; Yang, Guohua; Zhang, Yong; Ye, Mingxiang; Cao, Jing; Xiong, Jie; Han, Zhiping; Wu, Shuo; Shang, Lei; Zhang, Jian

2017-01-01

In this study, we introduce a novel amplification refractory mutation system (ARMS)-based assay, namely ARMS-Plus, for the detection of epidermal growth factor receptor (EGFR) mutations in plasma samples. We evaluated the performance of ARMS-Plus in comparison with droplet digital PCR (ddPCR) and assessed the significance of plasma EGFR mutations in predicting efficacy of EGFR-tyrosine kinase inhibitor (TKI) regimen. A total of 122 advanced non-small cell lung cancer (NSCLC) patients were enrolled in this study. The tumor tissue samples from these patients were evaluated by conventional ARMS PCR method to confirm their EGFR mutation status. For the 116 plasma samples analyzed by ARMS-Plus, the sensitivity, specificity, and concordance rate were 77.27% (34/44), 97.22% (70/72), and 89.66% (104/116; κ=0.77, P<0.0001), respectively. Among the 71 plasma samples analyzed by both ARMS-Plus and ddPCR, ARMS-Plus showed a higher sensitivity than ddPCR (83.33% versus 70.83%). The presence of EGFR activating mutations in plasma was not associated with the response to EGFR-TKI, although further validation with a larger cohort is required to confirm the correlation. Collectively, the performance of ARMS-Plus and ddPCR are comparable. ARMS-Plus could be a potential alternative to tissue genotyping for the detection of plasma EGFR mutations in NSCLC patients. PMID:29340107

Effects on abstinence of nicotine patch treatment before quitting smoking: parallel, two arm, pragmatic randomised trial.

PubMed

2018-06-13

To examine the effectiveness of a nicotine patch worn for four weeks before a quit attempt. Randomised controlled open label trial. Primary care and smoking cessation clinics in England, 2012-15. 1792 adults who were daily smokers with tobacco dependence. 899 were allocated to the preloading arm and 893 to the control arm. Participants were randomised 1:1, using concealed randomly permuted blocks stratified by centre, to either standard smoking cessation pharmacotherapy and behavioural support or the same treatment supplemented by four weeks of 21 mg nicotine patch use before quitting: "preloading." The primary outcome was biochemically confirmed prolonged abstinence at six months. Secondary outcomes were prolonged abstinence at four weeks and 12 months. Biochemically validated abstinence at six months was achieved by 157/899 (17.5%) participants in the preloading arm and 129/893 (14.4%) in the control arm: difference 3.0% (95% confidence interval -0.4% to 6.4%), odds ratio 1.25 (95% confidence interval 0.97 to 1.62), P=0.08 in the primary analysis. There was an imbalance between arms in the frequency of varenicline use as post-cessation treatment, and planned adjustment for this gave an odds ratio for the effect of preloading of 1.34 (95% confidence interval 1.03 to 1.73), P=0.03: difference 3.8% (0.4% to 7.2%). At four weeks, the difference in prolonged abstinence unadjusted for varenicline use was odds ratio 1.21 (1.00 to 1.48), difference 4.3% (0.0% to 8.7%), P=0.05, and adjusted for varenicline use was 1.32 (1.08 to 1.62) P=0.007. At 12 months the odds ratio was 1.28 (0.97 to 1.69), difference 2.7% (-0.4% to 5.8%), P=0.09 unadjusted for varenicline use and after adjustment was 1.36 (1.02 to 1.80) P=0.04. 5.9% of participants discontinued preloading owing to intolerance. Gastrointestinal symptoms-chiefly nausea-occurred in 4.0% (2.2% to 5.9%) more people in the preloading arm than control arm. Eight serious adverse events occurred in the preloading arm and

[The Activation of Interlimb Interactions Increase the Motor Output in Legs in Healthy Subjects under the Conditions of Arm and Leg Unloading].

PubMed

Selionov, V A; Solopova, I A; Zhvansky, D S

2016-01-01

We studied the effect of arm movements and movements of separate arm joints on the electrophysiological and kinematic characteristics of voluntary and vibration-triggered stepping-like leg movements under the conditions of horizontal support of upper and lower limbs. The horizontal support of arms provided a significantly increase in the rate of activation of locomotor automatism by non-invasive impact on tonic sensory inputs. The addition of active arm movements during involuntary rhytmic stepping-like leg movements led to an increase in EMG activity of hip muscles and was accompanied by an increase in the amplitude of hip and shin movements. Passive arm movements had the same effect on induced leg movements. The movement of the shoulder joints led to an increase in the activity of hip muscles and an increase in the amplitude of movements of the knee and hip joints. At the same time, the movement of forearms. and wrists had similar facilitating effect on electrophysiological and kinematic characteristics of rhytmic stepping-like movements, but influenced the distal segments of legs to a greater extent. Under the conditions of sub-threshold vibration of leg muscles, voluntary arm movements led to the activation of involuntary rhytmic stepping movements. During voluntary leg movements, the addition of arm movements had a significantly smaller impact on the parameters of rhytmic stepping than during involuntary leg movements. Thus, the simultaneous movements of upper and lower limbs are an effective method of activation of neural networks connecting the rhythm generators of arms and legs. Under the conditions of arm and leg unloading, the interactions between the cervical and lumbosacral segments of the spinal cord seem to play the major role in the impact of arm movements on the patterns of leg movements. The described methods of activation of interlimb interactions can be used in the rehabilitation of post-stroke patients and patients with spinal cord injuries

Bimanual coordination: A missing piece of arm rehabilitation after stroke.

PubMed

Kantak, Shailesh; Jax, Steven; Wittenberg, George

2017-01-01

Inability to use the arm in daily actions significantly lowers quality of life after stroke. Most contemporary post-stroke arm rehabilitation strategies that aspire to re-engage the weaker arm in functional activities have been greatly limited in their effectiveness. Most actions of daily life engage the two arms in a highly coordinated manner. In contrast, most rehabilitation approaches predominantly focus on restitution of the impairments and unilateral practice of the weaker hand alone. We present a perspective that this misalignment between real world requirements and intervention strategies may limit the transfer of unimanual capability to spontaneous arm use and functional recovery. We propose that if improving spontaneous engagement and use of the weaker arm in real life is the goal, arm rehabilitation research and treatment need to address the coordinated interaction between arms in targeted theory-guided interventions. Current narrow focus on unimanual deficits alone, difficulty in quantifying bimanual coordination in real-world actions and limited theory-guided focus on control and remediation of different coordination modes are some of the biggest obstacles to successful implementation of effective interventions to improve bimanual coordination in the real world. We present a theory-guided taxonomy of bimanual actions that will facilitate quantification of coordination for different real-world tasks and provide treatment targets for addressing coordination deficits. We then present evidence in the literature that points to bimanual coordination deficits in stroke survivors and demonstrate how current rehabilitation approaches are limited in their impact on bimanual coordination. Importantly, we suggest theory-based areas of future investigation that may assist quantification, identification of neural mechanisms and scientifically-based training/remediation approaches for bimanual coordination deficits post-stroke. Advancing the science and practice of

Rejuvenation of the Aging Arm: Multimodal Combination Therapy for Optimal Results.

PubMed

Wu, Douglas C; Green, Jeremy B

2016-05-01

The aging arm is characterized by increased dyspigmentation, a proliferation of ectactic blood vessels, excessive adiposity, excessive skin laxity, and actinic keratosis. A variety of laser, energy, and surgical techniques can be used to improve these features. The objective of this article is to describe the treatment modalities that have proven efficacious in rejuvenating the aging arm and combination therapies that have the potential to optimize patient outcomes while maintaining safety and tolerability. A Medline search was performed on nonsurgical aesthetic combination treatments because it relates to arm rejuvenation, and results are summarized. Practical applications for these combination treatments are also discussed. Although there is significant evidence supporting the effective use of nonsurgical treatments for arm rejuvenation, little in the literature was found on the safety and efficacy of combining such procedures and devices. However, in the authors' clinical experience, combining arm rejuvenation techniques can be done safely and often result in optimal outcomes. Arm rejuvenation can be safely and effectively achieved with combination nonsurgical aesthetic treatments.

Prosthesis Prescription Protocol of the Arm (PPP-Arm): The implementation of a national prosthesis prescription protocol.

PubMed

Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

2018-02-01

In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to structure, underpin, and evaluate the prescription of upper limb prostheses for clients with acquired or congenital arm defects. Prosthesis Prescription Protocol of the Arm (PPP-Arm) was developed on the basis of the International Classification of Functioning and consisted of several layers. All stakeholders (rehabilitation teams, orthopedic workshops, patients, and insurance companies) were involved in development and implementation. A national project coordinator and knowledge brokers in each team were essential for the project. PPP-Arm was successfully developed and implemented in nine Dutch rehabilitation teams. The protocol improved team collaboration, structure, and completeness of prosthesis prescriptions and treatment uniformity and might be interesting for other countries as well. Clinical relevance A national protocol to prescribe upper limb prostheses can be helpful to create uniformity in treatment of patients with upper limb defects. Such a protocol improves quality of care for all patients in the country.

Arm MRI scan

MedlinePlus

... MRI and often available in the emergency room. Alternative Names MRI - arm; Wrist MRI; MRI - wrist; Elbow ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

Segmental Blood Flow and Hemodynamic State of Lymphedematous and Nonlymphedematous Arms

PubMed Central

Montgomery, Leslie D.; Dietrich, Mary S.; Armer, Jane M.; Stewart, B. R.

2011-01-01

Abstract Background Findings regarding the influence hemodynamic factors, such as increased arterial blood flow or venous abnormalities, on breast cancer treatment-related lymphedema are mixed. The purpose of this study was to compare segmental arterial blood flow, venous blood return, and blood volumes between breast cancer survivors with treatment-related lymphedema and healthy normal individuals without lymphedema. Methods and Results A Tetrapolar High Resolution Impedance Monitor and Cardiotachometer were used to compare segmental arterial blood flow, venous blood return, and blood volumes between breast cancer survivors with treatment-related lymphedema and healthy normal volunteers. Average arterial blood flow in lymphedema-affected arms was higher than that in arms of healthy normal volunteers or in contralateral nonlymphedema affected arms. Time of venous outflow period of blood flow pulse was lower in lymphedema-affected arms than in healthy normal or lymphedema nonaffected arms. Amplitude of the venous component of blood flow pulse signal was lower in lymphedema-affected arms than in healthy or lymphedema nonaffected arms. Index of venular tone was also lower in lymphedema-affected arms than healthy or lymphedema nonaffected arms. Conclusions Both arterial and venous components may be altered in the lymphedema-affected arms when compared to healthy normal arms and contralateral arms in the breast cancer survivors. PMID:21417765

Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis.

PubMed

Marty, Francisco M; Ostrosky-Zeichner, Luis; Cornely, Oliver A; Mullane, Kathleen M; Perfect, John R; Thompson, George R; Alangaden, George J; Brown, Janice M; Fredricks, David N; Heinz, Werner J; Herbrecht, Raoul; Klimko, Nikolai; Klyasova, Galina; Maertens, Johan A; Melinkeri, Sameer R; Oren, Ilana; Pappas, Peter G; Ráčil, Zdeněk; Rahav, Galia; Santos, Rodrigo; Schwartz, Stefan; Vehreschild, J Janne; Young, Jo-Anne H; Chetchotisakd, Ploenchan; Jaruratanasirikul, Sutep; Kanj, Souha S; Engelhardt, Marc; Kaufhold, Achim; Ito, Masanori; Lee, Misun; Sasse, Carolyn; Maher, Rochelle M; Zeiher, Bernhardt; Vehreschild, Maria J G T

2016-07-01

Mucormycosis is an uncommon invasive fungal disease with high mortality and few treatment options. Isavuconazole is a triazole active in vitro and in animal models against moulds of the order Mucorales. We assessed the efficacy and safety of isavuconazole for treatment of mucormycosis and compared its efficacy with amphotericin B in a matched case-control analysis. In a single-arm open-label trial (VITAL study), adult patients (≥18 years) with invasive fungal disease caused by rare fungi, including mucormycosis, were recruited from 34 centres worldwide. Patients were given isavuconazole 200 mg (as its intravenous or oral water-soluble prodrug, isavuconazonium sulfate) three times daily for six doses, followed by 200 mg/day until invasive fungal disease resolution, failure, or for 180 days or more. The primary endpoint was independent data review committee-determined overall response-ie, complete or partial response (treatment success) or stable or progressive disease (treatment failure)-according to prespecified criteria. Mucormycosis cases treated with isavuconazole as primary treatment were matched with controls from the FungiScope Registry, recruited from 17 centres worldwide, who received primary amphotericin B-based treatment, and were analysed for day-42 all-cause mortality. VITAL is registered with ClinicalTrials.gov, number NCT00634049. FungiScope is registered with ClinicalTrials.gov, number NCT01731353. Within the VITAL study, from April 22, 2008, to June 21, 2013, 37 patients with mucormycosis received isavuconazole for a median of 84 days (IQR 19-179, range 2-882). By day 42, four patients (11%) had a partial response, 16 (43%) had stable invasive fungal disease, one (3%) had invasive fungal disease progression, three (8%) had missing assessments, and 13 (35%) had died. 35 patients (95%) had adverse events (28 [76%] serious). Day-42 crude all-cause mortality in seven (33%) of 21 primary-treatment isavuconazole cases was similar to 13 (39%) of 33

The application of active side arm controllers in helicopters

NASA Technical Reports Server (NTRS)

Knorr, R.; Melz, C.; Faulkner, A.; Obermayer, M.

1993-01-01

Eurocopter Deutschland (ECD) started simulation trials to investigate the particular problems of Side Arm Controllers (SAC) applied to helicopters. Two simulation trials have been performed. In the first trial, the handling characteristics of a 'passive' SAC and the basic requirements for the application of an 'active' SAC were evaluated in pilot-in-the-loop simulations, performing the tasks in a realistic scenario representing typical phases of a transport mission. The second simulation trial investigated the general control characteristics of the 'active' in comparison to the 'passive' control principle. A description of the SACs developed by ECD and the principle of the 'passive' and 'active' control concept is given, as well as specific ratings for the investigated dynamic and ergonomic parameters effecting SAC characteristics. The experimental arrangements, as well as the trials procedures of both simulation phases, are described and the results achieved are discussed emphasizing the advantages of the 'active' as opposed to the 'passive' SAC concept. This also includes the presentation of some critical aspects still to be improved and proposals to solve them.

Blood pressure measurement: one arm or both arm?

PubMed

Kulkarni, Prasad K; Shekhar, Susheela; Reddy, B N; Nirmala, B C

2011-09-01

Guidelines for measuring blood pressure includes measurement of blood pressure on both arms but it is often ignored. Our case report aims at highlighting the need follow the guidelines. A 60 year old 59 kg weighing male asymptomatic patient without any comobidities was posted for bilateral inguinal hernia repair. The interarm blood pressure difference was discovered incidentally during his preanaesthetic evalution. On further evaluation patient was found to be having subclavian stenosis on left side which was asymptomatic. Intraoperative and post operative period was uneventful. Blood pressure measurement should be done in accordance with the stipulated guidelines. Inter arm blood pressure difference should be noted in all patients as not only for diagnosis and treatment of hypertension but also as a tool to diagnose asymptomatic peripheral vascular disesase.

LISA Long-Arm Interferometry

NASA Technical Reports Server (NTRS)

Thorpe, James I.

2009-01-01

An overview of LISA Long-Arm Interferometry is presented. The contents include: 1) LISA Interferometry; 2) Constellation Design; 3) Telescope Design; 4) Constellation Acquisition; 5) Mechanisms; 6) Optical Bench Design; 7) Phase Measurement Subsystem; 8) Phasemeter Demonstration; 9) Time Delay Interferometry; 10) TDI Limitations; 11) Active Frequency Stabilization; 12) Spacecraft Level Stabilization; 13) Arm-Locking; and 14) Embarassment of Riches.

Non-paretic arm force does not over-inhibit the paretic arm in chronic post-stroke hemiparesis

PubMed Central

Dimyan, Michael A.; Perez, Monica A.; Auh, Sungyoung; Tarula, Erick; Wilson, Matthew; Cohen, Leonardo G.

2014-01-01

Objective To determine whether non-paretic arm force over-inhibits the paretic arm in patients with chronic unilateral post-stroke hemiparesis. We hypothesized that interhemispheric inhibition would increase more in healthy controls than in hemiparetic patients. Design Case-control neurophysiologic and behavioral study of patients with chronic stroke. Setting Federal research institution, outpatient clinical research setting Participants Eighty-six referred patients were screened to enroll 9 participants with greater than 6 month history of one unilateral ischemic infarct that resulted in arm hemiparesis, with residual ability to produce 1Nm of wrist flexion torque, without contraindication to transcranial magnetic stimulation. 8 age- and handedness-matched healthy volunteers without neurologic diagnosis were studied for comparison. Interventions Not Applicable Main Outcome Measures Change in interhemispheric inhibition targeting the ipsilesional primary-motor-cortex (M1) during non-paretic arm force. Results Healthy age-matched controls had significantly greater increases in inhibition from their active to resting M1 than did stroke patients from their active contralesional to resting ipsilesional M1 in the same scenario (20% ±7 vs. −1% ±4, F1,12=6.61, p=0.0245). Patients with greater increases in contralesional to ipsilesional inhibition were better performers on the nine-hole-peg-test of paretic arm function. Conclusions Our findings reveal that producing force with the non-paretic arm does not necessarily over-inhibit the paretic arm. Though limited in generalizability by the small sample size, we found that greater active contralesional to resting ipsilesional M1 inhibition was related to better recovery in this subset of chronic post-stroke patients. PMID:24440364

Dynamic model of the octopus arm. II. Control of reaching movements.

PubMed

Yekutieli, Yoram; Sagiv-Zohar, Roni; Hochner, Binyamin; Flash, Tamar

2005-08-01

The dynamic model of the octopus arm described in the first paper of this 2-part series was used here to investigate the neural strategies used for controlling the reaching movements of the octopus arm. These are stereotypical extension movements used to reach toward an object. In the dynamic model, sending a simple propagating neural activation signal to contract all muscles along the arm produced an arm extension with kinematic properties similar to those of natural movements. Control of only 2 parameters fully specified the extension movement: the amplitude of the activation signal (leading to the generation of muscle force) and the activation traveling time (the time the activation wave takes to travel along the arm). We found that the same kinematics could be achieved by applying activation signals with different activation amplitudes all exceeding some minimal level. This suggests that the octopus arm could use minimal amplitudes of activation to generate the minimal muscle forces required for the production of the desired kinematics. Larger-amplitude signals would generate larger forces that increase the arm's stability against perturbations without changing the kinematic characteristics. The robustness of this phenomenon was demonstrated by examining activation signals with either a constant or a bell-shaped velocity profile. Our modeling suggests that the octopus arm biomechanics may allow independent control of kinematics and resistance to perturbation during arm extension movements.

Pelvic floor muscle training added to another active treatment versus the same active treatment alone for urinary incontinence in women.

PubMed

Ayeleke, Reuben Olugbenga; Hay-Smith, E Jean C; Omar, Muhammad Imran

2015-11-03

Pelvic floor muscle training (PFMT) is a first-line conservative treatment for urinary incontinence in women. Other active treatments include: physical therapies (e.g. vaginal cones); behavioural therapies (e.g. bladder training); electrical or magnetic stimulation; mechanical devices (e.g. continence pessaries); drug therapies (e.g. anticholinergics (solifenacin, oxybutynin, etc.) and duloxetine); and surgical interventions including sling procedures and colposuspension. This systematic review evaluated the effects of adding PFMT to any other active treatment for urinary incontinence in women To compare the effects of pelvic floor muscle training combined with another active treatment versus the same active treatment alone in the management of women with urinary incontinence. We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE in process, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 5 May 2015), and CINAHL (January 1982 to 6 May 2015), and the reference lists of relevant articles. We included randomised or quasi-randomised trials with two or more arms, of women with clinical or urodynamic evidence of stress urinary incontinence, urgency urinary incontinence or mixed urinary incontinence. One arm of the trial included PFMT added to another active treatment; the other arm included the same active treatment alone. Two review authors independently assessed trials for eligibility and methodological quality and resolved any disagreement by discussion or consultation with a third party. We extracted and processed data in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Other potential sources of bias we incorporated into the 'Risk of bias' tables were ethical approval, conflict of interest and funding source. Thirteen trials met the inclusion criteria

Arm mechanical efficiency and arm exercise capacity are relatively preserved in chronic obstructive pulmonary disease.

PubMed

Franssen, Frits M E; Wouters, Emiel F M; Baarends, Erica M; Akkermans, Marco A; Schols, Annemie M W J

2002-10-01

Previous studies indicate that energy expenditure related to physical activity is enhanced and that mechanical efficiency of leg exercise is reduced in patients with chronic obstructive pulmonary disease (COPD). However, it is yet unclear whether an inefficient energy expenditure is also present during other activities in COPD. This study was carried out to examine arm efficiency and peak arm exercise performance relative to leg exercise in 33 (23 male) patients with COPD ((mean +/- SEM) age: 61 +/- 2 yr; FEV : 40 +/- 2% of predicted) and 20 sex- and age-matched healthy controls. Body composition, pulmonary function, resting energy expenditure (REE), and peak leg and arm exercise performance were determined. To calculate mechanical efficiency, subjects performed submaximal leg and arm ergometry at 50% of achieved peak loads. During exercise testing, metabolic and ventilatory parameters were measured. In contrast to a reduced leg mechanical efficiency in patients compared with controls (15.6 +/- 0.6% and 22.5 +/- 0.6%, respectively; < 0.001), arm mechanical efficiency was comparable in both groups (COPD: 18.3 +/- 0.9%, controls: 21.0 +/- 1.2%; NS). Arm efficiency was not related to leg efficiency, pulmonary function, work of breathing, or REE. Also, arm exercise capacity was relatively preserved in patients with COPD (ratio arm peak work rate/leg peak work rate in patients: 89% vs 53% in controls; < 0.001). Mechanical efficiency and exercise capacity of the upper and lower limbs are not homogeneously affected in COPD, with a relative preservation of the upper limbs. This may have implications for screening of exercise tolerance and prescription of training interventions in patients with COPD. Future studies need to elucidate the mechanism behind this observation.

An overview and categorization of dynamic arm supports for people with decreased arm function.

PubMed

Van der Heide, Loek A; van Ninhuijs, Bob; Bergsma, Arjen; Gelderblom, Gert Jan; van der Pijl, Dick J; de Witte, Luc P

2014-08-01

Assistive devices that augment arm function were already introduced during the polio era. Devices are still being developed, but a review has not been performed thus far. To create an overview and categorize assistive devices facilitating arm function in activities of daily living for people with decreased arm function. Literature review. A systematic review in three scientific literature databases. Conference proceedings, assistive technology databases, and references were searched and experts consulted. This resulted in a database of dynamic arm supports. Product information was added, and the devices were categorized. A total of 104 dynamic arm supports were found. These could be categorized as nonactuated devices (N = 39), passively actuated devices (N = 24), actively actuated devices (N = 34), or devices using the functional electrical stimulation principle (N = 7). Functionality analysis resulted in second-level categorization: tremor suppression, facilitation of anti-gravity movement, and assistance of specific joint motion. All devices could be ordered in a categorization of low complexity. Many have been developed; most have disappeared and have been succeeded by similar devices. Limitations of the devices found mainly concern interfacing and the range of motion facilitated. Future devices could make use of whatever residual strength is available in the users' arm for control. The provided overview of devices in this article and the classification developed is relevant for practitioners seeking assistive solutions for their clients as it makes the range of developed solutions both accessible and comprehensible. © The International Society for Prosthetics and Orthotics 2013.

The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance

PubMed Central

2013-01-01

Background Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. Methods The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20 cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user’s arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24 months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45 minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. Results In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0

The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance.

PubMed

Zondervan, Daniel K; Palafox, Lorena; Hernandez, Jorge; Reinkensmeyer, David J

2013-04-18

Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20 cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user's arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24 months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45 minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0.009). Subjects did not report

50 CFR 404.9 - Armed Forces actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Wildlife and Fisheries JOINT REGULATIONS (UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE... activities and exercises of the Armed Forces (including those carried out by the United States Coast Guard... environment and admitting of no other feasible solution. (c) All activities and exercises of the Armed Forces...

Hello to Arms

NASA Technical Reports Server (NTRS)

2005-01-01

This image highlights the hidden spiral arms (blue) that were discovered around the nearby galaxy NGC 4625 by the ultraviolet eyes of NASA's Galaxy Evolution Explorer.

The image is composed of ultraviolet and visible-light data, from the Galaxy Evolution Explorer and the California Institute of Technology's Digitized Sky Survey, respectively. Near-ultraviolet light is colored green; far-ultraviolet light is colored blue; and optical light is colored red.

As the image demonstrates, the lengthy spiral arms are nearly invisible when viewed in optical light while bright in ultraviolet. This is because they are bustling with hot, newborn stars that radiate primarily ultraviolet light.

The youthful arms are also very long, stretching out to a distance four times the size of the galaxy's core. They are part of the largest ultraviolet galactic disk discovered so far.

Located 31 million light-years away in the constellation Canes Venatici, NGC 4625 is the closest galaxy ever seen with such a young halo of arms. It is slightly smaller than our Milky Way, both in size and mass. However, the fact that this galaxy's disk is forming stars very actively suggests that it might evolve into a more massive and mature galaxy resembling our own.

The armless companion galaxy seen below NGC 4625 is called NGC 4618. Astronomers do not know why it lacks arms but speculate that it may have triggered the development of arms in NGC 4625.

Efficacy of EMG-triggered electrical arm stimulation in chronic hemiparetic stroke patients.

PubMed

von Lewinski, Friederike; Hofer, Sabine; Kaus, Jürgen; Merboldt, Klaus-Dietmar; Rothkegel, Holger; Schweizer, Renate; Liebetanz, David; Frahm, Jens; Paulus, Walter

2009-01-01

EMG-triggered electrostimulation (EMG-ES) may improve the motor performance of affected limbs of hemiparetic stroke patients even in the chronic stage. This study was designed to characterize cortical activation changes following intensified EMG-ES in chronic stroke patients and to identify predictors for successful rehabilitation depending on disease severity. We studied 9 patients with severe residual hemiparesis, who underwent 8 weeks of daily task-orientated multi-channel EMG-ES of the paretic arm. Before and after treatment, arm function was evaluated clinically and cortical activation patterns were assessed with functional MRI (fMRI) and/or transcranial magnetic stimulation (TMS). As response to therapy, arm function improved in a subset of patients with more capacity in less affected subjects, but there was no significant gain for those with Box & Block test values below 4 at inception. The clinical improvement, if any, was accompanied by an ipsilesional increase in the sensorimotor cortex (SMC) activation area in fMRI and enhanced intracortical facilitation (ICF) as revealed by paired TMS. The SMC activation change in fMRI was predicted by the presence or absence of motor-evoked potentials (MEPs) on the affected side. The present findings support the notion that intensified EMG-ES may improve the arm function in individual chronic hemiparetic stroke patients but not in more severely impaired individuals. Functional improvements are paralleled by increased ipsilesional SMC activation and enhanced ICF supporting neuroplasticity as contributor to rehabilitation. The clinical score at inception and the presence of MEPs have the best predictive potential.

50 CFR 404.9 - Armed Forces actions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Armed Forces actions. 404.9 Section 404.9... MARINE NATIONAL MONUMENT § 404.9 Armed Forces actions. (a) The prohibitions in this part do not apply to activities and exercises of the Armed Forces (including those carried out by the United States Coast Guard...

Design and analysis of three-arm trials with negative binomially distributed endpoints.

PubMed

Mütze, Tobias; Munk, Axel; Friede, Tim

2016-02-20

A three-arm clinical trial design with an experimental treatment, an active control, and a placebo control, commonly referred to as the gold standard design, enables testing of non-inferiority or superiority of the experimental treatment compared with the active control. In this paper, we propose methods for designing and analyzing three-arm trials with negative binomially distributed endpoints. In particular, we develop a Wald-type test with a restricted maximum-likelihood variance estimator for testing non-inferiority or superiority. For this test, sample size and power formulas as well as optimal sample size allocations will be derived. The performance of the proposed test will be assessed in an extensive simulation study with regard to type I error rate, power, sample size, and sample size allocation. For the purpose of comparison, Wald-type statistics with a sample variance estimator and an unrestricted maximum-likelihood estimator are included in the simulation study. We found that the proposed Wald-type test with a restricted variance estimator performed well across the considered scenarios and is therefore recommended for application in clinical trials. The methods proposed are motivated and illustrated by a recent clinical trial in multiple sclerosis. The R package ThreeArmedTrials, which implements the methods discussed in this paper, is available on CRAN. Copyright © 2015 John Wiley & Sons, Ltd.

Arm blood flow and metabolism during arm and combined arm and leg exercise in humans

PubMed Central

Volianitis, S; Secher, N H

2002-01-01

The cardiovascular response to exercise with several groups of skeletal muscle suggests that work with the arms may decrease leg blood flow. This study evaluated whether intense exercise with the legs would have a similar effect on arm blood flow (Q̇arm) and O2 consumption (V̇O2,arm). Ten healthy male subjects (age 21 ± 1 year; mean ± S.D.) performed arm cranking at 80 % of maximum arm work capacity (A trial) and combined arm cranking with cycling at 60 % of maximum leg work capacity (A + L trial). The combined trial was a maximum effort for 5-6 min. Q̇arm measurement by thermodilution in the axilliary vein and arterial and venous blood samples permitted calculation of V̇O2,arm. During the combined trial, Q̇arm was reduced by 0.58 ± 0.25 l min−1 (19.1 ± 3.0 %, P < 0.05) from the value during arm cranking (3.00 ± 0.46 l min−1). The arterio-venous O2 difference increased from 122 ± 15 ml l−1 during the arm trial to 150 ± 21 ml l−1 (P < 0.05) during the combined trial. Thus, V̇O2,arm (0.45 ± 0.06 l min−1) was reduced by 9.6 ± 6.3 % (P < 0.05) and arm vascular conductance from 27 ± 4 to 23 ± 3 ml min−1 (mmHg)−1 (P < 0.05) as noradrenaline spillover from the arm increased from 7.5 ± 3.5 to 13.8 ± 4.2 nmol min−1 (P < 0.05). The data suggest that during maximal whole body exercise in humans, arm vasoconstriction is established to an extent that affects oxygen delivery to and utilisation by working skeletal muscles. PMID:12411540

Robotic Arm Comprising Two Bending Segments

NASA Technical Reports Server (NTRS)

Mehling, Joshua S.; Difler, Myron A.; Ambrose, Robert O.; Chu, Mars W.; Valvo, Michael C.

2010-01-01

The figure shows several aspects of an experimental robotic manipulator that includes a housing from which protrudes a tendril- or tentacle-like arm 1 cm thick and 1 m long. The arm consists of two collinear segments, each of which can be bent independently of the other, and the two segments can be bent simultaneously in different planes. The arm can be retracted to a minimum length or extended by any desired amount up to its full length. The arm can also be made to rotate about its own longitudinal axis. Some prior experimental robotic manipulators include single-segment bendable arms. Those arms are thicker and shorter than the present one. The present robotic manipulator serves as a prototype of future manipulators that, by virtue of the slenderness and multiple- bending capability of their arms, are expected to have sufficient dexterity for operation within spaces that would otherwise be inaccessible. Such manipulators could be especially well suited as means of minimally invasive inspection during construction and maintenance activities. Each of the two collinear bending arm segments is further subdivided into a series of collinear extension- and compression-type helical springs joined by threaded links. The extension springs occupy the majority of the length of the arm and engage passively in bending. The compression springs are used for actively controlled bending. Bending is effected by means of pairs of antagonistic tendons in the form of spectra gel spun polymer lines that are attached at specific threaded links and run the entire length of the arm inside the spring helix from the attachment links to motor-driven pulleys inside the housing. Two pairs of tendons, mounted in orthogonal planes that intersect along the longitudinal axis, are used to effect bending of each segment. The tendons for actuating the distal bending segment are in planes offset by an angle of 45 from those of the proximal bending segment: This configuration makes it possible to

Endogenous pro-thrombotic biomarkers from the arm and leg may not have the same value.

PubMed

Lattimer, Christopher R; Kalodiki, Evi; Geroulakos, George; Hoppensteadt, Debra; Fareed, Jawed

2016-05-01

Assessments of endogenous pro-thrombotic biomarkers are performed invariably on arm blood. However, the commonest site for thrombosis is in the leg. A leg blood sample may reflect local pro-thrombotic processes more accurately than systemic arm blood. The aim was to determine whether pro-thrombotic biomarkers from standard venous arm samples differed significantly from leg samples. Concurrent blood samples were taken from an ankle/lower calf varicose vein and an ante-cubital vein in 24 patients awaiting laser treatment as well as age approximated and sex matched healthy controls without venous disease. The following assays were performed: thrombin-antithrombin (ng/ml), antithrombin (%) activity, microparticles (nM), fibrinogen (mg/dl), prothrombin fragment 1.2 (F1.2) (pM) and P-selectin (ng/ml). Expressed as median (inter-quartile range). Significant arm/leg differences were observed in thrombin-antithrombin, antithrombin, prothrombin fragment 1.2 and P-selectin. The legs of patients had significantly reduced antithrombin activity and P-selectin concentrations compared to their arms (leg: 101 (90-108) versus arm: 112 (99-126), P = 0.001 and leg: 42 (26-52) versus 45 (27-52), P = 0.044, respectively). Control leg samples had significantly increased thrombin-antithrombin and P-selectin compared to control arm samples (leg: 2.1 (0.9-3.2) versus arm: 0.8 (0.5-1.7), P = 0.015 and leg: 36 (24-50) versus arm: 30 (23-41), P = 0.007, respectively). However, the control legs had significantly reduced F1.2 (leg: 265 (230-333) versus arm: 299 (236-361), P = 0.028). No significant arm/leg differences were detected in the microparticle or fibrinogen levels. These findings indicate that venous arm blood is significantly different from venous leg blood in four out of six biomarkers studied. Recognition of local venous leg sampling as a site for investigation may unravel why the leg has a greater predisposition to thrombosis and lead the way towards an arm

Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial.

PubMed

Kwakkel, G; Wagenaar, R C; Twisk, J W; Lankhorst, G J; Koetsier, J C

1999-07-17

We investigated the effects of different intensities of arm and leg rehabilitation training on the functional recovery of activities of daily living (ADL), walking ability, and dexterity of the paretic arm, in a single-blind randomised controlled trial. Within 14 days after stroke onset, 101 severely disabled patients with a primary middle-cerebral-artery stroke were randomly assigned to: a rehabilitation programme with emphasis on arm training; a rehabilitation programme with emphasis on leg training; or a control programme in which the arm and leg were immobilised with an inflatable pressure splint. Each treatment regimen was applied for 30 min, 5 days a week during the first 20 weeks after stroke. In addition, all patients underwent a basic rehabilitation programme. The main outcome measures were ability in ADL (Barthel index), walking ability (functional ambulation categories), and dexterity of the paretic arm (Action Research arm test) at 6, 12, 20, and 26 weeks. Analyses were by intention to treat. At week 20, the leg-training group (n=31) had higher scores than the control group (n=37) for ADL ability (median 19 [IQR 16-20] vs 16 [10-19], p<0.05), walking ability (4 [3-5] vs 3 [1-4], p<0.05), and dexterity (2 [0-56] vs 0 [0-2], p<0.01). The arm-training group (n=33) differed significantly from the control group only in dexterity (9 [0-39] vs 0 [0-2], p<0.01). There were no significant differences in these endpoints at 20 weeks between the arm-training and leg-training groups. Greater intensity of leg rehabilitation improves functional recovery and health-related functional status, whereas greater intensity of arm rehabilitation results in small improvements in dexterity, providing further evidence that exercise therapy primarily induces treatment effects on the abilities at which training is specifically aimed.

Internet-based treatment for panic disorder: A three-arm randomized controlled trial comparing guided (via real-time video sessions) with unguided self-help treatment and a waitlist control. PAXPD study results.

PubMed

Ciuca, Amalia M; Berger, Thomas; Crişan, Liviu G; Miclea, Mircea

2018-05-01

A growing body of evidence suggests that Internet-based cognitive behavioral treatments (ICBT) are effective to treat anxiety disorders. However, the effect of therapist guidance in ICBT is still under debate and guided ICBT offered in a real-time audio-video communication format has not yet been systematically investigated. This three-arm RCT compared the efficacy of guided with unguided ICBT (12 weeks intervention) and a waitlist (WL). A total of 111 individuals meeting the diagnostic criteria for panic disorder (PD) were randomly assigned to one of three conditions. Primary outcomes were the severity of self-report panic symptoms and diagnostic status. Secondary outcomes were symptoms of depression, functional impairment, catastrophic cognitions, fear of sensations and body vigilance. At post-treatment, both active conditions showed superior outcomes regarding PD and associated symptoms (guided ICBT vs. WL: d = 1.04-1.36; unguided ICBT vs. WL: d = 0.70-1.06). At post-treatment, the two active conditions did not differ significantly in self-reported symptom reduction (d = 0.21-0.54, all ps > 0.05), but the guided treatment was superior to the unguided treatment in terms of diagnostic status (χ 2 (1) = 13.15, p < 0.01). Treatment gains were maintained at successive follow-ups and the guided treatment became superior to the unguided treatment at 6 months follow-up (d = 0.72-1.05, all ps < 0.05). Copyright © 2018 Elsevier Ltd. All rights reserved.

Representation of virtual arm movements in precuneus.

PubMed

Dohle, Christian; Stephan, Klaus Martin; Valvoda, Jakob T; Hosseiny, Omid; Tellmann, Lutz; Kuhlen, Torsten; Seitz, Rüdiger J; Freund, Hans-Joachim

2011-02-01

Arm movements can easily be adapted to different biomechanical constraints. However, the cortical representation of the processing of visual input and its transformation into motor commands remains poorly understood. In a visuo-motor dissociation paradigm, subjects were presented with a 3-D computer-graphical representation of a human arm, presenting movements of the subjects' right arm either as right or left arm. In order to isolate possible effects of coordinate transformations, coordinate mirroring at the body midline was implemented independently. In each of the resulting four conditions, 10 normal, right-handed subjects performed three runs of circular movements, while being scanned with O(15)-Butanol-PET. Kinematic analysis included orientation and accuracy of a fitted ellipsoid trajectory. Imaging analysis was performed with SPM 99 with activations threshold at P < 0.0001 (not corrected). The shape of the trajectory was dependent on the laterality of the arm, irrespective of movement mirroring, and accompanied by a robust activation difference in the contralateral precuneus. Movement mirroring decreased movement accuracy, which was related to increased activation in the left insula. Those two movement conditions that cannot be observed in reality were related to an activation focus at the left middle temporal gyrus, but showed no influence on movement kinematics. These findings demonstrate the prominent role of the precuneus for mediating visuo-motor transformations and have implications for the use of mirror therapy and virtual reality techniques, especially avatars, such as Nintendo Wii in neurorehabilitation.

Mechanical arm trainer for the treatment of the severely affected arm after a stroke: a single-blinded randomized trial in two centers.

PubMed

Hesse, S; Werner, C; Pohl, M; Mehrholz, J; Puzich, U; Krebs, H I

2008-10-01

To test whether training with a new mechanical arm trainer leads to better outcomes than electrical stimulation of the paretic wrist extensors in subacute stroke patients with severe upper limb paresis. Electrical stimulation is a standard and reimbursable form of therapy in Germany. Randomized controlled trial of 54 inpatients enrolled 4-8 wks from stroke onset, mean upper-extremity subsection of Fugl-Meyer assessment (0-66) at admission less than 18. In addition to standard care, all patients practiced 20-30 mins arm trainer or electrical stimulation every workday for 6 wks, totaling 30 sessions. Primary outcome was the Fugl-Meyer assessment, secondary outcomes were the Box and Block test, the Medical Research Council and the modified Ashworth scale, blindly assessed at enrollment, after 6 wks, and at 3-mo follow-up. Both groups were homogeneous at study onset. Shoulder pain occurred in two arm trainer patients. The primary Fugl-Meyer assessment outcome improved for both groups over time (P < 0.001), but this improvement did not differ between groups. The initial (terminal) mean Fugl-Meyer assessment scores were 8.8 +/- 4.8 (19.2 +/- 14.5) for the arm trainer and 8.6 +/- 3.5 (13.6 +/- 7.9) for the electrical stimulation group. No patient could transport a block initially, but at completion significantly more arm trainer patients were able to transport at least three blocks (five vs. zero, P = 0.023). No significant differences were observed between the groups on the secondary Box and Block outcome at follow-up (eight vs. four patients). All Box and Block responders had an initial Fugl-Meyer assessment > or =10. Arm trainer training did not lead to a superior primary outcome over electrical stimulation training. However, "good performers" on the secondary outcome seemed to benefit more from the arm trainer training.

Controller arm for a remotely related slave arm

NASA Technical Reports Server (NTRS)

Salisbury, J. K., Jr. (Inventor)

1979-01-01

A segmented controller arm configured and dimensioned to form a miniature kinematic replica of a remotely related slave arm is disclosed. The arm includes: (1) a plurality of joints for affording segments of the arm simultaneous angular displacement about a plurality of pairs of intersecting axes, (2) a plurality of position sensing devices for providing electrical signals indicative of angular displacement imparted to corresponding segments of the controller shaft about the axes, and (3) a control signal circuit for generating control signals to be transmitted to the slave arm. The arm is characterized by a plurality of yokes, each being supported for angular displacement about a pair of orthogonally related axes and counterbalanced against gravitation by a cantilevered mass.

Kinematically redundant arm formulations for coordinated multiple arm implementations

NASA Technical Reports Server (NTRS)

Bailey, Robert W.; Quiocho, Leslie J.; Cleghorn, Timothy F.

1990-01-01

Although control laws for kinematically redundant robotic arms were presented as early as 1969, redundant arms have only recently become recognized as viable solutions to limitations inherent to kinematically sufficient arms. The advantages of run-time control optimization and arm reconfiguration are becoming increasingly attractive as the complexity and criticality of robotic systems continues to progress. A generalized control law for a spatial arm with 7 or more degrees of freedom (DOF) based on Whitney's resolved rate formulation is given. Results from a simulation implementation utilizing this control law are presented. Furthermore, results from a two arm simulation are presented to demonstrate the coordinated control of multiple arms using this formulation.

[Clinical efficacy of mouse nerve growth factor in treatment of occupational hand-arm vibration disease].

PubMed

Fan, Chunyue; Wang, Yanyan; Zhang, Ying; Lang, Li; Deng, Xiaofeng; Cheng, Ying

2014-12-01

To investigate the efficacy of mouse nerve growth factor (mNGF) in treating occupational hand-arm vibration disease (HAVD). Sixty-four patients with HAVD were equally and randomly divided into treatment group and control group. The control group was given Salvia miltiorrhiza Bunge and deproteinized extract of calf blood to improve circulation, and also given methylcobalamin tablets and vitamin B6 for neurotrophic treatment. In addition to the above treatments for the control group, the treatment group was also given 30 µg/d mNGF by intramuscular injection for two courses (4 weeks for each course) with a 15-day interval. Both the treatment group and the control group showed significant improvements in clinical symptoms and signs (hand numbness and pain, and reduced senses of touch, pain, and vibration), cold water loading test (CWLT), and electroneuromyography (ENMG) after treatments (P < 0.05). And the treatment group had significantly more improvements than the control group (P < 0.05). mNGF can significantly improve hand numbness and pain, reduced senses of touch, pain, and vibration, CWLT, and ENMG, so it has better clinical effect and safety in treating HAVD. Early diagnosis and treatment can improve the outcome of patients with HAVD.

Reducing Disease Activity in Animal Models of MS by Activation of the Protective Arm of the Renin-Angiotensin System

DTIC Science & Technology

2015-10-01

patients, there is little evidence for a role of ACE2/A( 1 -7)/Mas axis, only a solitary assessment showing decreased ACE2 levels in the CSF of MS...project? Major Goals (Year 1 ): 1 : Measure levels of RAS components in the spinal cord of mice with EAE (animal model of MS) prior to, and at multiple...AWARD NUMBER: W81XWH-14- 1 -0523 TITLE: Reducing Disease Activity in Animal Models of MS by Activation of the Protective Arm of the Renin

The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in Polio survivors: a randomised controlled trial.

PubMed

Murray, D; Hardiman, O; Campion, A; Vance, R; Horgan, F; Meldrum, D

2017-07-01

To investigate the effect of an eight-week home-based arm ergometry aerobic exercise programme on physical fitness, fatigue, activity and quality of life in Polio Survivors. An assessor blinded randomised controlled trial. Home-based exercise. Fifty-five Polio survivors randomised to exercise or control groups. Home-based arm ergometry at an intensity of 50%-70% maximum heart rate, compared with usual physiotherapy care. The Six-minute Arm Test, Fatigue Severity Scale, Physical Activity Scale for Individuals with Physical Disabilities and SF-36. Assessments were completed at baseline and at eight weeks. There was no significant difference in the primary outcome, exercising heart rate during the Six-minute Arm Test, between the groups at follow-up [97.6 (SD10.1) compared to 102.4 (SD13.7) beats per minute ( P=0.20)]. Blood pressure was significantly lower in the intervention group at follow-up [systolic blood pressure 132(18.6)mmHg compared to 144.1(14.6)mmHg ( P=0.002)]. There were no between group differences in the Fatigue Severity Scale ( P=0.25) or Physical Activity Scale for Individuals with Physical Disabilities ( P=0.49), with a small difference in SF-36 physical component score ( P=0.04). This home-based arm ergometry programme successfully facilitated aerobic exercise in Polio Survivors, but did not result in a significant change in physical fitness, measured by the Six-minute Arm Test.

Proprioceptive Interaction between the Two Arms in a Single-Arm Pointing Task.

PubMed

Kigawa, Kazuyoshi; Izumizaki, Masahiko; Tsukada, Setsuro; Hakuta, Naoyuki

2015-01-01

Proprioceptive signals coming from both arms are used to determine the perceived position of one arm in a two-arm matching task. Here, we examined whether the perceived position of one arm is affected by proprioceptive signals from the other arm in a one-arm pointing task in which participants specified the perceived position of an unseen reference arm with an indicator paddle. Both arms were hidden from the participant's view throughout the study. In Experiment 1, with both arms placed in front of the body, the participants received 70-80 Hz vibration to the elbow flexors of the reference arm (= right arm) to induce the illusion of elbow extension. This extension illusion was compared with that when the left arm elbow flexors were vibrated or not. The degree of the vibration-induced extension illusion of the right arm was reduced in the presence of left arm vibration. In Experiment 2, we found that this kinesthetic interaction between the two arms did not occur when the left arm was vibrated in an abducted position. In Experiment 3, the vibration-induced extension illusion of one arm was fully developed when this arm was placed at an abducted position, indicating that the brain receives increased proprioceptive input from a vibrated arm even if the arm was abducted. Our results suggest that proprioceptive interaction between the two arms occurs in a one-arm pointing task when the two arms are aligned with one another. The position sense of one arm measured using a pointer appears to include the influences of incoming information from the other arm when both arms were placed in front of the body and parallel to one another.

A longitudinal analysis of chronic arm morbidity following breast cancer surgery.

PubMed

Boquiren, Virginia M; Hack, Thomas F; Thomas, Roanne L; Towers, Anna; Kwan, Winkle B; Tilley, Andrea; Quinlan, Elizabeth; Miedema, Baukje

2016-06-01

Arm morbidity (AM) arising from breast cancer (BC) treatment can detrimentally impact quality of life; often limiting a survivor's ability to participate in valued activities. The present study explored (a) the developmental time course of AM [restricted range of motion (ROM), pain, and arm volume changes], negative affect, and perceived disability in the immediate years post-surgery, and (b) the mediating role of perceived disability on the relationship between AM and negative affect over time. In this 5-year longitudinal study, BC survivors from four Canadian oncology clinics (n = 431) completed five annual clinical assessments, where differences in ROM (shoulder abduction, external rotation) and arm volume between the affected and non-affected arm were measured. The profile of mood states (POMS), disability of arm, shoulder, hand, and McGill Pain Questionnaire-Short form were completed. Results from general linear modeling showed that AM, negative affect, and perceived disability were greatest 1-year post-surgery, declined, and with the exception of arm volume changes, were significantly lower 5 years later. Negative affect was significantly associated with restrictions in shoulder abduction and external rotation (average r = -0.15; p < 0.05) and present arm pain (average r = 0.28, p < 0.01) at most assessments. The mediating role of perceived disability on the relationship between AM and negative affect was statistically significant in a majority of assessments. Perceived disability is the underlying factor driving the relationship between AM and mood disturbance over time. Rehabilitative therapy to improve survivors' functional well-being might mitigate the negative impacts of AM on emotional health.

Proprioceptive Interaction between the Two Arms in a Single-Arm Pointing Task

PubMed Central

Kigawa, Kazuyoshi; Izumizaki, Masahiko; Tsukada, Setsuro; Hakuta, Naoyuki

2015-01-01

Proprioceptive signals coming from both arms are used to determine the perceived position of one arm in a two-arm matching task. Here, we examined whether the perceived position of one arm is affected by proprioceptive signals from the other arm in a one-arm pointing task in which participants specified the perceived position of an unseen reference arm with an indicator paddle. Both arms were hidden from the participant’s view throughout the study. In Experiment 1, with both arms placed in front of the body, the participants received 70–80 Hz vibration to the elbow flexors of the reference arm (= right arm) to induce the illusion of elbow extension. This extension illusion was compared with that when the left arm elbow flexors were vibrated or not. The degree of the vibration-induced extension illusion of the right arm was reduced in the presence of left arm vibration. In Experiment 2, we found that this kinesthetic interaction between the two arms did not occur when the left arm was vibrated in an abducted position. In Experiment 3, the vibration-induced extension illusion of one arm was fully developed when this arm was placed at an abducted position, indicating that the brain receives increased proprioceptive input from a vibrated arm even if the arm was abducted. Our results suggest that proprioceptive interaction between the two arms occurs in a one-arm pointing task when the two arms are aligned with one another. The position sense of one arm measured using a pointer appears to include the influences of incoming information from the other arm when both arms were placed in front of the body and parallel to one another. PMID:26317518

ARMS depletion facilitates UV irradiation induced apoptotic cell death in melanoma.

PubMed

Liao, Yi-Hua; Hsu, Su-Ming; Huang, Pei-Hsin

2007-12-15

Tumor cells often aberrantly reexpress molecules that mediate proper embryonic development for advantageous growth or survival. Here, we report that ankyrin repeat-rich membrane spanning (ARMS), a transmembrane protein abundant in the developing and adult neural tissues, is overexpressed in melanoma, a tumor ontogenetically originating from neural crest. Immunohistochemical study of 79 melanocytic lesions showed significantly increased expression of ARMS in primary malignant melanomas (92.9%) and metastatic melanoma (60.0%) in comparison with benign nevocellular nevi (26.7%). To investigate the role of ARMS in melanoma formation, murine B16F0 melanoma cells with stable knockdown of ARMS were established by RNA interference. Down-regulation of ARMS resulted in significant inhibition of anchorage-independent growth in soft agar and restrictive growth of melanoma in severe combined immunodeficient mice. Importantly, depletion of ARMS facilitated UVB-induced apoptosis in melanoma cells through inactivation of mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) kinase (MEK)/ERK. Addition of MEK inhibitor PD98059 further sensitized ARMS-depleted melanoma cells to UVB-induced apoptosis, whereas constitutively active MEK rescued ARMS-depleted cells from apoptosis. We further showed that BRAF, a downstream signaling molecule of ARMS in ERK pathway, is not mutated as a constitutively active form in acral lentiginous melanoma; in contrast, BRAF(T1799A) mutation, which leads to constitutive activation of ERK signaling, was detected in 57.1% of superficial spreading melanoma. Our study suggests that overexpression of ARMS per se serves as one mechanism to promote melanoma formation by preventing stress-induced apoptotic death mediated by the MEK/ERK signaling pathway, especially in acral lentiginous melanoma, most of which does not harbor BRAF mutation.

Octopus-inspired multi-arm robotic swimming.

PubMed

Sfakiotakis, M; Kazakidi, A; Tsakiris, D P

2015-05-13

The outstanding locomotor and manipulation characteristics of the octopus have recently inspired the development, by our group, of multi-functional robotic swimmers, featuring both manipulation and locomotion capabilities, which could be of significant engineering interest in underwater applications. During its little-studied arm-swimming behavior, as opposed to the better known jetting via the siphon, the animal appears to generate considerable propulsive thrust and rapid acceleration, predominantly employing movements of its arms. In this work, we capture the fundamental characteristics of the corresponding complex pattern of arm motion by a sculling profile, involving a fast power stroke and a slow recovery stroke. We investigate the propulsive capabilities of a multi-arm robotic system under various swimming gaits, namely patterns of arm coordination, which achieve the generation of forward, as well as backward, propulsion and turning. A lumped-element model of the robotic swimmer, which considers arm compliance and the interaction with the aquatic environment, was used to study the characteristics of these gaits, the effect of various kinematic parameters on propulsion, and the generation of complex trajectories. This investigation focuses on relatively high-stiffness arms. Experiments employing a compliant-body robotic prototype swimmer with eight compliant arms, all made of polyurethane, inside a water tank, successfully demonstrated this novel mode of underwater propulsion. Speeds of up to 0.26 body lengths per second (approximately 100 mm s(-1)), and propulsive forces of up to 3.5 N were achieved, with a non-dimensional cost of transport of 1.42 with all eight arms and of 0.9 with only two active arms. The experiments confirmed the computational results and verified the multi-arm maneuverability and simultaneous object grasping capability of such systems.

Neural control of rhythmic arm cycling after stroke

PubMed Central

Loadman, Pamela M.; Hundza, Sandra R.

2012-01-01

Disordered reflex activity and alterations in the neural control of walking have been observed after stroke. In addition to impairments in leg movement that affect locomotor ability after stroke, significant impairments are also seen in the arms. Altered neural control in the upper limb can often lead to altered tone and spasticity resulting in impaired coordination and flexion contractures. We sought to address the extent to which the neural control of movement is disordered after stroke by examining the modulation pattern of cutaneous reflexes in arm muscles during arm cycling. Twenty-five stroke participants who were at least 6 mo postinfarction and clinically stable, performed rhythmic arm cycling while cutaneous reflexes were evoked with trains (5 × 1.0-ms pulses at 300 Hz) of constant-current electrical stimulation to the superficial radial (SR) nerve at the wrist. Both the more (MA) and less affected (LA) arms were stimulated in separate trials. Bilateral electromyography (EMG) activity was recorded from muscles acting at the shoulder, elbow, and wrist. Analysis was conducted on averaged reflexes in 12 equidistant phases of the movement cycle. Phase-modulated cutaneous reflexes were present, but altered, in both MA and LA arms after stroke. Notably, the pattern was “blunted” in the MA arm in stroke compared with control participants. Differences between stroke and control were progressively more evident moving from shoulder to wrist. The results suggest that a reduced pattern of cutaneous reflex modulation persists during rhythmic arm movement after stroke. The overall implication of this result is that the putative spinal contributions to rhythmic human arm movement remain accessible after stroke, which has translational implications for rehabilitation. PMID:22572949

Robotic arm

DOEpatents

Kwech, Horst

1989-04-18

A robotic arm positionable within a nuclear vessel by access through a small diameter opening and having a mounting tube supported within the vessel and mounting a plurality of arm sections for movement lengthwise of the mounting tube as well as for movement out of a window provided in the wall of the mounting tube. An end effector, such as a grinding head or welding element, at an operating end of the robotic arm, can be located and operated within the nuclear vessel through movement derived from six different axes of motion provided by mounting and drive connections between arm sections of the robotic arm. The movements are achieved by operation of remotely-controllable servo motors, all of which are mounted at a control end of the robotic arm to be outside the nuclear vessel.

Sensory-Feedback Exoskeletal Arm Controller

NASA Technical Reports Server (NTRS)

An, Bin; Massie, Thomas H.; Vayner, Vladimir

2004-01-01

An electromechanical exoskeletal arm apparatus has been designed for use in controlling a remote robotic manipulator arm. The apparatus, called a force-feedback exoskeleton arm master (F-EAM) is comfortable to wear and easy to don and doff. It provides control signals from the wearer s arm to a robot arm or a computer simulator (e.g., a virtual-reality system); it also provides force and torque feedback from sensors on the robot arm or from the computer simulator to the wearer s arm. The F-EAM enables the wearer to make the robot arm gently touch objects and finely manipulate them without exerting excessive forces. The F-EAM features a lightweight design in which the motors and gear heads that generate force and torque feedback are made smaller than they ordinarily would be: this is achieved by driving the motors to power levels greater than would ordinarily be used in order to obtain higher torques, and by providing active liquid cooling of the motors to prevent overheating at the high drive levels. The F-EAM (see figure) includes an assembly that resembles a backpack and is worn like a backpack, plus an exoskeletal arm mechanism. The FEAM has five degrees of freedom (DOFs) that correspond to those of the human arm: 1. The first DOF is that of the side-to-side rotation of the upper arm about the shoulder (rotation about axis 1). The reflected torque for this DOF is provided by motor 1 via drum 1 and a planar four-bar linkage. 2. The second DOF is that of the up-and-down rotation of the arm about the shoulder. The reflected torque for this DOF is provided by motor 2 via drum 2. 3. The third DOF is that of twisting of the upper arm about its longitudinal axis. This DOF is implemented in a cable remote-center mechanism (CRCM). The reflected torque for this DOF is provided by motor 3, which drives the upper-arm cuff and the mechanism below it. A bladder inflatable by gas or liquid is placed between the cuff and the wearer s upper arm to compensate for misalignment

Localization Performance of Multiple Vibrotactile Cues on Both Arms.

PubMed

Wang, Dangxiao; Peng, Cong; Afzal, Naqash; Li, Weiang; Wu, Dong; Zhang, Yuru

2018-01-01

To present information using vibrotactile stimuli in wearable devices, it is fundamental to understand human performance of localizing vibrotactile cues across the skin surface. In this paper, we studied human ability to identify locations of multiple vibrotactile cues activated simultaneously on both arms. Two haptic bands were mounted in proximity to the elbow and shoulder joints on each arm, and two vibrotactile motors were mounted on each band to provide vibration cues to the dorsal and palmar side of the arm. The localization performance under four conditions were compared, with the number of the simultaneously activated cues varying from one to four in each condition. Experimental results illustrate that the rate of correct localization decreases linearly with the increase in the number of activated cues. It was 27.8 percent for three activated cues, and became even lower for four activated cues. An analysis of the correct rate and error patterns show that the layout of vibrotactile cues can have significant effects on the localization performance of multiple vibrotactile cues. These findings might provide guidelines for using vibrotactile cues to guide the simultaneous motion of multiple joints on both arms.

Phase-dependent organization of postural adjustments associated with arm movements while walking.

PubMed

Nashner, L M; Forssberg, H

1986-06-01

This study examines the interactions between anteroposterior postural responses and the control of walking in human subjects. In the experimental paradigm, subjects walked upon a treadmill, gripping a rigid handle with one hand. Postural responses at different phases of stepping were elicited by rapid arm pulls or pushes against the handle. During arm movements, EMG's recorded the activity of representative arm, ankle, and thigh segment muscles. Strain gauges in the handle measured the force of the arm movement. A Selspot II system measured kinematics of the stepping movements. The duration of support and swing phases were marked by heel and toe switches in the soles of the subjects' shoes. In the first experiment, subjects were instructed to pull on the handle at their own pace. In these trials all subjects preferred to initiate pulls near heel strikes. Next, when instructed to pull as rapidly as possible in response to tone stimuli, reaction times were similar for all phases of the step cycle. Leg muscle responses associated with arm pulls and pushes, referred to as "postural activations," were directionally specific and preceded arm muscle activity. The temporal order and spatial distribution of postural activations in the muscles of the support leg were similar when arm pull movements occurred while the subject was standing in place and after heel strike while walking. Activations began in the ankle and radiated proximally to the thigh and then the arm. Activations of swing leg muscles were also directionally specific and involved flexion and forward or backward thrust of the limb. When arm movements were initiated during transitions from support by one leg to the other, patterns of postural activations were altered. Alterations usually occurred 10-20 ms before hell strikes and involved changes in the timing and sometimes the spatial structure of postural activations. Postural activation patterns are similar during in-place standing and during the support phase

Experiencing a reaching task passively with one arm while adapting to a visuomotor rotation with the other can lead to substantial transfer of motor learning across the arms.

PubMed

Bao, Shancheng; Lei, Yuming; Wang, Jinsung

2017-01-18

The extent of transfer following visuomotor adaptation across the arms is typically limited as compared to that within the same arm. However, we have demonstrated that interlimb transfer can occur nearly completely if one arm performs reaching movements associated with a desired trajectory repeatedly and actively during an initial training session in which the other arm adapts to a novel visuomotor adaptation. Based on that finding, we argued that the absence of instances associated with specific motor effectors is the major reason for limited interlimb transfer. Here, we examined whether providing movement instances associated with one arm passively while adapting to a visuomotor rotation with the opposite arm could also lead to a greater extent of interlimb transfer. We had subjects perform reaching movements either actively or passively with the right arm while adapting to a 30° visuomotor rotation with the left arm (training session), and then had them perform reaching movements under the rotation condition with the right arm (transfer session). Results showed that the extent of transfer observed in the active and the passive training groups was significantly greater than that observed in a control group who only experienced the testing session. This finding suggests that providing effector-specific instances can increase the extent of interlimb transfer substantially, regardless of whether the instances are provided actively or passively. The current finding may have implications for neurorehabilitation targeted for individuals with motor impairment, such as persons with stroke or spinal cord injury. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Visual Analytics Approach to Structured Data Analysis to Enhance Nonproliferation and Arms Control Verification Activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gillen, David S.

Analysis activities for Nonproliferation and Arms Control verification require the use of many types of data. Tabular structured data, such as Excel spreadsheets and relational databases, have traditionally been used for data mining activities, where specific queries are issued against data to look for matching results. The application of visual analytics tools to structured data enables further exploration of datasets to promote discovery of previously unknown results. This paper discusses the application of a specific visual analytics tool to datasets related to the field of Arms Control and Nonproliferation to promote the use of visual analytics more broadly in thismore » domain. Visual analytics focuses on analytical reasoning facilitated by interactive visual interfaces (Wong and Thomas 2004). It promotes exploratory analysis of data, and complements data mining technologies where known patterns can be mined for. Also with a human in the loop, they can bring in domain knowledge and subject matter expertise. Visual analytics has not widely been applied to this domain. In this paper, we will focus on one type of data: structured data, and show the results of applying a specific visual analytics tool to answer questions in the Arms Control and Nonproliferation domain. We chose to use the T.Rex tool, a visual analytics tool developed at PNNL, which uses a variety of visual exploration patterns to discover relationships in structured datasets, including a facet view, graph view, matrix view, and timeline view. The facet view enables discovery of relationships between categorical information, such as countries and locations. The graph tool visualizes node-link relationship patterns, such as the flow of materials being shipped between parties. The matrix visualization shows highly correlated categories of information. The timeline view shows temporal patterns in data. In this paper, we will use T.Rex with two different datasets to demonstrate how interactive

Arm CT scan

MedlinePlus

CAT scan - arm; Computed axial tomography scan - arm; Computed tomography scan - arm; CT scan - arm ... Healing problems or scar tissue following surgery A CT scan may also be used to guide a surgeon ...

Constraint-Induced Movement Therapy for Rehabilitation of Arm Dysfunction After Stroke in Adults

PubMed Central

2011-01-01

rehabilitative care for the treatment of arm dysfunction after stroke in persons 18 years of age and older? Research Methods Literature Search Search Strategy A literature search was performed on January 21, 2011 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library, Centre for Reviews and Dissemination. (Appendix 1) A preliminary search completed in August 2010 found a Cochrane Systematic review published in 2009. As a result, the literature search for this evidence-based analysis was designed to include studies published from January 1, 2008 to January 21, 2011. Inclusion Criteria Systematic reviews of randomized controlled trials with or without meta-analysis. Study participants 18 years of age and older with arm dysfunction after stroke. Studies comparing the use of CIMT with occupational therapy and/or physiotherapy rehabilitative care (usual care) to improve arm function. Studies which described CIMT as having the following three components: i) restraining unimpaired arm and/or wrist with a sling, hand splint or cast; ii) intensive training with functional task practice of the affected arm; iii) application of shaping methodology during training. No restriction was placed on intensity or duration of treatment otherwise. Duration and intensity of therapy is equal in treatment and control groups. Therapy beginning a minimum of one month after stroke. Published between 2008 and 2011. Exclusion Criteria Narrative reviews, case series, case reports, controlled clinical trials. Letters to the editor Grey literature. Non-English language publications. Outcomes of Interest Primary Outcome Arm motor function: Action Research Arm Test (ARAT) Secondary Outcome Arm motor impairment: Fugl-Meyer Motor Assessment (FMA) Activities of daily living (ADL): Functional Independence Measure (FIM), Chedoke Arm and Hand Inventory Perceived motor function: Motor Activity

Ergonomically neutral arm support system

DOEpatents

Siminovitch, Michael J; Chung, Jeffrey Y; Dellinges, Steven; Lafever, Robin E

2005-08-02

An ergonomic arm support system maintains a neutral position for the forearm. A mechanical support structure attached to a chair or other mounting structure supports the arms of a sitting or standing person. The system includes moving elements and tensioning elements to provide a dynamic balancing force against the forearms. The support structure is not fixed or locked in a rigid position, but is an active dynamic system that is maintained in equipoise by the continuous operation of the opposing forces. The support structure includes an armrest connected to a flexible linkage or articulated or pivoting assembly, which includes a tensioning element such as a spring. The pivoting assembly moves up and down, with the tensioning element providing the upward force that balances the downward force of the arm.

Effective Treatment for Rapid Improvement of Both Disease Activity and Self-Reported Physical Activity in Early Rheumatoid Arthritis.

PubMed

Konijn, Nicole P C; van Tuyl, Lilian H D; Boers, Maarten; den Uyl, Debby; Ter Wee, Marieke M; Kerstens, Pit; Voskuyl, Alexandre E; Nurmohamed, Michael; van Schaardenburg, Dirkjan; Lems, Willem F

2016-02-01

To investigate the longitudinal relationship between disease activity and self-reported physical activity (PA) in patients with early rheumatoid arthritis during the first year of treatment with combination therapy. PA was measured with the Short Questionnaire to Assess Health-Enhancing Physical Activity at baseline, 13 weeks, 26 weeks, and 52 weeks after start of treatment in the context of the Combinatietherapie Bij Reumatoïde Artritis-Light trial. The reported PA classified patients as meeting or not meeting the World Health Organization (WHO) PA guideline (cutoff: 150 minutes of moderate-to-intense activity per week). Other measurements included the Disease Activity Score (DAS). Since both treatment arms showed equal treatment effect, these were analyzed as 1 group with simple before-after analyses and generalized estimating equations (GEE). In these analyses, 140 patients (86% of the trial population, 66% women, mean age 52 years) with complete data were included. At entry, 69% of the patients met the WHO PA guideline, increasing to 90% at week 13, and remaining stable at 89% after 1 year (P < 0.001). Mean DAS improved from 4.0 to 1.8 during the first year of treatment (P < 0.001). In GEE analyses, DAS decreases were significantly associated with PA increases (P = 0.008). Patients with clinically relevant responses (expressed as DAS remission, European League Against Rheumatism good response or American College of Rheumatology criteria for 70% improvement response) showed higher PA levels compared to nonresponders, regardless of the definition of response, for both the WHO and Dutch PA guideline. Early rheumatoid arthritis patients using combination therapy improved both disease activity and PA, a beneficial effect persisting for at least 1 year. © 2016, American College of Rheumatology.

Brain-Machine Interface Enables Bimanual Arm Movements in Monkeys

PubMed Central

Ifft, Peter J.; Shokur, Solaiman; Li, Zheng; Lebedev, Mikhail A.; Nicolelis, Miguel A. L.

2014-01-01

Brain-machine interfaces (BMIs) are artificial systems that aim to restore sensation and movement to severely paralyzed patients. However, previous BMIs enabled only single arm functionality, and control of bimanual movements was a major challenge. Here, we developed and tested a bimanual BMI that enabled rhesus monkeys to control two avatar arms simultaneously. The bimanual BMI was based on the extracellular activity of 374–497 neurons recorded from several frontal and parietal cortical areas of both cerebral hemispheres. Cortical activity was transformed into movements of the two arms with a decoding algorithm called a 5th order unscented Kalman filter (UKF). The UKF is well-suited for BMI decoding because it accounts for both characteristics of reaching movements and their representation by cortical neurons. The UKF was trained either during a manual task performed with two joysticks or by having the monkeys passively observe the movements of avatar arms. Most cortical neurons changed their modulation patterns when both arms were engaged simultaneously. Representing the two arms jointly in a single UKF decoder resulted in improved decoding performance compared with using separate decoders for each arm. As the animals’ performance in bimanual BMI control improved over time, we observed widespread plasticity in frontal and parietal cortical areas. Neuronal representation of the avatar and reach targets was enhanced with learning, whereas pairwise correlations between neurons initially increased and then decreased. These results suggest that cortical networks may assimilate the two avatar arms through BMI control. PMID:24197735

Activation timing of postural muscles of lower legs and prediction of postural disturbance during bilateral arm flexion in older adults.

PubMed

Yaguchi, Chie; Fujiwara, Katsuo; Kiyota, Naoe

2017-12-22

Activation timings of postural muscles of lower legs and prediction of postural disturbance were investigated in young and older adults during bilateral arm flexion in a self-timing task and an oddball task with different probabilities of target presentation. Arm flexion was started from a standing posture with hands suspended 10 cm below the horizontal level in front of the body, in which postural control focused on the ankles is important. Fourteen young and 14 older adults raised the arms in response to the target sound signal. Three task conditions were used: 15 and 45% probabilities of the target in the oddball task and self-timing. Analysis items were activation timing of postural muscles (erector spinae, biceps femoris, and gastrocnemius) with respect to the anterior deltoid (AD), and latency and amplitude of the P300 component of event-related brain potential. For young adults, all postural muscles were activated significantly earlier than AD under each condition, and time of preceding gastrocnemius activation was significantly longer in the order of the self-timing, 45 and 15% conditions. P300 latency was significantly shorter, and P300 amplitude was significantly smaller under the 45% condition than under the 15% condition. For older adults, although all postural muscles, including gastrocnemius, were activated significantly earlier than AD in the self-timing condition, only activation timing of gastrocnemius was not significantly earlier than that of AD in oddball tasks, regardless of target probability. No significant differences were found between 15 and 45% conditions in onset times of all postural muscles, and latency and amplitude of P300. These results suggest that during arm movement, young adults can achieve sufficient postural preparation in proportion to the probability of target presentation in the oddball task. Older adults can achieve postural control using ankle joints in the self-timing task. However, in the oddball task, older adults

Tubulin Glutamylation Regulates Ciliary Motility by Altering Inner Dynein Arm Activity

PubMed Central

Suryavanshi, Swati; Eddé, Bernard; Fox, Laura A.; Guerrero, Stella; Hard, Robert; Hennessey, Todd; Kabi, Amrita; Malison, David; Pennock, David; Sale, Winfield S.; Wloga, Dorota; Gaertig, Jacek

2010-01-01

SUMMMARY How microtubule-associated motor proteins are regulated is not well understood. A potential mechanism for spatial regulation of motor proteins is provided by post-translational modifications of tubulin subunits that form patterns on microtubules. Glutamylation is a conserved tubulin modification [1] that is enriched in axonemes. The enzymes responsible for this PTM, glutamic acid ligases (E-ligases), belong to a family of proteins with a tubulin tyrosine ligase (TTL) homology domain (TTL-like or TTLL proteins) [2]. We show that in cilia of Tetrahymena, TTLL6 E-ligases generate glutamylation mainly on the B-tubule of outer doublet microtubules, the site of force production by ciliary dynein. Deletion of two TTLL6 paralogs caused severe deficiency in ciliary motility associated with abnormal waveform and reduced beat frequency. In isolated axonemes with a normal dynein arm composition, TTLL6 deficiency did not affect the rate of ATP-induced doublet microtubule sliding. Unexpectedly, the same TTLL6 deficiency increased the velocity of microtubule sliding in axonemes that also lack outer dynein arms, in which forces are generated by inner dynein arms. We conclude that tubulin glutamylation on the B-tubule inhibits the net force imposed on sliding doublet microtubules by inner dynein arms. PMID:20189389

New approach to evaluate late arm impairment and effects of dragon boat activity in breast cancer survivors.

PubMed

Melchiorri, Giovanni; Viero, Valerio; Triossi, Tamara; Sorge, Roberto; Tancredi, Virginia; Cafaro, Domenico; Andreis, Caterina; Vulpiani, Maria Chiara; Saraceni, Vincenzo Maria

2017-11-01

To verify the applicability of a new approach based on the strength curves (SCs) methodology in late arm impairment in breast cancer (BC) survivors and to evaluate the effects of dragon boat (DB) activity on the late regaining of the muscle strength, upper limb impairment, and quality of life in patients undergoing surgery for BC.Retrospective observational study on 64 subjects (54.5 ± 9.7 years), 47 of them had undergone unilateral mastectomy surgery and were evaluated for late arm impairment. A clinical evaluation of the shoulder and compilation of functional assessment (DASH, Rowe, Constant-Murley) and quality of life (SF-36) scales were carried out. Assessment of muscle strength with SC obtained with isometric assessments and serratus anterior muscle test were performed.Differences between the SC are evident between healthy and operated subjects. Among the 3 groups of operated subjects the difference in strength is maximum at 0°. Statistically significant difference was found between operated and nonoperated only in SF-36 scale. No significant difference was found between groups for shoulder instability and winged scapula.The SC can be used in the study of upper limb impairment after surgery for BC: measurements carried out at 1st degrees of the range of motion are more useful for clinicians. DB activity is useful to reduce the late arm impairment.

Curiosity Arm Holding Steady, Sol 915

NASA Image and Video Library

2015-03-06

This image from the Navigation Camera (Navcam) on NASA's Curiosity Mars rover shows the position in which the rover held its arm for several days after a transient short circuit triggered onboard fault-protection programming to halt arm activities on Feb. 27, 2015, the 911th Martian day, or sol, of the rover's work on Mars. The rover team chose to hold the arm in the same position for several days of tests to diagnose the underlying cause of the Sol 911 event. Observations with instruments on the rover's mast continued during this period. The Navcam took this image on March 4, 2015, during Sol 915. http://photojournal.jpl.nasa.gov/catalog/PIA19147

Centchroman as First-line Treatment for Mastalgia: Results of an Open-label, Single-arm Trial.

PubMed

Rathi, Jalaj; Chawla, Inderjit; Singh, Karnail; Chawla, Arjun

2016-07-01

Mastalgia is a distressing symptom and may be severe enough to interfere with usual daily activities. Breast pain is either cyclical or noncyclical. Currently; multiple options are available for the treatment of mastalgia including hormonal and nonhormonal agents. This study was conducted to evaluate the role of centchroman as a nonhormonal first-line treatment for moderate to severe mastalgia. To accomplish this; a prospective open-label, single-arm study was done using the Pretest-Posttest Design. A total of 100 women suffering from mastalgia were grouped according to the characteristic pattern of breast pain (cyclic and noncyclic) and received centchroman 30 mg/day for 12 weeks followed by observation for 12 weeks. The efficacy analysis of centchroman was done by comparing median Visual Analog Scale score, median pain duration and side effects over time among the two groups. Centchroman significantly alleviates mastalgia with minimal side effects. The median pain score was significantly reduced over successive visits (1, 4, 12, and 24 weeks). The median pain duration decreased remarkably over time in comparison to the baseline (p = 0.001). Overall the response rate was 88% at the end of 12 weeks and 85% at the end of 24 weeks. The drug was found more effective with a quicker response in cyclic pattern of matalgia. Complete response was observed in 66% of cyclic mastalgia and 40% of noncyclic mastalgia patients at 1 week of therapy. The response was improved over time in both groups and at completion of treatment (12 weeks) 92% patients in cyclic group and 80% patients in noncyclic group were pain free. The effect of the drug persisted till the completion (24 weeks) of the study (p = 0.001). These results imply that centchroman is very effective in treating breast pain and can be prescribed as drug of first choice for mastalgia. © 2016 Wiley Periodicals, Inc.

The spiral arms of the Milky Way: The relative location of each different arm tracer within a typical spiral arm width

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vallée, Jacques P., E-mail: jacques.vallee@nrc-cnrc.gc.ca

2014-07-01

From the Sun's location in the Galactic disk, different arm tracers (CO, H I, hot dust, etc.) have been employed to locate a tangent to each spiral arm. Using all various and different observed spiral arm tracers (as published elsewhere), we embark on a new goal, namely the statistical analysis of these published data (data mining) to statistically compute the mean location of each spiral arm tracer. We show for a typical arm cross-cut, a separation of 400 pc between the mid-arm and the dust lane (at the inner edge of the arm, toward the Galactic center). Are some armsmore » major and others minor? Separating arms into two sets, as suggested by some, we find the same arm widths between the two sets. Our interpretation is that we live in a multiple (four-arm) spiral (logarithmic) pattern (around a pitch angle of 12°) for the stars and gas in the Milky Way, with a sizable interarm separation (around 3 kpc) at the Sun's location and the same arm width for each arm (near 400 pc from mid-arm to dust lane).« less

How do the outcomes of the DEKA Arm compare to conventional prostheses?

PubMed

Resnik, Linda J; Borgia, Matthew L; Acluche, Frantzy; Cancio, Jill M; Latlief, Gail; Sasson, Nicole

2018-01-01

Objectives were to 1) compare self-reported function, dexterity, activity performance, quality of life and community integration of the DEKA Arm to conventional prostheses; and 2) examine differences in outcomes by conventional prosthesis type, terminal device type and by DEKA Arm configuration level. This was a two-part study; Part A consisted of in-laboratory training. Part B consisted of home use. Study participants were 23 prosthesis users (mean age = 45 ± 16; 87% male) who completed Part A, and 15 (mean age = 45 ± 18; 87% male) who completed Parts A and B. Outcomes including self-report and performance measures, were collected at Baseline using participants' personal prostheses and at the End of Parts A and B. Scores were compared using paired t-tests. Wilcoxon signed-rank tests were used to compare outcomes for the full sample, and for the sample stratified by device and terminal device type. Analysis of outcomes by configuration level was performed graphically. At the End of Part A activity performance using the DEKA Arm and conventional prosthesis was equivalent, but slower with the DEKA Arm. After Part B, performance using the DEKA Arm surpassed conventional prosthesis scores, and speed of activity completion was equivalent. Participants reported using the DEKA Arm to perform more activities, had less perceived disability, and less difficulty in activities at the End of A and B as compared to Baseline. No differences were observed in dexterity, prosthetic skill, spontaneity, pain, community integration or quality of life. Comparisons stratified by device type revealed similar patterns. Graphic comparisons revealed variations by configuration level. Participants using the DEKA Arm had less perceived disability and more engagement of the prosthesis in everyday tasks, although activity performance was slower. After home use experience, activity performance was improved and activity speed equivalent to using conventional prostheses.

A brain-machine interface enables bimanual arm movements in monkeys.

PubMed

Ifft, Peter J; Shokur, Solaiman; Li, Zheng; Lebedev, Mikhail A; Nicolelis, Miguel A L

2013-11-06

Brain-machine interfaces (BMIs) are artificial systems that aim to restore sensation and movement to paralyzed patients. So far, BMIs have enabled only one arm to be moved at a time. Control of bimanual arm movements remains a major challenge. We have developed and tested a bimanual BMI that enables rhesus monkeys to control two avatar arms simultaneously. The bimanual BMI was based on the extracellular activity of 374 to 497 neurons recorded from several frontal and parietal cortical areas of both cerebral hemispheres. Cortical activity was transformed into movements of the two arms with a decoding algorithm called a fifth-order unscented Kalman filter (UKF). The UKF was trained either during a manual task performed with two joysticks or by having the monkeys passively observe the movements of avatar arms. Most cortical neurons changed their modulation patterns when both arms were engaged simultaneously. Representing the two arms jointly in a single UKF decoder resulted in improved decoding performance compared with using separate decoders for each arm. As the animals' performance in bimanual BMI control improved over time, we observed widespread plasticity in frontal and parietal cortical areas. Neuronal representation of the avatar and reach targets was enhanced with learning, whereas pairwise correlations between neurons initially increased and then decreased. These results suggest that cortical networks may assimilate the two avatar arms through BMI control. These findings should help in the design of more sophisticated BMIs capable of enabling bimanual motor control in human patients.

ARM Radar Contoured Frequency by Altitude Diagram (CFAD) Data Products

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Yuying

2017-03-10

To compare with ARM cloud radar simulator outputs, observational reflectivity-height joint histograms, i.e., CFADs, are constructed from the operational ARM Active Remote Sensing of CLouds (ARSCL) Value-Added Product.

The APPLE Trial: Feasibility and Activity of AZD9291 (Osimertinib) Treatment on Positive PLasma T790M in EGFR-mutant NSCLC Patients. EORTC 1613.

PubMed

Remon, Jordi; Menis, Jessica; Hasan, Baktiar; Peric, Aleksandra; De Maio, Eleonora; Novello, Silvia; Reck, Martin; Berghmans, Thierry; Wasag, Bartosz; Besse, Benjamin; Dziadziuszko, Rafal

2017-09-01

The AZD9291 (Osimertinib) Treatment on Positive PLasma T790M in EGFR-mutant NSCLC Patients (APPLE) trial is a randomized, open-label, multicenter, 3-arm, phase II study in advanced, epidermal growth factor receptor (EGFR)-mutant and EGFR tyrosine kinase inhibitor (TKI)-naive non-small-cell lung cancer (NSCLC) patients, to evaluate the best strategy for sequencing gefitinib and osimertinib treatment. Advanced EGFR-mutant NSCLC patients, with World Health Organization performance status 0-2 who are EGFR TKI treatment-naive and eligible to receive first-line treatment with EGFR TKI will be randomized to: In all arms, a plasmatic ctDNA T790M test will be performed by a central laboratory at the Medical University of Gdansk (Poland) but will be applied as a predictive marker for making treatment decisions only in arm B. The primary objective is to evaluate the best strategy for sequencing of treatment with gefitinib and osimertinib in advanced NSCLC patients with common EGFR mutations, and to understand the value of liquid biopsy for the decision-making process. The progression-free survival rate at 18 months is the primary end point of the trial. The activity of osimertinib versus gefitinib to prevent brain metastases will be evaluated. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

A limit-cycle self-organizing map architecture for stable arm control.

PubMed

Huang, Di-Wei; Gentili, Rodolphe J; Katz, Garrett E; Reggia, James A

2017-01-01

Inspired by the oscillatory nature of cerebral cortex activity, we recently proposed and studied self-organizing maps (SOMs) based on limit cycle neural activity in an attempt to improve the information efficiency and robustness of conventional single-node, single-pattern representations. Here we explore for the first time the use of limit cycle SOMs to build a neural architecture that controls a robotic arm by solving inverse kinematics in reach-and-hold tasks. This multi-map architecture integrates open-loop and closed-loop controls that learn to self-organize oscillatory neural representations and to harness non-fixed-point neural activity even for fixed-point arm reaching tasks. We show through computer simulations that our architecture generalizes well, achieves accurate, fast, and smooth arm movements, and is robust in the face of arm perturbations, map damage, and variations of internal timing parameters controlling the flow of activity. A robotic implementation is evaluated successfully without further training, demonstrating for the first time that limit cycle maps can control a physical robot arm. We conclude that architectures based on limit cycle maps can be organized to function effectively as neural controllers. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 54599 - Takes of Marine Mammals Incidental to Specified Activities; Construction of the Knik Arm Crossing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... phocoena). KABATA has not requested authorization for incidental take by injury (Level A harassment), serious injury or mortality. Specified Activities KABATA is proposing to construct a new bridge spanning... sides of the Arm that will run adjacent to the water's edge to varying degrees. A full description of...

Robot arm system for automatic satellite capture and berthing

NASA Technical Reports Server (NTRS)

Nishida, Shinichiro; Toriu, Hidetoshi; Hayashi, Masato; Kubo, Tomoaki; Miyata, Makoto

1994-01-01

Load control is one of the most important technologies for capturing and berthing free flying satellites by a space robot arm because free flying satellites have different motion rates. The performance of active compliance control techniques depend on the location of the force sensor and the arm's structural compliance. A compliance control technique for the robot arm's structural elasticity and a consideration for an end-effector appropriate for it are presented in this paper.

The effect of arm weight support on upper limb muscle synergies during reaching movements

PubMed Central

2014-01-01

Background Compensating for the effect of gravity by providing arm-weight support (WS) is a technique often utilized in the rehabilitation of patients with neurological conditions such as stroke to facilitate the performance of arm movements during therapy. Although it has been shown that, in healthy subjects as well as in stroke survivors, the use of arm WS during the performance of reaching movements leads to a general reduction, as expected, in the level of activation of upper limb muscles, the effects of different levels of WS on the characteristics of the kinematics of motion and of the activity of upper limb muscles have not been thoroughly investigated before. Methods In this study, we systematically assessed the characteristics of the kinematics of motion and of the activity of 14 upper limb muscles in a group of 9 healthy subjects who performed 3-D arm reaching movements while provided with different levels of arm WS. We studied the hand trajectory and the trunk, shoulder, and elbow joint angular displacement trajectories for different levels of arm WS. Besides, we analyzed the amplitude of the surface electromyographic (EMG) data collected from upper limb muscles and investigated patterns of coordination via the analysis of muscle synergies. Results The characteristics of the kinematics of motion varied across WS conditions but did not show distinct trends with the level of arm WS. The level of activation of upper limb muscles generally decreased, as expected, with the increase in arm WS. The same eight muscle synergies were identified in all WS conditions. Their level of activation depended on the provided level of arm WS. Conclusions The analysis of muscle synergies allowed us to identify a modular organization underlying the generation of arm reaching movements that appears to be invariant to the level of arm WS. The results of this study provide a normative dataset for the assessment of the effects of the level of arm WS on muscle synergies in stroke

Evolution of robotic arms.

PubMed

Moran, Michael E

2007-01-01

The foundation of surgical robotics is in the development of the robotic arm. This is a thorough review of the literature on the nature and development of this device with emphasis on surgical applications. We have reviewed the published literature and classified robotic arms by their application: show, industrial application, medical application, etc. There is a definite trend in the manufacture of robotic arms toward more dextrous devices, more degrees-of-freedom, and capabilities beyond the human arm. da Vinci designed the first sophisticated robotic arm in 1495 with four degrees-of-freedom and an analog on-board controller supplying power and programmability. von Kemplen's chess-playing automaton left arm was quite sophisticated. Unimate introduced the first industrial robotic arm in 1961, it has subsequently evolved into the PUMA arm. In 1963 the Rancho arm was designed; Minsky's Tentacle arm appeared in 1968, Scheinman's Stanford arm in 1969, and MIT's Silver arm in 1974. Aird became the first cyborg human with a robotic arm in 1993. In 2000 Miguel Nicolalis redefined possible man-machine capacity in his work on cerebral implantation in owl-monkeys directly interfacing with robotic arms both locally and at a distance. The robotic arm is the end-effector of robotic systems and currently is the hallmark feature of the da Vinci Surgical System making its entrance into surgical application. But, despite the potential advantages of this computer-controlled master-slave system, robotic arms have definite limitations. Ongoing work in robotics has many potential solutions to the drawbacks of current robotic surgical systems.

Arm-in-Arm Response Regulator Dimers Promote Intermolecular Signal Transduction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baker, Anna W.; Satyshur, Kenneth A.; Moreno Morales, Neydis

2016-02-01

ABSTRACT Bacteriophytochrome photoreceptors (BphPs) and their cognate response regulators make up two-component signal transduction systems which direct bacteria to mount phenotypic responses to changes in environmental light quality. Most of these systems utilize single-domain response regulators to transduce signals through unknown pathways and mechanisms. Here we describe the photocycle and autophosphorylation kinetics of RtBphP1, a red light-regulated histidine kinase from the desert bacteriumRamlibacter tataouinensis. RtBphP1 undergoes red to far-red photoconversion with rapid thermal reversion to the dark state. RtBphP1 is autophosphorylated in the dark; this activity is inhibited under red light. The RtBphP1 cognate response regulator, theR. tataouinensisbacteriophytochrome response regulatormore » (RtBRR), and a homolog, AtBRR fromAgrobacterium tumefaciens, crystallize unexpectedly as arm-in-arm dimers, reliant on a conserved hydrophobic motif, hFWAhL (where h is a hydrophobic M, V, L, or I residue). RtBRR and AtBRR dimerize distinctly from four structurally characterized phytochrome response regulators found in photosynthetic organisms and from all other receiver domain homodimers in the Protein Data Bank. A unique cacodylate-zinc-histidine tag metal organic framework yielded single-wavelength anomalous diffraction phases and may be of general interest. Examination of the effect of the BRR stoichiometry on signal transduction showed that phosphorylated RtBRR is accumulated more efficiently than the engineered monomeric RtBRR (RtBRR mon) in phosphotransfer reactions. Thus, we conclude that arm-in-arm dimers are a relevant signaling intermediate in this class of two-component regulatory systems. IMPORTANCEBphP histidine kinases and their cognate response regulators comprise widespread red light-sensing two-component systems. Much work on BphPs has focused on structural understanding of light sensing and on enhancing the natural infrared fluorescence of

Inspiratory muscle fatigue affects latissimus dorsi but not pectoralis major activity during arms only front crawl sprinting.

PubMed

Lomax, Mitch; Tasker, Louise; Bostanci, Ozgur

2014-08-01

The purpose of this study was to determine whether inspiratory muscle fatigue (IMF) affects the muscle activity of the latissimus dorsi and pectoralis major during maximal arms only front crawl swimming. Eight collegiate swimmers were recruited to perform 2 maximal 20-second arms only front crawl sprints in a swimming flume. Both sprints were performed on the same day, and IMF was induced 30 minutes after the first (control) sprint. Maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) were measured before and after each sprint. The median frequency (MDF) of the electromyographic signal burst was recorded from the latissimus dorsi and pectoralis major during each 20-second sprint along with stroke rate and breathing frequency. Median frequency was assessed in absolute units (Hz) and then referenced to the start of the control sprint for normalization. After IMF inducement, stroke rate increased from 56 ± 4 to 59 ± 5 cycles per minute, and latissimus dorsi MDF fell from 67 ± 11 Hz at the start of the sprint to 61 ± 9 Hz at the end. No change was observed in the MDF of the latissimus dorsi during the control sprint. Conversely, the MDF of the pectoralis major shifted to lower frequencies during both sprints but was unaffected by IMF. As the latter induced fatigue in the latissimus dorsi, which was not otherwise apparent during maximal arms only control sprinting, the presence of IMF affects the activity of the latissimus dorsi during front crawl sprinting.

Lack of significant anti-inflammatory activity with clindamycin in the treatment of rosacea: results of 2 randomized, vehicle-controlled trials.

PubMed

Martel, Philippe; Jarratt, Michael; Weiss, Jonathan; Carlavan, Isabelle

2017-07-01

Rosacea is a chronic inflammatory skin disease of the face. The objective of the studies described here was to evaluate the efficacy of clindamycin in the treatment of rosacea. Two multicenter, randomized, vehicle-controlled, phase 2 studies were conducted in participants with moderate to severe rosacea. Study A was a 12-week dose-comparison, 5-arm, parallel group comparison of clindamycin cream 1% or vehicle once or twice daily and clindamycin cream 0.3% once daily. Study B was a 2-arm comparison of twice daily clindamycin gel 1% versus vehicle gel. A total of 629 participants (study A, N=416; study B, N=213) were randomized. The results of these studies indicated that clindamycin cream 0.3% and 1% and clindamycin gel 1% were no more effective than the vehicle in the treatment of moderate to severe rosacea, suggesting clindamycin has no intrinsic anti-inflammatory activity in rosacea.

The Norma arm region Chandra survey catalog: X-ray populations in the spiral arms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fornasini, Francesca M.; Tomsick, John A.; Bodaghee, Arash

2014-12-01

We present a catalog of 1415 X-ray sources identified in the Norma Arm Region Chandra Survey (NARCS), which covers a 2° × 0.°8 region in the direction of the Norma spiral arm to a depth of ≈20 ks. Of these sources, 1130 are point-like sources detected with ≥3σ confidence in at least one of three energy bands (0.5-10, 0.5-2, and 2-10 keV), five have extended emission, and the remainder are detected at low significance. Since most sources have too few counts to permit individual classification, they are divided into five spectral groups defined by their quantile properties. We analyze stackedmore » spectra of X-ray sources within each group, in conjunction with their fluxes, variability, and infrared counterparts, to identify the dominant populations in our survey. We find that ∼50% of our sources are foreground sources located within 1-2 kpc, which is consistent with expectations from previous surveys. Approximately 20% of sources are likely located in the proximity of the Scutum-Crux and near Norma arm, while 30% are more distant, in the proximity of the far Norma arm or beyond. We argue that a mixture of magnetic and nonmagnetic cataclysmic variables dominates the Scutum-Crux and near Norma arms, while intermediate polars and high-mass stars (isolated or in binaries) dominate the far Norma arm. We also present the cumulative number count distribution for sources in our survey that are detected in the hard energy band. A population of very hard sources in the vicinity of the far Norma arm and active galactic nuclei dominate the hard X-ray emission down to f{sub X} ≈ 10{sup –14} erg cm{sup –2} s{sup –1}, but the distribution curve flattens at fainter fluxes. We find good agreement between the observed distribution and predictions based on other surveys.« less

Does "hidden undercuffing" occur among obese patients? Effect of arm sizes and other predictors of the difference between wrist and upper arm blood pressures.

PubMed

Doshi, Hardik; Weder, Alan B; Bard, Robert L; Brook, Robert D

2010-02-01

Arm size can affect the accuracy of blood pressure (BP) measurement, and "undercuffing" of large upper arms is likely to be a growing problem. Therefore, the authors investigated the relationship between upper arm and wrist readings. Upper arm and wrist circumferences and BP were measured in 261 consecutive patients. Upper arm auscultation and wrist BP was measured in triplicate, rotating measurements every 30 seconds between sites. Upper arm BP was 131.9+/-20.6/71.6+/-12.6 mm Hg in an obese population (body mass index, 30.6+/-6.6 kg/m(2)) with mean upper arm size of 30.7+/-5.1 cm. Wrist BP was higher (2.6+/-9.2 mm Hg and 4.9+/-6.6 mm Hg, respectively, P<.001); however, there was moderate concordance for the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) strata (kappa value=0.27-0.71), and the difference was >or=5 mm Hg in 72% of the patients. The authors conclude that there was poor concordance between arm and wrist BP measurement and found no evidence that "hidden undercuffing" was associated with obesity; therefore, they do not support routine use of wrist BP measurements.

Arm Care. Relief and Prevention for Shoulder Tendonitis, Tennis Elbow, Bursitis and Wrist Sprain in Athletics and Other Activities.

ERIC Educational Resources Information Center

Nirschl, Robert P.

The book provides a practical and meaningful treatment program for athletes involved in sports which injure the arm or shoulder to a high degree, such as tennis, baseball, swimming, raquetball, pole vaulting, javelin throwing, and weight training. The book's chapters present information on: (1) symptoms of injury; (2) the anatomy of injury; (3)…

Design and implementation of a training strategy in chronic stroke with an arm robotic exoskeleton.

PubMed

Frisoli, Antonio; Sotgiu, Edoardo; Procopio, Caterina; Bergamasco, Massimo; Rossi, Bruno; Chisari, Carmelo

2011-01-01

The distinguishing features of active exoskeletons are the capability of guiding arm movement at the level of the full kinematic chain of the human arm, and training full 3D spatial movements. We have specifically developed a PD sliding mode control for upper limb rehabilitation with gain scheduling for providing "assistance as needed", according to the force capability of the patient, and an automatic measurement of the impaired arm joint torques, to evaluate the hypertonia associated to the movement during the execution of the training exercise. Two different training tasks in Virtual Reality were devised, that make use of the above control, and allow to make a performance based evaluation of patient's motor status. The PERCRO L-Exos (Light-Exoskeleton) was used to evaluate the proposed algorithms and training exercises in two clinical case studies of patients with chronic stroke, that performed 6 weeks of robotic assisted training. Clinical evaluation (Fugl-Meyer Scale, Modified Ashworth Scale, Bimanual Activity Test) was conducted before and after treatment and compared to the scores and the quantitative indices, such as task time, position/joint error and resistance torques, associated to the training exercises. © 2011 IEEE

A multi-stage drop-the-losers design for multi-arm clinical trials.

PubMed

Wason, James; Stallard, Nigel; Bowden, Jack; Jennison, Christopher

2017-02-01

Multi-arm multi-stage trials can improve the efficiency of the drug development process when multiple new treatments are available for testing. A group-sequential approach can be used in order to design multi-arm multi-stage trials, using an extension to Dunnett's multiple-testing procedure. The actual sample size used in such a trial is a random variable that has high variability. This can cause problems when applying for funding as the cost will also be generally highly variable. This motivates a type of design that provides the efficiency advantages of a group-sequential multi-arm multi-stage design, but has a fixed sample size. One such design is the two-stage drop-the-losers design, in which a number of experimental treatments, and a control treatment, are assessed at a prescheduled interim analysis. The best-performing experimental treatment and the control treatment then continue to a second stage. In this paper, we discuss extending this design to have more than two stages, which is shown to considerably reduce the sample size required. We also compare the resulting sample size requirements to the sample size distribution of analogous group-sequential multi-arm multi-stage designs. The sample size required for a multi-stage drop-the-losers design is usually higher than, but close to, the median sample size of a group-sequential multi-arm multi-stage trial. In many practical scenarios, the disadvantage of a slight loss in average efficiency would be overcome by the huge advantage of a fixed sample size. We assess the impact of delay between recruitment and assessment as well as unknown variance on the drop-the-losers designs.

Lasting improvements in left spatial neglect following a protocol combining neck-muscle vibration and voluntary arm movements: a case-study.

PubMed

Ceyte, Hadrien; Beis, Jean-Marie; Simon, Mathilde; Rémy, Ariane; Anxionnat, René; Paysant, Jean; Caudron, Sébastien

2018-01-22

Beyond promising experimental results of sensory passive stimulations in spatial cognition disorders, some questions still remain regarding interests of these stimulations during the daily activities in neglect. The aim of this case-study was to evaluate the effects of a protocol combining left neck-muscle vibration with daily simple movements, like arm pointing movements, on perceptivo-locomotor deficits in a left spatial neglect patient. Two neuropsychological tests, one subjective straight-ahead pointing (SSA) test and one wheelchair navigation test were carried out before the combination protocol, immediately after, 1 h later, and 24 h later. The results showed a reduction of neglect spatial bias following the protocol lasted at least 24 h in all the tests (except for the SSA test due to the unavailability of the pointing device). The range of improvements in the symptoms of spatial neglect suggests that this therapeutic intervention based on the combining neck-muscle vibration to voluntary arm movements could be a useful treatment for this condition. One of future investigation axes should be the development of a vibratory tool in order to facilitate the combining this proprioceptive stimulation to daily activities. Implications for rehabilitation Spatial neglect is a perplexing neuropsychological syndrome, affecting different domains of spatial cognition and impacting also the functional domain. The treatments based on neck-muscle vibration are simple to use, non-invasive and requires none active participation of patient. A therapeutic intervention based on the combining left neck-muscle vibration and voluntary arm movements in a left-spatial-neglect show a lasting reduction of symptoms especially in daily activities. The combination of treatments based on the Bottom-Up approach opens innovative perspectives in rehabilitation.

78 FR 65451 - Agency Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... and Arm Conditions Disability Benefits Questionnaire) Activity Under OMB Review AGENCY: Veterans... Control No. 2900- NEW (Shoulder and Arm Conditions Disability Benefits Questionnaire)'' in any... Benefits Questionnaire).'' SUPPLEMENTARY INFORMATION: Title: (Shoulder and Arm Conditions Disability...

Clinimetric properties of the motor activity log for the assessment of arm use in hemiparetic patients.

PubMed

van der Lee, J H; Beckerman, H; Knol, D L; de Vet, H C W; Bouter, L M

2004-06-01

The Motor Activity Log (MAL) is a semistructured interview for hemiparetic stroke patients to assess the use of their paretic arm and hand (amount of use [AOU]) and quality of movement [QOM]) during activities of daily living. Scores range from 0 to 5. The following clinimetric properties of the MAL were quantified: internal consistency (Cronbach alpha), test-retest agreement (Bland and Altman method), cross-sectional construct validity (correlation between AOU and QOM and with the Action Research Arm [ARA] test), longitudinal construct validity (correlation of change on the MAL during the intervention with a global change rating [GCR] and with change on the ARA), and responsiveness (effect size). Two baseline measurements 2 weeks apart and 1 follow-up measurement immediately after 2 weeks of intensive exercise therapy either with or without immobilization of the unimpaired arm (forced use) were performed in 56 chronic stroke patients. Internal consistency was high (AOU: alpha=0.88; QOM: alpha=0.91). The limits of agreement were -0.70 to 0.85 and -0.61 to 0.71 for AOU and QOM, respectively. The correlation with the ARA score (Spearman rho) was 0.63 (AOU and QOM). However, the improvement on the MAL during the intervention was only weakly related to the GCR and to the improvement on the ARA, Spearman rho was between 0.16 and 0.22. The responsiveness ratio was 1.9 (AOU) and 2.0 (QOM). The MAL is internally consistent and relatively stable in chronic stroke patients not undergoing an intervention. The cross-sectional construct validity of the MAL is reasonable, but the results raise doubt about its longitudinal construct validity.

Individuals with chronic hemiparetic stroke can correctly match forearm positions within a single arm

PubMed Central

Gurari, Netta; Drogos, Justin M.; Dewald, Julius P.A.

2017-01-01

Objective Previous studies determined, using between arms position matching assessments, that at least one-half of individuals with stroke have an impaired position sense. We investigated whether individuals with chronic stroke who have impairments mirroring arm positions also have impairments identifying the location of each arm in space. Methods Participants with chronic hemiparetic stroke and age-matched participants without neurological impairments (controls) performed a between forearms position matching task based on a clinical assessment and a single forearm position matching task, using passive and active movements, based on a robotic assessment. Results 12 out of our 14 participants with stroke who had clinically determined between forearms position matching impairments had greater errors than the controls in both their paretic and non-paretic arm when matching positions during passive movements; yet stroke participants performed comparable to the controls during active movements. Conclusions Many individuals with chronic stroke may have impairments matching positions in both their paretic and non-paretic arm if their arm is moved for them, yet not within either arm if these individuals control their own movements. Significance The neural mechanisms governing arm location perception in the stroke population may differ depending on whether arm movements are made passively versus actively. PMID:27866116

Curiosity Robotic Arm

NASA Image and Video Library

2012-09-06

This engineering drawing shows the location of the arm on NASA Curiosity rover, in addition to the arm turret, which holds two instruments and three tools. The arm places and holds turret-mounted tools on rock and soil targets.

Correcting for multiple-testing in multi-arm trials: is it necessary and is it done?

PubMed

Wason, James M S; Stecher, Lynne; Mander, Adrian P

2014-09-17

Multi-arm trials enable the evaluation of multiple treatments within a single trial. They provide a way of substantially increasing the efficiency of the clinical development process. However, since multi-arm trials test multiple hypotheses, some regulators require that a statistical correction be made to control the chance of making a type-1 error (false-positive). Several conflicting viewpoints are expressed in the literature regarding the circumstances in which a multiple-testing correction should be used. In this article we discuss these conflicting viewpoints and review the frequency with which correction methods are currently used in practice. We identified all multi-arm clinical trials published in 2012 by four major medical journals. Summary data on several aspects of the trial design were extracted, including whether the trial was exploratory or confirmatory, whether a multiple-testing correction was applied and, if one was used, what type it was. We found that almost half (49%) of published multi-arm trials report using a multiple-testing correction. The percentage that corrected was higher for trials in which the experimental arms included multiple doses or regimens of the same treatments (67%). The percentage that corrected was higher in exploratory than confirmatory trials, although this is explained by a greater proportion of exploratory trials testing multiple doses and regimens of the same treatment. A sizeable proportion of published multi-arm trials do not correct for multiple-testing. Clearer guidance about whether multiple-testing correction is needed for multi-arm trials that test separate treatments against a common control group is required.

Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial.

PubMed

Bouchard, Stéphane; Dumoulin, Stéphanie; Robillard, Geneviève; Guitard, Tanya; Klinger, Évelyne; Forget, Hélène; Loranger, Claudie; Roucaut, François Xavier

2017-04-01

Background People with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive-behavioural therapy (CBT), could be an answer. Aims To show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposure in vivo Method Participants were randomly assigned to either VR exposure ( n = 17), in vivo exposure ( n = 22) or waiting list ( n = 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069) Results Improvements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment than in vivo on the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists than in vivo exposure. Conclusions Using VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure. © The Royal College of Psychiatrists 2017.

Reporting of interventions and "standard of care" control arms in pediatric clinical trials: a quantitative analysis.

PubMed

Yu, Ashley M; Balasubramanaiam, Bannuya; Offringa, Martin; Kelly, Lauren E

2018-06-13

In pediatric medicine, the usual treatment received by children ("standard of care") varies across centers. Evaluations of new treatments often compare to the existing "standard of care" to determine if a treatment is more effective, has a better safety profile, or costs less. The objective of our study was to evaluate intervention and "standard of care" control arms reported in published pediatric clinical trials. Pediatric clinical trials, published in 2014, reporting the use of a "standard of care" control arm were included. Duplicate assessment of reporting completeness was done using the 12-item TIDieR (Template for Intervention Description and Replication) checklist for both the "standard of care" control arms and intervention arms within the same published study. Following screening, 214 pediatric trials in diverse therapeutic areas were included. Several different terms were used to describe "standard of care." There was a significant difference between the mean reported TIDieR checklist items of "standard of care" control arms (5.81 (SD 2.13) and intervention arms (8.45 (SD 1.39, p < 0.0001). Reporting of intervention and "standard of care" control arms in pediatric clinical trials should be improved as current "standard of care" reporting deficiencies limit reproducibility of research and may ultimately contribute to research waste.

Transcranial direct current stimulation (tDCS) of the primary motor cortex and robot-assisted arm training in chronic incomplete cervical spinal cord injury: A proof of concept sham-randomized clinical study.

PubMed

Yozbatiran, Nuray; Keser, Zafer; Davis, Matthew; Stampas, Argyrios; O'Malley, Marcia K; Cooper-Hay, Catherine; Frontera, Joel; Fregni, Felipe; Francisco, Gerard E

2016-07-15

After cervical spinal cord injury, current options for treatment of upper extremity motor functions have been limited to traditional approaches. However, there is a substantial need to explore more rigorous alternative treatments to facilitate motor recovery. To demonstrate whether anodal-primary motor cortex (M1) excitability enhancement (with cathodal-supra orbital area) (atDCS) combined with robot-assisted arm training (R-AAT) will provide greater improvement in contralateral arm and hand motor functions compared to sham stimulation (stDCS) and R-AAT in patients with chronic, incomplete cervical spinal cord injury (iCSCI). In this parallel-group, double-blinded, randomized and sham-controlled trial, nine participants with chronic iCSCI (AIS C and D level) were randomized to receive 10 sessions of atDCS or stDSC combined with R-AAT. Feasibility and tolerability was assessed with attrition rate and occurrence of adverse events, Changes in arm and hand function were assessed with Jebson Taylor Hand Function Test (JTHFT). Amount of Use Scale of Motor Activity Log (AOU-MAL), American Spinal Injury Association Upper Extremity Motor Score and Modified Ashworth Scale (MAS) at baseline, after treatment, and at two-month follow-up. None of the participants missed a treatment session or dropped-out due to adverse events related to the treatment protocol. Participants tended to perform better in JTHFT and AOU-MAL after treatment. Active group at post-treatment and two-month follow-up demonstrated better arm and hand performance compared to sham group. These preliminary findings support that modulating excitatory input of the corticospinal tracts on spinal circuits may be a promising strategy in improving arm and hand functions in persons with incomplete tetraplegia. Further study is needed to explore the underlying mechanisms of recovery.

EDUCATION IN THE ARMED FORCES.

ERIC Educational Resources Information Center

GROVES, KENNETH J.; SHELBURNE, JAMES C.

IN THIS SURVEY OF THE TRAINING OF ACTIVE DUTY ARMED FORCES, VARIOUS CATEGORIES ARE IDENTIFIED AND DISCUSSED--TRAINING AND EDUCATION OF ENLISTED MEN (INCLUDING SPECIALISTS AND POTENTIAL NONCOMMISSIONED OFFICERS), OFFICER TRAINING AND SPECIALIZED EDUCATION, PROFESSIONAL MILITARY EDUCATION, UNIT TRAINING, AND OFF-DUTY ACADEMIC AND VOCATIONAL…

An MR-compatible gyroscope-based arm movement tracking system.

PubMed

Shirinbayan, S Iman; Rieger, Jochem W

2017-03-15

Functional magnetic resonance imaging is well suited to link neural population activation with movement parameters of complex natural arm movements. However, currently existing MR-compatible arm tracking devices are not constructed to measure arm joint movement parameters of unrestricted movements. Therefore, to date most research focuses on simple arm movements or includes very little knowledge about the actual movement kinematics. We developed a low cost gyroscope-based arm movement tracking system (GAMTS) that features MR-compatibility. The system consists of dual-axis analogue gyroscopes that measure rotations of upper and lower arm joints. After MR artifact reduction, the rotation angles of the individual arm joints are calculated and used to animate a realistic arm model that is implemented in the OpenSim platform. The OpenSim platform can then provide the kinematics of any point on the arm model. In order to demonstrate the capabilities of the system, we first assessed the quality of reconstructed wrist movements in a low-noise environment where typical MR-related problems are absent and finally, we validated the reconstruction in the MR environment. The system provides the kinematics of the whole arm when natural unrestricted arm movements are performed inside the MR-scanner. The GAMTS is reliably capable of reconstructing the kinematics of trajectories and the reconstruction error is small in comparison with the movement induced variation of speed, displacement, and rotation. Moreover, the system can be used to probe brain areas for their correlation with movement kinematics. Copyright © 2017 Elsevier B.V. All rights reserved.

78 FR 36307 - Proposed Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... (Shoulder and Arm Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... ``OMB Control No. 2900--NEW (Shoulder and Arm Conditions Disability Benefits Questionnaire)'' in any...: Shoulder and Arm Conditions Disability Benefits Questionnaire, VA Form 21-0960M-12. OMB Control Number...

Dopaminergic modulation of arm swing during gait among Parkinson's disease patients.

PubMed

Sterling, Nicholas W; Cusumano, Joseph P; Shaham, Noam; Piazza, Stephen J; Liu, Guodong; Kong, Lan; Du, Guangwei; Lewis, Mechelle M; Huang, Xuemei

2015-01-01

Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson's disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. We aimed to investigate the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p = 0.0018), but not faster- (p = 0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p = 0.0046) and lower maximum cross-correlation (p = 0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p = 0.0182), but not faster- (p = 0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p = 0.0386), whereas maximum cross-correlation showed no change (p = 0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R = -0.73824, p = 0.0011). This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression.

Accounting for uncertainty in the historical response rate of the standard treatment in single-arm two-stage designs based on Bayesian power functions.

PubMed

Matano, Francesca; Sambucini, Valeria

2016-11-01

In phase II single-arm studies, the response rate of the experimental treatment is typically compared with a fixed target value that should ideally represent the true response rate for the standard of care therapy. Generally, this target value is estimated through previous data, but the inherent variability in the historical response rate is not taken into account. In this paper, we present a Bayesian procedure to construct single-arm two-stage designs that allows to incorporate uncertainty in the response rate of the standard treatment. In both stages, the sample size determination criterion is based on the concepts of conditional and predictive Bayesian power functions. Different kinds of prior distributions, which play different roles in the designs, are introduced, and some guidelines for their elicitation are described. Finally, some numerical results about the performance of the designs are provided and a real data example is illustrated. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Mental health service acceptability for the armed forces veteran community.

PubMed

Farrand, P; Jeffs, A; Bloomfield, T; Greenberg, N; Watkins, E; Mullan, E

2018-06-15

Despite developments in mental health services for armed forces veterans and family members, barriers to access associated with poor levels of acceptability regarding service provision remain. Adapting a Step 2 mental health service based on low-intensity cognitive behavioural therapy (CBT) interventions to represent a familiar context and meet the needs of the armed forces veteran community may serve to enhance acceptability and reduce help-seeking barriers. To examine acceptability of a Step 2 low-intensity CBT mental health service adapted for armed forces veterans and family members provided by a UK Armed Forces charity. Qualitative study using individual semi-structured interviews with armed forces veterans and family members of those injured or becoming unwell while serving in the British Armed Forces. Data analysis was undertaken using thematic alongside disconfirming case analysis. Adapting a Step 2 mental health service for armed forces veterans and family members enhanced acceptability and promoted help-seeking. Wider delivery characteristics associated with Step 2 mental health services within the Improving Access to Psychological Therapies (IAPT) programme also contributed to service acceptability. However, limitations of Step 2 mental health service provision were also identified. A Step 2 mental health service adapted for armed forces veterans and family members enhances acceptability and may potentially overcome help-seeking barriers. However, concerns remain regarding ways to accommodate the treatment of post-traumatic stress disorder and provide support for family members.

The Effect of Restricted Arm Swing on Energy Expenditure in Healthy Men

ERIC Educational Resources Information Center

Yizhar, Ziva; Boulos, Spiro; Inbar, Omri; Carmeli, Eli

2009-01-01

Arm swing in human walking is an active natural motion involving the upper extremities. Earlier studies have described the interrelationship between arms and legs during walking, but the effect of arm swing on energy expenditure and dynamic parameters during normal gait, is inconclusive. The aim of this study was to investigate the effect of…

Orthotic arm joint. [for use in mechanical arms

NASA Technical Reports Server (NTRS)

Dane, D. H. (Inventor)

1974-01-01

An improved orthopedic (orthotic) arm joint that can be used in various joint of mechanical arms is described. The arm joints includes a worm, which is coupled to an electric motor for rotating a worm gear carried within a rotatable housing. The worm gear is supported on a thrust bearing and the rotatable housing is supported on a radial thrust bearing. A bolt extends through the housing, bearings, and worm gear for securing the device together. A potentiometer extends through the bolt, and is coupled to the rotatable housing for rotating therewith, so as to produce an electrical signal indicating the angular position of the rotatable housing.

Change in Functional Arm Use Is Associated With Somatosensory Skills After Sensory Retraining Poststroke.

PubMed

Turville, Megan; Carey, Leeanne M; Matyas, Thomas A; Blennerhassett, Jannette

We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills. Data were pooled (N = 80) from two randomized controlled trials of somatosensory retraining. We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity. Somatosensory discrimination skills were measured using standardized modality-specific measures. Participants' arm use improved after somatosensory retraining (z = -6.80, p < .01). Change in arm use was weakly associated with somatosensation (tactile, β = 0.31, p < .01; proprioception, β = -0.17, p > .05; object recognition, β = 0.13, p < .05). Change in daily arm use was related to a small amount of variance in somatosensory outcomes. Stroke survivors' functional arm use can increase after somatosensory retraining, with change varying among survivors. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Cryolipolysis for Reduction of Arm Fat: Safety and Efficacy of a Prototype CoolCup Applicator With Flat Contour

PubMed Central

Humphrey, Shannon; Rivers, Jason K.

2017-01-01

BACKGROUND Cryolipolysis of the arms has been shown to be an effective but somewhat time-consuming process. OBJECTIVE The study evaluated safety and efficacy of a contoured cup cryolipolysis applicator for reduction of arm fat. The prototype was designed to maximize tissue contact with the cooling surface to improve comfort, while reducing treatment time by 25 minutes. MATERIALS AND METHODS Both arms were treated using a prototype device that delivered treatment in 35 minutes at −11°C. Photographic and ultrasound documentation was captured at baseline and 12 weeks post-treatment. Efficacy was assessed by photo review and measurement of fat reduction in ultrasound images. Immediately after 1, 4, and 12 weeks post-treatment, clinical assessments were performed to evaluate treatment areas and sensory alterations. RESULTS Thirty women were enrolled and completed treatments to both arms. Ultrasound measurements found mean fat layer reduction of 3.2 mm with an SD of 2.7 mm. Blinded independent photo review found 85.2% correct identification of baseline photographs by at least 2/3 of reviewers. There were no unanticipated adverse device effects. Four study subjects experienced numbness in the treatment area beyond the 12-week visit that subsequently resolved without intervention. CONCLUSION These data suggest that the CoolCup prototype applicator provides rapid, safe, and effective arm treatment. PMID:28595246

Robotic Arm Manipulation Laboratory With a Six Degree of Freedom JACO Arm

DTIC Science & Technology

2015-12-01

MANIPULATION LABORATORY WITH A SIX DEGREE OF FREEDOM JACO ARM by Ronald H. Palacios December 2015 Thesis Advisor: Richard M. Harkins Second...TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE ROBOTIC ARM MANIPULATION LABORATORY WITH A SIX DEGREE OF FREEDOM JACO ARM 5. FUNDING...distribution is unlimited 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) The JACO six degree of freedom robotic arm and associated software

ARM Tethered Balloon System & AALCO Activities at AMF3 Site at Oliktok Point, AK

NASA Astrophysics Data System (ADS)

Hardesty, J.; Dexheimer, D.; Mei, F.; Roesler, E. L.; Longbottom, C.; Hillman, B. R.

2017-12-01

Sandia National Laboratories (SNL) has operated the Atmospheric Radiation Measurement program's (ARM) third ARM Mobile Facility (AMF3) and the restricted airspace associated with it at Oliktok Point, Alaska, since October 2013. The site hosts ground-based instrumentation which collects a variety of continuous atmospheric measurements as well as user-conducted unmanned aircraft and tethered balloon campaigns. SNL has operated ARM's tethered balloon system (TBS) as part of the Inaugural Campaigns for ARM Research using Unmanned Systems (ICARUS) since 2016. AALCO (Aerial Assessment of Liquid in Clouds at Oliktok), is an ARM Intensive Operations Period conducted by SNL at the AMF3 since 2016. The operation of the TBS during ICARUS and AALCO to altitudes above 4,000' AGL in a variety of seasons and conditions is addressed. A Distributed Temperature Sensing (DTS) system and supercooled liquid water content (SLWC) sensors have been deployed under both campaigns. The performance of these sensors is discussed and results are presented. DTS measurements and their relationship to concurrent temperature measurements from unmanned aircraft and radiosondes are shown. SLWC sensor in situ measurements are compared with microwave radiometer and radiosonde-derived measurements. Preliminary analysis of using Large Eddy Simulations to compare with the SLWC measurements reveals three-dimensional properties of the observed clouds.

Incident Diagnoses of Cancers and Cancer-related Deaths, Active Component, U.S. Armed Forces, 2000-2011

DTIC Science & Technology

2012-06-01

diagnosis was older age. For example, for all cancer sites except the cervix and tes- ticle, the highest rates of diagnoses were among those older than... cancer screening exami- nations such as mammography, prostate specifi c antigen (PSA) testing, cytological examination of the cervix (Papanicolaou...M S M R Vol. 19 No. 6 June 2012Page 18 Incident Diagnoses of Cancers and Cancer -related Deaths, Active Component, U.S. Armed Forces, 2000-2011

Proprioceptive illusions created by vibration of one arm are altered by vibrating the other arm.

PubMed

Hakuta, Naoyuki; Izumizaki, Masahiko; Kigawa, Kazuyoshi; Murai, Norimitsu; Atsumi, Takashi; Homma, Ikuo

2014-07-01

There is some evidence that signals coming from both arms are used to determine the perceived position and movement of one arm. We examined whether the sense of position and movement of one (reference) arm is altered by increases in muscle spindle signals in the other (indicator) arm in blindfolded participants (n = 26). To increase muscle spindle discharge, we applied 70-80 Hz muscle vibration to the elbow flexors of the indicator arm. In a first experiment, proprioceptive illusions in the vibrated reference arm in a forearm position-matching task were compared between conditions in which the indicator arm elbow flexors were vibrated or not vibrated. We found that the vibration illusion of arm extension induced by vibration of reference arm elbow flexors was reduced in the presence of vibration of the indicator elbow flexors. In a second experiment, participants were asked to describe their perception of the illusion of forearm extension movements of the reference arm evoked by vibration of reference arm elbow flexors in response to on/off and off/on transitions of vibration of non-reference arm elbow flexors. When vibration of non-reference arm elbow flexors was turned on, they reported a sensation of slowing down of the illusion of the reference arm. When it was turned off, they reported a sensation of speeding up. To conclude, the present study shows that both the sense of limb position and the sense of limb movement of one arm are dependent to some extent on spindle signals coming from the other arm.

Defibrotide for the treatment of severe hepatic veno-occlusive disease and multiorgan failure after stem cell transplantation: a multicenter, randomized, dose-finding trial.

PubMed

Richardson, Paul G; Soiffer, Robert J; Antin, Joseph H; Uno, Hajime; Jin, Zhezhen; Kurtzberg, Joanne; Martin, Paul L; Steinbach, Gideon; Murray, Karen F; Vogelsang, Georgia B; Chen, Allen R; Krishnan, Amrita; Kernan, Nancy A; Avigan, David E; Spitzer, Thomas R; Shulman, Howard M; Di Salvo, Donald N; Revta, Carolyn; Warren, Diane; Momtaz, Parisa; Bradwin, Gary; Wei, L J; Iacobelli, Massimo; McDonald, George B; Guinan, Eva C

2010-07-01

Therapeutic options for severe hepatic veno-occlusive disease (VOD) are limited and outcomes are dismal, but early phase I/II studies have suggested promising activity and acceptable toxicity using the novel polydisperse oligonucleotide defibrotide. This randomized phase II dose-finding trial determined the efficacy of defibrotide in patients with severe VOD following hematopoietic stem cell transplantation (HSCT) and identified an appropriate dose for future trials. Adult and pediatric patients received either lower-dose (arm A: 25 mg/kg/day; n = 75) or higher-dose (arm B: 40 mg/kg/day; n = 74) i.v. defibrotide administered in divided doses every 6 hours for > or =14 days or until complete response, VOD progression, or any unacceptable toxicity occurred. Overall complete response and day +100 post-HSCT survival rates were 46% and 42%, respectively, with no significant difference between treatment arms. The incidence of treatment-related adverse events was low (8% overall; 7% in arm A, 10% in arm B); there was no significant difference in the overall rate of adverse events between treatment arms. Early stabilization or decreased bilirubin was associated with better response and day +100 survival, and decreased plasminogen activator inhibitor type 1 (PAI-1) during treatment was associated with better outcome; changes were similar in both treatment arms. Defibrotide 25 or 40 mg/kg/day also appears effective in treating severe VOD following HSCT. In the absence of any differences in activity, toxicity or changes in PAI-1 level, defibrotide 25 mg/kg/day was selected for ongoing phase III trials in VOD.

Defibrotide for the Treatment of Severe Hepatic Veno-Occlusive Disease and Multiorgan Failure after Stem Cell Transplantation: A Multicenter, Randomized, Dose-Finding Trial

PubMed Central

Richardson, Paul G.; Soiffer, Robert J.; Antin, Joseph H.; Uno, Hajime; Jin, Zhezhen; Kurtzberg, Joanne; Martin, Paul L.; Steinbach, Gideon; Murray, Karen F.; Vogelsang, Georgia B.; Chen, Allen R.; Krishnan, Amrita; Kernan, Nancy A.; Avigan, David E.; Spitzer, Thomas R.; Shulman, Howard M.; Di Salvo, Donald N.; Revta, Carolyn; Warren, Diane; Momtaz, Parisa; Bradwin, Gary; Wei, L. J.; Iacobelli, Massimo; McDonald, George B.; Guinan, Eva C.

2010-01-01

Therapeutic options for severe hepatic veno-occlusive disease (VOD) are limited and outcomes are dismal, but early phase I/II studies have suggested promising activity and acceptable toxicity using the novel polydisperse oligonucleotide defibrotide. This randomized phase II dose-finding trial determined the efficacy of defibrotide in patients with severe VOD following hematopoietic stem cell transplantation (HSCT) and identified an appropriate dose for future trials. Adult and pediatric patients received either lower-dose (arm A: 25 mg/kg/day; n = 75) or higher-dose (arm B: 40 mg/kg/day; n = 74) i.v. defibrotide administered in divided doses every 6 hours for ≥ 14 days or until complete response, VOD progression, or any unacceptable toxicity occurred. Overall complete response and day + 100 post-HSCT survival rates were 46% and 42%, respectively, with no significant difference between treatment arms. The incidence of treatment-related adverse events was low (8% overall; 7% in arm A, 10% in arm B); there was no significant difference in the overall rate of adverse events between treatment arms. Early stabilization or decreased bilirubin was associated with better response and day + 100 survival, and decreased plasminogen activator inhibitor type 1 (PAI-1) during treatment was associated with better outcome; changes were similar in both treatment arms. Defibrotide 25 or 40 mg/kg/day also appears effective in treating severe VOD following HSCT. In the absence of any differences in activity, toxicity or changes in PAI-1 level, defibrotide 25 mg/kg/day was selected for ongoing phase III trials in VOD. PMID:20167278

Robots testing robots: ALAN-Arm, a humanoid arm for the testing of robotic rehabilitation systems.

PubMed

Brookes, Jack; Kuznecovs, Maksims; Kanakis, Menelaos; Grigals, Arturs; Narvidas, Mazvydas; Gallagher, Justin; Levesley, Martin

2017-07-01

Robotics is increasing in popularity as a method of providing rich, personalized and cost-effective physiotherapy to individuals with some degree of upper limb paralysis, such as those who have suffered a stroke. These robotic rehabilitation systems are often high powered, and exoskeletal systems can attach to the person in a restrictive manner. Therefore, ensuring the mechanical safety of these devices before they come in contact with individuals is a priority. Additionally, rehabilitation systems may use novel sensor systems to measure current arm position. Used to capture and assess patient movements, these first need to be verified for accuracy by an external system. We present the ALAN-Arm, a humanoid robotic arm designed to be used for both accuracy benchmarking and safety testing of robotic rehabilitation systems. The system can be attached to a rehabilitation device and then replay generated or human movement trajectories, as well as autonomously play rehabilitation games or activities. Tests of the ALAN-Arm indicated it could recreate the path of a generated slow movement path with a maximum error of 14.2mm (mean = 5.8mm) and perform cyclic movements up to 0.6Hz with low gain (<1.5dB). Replaying human data trajectories showed the ability to largely preserve human movement characteristics with slightly higher path length and lower normalised jerk.

Natural Resource Extraction, Armed Violence, and Environmental Degradation

PubMed Central

Downey, Liam; Bonds, Eric; Clark, Katherine

2011-01-01

The goal of this article is to demonstrate that environmental sociologists cannot fully explain the relationship between humans and the natural world without theorizing a link between natural resource extraction, armed violence, and environmental degradation. The authors begin by arguing that armed violence is one of several overlapping mechanisms that provide powerful actors with the means to (a) prevail over others in conflicts over natural resources and (b) ensure that natural resources critical to industrial production and state power continue to be extracted and sold in sufficient quantities to promote capital accumulation, state power, and ecological unequal exchange. The authors then identify 10 minerals that are critical to the functioning of the U.S. economy and/or military and demonstrate that the extraction of these minerals often involves the use of armed violence. They further demonstrate that armed violence is associated with the activities of the world’s three largest mining companies, with African mines that receive World Bank funding, and with petroleum and rainforest timber extraction. The authors conclude that the natural resource base on which industrial societies stand is constructed in large part through the use and threatened use of armed violence. As a result, armed violence plays a critical role in fostering environmental degradation and ecological unequal exchange. PMID:21909231

The Arms Race and World Hunger. Facts for Action #4.

ERIC Educational Resources Information Center

Phillips, Jim

Designed for high school global education classes, this document examines ways in which the arms race affects the poor. Military expenditures and foreign economic aid of the developed nations are compared with survival needs of developing nations. Statistics support five premises: the arms race (1) diverts resources from productive activity and…

Isolated effects of peripheral arm and central body cooling on arm performance.

PubMed

Giesbrecht, G G; Wu, M P; White, M D; Johnston, C E; Bristow, G K

1995-10-01

Whole body cooling impairs manual arm performance. The independent contributions of local (peripheral) and/or whole body (central) cooling are not known. Therefore, a protocol was developed in which the arm and the rest of the body could be independently cooled. Biceps temperature (Tmus), at a depth of 20 mm, and esophageal temperature (Tes) were measured. Six subjects were immersed to the clavicles in a tank (body tank) of water under 3 conditions: 1) cold body-cold arm (CB-CA); 2) warm body-cold arm (WB-CA); and 3) cold body-warm arm (CB-WA). In the latter two conditions, subjects placed their dominant arm in a separate (arm) tank. Water temperature (Tw) in each tank was independently controlled. In conditions requiring cold body and/or cold arm, Tw in the appropriate tanks was 8 degrees C. In conditions requiring warm body and/or warm arm, Tw in the appropriate tanks was adjusted between 29 and 38 degrees C to maintain body/arm temperature at baseline values. A battery of 6 tests, requiring fine or gross motor movements, were performed immediately before immersion and after 15, 45, and 70 minutes of immersion. In CB-CA, Tes decreased from an average of 37.2 to 35.6 degrees C and Tmus decreased from 34.6 to 22.0 degrees C. In WB-CA, Tmus decreased to 18.1 degrees C (Tes = 37.1 degrees C), and in CB-WA, Tes decreased to 35.8 degrees C (Tmus = 34.5 degrees C). By the end of immersion, there were significant decrements (43-85%) in the performance of all tests in CB-CA and WB-CA (p < 0.0002); scores for each test were similar in these two conditions. There was no significant change in scores throughout the CB-WA condition. In both conditions with arm cooling (i.e., WB-CA and CB-CA), Tmus accounted for 85-98% of the variance in all tests. When the core was cooled in the CB-WA condition, Tes was significantly correlated to scores in only two tests (accounted for 90 and 93% of the variance) although the actual effect was small. In the CB-CA condition, partial

ARM Airborne Carbon Measurements (ARM-ACME) and ARM-ACME 2.5 Final Campaign Reports

DOE Office of Scientific and Technical Information (OSTI.GOV)

Biraud, S. C.; Tom, M. S.; Sweeney, C.

2016-01-01

We report on a 5-year multi-institution and multi-agency airborne study of atmospheric composition and carbon cycling at the Atmospheric Radiation Measurement (ARM) Climate Research Facility’s Southern Great Plains (SGP) site, with scientific objectives that are central to the carbon-cycle and radiative-forcing goals of the U.S. Global Change Research Program and the North American Carbon Program (NACP). The goal of these measurements is to improve understanding of 1) the carbon exchange of the Atmospheric Radiation Measurement (ARM) SGP region; 2) how CO 2 and associated water and energy fluxes influence radiative-forcing, convective processes, and CO 2 concentrations over the ARM SGPmore » region, and 3) how greenhouse gases are transported on continental scales.« less

Multi-arm group sequential designs with a simultaneous stopping rule.

PubMed

Urach, S; Posch, M

2016-12-30

Multi-arm group sequential clinical trials are efficient designs to compare multiple treatments to a control. They allow one to test for treatment effects already in interim analyses and can have a lower average sample number than fixed sample designs. Their operating characteristics depend on the stopping rule: We consider simultaneous stopping, where the whole trial is stopped as soon as for any of the arms the null hypothesis of no treatment effect can be rejected, and separate stopping, where only recruitment to arms for which a significant treatment effect could be demonstrated is stopped, but the other arms are continued. For both stopping rules, the family-wise error rate can be controlled by the closed testing procedure applied to group sequential tests of intersection and elementary hypotheses. The group sequential boundaries for the separate stopping rule also control the family-wise error rate if the simultaneous stopping rule is applied. However, we show that for the simultaneous stopping rule, one can apply improved, less conservative stopping boundaries for local tests of elementary hypotheses. We derive corresponding improved Pocock and O'Brien type boundaries as well as optimized boundaries to maximize the power or average sample number and investigate the operating characteristics and small sample properties of the resulting designs. To control the power to reject at least one null hypothesis, the simultaneous stopping rule requires a lower average sample number than the separate stopping rule. This comes at the cost of a lower power to reject all null hypotheses. Some of this loss in power can be regained by applying the improved stopping boundaries for the simultaneous stopping rule. The procedures are illustrated with clinical trials in systemic sclerosis and narcolepsy. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Perspectives on Arms Control

DTIC Science & Technology

2004-07-01

perspective. He traces the important and integral place of arms control diplomacy to United States traditions, and projects continuing relevance for... The second is commonality surrounding the ongoing arms control process on nuclear weapons and missiles between America and Russia that needs...summits were built around arms control discussions, large delegations met frequently in places like Geneva, and even trivial changes in the arms

The Influences of Arm Resist Motion on a CAR Crash Test Using Hybrid III Dummy with Human-Like Arm

NASA Astrophysics Data System (ADS)

Kim, Yongchul; Youm, Youngil; Bae, Hanil; Choi, Hyeonki

Safety of the occupant during the crash is very essential design element. Many researches have been investigated in reducing the fatal injury of occupant. They are focusing on the development of a dummy in order to obtain the real human-like motion. However, they have not considered the arm resist motion during the car accident. In this study, we would like to suggest the importance of the reactive force of the arm in a car crash. The influences of reactive force acting on the human upper extremity were investigated using the impedance experimental method with lumped mass model of hand system and a Hybrid III dummy with human-like arm. Impedance parameters (e.g. inertia, spring constant and damping coefficient) of the elbow joint in maximum activation level were measured by free oscillation test using single axis robot. The results showed that without seat belt, the reactive force of human arm reduced the head, chest, and femur injury, and the flexion moment of the neck is higher than that of the conventional dummy.

Two-Armed, Mobile, Sensate Research Robot

NASA Technical Reports Server (NTRS)

Engelberger, J. F.; Roberts, W. Nelson; Ryan, David J.; Silverthorne, Andrew

2004-01-01

The Anthropomorphic Robotic Testbed (ART) is an experimental prototype of a partly anthropomorphic, humanoid-size, mobile robot. The basic ART design concept provides for a combination of two-armed coordination, tactility, stereoscopic vision, mobility with navigation and avoidance of obstacles, and natural-language communication, so that the ART could emulate humans in many activities. The ART could be developed into a variety of highly capable robotic assistants for general or specific applications. There is especially great potential for the development of ART-based robots as substitutes for live-in health-care aides for home-bound persons who are aged, infirm, or physically handicapped; these robots could greatly reduce the cost of home health care and extend the term of independent living. The ART is a fully autonomous and untethered system. It includes a mobile base on which is mounted an extensible torso topped by a head, shoulders, and two arms. All subsystems of the ART are powered by a rechargeable, removable battery pack. The mobile base is a differentially- driven, nonholonomic vehicle capable of a speed >1 m/s and can handle a payload >100 kg. The base can be controlled manually, in forward/backward and/or simultaneous rotational motion, by use of a joystick. Alternatively, the motion of the base can be controlled autonomously by an onboard navigational computer. By retraction or extension of the torso, the head height of the ART can be adjusted from 5 ft (1.5 m) to 6 1/2 ft (2 m), so that the arms can reach either the floor or high shelves, or some ceilings. The arms are symmetrical. Each arm (including the wrist) has a total of six rotary axes like those of the human shoulder, elbow, and wrist joints. The arms are actuated by electric motors in combination with brakes and gas-spring assists on the shoulder and elbow joints. The arms are operated under closed-loop digital control. A receptacle for an end effector is mounted on the tip of the wrist and

Dominant vs. nondominant arm advantage in mentally simulated actions in right handers.

PubMed

Gandrey, Philippe; Paizis, Christos; Karathanasis, Vassilis; Gueugneau, Nicolas; Papaxanthis, Charalambos

2013-12-01

Although plentiful data are available regarding mental states involving the dominant-right arm, the evidence for the nondominant-left arm is sparse. Here, we investigated whether right-handers can generate accurate predictions with either the right or the left arm. Fifteen adults carried out actual and mental arm movements in two directions with varying inertial resistance (inertial anisotropy phenomenon). We recorded actual and mental movement times and used the degree of their similarity as an indicator for the accuracy of motor imagery/prediction process. We found timing correspondences (isochrony) between actual and mental right arm movements in both rightward (low inertia resistance) and leftward (high inertia resistance) directions. Timing similarities between actual and mental left arm movements existed for the leftward direction (low inertia resistance) but not for the rightward direction (high inertia resistance). We found similar results when participants reaching towards the midline of the workspace, a result that excludes a hemispace effect. Electromyographic analysis during mental movements showed that arm muscles remained inactivate, thus eliminating a muscle activation strategy that could explain intermanual differences. Furthermore, motor-evoked potentials enhancement in both right and left biceps brachii during mental actions indicated that subjects were actively engaged in mental movement simulation and that the disadvantage of the left arm cannot be attributed to the nonactivation of the right motor cortex. Our findings suggest that predictive mechanisms are more robust for the right than the left arm in right-handers. We discussed these findings from the perspective of the internal models theory and the dynamic-dominance hypothesis of laterality.

Chemovirotherapy for head and neck squamous cell carcinoma with EGFR-targeted and CD/UPRT-armed oncolytic measles virus.

PubMed

Zaoui, K; Bossow, S; Grossardt, C; Leber, M F; Springfeld, C; Plinkert, P K; Kalle, C von; Ungerechts, G

2012-03-01

First-line treatment of recurrent and/or refractory head and neck squamous cell carcinoma (HNSCC) is based on platinum, 5-fluorouracil (5-FU) and the monoclonal antiEGFR antibody cetuximab. However, in most cases this chemoimmunotherapy does not cure the disease, and more than 50% of HNSCC patients are dying because of local recurrence of the tumors. In the majority of cases, HNSCC overexpress the epidermal growth factor receptor (EGFR), and its presence is associated with a poor outcome. In this study, we engineered an EGFR-targeted oncolytic measles virus (MV), armed with the bifunctional enzyme cytosine deaminase/uracil phosphoribosyltransferase (CD/UPRT). CD/UPRT converts 5-fluorocytosine (5-FC) into the chemotherapeutic 5-FU, a mainstay of HNSCC chemotherapy. This virus efficiently replicates in and lyses primary HNSCC cells in vitro. Arming with CD/UPRT mediates efficient prodrug activation with high bystander killing of non-infected tumor cells. In mice bearing primary HNSCC xenografts, intratumoral administration of MV-antiEGFR resulted in statistically significant tumor growth delay and prolongation of survival. Importantly, combination with 5-FC is superior to virus-only treatment leading to significant tumor growth inhibition. Thus, chemovirotherapy with EGFR-targeted and CD/UPRT-armed MV is highly efficacious in preclinical settings with direct translational implications for a planned Phase I clinical trial of MV for locoregional treatment of HNSCC.

Dopaminergic modulation of arm swing during gait among Parkinson’s disease patients

PubMed Central

Sterling, Nicholas W.; Cusumano, Joseph P.; Shaham, Noam; Piazza, Stephen J.; Liu, Guodong; Kong, Lan; Du, Guangwei; Lewis, Mechelle M.; Huang, Xuemei

2015-01-01

Background Reduced arm swing amplitude, symmetry, and coordination during gait have been reported in Parkinson’s disease (PD), but the relationship between dopaminergic depletion and these upper limb gait changes remains unclear. This study investigated the effects of dopaminergic drugs on arm swing velocity, symmetry, and coordination in PD. Methods Forearm angular velocity was recorded in 16 PD and 17 control subjects (Controls) during free walking trials. Angular velocity amplitude of each arm, arm swing asymmetry, and maximum cross-correlation were compared between control and PD groups, and between OFF- and ON-medication states among PD subjects. Results Compared to Controls, PD subjects in the OFF-medication state exhibited lower angular velocity amplitude of the slower- (p=0.0018), but not faster- (p=0.2801) swinging arm. In addition, PD subjects demonstrated increased arm swing asymmetry (p=0.0046) and lower maximum cross-correlation (p=0.0026). Following dopaminergic treatment, angular velocity amplitude increased in the slower- (p=0.0182), but not faster- (p=0.2312) swinging arm among PD subjects. Furthermore, arm swing asymmetry decreased (p=0.0386), whereas maximum cross-correlation showed no change (p=0.7436). Pre-drug angular velocity amplitude of the slower-swinging arm was correlated inversely with the change in arm swing asymmetry (R=−0.73824, p=0.0011). Conclusions This study provides quantitative evidence that reduced arm swing and symmetry in PD can be modulated by dopaminergic replacement. The lack of modulations of bilateral arm coordination suggests that additional neurotransmitters may also be involved in arm swing changes in PD. Further studies are warranted to investigate the longitudinal trajectory of arm swing dynamics throughout PD progression. PMID:25502948

Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms.

PubMed

Beom, Jaewon; Koh, Sukgyu; Nam, Hyung Seok; Kim, Wonshik; Kim, Yoonjae; Seo, Han Gil; Oh, Byung-Mo; Chung, Sun Gun; Kim, Sungwan

2016-08-15

Mirror therapy has been performed as effective occupational therapy in a clinical setting for functional recovery of a hemiplegic arm after stroke. It is conducted by eliciting an illusion through use of a mirror as if the hemiplegic arm is moving in real-time while moving the healthy arm. It can facilitate brain neuroplasticity through activation of the sensorimotor cortex. However, conventional mirror therapy has a critical limitation in that the hemiplegic arm is not actually moving. Thus, we developed a real-time 2-axis mirror robot system as a simple add-on module for conventional mirror therapy using a closed feedback mechanism, which enables real-time movement of the hemiplegic arm. We used 3 Attitude and Heading Reference System sensors, 2 brushless DC motors for elbow and wrist joints, and exoskeletal frames. In a feasibility study on 6 healthy subjects, robotic mirror therapy was safe and feasible. We further selected tasks useful for activities of daily living training through feedback from rehabilitation doctors. A chronic stroke patient showed improvement in the Fugl-Meyer assessment scale and elbow flexor spasticity after a 2-week application of the mirror robot system. Robotic mirror therapy may enhance proprioceptive input to the sensory cortex, which is considered to be important in neuroplasticity and functional recovery of hemiplegic arms. The mirror robot system presented herein can be easily developed and utilized effectively to advance occupational therapy.

ARM Airborne Carbon Measurements VI (ARM-ACME VI) Field Campaign Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Biraud, Sebastien

2017-05-01

From October 1, 2015 through September 30, 2016, AAF deployed a Cessna 206 aircraft over the Southern Great Plains, collecting observations of trace gas mixing ratios over the ARM/SGP Central Facility. The aircraft payload included two Atmospheric Observing Systems (AOS Inc.) analyzers for continuous measurements of CO2, and a 12-flask sampler for analysis of carbon cycle gases (CO2, CO, CH4, N2O, 13CO2). The aircraft payload also includes solar/infrared radiation measurements. This research (supported by DOE ARM and TES programs) builds upon previous ARM-ACME missions. The goal of these measurements is to improve understanding of: (a) the carbon exchange of themore » ARM region; (b) how CO2 and associated water and energy fluxes influence radiative forcing, convective processes, and CO2 concentrations over the ARM region, and (c) how greenhouse gases are transported on continental scales.« less

Effect of afferent feedback and central motor commands on soleus H-reflex suppression during arm cycling.

PubMed

Hundza, S R; de Ruiter, Geoff C; Klimstra, M; Zehr, E Paul

2012-12-01

Suppression of soleus H-reflex amplitude in stationary legs is seen during rhythmic arm cycling. We examined the influence of various arm-cycling parameters on this interlimb reflex modulation to determine the origin of the effect. We previously showed the suppression to be graded with the frequency of arm cycling but not largely influenced by changes in peripheral input associated with crank length. Here, we more explicitly explored the contribution of afferent feedback related to arm movement on the soleus H-reflex suppression. We explored the influence of load and rate of muscle stretch by manipulating crank-load and arm-muscle vibration during arm cycling. Furthermore, internally driven ("Active") and externally driven ("Passive") arm cycling was compared. Soleus H-reflexes were evoked with tibial nerve stimulation during stationary control and rhythmic arm-cycling conditions, including: 1) six different loads; 2) with and without vibration to arm muscles; and 3) Active and Passive conditions. No significant differences were seen in the level of suppression between the different crank loads or between conditions with and without arm-muscle vibration. Furthermore, in contrast to the clear effect seen during active cycling, passive arm cycling did not significantly suppress the soleus H-reflex amplitude. Current results, in conjunction with previous findings, suggest that the afferent feedback examined in these studies is not the primary source responsible for soleus H-reflex suppression. Instead, it appears that central motor commands (supraspinal or spinal in origin) associated with frequency of arm cycling are relatively more dominant sources.

A Conceptual Working Paper on Arms Control Verification,

DTIC Science & Technology

1981-08-01

AD-AlIO 748 OPIRATIONAL RESEARCH AND ANALYSIS ESTABLISMENT OTTA-ETC F/S 5/4 -A CONCEPTUAL WORKING PAP" ON ARMS CONTROL VERItFCATION.(U) AUG 81 F R... researched for the paper comes from ORAE Report No. R73, Compendium of Arms Control Verification Proposals, submitted simultaneously to the Committee on...nuclear activities within the territory" of the non -nuclear weapon state, or carried out under its control anywhere. Parties also undertake not to

Darwin : The Third DOE ARM TWP ARCS Site /

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clements, William E.; Jones, L. A.; Baldwin, T.

2002-01-01

The United States Department of Energy's (DOE) Atmospheric Radiation Measurement (ARM) Program began operations in its Tropical Western Pacific (TWP) locale in October 1996 when the first Atmospheric Radiation and Cloud Station (ARCS) began collecting data on Manus Island in Papua New Guinea (PNG). Two years later, in November 1998, a second ARCS began operations on the island of Nauru in the Central Pacific. Now a third ARCS has begun collecting data in Darwin, Australia. The Manus, Nauru, and Darwin sites are operated through collaborative agreements with the PNG National Weather Service, The Nauru Department of Industry and Economic Developmentmore » (IED), and the Australian Bureau of Meteorology's (BOM) Special Services Unit (SSU) respectively. All ARM TWP activities in the region are coordinated with the South Pacific Regional Environment Programme (SPREP) based in Apia, Samoa. The Darwin ARM site and its role in the ARM TWP Program are discussed.« less

ARM Spacecraft Illustration

NASA Image and Video Library

2016-09-20

This graphic depicts the Asteroid Redirect Vehicle conducting a flyby of its target asteroid. During these flybys, the Asteroid Redirect Mission (ARM) would come within 0.6 miles (1 kilometer), generating imagery with resolution of up to 0.4 of an inch (1 centimeter) per pixel. The robotic segment of ARM will demonstrate advanced, high-power, high-throughput solar electric propulsion; advanced autonomous precision proximity operations at a low-gravity planetary body; and controlled touchdown and liftoff with a multi-ton mass. The crew segment of the mission will include spacewalk activities for sample selection, extraction, containment and return; and mission operations of integrated robotic and crewed vehicle stack -- all key components of future in-space operations for human missions to the Mars system. After collecting a multi-ton boulder from the asteroid, the robotic spacecraft will redirect the boulder to a crew-accessible orbit around the moon, where NASA plans to conduct a series of proving ground missions in the 2020s that will help validate capabilities needed for NASA's Journey to Mars. http://photojournal.jpl.nasa.gov/catalog/PIA21062

27 CFR 478.114 - Importation by members of the U.S. Armed Forces.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the U.S. Armed Forces. 478.114 Section 478.114 Alcohol, Tobacco Products, and Firearms BUREAU OF... FIREARMS AND AMMUNITION Importation § 478.114 Importation by members of the U.S. Armed Forces. (a) The... to the place of residence of any military member of the U.S. Armed Forces who is on active duty...

27 CFR 478.114 - Importation by members of the U.S. Armed Forces.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the U.S. Armed Forces. 478.114 Section 478.114 Alcohol, Tobacco Products, and Firearms BUREAU OF... FIREARMS AND AMMUNITION Importation § 478.114 Importation by members of the U.S. Armed Forces. (a) The... to the place of residence of any military member of the U.S. Armed Forces who is on active duty...

ARM Mentor Selection Process

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sisterson, D. L.

2015-10-01

The Atmospheric Radiation Measurement (ARM) Program was created in 1989 with funding from the U.S. Department of Energy (DOE) to develop several highly instrumented ground stations to study cloud formation processes and their influence on radiative transfer. In 2003, the ARM Program became a national scientific user facility, known as the ARM Climate Research Facility. This scientific infrastructure provides for fixed sites, mobile facilities, an aerial facility, and a data archive available for use by scientists worldwide through the ARM Climate Research Facility—a scientific user facility. The ARM Climate Research Facility currently operates more than 300 instrument systems that providemore » ground-based observations of the atmospheric column. To keep ARM at the forefront of climate observations, the ARM infrastructure depends heavily on instrument scientists and engineers, also known as lead mentors. Lead mentors must have an excellent understanding of in situ and remote-sensing instrumentation theory and operation and have comprehensive knowledge of critical scale-dependent atmospheric processes. They must also possess the technical and analytical skills to develop new data retrievals that provide innovative approaches for creating research-quality data sets. The ARM Climate Research Facility is seeking the best overall qualified candidate who can fulfill lead mentor requirements in a timely manner.« less

The effect of swinging the arms on muscle activation and production of leg force during ski skating at different skiing speeds.

PubMed

Göpfert, Caroline; Lindinger, Stefan J; Ohtonen, Olli; Rapp, Walter; Müller, Erich; Linnamo, Vesa

2016-06-01

The study investigated the effects of arm swing during leg push-off in V2-alternate/G4 skating on neuromuscular activation and force production by the leg muscles. Nine skilled cross-country skiers performed V2-alternate skating without poles at moderate, high, and maximal speeds, both with free (SWING) and restricted arm swing (NOSWING). Maximal speed was 5% greater in SWING (P<0.01), while neuromuscular activation and produced forces did not differ between techniques. At both moderate and high speed the maximal (2% and 5%, respectively) and average (both 5%) vertical force and associated impulse (10% and 14%) were greater with SWING (all P<0.05). At high speed range of motion and angular velocity of knee flexion were 24% greater with SWING (both P<0.05), while average EMG of m. biceps femoris was 31% lower (all P<0.05) in SWING. In a similar manner, the average EMG of m. vastus medialis and m. biceps femoris were lower (17% and 32%, P<0.05) during the following knee extension. Thus, swinging the arms while performing V2-alternate can enhance both maximal speed and skiing economy at moderate and, in particularly, high speeds. Copyright © 2016 Elsevier B.V. All rights reserved.

How do octopuses use their arms?

PubMed

Mather, J A

1998-09-01

A taxonomy of the movement patterns of the 8 flexible arms of octopuses is constructed. Components consist of movements of the arm itself, the ventral suckers and their stalks, as well as the relative position of arms and the skin web between them. Within 1 arm, combinations of components result in a variety of behaviors. At the level of all arms, 1 group of behaviors is described as postures, on the basis of the spread of all arms and the web to make a 2-dimensional surface whose position differs in the 3rd dimension. Another group of arm behaviors is actions, more or less coordinated and involving several to all arms. Arm control appears to be based on radial symmetry, relative equipotentiality of all arms, relative independence of each arm, and separability of components within the arm. The types and coordination of arm behaviors are discussed with relationship to biomechanical limits, muscle structures, and neuronal programming.

Arm Injuries and Disorders

MedlinePlus

... your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, ... Injuries to any of these parts of the arm can occur during sports, a fall, or an ...

Research on the measurement technology of effective arm length of swing arm profilometer

NASA Astrophysics Data System (ADS)

Chen, Lin; Jing, Hongwei; Wei, Zhongwei; Li, Jie; Cao, Xuedong

2014-09-01

When the swing arm profilometer(SAP) measuring the mirror, the effective arm length of SAP which haves an obvious influence on the measurement results of the mirror surface shape needs to be measured accurately. It requires the measurement uncertainty of the effective arm length to reach 10μm in order to meet the measurement requirements, in this paper, we present a kind of technology based on laser tracker to measure the effective arm length of SAP. When the swing arm rotates around the shaft axis of swing arm rotary stage, the probe and two laser tracker balls form three sections of circular arc around the shaft axis of swing arm rotary stage in space. Laser tracker tracks and measures the circular arcs of two laser tracker balls, the center coordinates of the circular plane of circular arc can be calculated by data processing. The linear equation that passes through the two center coordinates is the equation of the shaft axis of rotary stage, the vertical distance from the probe to the shaft axis of rotary stage which can be calculated refer to the equation from the point to the line is the effective arm length. After Matlab simulation, this measurement method can meet the measurement accuracy.

Effect of Tendon Vibration on Hemiparetic Arm Stability in Unstable Workspaces.

PubMed

Conrad, Megan O; Gadhoke, Bani; Scheidt, Robert A; Schmit, Brian D

2015-01-01

Sensory stimulation of wrist musculature can enhance stability in the proximal arm and may be a useful therapy aimed at improving arm control post-stroke. Specifically, our prior research indicates tendon vibration can enhance stability during point-to-point arm movements and in tracking tasks. The goal of the present study was to investigate the influence of forearm tendon vibration on endpoint stability, measured at the hand, immediately following forward arm movements in an unstable environment. Both proximal and distal workspaces were tested. Ten hemiparetic stroke subjects and 5 healthy controls made forward arm movements while grasping the handle of a two-joint robotic arm. At the end of each movement, the robot applied destabilizing forces. During some trials, 70 Hz vibration was applied to the forearm flexor muscle tendons. 70 Hz was used as the stimulus frequency as it lies within the range of optimal frequencies that activate the muscle spindles at the highest response rate. Endpoint position, velocity, muscle activity and grip force data were compared before, during and after vibration. Stability at the endpoint was quantified as the magnitude of oscillation about the target position, calculated from the power of the tangential velocity data. Prior to vibration, subjects produced unstable, oscillating hand movements about the target location due to the applied force field. Stability increased during vibration, as evidenced by decreased oscillation in hand tangential velocity.

Effect of Tendon Vibration on Hemiparetic Arm Stability in Unstable Workspaces

PubMed Central

Conrad, Megan O.; Gadhoke, Bani; Scheidt, Robert A.; Schmit, Brian D.

2015-01-01

Sensory stimulation of wrist musculature can enhance stability in the proximal arm and may be a useful therapy aimed at improving arm control post-stroke. Specifically, our prior research indicates tendon vibration can enhance stability during point-to-point arm movements and in tracking tasks. The goal of the present study was to investigate the influence of forearm tendon vibration on endpoint stability, measured at the hand, immediately following forward arm movements in an unstable environment. Both proximal and distal workspaces were tested. Ten hemiparetic stroke subjects and 5 healthy controls made forward arm movements while grasping the handle of a two-joint robotic arm. At the end of each movement, the robot applied destabilizing forces. During some trials, 70 Hz vibration was applied to the forearm flexor muscle tendons. 70 Hz was used as the stimulus frequency as it lies within the range of optimal frequencies that activate the muscle spindles at the highest response rate. Endpoint position, velocity, muscle activity and grip force data were compared before, during and after vibration. Stability at the endpoint was quantified as the magnitude of oscillation about the target position, calculated from the power of the tangential velocity data. Prior to vibration, subjects produced unstable, oscillating hand movements about the target location due to the applied force field. Stability increased during vibration, as evidenced by decreased oscillation in hand tangential velocity. PMID:26633892

Evolving Arms Transfer Rationales: The Case of Italy

DTIC Science & Technology

1987-06-01

began to 5 Libro Bianco-La Difesa, 1977, 57-92. 6 1bid. 23 reconstitute and reequip her armed forces. The 1950’s were tumultuous for the activity in...discussion of the early arms trade in Italy. 8 La Difesa-- Libro Bianco, Ministero della Difesa d’Italia, 1985. 74. 24 in recognizing the problem, the... Libro Bianco, p.xiv. This quote is a portion of the introduction to the White Book written by the Minister of Defense, Giovanni Spadolini. 31 however

A sorrow shared is a sorrow halved? A three-arm randomized controlled trial comparing internet-based clinician-guided individual versus group treatment for social anxiety disorder.

PubMed

Schulz, Ava; Stolz, Timo; Vincent, Alessia; Krieger, Tobias; Andersson, Gerhard; Berger, Thomas

2016-09-01

A growing body of evidence suggests that internet-based cognitive behavioural treatments (ICBT) are effective to treat social anxiety disorder (SAD). Whereas the efficacy of clinician-guided ICBT has been established, ICBT in a group format has not yet been systematically investigated. This three-arm RCT compared the efficacy of clinician-guided group ICBT (GT) with clinician guided individual ICBT (IT) and a wait-list (WL). A total of 149 individuals meeting the diagnostic criteria for SAD were randomly assigned to one of three conditions. Primary endpoints were self-report measures of SAD and diagnostic status taken at baseline, after the twelve-week intervention and at six-month follow-up. Secondary endpoints were symptoms of depression, interpersonal problems and general symptomatology. At post-treatment, both active conditions showed superior outcome regarding SAD symptoms (GT vs. WL: d = 0.84-0.74; IT vs. WL: d = 0.94-1.22). The two active conditions did not differ significantly in symptom reduction (d = 0.12-0.26, all ps > 0.63), diagnostic response rate or attrition. Treatment gains were maintained at follow-up. The group format reduced weekly therapist time per participant by 71% (IT: 17 min, GT: 5 min). Findings indicate that a clinician-guided group format is a promising approach in treating SAD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Biodiversity conservation and armed conflict: a warfare ecology perspective.

PubMed

Hanson, Thor

2018-04-23

The activities involved in preparing for, executing, and recovering from armed conflict are globally pervasive and consequential, with significant impacts on natural systems. Effects on biodiversity are predominantly negative, produced by direct and indirect battlefield impacts, as well as the general breakdown of social, economic, and governance systems during wartime. Certain conservation opportunities do occur, however, particularly on lands set aside for training exercises, buffer zones, and peace parks. Here, the relationship between armed conflict and biodiversity is reviewed using the temporal framework of warfare ecology, which defines warfare as an ongoing process of three overlapping stages: preparations, war (armed conflict), and postwar activities. Several themes emerge from recent studies, including a heightened awareness of biodiversity conservation on military lands, the potential for scientific and conservation engagement to mitigate negative biodiversity impacts in war zones, and the importance of the postwar period for incorporating biodiversity priorities into reconstruction and recovery efforts. Research limitations and knowledge gaps are also discussed. © 2018 New York Academy of Sciences.

A Retrospective Study of the Effects of Oncology Pharmacist Participation in Treatment on Therapeutic Outcomes and Medical Costs.

PubMed

Imamura, Makio; Ogawa, Daisuke; Takatori, Toshikazu; Yamaguchi, Maiko; Takata, Tomoyuki; Hada, Tomonori; Ota, Yoshiaki; Uehara, Takashi

2017-01-01

Specialist oncology pharmacists are being trained in Japan to assist cancer treatment teams. These specialized pharmacists address patients' physical and mental problems in pharmacist-managed cancer care clinics, actively participate in formulating treatment policies, and are beneficial in offering qualitative improvements to patient services and team medical care. However, the effect of outpatient treatment by oncology pharmacists on therapeutic outcomes and medical costs is still unknown. A retroactive comparative analysis of the treatment details and clinical course was conducted among three groups of patients: patients who underwent adjuvant chemotherapy managed by a gynecologic oncologist only (S arm), patients managed by a non-oncologist (general practice gynecologist) only (NS arm), and patients managed by both a non-oncologist and a specialist oncology pharmacist (NS+Ph arm). The medical cost per course was significantly lower for patients in the NS+Ph arm than for those in the other two arms. Surprisingly, the outpatient treatment rate in the NS+Ph arm was overwhelmingly high. The involvement of an oncology pharmacist did not make a significant difference in therapeutic outcomes such as recurrence rate and survival. The participation of oncology pharmacists in the management of cancer patients undergoing chemotherapy enables safe outpatient treatment and also reduces medical costs.

Locomotor-Like Leg Movements Evoked by Rhythmic Arm Movements in Humans

PubMed Central

Sylos-Labini, Francesca; Ivanenko, Yuri P.; MacLellan, Michael J.; Cappellini, Germana; Poppele, Richard E.; Lacquaniti, Francesco

2014-01-01

Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e. whether arm movements can affect the lumbosacral locomotor circuitry. Here we tested the effects of voluntary rhythmic arm movements on the lower limbs. Participants lay horizontally on their side with each leg suspended in an unloading exoskeleton. They moved their arms on an overhead treadmill as if they walked on their hands. Hand-walking in the antero-posterior direction resulted in significant locomotor-like movements of the legs in 58% of the participants. We further investigated quantitatively the responses in a subset of the responsive subjects. We found that the electromyographic (EMG) activity of proximal leg muscles was modulated over each cycle with a timing similar to that of normal locomotion. The frequency of kinematic and EMG oscillations in the legs typically differed from that of arm oscillations. The effect of hand-walking was direction specific since medio-lateral arm movements did not evoke appreciably leg air-stepping. Using externally imposed trunk movements and biomechanical modelling, we ruled out that the leg movements associated with hand-walking were mainly due to the mechanical transmission of trunk oscillations. EMG activity in hamstring muscles associated with hand-walking often continued when the leg movements were transiently blocked by the experimenter or following the termination of arm movements. The present results reinforce the idea that there exists a functional neural coupling between arm and legs. PMID:24608249

The effects of additional arm weights on arm-swing magnitude and gait patterns in Parkinson's disease.

PubMed

Yoon, Jiyeon; Park, Jinse; Park, Kunbo; Jo, Geunyeol; Kim, Haeyu; Jang, Wooyoung; Kim, Ji Sun; Youn, Jinyoung; Oh, Eung Seok; Kim, Hee-Tae; Youm, Chang Hong

2016-01-01

Recently, arm facilitation has been interested in gait rehabilitation. However, there have been few studies concerning arm facilitation in patients with Parkinson's disease (PD). The aim of our study was to investigate the effect of increasing arm weights on gait pattern in patients with PD. Twenty-seven patients with PD were enrolled, and they underwent gait analysis using a three-dimensional motion capture system. Sandbags were applied to the distal forearms in all participants. We compared gait parameters including arm swing, pelvic motion, spatiotemporal data, and relative rotational angle between the weighted and unweighted gaits. The total arm-swing amplitude and pelvic rotation were significantly higher when walking with additional arm weights than without arm weights. Cadence, walking speed, stride length, and swing phase were significantly higher, whereas stride time, double-support time, and stance phase were significantly lower, when walking with additional arm weights than without arm weights. We conclude that adding weights to the arm during walking may facilitate arm and pelvic movements, which results in changes to gait patterns. The therapeutic use of additional arm weights could be considered for gait rehabilitation in PD to improve gait impairment. Arm-swing facilitation using weight load improved gait in Parkinson's disease. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Computer interface for mechanical arm

NASA Technical Reports Server (NTRS)

Derocher, W. L.; Zermuehlen, R. O.

1978-01-01

Man/machine interface commands computer-controlled mechanical arm. Remotely-controlled arm has six degrees of freedom and is controlled through "supervisory-control" mode, in which all motions of arm follow set of preprogramed sequences. For simplicity, few prescribed commands are required to accomplish entire operation. Applications include operating computer-controlled arm to handle radioactive of explosive materials or commanding arm to perform functions in hostile environments. Modified version using displays may be applied in medicine.

The metabolic cost of human running: is swinging the arms worth it?

PubMed

Arellano, Christopher J; Kram, Rodger

2014-07-15

Although the mechanical function is quite clear, there is no consensus regarding the metabolic benefit of arm swing during human running. We compared the metabolic cost of running using normal arm swing with the metabolic cost of running while restricting the arms in three different ways: (1) holding the hands with the arms behind the back in a relaxed position (BACK), (2) holding the arms across the chest (CHEST) and (3) holding the hands on top of the head (HEAD). We hypothesized that running without arm swing would demand a greater metabolic cost than running with arm swing. Indeed, when compared with running using normal arm swing, we found that net metabolic power demand was 3, 9 and 13% greater for the BACK, CHEST and HEAD conditions, respectively (all P<0.05). We also found that when running without arm swing, subjects significantly increased the peak-to-peak amplitudes of both shoulder and pelvis rotation about the vertical axis, most likely a compensatory strategy to counterbalance the rotational angular momentum of the swinging legs. In conclusion, our findings support our general hypothesis that swinging the arms reduces the metabolic cost of human running. Our findings also demonstrate that arm swing minimizes torso rotation. We infer that actively swinging the arms provides both metabolic and biomechanical benefits during human running. © 2014. Published by The Company of Biologists Ltd.

Effects of sling and voluntary constraint during constraint-induced movement therapy for the arm after stroke: a randomized, prospective, single-centre, blinded observer rated study.

PubMed

Krawczyk, Maciej; Sidaway, Marta; Radwanska, Anna; Zaborska, Joanna; Ujma, Renata; Czlonkowska, Anna

2012-11-01

To determine whether a combination of constraint-induced movement therapy and physiotherapy in stroke patients using different constraint regimens (sling versus voluntary constraint) changes or reduces motor deficits, the amount of functional use of the arm and whether the effects of treatment continue after 12 months. Forty-seven stroke patients were stratified and randomly divided into intensive physiotherapy programmes focused on regaining arm functions. Neurorehabilitation Unit of IInd Department of Neurology at Institute of Psychiatry and Neurology in Warsaw. Patients were randomly allocated to: the sling-constraint group (n = 24) or to the voluntary-constraint group (n = 23). Massed practice with the paretic arm (5 hours/day for 15 consecutive working days). Sling-constraint group had their arm immobilized in a hemi-sling during therapy. In addition, individual, 1-hour physiotherapy sessions were conducted in both groups. Rivermead Motor Assessment (RMA) Arm scale, (0-15), Motor Activity Log - Quality of Movement (MAL-QOM) (0-5 for 30 daily tasks). There was no significant difference between groups after therapy (MAL-QOM mean change for sling group 0.78, SD = 0.46 and for voluntary-constraint group 0.84, SD = 0.48; P = 0.687). All treated patients retained mean gains in real-world arm use (MAL-QOM) mean scores after 12 months follow-up compared with posttreatment values but there was no significant difference between groups (comparison of estimated mean change of MAL-QOM stated 0.23. 95% confidence interval = -0.04-0.50). Voluntary activity constraint in the intact arm is equivalent to sling, standard constraint during massed practice of paretic arm.

Silymarin (Livergol®) Decreases Disease Activity Score in Patients with Rheumatoid Arthritis: A Non-randomized Single-arm Clinical Trial.

PubMed

Shavandi, Mehrdad; Moini, Ali; Shakiba, Yadollah; Mashkorinia, Ahamad; Dehghani, Milad; Asar, Shirin; Kiani, Amir

2017-04-01

Rheumatoid arthritis (RA) is a chronic autoimmune disease, which can lead to joint destruction and disability. Pannus formation due to chronic synovitis is the hallmark of RA. Oxidative stress as a consequence of immune cell activation and disease-modifying anti-rheumatic drugs can prevent inflammation and tissue destruction. Silymarin, an antioxidant extract from Silybum marianum, has been traditionally used for the treatment of liver diseases for decades. In the present non-randomized single-arm clinical trial (NRSACT) study we evaluated the effects of silymarin tablet (Livergol®) on inflammatory markers in stable RA patients. Disease activity score (DAS-28) was measured before and after adding silymarin to standard drug regimen used for controlling inflammation in RA patients. Silymarin significantly reduced the DAS28 related symptoms in 44 RA patients after 90 days (3.02±0.98 versus 2.3±0.74, p<0.001). The exact mechanism of therapeutic effects of silymarin in RA patients is not clear but it could be as the results of its anti-inflammatory and anti-oxidative properties. Conducting the study on larger number of patients and also measuring cytokines levels including TNF-α and IL-1β may clarify the underlying mechanisms of the anti-inflammatory effects of silymarin in RA patients.

Septal serotonin depletion in rats facilitates working memory in the radial arm maze and increases hippocampal high-frequency theta activity.

PubMed

López-Vázquez, Miguel Ángel; López-Loeza, Elisa; Lajud Ávila, Naima; Gutiérrez-Guzmán, Blanca Erika; Hernández-Pérez, J Jesús; Reyes, Yoana Estrada; Olvera-Cortés, María Esther

2014-07-05

Hippocampal theta activity, which is strongly modulated by the septal medial/Broca׳s diagonal band neurons, has been linked to information processing of the hippocampus. Serotonin from the medial raphe nuclei desynchronises hippocampal theta activity, whereas inactivation or a lesion of this nucleus induces continuous and persistent theta activity in the hippocampus. Hippocampal serotonin depletion produces an increased expression of high-frequency theta activity concurrent with the facilitation of place learning in the Morris maze. The medial septum-diagonal band of Broca complex (MS/DBB) has been proposed as a key structure in the serotonin modulation of theta activity. We addressed whether serotonin depletion of the MS/DBB induces changes in the characteristics of hippocampal theta activity and whether the depletion is associated with learning in a working memory spatial task in the radial arm maze. Sprague Dawley rats were depleted of 5HT with the infusion of 5,7-dihydroxytriptamine (5,7-DHT) in MS/DBB and were subsequently trained in the standard test (win-shift) in the radial arm, while the CA1 EEG activity was simultaneously recorded through telemetry. The MS/DBB serotonin depletion induced a low level of expression of low-frequency (4.5-6.5Hz) and a higher expression of high-frequency (6.5-9.5Hz) theta activity concomitant to a minor number of errors committed by rats on the working memory test. Thus, the depletion of serotonin in the MS/DBB caused a facilitator effect on working memory and a predominance of high-frequency theta activity. Copyright © 2014 Elsevier B.V. All rights reserved.

Statistical Approaches to Adjusting Weights for Dependent Arms in Network Meta-analysis.

PubMed

Su, Yu-Xuan; Tu, Yu-Kang

2018-05-22

Network meta-analysis compares multiple treatments in terms of their efficacy and harm by including evidence from randomized controlled trials. Most clinical trials use parallel design, where patients are randomly allocated to different treatments and receive only one treatment. However, some trials use within person designs such as split-body, split-mouth and cross-over designs, where each patient may receive more than one treatment. Data from treatment arms within these trials are no longer independent, so the correlations between dependent arms need to be accounted for within the statistical analyses. Ignoring these correlations may result in incorrect conclusions. The main objective of this study is to develop statistical approaches to adjusting weights for dependent arms within special design trials. In this study, we demonstrate the following three approaches: the data augmentation approach, the adjusting variance approach, and the reducing weight approach. These three methods could be perfectly applied in current statistic tools such as R and STATA. An example of periodontal regeneration was used to demonstrate how these approaches could be undertaken and implemented within statistical software packages, and to compare results from different approaches. The adjusting variance approach can be implemented within the network package in STATA, while reducing weight approach requires computer software programming to set up the within-study variance-covariance matrix. This article is protected by copyright. All rights reserved.

The effects of mirror therapy on arm and hand function in subacute stroke in patients.

PubMed

Radajewska, Alina; Opara, Józef A; Kucio, Cezary; Błaszczyszyn, Monika; Mehlich, Krzysztof; Szczygiel, Jarosław

2013-09-01

The aim of this study was to evaluate the effect of mirror therapy on arm and hand function in subacute stroke in patients. The study included 60 hemiparetic right-handed patients after ischemic stroke 8-10 weeks after onset. They underwent stationary comprehensive rehabilitation in the rehabilitation centre. They were divided into two randomly assigned groups: mirror (n=30) and control (n=30). For both groups, two subgroups were created: one that included patients with right arm paresis (n=15) and the other that included patients with left arm paresis (n=15). The mirror group received an additional intervention: training with a mirror for 5 days/week, 2 sessions/day, for 21 days. Each single session lasted for 15 min. The control group (n=30) underwent a conventional rehabilitation program without mirror therapy. To evaluate self-care in performing activities of daily living, the Functional Index 'Repty' was used. To evaluate hand and arm function, the Frenchay Arm Test and the Motor Status Score were used. Measurements were performed twice: before and after 21 days of applied rehabilitation. No significant improvement in hand and arm function in both subgroups in Frenchay Arm Test and Motor Status Score scales was observed. However, there was a significant improvement in self-care of activities of daily living in the right arm paresis subgroup in the mirror group measured using the Functional Index 'Repty'. Mirror therapy improves self-care of activities of daily living for patients with right arm paresis after stroke.

Activity and immobilization after eccentric exercise: II. Serum CK.

PubMed

Sayers, S P; Clarkson, P M; Lee, J

2000-09-01

The purpose of the present study was to examine the effect of muscle activity level on serum creatine kinase (CK) activity after high-force eccentric exercise of the elbow flexors. Twenty-six male volunteers were randomly assigned to one of three groups for a 4-d treatment period after exercise: immobilization (N = 9), control (N = 8), and light exercise (N = 9). During the treatment period, the immobilization group had their arm casted and supported in a sling at 90 degrees. The control group had no restriction of their arm activity. The light exercise group performed a daily exercise regimen of 50 biceps curls with a 5-lb dumbbell. Serum CK activity was obtained by venipuncture for three consecutive days before eccentric exercise and during the 4-d treatment period. To quantify activity of the arm, CSA (Computer Science and Applications, Inc.) activity-monitoring devices were worn. Serum CK measurements revealed that there was a significant group by time interaction in the analysis of variance (P < 0.05). Peak serum CK activity of the immobilized group (668 IU) was lower than either the control (4230 IU) or light exercise (2740 IU) group. During the treatment period, activity level among the three groups was significantly different from each other (P < 0.001): 529 counts x min(-1) for the immobilization group, 944 counts x min(-1) for the control group, and 1334 counts x min(-1) for the light exercise group. These results suggest that immobilization of exercised damaged muscle during recovery significantly blunted serum CK activity, which may be due to attenuated removal of CK from the muscle and/or decrease lymphatic transport.

Effects of spiral arms on star formation in nuclear rings of barred-spiral galaxies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seo, Woo-Young; Kim, Woong-Tae, E-mail: seowy@astro.snu.ac.kr, E-mail: wkim@astro.snu.ac.kr

2014-09-01

We use hydrodynamic simulations to study the effect of spiral arms on the star formation rate (SFR) in nuclear rings of barred-spiral galaxies. We find that spiral arms can be an efficient means of gas transport from the outskirts to the central parts, provided that the arms are rotating slower than the bar. While the ring star formation in models with no arms or corotating arms is active only during around the bar growth phase, arm-driven gas accretion both significantly enhances and prolongs the ring star formation in models with slow-rotating arms. The arm-enhanced SFR is larger by a factormore » of ∼3-20 than in the no-arm model, with larger values corresponding to stronger and slower arms. Arm-induced mass inflows also make dust lanes stronger. Nuclear rings in slow-arm models are ∼45% larger than in the no-arm counterparts. Star clusters that form in a nuclear ring exhibit an age gradient in the azimuthal direction only when the SFR is small, whereas no notable age gradient is found in the radial direction for models with arm-induced star formation.« less

Coordination of multiple robot arms

NASA Technical Reports Server (NTRS)

Barker, L. K.; Soloway, D.

1987-01-01

Kinematic resolved-rate control from one robot arm is extended to the coordinated control of multiple robot arms in the movement of an object. The structure supports the general movement of one axis system (moving reference frame) with respect to another axis system (control reference frame) by one or more robot arms. The grippers of the robot arms do not have to be parallel or at any pre-disposed positions on the object. For multiarm control, the operator chooses the same moving and control reference frames for each of the robot arms. Consequently, each arm then moves as though it were carrying out the commanded motions by itself.

The effects of arm movement on reaction time in patients with latent and active upper trapezius myofascial trigger point.

PubMed

Yassin, Marzieh; Talebian, Saeed; Ebrahimi Takamjani, Ismail; Maroufi, Nader; Ahmadi, Amir; Sarrafzadeh, Javad; Emrani, Anita

2015-01-01

Myofascial pain syndrome is a significant source of mechanical pain. The aim of this study was to investigate the effects of arm movement on reaction time in females with latent and active upper trapezius myofascial trigger point. In this interventional study, a convenience sample of fifteen women with one active MTP, fifteen women with one latent MTP in the upper trapezius, and fifteen normal healthy women were participated. Participants were asked to stand for 10 seconds in an erect standing position. Muscle reaction times were recorded including anterior deltoid (AD), cervical paraspinal (CP) lumbar paraspinal (LP), both of upper trapezius (UT), sternocleidomastoid (SCM) and medial head of gastrocnemius (GcM). Participants were asked to flex their arms in response to a sound stimulus preceded by a warning sound stimulus. Data were analyzed using one-way ANOVA Test. There was significant differences in motor time and reaction time between active and control groups (p< 0.05) except for GcM. There was no significant difference in motor time between active and passive groups except for UT without MTP and SCM (p< 0.05). Also, there were no significant differences in motor times between latent MTP and control groups. Furthermore, there was no significant difference in premotor times between the three groups. The present study shows that patients with active MTP need more time to react to stimulus, but patients with latent MTP are similar to healthy subjects in the reaction time. Patients with active MTP had less compatibility with environmental stimulations, and they responded to a specific stimulation with variability in Surface Electromyography (SEMG).

Radial arm strike rail

DOEpatents

McKeown, Mark H.; Beason, Steven C.

1991-01-01

The radial arm strike rail assembly is a system for measurement of bearings, directions, and stereophotography for geologic mapping, particularly where magnetic compasses are not appropriate. The radial arm, pivoting around a shaft axis, provides a reference direction determination for geologic mapping and bearing or direction determination. The centerable and levelable pedestal provide a base for the radial arm strike rail and the telescoping camera pedestal. The telescoping feature of the radial arm strike rail allows positioning the end of the rail for strike direction or bearing measurement with a goniometer.

Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.

PubMed

Francisco, Gerard E; Yozbatiran, Nuray; Berliner, Jeffrey; OʼMalley, Marcia K; Pehlivan, Ali Utku; Kadivar, Zahra; Fitle, Kyle; Boake, Corwin

2017-10-01

The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.

Armed conflict and child health.

PubMed

Rieder, Michael; Choonara, Imti

2012-01-01

Armed conflict has a major impact on child health throughout the world. One in six children worldwide lives in an area of armed conflict and civilians are more likely to die than soldiers as a result of the conflict. In stark contrast to the effect on children, the international arms trade results in huge profits for the large corporations involved in producing arms, weapons and munitions. Armed conflict is not inevitable but is an important health issue that should be prevented.

Effects and effectiveness of dynamic arm supports: a technical review.

PubMed

van der Heide, Loek A; Gelderblom, Gert Jan; de Witte, Luc P

2015-01-01

Numerous dynamic arm supports have been developed in recent decades to increase independence in the performance of activities of daily living. Much effort and money have been spent on their development and prescription, yet insight into their effects and effectiveness is lacking. This article is a systematic review of evaluations of dynamic arm supports. The 8 technical evaluations, 12 usability evaluations, and 27 outcome studies together make 47 evaluations. Technical evaluations were often used as input for new developments and directed at balancing quality, forces and torques, and range of motion of prototypes. Usability studies were mostly single-measure designs that had varying results as to whether devices were usable for potential users. An increased ability to perform activities of daily living and user satisfaction were reported in outcome studies. However, the use of dynamic arm supports in the home situation was reported to be low. Gaining insight into why devices are not used when their developers believe them to be effective seems crucial for every new dynamic arm support developed. The methodological quality of the outcome studies was often low, so it is important that this is improved in the future.

New Horizons and New Strategies in Arms Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, J. editor

In the last ten years, since the break-up of the Soviet Union, remarkable progress in arms control and disarmament has occurred. The Nuclear Non-Proliferation Treaty (NPT), the completion of the Comprehensive Test Ban Treaty (CTBT), and the Chemical Weapons Treaty (CWC) are indicative of the great strides made in the non- proliferation arena. Simultaneously, the Intermediate Nuclear Forces Treaty (INF), the Conventional Forces Treaty in Europe (CFE), and the Strategic Arms Reduction Treaties (START), all associated with US-Soviet Union (now Russia) relations have assisted in redefining European relations and the security landscape. Finally, it now appears that progress is inmore » the offing in developing enhanced compliance measures for the Biological and Toxin Weapons Convention (BTWC). In sum, all of these achievements have set the stage for the next round of arms control activities, which may lead to a much broader, and perhaps more diffused multilateral agenda. In this new and somewhat unpredictable international setting, arms control and disarmament issues will require solutions that are both more creative and innovative than heretofore.« less

Comparable Neutrophil Responses for Arm and Intensity-matched Leg Exercise.

PubMed

Leicht, Christof A; Goosey-Tolfrey, Victoria L; Bishop, Nicolette C

2017-08-01

Arm exercise is performed at lower absolute intensities than lower body exercise. This may impact on intensity-dependent neutrophil responses, and it is unknown whether individuals restricted to arm exercise experience the same changes in the neutrophil response as found for lower body exercise. Therefore, we aimed to investigate the importance of exercise modality and relative exercise intensity on the neutrophil response. Twelve moderately trained men performed three 45-min constant load exercise trials after determination of peak oxygen uptake for arm exercise (V˙O2peak arms) and cycling (V˙O2peak legs): 1) arm cranking exercise at 60% V˙O2peak arms, 2) moderate cycling at 60% V˙O2peak legs, and 3) easy cycling at 60% V˙O2peak arms. Neutrophil numbers in the circulation increased for all exercise trials, but were significantly lower for easy cycling when compared with arm exercise (P = 0.009), mirroring the blunted increase in HR and epinephrine during easy cycling. For all trials, exercising HR explained some of the variation of the neutrophil number 2 h postexercise (R = 0.51-0.69), epinephrine explaining less of this variation (R = 0.21-0.34). The number of neutrophils expressing CXCR2 decreased in the recovery from exercise in all trials (P < 0.05). Arm and leg exercise elicits the same neutrophil response when performed at the same relative intensity, implying that populations restricted to arm exercise might achieve a similar exercise induced neutrophil response as those performing lower body exercise. A likely explanation for this is the higher sympathetic activation and cardiac output for arm and relative intensity-matched leg exercise when compared with easy cycling, which is partly reflected in HR. This study further shows that the downregulation of CXCR2 may be implicated in exercise-induced neutrophilia.

Visual Display of 5p-arm and 3p-arm miRNA Expression with a Mobile Application.

PubMed

Pan, Chao-Yu; Kuo, Wei-Ting; Chiu, Chien-Yuan; Lin, Wen-Chang

2017-01-01

MicroRNAs (miRNAs) play important roles in human cancers. In previous studies, we have demonstrated that both 5p-arm and 3p-arm of mature miRNAs could be expressed from the same precursor and we further interrogated the 5p-arm and 3p-arm miRNA expression with a comprehensive arm feature annotation list. To assist biologists to visualize the differential 5p-arm and 3p-arm miRNA expression patterns, we utilized a user-friendly mobile App to display. The Cancer Genome Atlas (TCGA) miRNA-Seq expression information. We have collected over 4,500 miRNA-Seq datasets from 15 TCGA cancer types and further processed them with the 5p-arm and 3p-arm annotation analysis pipeline. In order to be displayed with the RNA-Seq Viewer App, annotated 5p-arm and 3p-arm miRNA expression information and miRNA gene loci information were converted into SQLite tables. In this distinct application, for any given miRNA gene, 5p-arm miRNA is illustrated on the top of chromosome ideogram and 3p-arm miRNA is illustrated on the bottom of chromosome ideogram. Users can then easily interrogate the differentially 5p-arm/3p-arm expressed miRNAs with their mobile devices. This study demonstrates the feasibility and utility of RNA-Seq Viewer App in addition to mRNA-Seq data visualization.

Armed conflict and child health

PubMed Central

Rieder, Michael; Choonara, Imti

2012-01-01

Summary Armed conflict has a major impact on child health throughout the world. One in six children worldwide lives in an area of armed conflict and civilians are more likely to die than soldiers as a result of the conflict. In stark contrast to the effect on children, the international arms trade results in huge profits for the large corporations involved in producing arms, weapons and munitions. Armed conflict is not inevitable but is an important health issue that should be prevented. PMID:21393303

TCLS ARM for Space

NASA Astrophysics Data System (ADS)

Poupat, Jean-Luc; Leroy, Benoit; Helfers, Tim

2016-08-01

The TCLS ARM FOR SPACE proposal was an answer to the H2020 topic "COMPET-6-2014: Bottom-up Space Technologies at low TRL".This paper presents the status on this H2020 TCLS ARM FOR SPACE initiative led by Airbus DS and which aims at fostering the use of European technology such as ARM processing for Space.

Effects of wrist tendon vibration on targeted upper-arm movements in poststroke hemiparesis.

PubMed

Conrad, Megan O; Scheidt, Robert A; Schmit, Brian D

2011-01-01

Impaired motor control of the upper extremity after stroke may be related to lost sensory, motor, and integrative functions of the brain. Artificial activation of sensory afferents might improve control of movement by adding excitatory drive to sensorimotor control structures. The authors evaluated the effect of wrist tendon vibration (TV) on paretic upper-arm stability during point-to-point planar movements. TV (70 Hz) was applied to the forearm wrist musculature of 10 hemiparetic stroke patients as they made center-out planar arm movements. End-point stability, muscle activity, and grip pressure were compared as patients stabilized at the target position for trials completed before, during, and after the application of the vibratory stimulus. Prior to vibration, hand position fluctuated as participants attempted to maintain the hand at the target after movement termination. TV improved arm stability, as evidenced by decreased magnitude of hand tangential velocity at the target. Improved stability was accompanied by a decrease in muscle activity throughout the arm as well as a mean decrease in grip pressure. These results suggest that vibratory stimulation of the distal wrist musculature enhances stability of the proximal arm and can be studied further as a mode for improving end-point stability during reaching in hemiparetic patients.

Load emphasizes muscle effort minimization during selection of arm movement direction

PubMed Central

2012-01-01

Background Directional preferences during center-out horizontal shoulder-elbow movements were previously established for both the dominant and non-dominant arm with the use of a free-stroke drawing task that required random selection of movement directions. While the preferred directions were mirror-symmetrical in both arms, they were attributed to a tendency specific for the dominant arm to simplify control of interaction torque by actively accelerating one joint and producing largely passive motion at the other joint. No conclusive evidence has been obtained in support of muscle effort minimization as a contributing factor to the directional preferences. Here, we tested whether distal load changes directional preferences, making the influence of muscle effort minimization on the selection of movement direction more apparent. Methods The free-stroke drawing task was performed by the dominant and non-dominant arm with no load and with 0.454 kg load at the wrist. Motion of each arm was limited to rotation of the shoulder and elbow in the horizontal plane. Directional histograms of strokes produced by the fingertip were calculated to assess directional preferences in each arm and load condition. Possible causes for directional preferences were further investigated by studying optimization across directions of a number of cost functions. Results Preferences in both arms to move in the diagonal directions were revealed. The previously suggested tendency to actively accelerate one joint and produce passive motion at the other joint was supported in both arms and load conditions. However, the load increased the tendency to produce strokes in the transverse diagonal directions (perpendicular to the forearm orientation) in both arms. Increases in required muscle effort caused by the load suggested that the higher frequency of movements in the transverse directions represented increased influence of muscle effort minimization on the selection of movement direction. This

Using pilot data to size a two-arm randomized trial to find a nearly optimal personalized treatment strategy.

PubMed

Laber, Eric B; Zhao, Ying-Qi; Regh, Todd; Davidian, Marie; Tsiatis, Anastasios; Stanford, Joseph B; Zeng, Donglin; Song, Rui; Kosorok, Michael R

2016-04-15

A personalized treatment strategy formalizes evidence-based treatment selection by mapping patient information to a recommended treatment. Personalized treatment strategies can produce better patient outcomes while reducing cost and treatment burden. Thus, among clinical and intervention scientists, there is a growing interest in conducting randomized clinical trials when one of the primary aims is estimation of a personalized treatment strategy. However, at present, there are no appropriate sample size formulae to assist in the design of such a trial. Furthermore, because the sampling distribution of the estimated outcome under an estimated optimal treatment strategy can be highly sensitive to small perturbations in the underlying generative model, sample size calculations based on standard (uncorrected) asymptotic approximations or computer simulations may not be reliable. We offer a simple and robust method for powering a single stage, two-armed randomized clinical trial when the primary aim is estimating the optimal single stage personalized treatment strategy. The proposed method is based on inverting a plugin projection confidence interval and is thereby regular and robust to small perturbations of the underlying generative model. The proposed method requires elicitation of two clinically meaningful parameters from clinical scientists and uses data from a small pilot study to estimate nuisance parameters, which are not easily elicited. The method performs well in simulated experiments and is illustrated using data from a pilot study of time to conception and fertility awareness. Copyright © 2015 John Wiley & Sons, Ltd.

Analysis of reaching movements of upper arm in robot assisted exercises. Kinematic assessment of robot assisted upper arm reaching single-joint movements.

PubMed

Iuppariello, Luigi; D'Addio, Giovanni; Romano, Maria; Bifulco, Paolo; Lanzillo, Bernardo; Pappone, Nicola; Cesarelli, Mario

2016-01-01

Robot-mediated therapy (RMT) has been a very dynamic area of research in recent years. Robotics devices are in fact capable to quantify the performances of a rehabilitation task in treatments of several disorders of the arm and the shoulder of various central and peripheral etiology. Different systems for robot-aided neuro-rehabilitation are available for upper limb rehabilitation but the biomechanical parameters proposed until today, to evaluate the quality of the movement, are related to the specific robot used and to the type of exercise performed. Besides, none study indicated a standardized quantitative evaluation of robot assisted upper arm reaching movements, so the RMT is still far to be considered a standardised tool. In this paper a quantitative kinematic assessment of robot assisted upper arm reaching movements, considering also the effect of gravity on the quality of the movements, is proposed. We studied a group of 10 healthy subjects and results indicate that our advised protocol can be useful for characterising normal pattern in reaching movements.

C-arm rotation encoding with accelerometers.

PubMed

Grzeda, Victor; Fichtinger, Gabor

2010-07-01

Fluoroscopic C-arms are being incorporated in computer-assisted interventions in increasing number. For these applications to work, the relative poses of imaging must be known. To find the pose, tracking methods such as optical cameras, electromagnetic trackers, and radiographic fiducials have been used-all hampered by significant shortcomings. We propose to recover the rotational pose of the C-arm using the angle-sensing ability of accelerometers, by exploiting the capability of the accelerometer to measure tilt angles. By affixing the accelerometer to a C-arm, the accelerometer tracks the C-arm pose during rotations of the C-arm. To demonstrate this concept, a C-arm analogue was constructed with a webcam device affixed to the C-arm model to mimic X-ray imaging. Then, measuring the offset between the accelerometer angle readings to the webcam pose angle, an angle correction equation (ACE) was created to properly tracking the C-arm rotational pose. Several tests were performed on the webcam C-arm model using the ACEs to tracking the primary and secondary angle rotations of the model. We evaluated the capability of linear and polynomial ACEs to tracking the webcam C-arm pose angle for different rotational scenarios. The test results showed that the accelerometer could track the pose of the webcam C-arm model with an accuracy of less than 1.0 degree. The accelerometer was successful in sensing the C-arm's rotation with clinically adequate accuracy in the C-arm webcam model.

Overcoming Robot-Arm Joint Singularities

NASA Technical Reports Server (NTRS)

Barker, L. K.; Houck, J. A.

1986-01-01

Kinematic equations allow arm to pass smoothly through singular region. Report discusses mathematical singularities in equations of robotarm control. Operator commands robot arm to move in direction relative to its own axis system by specifying velocity in that direction. Velocity command then resolved into individual-joint rotational velocities in robot arm to effect motion. However, usual resolved-rate equations become singular when robot arm is straightened.

Effects of age, sex and arm on the precision of arm position sense-left-arm superiority in healthy right-handers.

PubMed

Schmidt, Lena; Depper, Lena; Kerkhoff, Georg

2013-01-01

Position sense is an important proprioceptive ability. Disorders of arm position sense (APS) often occur after unilateral stroke, and are associated with a negative functional outcome. In the present study we assessed horizontal APS by measuring angular deviations from a visually defined target separately for each arm in a large group of healthy subjects. We analyzed the accuracy and instability of horizontal APS as a function of age, sex and arm. Subjects were required to specify verbally the position of their unseen arm on a 0-90° circuit by comparing the current position with the target position indicated by a LED lamp, while the arm was passively moved by the examiner. Eighty-seven healthy subjects participated in the study, ranging from 20 to 77 years, subdivided into three age groups. The results revealed that APS was not a function of age or sex, but was significantly better in the non-dominant (left) arm in absolute errors (AE) but not in constant errors (CE) across all age groups of right-handed healthy subjects. This indicates a right-hemisphere superiority for left APS in right-handers and neatly fits to the more frequent and more severe left-sided body-related deficits in patients with unilateral stroke (i.e. impaired APS in left spatial neglect, somatoparaphrenia) or in individuals with abnormalities of the right cerebral hemisphere. These clinical issues will be discussed.

Mirror therapy for patients with severe arm paresis after stroke--a randomized controlled trial.

PubMed

Thieme, Holm; Bayn, Maria; Wurg, Marco; Zange, Christian; Pohl, Marcus; Behrens, Johann

2013-04-01

To evaluate the effects of individual or group mirror therapy on sensorimotor function, activities of daily living, quality of life and visuospatial neglect in patients with a severe arm paresis after stroke. Randomized controlled trial. Inpatient rehabilitation centre. Sixty patients with a severe paresis of the arm within three months after stroke. Three groups: (1) individual mirror therapy, (2) group mirror therapy and (3) control intervention with restricted view on the affected arm. Motor function on impairment (Fugl-Meyer Test) and activity level (Action Research Arm Test), independence in activities of daily living (Barthel Index), quality of life (Stroke Impact Scale) and visuospatial neglect (Star Cancellation Test). After five weeks, no significant group differences for motor function were found (P > 0.05). Pre-post differences for the Action Research Arm Test and Fugl-Meyer Test: individual mirror therapy: 3.4 (7.1) and 3.2 (3.8), group mirror therapy: 1.1 (3.1) and 5.1 (10.0) and control therapy: 2.8 (6.7) and 5.2 (8.7). However, a significant effect on visuospatial neglect for patients in the individual mirror therapy compared to control group could be shown (P < 0.01). Furthermore, it was possible to integrate a mirror therapy group intervention for severely affected patients after stroke. This study showed no effect on sensorimotor function of the arm, activities of daily living and quality of life of mirror therapy compared to a control intervention after stroke. However, a positive effect on visuospatial neglect was indicated.

Partial weight support of the arm affects corticomotor selectivity of biceps brachii.

PubMed

Runnalls, Keith D; Anson, Greg; Byblow, Winston D

2015-10-26

Weight support of the arm (WS) can be used in stroke rehabilitation to facilitate upper limb therapy, but the neurophysiological effects of this technique are not well understood. While an overall reduction in muscle activity is expected, the mechanism by which WS may alter the expression of muscle synergies has not been examined until now. We explored the neurophysiological effect of WS on the selectivity of biceps brachii (BB) activation in healthy adults. Thirteen participants completed counterbalanced movement tasks in a repeated measures design. Three levels of WS (0, 45, and 90 % of full support) were provided to the arm using a commercial device (Saebo Mobile Arm Support). At each level of WS, participants maintained a flexed shoulder posture while performing rhythmic isometric elbow flexion (BB agonist) or forearm pronation (BB antagonist). Single-pulse transcranial magnetic stimulation of primary motor cortex was used to elicit motor-evoked potentials (MEPs) in BB 100-300 ms before muscle contraction. Baseline muscle activity and MEP amplitude were the primary dependent measures. Effects of movement TASK and SUPPORT LEVEL were statistically analyzed using linear mixed effects models. As expected, with increased support tonic activity was reduced across all muscles. This effect was greatest in the anti-gravity muscle anterior deltoid, and evident in biceps brachii and pronator teres as well. For BB MEP amplitude, TASK and SUPPORT LEVEL, interacted such that for elbow flexion, MEP amplitudes were smaller with incrementally greater WS whereas, for forearm pronation MEP amplitudes were smaller only at high WS. Weight support of the arm influences corticomotor selectivity of biceps brachii. WS may impact coordination independently of a global reduction in muscle activity. The amount of supportive force applied to the arm influences the neuromechanical control profile for the limb. These findings may inform the application of WS in upper limb stroke

Effects of dominant and non-dominant passive arm manoeuvres on the neurovascular coupling response.

PubMed

Llwyd, Osian; Panerai, Ronney B; Robinson, Thompson G

2017-11-01

Models designed to study neurovascular coupling (NVC) describe a possible cerebral hemisphere dominance dependent on task completed and preference in handedness. We investigated whether passive arm manoeuvre performed with dominant (Dom-Arm) or non-dominant arm (ND-Arm) stimulated haemodynamic differences in either contralateral (Cont-H) or ipsilateral (Ipsil-H) cerebral hemisphere. Healthy individuals lying in supine position, had measurements of beat-to-beat blood pressure (BP, mmHg), electrocardiogram (HR, bpm), end-tidal CO 2 (etCO 2 , mmHg), and bilateral insonation of the middle cerebral arteries (MCA, cm s -1 ). Arm movement was performed for 60 s with passive flexion and extension of the elbow (1 Hz), before manoeuvre was repeated on other arm. Data were normalised and effect of treatment was analysed for differences between manoeuvres and within each time period. Seventeen (eight males) healthy volunteers, aged 56 ± 7 years, were studied. Dom-Arm and ND-Arm manoeuvres stimulated a comparable temporal response in peripheral and cerebral haemodynamic parameters between Cont-H and Ipsil-H. Both manoeuvres can be used to evoke similar bilateral MCA responses in assessing NVC. This finding should lead to more efficient protocols when using passive arm movement for NVC studies in healthy subjects.

Bobath Concept versus constraint-induced movement therapy to improve arm functional recovery in stroke patients: a randomized controlled trial.

PubMed

Huseyinsinoglu, Burcu Ersoz; Ozdincler, Arzu Razak; Krespi, Yakup

2012-08-01

To compare the effects of the Bobath Concept and constraint-induced movement therapy on arm functional recovery among stroke patients with a high level of function on the affected side. A single-blinded, randomized controlled trial. Outpatient physiotherapy department of a stroke unit. A total of 24 patients were randomized to constraint-induced movement therapy or Bobath Concept group. The Bobath Concept group was treated for 1 hour whereas the constraint-induced movement therapy group received training for 3 hours per day during 10 consecutive weekdays. Main measures were the Motor Activity Log-28, the Wolf Motor Function Test, the Motor Evaluation Scale for Arm in Stroke Patients and the Functional Independence Measure. The two groups were found to be homogeneous based on demographic variables and baseline measurements. Significant improvements were seen after treatment only in the 'Amount of use' and 'Quality of movement' subscales of the Motor Activity Log-28 in the constraint-induced movement therapy group over the the Bobath Concept group (P = 0.003; P = 0.01 respectively). There were no significant differences in Wolf Motor Function Test 'Functional ability' (P = 0.137) and 'Performance time' (P = 0.922), Motor Evaluation Scale for Arm in Stroke Patients (P = 0.947) and Functional Independence Measure scores (P = 0.259) between the two intervention groups. Constraint-induced movement therapy and the Bobath Concept have similar efficiencies in improving functional ability, speed and quality of movement in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seems to be slightly more efficient than the Bobath Concept in improving the amount and quality of affected arm use.

Consistency of breast and arm symptoms during the first two years after breast cancer surgery.

PubMed

Wennman-Larsen, Agneta; Petersson, Lena-Marie; Saboonchi, Fredrik; Alexanderson, Kristina; Vaez, Marjan

2015-03-01

To examine the severity and development of breast and arm symptoms separately during the two years following breast cancer surgery, and to examine whether previously defined predictors of arm symptoms are associated with breast symptoms. Prospective cohort study with two-year follow-up. Three institutions in the Stockholm, Sweden, region. 645 women, aged 20-63 years, enrolled within 12 weeks of surgery for primary breast cancer. Baseline register and questionnaire data with five follow-ups were submitted to descriptive, inferential, and logistic regression analysis. Severity of breast and arm symptoms measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire. Most participants had undergone breast-conserving 
surgery and sentinel lymph node dissection, and were scheduled for postoperative radiation therapy. Overall mean levels of breast and arm symptoms were low, but with large individual variations. At all six time points, the mean levels of breast symptoms were significantly higher than those of arm symptoms. Overall, the mean level of both types of symptoms decreased during follow-up. A body mass index (BMI) of 25 or greater and breast symptoms at eight months were associated with having breast symptoms at two years. Arm symptoms at baseline and at eight months, and radiation therapy and a BMI of 25 or greater were associated with having arm symptoms at two years. Breast symptoms show different patterns of change and are not associated with the same factors as arm symptoms. For nurses monitoring women treated for breast cancer, the results of this study provide knowledge regarding the importance of early symptom identification and long-term symptoms after treatment.

Laser-assisted lipolysis for arm contouring in Teimourian grades I and II: a prospective study of 45 patients.

PubMed

Leclère, Franck Marie; Alcolea, Justo M; Vogt, Peter; Moreno-Moraga, Javier; Mordon, Serge; Casoli, Vincent; Trelles, Mario A

2015-04-01

Upper arm deformities secondary to weight loss or senile elastosis have led to an increased demand for aesthetic contouring procedures. We conducted this study to objectively assess if, in Teimourian low-grade upper arm remodelling, one session of laser-assisted lypolisis (LAL) could result in full patient satisfaction. Between 2011 and 2013, 45 patients were treated for unsightly fat arm Teimourian grade I (15 patients), grade IIa (15 patients) and grade IIb (15 patients) with one session of LAL. The laser used in this study was a 1470-nm diode laser (Alma Lasers, Cesarea, Israel) with the following parameters: continuous mode, 15 W power and transmission through a 600-μm optical fibre. Previous mathematical modelling suggested that 0.1 kJ was required in order to destroy 1 ml of fat. Treatment parameters and adverse effects were recorded.The arm circumference and skin pinch measurements were assessed pre and postoperatively. Patients were asked to file a satisfaction questionnaire. Pain during the anaesthesia and discomfort after the procedure were minimal. Complications included prolonged oedema in 11 patients. The average arm circumference decreased by 4.9 ± 0.4 cm in the right arm (p < 0.01) and 4.7 ± 0.5 cm in the left arm (p < 0.01) in grade I patients, 5.5 ± 0.6 cm in the right arm (p < 0.01) and 5.2 ± 0.5 cm in the left arm (p < 0.01) in grade IIa patients and 5.4 ± 0.5 cm in the right arm (p < 0.01) and 5.3 ± 0.5 cm in the left arm (p < 0.01) in grade IIB patients. The skin tightening effect was confirmed by the reduction of the skin calliper measurements in all three groups. Overall mean opinion of treatment was high for both patients and investigators. Of the 45 patients, all but one would recommend this treatment. A single session of LAL in upper arm remodelling for Teimourian grades I to IIb is a safe and reproducible technique. The procedure allows reduction in the amount of adipose deposits

Galaxy Zoo and SPARCFIRE: constraints on spiral arm formation mechanisms from spiral arm number and pitch angles

NASA Astrophysics Data System (ADS)

Hart, Ross E.; Bamford, Steven P.; Hayes, Wayne B.; Cardamone, Carolin N.; Keel, William C.; Kruk, Sandor J.; Lintott, Chris J.; Masters, Karen L.; Simmons, Brooke D.; Smethurst, Rebecca J.

2017-12-01

In this paper, we study the morphological properties of spiral galaxies, including measurements of spiral arm number and pitch angle. Using Galaxy Zoo 2, a stellar mass-complete sample of 6222 SDSS spiral galaxies is selected. We use the machine vision algorithm SPARCFIRE to identify spiral arm features and measure their associated geometries. A support vector machine classifier is employed to identify reliable spiral features, with which we are able to estimate pitch angles for half of our sample. We use these machine measurements to calibrate visual estimates of arm tightness, and hence estimate pitch angles for our entire sample. The properties of spiral arms are compared with respect to various galaxy properties. The star formation properties of galaxies vary significantly with arm number, but not pitch angle. We find that galaxies hosting strong bars have spiral arms substantially (4°-6°) looser than unbarred galaxies. Accounting for this, spiral arms associated with many-armed structures are looser (by 2°) than those in two-armed galaxies. In contrast to this average trend, galaxies with greater bulge-to-total stellar mass ratios display both fewer and looser spiral arms. This effect is primarily driven by the galaxy disc, such that galaxies with more massive discs contain more spiral arms with tighter pitch angles. This implies that galaxy central mass concentration is not the dominant cause of pitch angle and arm number variations between galaxies, which in turn suggests that not all spiral arms are governed by classical density waves or modal theories.

Cognitive–Behavioral Therapy for Hand and Arm Pain

PubMed Central

Vranceanu, Ana-Maria; Safren, Steve

2016-01-01

Cognitive–behavioral therapy (CBT) is a psychological treatment that emphasizes the interrelation among thoughts, behaviors, feelings, and sensations. CBT has been proved effective not only for treatment of psychological illness but also for teaching adaptive coping strategies in the context of chronic illnesses, including chronic pain. The present article provides general information on CBT, specific information on CBT for pain, as well as guidelines and strategies for using CBT for hand and arm pain patients, as part of multidisciplinary care models. PMID:21051204

The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu; Brinkmann, Debra H.; Ward, Shelly B.

2013-03-15

Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the secondmore » (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.« less

The addition of SPECT/CT lymphoscintigraphy to breast cancer radiation planning spares lymph nodes critical for arm drainage.

PubMed

Cheville, Andrea L; Brinkmann, Debra H; Ward, Shelly B; Durski, Jolanta; Laack, Nadia N; Yan, Elizabeth; Schomberg, Paula J; Garces, Yolanda I; Suman, Vera J; Petersen, Ivy A

2013-03-15

This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema. Copyright © 2013 Elsevier Inc. All rights reserved.

Dynamic model of the octopus arm. I. Biomechanics of the octopus reaching movement.

PubMed

Yekutieli, Yoram; Sagiv-Zohar, Roni; Aharonov, Ranit; Engel, Yaakov; Hochner, Binyamin; Flash, Tamar

2005-08-01

The octopus arm requires special motor control schemes because it consists almost entirely of muscles and lacks a rigid skeletal support. Here we present a 2D dynamic model of the octopus arm to explore possible strategies of movement control in this muscular hydrostat. The arm is modeled as a multisegment structure, each segment containing longitudinal and transverse muscles and maintaining a constant volume, a prominent feature of muscular hydrostats. The input to the model is the degree of activation of each of its muscles. The model includes the external forces of gravity, buoyancy, and water drag forces (experimentally estimated here). It also includes the internal forces generated by the arm muscles and the forces responsible for maintaining a constant volume. Using this dynamic model to investigate the octopus reaching movement and to explore the mechanisms of bend propagation that characterize this movement, we found the following. 1) A simple command producing a wave of muscle activation moving at a constant velocity is sufficient to replicate the natural reaching movements with similar kinematic features. 2) The biomechanical mechanism that produces the reaching movement is a stiffening wave of muscle contraction that pushes a bend forward along the arm. 3) The perpendicular drag coefficient for an octopus arm is nearly 50 times larger than the tangential drag coefficient. During a reaching movement, only a small portion of the arm is oriented perpendicular to the direction of movement, thus minimizing the drag force.

Effects of age, sex and arm on the precision of arm position sense—left-arm superiority in healthy right-handers

PubMed Central

Schmidt, Lena; Depper, Lena; Kerkhoff, Georg

2013-01-01

Position sense is an important proprioceptive ability. Disorders of arm position sense (APS) often occur after unilateral stroke, and are associated with a negative functional outcome. In the present study we assessed horizontal APS by measuring angular deviations from a visually defined target separately for each arm in a large group of healthy subjects. We analyzed the accuracy and instability of horizontal APS as a function of age, sex and arm. Subjects were required to specify verbally the position of their unseen arm on a 0-90° circuit by comparing the current position with the target position indicated by a LED lamp, while the arm was passively moved by the examiner. Eighty-seven healthy subjects participated in the study, ranging from 20 to 77 years, subdivided into three age groups. The results revealed that APS was not a function of age or sex, but was significantly better in the non-dominant (left) arm in absolute errors (AE) but not in constant errors (CE) across all age groups of right-handed healthy subjects. This indicates a right-hemisphere superiority for left APS in right-handers and neatly fits to the more frequent and more severe left-sided body-related deficits in patients with unilateral stroke (i.e. impaired APS in left spatial neglect, somatoparaphrenia) or in individuals with abnormalities of the right cerebral hemisphere. These clinical issues will be discussed. PMID:24399962

ARM KAZR-ARSCL Value Added Product

DOE Data Explorer

Jensen, Michael

2012-09-28

The Ka-band ARM Zenith Radars (KAZRs) have replaced the long-serving Millimeter Cloud Radars, or MMCRs. Accordingly, the primary MMCR Value Added Product (VAP), the Active Remote Sensing of CLouds (ARSCL) product, is being replaced by a KAZR-based version, the KAZR-ARSCL VAP. KAZR-ARSCL provides cloud boundaries and best-estimate time-height fields of radar moments.

Rifaximin has a Marginal Impact on Microbial Translocation, T-cell Activation and Inflammation in HIV-Positive Immune Non-responders to Antiretroviral Therapy – ACTG A5286

PubMed Central

Tenorio, Allan R.; Chan, Ellen S.; Bosch, Ronald J.; Macatangay, Bernard J. C.; Read, Sarah W.; Yesmin, Suria; Taiwo, Babafemi; Margolis, David M.; Jacobson, Jeffrey M.; Landay, Alan L.; Wilson, Cara C.; Mellors, John W.; Keshavarzian, Ali; Rodriguez, Benigno; Aziz, Mariam; Presti, Rachel; Deeks, Steven; Ebiasah, Ruth; Myers, Laurie; Borowski, LuAnn; Plants, Jill; Palm, David A.; Weibel, Derek; Putnam, Beverly; Lindsey, Elizabeth; Player, Amy; Albrecht, Mary; Kershaw, Andrea; Sax, Paul; Keenan, Cheryl; Walton, Patricia; Baum, Jane; Stroberg, Todd; Hughes, Valery; Coster, Laura; Kumar, Princy N.; Yin, Michael T.; Noel-Connor, Jolene; Tebas, Pablo; Thomas, Aleshia; Davis, Charles E.; Redfield, Robert R.; Sbrolla, Amy; Flynn, Teri; Davis, Traci; Whitely, Kim; Singh, Baljinder; Swaminathan, Shobha; McGregor, Donna; Palella, Frank; Aberg, Judith; Cavanagh, Karen; Santana Bagur, Jorge L.; Flores, Olga Méndez; Fritsche, Janice; Sha, Beverly; Slamowitz, Debbie; Valle, Sandra; Tashima, Karen; Patterson, Helen; Harber, Heather; Para, Michael; Eaton, Molly; Maddox, Dale; Currier, Judith; Cajahuaringa, Vanessa; Luetkemeyer, Annie; Dwyer, Jay; Fichtenbaum, Carl J.; Saemann, Michelle; Ray, Graham; Campbell, Thomas; Fischl, Margaret A.; Bolivar, Hector; Oakes, Jonathan; Chicurel-Bayard, Miriam; Tripoli, Christine; Weinman, D. Renee; Adams, Mary; Hurley, Christine; Dunaway, Shelia; Storey, Sheryl; Klebert, Michael; Royal, Michael

2015-01-01

Background. Rifaximin, a nonabsorbable antibiotic that decreases lipopolysaccharide (LPS) in cirrhotics, may decrease the elevated levels of microbial translocation, T-cell activation and inflammation in human immunodeficiency virus (HIV)-positive immune nonresponders to antiretroviral therapy (ART). Methods. HIV-positive adults receiving ART for ≥96 weeks with undetectable viremia for ≥48 weeks and CD4+ T-cell counts <350 cells/mm3 were randomized 2:1 to rifaximin versus no study treatment for 4 weeks. T-cell activation, LPS, and soluble CD14 were measured at baseline and at weeks 2, 4, and 8. Wilcoxon rank sum tests compared changes between arms. Results. Compared with no study treatment (n = 22), rifaximin (n = 43) use was associated with a significant difference between study arms in the change from baseline to week 4 for CD8+T-cell activation (median change, 0.0% with rifaximin vs +0.6% with no treatment; P = .03). This difference was driven by an increase in the no-study-treatment arm because there was no significant change within the rifaximin arm. Similarly, although there were significant differences between study arms in change from baseline to week 2 for LPS and soluble CD14, there were no significant changes within the rifaximin arm. Conclusions. In immune nonresponders to ART, rifaximin minimally affected microbial translocation and CD8+T-cell activation. Trial registration number. NCT01466595. PMID:25214516

Efficacy and safety of nilotinib in patients with KIT-mutated metastatic or inoperable melanoma: final results from the global, single-arm, phase II TEAM trial.

PubMed

Guo, J; Carvajal, R D; Dummer, R; Hauschild, A; Daud, A; Bastian, B C; Markovic, S N; Queirolo, P; Arance, A; Berking, C; Camargo, V; Herchenhorn, D; Petrella, T M; Schadendorf, D; Sharfman, W; Testori, A; Novick, S; Hertle, S; Nourry, C; Chen, Q; Hodi, F S

2017-06-01

The single-arm, phase II Tasigna Efficacy in Advanced Melanoma (TEAM) trial evaluated the KIT-selective tyrosine kinase inhibitor nilotinib in patients with KIT-mutated advanced melanoma without prior KIT inhibitor treatment. Forty-two patients with KIT-mutated advanced melanoma were enrolled and treated with nilotinib 400 mg twice daily. TEAM originally included a comparator arm of dacarbazine (DTIC)-treated patients; the design was amended to a single-arm trial due to an observed low number of KIT-mutated melanomas. Thirteen patients were randomized to DTIC before the protocol amendment removing this study arm. The primary endpoint was objective response rate (ORR), determined according to Response Evaluation Criteria In Solid Tumors. ORR was 26.2% (n = 11/42; 95% CI, 13.9%-42.0%), sufficient to reject the null hypothesis (ORR ≤10%). All observed responses were partial responses (PRs; median response duration, 7.1 months). Twenty patients (47.6%) had stable disease and 10 (23.8%) had progressive disease; 1 (2.4%) response was unknown. Ten of the 11 responding patients had exon 11 mutations, four with an L576P mutation. The median progression-free survival and overall survival were 4.2 and 18.0 months, respectively. Three of the 13 patients on DTIC achieved a PR, and another patient had a PR following switch to nilotinib. Nilotinib activity in patients with advanced KIT-mutated melanoma was similar to historical data from imatinib-treated patients. DTIC treatment showed potential activity, although the low patient number limits interpretation. Similar to previously reported results with imatinib, nilotinib showed greater activity among patients with an exon 11 mutation, including L576P, suggesting that nilotinib may be an effective treatment option for patients with specific KIT mutations. ClinicalTrials.gov, NCT01028222. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved

Understanding the conventional arms trade

NASA Astrophysics Data System (ADS)

Stohl, Rachel

2017-11-01

The global conventional arms trade is worth tens of billions of dollars every year and is engaged in by every country in the world. Yet, it is often difficult to control the legal trade in conventional arms and there is a thriving illicit market, willing to arm unscrupulous regimes and nefarious non-state actors. This chapter examines the international conventional arms trade, the range of tools that have been used to control it, and challenges to these international regimes.

Neuromechanical considerations for incorporating rhythmic arm movement in the rehabilitation of walking

NASA Astrophysics Data System (ADS)

Klimstra, Marc D.; Thomas, Evan; Stoloff, Rebecca H.; Ferris, Daniel P.; Zehr, E. Paul

2009-06-01

We have extensively used arm cycling to study the neural control of rhythmic movements such as arm swing during walking. Recently rhythmic movement of the arms has also been shown to enhance and shape muscle activity in the legs. However, restricted information is available concerning the conditions necessary to maximally alter lumbar spinal cord excitability. Knowledge on the neuromechanics of a task can assist in the determination of the type, level, and timing of neural signals, yet arm swing during walking and arm cycling have not received a detailed neuromechanical comparison. The purpose of this research was to provide a combined neural and mechanical measurement approach that could be used to assist in the determination of the necessary and sufficient conditions for arm movement to assist in lower limb rehabilitation after stroke and spinal cord injury. Subjects performed three rhythmic arm movement tasks: (1) cycling (cycle); (2) swinging while standing (swing); and (3) swinging while treadmill walking (walk). We hypothesized that any difference in neural control between tasks (i.e., pattern of muscle activity) would reflect changes in the mechanical constraints unique to each task. Three-dimensional kinematics were collected simultaneously with force measurement at the hand and electromyography from the arms and trunk. All data were appropriately segmented to allow a comparison between and across conditions and were normalized and averaged to 100% movement cycle based on shoulder excursion. Separate mathematical principal components analysis of kinematic and neural variables was performed to determine common task features and muscle synergies. The results highlight important neural and mechanical features that distinguish differences between tasks. For example, there are considerable differences in the anatomical positions of the arms during each task, which relate to the moments experienced about the elbow and shoulder. Also, there are differences between

26 CFR 20.2201-1 - Members of the Armed Forces dying during an induction period.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Members of the Armed Forces dying during an... Miscellaneous § 20.2201-1 Members of the Armed Forces dying during an induction period. (a) The additional...) (see paragraph (b) of this section) and while in active service as a member of the Armed Forces of the...

Diagnosis and treatment of hand-arm vibration syndrome and its relationship to carpal tunnel syndrome.

PubMed

Falkiner, Sonja

2003-07-01

Hand-arm vibration syndrome (HAVS) is a condition associated with the use of vibrating tools that occurs mainly in men. It consists primarily of 'occupational' Raynaud disease and digital polyneuropathy. Carpal tunnel syndrome (CTS) is also associated with hand transmitted vibration exposure and can coexist with HAVS. This article examines recent papers on causation, diagnosis, relationship to CTS and treatment. A Medline search was conducted, as was a search of UK, USA and Australian government occupational health and safety websites. Published papers that were single case studies or of poor design were not included. There are no 'gold standard' diagnostic tests for HAVS. It can mimic CTS in temperate climates and can occur with CTS. This is the diagnostic challenge when a male worker presents with apparent CTS symptoms. If he has worked with vibrating tools for many years, a diagnosis of HAVS or co-diagnosis of HAVS should be considered before a diagnosis of pure CTS is made. Nonwork risk factors for HAVS are predisposition, smoking, and exposure to vibration outside work. Cessation of exposure (and smoking) and redeployment is a critical part of treatment due to the dose response relationship of HAVS. This contrasts with adequately treated CTS, where the vast majority of workers can return to pre-injury duties. In severe cases, calcium antagonists are also used, but treatment is often ineffective. Few workplaces in Australia manage vibration risk or conduct screening to identify workers with early HAVS who should be redeployed. Local doctors have an important opportunity to diagnose HAVS and to make recommendations to the workplace on redeployment as part of treatment before symptoms become irreversible.

Arm pain in youth baseball players: a survey of healthy players.

PubMed

Makhni, Eric C; Morrow, Zachary S; Luchetti, Timothy J; Mishra-Kalyani, Pallavi S; Gualtieri, Anthony P; Lee, Randall W; Ahmad, Christopher S

2015-01-01

Overuse injury in youth baseball players is increasing in prevalence, and these injuries have been correlated to pitching mechanics and pitch counts/types. Prior studies regarding arm pain in these athletes have focused simply on presence or absence of pain during the season rather than on detailed factors related to arm pain with respect to frequency, severity, and associated performance and psychosocial effect. The goal of this study was to investigate frequency, quality, and effect of arm pain in healthy youth baseball players. The hypothesis was that arm pain will affect a majority of healthy baseball players and will be associated with adverse psychosocial effects. Descriptive epidemiological study. A novel survey focusing on arm pain in youth baseball players was developed for the purpose of this study. Survey questions were formulated by a consortium of trainers, clinicians, and coaches. Surveys were administered to healthy youth baseball players throughout the states of New Jersey and New York. A total of 203 healthy players completed the survey; 23% of players (n=47) reported a prior overuse injury. Only 26% and 20% of players reported that their arm never hurt when throwing or the day after throwing, respectively; 30% of players reported that arm pain at least sometimes caused them to have less fun playing; and 46% of players reported at least once being encouraged to keep playing despite having arm pain. Pitchers were more likely to report arm pain while throwing and the day after throwing and to indicate that arm pain held them back from being a better player (all P<.05). Those with prior overuse injury were more likely to have arm pain while throwing, to have arm fatigue during a game or practice, and to be encouraged to keep playing despite having pain (all P<.05). A majority of healthy (actively competing) youth baseball players report at least some baseline arm pain and fatigue, and many players suffer adverse psychosocial effects from this pain. �

Accurate positioning of long, flexible ARM's (Articulated Robotic Manipulator)

NASA Technical Reports Server (NTRS)

Malachowski, Michael J.

1988-01-01

An articulated robotic manipulator (ARM) system is being designed for space applications. Work being done on a concept utilizing an infinitely stiff laser beam for position reference is summarized. The laser beam is projected along the segments of the ARM, and the position is sensed by the beam rider modules (BRM) mounted on the distal ends of the segments. The BRM concept is the heart of the system. It utilizes a combination of lateral displacements and rotational and distance measurement sensors. These determine the relative position of the two ends of the segments with respect to each other in six degrees of freedom. The BRM measurement devices contain microprocessor controlled data acquisition and active positioning components. An indirect adaptive controller is used to accurately control the position of the ARM.

Psychological interventions for the treatment of depression, anxiety, alcohol misuse or anger in armed forces veterans and their families: systematic review and meta-analysis protocol.

PubMed

O'Shea, Luke; Watkins, Ed; Farrand, Paul

2017-06-15

Evidence highlights a high prevalence of common mental health disorders in armed forces veterans and their families, with depression, anxiety, alcohol misuse and anger being more common than PTSD. This paper presents a protocol for a systematic review and meta-analysis to identify existing randomised controlled trial (RCT) research testing the effectiveness of psychological interventions for these difficulties in armed forces veterans and their family members. Electronic databases (CENTRAL, PsycInfo, MEDLINE, CINAHL, The Cochrane Register of Clinical Trials, EMBASE and ASSIA) will be searched to identify suitable studies for inclusion in the review supplemented by forward and backward reference checking, grey literature searches and contact with subject authors. Research including armed forces veterans and their family members will be included in the review with research including serving personnel or individuals under the age of 18 being excluded. Few RCTs examining the treatment of depression, anxiety, alcohol misuse or anger exist in armed forces veterans to date. The primary outcome will be symptomatic change following intervention for these difficulties. The secondary outcomes will include methodological aspects of interest such as discharge type and recruitment setting if data permits. In the event that the number of studies identified is too low to undertake a meta-analysis, a narrative review will be conducted. Quality assessment will be undertaken using the Cochrane Collaboration Tool and Cochran's Q statistic calculated to test for heterogeneity as suggested by the Cochrane handbook. The review will examine the findings of existing intervention research for depression, anxiety, alcohol misuse or anger in armed forces veterans and their families, along with any effect sizes that may exist. PROSPERO CRD42016036676.

Arm coordination in octopus crawling involves unique motor control strategies.

PubMed

Levy, Guy; Flash, Tamar; Hochner, Binyamin

2015-05-04

To cope with the exceptional computational complexity that is involved in the control of its hyper-redundant arms [1], the octopus has adopted unique motor control strategies in which the central brain activates rather autonomous motor programs in the elaborated peripheral nervous system of the arms [2, 3]. How octopuses coordinate their eight long and flexible arms in locomotion is still unknown. Here, we present the first detailed kinematic analysis of octopus arm coordination in crawling. The results are surprising in several respects: (1) despite its bilaterally symmetrical body, the octopus can crawl in any direction relative to its body orientation; (2) body and crawling orientation are monotonically and independently controlled; and (3) contrasting known animal locomotion, octopus crawling lacks any apparent rhythmical patterns in limb coordination, suggesting a unique non-rhythmical output of the octopus central controller. We show that this uncommon maneuverability is derived from the radial symmetry of the arms around the body and the simple pushing-by-elongation mechanism by which the arms create the crawling thrust. These two together enable a mechanism whereby the central controller chooses in a moment-to-moment fashion which arms to recruit for pushing the body in an instantaneous direction. Our findings suggest that the soft molluscan body has affected in an embodied way [4, 5] the emergence of the adaptive motor behavior of the octopus. Copyright © 2015 Elsevier Ltd. All rights reserved.

Robotic Arm Unwrapped

NASA Technical Reports Server (NTRS)

2008-01-01

This image, taken shortly after NASA's Phoenix Mars Lander touched down on the surface of Mars, shows the spacecraft's robotic arm in its stowed configuration, with its biobarrier successfully unpeeled. The 'elbow' of the arm can be seen at the top center of the picture, and the biobarrier is the shiny film seen to the left of the arm.

The biobarrier is an extra precautionary measure for protecting Mars from contamination with any bacteria from Earth. While the whole spacecraft was decontaminated through cleaning, filters and heat, the robotic arm was given additional protection because it is the only spacecraft part that will directly touch the ice below the surface of Mars.

Before the arm was heated, it was sealed in the biobarrier, which is made of a trademarked film called Tedlar that holds up to baking like a turkey-basting bag. This ensures that any new bacterial spores that might have appeared during the final steps before launch and during the journey to Mars will not contact the robotic arm.

After Phoenix landed, springs were used to pop back the barrier, giving it room to deploy.

The base of the lander's Meteorological Station can be seen in this picture on the upper left. Because only the base of the station is showing, this image tells engineers that the instrument deployed successfully.

The image was taken on landing day, May 25, 2008, by the spacecraft's Surface Stereo Imager.

The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

Student measurement of blood pressure using a simulator arm compared with a live subject's arm.

PubMed

Lee, Jennifer J; Sobieraj, Diana M; Kuti, Effie L

2010-06-15

To compare accuracy of blood pressure measurements using a live subject and a simulator arm, and to determine students' preferences regarding measurement. This was a crossover study comparing blood pressure measurements from a live subject and a simulator arm. Students completed an anonymous survey instrument defining opinions on ease of measurement. Fifty-seven students completed blood pressure measurements on live subjects while 72 students completed blood pressure measurements using the simulator arm. There were no significant systematic differences between the 2 measurement techniques. Systolic blood pressure measurements from a live subject arm were less likely to be within 4 mm Hg compared with measurements of a simulator arm. Diastolic blood pressure measurements were not significantly different between the 2 techniques. Accuracy of student measurement of blood pressure using a simulator arm was similar to the accuracy with a live subject. There was no difference in students' preferences regarding measurement techniques.

Haptic stabilization of posture: changes in arm proprioception and cutaneous feedback for different arm orientations

NASA Technical Reports Server (NTRS)

Rabin, E.; Bortolami, S. B.; DiZio, P.; Lackner, J. R.

1999-01-01

Postural sway during quiet stance is attenuated by actively maintained contact of the index finger with a stationary surface, even if the level of applied force (<1 N) cannot provide mechanical stabilization. In this situation, changes in force level at the fingertip lead changes in center of foot pressure by approximately 250 ms. These and related findings indicate that stimulation of the fingertip combined with proprioceptive information about the hand and arm can serve as an active sensor of body position relative to the point of contact. A geometric analysis of the relationship between hand and torso displacement during body sway led to the prediction that arm and hand proprioceptive and finger somatosensory information about body sway would be maximized with finger contact in the plane of body sway. Therefore, the most postural stabilization should be possible with such contact. To test this analysis, subjects touched a laterally versus anteriorly placed surface while in each of two stances: the heel-to-toe tandem Romberg stance that reduces medial-lateral stability and the heel-to-heel, toes-outward, knees-bent, "duck stance" that reduces fore-aft stability. Postural sway was always least with finger contact in the unstable plane: for the tandem stance, lateral fingertip contact was significantly more effective than frontal contact, and, for the duck stance, frontal contact was more effective than lateral fingertip contact. Force changes at the fingertip led changes in center of pressure of the feet by approximately 250 ms for both fingertip contact locations for both test stances. These results support the geometric analysis, which showed that 1) arm joint angles change by the largest amount when fingertip contact is maintained in the plane of greatest sway, and 2) the somatosensory cues at the fingertip provide both direction and amplitude information about sway when the finger is contacting a surface in the unstable plane.

Haptic stabilization of posture: changes in arm proprioception and cutaneous feedback for different arm orientations.

PubMed

Rabin, E; Bortolami, S B; DiZio, P; Lackner, J R

1999-12-01

Postural sway during quiet stance is attenuated by actively maintained contact of the index finger with a stationary surface, even if the level of applied force (<1 N) cannot provide mechanical stabilization. In this situation, changes in force level at the fingertip lead changes in center of foot pressure by approximately 250 ms. These and related findings indicate that stimulation of the fingertip combined with proprioceptive information about the hand and arm can serve as an active sensor of body position relative to the point of contact. A geometric analysis of the relationship between hand and torso displacement during body sway led to the prediction that arm and hand proprioceptive and finger somatosensory information about body sway would be maximized with finger contact in the plane of body sway. Therefore, the most postural stabilization should be possible with such contact. To test this analysis, subjects touched a laterally versus anteriorly placed surface while in each of two stances: the heel-to-toe tandem Romberg stance that reduces medial-lateral stability and the heel-to-heel, toes-outward, knees-bent, "duck stance" that reduces fore-aft stability. Postural sway was always least with finger contact in the unstable plane: for the tandem stance, lateral fingertip contact was significantly more effective than frontal contact, and, for the duck stance, frontal contact was more effective than lateral fingertip contact. Force changes at the fingertip led changes in center of pressure of the feet by approximately 250 ms for both fingertip contact locations for both test stances. These results support the geometric analysis, which showed that 1) arm joint angles change by the largest amount when fingertip contact is maintained in the plane of greatest sway, and 2) the somatosensory cues at the fingertip provide both direction and amplitude information about sway when the finger is contacting a surface in the unstable plane.

The Asteroid Redirect Mission (ARM)

NASA Astrophysics Data System (ADS)

Abell, Paul; Gates, Michele; Johnson, Lindley; Chodas, Paul; Mazanek, Dan; Reeves, David; Ticker, Ronald

2016-07-01

To achieve its long-term goal of sending humans to Mars, the National Aeronautics and Space Administration (NASA) plans to proceed in a series of incrementally more complex human spaceflight missions. Today, human flight experience extends only to Low-Earth Orbit (LEO), and should problems arise during a mission, the crew can return to Earth in a matter of minutes to hours. The next logical step for human spaceflight is to gain flight experience in the vicinity of the Moon. These cis-lunar missions provide a "proving ground" for the testing of systems and operations while still accommodating an emergency return path to the Earth that would last only several days. Cis-lunar mission experience will be essential for more ambitious human missions beyond the Earth-Moon system, which will require weeks, months, or even years of transit time. In addition, NASA has been given a Grand Challenge to find all asteroid threats to human populations and know what to do about them. Obtaining knowledge of asteroid physical properties combined with performing technology demonstrations for planetary defense provide much needed information to address the issue of future asteroid impacts on Earth. Hence the combined objectives of human exploration and planetary defense give a rationale for the Asteroid Re-direct Mission (ARM). Mission Description: NASA's ARM consists of two mission segments: 1) the Asteroid Redirect Robotic Mission (ARRM), the first robotic mission to visit a large (greater than ~100 m diameter) near-Earth asteroid (NEA), collect a multi-ton boulder from its surface along with regolith samples, demonstrate a planetary defense technique, and return the asteroidal material to a stable orbit around the Moon; and 2) the Asteroid Redirect Crewed Mission (ARCM), in which astronauts will take the Orion capsule to rendezvous and dock with the robotic vehicle, conduct multiple extravehicular activities to explore the boulder, and return to Earth with samples. NASA's proposed

Colleges Grapple with the "Behavioral Broken Arm"

ERIC Educational Resources Information Center

Hoover, Eric

2008-01-01

After the fatal shootings at Virginia Tech last April, colleges went shopping for hardware. They bought sirens, mass-messaging systems, surveillance cameras, and door locks. Some colleges armed their police departments for the first time. Others added assault rifles to their arsenals. "Active shooter" drills happened everywhere. As administrators…

Contributions of Altered Stretch Reflex Coordination to Arm Impairments Following Stroke

PubMed Central

Ravichandran, Vengateswaran J.; Krutky, Matthew A.; Perreault, Eric J.

2010-01-01

Patterns of stereotyped muscle coactivation, clinically referred to as synergies, emerge following stroke and impair arm function. Although researchers have focused on cortical contributions, there is growing evidence that altered stretch reflex pathways may also contribute to impairment. However, most previous reflex studies have focused on passive, single-joint movements without regard to their coordination during volitional actions. The purpose of this study was to examine the effects of stroke on coordinated activity of stretch reflexes elicited in multiple arm muscles following multijoint perturbations. We hypothesized that cortical injury results in increased stretch reflexes of muscles characteristic of the abnormal flexor synergy during active arm conditions. To test this hypothesis, we used a robot to apply position perturbations to impaired arms of 10 stroke survivors and dominant arms of 8 healthy age-matched controls. Corresponding reflexes were assessed during volitional contractions simulating different levels of gravitational support, as well as during voluntary flexion and extension of the elbow and shoulder. Reflexes were quantified by average rectified surface electromyogram, recorded from eight muscles spanning the elbow and shoulder. Reflex coordination was quantified using an independent components analysis. We found stretch reflexes elicited in the stroke group were significantly less sensitive to changes in background muscle activation compared with those in the control group (P < 0.05). We also observed significantly increased reflex coupling between elbow flexor and shoulder abductor–extensor muscles in stroke subjects relative to that in control subjects. This increased coupling was present only during volitional tasks that required elbow flexion (P < 0.001), shoulder extension (P < 0.01), and gravity opposition (P < 0.01), but not during the “no load” condition. During volitional contractions, reflex amplitudes scaled with the level

The use of robots for arms control treaty verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michalowski, S.J.

1991-01-01

Many aspects of the superpower relationship now present a new set of challenges and opportunities, including the vital area of arms control. This report addresses one such possibility: the use of robots for the verification of arms control treaties. The central idea of this report is far from commonly-accepted. In fact, it was only encountered once in bibliographic review phase of the project. Nonetheless, the incentive for using robots is simple and coincides with that of industrial applications: to replace or supplement human activity in the performance of tasks for which human participation is unnecessary, undesirable, impossible, too dangerous ormore » too expensive. As in industry, robots should replace workers (in this case, arms control inspectors) only when questions of efficiency, reliability, safety, security and cost-effectiveness have been answered satisfactorily. In writing this report, it is not our purpose to strongly advocate the application of robots in verification. Rather, we wish to explore the significant aspects, pro and con, of applying experience from the field of flexible automation to the complex task of assuring arms control treaty compliance. We want to establish a framework for further discussion of this topic and to define criteria for evaluating future proposals. The authors' expertise is in robots, not arms control. His practical experience has been in developing systems for use in the rehabilitation of severely disabled persons (such as quadriplegics), who can use robots for assistance during activities of everyday living, as well as in vocational applications. This creates a special interest in implementations that, in some way, include a human operator in the control scheme of the robot. As we hope to show in this report, such as interactive systems offer the greatest promise of making a contribution to the challenging problems of treaty verification. 15 refs.« less

Spatiotemporal gait changes with use of an arm swing cueing device in people with Parkinson's disease.

PubMed

Thompson, Elizabeth; Agada, Peter; Wright, W Geoffrey; Reimann, Hendrik; Jeka, John

2017-10-01

Impaired arm swing is a common motor symptom of Parkinson's disease (PD), and correlates with other gait impairments and increased risk of falls. Studies suggest that arm swing is not merely a passive consequence of trunk rotation during walking, but an active component of gait. Thus, techniques to enhance arm swing may improve gait characteristics. There is currently no portable device to measure arm swing and deliver immediate cues for larger movement. Here we test report pilot testing of such a device, ArmSense (patented), using a crossover repeated-measures design. Twelve people with PD walked in a video-recorded gym space at self-selected comfortable and fast speeds. After baseline, cues were given either visually using taped targets on the floor to increase step length or through vibrations at the wrist using ArmSense to increase arm swing amplitude. Uncued walking then followed, to assess retention. Subjects successfully reached cueing targets on >95% of steps. At a comfortable pace, step length increased during both visual cueing and ArmSense cueing. However, we observed increased medial-lateral trunk sway with visual cueing, possibly suggesting decreased gait stability. In contrast, no statistically significant changes in trunk sway were observed with ArmSense cues compared to baseline walking. At a fast pace, changes in gait parameters were less systematic. Even though ArmSense cues only specified changes in arm swing amplitude, we observed changes in multiple gait parameters, reflecting the active role arm swing plays in gait and suggesting a new therapeutic path to improve mobility in people with PD. Copyright © 2017 Elsevier B.V. All rights reserved.

AmeriFlux US-ARb ARM Southern Great Plains burn site- Lamont

DOE Data Explorer

Torn, Margaret [Lawrence Berkeley National Laboratory

2016-01-01

This is the AmeriFlux version of the carbon flux data for the site US-ARb ARM Southern Great Plains burn site- Lamont. Site Description - The ARM SGP Burn site is located in the native tallgrass prairies of the USDA Grazinglands Research Laboratory near El Reno, OK. One of two adjacent 35 ha plots, the US-ARb plot was burned on 2005/03/08. The second plot, US-ARc, was left unburned as the control for experimental purposes. Aside from 2005, the region evaded burning activities for at least 15 years. Current disturbances consist of only light grazing activities.

22 CFR 130.3 - Armed forces.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Armed forces. 130.3 Section 130.3 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS POLITICAL CONTRIBUTIONS, FEES AND COMMISSIONS § 130.3 Armed forces. Armed forces means the army, navy, marine, air force, or coast guard, as...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Gate arm. 234.223 Section 234.223 Transportation... SYSTEMS Maintenance, Inspection, and Testing Maintenance Standards § 234.223 Gate arm. Each gate arm, when... maintained in a condition sufficient to be clearly viewed by approaching highway users. Each gate arm shall...

Exercise therapy for treatment of supraspinatus tears does not alter glenohumeral kinematics during internal/external rotation with the arm at the side.

PubMed

Ferrer, Gerald A; Miller, R Matthew; Zlotnicki, Jason P; Tashman, Scott; Irrgang, James J; Musahl, Volker; Debski, Richard E

2018-01-01

Rotator cuff tears are a significant clinical problem, with exercise therapy being a common treatment option for patients. Failure rates of exercise therapy may be due to the failure to improve glenohumeral kinematics. Tears involving the supraspinatus may result in altered glenohumeral kinematics and joint instability for internal/external rotation with the arm at the side because not all muscles used to stabilize the glenohumeral joint are functioning normally. The objective of the study is to assess in vivo glenohumeral kinematic changes for internal/external rotation motions with the arm at the side of patients with a symptomatic full-thickness supraspinatus tear before and after a 12-week exercise therapy programme. Five patients underwent dynamic stereoradiography analysis before and after a 12-week exercise therapy protocol to measure changes in glenohumeral kinematics during transverse plane internal/external rotation with the arm at the side. Patient-reported outcomes and shoulder strength were also evaluated. No patient sought surgery immediately following exercise therapy. Significant improvements in isometric shoulder strength and patient-reported outcomes were observed (p < 0.05). No significant changes in glenohumeral kinematics following physical therapy were found. Isolated supraspinatus tears resulted in increased joint translations compared to healthy controls from the previous literature for internal/external rotation with the arm at the side. Despite satisfactory clinical outcomes following exercise therapy, glenohumeral kinematics did not change. The lack of changes may be due to the motion studied or the focus of current exercise therapy protocols being increasing shoulder strength and restoring range of motion. Current exercise therapy protocols should be adapted to also focus on restoring glenohumeral kinematics to improve joint stability since exercise therapy may have different effects depending on the motions of daily living. Prognostic

[ Modern condition and prospects of development of cardiac surgery in the Armed Forces].

PubMed

Khubulava, G G; Ryzhman, N N; Ovchinnikov, Iu V; Tyrenko, V V; Peleshko, A S

2014-04-01

Authors consider the problem of delivery cardiac surgical care to contingent of the Defence Ministry. Perspective directions of development of cardiac surgery in the Armed Forces of the Russian Federation are the development of minimally invasive cardio surgery, endovascular development of modern methods of diagnosis and treatment, further development of electrophysiological methods for diagnosis and treatment of disorders of rhythm and conduction, the introduction of various kinds of auxiliary mechanical circulatory support systems in acute and chronic heart failure, development of transplantation in cardiac surgery, improvement of algorithm selection and referral of patients requiring cardiac care by providing primary health care to troop central military medical institutions, creating a single register of cardiac patients as part of the Armed Forces in order to determine the order and place of treatment, etc.

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Gate arm. 234.223 Section 234.223 Transportation... Maintenance Standards § 234.223 Gate arm. Each gate arm, when in the downward position, shall extend across... clearly viewed by approaching highway users. Each gate arm shall start its downward motion not less than...

49 CFR 234.223 - Gate arm.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Gate arm. 234.223 Section 234.223 Transportation... Maintenance Standards § 234.223 Gate arm. Each gate arm, when in the downward position, shall extend across... clearly viewed by approaching highway users. Each gate arm shall start its downward motion not less than...

Using biomarkers to predict TB treatment duration (Predict TB): a prospective, randomized, noninferiority, treatment shortening clinical trial.

PubMed

Chen, Ray Y; Via, Laura E; Dodd, Lori E; Walzl, Gerhard; Malherbe, Stephanus T; Loxton, André G; Dawson, Rodney; Wilkinson, Robert J; Thienemann, Friedrich; Tameris, Michele; Hatherill, Mark; Diacon, Andreas H; Liu, Xin; Xing, Jin; Jin, Xiaowei; Ma, Zhenya; Pan, Shouguo; Zhang, Guolong; Gao, Qian; Jiang, Qi; Zhu, Hong; Liang, Lili; Duan, Hongfei; Song, Taeksun; Alland, David; Tartakovsky, Michael; Rosenthal, Alex; Whalen, Christopher; Duvenhage, Michael; Cai, Ying; Goldfeder, Lisa C; Arora, Kriti; Smith, Bronwyn; Winter, Jill; Barry Iii, Clifton E

2017-11-06

Background : By the early 1980s, tuberculosis treatment was shortened from 24 to 6 months, maintaining relapse rates of 1-2%. Subsequent trials attempting shorter durations have failed, with 4-month arms consistently having relapse rates of 15-20%. One trial shortened treatment only among those without baseline cavity on chest x-ray and whose month 2 sputum culture converted to negative. The 4-month arm relapse rate decreased to 7% but was still significantly worse than the 6-month arm (1.6%, P<0.01).  We hypothesize that PET/CT characteristics at baseline, PET/CT changes at one month, and markers of residual bacterial load will identify patients with tuberculosis who can be cured with 4 months (16 weeks) of standard treatment. Methods : This is a prospective, multicenter, randomized, phase 2b, noninferiority clinical trial of pulmonary tuberculosis participants. Those eligible start standard of care treatment. PET/CT scans are done at weeks 0, 4, and 16 or 24. Participants who do not meet early treatment completion criteria (baseline radiologic severity, radiologic response at one month, and GeneXpert-detectable bacilli at four months) are placed in Arm A (24 weeks of standard therapy). Those who meet the early treatment completion criteria are randomized at week 16 to continue treatment to week 24 (Arm B) or complete treatment at week 16 (Arm C). The primary endpoint compares the treatment success rate at 18 months between Arms B and C. Discussion : Multiple biomarkers have been assessed to predict TB treatment outcomes. This study uses PET/CT scans and GeneXpert (Xpert) cycle threshold to risk stratify participants. PET/CT scans are not applicable to global public health but could be used in clinical trials to stratify participants and possibly become a surrogate endpoint. If the Predict TB trial is successful, other immunological biomarkers or transcriptional signatures that correlate with treatment outcome may be identified. NCT02821832.

Using biomarkers to predict TB treatment duration (Predict TB): a prospective, randomized, noninferiority, treatment shortening clinical trial

PubMed Central

Chen, Ray Y.; Via, Laura E.; Dodd, Lori E.; Walzl, Gerhard; Malherbe, Stephanus T.; Loxton, André G.; Dawson, Rodney; Wilkinson, Robert J.; Thienemann, Friedrich; Tameris, Michele; Hatherill, Mark; Diacon, Andreas H.; Liu, Xin; Xing, Jin; Jin, Xiaowei; Ma, Zhenya; Pan, Shouguo; Zhang, Guolong; Gao, Qian; Jiang, Qi; Zhu, Hong; Liang, Lili; Duan, Hongfei; Song, Taeksun; Alland, David; Tartakovsky, Michael; Rosenthal, Alex; Whalen, Christopher; Duvenhage, Michael; Cai, Ying; Goldfeder, Lisa C.; Arora, Kriti; Smith, Bronwyn; Winter, Jill; Barry III, Clifton E.

2017-01-01

Background: By the early 1980s, tuberculosis treatment was shortened from 24 to 6 months, maintaining relapse rates of 1-2%. Subsequent trials attempting shorter durations have failed, with 4-month arms consistently having relapse rates of 15-20%. One trial shortened treatment only among those without baseline cavity on chest x-ray and whose month 2 sputum culture converted to negative. The 4-month arm relapse rate decreased to 7% but was still significantly worse than the 6-month arm (1.6%, P<0.01).  We hypothesize that PET/CT characteristics at baseline, PET/CT changes at one month, and markers of residual bacterial load will identify patients with tuberculosis who can be cured with 4 months (16 weeks) of standard treatment. Methods: This is a prospective, multicenter, randomized, phase 2b, noninferiority clinical trial of pulmonary tuberculosis participants. Those eligible start standard of care treatment. PET/CT scans are done at weeks 0, 4, and 16 or 24. Participants who do not meet early treatment completion criteria (baseline radiologic severity, radiologic response at one month, and GeneXpert-detectable bacilli at four months) are placed in Arm A (24 weeks of standard therapy). Those who meet the early treatment completion criteria are randomized at week 16 to continue treatment to week 24 (Arm B) or complete treatment at week 16 (Arm C). The primary endpoint compares the treatment success rate at 18 months between Arms B and C. Discussion: Multiple biomarkers have been assessed to predict TB treatment outcomes. This study uses PET/CT scans and GeneXpert (Xpert) cycle threshold to risk stratify participants. PET/CT scans are not applicable to global public health but could be used in clinical trials to stratify participants and possibly become a surrogate endpoint. If the Predict TB trial is successful, other immunological biomarkers or transcriptional signatures that correlate with treatment outcome may be identified. Trial Registration: NCT02821832 PMID

[Assessment of the surgeon radiation exposure during a minimally invasive TLIF: Comparison between fluoroscopy and O-arm system].

PubMed

Grelat, M; Zairi, F; Quidet, M; Marinho, P; Allaoui, M; Assaker, R

2015-08-01

Transforaminal lumbar interbody fusion with a minimally invasive approach (MIS TLIF) has become a very popular technique in the treatment of degenerative diseases of the lumbar spine, as it allows a decrease in muscle iatrogenic. However, iterative radiological controls inherent to this technique are responsible for a significant increase in exposure to ionizing radiation for the surgeon. New techniques for radiological guidance (O-arm navigation-assisted) would overcome this drawback, but this remains unproven. To analyze the exposure of the surgeon to intraoperative X-ray during a MIS TLIF under fluoroscopy and under O-arm navigation-assisted. This prospective study was conducted at the University Hospital of Lille from February to May 2013. Twelve patients underwent a MIS TLIF for the treatment of low-grade spondylolisthesis; six under standard fluoroscopy (group 1) and six under O-arm system (group 2). Passive dosimeters (rings and glasses) and active dosimeters for thorax were used to measure the radiation exposure of the surgeon. For group 1, the average time of fluoroscopy was 3.718 minutes (3.13-4.56) while no radioscopy was perform on group 2. For the first group, the average exposure dose was 12 μSv (5-20 μSv) on the thorax, 1168 μSv (510-2790 μSv) on the main hand and 179 μSv (103-486 μSv) on the lens. The exposure dose was measured zero on the second group. The maximum recommended doses can be reached, mainly for the lens. In addition to the radioprotection measures, O-arm navigation systems are safe alternatives to significantly reduce surgeon exposure. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A slouched body posture decreases arm mobility and changes muscle recruitment in the neck and shoulder region.

PubMed

Malmström, Eva-Maj; Olsson, Joakim; Baldetorp, Johan; Fransson, Per-Anders

2015-12-01

Long-term use of unfavorable postures, congenital deformations and degenerative processes associated with aging or disease may generate an increased thoracic curvature resulting in pain and disability. We wanted to examine whether a slouched postural alignment with increased thoracic kyphosis changes the shoulder kinematics and muscle activity in upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) during arm elevation. The aim was to determine if a slouched posture influences range of motion, muscle activation patterns, maximal muscle activity and the total muscle work required when performing arm elevations. Twelve male subjects (23.3 ± 1.5 years) performed maximum arm elevations in upright and slouched postures. A combined 3D movement and EMG system recorded arm movements and spine curvature simultaneously with EMG activity in the UT, LT and SA. Slouched posture affected the biomechanical conditions by significantly decreasing maximum arm elevation by ~15° (p < 0.001) and decreasing arm movement velocity by ~8 % during movements upwards (p < 0.001) and downwards (p = 0.034). The peak muscle activity increased in all muscles: UT (p = 0.034, +32.3 %), LT (p = 0.001, +48.6 %) and SA (p = 0.007, +20.9 %). The total muscle work increased significantly in the slouched posture during movements upwards: UT (p = 0.003, +36.6 %), LT (p < 0.001, +89.0 %), SA (p = 0.002, +19.4 %) and downwards: UT (p = 0.012, +29.8 %) and LT (p < 0.001, +122.5 %). An increased thoracic kyphosis was found associated with marked increased physical costs when performing arm movements. Hence, patients suffering from neck-shoulder pain and disability should be investigated and treated for defective thoracic curvature issues.

Arms races between and within species.

PubMed

Dawkins, R; Krebs, J R

1979-09-21

An adaptation in one lineage (e.g. predators) may change the selection pressure on another lineage (e.g. prey), giving rise to a counter-adaptation. If this occurs reciprocally, an unstable runaway escalation or 'arms race' may result. We discuss various factors which might give one side an advantage in an arms race. For example, a lineage under strong selection may out-evolve a weakly selected one (' the life-dinner principle'). We then classify arms races in two independent ways. They may be symmetric or asymmetric, and they may be interspecific or intraspecific. Our example of an asymmetric interspecific arms race is that between brood parasites and their hosts. The arms race concept may help to reduce the mystery of why cuckoo hosts are so good at detecting cuckoo eggs, but so bad at detecting cuckoo nestlings. The evolutionary contest between queen and worker ants over relative parental investment is a good example of an intraspecific asymmetric arms race. Such cases raise special problems because the participants share the same gene pool. Interspecific symmetric arms races are unlikely to be important, because competitors tend to diverge rather than escalate competitive adaptations. Intraspecific symmetric arms races, exemplified by adaptations for male-male competition, may underlie Cope's Rule and even the extinction of lineages. Finally we consider ways in which arms races can end. One lineage may drive the other to extinction; one may reach an optimum, thereby preventing the other from doing so; a particularly interesting possibility, exemplified by flower-bee coevolution, is that both sides may reach a mutual local optimum; lastly, arms races may have no stable and but may cycle continuously. We do not wish necessarily to suggest that all, or even most, evolutionary change results from arms races, but we do suggest that the arms race concept may help to resolve three long-standing questions in evolutionary theory.

Rifaximin has a marginal impact on microbial translocation, T-cell activation and inflammation in HIV-positive immune non-responders to antiretroviral therapy - ACTG A5286.

PubMed

Tenorio, Allan R; Chan, Ellen S; Bosch, Ronald J; Macatangay, Bernard J C; Read, Sarah W; Yesmin, Suria; Taiwo, Babafemi; Margolis, David M; Jacobson, Jeffrey M; Landay, Alan L; Wilson, Cara C

2015-03-01

Rifaximin, a nonabsorbable antibiotic that decreases lipopolysaccharide (LPS) in cirrhotics, may decrease the elevated levels of microbial translocation, T-cell activation and inflammation in human immunodeficiency virus (HIV)-positive immune nonresponders to antiretroviral therapy (ART). HIV-positive adults receiving ART for ≥96 weeks with undetectable viremia for ≥48 weeks and CD4(+) T-cell counts <350 cells/mm(3) were randomized 2:1 to rifaximin versus no study treatment for 4 weeks. T-cell activation, LPS, and soluble CD14 were measured at baseline and at weeks 2, 4, and 8. Wilcoxon rank sum tests compared changes between arms. Compared with no study treatment (n = 22), rifaximin (n = 43) use was associated with a significant difference between study arms in the change from baseline to week 4 for CD8(+)T-cell activation (median change, 0.0% with rifaximin vs +0.6% with no treatment; P = .03). This difference was driven by an increase in the no-study-treatment arm because there was no significant change within the rifaximin arm. Similarly, although there were significant differences between study arms in change from baseline to week 2 for LPS and soluble CD14, there were no significant changes within the rifaximin arm. In immune nonresponders to ART, rifaximin minimally affected microbial translocation and CD8(+)T-cell activation. Trial registration number. NCT01466595. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The evolution of neuroArm.

PubMed

Sutherland, Garnette R; Wolfsberger, Stefan; Lama, Sanju; Zarei-nia, Kourosh

2013-01-01

Intraoperative imaging disrupts the rhythm of surgery despite providing an excellent opportunity for surgical monitoring and assessment. To allow surgery within real-time images, neuroArm, a teleoperated surgical robotic system, was conceptualized. The objective was to design and manufacture a magnetic resonance-compatible robot with a human-machine interface that could reproduce some of the sight, sound, and touch of surgery at a remote workstation. University of Calgary researchers worked with MacDonald, Dettwiler and Associates engineers to produce a requirements document, preliminary design review, and critical design review, followed by the manufacture, preclinical testing, and clinical integration of neuroArm. During the preliminary design review, the scope of the neuroArm project changed to performing microsurgery outside the magnet and stereotaxy inside the bore. neuroArm was successfully manufactured and installed in an intraoperative magnetic resonance imaging operating room. neuroArm was clinically integrated into 35 cases in a graded fashion. As a result of this experience, neuroArm II is in development, and advances in technology will allow microsurgery within the bore of the magnet. neuroArm represents a successful interdisciplinary collaboration. It has positive implications for the future of robotic technology in neurosurgery in that the precision and accuracy of robots will continue to augment human capability.

Dosimetric variations in permanent breast seed implant due to patient arm position.

PubMed

Watt, Elizabeth; Husain, Siraj; Sia, Michael; Brown, Derek; Long, Karen; Meyer, Tyler

2015-01-01

Planning and delivery for permanent breast seed implant (PBSI) are performed with the ipsilateral arm raised; however, changes in implant geometry can be expected because of healing and anatomical motion as the patient resumes her daily activities. The purpose of this study is to quantify the effect of ipsilateral arm position on postplan dosimetry. Twelve patients treated at the Tom Baker Cancer Centre were included in this study. Patients underwent two postimplant CT scans on the day of implant (Day 0) and two scans approximately 8 weeks later (Day 60). One scan at each time was taken with the ipsilateral arm raised, recreating the planning scan position, and the other with both arms down in a relaxed position beside the body, recreating a more realistic postimplant arm position. Postplans were completed on all four scans using deformable image registration (MIM Maestro). On the Day 0 scan, the V200 for the evaluation planning target volume was significantly increased in the arm-down position compared with the arm-up position. Lung, rib, and chest wall dose were significantly reduced at both time points. Left anterior descending coronary artery, heart, and skin dose showed no significant differences at either time point. Although some dosimetric indices show significant differences between the arm-up and arm-down positions, the magnitude of these differences is small and the values remain indicative of implant quality. Despite the delivery of the majority of dose with the arm down, it is reasonable to use CT scans taken in the arm-up position for postplanning. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Improved orthopedic arm joint

NASA Technical Reports Server (NTRS)

Dane, D. H.

1971-01-01

Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

Organization of octopus arm movements: a model system for studying the control of flexible arms.

PubMed

Gutfreund, Y; Flash, T; Yarom, Y; Fiorito, G; Segev, I; Hochner, B

1996-11-15

Octopus arm movements provide an extreme example of controlled movements of a flexible arm with virtually unlimited degrees of freedom. This study aims to identify general principles in the organization of these movements. Video records of the movements of Octopus vulgaris performing the task of reaching toward a target were studied. The octopus extends its arm toward the target by a wave-like propagation of a bend that travels from the base of the arm toward the tip. Similar bend propagation is seen in other octopus arm movements, such as locomotion and searching. The kinematics (position and velocity) of the midpoint of the bend in three-dimensional space were extracted using the direct linear transformation algorithm. This showed that the bend tends to move within a single linear plane in a simple, slightly curved path connecting the center of the animal's body with the target location. Approximately 70% of the reaching movements demonstrated a stereotyped tangential velocity profile. An invariant profile was observed when movements were normalized for velocity and distance. Two arms, extended together in the same behavioral context, demonstrated identical velocity profiles. The stereotyped features of the movements were also observed in spontaneous arm extensions (not toward an external target). The simple and stereotypic appearance of the bend trajectory suggests that the position of the bend in space and time is the controlled variable. We propose that this strategy reduces the immense redundancy of the octopus arm movements and hence simplifies motor control.

Determination of Large-Scale Cloud Ice Water Concentration by Combining Surface Radar and Satellite Data in Support of ARM SCM Activities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Guosheng

2013-03-15

cloud ice water contents in support of cloud modeling activities. The approach of the study is to expand a (surface) point measurement to an (satellite) area measurement. That is, the study takes the advantage of the high quality cloud measurements (particularly cloud radar and microwave radiometer measurements) at the point of the ARM sites. We use the cloud ice water characteristics derived from the point measurement to guide/constrain a satellite retrieval algorithm, then use the satellite algorithm to derive the 3-D cloud ice water distributions within an 10° (latitude) x 10° (longitude) area. During the research period, we have developed, validated and improved our cloud ice water retrievals, and have produced and archived at ARM website as a PI-product of the 3-D cloud ice water contents using combined satellite high-frequency microwave and surface radar observations for SGP March 2000 IOP and TWP-ICE 2006 IOP over 10 deg. x 10 deg. area centered at ARM SGP central facility and Darwin sites. We have also worked on validation of the 3-D ice water product by CloudSat data, synergy with visible/infrared cloud ice water retrievals for better results at low ice water conditions, and created a long-term (several years) of ice water climatology in 10 x 10 deg. area of ARM SGP and TWP sites and then compared it with GCMs.« less

Hand-arm vibration syndrome: A rarely seen diagnosis.

PubMed

Campbell, Rebecca A; Janko, Matthew R; Hacker, Robert I

2017-06-01

Hand-arm vibration syndrome (HAVS) is a collection of sensory, vascular, and musculoskeletal symptoms caused by repetitive trauma from vibration. This case report demonstrates how to diagnose HAVS on the basis of history, physical examination, and vascular imaging and its treatment options. A 41-year-old man who regularly used vibrating tools presented with nonhealing wounds on his right thumb and third digit. Arteriography revealed occlusions of multiple arteries in his hand with formation of collaterals. We diagnosed HAVS, and his wounds healed after several weeks with appropriate treatment. HAVS is a debilitating condition with often irreversible vascular damage, requiring early diagnosis and treatment.

Arm dominance affects feedforward strategy more than feedback sensitivity during a postural task.

PubMed

Walker, Elise H E; Perreault, Eric J

2015-07-01

Handedness is a feature of human motor control that is still not fully understood. Recent work has demonstrated that the dominant and nondominant arm each excel at different behaviors and has proposed that this behavioral asymmetry arises from lateralization in the cerebral cortex: the dominant side specializes in predictive trajectory control, while the nondominant side is specialized for impedance control. Long-latency stretch reflexes are an automatic mechanism for regulating posture and have been shown to contribute to limb impedance. To determine whether long-latency reflexes also contribute to asymmetric motor behavior in the upper limbs, we investigated the effect of arm dominance on stretch reflexes during a postural task that required varying degrees of impedance control. Our results demonstrated slightly but significantly larger reflex responses in the biarticular muscles of the nondominant arm, as would be consistent with increased impedance control. These differences were attributed solely to higher levels of voluntary background activity in the nondominant biarticular muscles, indicating that feedforward strategies for postural stability may differ between arms. Reflex sensitivity, which was defined as the magnitude of the reflex response for matched levels of background activity, was not significantly different between arms for a broad subject population ranging from 23 to 51 years of age. These results indicate that inter-arm differences in feedforward strategies are more influential during posture than differences in feedback sensitivity, in a broad subject population. Interestingly, restricting our analysis to subjects under 40 years of age revealed a small increase in long-latency reflex sensitivity in the nondominant arm relative to the dominant arm. Though our subject numbers were small for this secondary analysis, it suggests that further studies may be required to assess the influence of reflex lateralization throughout development.

Arm Dominance Affects Feedforward Strategy more than Feedback Sensitivity during a Postural Task

PubMed Central

Walker, Elise H. E.; Perreault, Eric J.

2015-01-01

Handedness is a feature of human motor control that is still not fully understood. Recent work has demonstrated that the dominant and nondominant arm each excel at different behaviors, and has proposed that this behavioral asymmetry arises from lateralization in the cerebral cortex: the dominant side specializes in predictive trajectory control, while the nondominant side is specialized for impedance control. Long-latency stretch reflexes are an automatic mechanism for regulating posture, and have been shown to contribute to limb impedance. To determine whether long-latency reflexes also contribute to asymmetric motor behavior in the upper limbs, we investigated the effect of arm dominance on stretch reflexes during a postural task that required varying degrees of impedance control. Our results demonstrated slightly but significantly larger reflex responses in the biarticular muscles of the nondominant arm, as would be consistent with increased impedance control. These differences were attributed solely to higher levels of voluntary background activity in the nondominant biarticular muscles, indicating that feedforward strategies for postural stability may differ between arms. Reflex sensitivity, which was defined as the magnitude of the reflex response for matched levels of background activity, was not significantly different between arms for a broad subject population ranging from 23–51 years of age. These results indicate that inter-arm differences in feedforward strategies are more influential during posture than differences in feedback sensitivity, in a broad subject population. Interestingly, restricting our analysis to subjects under 40 years of age revealed a small increase in long-latency reflex sensitivity in the nondominant arm relative to the dominant arm. Though our subject numbers were small for this secondary analysis, it suggests that further studies may be required to assess the influence of reflex lateralization throughout development. PMID

High precision detector robot arm system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shu, Deming; Chu, Yong

A method and high precision robot arm system are provided, for example, for X-ray nanodiffraction with an X-ray nanoprobe. The robot arm system includes duo-vertical-stages and a kinematic linkage system. A two-dimensional (2D) vertical plane ultra-precision robot arm supporting an X-ray detector provides positioning and manipulating of the X-ray detector. A vertical support for the 2D vertical plane robot arm includes spaced apart rails respectively engaging a first bearing structure and a second bearing structure carried by the 2D vertical plane robot arm.

Long term changes of the throwing arm of former elite javelin throwers.

PubMed

Schmitt, H; Hansmann, H J; Brocai, D R; Loew, M

2001-05-01

The aim of this study was to determine long term changes in shoulder and elbow joints of former elite javelin throwers. Twenty-one elite javelin throwers were examined at an average of 19 years after the end of their high performance phase. Mean age at examination was 50 years. Functional assessment of both shoulders was determined by the Constant-score. The shoulder of the throwing arm was examined by magnetic resonance imaging. Both elbow joints were examined clinically and radiographically. Five athletes complained about transient shoulder pain in their throwing arm affecting activities of daily living, fourteen athletes had a deficit of internal rotation of at least ten degrees. Constant-scores of throwing arms were six points lower than those of non-throwing arms (P < 0.05). Complete ruptures and partial tears of the rotator cuff were frequent. Three athletes complained about transient elbow pain in their throwing arm affecting activities of daily living; ten athletes had a deficit of extension of more than five degrees. All dominant elbows had advanced arthrotic alterations (osteophytes, sclerosis) compared to the non-dominant side. Athletes who trained with weights of more than 3 kg had a significantly higher risk of degenerative changes than athletes who did not (P < 0.01). We therefore recommend to avoid throwing training with weights of more than 3 kg.

Relationship between Arm Morbidity and Patient-Reported Outcomes Following Surgery in Women with Node-Negative Breast Cancer: NSABP Protocol B-32

PubMed Central

Kopec, Jacek A.; Colangelo, Linda H.; Land, Stephanie R.; Julian, Thomas B.; Brown, Ann M.; Anderson, Stewart J.; Krag, David N.; Ashikaga, Takamaru; Costantino, Joseph P.; Wolmark, Norman; Ganz, Patricia A.

2012-01-01

Background The impact of arm morbidity following breast cancer surgery on patient-observed changes in daily functioning and health-related quality of life (HRQoL) have not been well-studied. Objective To examine the association of objective measures such as range of motion (ROM) and lymphedema, with patient-reported outcomes (PROs) in the arm and breast, upper extremity function, activities, and HRQoL. Methods The National Surgical Adjuvant Breast and Bowel Project Protocol B-32 was a randomized trial comparing sentinel node resection (SNR) with axillary dissection (AD) in women with node-negative breast cancer. ROM and arm volume were measured objectively. PROs included symptoms; arm function; limitations in social, recreational, occupational, and other regular activities; and a global index of HRQoL. Statistical methods included cross-tabulations and multivariable linear regression models. Results In all, 744 women provided at least 1 postsurgery assessment. About one-third of the patients experienced arm mobility restrictions. A similar number of patients avoided the use of the arm 6 months after surgery. Limitations in work and other regular activities were reported by about a quarter of the patients. In this multivariable analysis, arm mobility and sensory neuropathy were predictors of patient-reported arm function and overall HRQoL. Predictors for activity limitations also included side of surgery (dominant vs nondominant). Edema was not significant after adjustment for sensory neuropathy and ROM. Limitations Arm mobility and edema were measured simultaneously only once during the follow-up (6 months). Conclusion Clinical measures of sensory neuropathy and restrictions in arm mobility following breast cancer surgery are associated with self-reported limitations in activity and reductions in overall HRQoL. PMID:22951047

AmeriFlux US-ARc ARM Southern Great Plains control site- Lamont

DOE Data Explorer

Torn, Margaret [Lawrence Berkeley National Laboratory

2016-01-01

This is the AmeriFlux version of the carbon flux data for the site US-ARc ARM Southern Great Plains control site- Lamont. Site Description - The ARM SGP Control site is located in the native tallgrass prairies of the USDA Grazinglands Research Laboratory near El Reno, OK. One of two adjacent 35 ha plots with identical towers, measurements at the US-ARc unburned plot are used as the experimental control. The second plot, US-Arb, was burned on 2005/03/08. Measurement comparisons between the control and burn plot are used to address questions regarding the effects of burning activities on carbon fluxes. The region evaded burning activities for at least 15 years. Current disturbances consist of only light grazing activities.

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training

PubMed Central

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme

2015-01-01

Background Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Methods Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Results Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Conclusions Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke

Residual Upper Arm Motor Function Primes Innervation of Paretic Forearm Muscles in Chronic Stroke after Brain-Machine Interface (BMI) Training.

PubMed

Curado, Marco Rocha; Cossio, Eliana Garcia; Broetz, Doris; Agostini, Manuel; Cho, Woosang; Brasil, Fabricio Lima; Yilmaz, Oezge; Liberati, Giulia; Lepski, Guilherme; Birbaumer, Niels; Ramos-Murguialday, Ander

2015-01-01

Abnormal upper arm-forearm muscle synergies after stroke are poorly understood. We investigated whether upper arm function primes paralyzed forearm muscles in chronic stroke patients after Brain-Machine Interface (BMI)-based rehabilitation. Shaping upper arm-forearm muscle synergies may support individualized motor rehabilitation strategies. Thirty-two chronic stroke patients with no active finger extensions were randomly assigned to experimental or sham groups and underwent daily BMI training followed by physiotherapy during four weeks. BMI sessions included desynchronization of ipsilesional brain activity and a robotic orthosis to move the paretic limb (experimental group, n = 16). In the sham group (n = 16) orthosis movements were random. Motor function was evaluated with electromyography (EMG) of forearm extensors, and upper arm and hand Fugl-Meyer assessment (FMA) scores. Patients performed distinct upper arm (e.g., shoulder flexion) and hand movements (finger extensions). Forearm EMG activity significantly higher during upper arm movements as compared to finger extensions was considered facilitation of forearm EMG activity. Intraclass correlation coefficient (ICC) was used to test inter-session reliability of facilitation of forearm EMG activity. Facilitation of forearm EMG activity ICC ranges from 0.52 to 0.83, indicating fair to high reliability before intervention in both limbs. Facilitation of forearm muscles is higher in the paretic as compared to the healthy limb (p<0.001). Upper arm FMA scores predict facilitation of forearm muscles after intervention in both groups (significant correlations ranged from R = 0.752, p = 0.002 to R = 0.779, p = 0.001), but only in the experimental group upper arm FMA scores predict changes in facilitation of forearm muscles after intervention (R = 0.709, p = 0.002; R = 0.827, p<0.001). Residual upper arm motor function primes recruitment of paralyzed forearm muscles in chronic stroke patients and predicts changes in their

Effect of gravity-like torque on goal-directed arm movements in microgravity.

PubMed

Bringoux, L; Blouin, J; Coyle, T; Ruget, H; Mouchnino, L

2012-05-01

Gravitational force level is well-known to influence arm motor control. Specifically, hyper- or microgravity environments drastically change pointing accuracy and kinematics, particularly during initial exposure. These modifications are thought to partly reflect impairment in arm position sense. Here we investigated whether applying normogravitational constraints at joint level during microgravity episodes of parabolic flights could restore movement accuracy equivalent to that observed on Earth. Subjects with eyes closed performed arm reaching movements toward predefined sagittal angular positions in four environment conditions: normogravity, hypergravity, microgravity, and microgravity with elastic bands attached to the arm to mimic gravity-like torque at the shoulder joint. We found that subjects overshot and undershot the target orientations in hypergravity and microgravity, respectively, relative to a normogravity baseline. Strikingly, adding gravity-like torque prior to and during movements performed in microgravity allowed subjects to be as accurate as in normogravity. In the former condition, arm movement kinematics, as notably illustrated by the relative time to peak velocity, were also unchanged relative to normogravity, whereas significant modifications were found in hyper- and microgravity. Overall, these results suggest that arm motor planning and control are tuned with respect to gravitational information issued from joint torque, which presumably enhances arm position sense and activates internal models optimally adapted to the gravitoinertial environment.

Armed Conflict, Substance Use and HIV: A Global Analysis

PubMed Central

Kerridge, Bradley T.; Saha, Tulshi D.; Hasin, Deborah S.

2015-01-01

Armed conflict is frequently assumed to be a contributor to the global HIV epidemic, but existing evidence is sparse. We examined the relationship between armed conflict between 2002-2008 and HIV disability life years (DALYs) in 2010 among WHO Member States. Using partial least squares analysis we also examined moderation of the armed conflict-HIV link by two susceptibility constructs (background risk, substance use) and one vulnerability mediator (numbers of refugees, people on ART, and total HIV spending). Background risk directly impacted HIV DALYs (p<0.05), substance use moderated the conflict-HIV relationship (p<0.01). The vulnerability construct mediated the conflict-HIV association (p<0.01). Findings underscore the need to align HIV prevention/intervention efforts with pre-existing HIV burden and reduce the impact of natural disasters on the populace in conflict-affected states. Integration of substance prevention/harm reduction programs within national HIV responses, attention to most-at-risk populations and increased surveillance/treatment of drug resistant HIV and TB is warranted. PMID:26286341

Opportunity's Arm in 'Hover-Stow' Position

NASA Technical Reports Server (NTRS)

2006-01-01

In January 2006, NASA's Mars Exploration Rover team adopted a new strategy for carrying Opportunity's robotic arm (the instrument deployment device with its turret of four tools at the end) when the rover is driving.

On short drives over smooth terrain, Opportunity now holds the arm in a 'hover-stow' position as shown in this image taken by the navigation camera during the rover's 706th Martian day, or sol (Jan. 18, 2006), with elbow forward and the tool turret held above the rover deck. (In this image, the Moessbauer spectrometer is facing upwards, the alpha particle X-ray spectrometer faces to the right and the rock abrasion tool faces to the left). On longer or rougher drives, Opportunity still holds the arm in the original stow position used throughout the mission, tucked underneath the deck.

During Opportunity's 654th sol (Nov. 25, 2005), symptoms began appearing that have been diagnosed as a broken wire in the motor windings for the azimuth actuator at the shoulder joint, a motor that moves the arm from side to side. The motor still works when given extra current, but the change in strategy for stowing the arm results from concern that, if the motor were to completely fail with the arm in the original stow position, the arm could no longer be unstowed for use. If that motor were to fail while the arm is in the hover-stow position, the arm could still be manipulated for full use of the tools on the turret. However, the hover-stow position gives less protection to the arm during drives. Concern about protecting the arm during drives led to the compromise strategy of using hover-stow only during short, smooth drives.

MS disease activity in RESTORE: a randomized 24-week natalizumab treatment interruption study.

PubMed

Fox, Robert J; Cree, Bruce A C; De Sèze, Jerome; Gold, Ralf; Hartung, Hans-Peter; Jeffery, Douglas; Kappos, Ludwig; Kaufman, Michael; Montalbán, Xavier; Weinstock-Guttman, Bianca; Anderson, Britt; Natarajan, Amy; Ticho, Barry; Duda, Petra

2014-04-29

RESTORE was a randomized, partially placebo-controlled exploratory study evaluating multiple sclerosis (MS) disease activity during a 24-week interruption of natalizumab. Eligible patients were relapse-free through the prior year on natalizumab and had no gadolinium-enhancing lesions on screening brain MRI. Patients were randomized 1:1:2 to continue natalizumab, to switch to placebo, or to receive alternative immunomodulatory therapy (other therapies: IM interferon β-1a [IM IFN-β-1a], glatiramer acetate [GA], or methylprednisolone [MP]). During the 24-week randomized treatment period, patients underwent clinical and MRI assessments every 4 weeks. Patients (n = 175) were randomized to natalizumab (n = 45), placebo (n = 42), or other therapies (n = 88: IM IFN-β-1a, n = 17; GA, n = 17; MP, n = 54). Of 167 patients evaluable for efficacy, 49 (29%) had MRI disease activity recurrence: 0/45 (0%) natalizumab, 19/41 (46%) placebo, 1/14 (7%) IM IFN-β-1a, 8/15 (53%) GA, and 21/52 (40%) MP. Relapse occurred in 4% of natalizumab patients and in 15%-29% of patients in the other treatment arms. MRI disease activity recurred starting at 12 weeks (n = 3 at week 12) while relapses were reported as early as 4-8 weeks (n = 2 in weeks 4-8) after the last natalizumab dose. Overall, 50/167 patients (30%), all in placebo or other-therapies groups, restarted natalizumab early because of disease activity. MRI and clinical disease activity recurred in some patients during natalizumab interruption, despite use of other therapies. This study provides Class II evidence that for patients with MS taking natalizumab who are relapse-free for 1 year, stopping natalizumab increases the risk of MS relapse or MRI disease activity as compared with continuing natalizumab.

Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis.

PubMed

Bello, Natalia; Etcheto, Adrien; Béal, Caroline; Dougados, Maxime; Moltó, Anna

2016-02-09

Fibromyalgia (FM) can coexist with Spondyloarthritis (SpA) leading to diagnostic and treatment dilemmas, especially in the presence of enthesitis. With this study we aimed to estimate the prevalence of FM in SpA and to compare the clinical/disease features and TNF inhibitors (TNFi) in patients with/without FM. FM was defined by a score = > 5/6 of the Fibromyalgia Rapid Screening Tool (FiRST). SpA patients (according to the rheumatologist) and consecutively consulting in the day care hospital but also in the outpatient clinic at the rheumatology department of a tertiary care university hospital were included. Demographics, disease characteristics, activity and severity and TNFi treatment were compared in patients with and without FM; retention rate of the first TNFi and associated factors were explored (Kaplan Meier and Cox regression). Of the 196 enrolled SpA patients, 42 (21.4 %) were positively screened for FM. No statistically significant differences in the prevalence of FM were found with regard to the fulfillment of the ASAS criteria for peripheral/axial SpA, nor with regard to the fulfillment of the imaging vs. clinical arm of the ASAS criteria. However, patients with coexisting FM presented significantly with more enthesitis, higher disease activity (BASDAI and VAS) and poorer function scores (BASFI). No differences were found with regard to the initiation of TNFi treatment (79.0 % vs. 70.0 %, respectively), but the retention rate of the first TNFi after 2 years was shorter in the group of patients with FM (28.1 % (95 % CI 12.5-44.0) vs. 41.7 % (95 % CI 32.2-51.3), p = 0.01). This study confirms that coexistent FM in SpA might impact the patient-reported outcome indices for disease activity and function, and the retention rate of TNFi treatment.

Noninvasive lifting of arm, thigh, and knee skin with transcutaneous intense focused ultrasound.

PubMed

Alster, Tina S; Tanzi, Elizabeth L

2012-05-01

Transcutaneous intense focused ultrasound is a novel Food and Drug Administration-approved technology for noninvasive skin tightening of the face and neck. No studies have reported on its safety and effectiveness on nonfacial areas. Eighteen paired areas (6 each) on the upper arms, medial thighs, and extensor knees were randomly treated with two different transducers (4.0 MHz, 4.5-mm focal depth and 7.0 MHz, 3.0-mm focal depth). One side was randomly assigned to receive a single pass (single plane) of microthermal coagulation zones over the involved area with the 4.0 MHz, 4.5-mm-depth transducer, and the contralateral side was assigned to receive consecutive single passes (dual plane) using both transducers (4.0 MHz, 4.5-mm depth followed by 7.0 MHz, 3.0-mm depth). Two independent masked assessors determined clinical improvement scores using comparative standardized photographs obtained at baseline and 3 and 6 months after treatment. Subjective assessments of clinical improvement and side effects of treatment were obtained. Global assessment scores revealed significant improvement in all treated areas, with the upper arms and knees demonstrating more skin lifting and tightening than the thighs. Areas receiving dual-plane treatment had slightly better clinical scores than those receiving single-plane treatment in all three sites. Clinical scores from single-plane and dual-plane treated areas continued to improve between 3 and 6 months after treatment. Side effects were mild and transient and included erythema, warmth, and skin tenderness. Rare focal bruising was noted in two patients on the upper arms that resolved within 7 days. No other side effects were reported or observed. Transcutaneous intense focused ultrasound can be safely and effectively used to improve the clinical appearance (texture and contour) of the upper arms, extensor knees, and medial thighs. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Plasma BDNFs level initially and post treatment in acute mania: comparison between ECT and atypical antipsychotic treatment and healthy controls.

PubMed

Karamustafalioglu, Nesrin; Genc, Abdullah; Kalelioglu, Tevfik; Tasdemir, Akif; Umut, Gokhan; Incir, Said; Akkuş, Mustafa; Emul, Murat

2015-08-01

Inconsistent findings concerning brain-derived neurotrophic factor (BDNF) levels across different episodes in bipolar disorder have been reported, which is also in line with the treatment effects on BDNF levels in acute mania. We aimed to compare plasma BDNF level alterations after pure antipsychotic drug or ECT plus antipsychotic drug treatment in acute mania. Sixty-eight patients with mania were divided into two treatment arms: the antipsychotic treatment arm (AP) and electroconvulsive therapy (ECT)+AP arm. In addition, 30 healthy controls were included in the study. There was no significant statistical difference according to mean age, education level, marital and working status between patients and healthy controls. The initial serum BDNF level in patients with acute mania was significantly lower than healthy controls. The initial BDNF level between the ECT arm and AP arm was not significant. The BDNF level decreased significantly after reaching remission in patients with acute mania. The change in BDNF level in the AP arm was not significant while in the ECT arm it was significant after treatment. In this study, for the first time we revealed a significant decrease in BDNF levels after ECT sessions in acute manic patients. Besides clinical remission after treatment in acute mania, the decrement in BDNF levels does not seem to be related to clinical response. Thus cumulative effects of mood episodes for the ongoing decrease in BDNF levels might be borne in mind despite the achievement of remission and/or more time being required for an increase in BDNF levels after treatment. © The Author(s) 2015.

75 FR 3331 - Ordering the Selected Reserve and Certain Individual Ready Reserve Members of the Armed Forces to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... Members of the Armed Forces to Active Duty By the authority vested in me as President by the Constitution... States Code, I hereby determine that it is necessary to augment the active Armed Forces of the United... respective jurisdictions, to order to active duty any units, and any individual members not assigned to a...

Computing Arm Movements with a Monkey Brainet.

PubMed

Ramakrishnan, Arjun; Ifft, Peter J; Pais-Vieira, Miguel; Byun, Yoon Woo; Zhuang, Katie Z; Lebedev, Mikhail A; Nicolelis, Miguel A L

2015-07-09

Traditionally, brain-machine interfaces (BMIs) extract motor commands from a single brain to control the movements of artificial devices. Here, we introduce a Brainet that utilizes very-large-scale brain activity (VLSBA) from two (B2) or three (B3) nonhuman primates to engage in a common motor behaviour. A B2 generated 2D movements of an avatar arm where each monkey contributed equally to X and Y coordinates; or one monkey fully controlled the X-coordinate and the other controlled the Y-coordinate. A B3 produced arm movements in 3D space, while each monkey generated movements in 2D subspaces (X-Y, Y-Z, or X-Z). With long-term training we observed increased coordination of behavior, increased correlations in neuronal activity between different brains, and modifications to neuronal representation of the motor plan. Overall, performance of the Brainet improved owing to collective monkey behaviour. These results suggest that primate brains can be integrated into a Brainet, which self-adapts to achieve a common motor goal.

Computing Arm Movements with a Monkey Brainet

PubMed Central

Ramakrishnan, Arjun; Ifft, Peter J.; Pais-Vieira, Miguel; Woo Byun, Yoon; Zhuang, Katie Z.; Lebedev, Mikhail A.; Nicolelis, Miguel A.L.

2015-01-01

Traditionally, brain-machine interfaces (BMIs) extract motor commands from a single brain to control the movements of artificial devices. Here, we introduce a Brainet that utilizes very-large-scale brain activity (VLSBA) from two (B2) or three (B3) nonhuman primates to engage in a common motor behaviour. A B2 generated 2D movements of an avatar arm where each monkey contributed equally to X and Y coordinates; or one monkey fully controlled the X-coordinate and the other controlled the Y-coordinate. A B3 produced arm movements in 3D space, while each monkey generated movements in 2D subspaces (X-Y, Y-Z, or X-Z). With long-term training we observed increased coordination of behavior, increased correlations in neuronal activity between different brains, and modifications to neuronal representation of the motor plan. Overall, performance of the Brainet improved owing to collective monkey behaviour. These results suggest that primate brains can be integrated into a Brainet, which self-adapts to achieve a common motor goal. PMID:26158523

Design and pilot validation of A-gear: a novel wearable dynamic arm support.

PubMed

Kooren, Peter N; Dunning, Alje G; Janssen, Mariska M H P; Lobo-Prat, Joan; Koopman, Bart F J M; Paalman, Micha I; de Groot, Imelda J M; Herder, Just L

2015-09-18

Persons suffering from progressive muscular weakness, like those with Duchenne muscular dystrophy (DMD), gradually lose the ability to stand, walk and to use their arms. This hinders them from performing daily activities, social participation and being independent. Wheelchairs are used to overcome the loss of walking. However, there are currently few efficient functional substitutes to support the arms. Arm supports or robotic arms can be mounted to wheelchairs to aid in arm motion, but they are quite visible (stigmatizing), and limited in their possibilities due to their fixation to the wheelchair. The users prefer inconspicuous arm supports that are comfortable to wear and easy to control. In this paper the design, characterization, and pilot validation of a passive arm support prototype, which is worn on the body, is presented. The A-gear runs along the body from the contact surface between seat and upper legs via torso and upper arm to the forearm. Freedom of motion is accomplished by mechanical joints, which are nearly aligned with the human joints. The system compensates for the arm weight, using elastic bands for static balance, in every position of the arm. As opposed to existing devices, the proposed kinematic structure allows trunk motion and requires fewer links and less joint space without compromising balancing precision. The functional prototype has been validated in three DMD patients, using 3D motion analysis. Measurements have shown increased arm performance when the subjects were wearing the prototype. Upward and forward movements were easier to perform. The arm support is easy to put on and remove. Moreover, the device felt comfortable for the subjects. However, downward movements were more difficult, and the patients would prefer the device to be even more inconspicuous. The A-gear prototype is a step towards inconspicuousness and therefore well-received dynamic arm supports for people with muscular weakness.

Safety and efficacy of nivolumab and standard chemotherapy drug combination in patients with advanced non-small-cell lung cancer: a four arms phase Ib study

PubMed Central

Kanda, S.; Goto, K.; Shiraishi, H.; Kubo, E.; Tanaka, A.; Utsumi, H.; Sunami, K.; Kitazono, S.; Mizugaki, H.; Horinouchi, H.; Fujiwara, Y.; Nokihara, H.; Yamamoto, N.; Hozumi, H.; Tamura, T.

2016-01-01

Background The human IgG4 monoclonal antibody nivolumab targets programmed cell death-1 (PD-1) and promotes antitumor response by blocking the interaction of PD-1 with its ligands. This single-center phase Ib study investigated the tolerability, safety, and pharmacokinetics of nivolumab combined with standard chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC). Patients and methods Patients who had stage IIIB without indication for definitive radiotherapy, stage IV, or recurrent NSCLC were eligible. Regimens were nivolumab 10 mg/kg + gemcitabine/cisplatin (arm A), pemetrexed/cisplatin (arm B), paclitaxel/carboplatin/bevacizumab (arm C), or docetaxel (arm D). Regimens A, B, and D were repeated every 3 weeks for up to four cycles and regimen C was repeated for up to six cycles; nivolumab alone (arm A), with pemetrexed (arm B), bevacizumab (arm C), or docetaxel (arm D) was continued every 3 weeks as maintenance therapy until disease progression or unacceptable toxicity. Dose-limiting toxicity (DLT) was evaluated during the first treatment cycle. Results As of March 2014, six patients were enrolled in each arm. The combination of nivolumab 10 mg/kg and chemotherapy was well tolerated. DLT was observed in only one patient in arm A (alanine aminotransferase increased). Select adverse events (those with a potential immunologic cause) of any grade were observed in six, four, six, and five patients in arms A, B, C, and D, respectively. Three, three, six, and one patient achieved partial response while median progression-free survival was 6.28, 9.63 months, not reached, and 3.15 months in arms A, B, C, and D, respectively. Conclusions Combination of nivolumab 10 mg/kg and chemotherapy showed an acceptable toxicity profile and encouraging antitumor activity in patients with advanced NSCLC. Clinical trials number Japanese Pharmaceutical Information Center Clinical Trials Information (JapicCTI)-132071. PMID:27765756

Safety and efficacy of nivolumab and standard chemotherapy drug combination in patients with advanced non-small-cell lung cancer: a four arms phase Ib study.

PubMed

Kanda, S; Goto, K; Shiraishi, H; Kubo, E; Tanaka, A; Utsumi, H; Sunami, K; Kitazono, S; Mizugaki, H; Horinouchi, H; Fujiwara, Y; Nokihara, H; Yamamoto, N; Hozumi, H; Tamura, T

2016-12-01

The human IgG4 monoclonal antibody nivolumab targets programmed cell death-1 (PD-1) and promotes antitumor response by blocking the interaction of PD-1 with its ligands. This single-center phase Ib study investigated the tolerability, safety, and pharmacokinetics of nivolumab combined with standard chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC). Patients who had stage IIIB without indication for definitive radiotherapy, stage IV, or recurrent NSCLC were eligible. Regimens were nivolumab 10 mg/kg + gemcitabine/cisplatin (arm A), pemetrexed/cisplatin (arm B), paclitaxel/carboplatin/bevacizumab (arm C), or docetaxel (arm D). Regimens A, B, and D were repeated every 3 weeks for up to four cycles and regimen C was repeated for up to six cycles; nivolumab alone (arm A), with pemetrexed (arm B), bevacizumab (arm C), or docetaxel (arm D) was continued every 3 weeks as maintenance therapy until disease progression or unacceptable toxicity. Dose-limiting toxicity (DLT) was evaluated during the first treatment cycle. As of March 2014, six patients were enrolled in each arm. The combination of nivolumab 10 mg/kg and chemotherapy was well tolerated. DLT was observed in only one patient in arm A (alanine aminotransferase increased). Select adverse events (those with a potential immunologic cause) of any grade were observed in six, four, six, and five patients in arms A, B, C, and D, respectively. Three, three, six, and one patient achieved partial response while median progression-free survival was 6.28, 9.63 months, not reached, and 3.15 months in arms A, B, C, and D, respectively. Combination of nivolumab 10 mg/kg and chemotherapy showed an acceptable toxicity profile and encouraging antitumor activity in patients with advanced NSCLC. Japanese Pharmaceutical Information Center Clinical Trials Information (JapicCTI)-132071. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

ML Crew Access Arm Move

NASA Image and Video Library

2017-10-16

The Orion crew access arm departs Precision Fabricating and Cleaning in Cocoa, Florida, atop a flatbed truck. The access arm is transported to a storage location at NASA's Kennedy Space Center in Florida. Later this month, the arm will be transported to the mobile launcher (ML) tower at the center. The crew access arm will be located at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces.

PubMed

Zimmermann, Wes O; Helmhout, P H; Beutler, A

2017-04-01

Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from the Dutch Armed Forces are reviewed, with an emphasis on the most prevalent conditions of medial tibial stress syndrome and chronic exertional compartment syndrome. The conclusion is that exercise related leg pain in the military is an occupational problem that deserves further study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

No improvements in postnatal dietary outcomes were apparent in a two-arm, randomized, controlled, comparative impact trial targeting rural, Southern, African American women

USDA-ARS?s Scientific Manuscript database

Objective: The primary objective was to determine if postnatal diet quality scores of participants in the two treatment arms differed or changed over time. The secondary objectives were to determine if postnatal psychosocial constructs related to diet differed in the two treatment arms, changed ov...

Quantifying arm nonuse in individuals poststroke.

PubMed

Han, Cheol E; Kim, Sujin; Chen, Shuya; Lai, Yi-Hsuan; Lee, Jeong-Yoon; Osu, Rieko; Winstein, Carolee J; Schweighofer, Nicolas

2013-06-01

Arm nonuse, defined as the difference between what the individual can do when constrained to use the paretic arm and what the individual does when given a free choice to use either arm, has not yet been quantified in individuals poststroke. (1) To quantify nonuse poststroke and (2) to develop and test a novel, simple, objective, reliable, and valid instrument, the Bilateral Arm Reaching Test (BART), to quantify arm use and nonuse poststroke. First, we quantify nonuse with the Quality of Movement (QOM) subscale of the Actual Amount of Use Test (AAUT) by subtracting the AAUT QOM score in the spontaneous use condition from the AAUT QOM score in a subsequent constrained use condition. Second, we quantify arm use and nonuse with BART by comparing reaching performance to visual targets projected over a 2D horizontal hemi-work space in a spontaneous-use condition (in which participants are free to use either arm at each trial) with reaching performance in a constrained-use condition. All participants (N = 24) with chronic stroke and with mild to moderate impairment exhibited nonuse with the AAUT QOM. Nonuse with BART had excellent test-retest reliability and good external validity. BART is the first instrument that can be used repeatedly and practically in the clinic to quantify the effects of neurorehabilitation on arm use and nonuse and in the laboratory for advancing theoretical knowledge about the recovery of arm use and the development of nonuse and "learned nonuse" after stroke.

Dual-arm manipulators with adaptive control

NASA Technical Reports Server (NTRS)

Seraji, Homayoun (Inventor)

1991-01-01

The described and improved multi-arm invention of this application presents three strategies for adaptive control of cooperative multi-arm robots which coordinate control over a common load. In the position-position control strategy, the adaptive controllers ensure that the end-effector positions of both arms track desired trajectories in Cartesian space despite unknown time-varying interaction forces exerted through a load. In the position-hybrid control strategy, the adaptive controller of one arm controls end-effector motions in the free directions and applied forces in the constraint directions; while the adaptive controller of the other arm ensures that the end-effector tracks desired position trajectories. In the hybrid-hybrid control strategy, the adaptive controllers ensure that both end-effectors track reference position trajectories while simultaneously applying desired forces on the load. In all three control strategies, the cross-coupling effects between the arms are treated as disturbances which are compensated for by the adaptive controllers while following desired commands in a common frame of reference. The adaptive controllers do not require the complex mathematical model of the arm dynamics or any knowledge of the arm dynamic parameters or the load parameters such as mass and stiffness. Circuits in the adaptive feedback and feedforward controllers are varied by novel adaptation laws.

Figure-of-eight bandage versus arm sling for treating middle-third clavicle fractures in adults: study protocol for a randomised controlled trial.

PubMed

Lenza, Mario; Taniguchi, Luiz Fabiano Presente; Ferretti, Mario

2016-05-04

Fracture of the clavicle is common, accounting for 2.6 to 4.0 % of all fractures, with an overall incidence of 36.5 to 64 per 100,000 per year. Around 80 % of clavicle fractures occur in the middle third of the clavicle. Randomised controlled trials comparing treatment interventions have failed to indicate the best therapeutic practices for these fractures. The objective of this study is to evaluate the effects (benefits and harms) of two commonly-used conservative interventions: the figure-of-eight bandage versus the arm sling as treatments of middle-third clavicle fractures. This project has been designed as a single-centre, two-arm randomised controlled trial that will compare two interventions: figure-of-eight bandage versus the arm sling. We propose to recruit 110 adults, aged 18 years or older, with an acute (less than 10 days since injury) middle-third clavicle fracture. The primary outcomes to be evaluated will be function and/or disability measured by the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. In order to assess the secondary outcomes, the Modified University of California at Los Angeles (modified - UCLA) Shoulder Rating Scale will be used. The occurrence of pain (Visual Analogue Scale for pain (VAS)), treatment failure, adverse events and the ability to return to previous activities will also be recorded and evaluated as secondary outcomes. the primary outcome DASH score and the secondary outcomes - modified UCLA and VAS scores - will be analysed graphically. We will apply generalised mixed models with the intervention groups (two levels), and time-point assessments (seven levels) as fixed effects and patients as a random effect. According to the current literature there is very limited evidence from two small trials regarding the effectiveness of different methods of conservative interventions for treating clavicle fractures. This is the first randomised controlled trial comparing the figure-of-eight bandage versus the arm

Planning Evaluation of C-Arm Cone Beam CT Angiography for Target Delineation in Stereotactic Radiation Surgery of Brain Arteriovenous Malformations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Jun; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Huang, Judy

Purpose: Stereotactic radiation surgery (SRS) is one of the therapeutic modalities currently available to treat cerebral arteriovenous malformations (AVM). Conventionally, magnetic resonance imaging (MRI) and MR angiography (MRA) and digital subtraction angiography (DSA) are used in combination to identify the target volume for SRS treatment. The purpose of this study was to evaluate the use of C-arm cone beam computed tomography (CBCT) in the treatment planning of SRS for cerebral AVMs. Methods and Materials: Sixteen consecutive patients treated for brain AVMs at our institution were included in this retrospective study. Prior to treatment, all patients underwent MRA, DSA, and C-arm CBCT.more » All images were coregistered using the GammaPlan planning system. AVM regions were delineated independently by 2 physicians using either C-arm CBCT or MRA, resulting in 2 volumes: a CBCT volume (VCBCT) and an MRA volume (V{sub MRA}). SRS plans were generated based on the delineated regions. Results: The average volume of treatment targets delineated using C-arm CBCT and MRA were similar, 6.40 cm{sup 3} and 6.98 cm{sup 3}, respectively (P=.82). However, significant regions of nonoverlap existed. On average, the overlap of the MRA with the C-arm CBCT was only 52.8% of the total volume. In most cases, radiation plans based on V{sub MRA} did not provide adequate dose to the region identified on C-arm CBCT; the mean minimum dose to V{sub CBCT} was 29.5%, whereas the intended goal was 45% (P<.001). The mean volume of normal brain receiving 12 Gy or more in C-arm CBCT-based plans was not greater than in the MRA-based plans. Conclusions: Use of C-arm CBCT images significantly alters the delineated regions of AVMs for SRS planning, compared to that of MRA/MRI images. CT-based planning can be accomplished without increasing the dose to normal brain and may represent a more accurate definition of the nidus, increasing the chances for successful obliteration.« less

Early manifestation of arm-leg coordination during stepping on a surface in human neonates.

PubMed

La Scaleia, Valentina; Ivanenko, Y; Fabiano, A; Sylos-Labini, F; Cappellini, G; Picone, S; Paolillo, P; Di Paolo, A; Lacquaniti, F

2018-04-01

The accomplishment of mature locomotor movements relies upon the integrated coordination of the lower and upper limbs and the trunk. Human adults normally swing their arms and a quadrupedal limb coordination persists during bipedal walking despite a strong corticospinal control of the upper extremities that allows to uncouple this connection during voluntary activities. Here we investigated arm-leg coordination during stepping responses on a surface in human neonates. In eight neonates, we found the overt presence of alternating arm-leg oscillations, the arms moving up and down in alternation with ipsilateral lower limb movements. These neonates moved the diagonal limbs together, and the peak of the arm-to-trunk angle (i.e., maximum vertical excursion of the arm) occurred around the end of the ipsilateral stance phase, as it occurs during typical adult walking. Although episodes of arm-leg coordination were sporadic in our sample of neonates, their presence provides significant evidence for a neural coupling between the upper and lower limbs during early ontogenesis of locomotion in humans.

Shoulder-arm morbidity in patients with sentinel node biopsy and complete axillary dissection--data from a prospective randomised trial.

PubMed

Helms, G; Kühn, T; Moser, L; Remmel, E; Kreienberg, R

2009-07-01

Axillary lymph node dissection (ALND) as part of surgical treatment in breast cancer has been the standard procedure for many decades. However, patients frequently develop shoulder-arm morbidity postoperatively. Recently, sentinel node (SN) biopsy has been established as a new standard of care for axillary staging in breast cancer. This study compares postoperative morbidity between ALND and SN biopsy. The results are compared with the existing literature. Between November 2000 and September 2002, 181 women with early stage breast cancer underwent primary surgery following preoperative randomisation into two groups, a "standard group" (SN biopsy was followed by ALND) and a study group (surgical procedure consisting of only SN biopsy when histologically metastasis-free SN was present). Follow-up data (362 sessions; 6 months to 3 years after primary surgery) were available from 150 patients. A summary morbidity score was calculated from four subjective (arm-strength, arm-mobility, arm swelling, pain) and four objective (arm-strength, arm-mobility, lymphedema, sensitivity) criteria. Fifty seven patients underwent SN biopsy only. Ninety three patients underwent ALND, 57 of which had lymph nodes free of metastasis and 36 had lymph nodes with metastasis and axillary clearing. Shoulder-arm morbidity was significantly different between the groups. Patients treated with SN biopsy only scored better on subjective and objective criteria. Postsurgical shoulder-arm morbidity is a major long-term problem in patients undergoing surgical treatment for breast cancer. This prospective study showed significantly less severe shoulder-arm morbidity following SN biopsy compared to patients undergoing ALND.

Localized Arm Volume Index: A New Method for Body Type-Corrected Evaluation of Localized Arm Lymphedematous Volume Change.

PubMed

Yamamoto, Takumi; Yamamoto, Nana; Yoshimatsu, Hidehiko

2017-10-01

Volume measurement is a common evaluation for upper extremity lymphedema. However, volume comparison between different patients with different body types may be inappropriate, and it is difficult to evaluate localized limb volume change using arm volume. Localized arm volumes (Vk, k = 1-5) and localized arm volume indices (LAVIk) at 5 points (1, upper arm; 2, elbow; 3, forearm; 4, wrist; 5, hand) of 106 arms of 53 examinees with no arm edema were calculated based on physical measurements (arm circumferences and lengths and body mass index [BMI]). Interrater and intrarater reliabilities of LAVIk were assessed, and Vk and LAVIk were compared between lower BMI (BMI, <22 kg/m) group and higher BMI (BMI, ≥22 kg/m) group. Interrater and intrarater reliabilities of LAVIk were all high (all, r > 0.98). Between lower and higher BMI groups, significant differences were observed in all Vk (V1 [P = 6.8 × 10], V2 [P = 3.1 × 10], V3 [P = 1.1 × 10], V4 [P = 8.3 × 10], and V5 [P = 3.0 × 10]). Regarding localized arm volume index (LAVI) between groups, significant differences were seen in LAVI1 (P = 9.7 × 10) and LAVI5 (P = 1.2 × 10); there was no significant difference in LAVI2 (P = 0.60), LAVI3 (P = 0.61), or LAVI4 (P = 0.22). Localized arm volume index is a convenient and highly reproducible method for evaluation of localized arm volume change, which is less affected by body physique compared with arm volumetry.

Consecutive learning of opposing unimanual motor tasks using the right arm followed by the left arm causes intermanual interference

PubMed Central

Thürer, Benjamin; Stein, Thorsten

2017-01-01

Intermanual transfer (motor memory generalization across arms) and motor memory interference (impairment of retest performance in consecutive motor learning) are well-investigated motor learning phenomena. However, the interplay of these phenomena remains elusive, i.e., whether intermanual interference occurs when two unimanual tasks are consecutively learned using different arms. Here, we examine intermanual interference when subjects consecutively adapt their right and left arm movements to novel dynamics. We considered two force field tasks A and B which were of the same structure but mirrored orientation (B = -A). The first test group (ABA-group) consecutively learned task A using their right arm and task B using their left arm before being retested for task A with their right arm. Another test group (AAA-group) learned only task A in the same right-left-right arm schedule. Control subjects learned task A using their right arm without intermediate left arm learning. All groups were able to adapt their right arm movements to force field A and both test groups showed significant intermanual transfer of this initial learning to the contralateral left arm of 21.9% (ABA-group) and 27.6% (AAA-group). Consecutively, both test groups adapted their left arm movements to force field B (ABA-group) or force field A (AAA-group). For the ABA-group, left arm learning caused significant intermanual interference of the initially learned right arm task (68.3% performance decrease). The performance decrease of the AAA-group (10.2%) did not differ from controls (15.5%). These findings suggest that motor control and learning of right and left arm movements involve partly similar neural networks or underlie a vital interhemispheric connectivity. Moreover, our results suggest a preferred internal task representation in extrinsic Cartesian-based coordinates rather than in intrinsic joint-based coordinates because interference was absent when learning was performed in extrinsically

Consecutive learning of opposing unimanual motor tasks using the right arm followed by the left arm causes intermanual interference.

PubMed

Stockinger, Christian; Thürer, Benjamin; Stein, Thorsten

2017-01-01

Intermanual transfer (motor memory generalization across arms) and motor memory interference (impairment of retest performance in consecutive motor learning) are well-investigated motor learning phenomena. However, the interplay of these phenomena remains elusive, i.e., whether intermanual interference occurs when two unimanual tasks are consecutively learned using different arms. Here, we examine intermanual interference when subjects consecutively adapt their right and left arm movements to novel dynamics. We considered two force field tasks A and B which were of the same structure but mirrored orientation (B = -A). The first test group (ABA-group) consecutively learned task A using their right arm and task B using their left arm before being retested for task A with their right arm. Another test group (AAA-group) learned only task A in the same right-left-right arm schedule. Control subjects learned task A using their right arm without intermediate left arm learning. All groups were able to adapt their right arm movements to force field A and both test groups showed significant intermanual transfer of this initial learning to the contralateral left arm of 21.9% (ABA-group) and 27.6% (AAA-group). Consecutively, both test groups adapted their left arm movements to force field B (ABA-group) or force field A (AAA-group). For the ABA-group, left arm learning caused significant intermanual interference of the initially learned right arm task (68.3% performance decrease). The performance decrease of the AAA-group (10.2%) did not differ from controls (15.5%). These findings suggest that motor control and learning of right and left arm movements involve partly similar neural networks or underlie a vital interhemispheric connectivity. Moreover, our results suggest a preferred internal task representation in extrinsic Cartesian-based coordinates rather than in intrinsic joint-based coordinates because interference was absent when learning was performed in extrinsically

A case of motor neuropathy after cryolipolysis of the arm.

PubMed

Lee, Sang Jun; Kim, Young Jin; Park, Jae Beom; Suh, Dong Hye; Kwon, Do Young; Ryu, Hwa Jung

2016-11-01

Cryolipolysis treatment is a non-invasive option for localized fat reduction without damaging the surrounding tissue. Clinical studies about cryolipolysis show various side effects, including temporary erythema, bruising, and transient numbness. But, no reports are available on motor nerve malfunction after cryolipolysis. A 24-year-old female received cryolipolysis treatment on abdomen, both arms. After 10 days, patient complained of weakness and inability to lift heavy objects. Symptoms continued for 6 months, and fully recovered without treatment. Thus, we report a case of motor neuropathy after cryolipolysis, which is a rare complication of cryolipolysis.

Spiral-arm instability: giant clump formation via fragmentation of a galactic spiral arm

NASA Astrophysics Data System (ADS)

Inoue, Shigeki; Yoshida, Naoki

2018-03-01

Fragmentation of a spiral arm is thought to drive the formation of giant clumps in galaxies. Using linear perturbation analysis for self-gravitating spiral arms, we derive an instability parameter and define the conditions for clump formation. We extend our analysis to multicomponent systems that consist of gas and stars in an external potential. We then perform numerical simulations of isolated disc galaxies with isothermal gas, and compare the results with the prediction of our analytic model. Our model describes accurately the evolution of the spiral arms in our simulations, even when spiral arms dynamically interact with one another. We show that most of the giant clumps formed in the simulated disc galaxies satisfy the instability condition. The clump masses predicted by our model are in agreement with the simulation results, but the growth time-scale of unstable perturbations is overestimated by a factor of a few. We also apply our instability analysis to derive scaling relations of clump properties. The expected scaling relation between the clump size, velocity dispersion, and circular velocity is slightly different from that given by the Toomre instability analyses, but neither is inconsistent with currently available observations. We argue that the spiral-arm instability is a viable formation mechanism of giant clumps in gas-rich disc galaxies.

Modulation of corticospinal input to the legs by arm and leg cycling in people with incomplete spinal cord injury.

PubMed

Zhou, R; Alvarado, L; Kim, S; Chong, S L; Mushahwar, V K

2017-10-01

The spinal cervico-lumbar interaction during rhythmic movements in humans has recently been studied; however, the role of arm movements in modulating the corticospinal drive to the legs is not well understood. The goals of this study were to investigate the effect of active rhythmic arm movements on the corticospinal drive to the legs ( study 1 ) and assess the effect of simultaneous arm and leg training on the corticospinal pathway after incomplete spinal cord injury (iSCI) ( study 2). In study 1 , neurologically intact (NI) participants or participants with iSCI performed combinations of stationary and rhythmic cycling of the arms and legs while motor evoked potentials (MEPs) were recorded from the vastus lateralis (VL) muscle. In the NI group, arm cycling alone could facilitate the VL MEP amplitude, suggesting that dynamic arm movements strongly modulate the corticospinal pathway to the legs. No significant difference in VL MEP between conditions was found in participants with iSCI. In study 2 , participants with iSCI underwent 12 wk of electrical stimulation-assisted cycling training: one group performed simultaneous arm and leg (A&L) cycling and the other legs-only cycling. MEPs in the tibialis anterior (TA) muscle were compared before and after training. After training, only the A&L group had a significantly larger TA MEP, suggesting increased excitability in the corticospinal pathway. The findings demonstrate the importance of arm movements in modulating the corticospinal drive to the legs and suggest that active engagement of the arms in lower limb rehabilitation may produce better neural regulation and restoration of function. NEW & NOTEWORTHY This study aimed to demonstrate the importance of arm movements in modulating the corticospinal drive to the legs. It provides direct evidence in humans that active movement of the arms could facilitate corticospinal transmission to the legs and, for the first time, shows that facilitation is absent after spinal cord

Goal driven kinematic simulation of flexible arm robot for space station missions

NASA Technical Reports Server (NTRS)

Janssen, P.; Choudry, A.

1987-01-01

Flexible arms offer a great degree of flexibility in maneuvering in the space environment. The problem of transporting an astronaut for extra-vehicular activity using a space station based flexible arm robot was studied. Inverse kinematic solutions of the multilink structure were developed. The technique is goal driven and can support decision making for configuration selection as required for stability and obstacle avoidance. Details of this technique and results are given.

Preliminary Analysis of the Surgical Treatment of Anorectal Malformations in Russia.

PubMed

Morozov, Dmitry; Pimenova, Evgeniya; Oculov, Evgeniy; Gusev, Alexey; Utkina, Kseniya

2015-12-01

The article provides the analysis of a survey of the professional community of Russian pediatric surgeons, dedicated to the treatment of anorectal malformations (ARM). The authors evaluated the differences and similarities in classification, surgical procedures, time of definitive repair, and postoperative management of ARM in different hospitals and centers. This was done by a survey upon specialists and experts in Russia followed by a symposium with live surgery, open discussion, and vote. Overall, 85% of the delegates supported the idea to create several regional centers of pediatric coloproctology as the way to improve the treatment of ARM in Russia. Moreover, 80% of delegates agreed to create a universal database of ARM information. The development of neonatal surgery and videoendoscopic surgical methods in the treatment of patients with ARM requires creation of a national guideline by the Russian Association of Pediatric Surgeons. Next step will concern standardization of the diagnosis and surgical treatment of children with ARM. This study is a collaborative effort to provide Russian Consensus on treatment of ARM. Georg Thieme Verlag KG Stuttgart · New York.

Adaptive control of dual-arm robots

NASA Technical Reports Server (NTRS)

Seraji, H.

1987-01-01

Three strategies for adaptive control of cooperative dual-arm robots are described. In the position-position control strategy, the adaptive controllers ensure that the end-effector positions of both arms track desired trajectories in Cartesian space despite unknown time-varying interaction forces exerted through the load. In the position-hybrid control strategy, the adaptive controller of one arm controls end-effector motions in the free directions and applied forces in the constraint directions, while the adaptive controller of the other arm ensures that the end-effector tracks desired position trajectories. In the hybrid-hybrid control strategy, the adaptive controllers ensure that both end-effectors track reference position trajectories while simultaneously applying desired forces on the load. In all three control strategies, the cross-coupling effects between the arms are treated as disturbances which are rejected by the adaptive controllers while following desired commands in a common frame of reference. The adaptive controllers do not require the complex mathematical model of the arm dynamics or any knowledge of the arm dynamic parameters or the load parameters such as mass and stiffness. The controllers have simple structures and are computationally fast for on-line implementation with high sampling rates.

Central command increases muscular oxygenation of the non-exercising arm at the early period of voluntary one-armed cranking.

PubMed

Ishii, Kei; Matsukawa, Kanji; Asahara, Ryota; Liang, Nan; Endo, Kana; Idesako, Mitsuhiro; Michioka, Kensuke; Sasaki, Yu; Hamada, Hironobu; Yamashita, Kaori; Watanabe, Tae; Kataoka, Tsuyoshi; Takahashi, Makoto

2017-04-01

This study aimed to examine whether central command increases oxygenation in non-contracting arm muscles during contralateral one-armed cranking and whether the oxygenation response caused by central command differs among skeletal muscles of the non-exercising upper limb. In 13 male subjects, the relative changes in oxygenated-hemoglobin concentration (Oxy-Hb) of the non-contracting arm muscles [the anterior deltoid, triceps brachii, biceps brachii, and extensor carpi radialis (ECR)] were measured during voluntary one-armed cranking (intensity, 35-40% of maximal voluntary effort) and mental imagery of the one-armed exercise for 1 min. Voluntary one-armed cranking increased ( P  <   0.05) the Oxy-Hb of the triceps, biceps, and ECR muscles to the same extent (15 ± 4% of the baseline level, 17 ± 5%, and 16 ± 4%, respectively). The greatest increase in the Oxy-Hb was observed in the deltoid muscle. Intravenous injection of atropine (10-15  μ g/kg) and/or propranolol (0.1 mg/kg) revealed that the increased Oxy-Hb of the arm muscles consisted of the rapid atropine-sensitive and delayed propranolol-sensitive components. Mental imagery of the exercise increased the Oxy-Hb of the arm muscles. Motor-driven passive one-armed cranking had little influence on the Oxy-Hb of the arm muscles. It is likely that central command plays a role in the initial increase in oxygenation in the non-contracting arm muscles via sympathetic cholinergic vasodilatation at the early period of one-armed cranking. The centrally induced increase in oxygenation may not be different among the distal arm muscles but may augment in the deltoid muscle. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Acute effects of vibration from a chipping hammer and a grinder on the hand-arm system.

PubMed Central

Kihlberg, S; Attebrant, M; Gemne, G; Kjellberg, A

1995-01-01

OBJECTIVES--The purpose of this study was to compare various effects on the hand-arm system of vibration exposure from a chipping hammer and a grinder with the same frequency weighted acceleration. Grip and push forces were measured and monitored during the exposure. The various effects were: muscle activity (measured with surface electrodes), discomfort ratings for different parts of the hand-arm system (made during and after exposure), and vibration perception threshold (for 10 minutes before and 10 minutes after the exposure). RESULTS--No increase in muscle activity due to exposure to vibration was found in the hand muscle studied. In the forearm, conversely, there was an increase in both muscle studied. For the upper arm the muscle activity only increased when exposed to impact vibration. Subjective ratings in the hand and shift in vibration perception threshold were effected more by the grinder than the hammer exposure. CONCLUSION--These results show that the reaction of the hand-arm system to vibration varies with frequency quantitatively as well as qualitatively. They do not support the notion that one single frequency weighted curve would be valid for the different health effects of hand-arm vibration (vascular, musculoskeletal, neurological, and psychophysiological). PMID:8535492

Upper limb discomfort profile due to intermittent isometric pronation torque at different postural combinations of the shoulder-arm system.

PubMed

Mukhopadhyay, Prabir; O'Sullivan, Leonard W; Gallwey, Timothy J

2009-05-01

Twenty-seven right-handed male university students participated in this study, which comprised a full factorial model consisting of three forearm rotation angles (60% prone and supine and neutral range of motion), three elbow angles (45 degrees , 90 degrees and 135 degrees ), three upper arm angles (45 degrees flexion/extension and neutral), one exertion frequency (15 per min) and one level of pronation torque (20% maximum voluntary contraction (MVC) relative to MVC at each articulation). Discomfort rating after the end of each 5 min treatment was recorded on a visual analogue scale. Results of a repeated measures analysis of covariance on discomfort score, with torque endurance time as covariate, indicated that none of the factors was significant including torque endurance time (p = 0.153). An initial data collection phase preceded the main experiment in order to ensure that participants exerted exactly 20% MVC of the particular articulation. In this phase MVC pronation torque was measured at each articulation. The data revealed a significant forearm rotation angle effect (p = 0.001) and participant effect (p = 0.001). Of the two-way interactions, elbow*participant (p = 0.004), forearm*participant (p = 0.001) and upper arm*participant (p = 0.005) were the significant factors. Electromyographic activity of the pronator teres and biceps brachii muscles revealed no significant change in muscle activity in most of the articulations. Industrial jobs involving deviated upper arm postures are typical in industry but have a strong association with injury. Data from this study will enable better understanding of the effects of deviated upper arm postures on musculoskeletal disorders and can also be used to identify and control high-risk tasks in industry.

Association between intramuscular fat in the arm following arm training and INSIG2.

PubMed

Popadic Gacesa, J Z; Secher, N H; Momcilovic, M; Grujic, N G

2014-12-01

Insulin-induced gene 2 (INSIG2) single-nucleotide polymorphism (SNP rs7566605) is linked to lipid metabolism, and this study assessed its potential influence on fat in the upper arm following arm training. Twenty healthy sedentary volunteers (22.0 ± 1.1 years, body mass index 25.4 ± 4.0 kg/m(2) ; mean ± standard deviation) carried out a 12-week two-arm elbow extensor training (10 maximal extensions with 1 min recovery between bouts) five times per day, five times per week. For 17 volunteers, upper arm muscle and adipose tissue [subcutaneous (SCAT) and intramuscular (IMAT)] volumes were evaluated by magnetic resonance imaging before, immediately after, and 12 months after training and variables were related to the subjects' INSIG2 SNP rs7566605 genotype. Muscle volume and SCAT for the upper arm, as the decrease in IMAT during training were not related to INSIG2 SNP rs7566605: GG: %IMAT 1.0 ± 0.9%; GC/CC: %IMAT 0.6 ± 0.5% (P > 0.05). However, in the year following the training, accumulation of upper arm IMAT was twice as large in participants homozygous for the G allele (GG: Δ%IMAT +2.5 ± 0.8%; GC/CC: Δ%IMAT +1.1 ± 0.7%; P < 0.01). This study suggests that the G allele in the INSIG2 SNP rs7566605 is more relevant for changes in IMAT following training than for the amount of subcutaneous fat. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A pilot single-blind multicentre randomized controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on the arm function of children with spastic cerebral palsy.

PubMed

Preston, Nick; Weightman, Andrew; Gallagher, Justin; Levesley, Martin; Mon-Williams, Mark; Clarke, Mike; O'Connor, Rory J

2016-10-01

To evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy. A single-blind randomized controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference. Intervention was home-based; recruitment took place in regional spasticity clinics. A total of 15 children with cerebral palsy aged five to 12 years were recruited; eight to the device group. Both study groups received 'usual follow-up treatment' following spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device. ABILHAND-kids and Canadian Occupational Performance Measure were performed by blinded assessors at baseline, six and 12 weeks. An analysis of covariance showed no group differences in mean ABILHAND-kids scores between time points. A non-parametric analysis of variance on Canadian Occupational Performance Measure scores showed a statistically significant improvement across time points (χ 2 (2,15) = 6.778, p = 0.031), but this improvement did not reach minimal clinically important difference. Mean daily device use was seven minutes. Recruitment did not reach target owing to unanticipated staff shortages in clinical services. Feedback from children and their families indicated that the games were not sufficiently engaging to promote sufficient use that was likely to result in functional benefits. This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function, but a Type II error cannot be ruled out. © The Author(s) 2015.

Transversus abdominis is part of a global not local muscle synergy during arm movement.

PubMed

Morris, S L; Lay, B; Allison, G T

2013-10-01

The trunk muscle transversus abdominis (TrA) is thought to be controlled independently of the global trunk muscles. Methodological issues in the 1990s research such as unilateral electromyography and a limited range of arm movements justify a re-examination of this theory. The hypothesis tested is that TrA bilateral co-contraction is a typical muscle synergy during arm movement. The activity of 6 pairs of trunk and lower limb muscles was recorded using bilateral electromyography during anticipatory postural adjustments (APAs) associated with the arm movements. The integrated APA electromyographical signals were analyzed for muscle synergy using Principle Component Analysis. TrA does not typically bilaterally co-contract during arm movements (1 out of 6 participants did). APA muscle activity of all muscles during asymmetrical arm movements typically reflected a direction specific diagonal pattern incorporating a twisting motion to transfer energy from the ground up. This finding is not consistent with the hypothesis that TrA plays a unique role providing bilateral, feedforward, multidirectional stiffening of the spine. This has significant implications to the theories underlying the role of TrA in back pain and in the training of isolated bilateral co-contraction of TrA in the prophylaxis of back pain. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

Exact positioning of the robotic arm end effector

NASA Astrophysics Data System (ADS)

Korepanov, Valery; Dudkin, Fedir

2016-07-01

Orbital service becomes a new challenge of space exploration. The necessity to introduce it is connected first of all with an attractive opportunity to prolong the exploitation terms of expensive commercial satellites by, e.g., refilling of fuel or changing batteries. Other application area is a fight with permanently increasing amount of space litter - defunct satellites, burnt-out rocket stages, discarded trash and other debris. Now more than few tens of thousands orbiting objects larger than 5-10 cm (or about 1 million junks larger than 1 cm) are a huge problem for crucial and costly satellites and manned vehicles. For example, in 2014 the International Space Station had to change three times its orbit to avoid collision with space debris. So the development of the concepts and actions related to removal of space debris or non-operational satellites with use of robotic arm of a servicing satellite is very actual. Such a technology is also applicable for unmanned exploratory missions in solar system, for example for collecting a variety of samples from a celestial body surface. Naturally, the robotic arm movements should be controlled with great accuracy at influence of its non-rigidity, thermal and other factors. In these circumstances often the position of the arm end effector has to be controlled with high accuracy. The possibility of coordinate determination for the robotic arm end effector with use of a low frequency active electromagnetic system has been considered in the presented report. The proposed design of such a system consists of a small magnetic dipole source, which is mounted inside of the arm end effector and two or three 3-component magnetic field sensors mounted on a servicing satellite body. The data from this set of 3-component magnetic field sensors, which are fixed relatively to the satellite body, allows use of the mathematical approach for determination of position and orientation of the magnetic dipole source. The theoretical

33 CFR 154.510 - Loading arms.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Loading arms. 154.510 Section 154... FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Equipment Requirements § 154.510 Loading arms. (a) Each mechanical loading arm used for transferring oil or hazardous material and placed into service...

33 CFR 154.510 - Loading arms.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Loading arms. 154.510 Section 154... FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Equipment Requirements § 154.510 Loading arms. (a) Each mechanical loading arm used for transferring oil or hazardous material and placed into service...

33 CFR 154.510 - Loading arms.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Loading arms. 154.510 Section 154... FACILITIES TRANSFERRING OIL OR HAZARDOUS MATERIAL IN BULK Equipment Requirements § 154.510 Loading arms. (a) Each mechanical loading arm used for transferring oil or hazardous material and placed into service...

Teaching about Reversing the Arms Race.

ERIC Educational Resources Information Center

Melman, Seymour

1982-01-01

The scarcity of college courses dealing with disarmament is noted, and educators are urged to address the question of arms limitation. Military and economic factors which limit the ability of the United States to continue the arms race are listed, and plans for reversing the arms race are discussed. (PP)

Altered dorsal premotor-motor interhemispheric pathway activity in focal arm dystonia.

PubMed

Koch, Giacomo; Schneider, Susanne; Bäumer, Tobias; Franca, Michele; Münchau, Alexander; Cheeran, Binith; Fernandez del Olmo, Miguel; Cordivari, Carla; Rounis, Elisabeth; Caltagirone, Carlo; Bhatia, Kailash; Rothwell, John C

2008-04-15

Given the possible role of dorsal premotor cortex (PMd) in the pathophysiology of dystonia, we used transcranial magnetic stimulation (TMS) methods to study PMd and PMd-primary motor cortex (M1) interactions in patients with focal arm dystonia. Here, we tested the connectivity between left PMd and right M1 as well as the intracortical excitability of PMd in 11 right-handed patients with focal arm/hand dystonia and nine age-matched healthy controls. The results showed that excitability of the inhibitory connection between PMd and M1 was reduced in patients, but there was no significant difference to healthy subjects in the excitability of the facilitatory connection. A triple stimulation technique in which pairs of TMS pulses are given over PMd and their interaction measured in terms of the effect on the baseline PMd-M1 connection failed to reveal the usual pattern of interaction between the pairs of PMd stimuli. Indeed, the results in patients were similar to those seen in a group of young healthy subjects after the excitability of PMd had been changed by pretreatment with high-frequency rTMS. We suggest that reduced transcallosal inhibition from the PMd may be involved in the altered pattern of abnormal muscle contractions of agonists and antagonists (overflow). 2007 Movement Disorder Society

Characteristics and response to treatment among Indigenous people receiving injectable diacetylmorphine or hydromorphone in a randomised controlled trial for the treatment of long-term opioid dependence.

PubMed

Oviedo-Joekes, Eugenia; Palis, Heather; Guh, Daphne; Marchand, Kirsten; Brissette, Suzanne; Lock, Kurt; MacDonald, Scott; Harrison, Scott; Anis, Aslam H; Krausz, Michael; Marsh, David C; Schechter, Martin T

2018-01-01

To determine the effectiveness of injectable hydromorphone and dicaetylmorphine for Indigenous participants in the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME) clinical trial. The study additionally aims to explore the prevalence and frequency of crack cocaine use among subgroups of participants (by gender and ethnicity). This secondary analysis is particularly relevant given the current need for expanded medication assisted treatments for opioid dependence across North America. Participants self-identifying as First Nations, Métis or Inuit were included in the analysis of Indigenous participants. Six-month treatment outcomes are reported as the difference between diacetylmorphine and hydromorphone treatment arms among Indigenous participants and change from baseline to 6 months in each treatment arm. Differences in outcomes are tested between Indigenous and non-Indigenous participants. Crack cocaine use was explored to determine differences between and within subgroups. Approximately one-third of SALOME participants self-identified as Indigenous. Indigenous participants presented to treatment with more structural vulnerabilities (e.g. lower education, higher rates of foster care and separation from biological parents) compared to non-Indigenous participants. After 6 months, Indigenous participants in both treatment arms had a significant reduction in days of street heroin use, opioid use, crack cocaine use and illegal activity. Treatment retention did not differ by treatment arm. Indigenous people that are not engaged by first-line treatments for opioid dependence are in need of effective alternative treatments. Given the political and logistical barriers facing diacetylmorphine, hydromorphone could serve as a more accessible medication to reach and treat this population. [Oviedo-Joekes E, Palis H, Guh D, Marchand K, Brissette S, Lock K, MacDonald S, Harrison S, Anis AH, Krausz M, March DC, Schechter MT. Characteristics and response to

Evaluating treatment of obstructive sleep apnea comorbid with insomnia disorder using an incomplete factorial design

PubMed Central

Crawford, Megan R.; Turner, Arlener D.; Wyatt, James K.; Fogg, Louis F.; Ong, Jason C.

2016-01-01

Chronic insomnia disorder is a prevalent condition and a significant proportion of these individuals also have obstructive sleep apnea (OSA). These two sleep disorders have distinct pathophysiology and are managed with different treatment approaches. High comorbidity rates have been a catalyst for emerging studies examining multidisciplinary treatment for OSA comorbid with insomnia disorder. In this article, we describe a randomized clinical trial of Cognitive Behavioral Treatment for insomnia (CBT-I) and Positive Airway Pressure (PAP) for OSA. Participants are randomized to receive one of three treatment combinations. Individuals randomized to treatment Arm A receive sequential treatment beginning with CBT-I followed by PAP, in treatment Arm B CBT-I and PAP are administered concurrently. These treatment arms are compared to a control condition, treatment Arm C, where individuals receive PAP alone. Adopting an incomplete factorial study design will allow us to evaluate the efficacy of multidisciplinary treatment (Arms A & B) versus standard treatment alone (Arm C). In addition, the random allocation of individuals to the two different combined treatment sequences (Arm A and Arm B) will allow us to understand the benefits of the sequential administration of CBT-I and PAP relative to concurrent treatment of PAP and CBT-I. These findings will provide evidence of the clinical benefits of treating insomnia disorder in the context of OSA. PMID:26733360

Phoenix Robotic Arm

NASA Technical Reports Server (NTRS)

2007-01-01

A vital instrument on NASA's Phoenix Mars Lander is the robotic arm, which will dig into the icy soil and bring samples back to the science deck of the spacecraft for analysis. In September 2006 at a Lockheed Martin Space Systems clean room facility near Denver, spacecraft technician Billy Jones inspects the arm during the assembly phase of the mission.

Using the robotic arm -- built by the Jet Propulsion Laboratory, Pasadena -- the Phoenix mission will study the history of water and search for complex organic molecules in the ice-rich soil.

The Phoenix mission is led by Principal Investigator Peter H. Smith of the University of Arizona, Tucson, with project management at NASA's Jet Propulsion Laboratory and development partnership with Lockheed Martin Space Systems. International contributions for Phoenix are provided by the Canadian Space Agency, the University of Neuchatel (Switzerland), the University of Copenhagen, and the Max Planck Institute in Germany. JPL is a division of the California Institute of Technology in Pasadena.

Everyday movement and use of the arms: Relationship in children with hemiparesis differs from adults.

PubMed

Sokal, Brad; Uswatte, Gitendra; Vogtle, Laura; Byrom, Ezekiel; Barman, Joydip

2015-01-01

In adults with hemiparesis amount of movement of the more-affected arm is related to its amount of use in daily life. In children, little is known about everyday arm use. This report examines the relationships between everyday movement of the more-affected arm and its (a) everyday use and (b) motor capacity in children with hemiparesis. Participants were 28 children with a wide range of upper-extremity hemiparesis subsequent to cerebral palsy due to pre- or peri-natal stroke. Everyday movement of the more-affected arm was assessed by putting accelerometers on the children's forearms for three days. Everyday use of that arm and its motor capacity were assessed with the Pediatric Motor Activity Log-Revised and Pediatric Arm Function Test, respectively. Intensity of everyday movement of the more-affected arm was correlated with its motor capacity (rs ≥ 0.52, ps ≤ 0.003). However, everyday movement of that arm was not correlated with its everyday use (rs ≤ 0.30, ps ≥ $ 0.126). In children with upper-extremity hemiparesis who meet the study intake criteria amount of movement of the more-affected arm in daily life is not related to its amount to use, suggesting that children differ from adults in this respect.

Reference ranges for midupper arm circumference, upper arm muscle area, and upper arm fat area in US children and adolescents aged 1-20 y.

PubMed

Addo, O Yaw; Himes, John H; Zemel, Babette S

2017-01-01

Midupper arm circumference (MUAC) has long been used in anthropometric assessments of nutritional status in field settings, especially in emergency situations, but percentile ranges for healthy, well-nourished children are currently unavailable. We developed reference curves for MUAC and derived measures of arm muscle area (AMA) and arm fat area (AFA) on the basis of the population used in the current CDC body mass index growth charts. We analyzed cross-sectional MUAC and triceps (triceps skinfold thickness) data from 32,952 US children aged 1-20 y. Generalized additive models for location, scale, and shape were used to calculate semiparametric smoothed percentiles and L, M, and S coefficients needed for z-score estimation by age and sex. Equations were developed with the use of the height-for-age z score (HAZ) to adjust for the associations of stature with upper arm measures. MUAC increased with age steadily throughout the growing period. For children <5 y old, lower percentile ranges varied markedly across age and sex such that the single cutoff (<11.5 or 12.5 cm) for field screening of acute malnutrition did not track along the same percentile. AFA and AMA growth patterns exhibited sex-specific trends including multiple distinct age-related inflections that were more pronounced in males for AFA-for-age than in females. HAZ and age were substantially and independently related with all arm measures. The new reference percentile ranges for midupper arm measures for healthy children provide a useful nutritional assessment tool in a wide variety of settings. Height status (HAZ) has complex independent associations with arm measures irrespective of the distributional ranking by age and sex. Prediction equations that account for these effects further extend the practical use of the new curves. © 2017 American Society for Nutrition.

TRIMETHYLTIN, A SELECTIVE LIMBIC SYSTEM NEUROTOXICANT, IMPAIRS RADIAL-ARM MAZE PERFORMANCE

EPA Science Inventory

Rats were trained for fifteen sessions in an automated eight arm radial maze prior to treatment with 6 mg/kg trimethyltin chloride. This compound is a neurotoxicant which primarily damages the limbic system, in particular pyramidal cells in the CA3 region of the hippocampus. Foll...

42 CFR 441.154 - Active treatment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Active treatment. 441.154 Section 441.154 Public... Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs § 441.154 Active treatment. Inpatient psychiatric services must involve “active treatment”, which means implementation of a...

42 CFR 441.154 - Active treatment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Active treatment. 441.154 Section 441.154 Public... Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs § 441.154 Active treatment. Inpatient psychiatric services must involve “active treatment”, which means implementation of a...

42 CFR 441.154 - Active treatment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Active treatment. 441.154 Section 441.154 Public... Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs § 441.154 Active treatment. Inpatient psychiatric services must involve “active treatment”, which means implementation of a...

42 CFR 441.154 - Active treatment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Active treatment. 441.154 Section 441.154 Public... Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs § 441.154 Active treatment. Inpatient psychiatric services must involve “active treatment”, which means implementation of a...

A general approach for sample size calculation for the three-arm 'gold standard' non-inferiority design.

PubMed

Stucke, Kathrin; Kieser, Meinhard

2012-12-10

In the three-arm 'gold standard' non-inferiority design, an experimental treatment, an active reference, and a placebo are compared. This design is becoming increasingly popular, and it is, whenever feasible, recommended for use by regulatory guidelines. We provide a general method to calculate the required sample size for clinical trials performed in this design. As special cases, the situations of continuous, binary, and Poisson distributed outcomes are explored. Taking into account the correlation structure of the involved test statistics, the proposed approach leads to considerable savings in sample size as compared with application of ad hoc methods for all three scale levels. Furthermore, optimal sample size allocation ratios are determined that result in markedly smaller total sample sizes as compared with equal assignment. As optimal allocation makes the active treatment groups larger than the placebo group, implementation of the proposed approach is also desirable from an ethical viewpoint. Copyright © 2012 John Wiley & Sons, Ltd.

Gravitoinertial force level influences arm movement control

NASA Technical Reports Server (NTRS)

Fisk, J.; Lackner, J. R.; DiZio, P.

1993-01-01

1. The ability to move the forearm between remembered elbow joint angles immediately after rapid increases or decreases of the background gravitoinertial force (G) level was measured. The movements had been well-practiced in a normal 1G environment before the measurements in high-(1.8G) and low-force (0G) environments. The forearm and upper arm were always unsupported to maximize the influence of altered G-loading and to minimize extraneous cues about arm position. 2. Horizontal and vertical movement planes were studied to measure the effects of varying the G load in the movement plane within a given G background. Rapid and slow movements were studied to assess the role of proprioceptive feedback. 3. G level did not affect the amplitude of rapid movements, indicating that subjects were able to plan and to generate appropriate motor commands for the new G loading of the arm. The amplitude of slow movements was affected by G level, indicating that proprioceptive feedback is influenced by G level. 4. The effects of G level were similar for horizontal and vertical movements, indicating that proprioceptive information from supporting structures, such as the shoulder joint and muscles, had a role in allowing generation of the appropriate motor commands. 5. The incidence and size of dynamic overshoots were greater in 0G and for rapid movements. This G-related change in damping suggests a decrease in muscle spindle activity in 0G. A decrease in muscle spindle activity in 0G and an increase in 1.8G are consistent with the results of our prior studies on the tonic vibration reflex, locomotion, and perception of head movement trajectory in varying force backgrounds.

[Arm rehabilitation : Current concepts and therapeutic options].

PubMed

Platz, T; Schmuck, L

2016-10-01

Arm paralysis after a stroke is a major cause of impairment. Presentation of therapeutic options and the efficacy in arm rehabilitation after stroke. Based on a systematic critical appraisal of randomized controlled trials (RCT) the therapeutic procedures for arm paralysis after stroke in the context of their effectiveness are introduced, including robotic therapy, mirror therapy, constraint-induced movement therapy (CIMT), arm basis training, arm ability training, neuromuscular electrical stimulation, bilateral and task-specific training, mental training and transcranial stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Several therapeutic procedures with proven efficacy are currently available for arm rehabilitation after stroke. Their differential indications are presented and associated with conclusions for clinical practice.

O-arm with navigation versus C-arm: a review of screw placement over 3 years at a major trauma center.

PubMed

Verma, S K; Singh, P K; Agrawal, D; Sinha, S; Gupta, D; Satyarthee, G D; Sharma, B S

2016-12-01

There is a relatively high incidence of screw misplacement during spinal instrumentation due to distortion of normal anatomy following spinal trauma. The O-arm is the next-generation spinal navigation tool that provides intraoperative 3-D imaging and navigation for spine surgeries. To evaluate and compare the use of O-arm as compared to C-arm for spinal trauma in a Level I trauma center in India. In this retrospective study over 3 years (July 2010-April 2013), All patients of spinal injury who underwent spinal instrumentation were divided into O-arm group and C-arm group. Accuracy of screw placement was assessed during each surgery in both groups. A total of 587 patients were evaluated during the study period. There were 278 patients in O-arm group and 309 patients in C-arm group. Both groups were well matched in mean age (27.7 vs. 28.9 years), ASIA grades, and level of injury. The number of screws placed was significantly higher in the C-arm group as compared to the O-arm group (2173 vs. 1720). However, the O-arm group had significantly less screw malplacement rate of 0.93% (n = 16) as compared to malplacement rate in C-arm group of 8.79% (n = 191, p < 0.05). Use of O-arm imaging system ensures accurate screw placement and dramatically decreases screw malplacement rate, thus providing better patient safety. Its use is especially beneficial in academic and teaching centers where novice surgeons can attain results equivalent to that of experts in spinal instrumentation.

JPL Activated Carbon Treatment System (ACTS) for sewage

NASA Technical Reports Server (NTRS)

1976-01-01

An Activated Carbon Treatment System (ACTS) was developed for sewage treatment and is being applied to a one-million gallon per day sewage treatment pilot plant in Orange County California. Activities reported include pyrolysis and activation of carbon-sewage sludge, and activated carbon treatment of sewage to meet ocean discharge standards. The ACTS Sewage treatment operations include carbon-sewage treatment, primary and secondary clarifiers, gravity (multi-media) filter, filter press dewatering, flash drying of carbon-sewage filter cake, and sludge pyrolysis and activation. Tests were conducted on a laboratory scale, 10,000 gallon per day demonstration plant and pilot test equipment. Preliminary economic studies are favorable to the ACTS process relative to activated sludge treatment for a 175,000,000 gallon per day sewage treatment plant.

32 CFR 935.134 - Arm signals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Arm signals. 935.134 Section 935.134 National... WAKE ISLAND CODE Motor Vehicle Code § 935.134 Arm signals. (a) Any person operating a motor vehicle and... signal for a turn or stop is made by fully extending the left arm as follows: (1) Left turn—extend left...

32 CFR 935.134 - Arm signals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Arm signals. 935.134 Section 935.134 National... WAKE ISLAND CODE Motor Vehicle Code § 935.134 Arm signals. (a) Any person operating a motor vehicle and... signal for a turn or stop is made by fully extending the left arm as follows: (1) Left turn—extend left...

32 CFR 935.134 - Arm signals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Arm signals. 935.134 Section 935.134 National... WAKE ISLAND CODE Motor Vehicle Code § 935.134 Arm signals. (a) Any person operating a motor vehicle and... signal for a turn or stop is made by fully extending the left arm as follows: (1) Left turn—extend left...

Design of a biomimetic robotic octopus arm.

PubMed

Laschi, C; Mazzolai, B; Mattoli, V; Cianchetti, M; Dario, P

2009-03-01

This paper reports the rationale and design of a robotic arm, as inspired by an octopus arm. The octopus arm shows peculiar features, such as the ability to bend in all directions, to produce fast elongations, and to vary its stiffness. The octopus achieves these unique motor skills, thanks to its peculiar muscular structure, named muscular hydrostat. Different muscles arranged on orthogonal planes generate an antagonistic action on each other in the muscular hydrostat, which does not change its volume during muscle contractions, and allow bending and elongation of the arm and stiffness variation. By drawing inspiration from natural skills of octopus, and by analysing the geometry and mechanics of the muscular structure of its arm, we propose the design of a robot arm consisting of an artificial muscular hydrostat structure, which is completely soft and compliant, but also able to stiffen. In this paper, we discuss the design criteria of the robotic arm and how this design and the special arrangement of its muscular structure may bring the building of a robotic arm into being, by showing the results obtained by mathematical models and prototypical mock-ups.

Muscle short-range stiffness can be used to estimate the endpoint stiffness of the human arm

PubMed Central

Hu, Xiao; Murray, Wendy M.

2011-01-01

The mechanical properties of the human arm are regulated to maintain stability across many tasks. The static mechanics of the arm can be characterized by estimates of endpoint stiffness, considered especially relevant for the maintenance of posture. At a fixed posture, endpoint stiffness can be regulated by changes in muscle activation, but which activation-dependent muscle properties contribute to this global measure of limb mechanics remains unclear. We evaluated the role of muscle properties in the regulation of endpoint stiffness by incorporating scalable models of muscle stiffness into a three-dimensional musculoskeletal model of the human arm. Two classes of muscle models were tested: one characterizing short-range stiffness and two estimating stiffness from the slope of the force-length curve. All models were compared with previously collected experimental data describing how endpoint stiffness varies with changes in voluntary force. Importantly, muscle properties were not fit to the experimental data but scaled only by the geometry of individual muscles in the model. We found that force-dependent variations in endpoint stiffness were accurately described by the short-range stiffness of active arm muscles. Over the wide range of evaluated arm postures and voluntary forces, the musculoskeletal model incorporating short-range stiffness accounted for 98 ± 2, 91 ± 4, and 82 ± 12% of the variance in stiffness orientation, shape, and area, respectively, across all simulated subjects. In contrast, estimates based on muscle force-length curves were less accurate in all measures, especially stiffness area. These results suggest that muscle short-range stiffness is a major contributor to endpoint stiffness of the human arm. Furthermore, the developed model provides an important tool for assessing how the nervous system may regulate endpoint stiffness via changes in muscle activation. PMID:21289133

Towards a Digital Body: The Virtual Arm Illusion

PubMed Central

Slater, Mel; Perez-Marcos, Daniel; Ehrsson, H. Henrik; Sanchez-Vives, Maria V.

2008-01-01

The integration of the human brain with computers is an interesting new area of applied neuroscience, where one application is replacement of a person's real body by a virtual representation. Here we demonstrate that a virtual limb can be made to feel part of your body if appropriate multisensory correlations are provided. We report an illusion that is invoked through tactile stimulation on a person's hidden real right hand with synchronous virtual visual stimulation on an aligned 3D stereo virtual arm projecting horizontally out of their shoulder. An experiment with 21 male participants showed displacement of ownership towards the virtual hand, as illustrated by questionnaire responses and proprioceptive drift. A control experiment with asynchronous tapping was carried out with a different set of 20 male participants who did not experience the illusion. After 5 min of stimulation the virtual arm rotated. Evidence suggests that the extent of the illusion was also correlated with the degree of muscle activity onset in the right arm as measured by EMG during this period that the arm was rotating, for the synchronous but not the asynchronous condition. A completely virtual object can therefore be experienced as part of one's self, which opens up the possibility that an entire virtual body could be felt as one's own in future virtual reality applications or online games, and be an invaluable tool for the understanding of the brain mechanisms underlying body ownership. PMID:18958207

Unilateral versus bilateral robot-assisted rehabilitation on arm-trunk control and functions post stroke: a randomized controlled trial.

PubMed

Wu, Ching-Yi; Yang, Chieh-Ling; Chen, Ming-de; Lin, Keh-Chung; Wu, Li-Ling

2013-04-12

Although the effects of robot-assisted arm training after stroke are promising, the relative effects of unilateral (URT) vs. bilateral (BRT) robot-assisted arm training remain uncertain. This study compared the effects of URT vs. BRT on upper extremity (UE) control, trunk compensation, and function in patients with chronic stroke. This was a single-blinded, randomized controlled trial. The intervention was implemented at 4 hospitals. Fifty-three patients with stroke were randomly assigned to URT, BRT, or control treatment (CT). Each group received UE training for 90 to 105 min/day, 5 days/week, for 4 weeks. The kinematic variables for arm motor control and trunk compensation included normalized movement time, normalized movement units, and the arm-trunk contribution slope in unilateral and bilateral tasks. Motor function and daily function were measured by the Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and ABILHAND Questionnaire. The BRT and CT groups elicited significantly larger slope values (i.e., less trunk compensation) at the start of bilateral reaching than the URT group. URT led to significantly better effects on WMFT-Time than BRT. Differences in arm control kinematics and performance on the MAL and ABILHAND among the 3 groups were not significant. BRT and URT resulted in differential improvements in specific UE/trunk performance in patients with stroke. BRT elicited larger benefits than URT on reducing compensatory trunk movements at the beginning of reaching. In contrast, URT produced better improvements in UE temporal efficiency. These relative effects on movement kinematics, however, did not translate into differential benefits in daily functions. ClinicalTrials.gov: NCT00917605.

How does a planet excite multiple spiral arms?

NASA Astrophysics Data System (ADS)

Bae, Jaehan; Zhu, Zhaohuan

2018-01-01

Protoplanetary disk simulations show that a single planet excites multiple spiral arms in the background disk, potentially supported by the multi-armed spirals revealed with recent high-resolution observations in some disks. The existence of multiple spiral arms is of importance in many aspects. It is empirically found that the arm-to-arm separation increases as a function of the planetary mass, so one can use the morphology of observed spiral arms to infer the mass of unseen planets. In addition, a spiral arm opens a radial gap as it steepens into a shock, so when a planet excites multiple spiral arms it can open multiple gaps in the disk. Despite the important implications, however, the formation mechanism of multiple spiral arms has not been fully understood by far.In this talk, we explain how a planet excites multiple spiral arms. The gravitational potential of a planet can be decomposed into a Fourier series, a sum of individual azimuthal modes having different azimuthal wavenumbers. Using a linear wave theory, we first demonstrate that appropriate sets of Fourier decomposed waves can be in phase, raising a possibility that constructive interference among the waves can produce coherent structures - spiral arms. More than one spiral arm can form since such constructive interference can occur at different positions in the disk for different sets of waves. We then verify this hypothesis using a suite of two-dimensional hydrodynamic simulations. Finally, we present non-linear behavior in the formation of multiple spiral arms.

Conflict, famine and the arms trade.

PubMed

Judd, F

1995-01-01

Armed conflict has had horrendous humanitarian effects, causing 22 million deaths, over 80 per cent of them civilian, since 1945 and resulting today in 19 million refugees and 24 million displaced persons. War results in economic collapse, and high levels of military spending decrease regional stability. Benefits to the producers are limited or negative and developed countries should diversify away from arms production. There is a need for greater awareness in the developed countries, an end to the secrecy besetting the arms trade, and restructuring of the industry. A Code of Conduct governing arms exports is proposed.

Continuum robot arms inspired by cephalopods

NASA Astrophysics Data System (ADS)

Walker, Ian D.; Dawson, Darren M.; Flash, Tamar; Grasso, Frank W.; Hanlon, Roger T.; Hochner, Binyamin; Kier, William M.; Pagano, Christopher C.; Rahn, Christopher D.; Zhang, Qiming M.

2005-05-01

In this paper, we describe our recent results in the development of a new class of soft, continuous backbone ("continuum") robot manipulators. Our work is strongly motivated by the dexterous appendages found in cephalopods, particularly the arms and suckers of octopus, and the arms and tentacles of squid. Our ongoing investigation of these animals reveals interesting and unexpected functional aspects of their structure and behavior. The arrangement and dynamic operation of muscles and connective tissue observed in the arms of a variety of octopus species motivate the underlying design approach for our soft manipulators. These artificial manipulators feature biomimetic actuators, including artificial muscles based on both electro-active polymers (EAP) and pneumatic (McKibben) muscles. They feature a "clean" continuous backbone design, redundant degrees of freedom, and exhibit significant compliance that provides novel operational capacities during environmental interaction and object manipulation. The unusual compliance and redundant degrees of freedom provide strong potential for application to delicate tasks in cluttered and/or unstructured environments. Our aim is to endow these compliant robotic mechanisms with the diverse and dexterous grasping behavior observed in octopuses. To this end, we are conducting fundamental research into the manipulation tactics, sensory biology, and neural control of octopuses. This work in turn leads to novel approaches to motion planning and operator interfaces for the robots. The paper describes the above efforts, along with the results of our development of a series of continuum tentacle-like robots, demonstrating the unique abilities of biologically-inspired design.

A Comparison of Image Quality and Radiation Exposure Between the Mini C-Arm and the Standard C-Arm.

PubMed

van Rappard, Juliaan R M; Hummel, Willy A; de Jong, Tijmen; Mouës, Chantal M

2018-04-01

The use of intraoperative fluoroscopy has become mandatory in osseous hand surgery. Due to its overall practicality, the mini C-arm has gained popularity among hand surgeons over the standard C-arm. This study compares image quality and radiation exposure for patient and staff between the mini C-arm and the standard C-arm, both with flat panel technology. An observer-based subjective image quality study was performed using a contrast detail (CD) phantom. Five independent observers were asked to determine the smallest circles discernable to them. The results were plotted in a graph, forming a CD curve. From each curve, an image quality figure (IQF) was derived. A lower IQF equates to a better image quality. The patients' entrance skin dose was measured, and to obtain more information about the staff exposure dose, a perspex hand phantom was used. The scatter radiation was measured at various distances and angles relative to a central point on the detector. The IQF was significantly lower for the mini C-arm resulting in a better image quality. The patients' entrance dose was 10 times higher for the mini C-arm as compared with the standard C-arm, and the scatter radiation threefold. Due to its improved image quality and overall practicality, the mini C-arm is recommended for hand surgical procedures. To ensure that the surgeons' radiation exposure is not exceeding the safety limits, monitoring radiation exposure using mini C-arms with flat panel technology during surgery should be done in a future clinical study.

Model surgery with a passive robot arm for orthognathic surgery planning.

PubMed

Theodossy, Tamer; Bamber, Mohammad Anwar

2003-11-01

The aims of the study were to assess the degree of accuracy of model surgery performed manually using the Eastman technique and to compare it with model surgery performed with the aid of a robot arm. Twenty-one patients undergoing orthognathic surgery gave consent for this study. They were divided into 2 groups based on the model surgery technique used. Group A (52%) had model surgery performed manually, whereas group B (48%) had their model surgery performed using the robot arm. Patients' maxillary casts were measured before and after model surgery, and results were compared with those for the original treatment plan in horizontal (x-axis), vertical (y-axis), and transverse (z-axis) planes. Statistical analysis using Mann-Whitney U test for x- and y-axis and independent sample t test for z-axis have shown significant differences between both groups in x-axis (P =.024) and y-axis (P =.01) but not in z-axis (P =.776). Model surgery performed with the aid of a robot arm is significantly more accurate in anteroposterior and vertical planes than is manual model surgery. Robot arm has an important role to play in orthognathic surgery planning and in determining the biometrics of orthognathic surgical change at the model surgery stage.

Health care for children in Indian Armed Forces.

PubMed

Kanitkar, Madhuri

2017-10-01

Children of Armed Forces personnel constitute 33% of the clientele dependant on our healthcare. Various child health indicators and immunization coverage of Indian Armed Forces children is better than the national figures. With improved patient care, it has been observed that the morbidity and mortality pattern of diseases affecting the children of Armed Forces personnel has shown a change from infectious diseases in the past to more of chronic complex disorders at present. Hospital admissions of children in military hospitals due to nutritional and infectious diseases have reduced and constitute only around 21% of all paediatric hospital admissions. Various factors responsible for this shift are preventive health measures (antenatal care, immunization), Active promotion of health (baby friendly hospital concept, Well baby clinic) curative health services (outpatient services, in-patient care, specialty care, supportive Care) and supportive care-reaching beyond like ASHA schools. Presently, we need to handle, life style diseases like obesity, mental stress, teach coping mechanisms for common stressors such as parental separation, family reunification, parental loss, behavioral problems, diseases other than infectious diseases requiring super specialty care. The challenge lies in planning the road ahead for these children and adolescents ensuring a life-course approach.

Split-arm swinging: the effect of arm swinging manipulation on interlimb coordination during walking.

PubMed

Bondi, Moshe; Zeilig, Gabi; Bloch, Ayala; Fasano, Alfonso; Plotnik, Meir

2017-08-01

Human locomotion is defined by bilateral coordination of gait (BCG) and shared features with the fore-hindlimb coordination of quadrupeds. The objective of the present study is to explore the influence of arm swinging (AS) on BCG. Sixteen young, healthy individuals (eight women; eight right motor-dominant, eight left-motor dominant) participated. Participants performed 10 walking trials (2 min). In each of the trials AS was unilaterally manipulated (e.g., arm restriction, weight on the wrist), bilaterally manipulated, or not manipulated. The order of trials was random. Walking trials were performed on a treadmill. Gait kinematics were recorded by a motion capture system. Using feedback-controlled belt speed allowed the participants to walk at a self-determined gait speed. Effects of the manipulations were assessed by AS amplitudes and the phase coordination index (PCI), which quantifies the left-right anti-phased stepping pattern. Most of the AS manipulations caused an increase in PCI values (i.e., reduced lower limb coordination). Unilateral AS manipulation had a reciprocal effect on the AS amplitude of the other arm such that, for example, over-swinging of the right arm led to a decrease in the AS amplitude of the left arm. Side of motor dominance was not found to have a significant impact on PCI and AS amplitude. The present findings suggest that lower limb BCG is markedly influenced by the rhythmic AS during walking. It may thus be important for gait rehabilitation programs targeting BCG to take AS into account. NEW & NOTEWORTHY Control mechanisms for four-limb coordination in human locomotion are not fully known. To study the influence of arm swinging (AS) on bilateral coordination of the lower limbs during walking, we introduced a split-AS paradigm in young, healthy adults. AS manipulations caused deterioration in the anti-phased stepping pattern and impacted the AS amplitudes for the contralateral arm, suggesting that lower limb coordination is markedly

Effects of Task-oriented Approach on Affected Arm Function in Children with Spastic Hemiplegia Due to Cerebral Palsy.

PubMed

Song, Chiang-Soon

2014-06-01

[Purpose] The purpose of the present study was to examine the effects of task-oriented approach on motor function of the affected arm in children with spastic hemiplegia due to cerebral palsy. [Subjects] Twelve children were recruited by convenience sampling from 2 local rehabilitation centers. The present study utilized a one-group pretest-posttest design. All of children received task-oriented training for 6 weeks (40 min/day, 5 days/week) and also underwent regular occupational therapy. Three clinical tests, Box and Block Test (BBT), Manual Ability Measure (MAM-16), and Wee Functional Independence Measure (WeeFIM) were performed 1 day before and after training to evaluate the effects of the training. [Results] Compared with the pretest scores, there was a significant increase in the BBT, MAM-16, and WeeFIM scores of the children after the 6-week practice period. [Conclusion] The results of this study suggest that a task-oriented approach to treatment of the affected arm improves functional activities, such as manual dexterity and fine motor performance, as well as basic daily activities of patients with spastic hemiplegia due to cerebral palsy.

The effects of a 28-Hz vibration on arm muscle activity during isometric exercise.

PubMed

Mischi, Massimo; Cardinale, Marco

2009-03-01

The aim of this study was to evaluate activation and coactivation of biceps and triceps muscles during isometric exercise performed with and without superimposing a vibration stimulation. Twelve healthy volunteers (age = 22.7 +/- 2.6 yr) participated in this study. The subjects performed five trials of isometric elbow flexion and five trials of elbow extension with increasing levels of force in two conditions: vibration (V) and normal loading (C). V stimulation was characterized by a frequency of 28 Hz. Surface EMG activity of biceps and triceps muscles was simultaneously measured by bipolar surface electromyography and assessed by the estimation of the root mean square (RMS) of the electrical recordings over a fixed 5-s interval. Frequency analysis was adopted to estimate the RMS related to muscle activation and to exclude the harmonics generated by movement artifacts due to V. The analysis of the recordings revealed a significant EMG RMS increase when V was applied. On average, the EMG RMS of biceps and triceps during elbow flexion was, respectively, 26.1% (P < 0.05) and 18.2% (P = 0.15) higher than C. During elbow extension, the EMG RMS of biceps and triceps was 77.2% and 45.2% (P < 0.05) higher than C, respectively. The coactivation was assessed as the ratio between the activation of antagonist and agonist muscles during arm flexion and extension tasks. The results revealed an increase of coactivation during V exercise, especially for lighter loads. This study shows that V exercise at 28 Hz produces an increase of the activation and the coactivation of biceps and triceps. This exercise modality seems therefore suitable for various applications.

WE-FG-BRA-01: Cancer Treatment Utilizing Photo-Activation of Psoralen with KV X-Rays

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oldham, M; Yoon, S; Meng, B

Purpose: This work investigates X-PACT (X-ray Psoralen Activated Cancer Therapy): a new approach for the treatment of cancer. X-PACT utilizes psoralen, a potent anti-cancer therapeutic with immunogenic anti-cancer potential. Psoralen therapies have been limited due to the requirement for psoralen activation by UVA light. X-PACT solves this challenge by activating psoralen with UV light emitted from novel non-tethered phosphors (co-incubated with psoralen) that absorb x-rays and reradiate (phosphoresce) at UV wavelengths. Methods: The efficacy of X-PACT was evaluated in both in-vitro and in-vivo settings. In-vitro studies utilized breast (4T1), glioma (CT2A) and sarcoma (KP-B) cell lines. Cells were exposed tomore » X-PACT treatments where the concentrations of drug (psoralen and phosphor) and radiation parameters (energy, dose, and dose rate) were varied. Efficacy was evaluated primarily using flow cell cytometry to investigate treatment induced apoptosis. Methylene blue staining, and WST assays were also used. X-PACT was then evaluated in an in-vivo pilot study on BALBc mice with syngeneic 4T1 tumors, including control arms for X-PACT components. Analysis focused on tumor growth delay. Results: A multivariable regression analysis of 36 independent in-vitro irradiation experiments demonstrated that X-PACT induces significant tumor cell apoptosis and cytotoxicity on all three tumor cell lines in-vitro (p<0.0001). Neither psoralen nor phosphor alone had a strongly significant effect. The in-vivo studies show a pronounced tumor growth delay when compared to controls (42% reduction at 25 days, p=0.0002). Conclusions: These studies demonstrate for the first time a therapeutic effect for X-PACT, and provide a foundation and rationale for future studies. X-PACT represents a novel treatment approach in which well-tolerated low doses of x-ray radiation generate UVA light in-situ (including deep seated lesions) which in-turn photo-activates powerful anticancer therapeutics

Cognitive-behavioral treatment with behavioral activation for smokers with depressive symptomatology: study protocol of a randomized controlled trial.

PubMed

Becoña, Elisardo; Martínez-Vispo, Carmela; Senra, Carmen; López-Durán, Ana; Rodríguez-Cano, Rubén; Fernández Del Río, Elena

2017-04-08

Smoking is an important risk factor for mental health-related problems. Numerous studies have supported a bi-directional association between cigarette smoking and depression. Despite the advances in understanding the comorbidity between both problems, the most effective psychological treatment that simultaneously targets smoking and depressive symptomatology remains unclear. The objective of this study is to assess the effectiveness of a cognitive-behavioral intervention for smoking cessation with components of behavioral activation for managing depressed mood. A single blind, three-arm, superiority randomized controlled trial is proposed. Participants will be smokers over 18 years old, who smoke at least 8 cigarettes per day. Participants will be randomized to one of three conditions, using a 2:2:1 allocation ratio: 1) standard cognitive-behavioral smoking cessation treatment; 2) standard cognitive-behavioral smoking cessation treatment plus behavioral activation; or 3) a three-month delayed treatment control group. The primary outcome measures will be biochemically verified point-prevalence abstinence (carbon monoxide in expired air) and significant change from baseline in depressive symptoms to the end of treatment, and at the 3-, 6-, and 12-month follow-up. This study aims to assess the efficacy of a cognitive-behavioral intervention with behavioral activation components for smoking cessation and depressive symptoms, compared to a standard cognitive-behavioral intervention to quit smoking. As the relation between depressive symptoms, even at subclinical levels, and quitting smoking difficulties is well known, we expect that such intervention will allow obtaining higher abstinence rates, lower relapse rates, and mood improvement. ClinicalTrials.gov : NCT02844595 . Retrospectively registered 19th July, 2016. The study started in January 2016, and the recruitment is ongoing.

Kidins220/ARMS as a functional mediator of multiple receptor signalling pathways.

PubMed

Neubrand, Veronika E; Cesca, Fabrizia; Benfenati, Fabio; Schiavo, Giampietro

2012-04-15

An increasing body of evidence suggests that several membrane receptors--in addition to activating distinct signalling cascades--also engage in substantial crosstalk with each other, thereby adjusting their signalling outcome as a function of specific input information. However, little is known about the molecular mechanisms that control their coordination and integration of downstream signalling. A protein that is likely to have a role in this process is kinase-D-interacting substrate of 220 kDa [Kidins220, also known as ankyrin repeat-rich membrane spanning (ARMS), hereafter referred to as Kidins220/ARMS]. Kidins220/ARMS is a conserved membrane protein that is preferentially expressed in the nervous system and interacts with the microtubule and actin cytoskeleton. It interacts with neurotrophin, ephrin, vascular endothelial growth factor (VEGF) and glutamate receptors, and is a common downstream target of several trophic stimuli. Kidins220/ARMS is required for neuronal differentiation and survival, and its expression levels modulate synaptic plasticity. Kidins220/ARMS knockout mice show developmental defects mainly in the nervous and cardiovascular systems, suggesting a crucial role for this protein in modulating the cross talk between different signalling pathways. In this Commentary, we summarise existing knowledge regarding the physiological functions of Kidins220/ARMS, and highlight some interesting directions for future studies on the role of this protein in health and disease.

Fingerprints of nucleosynthesis in the local spiral arm

NASA Technical Reports Server (NTRS)

Knoedlseder, J.; Bennett, K.; Bloemen, H.; Diehl, R.; Hermsen, W.; Oberlack, U.; Ryan, J.; Schoenfelder, V.; vonBallmoos, P.

1997-01-01

The local spiral arm with its inherent massive star population is a natural site of recent nucleosynthesis activity. The features found in 1.8 MeV observation of candidate Al-26 sources situated in this structure are discussed. The emphasis is on Loop 1, a nearby superbubble which is possibly the site of a recent supernova explosion.

Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients.

PubMed

Wang, Yan; Zhang, Jin; Qian, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

2016-07-14

Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24-3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309-3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study.

A novel method for quantifying arm motion similarity.

PubMed

Zhi Li; Hauser, Kris; Roldan, Jay Ryan; Milutinovic, Dejan; Rosen, Jacob

2015-08-01

This paper proposes a novel task-independent method for quantifying arm motion similarity that can be applied to any kinematic/dynamic variable of interest. Given two arm motions for the same task, not necessarily with the same completion time, it plots the time-normalized curves against one another and generates four real-valued features. To validate these features we apply them to quantify the relationship between healthy and paretic arm motions of chronic stroke patients. Studying both unimanual and bimanual arm motions of eight chronic stroke patients, we find that inter-arm coupling that tends to synchronize the motions of both arms in bimanual motions, has a stronger effect at task-relevant joints than at task-irrelevant joints. It also revealed that the paretic arm suppresses the shoulder flexion of the non-paretic arm, while the latter encourages the shoulder rotation of the former.

Risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in a tertiary armed force referral and teaching hospital, Ethiopia.

PubMed

Demile, Biresaw; Zenebu, Amare; Shewaye, Haile; Xia, Siqing; Guadie, Awoke

2018-05-31

Ethiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. This study aimed to identify the prevalence and associated factors of multidrug-resistant tuberculosis (MDR-TB) using all armed force and civilian TB attendants in a tertiary level armed force hospital, where data for MDR-TB are previously unpublished. Cross-sectional study was conducted from September 2014 to August 2015 in a tertiary level Armed Force Referral and Teaching Hospital (AFRTH), Ethiopia. Armed force members (n = 251) and civilians (n = 130) which has been undergone TB diagnosis at AFRTH were included. All the specimens collected were subjected to microscopic smear observation, culture growth and drug susceptibility testing. Data were analyzed using statistical package for social sciences following binary logistic regression and Chi-square. P-values < 0.05 were considered statistically significant. Among 381 TB patients, 355 (93.2%) new and 26 (6.8%) retreatment cases were identified. Culture and smear positive TB cases were identified in 297 (77.9%) and 252 (66.1%) patients, respectively. The overall prevalence of MDR-TB in AFRTH was found 1.8% (1.3% for armed force members and 0.5% for civilian patients) all of which were previously TB treated cases. The entire treatment success rates were 92.6% achieved highest in the armed force (active and pension) than the civilian patients. The failure and dead cases were also found 2.5 and 4.6%, respectively. Using bivariate analysis, category of attendants and TB contact history were strong predictors of MDR-TB in armed force and civilian patients. Moreover, human immunodeficiency virus (HIV) infection also identified a significant (OR = 14.6; 95% CI = 2.3-92.1; p = 0.004) predicting factor for MDR-TB in armed force members. However, sex, age and body mass index were not associated factor for MDR-TB. In AFRTH, lower prevalence of

Activity of upper limb muscles during human walking.

PubMed

Kuhtz-Buschbeck, Johann P; Jing, Bo

2012-04-01

The EMG activity of upper limb muscles during human gait has rarely been studied previously. It was examined in 20 normal volunteers in four conditions: walking on a treadmill (1) with unrestrained natural arm swing (Normal), (2) while volitionally holding the arms still (Held), (3) with the arms immobilized (Bound), and (4) with the arms swinging in phase with the ipsilateral legs, i.e. opposite-to-normal phasing (Anti-Normal). Normal arm swing involved weak rhythmical lengthening and shortening contractions of arm and shoulder muscles. Phasic muscle activity was needed to keep the unrestricted arms still during walking (Held), indicating a passive component of arm swing. An active component, possibly programmed centrally, existed as well, because some EMG signals persisted when the arms were immobilized during walking (Bound). Anti-Normal gait involved stronger EMG activity than Normal walking and was uneconomical. The present results indicate that normal arm swing has both passive and active components. Copyright © 2011 Elsevier Ltd. All rights reserved.

On the Value of Estimating Human Arm Stiffness during Virtual Teleoperation with Robotic Manipulators

PubMed Central

Buzzi, Jacopo; Ferrigno, Giancarlo; Jansma, Joost M.; De Momi, Elena

2017-01-01

Teleoperated robotic systems are widely spreading in multiple different fields, from hazardous environments exploration to surgery. In teleoperation, users directly manipulate a master device to achieve task execution at the slave robot side; this interaction is fundamental to guarantee both system stability and task execution performance. In this work, we propose a non-disruptive method to study the arm endpoint stiffness. We evaluate how users exploit the kinetic redundancy of the arm to achieve stability and precision during the execution of different tasks with different master devices. Four users were asked to perform two planar trajectories following virtual tasks using both a serial and a parallel link master device. Users' arm kinematics and muscular activation were acquired and combined with a user-specific musculoskeletal model to estimate the joint stiffness. Using the arm kinematic Jacobian, the arm end-point stiffness was derived. The proposed non-disruptive method is capable of estimating the arm endpoint stiffness during the execution of virtual teleoperated tasks. The obtained results are in accordance with the existing literature in human motor control and show, throughout the tested trajectory, a modulation of the arm endpoint stiffness that is affected by task characteristics and hand speed and acceleration. PMID:29018319

Stereotypical reaching movements of the octopus involve both bend propagation and arm elongation.

PubMed

Hanassy, S; Botvinnik, A; Flash, T; Hochner, B

2015-05-13

force (<0.0016 for an average strain along the arm of around 0.5). This was not observed and moreover such extremely low value does not seem to be physiologically possible. Hence the assumptions made in applying the dynamic model to behaviors such as static arm stiffening that leads to arm extension through bend propagation and the patterns of activation used to simulate such behaviors should be modified to account for movements combining bend propagation and arm elongation.

Passive or simulated displacement of one arm (but not its mirror reflection) modulates the involuntary motor behavior of the other arm.

PubMed

Brun, C; Metral, M; Chancel, M; Kavounoudias, A; Luyat, M; Guerraz, M

2015-01-29

Recent studies of both healthy and patient populations have cast doubt on the mirror paradigm's beneficial effect on motor behavior. Indeed, the voluntary arm displacement that accompanies reflection in the mirror may be the determining factor in terms of the motor behavior of the contralateral arm. The objective of the present study was to assess the respective effects of mirror reflection and arm displacement (whether real or simulated) on involuntary motor behavior of the contralateral arm following sustained, isometric contraction (Kohnstamm phenomenon). Our results revealed that (i) passive displacement of one arm (displacement of the left arm via a motorized manipulandum moving at 4°/s) influenced the velocity of the Kohnstamm phenomenon (forearm flexion occurring shortly after the cessation of muscle contraction) in the contralateral arm and (ii) mirror vision had no effect. Indeed, the velocity of the Kohnstamm phenomenon tended to be adjusted to match the velocity of the passive displacement of the other arm. In a second experiment, arm displacement was simulated by vibrating the triceps at 25, 50 or 75 Hz. Results showed that the velocity of the Kohnstamm phenomenon in one arm increased with the vibration frequency applied to the other arm. Our results revealed the occurrence of bimanual coupling because involuntary displacement of one arm was regulated by muscle-related information generated by the actual or simulated displacement of the other arm. In line with the literature data on voluntary motor behavior, our study failed to evidence an additional impact of mirror vision on involuntary motor behavior. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: Exploratory secondary analysis of a randomised controlled trial.

PubMed

Blyth, M J G; Anthony, I; Rowe, P; Banger, M S; MacLean, A; Jones, B

2017-11-01

This study reports on a secondary exploratory analysis of the early clinical outcomes of a randomised clinical trial comparing robotic arm-assisted unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis of the knee with manual UKA performed using traditional surgical jigs. This follows reporting of the primary outcomes of implant accuracy and gait analysis that showed significant advantages in the robotic arm-assisted group. A total of 139 patients were recruited from a single centre. Patients were randomised to receive either a manual UKA implanted with the aid of traditional surgical jigs, or a UKA implanted with the aid of a tactile guided robotic arm-assisted system. Outcome measures included the American Knee Society Score (AKSS), Oxford Knee Score (OKS), Forgotten Joint Score, Hospital Anxiety Depression Scale, University of California at Los Angeles (UCLA) activity scale, Short Form-12, Pain Catastrophising Scale, somatic disease (Primary Care Evaluation of Mental Disorders Score), Pain visual analogue scale, analgesic use, patient satisfaction, complications relating to surgery, 90-day pain diaries and the requirement for revision surgery. From the first post-operative day through to week 8 post-operatively, the median pain scores for the robotic arm-assisted group were 55.4% lower than those observed in the manual surgery group (p = 0.040).At three months post-operatively, the robotic arm-assisted group had better AKSS (robotic median 164, interquartile range (IQR) 131 to 178, manual median 143, IQR 132 to 166), although no difference was noted with the OKS.At one year post-operatively, the observed differences with the AKSS had narrowed from a median of 21 points to a median of seven points (p = 0.106) (robotic median 171, IQR 153 to 179; manual median 164, IQR 144 to 182). No difference was observed with the OKS, and almost half of each group reached the ceiling limit of the score (OKS > 43). A greater proportion of patients

Self-locking telescoping manipulator arm

NASA Technical Reports Server (NTRS)

Nesmith, M. F. (Inventor)

1985-01-01

A telescoping manipulator arm and pivotable finger assembly are disclosed. The telescoping arm assembly includes a generally T-shaped arm having three outwardly extending fingers guided on grooved roller guides to compensate for environmental variations. The pivotable finger assembly includes four pivoting fingers. Arcuate teeth are formed on the ends of the fingers. A rack having teeth on four sides meshes with each one of the fingers. One surface of the rack includes teeth along its entire surface which mesh with teeth of one of the fingers. The teeth at the remote end of the rack engage teeth of a gear wheel. The wheel includes a worm which meshes with a worn drive shaft of the drive motor providing a ninety degree self-locking drive for locking the fingers in a desired position. A similar drive provides a self-locking drive for positioning the telescoping arm.

First ARM Aerosol Chemical Speciation Monitor Users’ Meeting Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watson, Thomas; Aiken, Allison; Zhang, Qi

The first U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) user facility aerosol chemical speciation monitor (ACSM) users’ meeting was held on April 11-13, 2017, at Aerodyne Research, Inc. in Billerica, Massachusetts, to discuss the Southern Great Plains (SGP) atmospheric observatory ACSM data quality and establish best practices for data collection and processing. The participants examined six years of calibration and processed data. Specific issues raised by data users were addressed and case studies from two field experiments were examined. The most recent data from the ACSM installed in the newly commissioned SGP ARM Mobile Facility 7 (AMF7) weremore » also evaluated. The participants recommended that the SGP ACSM data be reprocessed using calibration values averaged over the history of SGP ACSM calibrations. They also recommended that the data quality be evaluated by comparing (1) observed versus predicted particulate ammonium (NH4+) mass loadings, and (2) ACSM mass loadings versus mass loadings calculated from particle size and light scattering data. The contents of the datastreams from the ACSM were defined based on ARM requirements and the necessary tasks to implement these recommendations were assigned to the mentor and the instrument manufacturer. Some of the recommendations were implemented for the SGP data and are presented in this report. Data from two ARM sites located in marine environments were also analyzed. These analyses as well as instrument intercomparisons have led to further questions about data treatment. These will be addresses in the second users’ meeting scheduled for the summer of 2018.« less

CHARACTERISTICS OF SPIRAL ARMS IN LATE-TYPE GALAXIES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Honig, Z. N.; Reid, M. J., E-mail: mreid@cfa.harvard.edu

2015-02-10

We have measured the positions of large numbers of H II regions in four nearly face-on, late-type, spiral galaxies: NGC 628 (M74), NGC 1232, NGC 3184, and NGC 5194 (M51). Fitting log-periodic spiral models to segments of each arm yields local estimates of spiral pitch angle and arm width. While pitch angles vary considerably along individual arms, among arms within a galaxy, and among galaxies, we find no systematic trend with galactocentric distance. We estimate the widths of the arm segments from the scatter in the distances of the H II regions from the spiral model. All major arms in these galaxies show spiralmore » arm width increasing with distance from the galactic center, similar to the trend seen in the Milky Way. However, in the outermost parts of the galaxies, where massive star formation declines, some arms reverse this trend and narrow. We find that spiral arms often appear to be composed of segments of ∼5 kpc length, which join to form kinks and abrupt changes in pitch angle and arm width; these characteristics are consistent with properties seen in the large N-body simulations of D'Onghia et al. and others.« less

Galaxy Zoo: star formation versus spiral arm number

NASA Astrophysics Data System (ADS)

Hart, Ross E.; Bamford, Steven P.; Casteels, Kevin R. V.; Kruk, Sandor J.; Lintott, Chris J.; Masters, Karen L.

2017-06-01

Spiral arms are common features in low-redshift disc galaxies, and are prominent sites of star formation and dust obscuration. However, spiral structure can take many forms: from galaxies displaying two strong 'grand design' arms to those with many 'flocculent' arms. We investigate how these different arm types are related to a galaxy's star formation and gas properties by making use of visual spiral arm number measurements from Galaxy Zoo 2. We combine ultraviolet and mid-infrared (MIR) photometry from GALEX and WISE to measure the rates and relative fractions of obscured and unobscured star formation in a sample of low-redshift SDSS spirals. Total star formation rate has little dependence on spiral arm multiplicity, but two-armed spirals convert their gas to stars more efficiently. We find significant differences in the fraction of obscured star formation: an additional ˜10 per cent of star formation in two-armed galaxies is identified via MIR dust emission, compared to that in many-armed galaxies. The latter are also significantly offset below the IRX-β relation for low-redshift star-forming galaxies. We present several explanations for these differences versus arm number: variations in the spatial distribution, sizes or clearing time-scales of star-forming regions (I.e. molecular clouds), or contrasting recent star formation histories.

Behavioral activation-based guided self-help treatment administered through a smartphone application: study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background The need for cost-effective interventions for people suffering from major depressive disorders is essential. Behavioral activation is an intervention that can largely benefit from the use of new mobile technologies (for example smartphones). Therefore, developing smartphone-based behavioral activation interventions might be a way to develop cost-effective treatments for people suffering from major depressive disorders. The aim of this study will be to test the effects of a smartphone-delivered behavioral activation treatment. Methods The study will be a randomized controlled trial with a sample size of 120 participants, with 60 patients in each group. The treatment group includes an 8-week smartphone-based behavioral activation intervention, with minimal therapist contact. The smartphone-based intervention consists of a web-based psychoeducation, and a smartphone application. There is also a back-end system where the therapist can see reports from the patients or activities being reported. In the attention control group, we will include brief online education and then recommend use of a smartphone application that is not directly aimed at depression (for example, ‘Effective meditation’). The duration of the control condition will also be 8 weeks. For ethical reasons we will give the participants in the control group access to the behavioral activation treatment following the 8-week treatment period. Discussions We believe that this trial has at least three important implications. First, we believe that smartphones can be integrated even further into society and therefore may serve an important role in health care. Second, while behavioral activation is a psychological treatment approach for which there is empirical support, the use of a smartphone application could serve as the therapist’s prolonged arm into the daily life of the patient. Third, as we have been doing trials on guided Internet treatment for more than 10 years it is now time to

Assessment of body composition in dialysis patients by arm bioimpedance compared to MRI and 40K measurements.

PubMed

Carter, M; Zhu, F; Kotanko, P; Kuhlmann, M; Ramirez, L; Heymsfield, S B; Handelman, G; Levin, N W

2009-01-01

This study used multi-frequency bioimpedance spectroscopy (BIS) of the arm and whole body to estimate muscle mass (MM) and subcutaneous adipose tissue (SAT) in 31 hemodialysis (HD) patients comparing these results with magnetic resonance imaging (MRI) and body potassium ((40)K) as gold standards. Total body and arm MM (MM(MRI)) and SAT (SAT(MRI)) were measured by MRI. All measurements were made before dialysis treatment. Regression models with the arm (aBIS) and whole body (wBIS) resistances were established. Correlations between gold standards and the BIS model were high for the arm SAT (r(2) = 0.93, standard error of estimate (SEE) = 3.6 kg), and whole body SAT (r(2) = 0.92, SEE = 3.5 kg), and for arm MM (r(2) = 0.84, SEE = 2.28 kg) and whole body MM (r(2) = 0.86, SEE = 2.28 kg). Total body MM and SAT can be accurately predicted by arm BIS models with advantages of convenience and portability, and it should be useful to assess nutritional status in HD patients. Copyright (c) 2009 S. Karger AG, Basel.

Kootenay Lake Fertilization Experiment, Year 15 (North Arm) and Year 3 (South Arm) (2006) Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schindler, E.U.; Sebastian, D.; Andrusak, G.F.

2009-07-01

This report summarizes results from the fifteenth year (2006) of nutrient additions to the North Arm of Kootenay Lake and three years of nutrient additions to the South Arm. Experimental fertilization of the lake has been conducted using an adaptive management approach in an effort to restore lake productivity lost as a result of nutrient uptake in upstream reservoirs. The primary objective of the experiment is to restore kokanee (Oncorhynchus nerka) populations, which are the main food source for Gerrard rainbow trout (Oncorhynchus mykiss) and bull trout (Salvelinus confluentus). The quantity of agricultural grade liquid fertilizer (10-34-0, ammonium polyphosphate andmore » 28-0-0, urea ammonium nitrate) added to the North Arm in 2006 was 44.7 tonnes of P and 248.4 tonnes of N. The total fertilizer load added to the South Arm was 257 tonnes of nitrogen; no P was added. Kootenay Lake has an area of 395 km{sup 2}, a maximum depth of 150 m, a mean depth of 94 m, and a water renewal time of approximately two years. Kootenay Lake is a monomictic lake, generally mixing from late fall to early spring and stratifying during the summer. Surface water temperatures generally exceed 20 C for only a few weeks in July. Results of oxygen profiles were similar to previous years with the lake being well oxygenated from the surface to the bottom depths at all stations. Similar to past years, Secchi disc measurements at all stations in 2006 indicate a typical seasonal pattern of decreasing depths associated with the spring phytoplankton bloom, followed by increasing depths as the bloom gradually decreases by the late summer and fall. Total phosphorus (TP) ranged from 2-7 {micro}g/L and tended to decrease as summer advanced. Over the sampling season dissolved inorganic nitrogen (DIN) concentrations decreased, with the decline corresponding to nitrate (the dominant component of DIN) being utilized by phytoplankton during summer stratification. Owing to the importance of epilimnetic

Weapons for the world/update: the U. S. corporate role in International Arms Transfers. [Booklet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lydenberg, S.

1977-01-01

The substantial growth of American arms exports in recent years has prompted the Council on Economic Priorities to study the role played by U.S. corporations in the sale of U.S. military equipment, training, and services throughout the world. Major findings of this Report include: U.S. arms sales and exports to foreign countries have risen dramatically from $2.9 billion in 1967, to $5 billion in 1971, to $10 to 12 billion annually from 1974 through 1976. Since 1973 a major shift has taken place in the nature of U.S. arms transfers from arms aid under the Military Assistance Program to armsmore » sales under the Foreign Military Sales program. The 10 U.S. corporations (Northrop, McDonnell Douglas, Grumman, Litton, General Electric, Raytheon, FMC, Hughes, Lockheed, and Textron) most extensively involved in U.S. arms exports in 1976 (profiled in this Report) received approximately 30% of their total military business from foreign arms sales. Congress has increased its active participation in U.S. arms-transfer policy through legislation passed in 1975 and 1976. This legislation has extended Congress' control over the Foreign Military Sales program in particular.« less

The molecular spiral arms of NGC 6946

NASA Technical Reports Server (NTRS)

Tacconi, L. J.; Xie, S.

1990-01-01

From CO-12(J=1 to 0) observations at 45 seconds resolution Tacconi and Young (1989) have found evidence for enhancements in both the CO emissivity and the massive star formation efficiency (MSFE) on optical spiral arms of the bright spiral galaxy NGC 6946. In the optically luminous and well-defined spiral arm in the NE quadrant, there are enhancements in both the H2 surface density and MSFE relative to the interarm regions. In contrast, a poorly defined arm in the SW shows no arm-interarm contrast in the MSFE. To further investigate the molecular gas content of these two spiral arms, researchers have made CO-12 J=2 to 1 and 3 to 2 observations with the James Clerk Maxwell Telescope. In the J=2 to 1 line, they made observations of the NE and SW spiral arm and interarm regions in 4 x 9 10 seconds spaced grids (36 points per grid). Because of decreased sensitivity in the J=3 to 2 line, they were limited to mapping the two arm regions in 2 x 3 10 seconds spaced grids (6 points per grid). The centers of each of the grids lie 2.4 minutes to the NE and 2.3 minutes to the SW of the nucleus of NGC 6946. With the CO J=2 to 1 data researchers are able to fully resolve the two observed spiral arms in NGC 6946. In both cases the CO emission is largely confined to the optical spiral arm regions with the peak observed T asterisk sub A being up to 4 times higher on the spiral arms than in the interarm regions. Researchers are currently estimating massive star formation efficiencies on and off the spiral arms through direct comparison of the CO maps with an H alpha image. They are also comparing the CO J=2 to 1 data with an HI map made at similar resolution. Thus, they will be able to determine structure in all components of the IS on scales of less than 20 inches.

ML Crew Access Arm Move

NASA Image and Video Library

2017-11-09

The Orion crew access arm is secured in a storage location at NASA's Kennedy Space Center in Florida. The access arm will be prepared for its move to the mobile launcher (ML) tower near the Vehicle Assembly Building at the center. The crew access arm will be installed at about the 274-foot level on the tower. It will rotate from its retracted position and interface with the Orion crew hatch location to provide entry to the Orion crew module. The Ground Systems Development and Operations Program is overseeing installation of umbilicals and launch accessories on the ML tower.

Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

PubMed

Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

2016-06-01

Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, <20 kg/m), middle BMI (BMI, 20-25 kg/m), and high BMI (BMI, >25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P < 0.001]. There was no significant difference in UEL index between BMI groups [low BMI vs middle BMI vs high BMI, 97.2 (4.2) vs 96.6 (4.6) vs 96.7 (9.9), P > 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.